Campbell T Colin
a Division of Nutritional Biochemistry , Cornell University , Oxford , New York , USA.
Nutr Cancer. 2017 Aug-Sep;69(6):962-968. doi: 10.1080/01635581.2017.1339094. Epub 2017 Jul 25.
The role that nutrition plays in cancer development and treatment has received considerable attention in recent decades, but it still engenders considerable controversy. Within the cancer research and especially the clinical community, for example, nutritional factors are considered to play, at best, a secondary role. The role of nutrition in cancer development was noted by authorities as far back as the early 1800s, generally under the theory that cancer is "constitutional" in its origin, implying a complex, multifactorial, multistage etiology. Opponents of this idea insisted, rather vigorously, that cancer is a local unifactorial disease, best treated through surgery, with little attention paid to the etiology and possible prevention of cancer. This "local" theory, developed during the late 1700s and early 1800s, gradually included, in the late 1800s and early 1900s, chemotherapy and radiotherapy as treatment modalities, which now remain, along with surgery, as the basis of present-day cancer treatment. This highly reductionist paradigm left in its wake unfortunate consequences for the present day, which is the subject of this perspective.
近几十年来,营养在癌症发生发展及治疗中所起的作用已受到广泛关注,但仍引发了相当大的争议。例如,在癌症研究领域尤其是临床界,营养因素充其量被认为只起次要作用。早在19世纪初,权威人士就已指出营养在癌症发生中的作用,一般是基于癌症起源具有“体质性”这一理论,这意味着其病因复杂、多因素且多阶段。该观点的反对者则坚决主张癌症是一种局部单因素疾病,最好通过手术治疗,而很少关注癌症的病因及可能的预防措施。这种在18世纪末和19世纪初形成的“局部”理论,在19世纪末和20世纪初逐渐将化疗和放疗纳入治疗方式,如今手术、化疗和放疗仍是当今癌症治疗的基础。这种高度还原论的范式给当今带来了不幸的后果,而这正是本文观点的主题。