Yellow mustard flowers in a field, macro shot.
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The can­cer eats with you — can­cer ther­a­py with cru­cif­er­ous vegetables

Posted by in Prävention, Therapy

The Mol­e­c­u­lar Onco­Surgery work­ing group, a coop­er­a­tion between the Sur­gi­cal Uni­ver­si­ty of Hei­del­berg and the Ger­man Can­cer Research Cen­ter, inves­ti­gat­ed the effect of cru­cif­er­ous plants on tumor stem cells under the direc­tion of Prof. Ingrid Herr.

Since ancient times, cab­bage has been used as a nat­ur­al rem­e­dy against bac­te­ria, fun­gi, inflam­ma­tion and can­cer. Mar­cus Por­cius Cato Cen­so­rius, also called Cato the Elder (234 – 149 BC), a Roman his­to­ri­an, described that raw cab­bage mixed with vine­gar or boiled with oil ban­ish­es and cures all dis­eases “from hang­overs after exces­sive wine con­sump­tion to to seri­ous ill­ness­es like can­cer.” He wrote, “For a can­cer­ous breast ulcer, treat the breast with a crushed cab­bage leaf and it will heal.” These ancient tra­di­tions are still used today in naturopathy.

Dur­ing World War II, doc­tors would put sauer­kraut or crushed cab­bage leaves direct­ly on abscess­es, sup­pu­rat­ing wounds, or chilblains because med­i­cines were scarce. Cab­bage pads have a pain-reliev­ing and anti-inflam­ma­to­ry effect and are there­fore still used today for rheumat­ic com­plaints, gout, joint inflam­ma­tion, but also for back pain and lum­ba­go. A meal of cab­bage, radish­es, radish or sauer­kraut juice relieves heart­burn, gas­tri­tis, duo­de­nal and stom­ach ulcers, low­ers high blood pres­sure, and reduces obe­si­ty, dia­betes and inflam­ma­tion. Gar­den cress is said to low­er the blood sug­ar lev­el and mus­tard stim­u­lates diges­tion and pro­motes blood cir­cu­la­tion in the form of a mus­tard plaster.

The ther­a­peu­tic effects of mus­tard oils

Macro shot of harvested radishes in a black shell against a black background.

Broc­coli, cau­li­flower and all oth­er types of cab­bage, as well as radish­es, horse­rad­ish, cress, rock­et and mus­tard are cru­cif­er­ous veg­eta­bles whose active sub­stances are large­ly iso­lat­ed. Over 150 dif­fer­ent mus­tard oil gly­co­sides are known, which occur in dif­fer­ent amounts in the numer­ous cru­cif­er­ous plants. Mus­tard oils account for the pun­gent taste of radish, horse­rad­ish and mus­tard or the some­times bit­ter taste of var­i­ous types of cabbage. 

The typ­i­cal taste is cre­at­ed when the pre­cur­sor com­po­nents of mus­tard oil, the so-called glu­cosi­no­lates, come into con­tact with the enzyme myrosi­nase. These are stored sep­a­rate­ly in the plant cell. Only when the plant cell is injured, e.g. B. by bit­ing, chew­ing, cut­ting or food pro­cess­ing, the two com­po­nents come togeth­er and the mus­tard oil is formed. Many her­biv­o­rous ani­mals, but also virus­es, bac­te­ria and fun­gi, are poi­soned or die from a meal of cabbage. 

For humans, on the oth­er hand, this plant fam­i­ly does not pose a dan­ger in nor­mal house­hold quan­ti­ties, but has a health-pro­mot­ing effect. Exper­i­men­tal stud­ies show, for exam­ple, the anti-infec­tive prop­er­ties of horse­rad­ish, nas­tur­tium and water­cress, which also attack virus­es, fun­gi and bac­te­ria. This exper­i­men­tal data was the basis for the pro­duc­tion of phy­tother­a­peu­tics from nas­tur­tium and/or horse­rad­ish (e.g. Angocin® Anti-Infekt N, Cres­sana®, nas­tur­tium tablets, horse­rad­ish juice). These are rec­om­mend­ed for defense against infec­tion and treat­ment of acute inflam­ma­to­ry dis­eases of the bronchi, sinus­es and uri­nary tract. One can even spec­u­late on a can­cer-pre­vent­ing effect of the phenylethyl mus­tard oils from horse­rad­ish and water­cress, although an anti-car­cino­genic effect has so far only been proven in the mouse model.

Epi­demi­o­log­i­cal Stud­ies and Cru­cif­er­ous Vegetables

Woman in lab clothes uses a microscope while seated.

In fact, the results of numer­ous epi­demi­o­log­i­cal stud­ies indi­cate that cru­cif­er­ous veg­eta­bles have a high poten­tial for pre­ven­tion. In 87 stud­ies com­par­ing dietary habits to can­cer risk in large pop­u­la­tions, a major­i­ty of 67% show a reduced risk of many types of can­cer after fre­quent con­sump­tion of cru­cif­er­ous veg­eta­bles. The cor­re­spond­ing per­cent­ages for cab­bage, cau­li­flower, broc­coli, and Brus­sels sprouts were 70, 67, 56, and 29%. The asso­ci­a­tions were most con­sis­tent for malig­nan­cies of the lung, stom­ach, colon, and rec­tum, and least con­sis­tent for prostate, endometri­um, and ovary. 

Fur­ther­more, a sys­tem­at­ic lit­er­a­ture review by the WCRF/AICR found a ten­den­cy for fre­quent con­sump­tion of cab­bage and a low­er risk of pan­cre­at­ic car­ci­no­ma. In addi­tion, two well-con­trolled stud­ies in patients with prostate can­cer showed that eat­ing cau­li­flower or broc­coli three times a week inhib­it­ed metas­ta­sis, with five servings/week being more effec­tive. Inter­est­ing­ly, there is an indi­vid­ual vari­a­tion in the bioavail­abil­i­ty of mus­tard oils, which is attrib­uted to genet­i­cal­ly deter­mined dif­fer­ent activ­i­ties of the glu­tathione S‑transferase enzymes. In indi­vid­u­als with less enzyme activ­i­ty, the mus­tard oils bind less well to glu­tathione and are there­fore excret­ed more slow­ly, result­ing in longer bioavail­abil­i­ty and greater ther­a­peu­tic potential.

Sul­foraphane – the best described mus­tard oil for cancer

In terms of its ther­a­peu­tic effec­tive­ness, sul­foraphane is now the best-stud­ied mus­tard oil and is found in par­tic­u­lar­ly high con­cen­tra­tions in broc­coli and its sprouts. It has anti-micro­bial and anti-oxi­dant prop­er­ties because it increas­es glu­tathione levels. 

As a result, sul­foraphane con­tributes to detox­i­fi­ca­tion and pre­vents the for­ma­tion of car­cino­gen-induced DNA adducts. These are caused, for exam­ple, by het­e­ro­cyclic amines that are pro­duced when grilling, roast­ing, deep-fry­ing and bak­ing. Many exper­i­men­tal lab­o­ra­to­ry stud­ies and stud­ies in ani­mals show a pro­tec­tive and ther­a­peu­tic effect of sul­foraphane in var­i­ous types of tumors. Sul­foraphane induces pro­grammed cell death, inhibits cell divi­sion and reduces angiogenesis/vascularization. In addi­tion, sul­foraphane reduces the activ­i­ty of the over­rid­ing inflam­ma­to­ry medi­a­tor NF‑B and thus inhibits inflam­ma­to­ry process­es and tumor progression. 

The lat­est exper­i­men­tal stud­ies indi­cate that sul­foraphane even attacks can­cer stem cells that are par­tic­u­lar­ly resis­tant to ther­a­py, there­by mak­ing var­i­ous types of chemother­a­peu­tic agents more effec­tive again. This has so far been shown in exper­i­men­tal mod­els of pan­cre­at­ic, breast and prostate carcinoma.

Sul­foraphane in broc­coli makes resis­tant tumor stem cells in pan­cre­at­ic tumors vulnerable

Broccoli against a white background.

Around 12,650 peo­ple in Ger­many devel­op pan­cre­at­ic car­ci­no­ma each year, an extreme­ly aggres­sive tumor of the pan­creas. The dis­ease is often not noticed until late. Few patients sur­vive the diag­no­sis for more than a year. Pan­cre­at­ic car­ci­no­ma spreads aggres­sive­ly, spreads to oth­er organs and is large­ly insen­si­tive to cur­rent ther­a­pies. So-called can­cer stem cells, which can regen­er­ate very well and are there­fore resis­tant to drugs and radi­a­tion, are prob­a­bly respon­si­ble for this.

“In oth­er tumors, typ­i­cal­ly less than three per­cent of the can­cer cells are tumor stem cells. Pan­cre­at­ic car­ci­no­ma, on the oth­er hand, har­bors 10 per­cent or more of such aggres­sive cells,” says Prof. Herr. The sci­en­tists found that even new can­cer drugs that are effec­tive in oth­er tumors were unable to do any­thing against the tumor stem cells in pan­cre­at­ic car­ci­no­ma: the cells pro­tect them­selves with a spe­cial mech­a­nism, the NF-kB sig­nal­ing path­way, which seems to be involved in the pro­nounced resis­tance to ther­a­py of pan­cre­at­ic carcinoma .

Pan­cre­at­ic car­ci­no­ma is made sus­cep­ti­ble to therapy

Active sub­stances that block exact­ly this sig­nal­ing path­way and thus make the dan­ger­ous cells vul­ner­a­ble are pro­vid­ed by nature: veg­eta­bles from the cru­cif­er­ous fam­i­ly such as broc­coli, cau­li­flower, Brus­sels sprouts or kale have a high con­tent of sul­foraphane, an active ingre­di­ent against can­cer. It pro­tects body cells from dam­age to the genet­ic mate­r­i­al and ini­ti­ates cell death when cells divide uncon­trol­lably. Of all these veg­eta­bles, broc­coli has the high­est sul­foraphane content.

Exper­i­ments with cell cul­tures, mice and fresh­ly iso­lat­ed tumor cells from patients showed that sul­foraphane inhib­it­ed blood ves­sel for­ma­tion in the tumor and tumor growth with­out caus­ing any side effects. In com­bi­na­tion with can­cer drugs, this effect was increased. “Last year, a large-scale Cana­di­an study with 1,338 patients with prostate can­cer showed that a high con­sump­tion of broc­coli and cau­li­flower could pro­tect the patients from metas­ta­siz­ing the tumor,” says Pro­fes­sor Herr.

Sul­foraphane — how much broc­coli do you need?

Broc­coli has been an insid­er tip in oncol­o­gy since 1985 — and the trend is increas­ing to this day. Deci­sive was the colon can­cer of the for­mer US Pres­i­dent Ronald Rea­gan and the broc­coli cure pre­scribed by his per­son­al physi­cians. After all, he sur­vived the diag­no­sis 19 years. This is attrib­uted to the action of the isoth­io­cyanate sul­foraphane, which is formed in broc­coli from the inac­tive pre­cur­sor sub­stance glucoraphanin. 

In exper­i­men­tal stud­ies, 4.4 mg/kg/day sul­foraphane was able to inhib­it the growth of human pan­cre­at­ic car­ci­no­ma xenografts in mice. After nor­mal­iza­tion based on the body sur­face area method, this cor­re­sponds to an amount of 0.36 mg/kg/day in humans. Extrap­o­lat­ed to an aver­age per­son, this would be 25 mg sulforaphane/70 kg body weight/day.

Patients are now won­der­ing how much cru­cif­er­ous veg­eta­bles should be con­sumed to achieve such a con­cen­tra­tion. The answer is dif­fi­cult because the con­cen­tra­tion of gluko­raphanin varies great­ly between dif­fer­ent bras­si­cas and even between the same variety. 

Prepa­ra­tion is key

Torso of a man in a white T-shirt and blue apron in front of a crimson background and a yellow table on which a wooden board with pink cabbage leaves held in two hands lies.

The form of prepa­ra­tion is impor­tant for main­tain­ing the sul­foraphane con­tent in broc­coli and cab­bage. Blanch­ing and cook­ing destroys the myrosi­nase in veg­eta­bles. There­fore, the con­ver­sion of gluko­raphanin to active sul­foraphane in cooked broc­coli depends on the thioglu­cosi­dase activ­i­ty of the gut flo­ra. How­ev­er, this is more or less severe­ly attacked in many peo­ple by West­ern diets (too much fat, indus­tri­al sug­ar, white flour prod­ucts, meat and sausage), inflam­ma­to­ry bow­el dis­eases, antibi­otics and chemother­a­py. This means sul­foraphane is not bioavail­able because gluko­raphanin can­not be con­vert­ed into sul­foraphane in the body. There­fore, it is rec­om­mend­ed to eat the broc­coli raw and chew it well so that gluko­raphanin and myrosi­nase are released from the plant cell, react with each oth­er and form sulforaphane.

In order to obtain the high­est pos­si­ble gluko­raphanin con­tent when heat­ing the veg­eta­bles, the flo­rets and the peeled stalks should be cut as small as pos­si­ble before cook­ing in order to reduce the cook­ing time, which should not be longer than 5 min­utes. Cook­ing in the microwave very quick­ly destroys the gluko­raphanin and sul­foraphane. When boil­ing or steam­ing, the amount of cook­ing water should be reduced because the water-sol­u­ble glu­cosi­no­lates are washed out. How­ev­er, the ingre­di­ents remain avail­able if the cook­ing water is the basis for prepar­ing sauces or soups.

Broc­coli sprouts in patient studies

Broccoli sprouts from above, in a rectangular shape.

To get infor­ma­tion about a ther­a­peu­ti­cal­ly effec­tive dose, broc­coli sprouts have already been test­ed in patient stud­ies. One of these stud­ies exam­ined the dai­ly con­sump­tion of 70 g of broc­coli sprouts for eight weeks in 48 patients with Heli­cobac­ter pylori — 70 g of sprouts con­tain sul­foraphane in an amount equiv­a­lent to about two to three serv­ings of broc­coli daily. 

Four and eight weeks lat­er, the test group, but not the alfal­fa sprouts con­trol group, had sig­nif­i­cant­ly low­er lev­els of mark­ers for Heli­cobac­ter pylori in breath and stool, and the gas­tri­tis had improved. Unfor­tu­nate­ly, after the study was com­plet­ed, all mark­ers returned to their orig­i­nal lev­els, indi­cat­ing that the Heli­cobac­ter pylori infes­ta­tion was sup­pressed by the amount of broc­coli sprouts used, but not cured.

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