This phase 3 trial is examining the effectiveness and safety of niraparib (Zejula) in combination with abiraterone acetate (Zytiga) and prednisone (Deltasone) vs abiraterone acetate and prednisone plus placebo for patients with metastatic prostate cancer. The main outcome to be measured will be the survival time without cancer growing or spreading.

That doesn’t mean some veggies aren’t better than others. Some of these vegetables target multiple cancers at the same time. So, using this groundbreaking new data, let’s play “Which is healthier?”

Imagine you’re standing in line at one of those custom made-to-order salad places, where you get to choose your lettuce, choose your toppings, then choose your dressing. Let’s assume you don’t have a strong family history of any particular cancer, and so, aren’t trying to hone in on avoiding one tumor over any other.

First, let’s choose our lettuce. Boston, endive, radicchio, romaine, or spinach? Which is healthier? Out of the five, spinach is #1 against breast cancer—remember, the farther down, the better it is at slowing down these cancer cells. #1 against brain tumors, #1 against kidney cancer, #1 against lung cancer, and pediatric brain tumors—that’s why we need to feed our kids spinach! #1 against pancreatic cancer, prostate cancer, and stomach cancer.

Now it’s not #1 overall; there are 16 vegetables more powerful at stopping stomach cancer growth than spinach. But out of those five salad greens, spinach wins out across the board, against every cancer type tested.

What if the salad place said they were out of spinach, though? Which comes in second, out of the four left to choose from? For breast cancer, radicchio is #2. Against brain tumors? Radicchio. Kidney cancer? Radicchio. Radicchio, romaine, radicchio, radicchio, and radicchio. So, overall, out of those choices for greens, radicchio is second healthiest.

Back to the menu. Next, we get to choose four toppings. Now, there’s a long line of people behind you, all staring at us to make our choice. We don’t have time to ponder and pick the four absolute best, but we can at least make a guess as to roughly where on the graph they are.

Yes or no? According to this amazing new data, do carrots slow down cancer cell growth rates more than 50%? Yes or no? The answer is no. No, no, no, no, no, no, and no. So, shredded carrots aren’t going to make our top toppings choice.

What about shredded beets? Yes or no? Yes. Super yes! Brain tumor? Just beet it. Kidney cancer is a no; close to 50%, but not quite there. But then yes, yes, yes, yes, yes. So, overall, yes for beets.

Are we putting cucumber on our salad? As tasty as they may be, no. For most cancers it suppressed tumor cell growth less than 50%.

What about tomatoes? No tomatoes, either.

What about a potato? You can actually choose potatoes for your salad. Yes or no? No potatoes, either.

Wait a second; no iceberg lettuce, carrots, cucumbers, tomatoes, potatoes—that’s all people eat! That’s the problem. Even people eating their vegetables, aren’t really eating their vegetables. The majority of veggies people commonly eat have little effect.

Cutting to the chase: the line at the salad place is now out the door at this point. In this study, there was one clear winner. One vegetable that completely 100% stopped cancer growth in seven out of the eight tumor lines. One of the most important findings of the year. Which vegetable was it? Was it bok choy? Broccoli, Brussels sprouts, fiddlehead ferns, garlic, kale, or red cabbage?

#1 against breast cancer? Garlic. #1 against brain tumors? Garlic.#2 against kidney cancer: Garlic. Lung cancer? Garlic. Childhood brain tumors? Garlic. Pancreatic cancer? Garlic. Prostate cancer and stomach cancer? Garlic. So might I suggest a garlicky salad dressing?

But wait. Is it just that garlic is toxic to all cells? Yes, it stops the growth of cancer cells, but maybe it stops the growth of healthy cells, too? That wouldn’t be good. They tested for that. The black bars are the cancer cells; the white bars are the normal cells. As you can see, garlic slams cancer cells, but doesn’t touch normal cells, and the same thing with pretty much all the vegetables. They’re selective; they go after the cancer cells, but leave the normal cells alone. Veggies are amazing.

Now, if you didn’t pick garlic, and instead chose one of those others, you probably weren’t far off. The two best families of vegetables for cancer prevention are the cruciferous vegetables, like broccoli, kale, cabbage, and the allium family vegetables—like garlic, onions, and leeks. Let me just run through this one last time to highlight this important concept.

Starting from the beginning. Cruciferous vegetables in green; allium family vegetables in yellow. So what I want you to notice is the clustering of colors over to the right side, which illustrates the power of these two superfood classes of vegetables—whether for breast cancer, brain cancer, kidney cancer, lung cancer, or brain cancer.

Interestingly, you’ll notice that bok choy is often the kind of odd one out—apparently the least healthy of the cruciferous vegetables. Pancreatic cancer, prostate cancer, and finally, stomach cancer. So you know all those recipes that start with garlic and onions, and then throw you in some greens? That is the way to eat.

The researchers conclude: “The inclusion of cruciferous and Allium [family] vegetables in the diet is essential for effective dietary-based chemopreventive [or cancer-preventive] strategies.”

This study investigated the use of statins (a type of cholesterol-lowering drug) in older patients. They found that statins reduced the risk of major vascular events (MVEs) in all age groups. 

This study investigated the effectiveness of high-intensity interval training (HIIT) in improving muscle function after stroke. Researchers suggested that HIIT may improve outcomes in these patients.

This study investigated if an exercise regimen improved shoulder function in breast cancer survivors who received surgery to remove underarm lymph nodes. 

They found that both inflatable ball exercise and control standard exercise were beneficial for these patients. 

This phase 3 trial will investigate the effectiveness and safety of ribociclib (Kisquali) in breast cancer (BC). 

The main outcome will be the rate of survival without disease.

This study examined how long hormonal therapy should continue in patients who have received radiotherapy after prostate removal surgery (prostatectomy). This study concluded that patients with a higher number of risk risk factors should receive HT for a longer period of time. 

This study determined whether using vitamin D and E suppositories improved symptoms of vaginal atrophy in women with breast cancer treated with tamoxifen (Nolvadex). The study found that using vitamin D and E suppositories decreased feelings of vaginal dryness and pain for these patients.

In 1908, the presence of cholesterol crystals was noted “in the proliferating areas of cancers,” suggesting that perhaps cholesterol, in some way, was “associated with the regulation of [cancer] proliferation.” A century later, we now recognize “the accumulation of cholesterol [as] a general feature of cancer tissue, and recent evidence suggests that cholesterol [may indeed play] critical roles in the progression of cancers, including breast, prostate, and colorectal cancers.”

Perhaps that could explain why “egg consumption was associated with increased breast cancer risk.” And, indeed, a systematic review of the evidence suggests that “dietary cholesterol intake increases risk of breast cancer,” and the more cholesterol you eat, the higher the risk appears to go. But, why?

One thought is that the “[p]rolonged ingestion of a cholesterol-enriched diet induces chronic, auto-inflammatory responses,” and we know that “chronic…inflammation can lead to the initiation, promotion, and progression of tumor development.” It’s true that sprinkling some cholesterol on white blood cells in a test tube can trigger the release of inflammatory compounds, and LDL cholesterol can induce breast cancer proliferation and invasion. But again, that’s in vitro, where you can show that like breast cancer cells can migrate nearly twice as far within a day in a petri dish in the presence of LDL cholesterol. But what about in people?

Well, the level of LDL cholesterol in the blood of women diagnosed with breast cancer does appear to be “a predictive factor of breast tumor progression.” About two years after surgery/chemo/radiation, not one of the women in the lowest third of LDL cholesterol levels had a cancer recurrence. The same could not be said for women with higher cholesterol. We know cholesterol can cause inflammation in our artery walls; maybe it’s also playing an effect on breast cancer initiation and progression? They speculate that the high cholesterol levels may have a “cancer-fueling effect.” And indeed, women with breast cancer who happen to be taking cholesterol-lowering statin drugs appear to live about 40 percent longer before the cancer comes back. But the data isn’t good enough to ensure the drug benefits outweigh the risks, though lowering cholesterol with diet, one may be able to get the best of both worlds. But what does this have to do with dietary cholesterol?

Sure, animal studies show that if you feed mice cholesterol, you can accelerate their cancers, “but extrapolation to humans is difficult as dietary cholesterol has limited effects on blood cholesterol levels in humans.” Thus, “dietary cholesterol might [just] be indicative of a lifestyle prone to health-related problems, including cancer.” Maybe people are just more likely to chase bacon and eggs down with a cigarette, compared to oatmeal? It’s hard to imagine how dietary cholesterol alone could promote cancer development. But that all changed recently, with the discovery that 27-Hydroxycholesterol, a metabolite of cholesterol, “can function as an estrogen and increase the proliferation” of most breast cancer cells.

Ah, so it’s not the cholesterol itself, but what it turns into in the body. “Scientists have long struggled to understand why women with heart disease risk factors are more likely to develop breast cancer.” Now, perhaps we know. “The discovery that the most abundant oxidized cholesterol metabolite” in our bloodstream can have estrogenic effects may explain the link between high cholesterol and the development and progression of breast cancer and prostate cancer. Yes, 27-Hydroxycholesterol also stimulates the proliferation of prostate cancer cells, boosting growth by about 50 percent.

I’ve explored before the role oxycholesterols may play in mediating pro-oxidative and pro-inflammatory processes in degenerative diseases, such as Alzheimer’s and heart disease, but now it looks like oxidized cholesterol can play a role in all three stages of tumor development as well: initiation, promotion, and then the progression of cancer. Not just promoting the growth of breast cancer cells, but also inducing their invasion and migration—potentially facilitating breast cancer metastasis through suppressing anti-cancer immunity, and then inducing angiogenesis, helping breast tumors hook up their blood supply.

This is all supported by “several lines of evidence [that point to] a pathologic role” for this cholesterol metabolite. Yeah, you can feed mice cholesterol; their oxysterol levels go up and their tumors accelerate. It “also appears to dramatically hasten the spread, or metastasis, of breast tumors to other organs.” But turning to human breast tissue samples, they found that more aggressive tumors have higher levels of the enzyme that converts cholesterol into 27-HC. In breast cancer patients with estrogen receptor-positive tumors, the 27 Hydroxycholesterol content in their breast tissue is increased overall, and especially within the tumor itself—so much so that circulating oxysterol levels in the blood may one day be used as a prognostic factor. And “breast cancer patients with low tumor levels of [the enzyme] that breaks down 27-HC did not live as long” as women who can detoxify it better. “The bottom line…is that some estrogen-driven breast tumors may rely on 27-HC to grow when estrogen isn’t available.” And that may explain a second breast cancer mystery.

Over 80 percent of breast cancers start out responding to estrogen, and so what we do is use hormone blockers—either aromatase inhibitors to stop the formation of estrogen in the first place, or tamoxifen to block its action. Despite the efficacy of these drugs, many patients relapse with resistant tumors. And that’s where oxidized cholesterol can come in. 27-HC can fuel breast cancer growth without estrogen, which could explain why sometimes these estrogen blockers don’t work.

And finally, 27-HC may explain why breast cancer patients with higher vitamin D levels appear to live longer. Vitamin D supplementation decreases 27-HC levels in the blood. The best way, though, may be to just lower overall cholesterol. Lower cholesterol, and you lower oxidized cholesterol. So, discovering this role of cholesterol is actually really good news, since “cholesterol is a highly amenable risk factor, either by lifestyle, dietary, or pharmacologic interventions.” The implications of these findings, according to the principal investigator, is that “lowering cholesterol with dietary changes or [drugs] could reduce a women’s breast cancer risk or slow tumor growth.”

This study aimed to see if the DASH diet (Dietary Approaches to Stop Hypertension) could reduce the risk of stroke. The main finding of the study was that adherence to the DASH decreased the risk of stroke.