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What Are Cancer Signals
During the past twenty years, many strategies have been used for immunotherapy and cancer vaccination with little success. However, the very early detection and prevention of disease are the most promising vaccine. Unfortunately, obsession with curing advanced cancer has preempted the promise of prevention. Many scientists have understood that the onset of cancer, like heart disease, is a gradual stepwise process that may un-fold over decades, rather than a single identifiable event. The formation of cancer cells usually involves the prolonged accumulation of injuries at several different biological levels involving both genetic and biochemical changes in cells. At each of these levels, there is an opportunity for intervention, a chance to prevent, slow down or even halt the process towards cancer formation. Noting the success of cardiovascular intervention strategies in reducing deaths from heart disease, a revision in cancer signal detection that would emphasize the disease's beginnings rather than its terminal stages is long overdue.

Realizing the importance of cancer prevention, we have begun to apply molecular techniques to look for biomarkers capable of signaling a greater risk of cancer. It is possible to attain relatively quick answers by monitoring selected signs and damage in the body, which improve the environment for abnormal cell growth and differentiation. These molecular techniques aim to uncover critical pre-cancerous events taking place inside the body and identify measurable biological flags signaling their occurrence.

Biological Markers
Measurement of the biologic markers such as DNA and protein adducts, DNA damage, programmed cell death, DNA repair system, cell mitosis, gene activation, levels of antioxidants and efficient immune function are biological clues indicating that the body has been assaulted by toxic or cancer-causing agents. This early detection of selected signs of precancerous damage in the body can provide clinicians with these clues in order to attempt the use of natural and synthetic compounds to intervene with disease development. 

The power of this approach is sure to grow as re-searchers continue to identify promising new chemo prevention agents and clinical trials begin to provide insight into these substances' effects in humans. With the advancement of these investigations and our greater understanding of cancer, chemo prevention will undoubtedly play a major role in reducing cancer incidence as well as the number of deaths caused by the disease. 

Beyond genetic susceptibility, scientists are searching for markers of acquired vulnerability to carcinogenic agents. The likelihood of tumor development is increased by impairment of the immune system and by imbalances of apoptosis and mitosis.

Apoptosis (Programmed Cell Death)
Apoptosis and cell proliferation play an important role in tissue development, differentiation, homeostasis, and aging. The balance established between these two processes depends on a variety of growth and death signals, which are in turn influenced by diet, nutrition, lifestyle, and other environmental factors. When the equilibrium between life and death is disrupted by aberrant signals (for example, lack of antioxidants in the bloodstream or tissue cells), either tissue growth or atrophy may occur. 

Under normal conditions with optimal nutritional factors, tissue homeostasis is sustained by balancing the ratio of mitosis and apoptosis. During viral or chemical exposure and in preneoplastic tissue, the number of cells undergoing apoptosis increases, possibly to compensate for an increase in proliferation. As the cell loses functional tumor-suppressor genes (the P53), the propensity to undergo apoptosis decreases and the population of tumor cells grow.

Natural Killer (NK) Cell Cytotoxic Activity
The Natural Killer Cell (NK) is one of the most important soldiers (lymphocytes) in our body. It has the ability to defend us against a variety of human diseases. Abnormal or absent natural immunity, as measured in vitro by decreased NK activity and /or depressed absolute numbers of circulating NK cells, has been linked to the development and progression of cancer. It has also been linked to chronic and acute viral infections, including the acquired immunodeficiency syndrome (AIDS), chronic fatigue syndrome, psychologic dysfunction, various immunodeficiencies and certain autoimmune diseases.

Recent evidence indicates that NK cells are involved in multiple effect or, regulatory and developmental activities of the immune system and that deficiencies or abnormalities in NK cell may con-tribute to, or be a biological marker for disease. For the above reasons, it is important to reliably detect abnormalities in NK cell function and monitor prognosis of chronic illnesses after therapy with biological response modifiers or other agents.

Low NK cell activity due to stress or antioxidant deficiencies may contribute further to this mitosis and apoptosis imbalance, which results in additional tumor cell growth.

The Importance of Diet
Convincing evidence also indicates that a diet low in fruits and vegetables containing antioxidants and other nutrients (such as Vitamins A, C, and E) in-creases the probability of acquiring diverse cancers, including lung, esophageal, oral, laryngeal, cervical, and breast. Through a variety of mechanisms, antioxidants can block oxygen radicals, polycyclic aromatic hydrocarbons (PAHs) and other chemicals from damaging DNA and prevent tumor development.

Genetic Traits
Molecular epidemiology promises to refine estimates of cancer risk greatly by considering variation in innate and acquired susceptibility within a population. However, in most cases, calculations of risk based on single genetic characteristics will be incomplete and could even be misleading. The effect of any one, subtly acting gene can be modulated by environmental influences, by other genes, by health and nutritional status, and by an array of other host characteristics. To add to the complexity, certain genetic traits may protect against one type of cancer but may predispose to another (N-acetyl transferase A-phase-2 detoxification enzyme, for example, detoxifies bladder carcinogens but activates colon carcinogens). But assessment of multiple traits, combined with biological assessments of exposure and early damage, should eventually yield meaningful estimates of risk.

The Onset of Cancer
Selection of various traits and biological flags which may indicate early cellular damage are based on the following chain of events:

1. Carcinogens react with DNA or protein, form DNA adducts, and may cause DNA damage and mutation.
2. Carcinogens, by induction of DNA damage and mutation, convert a benign gene to a cancer causing one.
3. The mutated cancer cell starts to grow and differentiate in a very abnormal fashion until detectable disease appears. 

These, along with inefficient detoxification of carcinogens, low levels of antioxidants (intracellular and extra cellular), abnormal DNA repair system and inefficient natural killer cell activity (lack of recognition of malignant cells), further increase the likelihood of tumor development (see Figure). By detecting such abnormal markers laboratories may be able to identify groups or individuals who most need preventive interventions. 

For this purpose, different biological response modifiers, antioxidants, growth hormones, cytokines, plant extracts, and a variety of drugs, which reduce oxidative stress, may be recommended.

Conclusions
In summary, we firmly believe that:

1. By selecting and monitoring signs and dam-age in the body, it is possible to improve and pre-vent the body’s environment that prepares the ground for abnormal cell growth and differentiation which is the very first stage of cancer in the body.
2. By heeding dietary and healthy lifestyle advice and taking extra amounts of supplements containing antioxidants, it is possible to reduce chronic "messing up" of our DNA by toxic chemicals and prevent a significant number of cancers.
3. The concept that people with cancer are healthy until a doctor tells them that they have an invasive lesion makes no sense at all. And only a few in the oncology community who believe in chemo prevention, are doing something to change that viewpoint.

Test results are for physician use only.