Advice on Avoiding Cancer or a Recurrence

Lorenzo Cohen makes breakfast for his family every morning.

But not for him the easy lure of cereal and milk, pancakes or bacon and eggs.

"Most mornings, I sauté vegetables -- broccoli, cauliflower, Brussels sprouts. I look in the fridge and see what we have, and cook it up with seasonings," he says.

His three young children "love it," he adds. "It disappears in a second and, in fact, my children will not eat their eggs without veggies mixed in."

Cohen, Ph.D., professor in the departments of Behavioral Science and General Oncology, also directs MD Anderson's Integrative Medicine Program.

As his choice of breakfast foods implies, Cohen is an unabashed promoter of a healthy lifestyle. He meditates, practices yoga and carefully chooses what he eats and drinks, sticking to a mainly plant-based diet, whole grains and no sugar as much as possible.

Changed by year in Italy with grandmother
He started out a typical, meat-eating kid, then teenager. "I worked as an assistant butcher when I was in high school," he says.

He didn't get serious about watching what he ate until he went to live with his grandmother, Vanda Scaravelli, in Italy for a year when he was 24. She was a yoga master and a vegetarian. Cohen joined her in a daily yoga practice and gave up meat for the whole year.

The experience gave Cohen insight into how lifestyle changes can help people strengthen their defenses against cancer -- getting it, or having a recurrence.

The World Health Organization says cancer was the leading cause of death in 2010, he notes. More than 40% of Americans will be diagnosed with cancer in their lifetimes and at least 50% of these cancers are due to lifestyle factors - smoking, obesity, sedentary behaviors, diet, stress and environmental exposures.

The "diseases of the West" -- cancers of the breast, prostate and colon -- kill hundreds of thousands of Americans every year and are spreading eastward as citizens of Asian countries adopt a Western lifestyle.

"It may not be that your genes cause cancer, but how genes are expressed can increase your susceptibility to cancer. Lifestyle factors can affect gene expression and this can influence whether cancer occurs or recurs," he says.

He cites a recent study showing that a diet high in various vegetables decreased the incidence of breast cancer in women with the BRCA1 gene.

There's more to Cohen's lifestyle rules than eating mindfully. He also advocates regular exercise, careful management of stress, strong social connections and the avoidance of environmental pollutants.

'Things have to get really bad before they get better'
Cohen hopes his message is gaining traction in the United States and beyond. We've reached a tipping point, he says.

"Things have to get really bad before they get better. The statistics on the overweight and obese in the United States are staggering," he says. "It's a calamity."

"This is the first generation predicted to live fewer years than their parents. The incentives are all wrong. In medicine, we're financially rewarded for treating the sick, but not for helping people get or stay healthy."

For example, although research shows that obese women with breast cancer have worse outcomes, "there's no financial incentive to help these patients lose weight. People need support to make these changes," he says.

"You can't just tell people to stop smoking or lose weight. They need help -- a dietitian, a lifestyle coach, a smoking cessation counselor."

Fighting an unhealthy addiction
Cohen says that our national weight problem is a direct result of a lifetime of addiction to sugar, salt and fat.

He cites studies by former Food and Drug Administration commissioner David A. Kessler, M.D., and others showing that high amounts of these three substances are addictive.

Through functional MRIs, Kessler and others have shown that sugar and fat light up the same pleasure centers in the brain as do addictive drugs. The food industry manipulates the amount of fat and sugar to increase the "likability" of their products.

To those who complain that eating healthfully is boring, Cohen disagrees.

"It takes forethought and planning to make interesting vegetarian meals, "Cohen says. "But it can be done."

For example, his inventive, vegetable-rich breakfasts.

And what does this healthy lifestyle guru advise us to order at a restaurant? "Create a meal with the sides," he says.