Dr. Li Tang and her family almost always include broccoli on the dinner table.
It has a lot do with what she's learned in her lab at Roswell Comprehensive Cancer Center.
"I'm mostly interested in diet, vegetables and cancer, most specifically cruciferous vegetables," said Tang, associate professor of oncology in the Department of Cancer Prevention and Control at the Buffalo center.
She and a small circle of researchers across the country already have published information on the cancer-fighting benefits of vegetables that include broccoli, cauliflower, cabbage, Brussels sprouts, kale, and mustard, collard and turnip greens.
They also have begun an exciting new phase of examination to determine whether powerful phytochemicals – natural sulphur compounds produced by plants – can be used to treat certain types of cancer, as well as chronic disease.
Broccoli stands out.
Particularly raw broccoli.
"We see reduced risk for mortality," Tang said. "The most profound effect comes from broccoli."
Boiling, sautéing, steaming and stewing appears to wash away 60 percent to 90 percent of the cruciferous phytochemical that Tang studies most: isothiocyanates.
Those were part of the findings of a study of 275 Roswell cancer patients published in 2012 by Tang and Christine Ambrosone, chair of the department where Tang works.
Tang and other researchers have relied on questionnaires of cancer patients at Roswell Park and elsewhere to find a connection between survival and regular consumption of cruciferous vegetables. Participants included those with breast, bladder, prostate and many other types of cancer.
Their latest research involves taking a closer look at the impact of isothiocyanates on particular cancers – and whether they can one day be administered in pill or other medicinal form.
Johns Hopkins researchers already have shown that another phytochemical in cruciferous vegetables helps the body produce antioxidants which can help repair and purge damaged cells in the body.
Bladder cancer study
The Kaiser Foundation Research Institute seeks up to 1,800 bladder cancer patients in California willing to participate in a five-year, $4 million treatment study that will include isothiocyanates culled from young broccoli sprouts. The National Cancer Institute funded the study; Tang is helping to lead the research.
Bladder cancer is among the top 10 most common forms of cancer in the United States.
Roughly 60,000 people are diagnosed with it every year, and 10,000 people die from the disease.
Bladder cancer is detected early in three of every four cases, making it easier to treat by surgically removing related lesions and bladder tissue.
"But patients need to be monitored because the recurrence rate is extraordinarily high," Tang said.
Because of the high recurrence risk, bladder cancer is one of the most expensive forms of cancer to treat. Oncologists look inside the bladder every six months, even in patients with the lowest risk of recurrence. Patients also receive a bacteria-derived chemotherapy agent put into the bladder weekly for several cycles.
A logical approach
Previous research leads Tang and others to believe that adding broccoli sprout extract to that standard treatment could yield better results. That's because patients already questioned who ate more cruciferous vegetables – and in turn had higher concentrations of isothiocyanates in their bladders – tended to live longer than those who did not.
"The majority of bladder cancer originates in the cells on the surface of the bladder," Tang said, "and these bladder cells are exposed directly to the isothiocyanates metabolized in the urine. That kind of high dose, longer exposure, we felt, makes it the most promising target for the isothiocyanates in cruciferous vegetables."
Participating patients will be asked detailed "food frequency" questions designed to track their consumption of cruciferous veggies, what kinds they've eaten, and whether they've consumed them cooked or raw.
Tang and others involved in the Be-Well "lifestyle quality study" hope to have a full slate of patient volunteers by the end of 2019, follow them, and publish their first findings in 2020.
"Eventually," she said, "we want to give patients and the general population some advice about what are good ways to eat vegetables" to prevent cancer and lower risk of recurrence. "Without those results, we cannot give conclusive guidelines but the one thing we can say is that eating cruciferous vegetables won't be bad, and that raw cruciferous vegetables appear to have a good impact."
– Arrived in Buffalo in 2003 after she received her medical degree from Tongji Medical University in Wuhan, China.
– Earned her doctoral degree in cancer prevention and pathology from the University at Buffalo in 2006 and completed postdoctoral training in epidemiology at Roswell Park Comprehensive Cancer Center.
– Became a research assistant professor in 2010 in the Department of Cancer Prevention and Control. She is now an associate professor.
– Her special interests include molecular epidemiology, dietary approaches to improve cancer prognosis, and retroviruses and breast cancer risk and aggressiveness.
Be-Well Study: Bladder Cancer Epidemiology, Wellness and Lifestyle, is funded by the National Cancer Institute. Roswell Park also is conducting a related pilot clinical trial on breast cancer.
Those interested in participating in the Broccoli Sprout Extract and Breast Cancer Study can call Roswell at 877-275-7724; bladder cancer patients are being accepted for the the Be-Well bladder cancer study only in California.
Twitter: @BNrefresh, @ScottBScanlon