A nurse consulting a doctor via Mr. Rounder the Robot, Hackensack University Medical Center, Hackensack, New Jersey




Published by The New York Review of Books, October 10, 2011, by Arnold Relman



The US is facing a major crisis in the cost of health care. Corrected for inflation, health expenditures in the public sector are nearly doubling each decade, and those in the private sector are increasing even more rapidly. According to virtually all economists, this financial burden, which is now consuming about 17 percent of our entire economic output (far more than in any other country), cannot be sustained much longer. The federal share, including payments for Medicare and Medicaid, was 23 percent of the national budget in 2009 and is a prime cause of the deficit.1

There is no current prospect of raising taxes. If the federal long-term debt is to be reduced, government health expenditures on Medicare and Medicaid must be controlled. However, there is no agreement in Washington on how that can or should be done. Both parties claim to have the answer but, as I will make clear, no initiatives proposed by either party have much chance of significantly slowing the rise in federal health costs without reducing access to needed services. Major reform will be required, but that is not even under consideration. In any case, health legislation is currently stalled by a bitter political deadlock. No initiatives to improve health care will come out of Congress until after the 2012 elections and, unless the results are unexpectedly decisive, probably not even then. Still, as I will explain here, there is a chance that new developments in the way physicians are organizing themselves to deliver care might improve the currently dismal prospects for action on major reform and cost control.


In his September 8 address to Congress, the President spoke of the urgent need to control the costs of Medicare. To do this he is relying principally on the Affordable Care Act, passed by Democrats in March 2010. The Act expands insurance coverage but, as already explained in these pages,2 it is not likely to slow the rise of costs significantly. Republicans in Congress are seeking to stop it from being implemented and their potential candidates for president are demanding its repeal, while state governments that are controlled by Republicans are challenging its constitutionality in federal courts. They question the Act’s mandate that all citizens not covered by public or private insurance plans be required to purchase private insurance or incur a tax penalty. The Republican legal challenge has so far received a divided reception in lower courts and will probably reach the Supreme Court next year. The mandate is a critical part of the Act because private insurers will not offer coverage at affordable prices to all applicants, as the Act assumes, unless everyone—young and healthy included—is required to be insured. Whatever the Court’s decision, it will not have much effect on health costs because the law does very little or nothing to address some of the most important causes of the high cost of care and its rapid inflation.3


First, the Act does not replace—but expands—the investor-owned private health insurance industry. According to the actuary for the government’s Center for Medicare and Medicaid Services (CMS), this industry’s overhead and profits currently add over $152 billion to the cost of care.4

Second, the Act does not change the method of payment for most medical care, which is based on fees for each procedure and therefore encourages specialists to use expensive procedures excessively, while giving all physicians strong financial incentives to provide more services than needed.

Third, it does nothing to change the current fragmentation of medical care. This allows specialists to practice in isolation without restraints on cost, causes duplication and disorganization of services, and discourages the use of primary care physicians. The latter are essential to cost-effective care because they help patients avoid unnecessary, expensive procedures. But with specialists earning much higher incomes per unit of working time, primary care doctors are disappearing. The Act addresses this problem, but only by providing minimal financial incentives to primary care doctors; they are unlikely to make much difference.

In the absence of effective general solutions for these causes of rising costs, there is little chance that the Act will “bend the curve” of medical inflation as Democrats hope. The law does, however, propose to cover the cost of adding millions of beneficiaries to Medicaid and to private plans over ten years. It does this by cutting payments to the private “Medicare Advantage” plans now chosen by some 12 million Medicare beneficiaries, and by eliminating tax exemptions for expensive insurance coverage offered by employers to favored employees. Apart from two ill-conceived and probably unworkable exceptions, the Act offers no other broad initiatives directly aimed at reducing costs.

The first exception, in Section 3022 of the Act, proposes to share any Medicare savings with so-called accountable care organizations (ACOs). ACOs are defined as federally certified multispecialty groups of physicians that collaborate with one or more hospitals and contract with Medicare to provide comprehensive care to a designated group of patients on a fee-for-service basis. ACOs would in principle have incentives to control costs because the government would give them a share of any savings they produced by using fewer resources in delivering good care. But the 126 pages of regulations proposed to govern this program, published by the Department of Health and Human Services on April 7, 2011,5 threaten to undermine it. The regulations were considered so onerous and impractical, and the benefits to participating ACOs so dubious, that almost all multispecialty medical groups have indicated they would not participate.6

Even if the regulations are substantially modified before they are fully adopted, the CMS, which would administer the program, probably could not handle the extra work required to manage more than a relatively small number of participating ACOs. This program is therefore not likely to have much effect on health care costs.

Section 3403 of the Act is often cited as a powerful tool for controlling costs, but there is much reason to be skeptical. It establishes an Independent Payment Advisory Board (IPAB), a presidentially appointed independent committee of fifteen full-time members. If government spending rises too rapidly, the IPAB must offer proposals for cost control, and Congress must act on them or enact its own measures for equivalent savings. However, the law stipulates that the IPAB cannot reduce Medicare benefits or increase Medicare premiums, and it defers any proposed reductions in payments to hospitals for a few years. The IPAB would thus be limited to suggesting cuts in payments to physicians, payments for some ambulatory services such as emergency room visits, and payments for Medicare Advantage plans and Medicare Part D prescription drugs.

Unless the IPAB were to recommend some limitation to their total income, physicians could easily respond to reduced fee schedules by providing more services, such as performing more diagnostic tests. Physicians’ average incomes have not kept pace with the rising costs of managing an office, and there is widespread unhappiness among the profession over the threat of cuts in payment that have been mandated by past legislation. Some physicians are now refusing to see new Medicare patients for this reason, so I doubt there would be support in Congress for much further reduction in fee schedules.

Moreover, payments to physicians account for only about a fifth of total health expenditures. The other four fifths consist largely of costs of hospital and nursing home care as well as payments for drugs and other medical products, and the overhead costs of private insurers. A realistic reduction of payments to doctors could at most save one or two percent of total costs, and wouldn’t necessarily slow inflation. The other cost-saving options left open to the IPAB are also limited in scope and would have relatively little effect on “bending the curve.” Furthermore, and most importantly, there will probably be fierce Republican opposition in Congress to IPAB appointments and funding, which will hamstring its function. The IPAB’s prospects for success are therefore dim.


Republicans in Congress have pretty much limited their health policy to an unyielding opposition to “Obamacare,” to calls for reform of malpractice litigation, and to their traditional reliance on “market forces.” Their latest initiative is the proposal by Representative Paul Ryan of Wisconsin to privatize Medicare and change federal support of Medicaid by substituting fixed grants for its current open-ended commitment to paying a large share of costs to the states. Under his proposal the Medicare system covering most of the medical costs of elderly citizens would be gradually replaced by a federal voucher system. Starting in 2022 each new Medicare beneficiary would choose a private insurance plan and the government would give participants in the plan a voucher to help pay for coverage. The voucher would start at $8,000, which would grow only according to the Consumer Price Index, but with some undefined adjustment for people who are older and sicker.

However, actuarial experts predict a near doubling of total Medicare costs within a decade; so Ryan’s proposed vouchers would fall far behind actual costs, and beneficiaries would have an increasing financial burden. The Ryan plan reduces federal outlays for Medicare by shifting costs to patients. It has been passed by the Republican majority in the House, but not by the Senate, and the President strongly opposes it.

Defending Ryan’s plan, Republicans say that under current policies Medicare will soon be bankrupt. They are correct that rising Medicare costs are unsustainable, but the fact remains that the Ryan voucher plan puts an intolerable burden on the elderly and would undoubtedly reduce their access to needed care. We can predict, for example, that patients would make fewer visits to physicians for checkups and reduce their compliance with expensive drug regimens.

As for Ryan’s proposal to reduce Medicaid outlays by making fixed grants to states, the states would have considerable discretion in spending these grants, and their deficits would almost certainly force them to curtail Medicaid services in order to meet other budgetary needs. The grant idea, although favored by some state governors, has provoked wide opposition because it threatens the medical services needed by low-income citizens, and because Medicaid money now also supports nursing home care for the elderly.


If neither party is proposing effective solutions to the cost crisis, and political deadlock in Washington is preventing the consideration of new ideas, are we doomed to witness a slowly collapsing health care system that eventually will provide adequate care only to those who can afford to pay? In his latest book on health care,7 the Princeton sociologist Paul Starr, who worked on the ill-fated Clinton Health Security Plan, despairs of any political action that could bring about major reform. However, a new movement in the medical profession might help to start such reform by reconfiguring the way medicine will be practiced.

Traditionally, physicians have practiced either alone or in small partnerships with a single specialty, such as cardiology. Now a big shift to large groups containing many specialties is taking place. These multispecialty practices vary in size, but include physicians in almost all fields. Primary care physicians usually make up almost half the medical staff. They counsel patients and coordinate care by the specialists. Groups usually share common facilities, medical records, scheduling, and billing, and their physicians cooperate in the care of patients.

Many multispecialty groups pay doctors at least in part with base salaries, with the rest of their compensation derived from each physician’s collected fees. Only a few pay entirely by salary, but that may change. Most groups are owned by physicians, but many are now being organized and managed by hospitals. Well-established large groups owned by physicians include the Mayo Clinic, Cleveland Clinic, Permanente Medical Group, Intermountain Healthcare, Scott & White, Marshfield Clinic, Geisinger Health System, Lahey Clinic, and Harvard Vanguard. Many smaller physician-owned groups now exist throughout the country (though there are only a few in the Southeast), and their number is growing rapidly. So are groups owned by hospitals, including academic medical centers as well as large community hospitals. An unknown, but probably substantial, proportion of these groups are not for profit; i.e., they have no investors and use any net income to maintain and improve facilities and services.

The American Medical Group Association (AMGA) is the trade organization that represents most multispecialty physician-owned groups. The American Hospital Association (AHA) is the trade organization for almost all general hospitals. In recent communications with senior officials at the AMGA and the AHA, I learned that membership in the AMGA now stands at about four hundred groups, the highest ever, and is increasing at an unprecedented rate of about 10 percent annually. These four hundred multispecialty groups employ about 117,000 full-time medical doctors, but since many of their physicians work less than full-time, the total number of doctors now employed by such groups is probably close to 140,000, not counting the unknown number in physician-owned groups that are not members of the AMGA.

The AHA says that a 2010 survey of its member hospitals reveals that they employed roughly 120,000 practicing physicians, but the survey did not disclose how many were in multispecialty group practices. Allowing for this incomplete reporting, the total number of physicians now practicing in multispecialty groups could be close to 200,000, or about a quarter of all practicing physicians, and this number is increasing rapidly.  




Lisa Potetz and Juliette Cubanski, A Primer on Medicare Financing , Henry Kaiser Family Foundation, July 2009, Exhibit 2. 


Jonathan Oberlander and Theodore R. Marmor, “The Health Bill Explained at Last,” The New York Review , August 19, 2010


Arnold Relman, “Health Care: The Disquieting Truth,” The New York Review , September 30, 2010


Sean P. Keehan et al., “National Health Spending Projections Through 2020: Economic Recovery and Reform Drive Faster Spending Growth,” HealthAffairs , Vol. 30, No. 8 (August 2011). 


Department of Health and Human Services, Federal Register , Part II, Vol. 76, No. 67 (April 7, 2011). 


Ricardo Alonso-Zaldivar, “Medical Group Pans Key Element of Obama Health Plan,” The Boston Globe , May 12, 2011


Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform (Yale University Press, 2011.) 



American Association for Cancer Research  —  A concentrated extract of freeze dried broccoli sprouts cut development of bladder tumors in an animal model by more than half, according to recent research.

This finding reinforces human epidemiologic studies that have suggested that eating cruciferous vegetables like broccoli is associated with reduced risk for bladder cancer, according to the study’s senior investigator, Yuesheng Zhang, MD, PhD, professor of oncology at Roswell Park Cancer Institute. “Although this is an animal study, it provides potent evidence that eating vegetables is beneficial in bladder cancer prevention,” he said.

There is strong evidence that the protective action of cruciferous vegetables derives at least in part from isothyiocyanates (ITCs), a group of phytochemicals with well-known cancer preventive activities.”The bladder is particularly responsive to this group of natural chemicals,” Zhang said. “In our experiments, the broccoli sprout ITCs after oral administration were selectively delivered to the bladder tissues through urinary excretion.”

Other cruciferous vegetables with ITCs include mature broccoli, cabbage, kale, collard greens and others. Broccoli sprouts have approximately 30 times more ITCs than mature broccoli, and the sprout extract used by the researchers contains approximately 600 times as much.

Although animals that had the most protection against development of bladder cancer were given high doses of the extract, Zhang said humans at increased risk for this cancer likely do not need to eat huge amounts of broccoli sprouts in order to derive protective benefits.

“Epidemiologic studies have shown that dietary ITCs and cruciferous vegetable intake are inversely associated with bladder cancer risk in humans. It is possible that ITC doses much lower than those given to the rats in this study may be adequate for bladder cancer prevention,” he said.

Zhang and his colleagues tested the ability of the concentrate to prevent bladder tumors in five groups of rats. The first group acted as a control, while the second group was given only the broccoli extract to test for safety. The remaining three groups were given a chemical, N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) in drinking water, which induces bladder cancer. Two of these groups were given the broccoli extract in diet, beginning two weeks before the carcinogenic chemical was delivered.

In the control group and the group given only the extract, no tumors developed, and there was no toxicity from the extract in the rats.

About 96 percent of animals given only BBN developed an average of almost two tumors each of varying sizes. By comparison, about 74 percent of animals given a low dose of the extract developed cancer, and the number of tumors per rat was 1.39. The group given the high dose of extract had even fewer tumors. About 38 percent of this high-dose group developed cancer, and the average number of tumors per animal was only .46 and, unlike the other animals, the majority were very small in size.

The study was funded by the Vital Vegetables Research Program of Australia and New Zealand, the National Cancer Institute and the Roswell Park Alliance Foundation.

Story Source:

American Association for Cancer Research (2008, February 29). Extract Of Broccoli Sprouts May Protect Against Bladder Cancer.




Cancer Adjuvant Therapy & Prevention





For the past several years, researchers at Johns Hopkins University have urged the inclusion of broccoli sprouts in the diet. According to Dr. Paul Talalay, broccoli sprouts have 20-50 times more anticancer sulphoraphanes than grown vegetables.. Eating a few tablespoons of sprouts daily can supply the same amount of chemoprotection as 1-2 pounds of broccoli eaten weekly.

Broccoli sprouts contain a chemical that kills H. pylori, even in antibiotic-resistant conditions. The release of anticarcinogenic chemicals from Brassica vegetables is a sequential process that occurs as the plant tissue is broken down. Indole-3-carbinol (I3C), a product of cruciferous metabolism, is referred to as a secondary metabolite, meaning it is not found in a preformed state in the vegetables. Rather, I3C is formed after myrosinase (an enzyme inherent to the plant) is exposed to a phytochemical in the vegetable (glucobrassicin), a glucosinolate that subsequently delivers indole-3-carbinol. This occurs only when vegetable cells are crushed or eaten, a process known as enzymatic hydrolysis. I3C, thus formed, is then broken down in the presence of stomach acid to various byproducts including diindolylmethane (DIM), another powerful defense against cancer. It appears highly possible that the breakdown products of I3C may be delivering as much protection as I3C itself.

An undesirable effect is the conversion of estrone to a carcinogenic material called 16-alpha hydroxyestrone that damages DNA and inhibits apoptosis. The ratio of 2-hydroxyestrone to 16-hydroxyestrone indicates a woman’s risk for developing breast and ovarian cancer. Levels of 2-hydroxyestrone are typically higher in women who do not get cancer; 16-hydroxyestrone is higher in women with cancer. When breast cancer cells are treated with I3C (in vitro) 90% of cells undergo growth inhibition, whether the cells are estrogen positive or negative.

Broccoli (500 grams for 12 days) increased the average 2-alpha-hydroxyestrone:16- alpha-hydroxyestrone ratio (Kall et al. 1997). Hence, consuming vegetables rich in indole-3-carbinol gives hope that as 2-hydroxyestrone increases, cancers will be decreased in both men and women. The ability of I3C to neutralize estrogen metabolites as well as to block aflatoxin (a mycotoxin that promotes prostate cancer) makes cruciferous vegetables equally important to men.

By inhibiting protein kinases and other growth factors, restoring p21 activity, and encouraging apoptosis, I3C appears an effective chemopreventive/therapeutic agent against many types of malignancies. Evidencing its benefits, I3C reduced the incidence of cervical cancer from 76 to 8% in laboratory mice , and administered together with tamoxifen, I3C inhibited the growth of estrogen-dependent human MCF-7 breast cancer more effectively than either agent used alone.

If vegetables providing I3C are in short supply in the diet, indole-3-carbinol capsules are available. For those under 120 pounds, one 200-mg capsule taken 2 times a day is suggested; those between 120-180 pounds could take 200 mg 3 times a day, while those over 180 pounds could take four 200 mg a day. If the diet generally lacks adequate amounts of vegetables, powdered vegetable extracts are available, an example is PhytoFood; a suggested dosage for cancer patients is 1-2 tbsp daily (with food).

Cholesterol (Can It Be Too Low?)
Hypocholesterolemia (abnormally low levels of cholesterol) has been shown in several epidemiological studies to be related to increased mortality from human cancer. Cholesterol and triglyceride levels in 135 patients with squamous cell and small cell lung carcinoma were evaluated. All lung cancer patients had higher rates of hypocholesterolemia as well as lower triglyceride levels compared to a healthy control group. Total cholesterol concentrations were lower in both histological types, but triglyceride levels were lower only in patients with squamous cell lung cancer.

An article in Hematology and Oncology reported that 90% of 83 patients with acute myeloid leukemia were hypocholesterolemic. Additionally, another article in the European Journal of Haemtology reported that remission in acute myelogenous leukemia was associated with a significant increase in cholesterol levels in those patients with low cholesterol concentrations or high leukocyte counts at diagnosis (Reverter et al. 1988).

Various reports have emerged showing that low cholesterol levels are associated with higher death rates (particularly among elderly people), from cancer and infection. These findings raise concerns regarding hypocholesterolemic drug therapy and diet manipulation to drastically lower cholesterol levels in a subset of the population.


Few events are as stressful as a diagnosis of cancer. As the stress level increases, the outpouring of the adrenal cortex hormone (cortisol) also increases. Women with breast cancer who had abnormal cortisol rhythms survived an average of 3.2 years, while those with normal rhythms survived an average of 4.5 years (more than a year longer). The difference in survival times began to emerge about 1 year after the cortisol testing and continued for at least 6 additional years.

Animal studies, mostly involving rats, demonstrated stress as a causal factor in cancer. The onset of cancer appears similarly allied in humans, with the immune system highly responsive to emotional pitfalls. It is well established that when the individual is emotionally challenged, cancer has a significant advantage.

Psychobiologist Shamgar Ben-Eliyahu, Ph.D., has been working for the past decade on stress, tumor development, and the activity of NK cells. Considering all immune system cells, NK cells show the strongest activity in preventing metastasis and the strongest response to stress. Even short-term stress decreases NK cell activity in laboratory animals, significantly increasing the risk of certain types of cancer and metastasis. Gender plays a significant role in the NK cell response to stress, with men more adversely affected than women. The stress of abdominal surgery promotes the growth of cancerous tumors in rats, a sequence thought orchestrated by NK cell suppression .

High levels of neuropeptide-gamma are observed in the bloodstream of depressed individuals, an elevation synonymous with immune suppression . Macrophages (pathogen scavengers) have receptor sites that attract endorphins (mood enhancers with analgesic traits). With the right emotional programming, white blood cells swim through the bloodstream with determination; conversely, under stress, immune competence falters, and the immune attack becomes lethargic.

Breast cancer patients with the most anxiety had a weaker immune response and were less equipped to fight the disease. The following stress-associated situations and personality types are associated with breast cancer: (1) the use of denial or repression as a coping strategy, (2) an experience of separation or loss, (3) a history of stressful life experiences, (4) a tendency toward melancholy and hopelessness (this trait has, since antiquity, been associated with uterine and breast cancers), and (5) a personality type characterized by conflict avoidance. It is theorized that the genes that cause one to avoid conflict are the same genes that increase susceptibility to cancer.

Also, psychological stress induces the production of pro-inflammatory cytokines, such as TNF-alpha, IL-6, and IL-10 (Maes et al. 2000), which play a role in malignancies.

The effect of chronic stress on the immune system of 116 recently treated breast cancer patients found (reproducibly) that stress levels significantly predicted (1) lower NK cell activity, (2) diminished response of NK cells to interferon-gamma, and (3) decreased proliferation of lymphocytes, white blood cells considered the army of the immune system (Andersen et al. 1998). Oncologists often suggest stress management, such as meditation, yoga and breathing exercises, guided imagery, or spirituality, to help bring about calm.

Because the cells responsible for cancer surveillance work best in an environment favoring confidence and calm, it is important that the message springing from our thoughts and transmitted to cells is commensurate with healing. Fright, pessimism, and melancholy send uncertain instructions and the cells respond with a feeble effort. The enduring message (fear or assurance, despair or hopefulness, laughter or tears) reflects our hour-to-hour psyche and sets the tone for health victories or failures. Expect little more from your body than the quality of your thoughts at this very moment: “As a man thinks in his heart, so is he” (Proverbs 23:7).


The drugs, hormones, and nutrients discussed in this protocol have documented mechanisms of action that may benefit the cancer patient. The objective of implementing an adjuvant regimen consisting of multiple agents is to increase the odds of achieving a long remission. Once a remission is achieved, preventing recurrence and secondary cancers becomes a lifetime commitment.

Few oncologists aggressively seek to prevent recurrence once the primary disease appears to have been eradicated. However, the regrettable facts are that colonies of cancer cells can remain dormant in the body for years or decades before reappearing as full-blown disease that is highly resistant to treatment. This has been documented in autopsy studies of people who died of diseases other than cancer but nonetheless showed significant residual metastatic tumors in their bodies.

Nutrient Preventive Dose Cancer Adjuvant Dose
R-dyhydro-lipoic acid 150-600 mg/day 600-1200 mg/day
Coenzyme Q10 30-300 mg/day Up to 400 mg/day
EPA-DHA fatty acids 1400 mg/day 2800-4200 mg/day
Kyolic Reserve Garlic  600 mg/day Up to 5400 mg/day
Indole 3 Carbinol w/Resveratrol 1-2 caps/day 1-2 caps/day
Green Tea (725 mg) 1-2 caps/day 5 capsules 3 times/day
Life Extension Mix* 1 tbsp of powder, 9 tabs, or 14 capsules daily 1 tbsp of powder, 9 tabs, or 14 capsules daily
Liquid Emulsified Vitamin A Up to 35,000 IU/day** Up to 100,000 IU/day**
Vitamin C (included in LE Mix) 6-12 grams/day  
Vitamin D3 Up to 1400 IU/day 800-4000 IU/day**
Gamma Tocopherol w/Seseame Lignans 1 capsule/day 2-4 capsules/day
Grape Seed Extract 100 mg/day 300 mg/day
Phyto-Food (cruciferous vegetable concentrate) 1 tbsp/day 1-4 tbsp/day
Melatonin 300 mcg-6 mg/day 3-50 mg/day
Selenium (included in LE Mix) 200-400 mcg/day 200-400 mcg/day
Silibinin 260 mg/day Up to 2000 mg/day
Curcumin 900 mg/day 2700 mg 3 times/day
GLA (gamma-linolenic acid) 1 softge per day 900 mg/day


*Those individuals using the Life Extension Mix (powder, tablets, or capsules) are receiving a storehouse of nutrients targeted at maintaining good health. Very few of the cornerstone nutrients are not contained in the Life Extension Mix Formula, but exceptions are alpha-lipoic acid, coenzyme Q10, essential fatty acids, garlic, and melatonin. If indicated, the reader may wish to emphasize these nutrients for maximum support. Some people bolster their nutritional program by incorporating the Life Extension Booster (complete with gamma E tocopherol) together with the Life Extension Mix. These formulas are popular from both financial and convenience perspectives. While individuals with cancer will benefit from these suggestions, a more comprehensive program is recommended, such as supplements with precise anticancer mechanisms, targeted at specific cancer cell lines or established weaknesses.
**Refer to safety precautions that appear in this protocol when taking high doses of vitamins A and D.

In too many cases, a breast, melanoma, or other cancer reemerges that was supposed to have been cured. Scientists speculate that the body has natural anticancer control mechanisms that may diminish with age and exposure to physical and emotional stress factors. It is thus important for cancer patients to be vigilant in maintaining an inhospitable environment for cancer cells to propagate and protecting against age-associated immune dysfunction.

We have prepared the chart above to summarize recommendations on the basic dietary supplements and suggested doses for cancer prevention and adjuvant treatment. In addition to the agents listed here, a number of other potential adjuvant approaches are discussed in this protocol. For long-term control of cancer, some cancer patients attempt to incorporate as many of these adjuvant approaches as are tolerable and affordable. Others pick and choose which drugs, hormones, and supplements they want to consume over the long term.

Patients should read the other cancer protocols in this book, with special attention given to Cancer: Should Patients Take Dietary Supplements? and Cancer Treatment: The Critical Factors. If surgery, radiation, or chemotherapy is being considered, please refer to these specific protocols: Cancer Surgery, Cancer Radiation, and Cancer Chemotherapy.

Note: While it would be wholly inappropriate for the Life Extension Foundation to steer individuals in decisions of omission or commission regarding therapies, it would be equally improper to shun responsibility. Because we are challenged by a professional and moral commitment to assist in overcoming appalling statistics, we have discussed some controversial issues in this protocol. We look forward to new findings to better substantiate optimal therapeutic approaches.


R-dyhydro-lipoic acid, alpha-tocopherol succinate, L-arginine, buffered ascorbic acid, Bio Pro Thymic Protein A, biotin, calcium, Cell Forte with IP-6, Chloroplex, coenzyme Q10, conjugated linoleic acid (CLA), flaxseed oil, Gamma-E-Tocopherol/w Sesame Lignans, glutathione, goldenseal, grape seed-skin extract, green tea bags (organic), Kyolic Reserve Garlic, indole-3-carbinol w/Broccoli Extract, lactoferrin, L-glutamine, Life Extension Mix (caps, powder, or tablets), Super EPA/DHA w/Sesame Lignans, Mega GLA w/Sesame Lignans, melatonin, N-acetyl-cysteine, Pecta-Sol, perilla oil, Phyto-Food, Super Curcumin, selenium, Silibinin Plus, Ultra Soy Extract, Mega Green Tea Extract, Indole 3 Carbinol w/Resveratrol, theanine, tocotrienol w/Sesame Lignans, vitamin A, vitamin B12, vitamin D, and vitamin E are available by calling (800) 544-4440


The information published in this protocol is only as current as the day the book was sent to the printer. This cancer protocol raises many issues that are subject to change as new data emerge. Furthermore, cancer is still a disease with unacceptably high mortality rates, and none of our suggested treatment regimens can guarantee a cure.

The Life Extension Foundation is constantly uncovering information to provide the cancer patient with more ammunition to battle their disease. A special website has been established for the purpose of updating patients on new findings that directly pertain to the cancer protocols published in this book. Whenever Life Extension discovers information that points to a better way of treating cancer, it will be posted on the website www.lefcancer.org.

Before utilizing the cancer protocols in this book, we suggest that you log on to www.lefcancer.org to see if any substantive changes have been made to the recommendations described in this protocol. Based on the sheer number of newly published findings, there could be significant alterations to the information you have just read.
Alternatively, call 1-800-226-2370




About Broccoli sprouts



Broccoli sprouts

The varieties of sprouts range from the crunchy and firm ones to the spicy and delicate ones. The numerous nutrients make all the sprout species, including the broccoli sprouts to be very important factors of health, as they contain numerous vitamins, calcium, copper and iron. The broccoli sprouts contain a lot of sulfurophane and antioxidants and they also taste good. Broccoli is among the healthiest aliments that nature provides and its sprouts make no exception. Even more, just one ounce of broccoli sprouts has the nutritional values of 3 mature broccolis. Due to its valuable properties, the broccoli sprout is a medicinal aliment, which also has good influences as an anti-cancer oxidative.

These healthy sprouts can be consumed as the Greek stuffed chicken with broccoli sprouts, el charro tomato with broccoli sprouts, black beans and corn soup, vegetable pizzas, turkey sandwiches and southwestern broccoli sprouts wrap. The broccoli sprouts wrap is prepared with green bell peppers, red bell peppers, curry, lime juice, dried black beans, garlic, tortillas, broccoli sprouts and pepper.