Day 022 - 12 Sep 94 - Page 14

     
     1        there is mounting, though as yet inconclusive, evidence.
     2        They said it may be associated with a lower occurrence.
     3
     4   MR. JUSTICE BELL:  They say, "Obesity is also associated with"
     5         -- you miss out the next words -- "increased fatality
     6        from breast cancer in later life".
     7        A.  Yes, I have already stated that this morning.
     8
     9   Q.   That is for hormonal reasons, the theory?
    10        A.  The theory is that adipose tissue produces oestrogen,
    11        which is a female sex hormone; oestrogen likes substances,
    12        and we know that breast cancer is a hormonally dependent
    13        cancer.  Therefore, this is the assumption.
    14
    15   MR. MORRIS:  Yes, what I am saying ---
    16        A.  It is a theory.
    17
    18   Q.   -- that what they are saying here is that there is an
    19        association, but they are not sure on the exact path
    20        between obesity and cancer.
         A.  That is right.
    22
    23   Q.   They are willing to put their cards on the table and say
    24        there is an association, yes?
    25        A.  Only between gall bladder and uterus and a poorer
    26        outlook in breast cancer.  That is what they are saying.
    27        They are not saying there is an association between
    28        obesity and large bowel.
    29
    30   Q.   No, breast cancer we are talking about?
    31        A.  What they are saying is there is -- people who are
    32        obese and develop breast cancer have a poorer outlook.
    33        They are not saying that obesity is associated with an
    34        increased incidence of breast cancer.
    35
    36   Q.   Maybe it is a matter of interpretation.
    37
    38   MR. JUSTICE BELL:  That is what the sentence clearly says; it
    39        may say more somewhere else there.
    40
    MR. MORRIS:  Yes.
    42
    43   MR. JUSTICE BELL:  How common is cancer of the uterus?  You
    44        said gall bladder is rare.
    45        A.  It is about half as common as cancer of the cervix and
    46        cervix is about a quarter as common as cancer of the
    47        breast.
    48
    49   MR. MORRIS:  Right.  If we move over the page to page 66 we
    50        have The Health of the Nation, figure 11, European Code 
    51        Against Cancer, or "Ten Commandments".  Point 6, for 
    52        example.  On diet they say, "5. Frequently eat fresh fruit 
    53        and vegetables, and cereals with a high fibre content" to
    54        guard against cancer, and, "Avoid becoming overweight, and
    55        limit your intake of fatty foods".  Is that quite
    56        reasonable advice?
    57        A.  I think that is sensible advice in the current
    58        circumstances because, as we have already said this
    59        morning, some studies suggest there might be a
    60        relationship between fat and cancer; other studies suggest