Hot peppers are recommended for breast cancer in moderation
Hot peppers include peppers of many varieties in the genus Capsicum that are characterized by intense heat resulting from their capsaicinoid contents. Examples include cayenne chili peppers, hot chilli peppers, jalapeño peppers, and Sichuan peppers. Also included in this category are hot sauce, chili powder, red pepper flakes and red pepper paste. Not included are black pepper or bell peppers (or other mild or sweet peppers). By hot sauce, we mean supermarket sauces such as Tabasco Sauce and various Louisiana hot sauces, as well as specialty sauces advertised as fiery or hot in which the heat is derived from capsaicin-containing peppers. By chili powder, we mean the common supermarket spice mixture made primarily from the dried, ground fruit of red chili peppers (Capsicum annum L.), as well as specialty chili powders advertised as hot. Hot peppers have been shown to have anti-inflammatory, antioxidant, antiarthritic, analgesic, and antithrombotic properties and may improve cholesterol levels and glucose metabolism and assist in weight loss. Many peppers are good dietary sources of vitamin A and vitamin C.Studies concerning hot peppers, capsaicin and cancer have produced mixed results. On the one hand, capsaicin has been shown to induce apoptosis in several different types of cancer cells and mechanisms have been proposed to explain its apparent anti-cancer activity. On the other hand, capsaicin also appears to act as a carcinogen in some parts of the body.
As noted above, capsaicin has been shown to induce apoptosis or have chemoprotective actions in the laboratory in a variety of human cancer cells, including lung, pancreatic, bladder, colon, urothelial, and prostate cancer cells. Population studies have found hot pepper consumption to be associated with lower risks of lung and liver cancers. The population-based evidence with respect to colon cancer is inconsistent.
Frequent consumption of hot peppers has been found to be associated with esophageal, gall bladder and gastric (stomach and intestinal) cancers in multiple population studies. In Chileans (who have among the highest rates of gall bladder cancer in the world), those with the highest intake of red chilli peppers and a history of gallstone disease have the highest risk of developing gall bladder cancer. One Mexican study found that intake of capsaicin was associated with increased risk of gastric cancer independent of H. pylori infection. Maternal consumption of chili peppers during pregnancy has also been found to be associated with subsequent higher risk for the child of medulloblastoma/primitive neuroectodermal tumor (PNET), a common childhood brain tumor.
Breast cancer-related effects of consuming hot peppers
Capsaicin has been shown to inhibit growth and induce apoptosis in breast cancer cells, including HER2/Neu- and epidermal growth factor receptor (EGFR)-overexpressing breast cancer. Several population studies have found an association between hot pepper consumption and lower incidence of breast cancer.
There is some evidence that breast cancer survivors are at increased risk of developing stomach cancer. Lobular breast cancer survivors in particular are vulnerable to gastric metastases. Women with lobular breast cancer and those with gallstones, as well as pregnant women, should minimize their hot pepper consumption. On the other hand, moderate hot pepper consumption may be beneficial for other women with breast cancer or those at risk. By moderate, we mean modest amounts up to several times per week. Large or frequent meals that have been made very hot by the incorporation of one or more forms of hot peppers are to be avoided, as are capsaicin supplements.
Additional comments
Despite the heat of red chilli peppers, aflatoxin contamination has been found in some samples. Aflatoxins, which are produced by various species of Aspergillus fungus, are mutagenic, carcinogenic and teratogenic and cause immuno-suppression in humans. Aflatoxin B1 has been shown to cause liver cancer, especially in hepatitis B-positive individuals. One study of aflatoxin in Indonesian foods found that peanut-chilli sauces had one of the highest percentages of aflatoxin contamination, indicating that the addition of chili peppers to peanut sauce did not neutralize the aflatoxin. Buyers of hot peppers, sauces containing hot peppers, or hot pepper paste from specialty markets should assure themselves of their safety and quality.
Consuming substantial amounts of hot peppers in any of their forms could interfere with Warfarin (coumadin) and other blood-thinning therapy.
Selected studies
Circulating Carotenoids, Mammographic Density, and Subsequent Risk of Breast Cancer Cancer Research, November 2009The present nested case-control study was designed to investigate whether the association between carotenoid consumption and risk of breast cancer is related to mammographic density. High breast density as measured by mammography has been reported to be a powerful indicator of increased breast cancer risk. The study included 604 breast cancer cases and 626 cancer-free controls in the Nurses' Health Study for whom circulating carotenoid (alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, and lutein/zeaxanthin) levels had been measured and mammograms obtained prospectively. Using a computer-assisted method to determine mammographic density, circulating carotenoids were not found to be associated with mammographic density. However, mammographic density significantly influenced the association between total circulating carotenoids and risk of breast cancer (P heterogeneity = 0.008). Total circulating carotenoid levels were found to be inversely associated with overall breast cancer risk (P trend = 0.01). Among women in the highest third of mammographic density, total circulating carotenoids were associated with a 50% lower risk of breast cancer (odds ratio = 0.5; 95% confidence interval = 0.3 - 0.8). Similarly, among these women, high levels of circulating alpha-carotene, beta-cryptoxanthin, lycopene, and lutein/zeaxanthin were found to be associated with a significant 40% to 50% reduction in risk of breast cancer (P trend < 0.05). On the other hand, no such inverse association was observed between circulating carotenoids and breast cancer risk among study participants with low mammographic density. The authors conclude that plasma levels of carotenoids may play a role in reducing risk of breast cancer, especially among women with high breast density.
Capsaicin causes cell-cycle arrest and apoptosis in ER-positive and -negative breast cancer cells by modulating the EGFR/HER-2 pathway Oncogene, October 2009
The present study was designed to evaluate the impact of capsaicin (trans-8-methyl-N-vanillyl-6-nonenamide) on breast cancer cells in vitro and in vivo. Capsaicin is found in chili peppers and has been reported to have inhibitory effects against various types of cancer cells in the laboratory. In the study, capsaicin was found to inhibit the growth of MCF-7, T47D, and BT-474 estrogen receptor positive (ER+) breast cancer cells, as well as SKBR-3 HER-2 overexpressing and MDA-MB231 (ER-/PR-) breast cancer cells. Growth inhibition was associated with G(0)/G(1) cell-cycle arrest, increased apoptosis, reduced expression of HER-2, and activated extracellular-regulated kinase and cyclin D1. Cell-cycle regulator p27(KIP1), caspase activity, and poly-ADP ribose polymerase cleavage all were observed to increase. Importantly, capsaicin also blocked breast cancer cell migration in vitro. In further experimentation, MDA-MB231 tumors were grown in immunodeficient mice. Capsaicin was found to reduce the size of the tumors in the mice by approximately half without evidence of toxicity. Activation of extracellular-regulated kinase was clearly attenuated in the tumors, as well as expression of HER-2 and cyclin D1. Caspase activity and poly-ADP ribose polymerase cleavage products were heightened in the tumors of mice treated with capsaicin. In addition, capsaicin treatment was found to powerfully inhibit the development of pre-neoplastic breast lesions by up to 80% without any apparent side effects. The authors conclude that capsaicin is a novel modulator of the EGFR/HER-2 pathway in both ER+ and ER- breast cancer cells and has a potential role in the treatment and prevention of breast cancer.
Capsaicin-induced apoptosis in human breast cancer MCF-7 cells through caspase-independent pathway Oncology Reports, March 2009
The present study was designed to examine the molecular mechanism of apoptosis in MCF-7 breast cancer cells caused by capsaicin (trans-8-methyl-N-vanillyl-6-nonenamide). Capsaicin, a type of vanilloid, is a significant pungent component of a variety of hot peppers of the genus Capsicum. Treatment with capsaicin for 24 hours was found to result in dose-dependent apoptosis in MCF-7 cells. After the addition of capsaicin, the levels of reactive oxygen species were found to be lowered slightly in the earlier stage of the treatment. Of note is the fact that an increase of intracellular calcium ion concentration was also detected in the MCF-7 cells. In time course and dosage studies, the mitochondrial membrane potential of MCF-7 cells was found to decline, but this change was not significant. Interestingly, the apoptosis-inducing factor translocated into the cytosol and nucleus from the mitochondria. The authors conclude that capsaicin induces cellular apoptosis in MCF-7 cells by means of a caspase-independent pathway, and that reactive oxygen species and intracellular calcium ion fluctuation has a minimal role in this process.
Gastric malignancies in breast cancer survivors: Pathology and outcomes American Journal of Surgery, March 2009
As the number of breast cancer survivors increases, so does the appearance of second cancers and unusual metastatic patterns. In particular, the study authors and others have noted gastric malignancies in breast cancer survivors. 19,049 breast cancer cases in three regional hospital system cancer databases were reviewed to determine the number, types, and outcomes of subsequent gastric malignancies. Twenty-eight patients developed gastric malignancies after breast cancer, representing 0.15 percent of breast cancer survivors; 82% of these patients had gastric symptoms. Overall survival for this group was 39%. Twenty-four patients had gastric primary malignancies. Four patients had gastric metastases, all had lobular histology in both their primary breast tumors and the metastatic lesions.
Comparisons of food intake between breast cancer patients and controls in Korean women Nutrition Research and Practice, September 2007
The current case-control study was designed to compare the diets of a group of Korean breast cancer patients with a healthy control group. The cases included 97 women with newly confirmed diagnoses of breast cancer at the inpatient or outpatient clinic of Yeouido St. Mary’s Hospital in Seoul, and excluded women with any history of liver diseases, diabetes mellitus, respiratory disorders and cardiovascular diseases. The 97-person control group also excluded women with known malignant, hormonal, gynecological or endocrine diseases. Intake of nutrients in 117 food items were estimated in the breast cancer patients and age-matched healthy controls using a quantitative food frequency questionnaire administered by a trained dietitian. The questionnaire also included general information (age, sex and marital status), age at menarche, and pregnancy history. It was found that the average caloric intake of the breast cancer patients and the healthy controls did not differ significantly. However, the breast cancer patients consumed significantly less fat and antioxidant nutrients such as vitamin A, retinol, beta-carotene, vitamin C and vitamin E than did the controls. Consumption of eggs (p<0.01), legumes (p<0.05), vegetables (p<0.05), seasonings (p<0.001), and oils and fats (p<0.01) was significantly lower in the breast cancer patients. However, the level of energy from fat is relatively low in Korean patients compared to their Western counterparts, and fat consumption may not be an independent risk factor at this level of intake. With respect to particular foods, in addition to eggs, the breast cancer patients consumed a significantly lower quantity of bean curd (tofu), onion, garlic, green pepper, sweet pepper, kale, cucumber, seasoned bean sprouts, sesame leaf, zucchini, radish, mushroom, crown daisy, red pepper paste, bean paste, spicy bean paste, orange juice, grape juice, and tomato juice than the controls. On the other hand, the breast cancer patients consumed significantly greater quantities of cooked rice, noodles, deep fried chicken, satsuma mandarin, Korean melon, kimchi and coffee than the controls. The authors conclude that since the breast cancer patients consumed less soy and vegetables, they had a lower intake than the controls of rich sources of antioxidant nutrients, phytosterols, fiber and non-nutritional components that may reduce the risk of cancer. In addition, the breast cancer patients in this study consumed lower quantities of red pepper paste, bean paste and spicy bean paste, causing their intake of pepper flavonols (which may have a protective effect on breast cancer risk) to be lower than that of the controls.
Effect of spices on lipid metabolism in 1,2-dimethylhydrazine-induced rat colon carcinogenesis Journal of Medicinal Food, Summer 2006
The present study was designed to investigate the effects of red chilli (Capsicum annum L.), cumin (Cuminum cyminum L.), and black pepper (Piper nigrum L.) on carcinogen-induced colon cancer in rats. Colon cancer was induced by injection of 15 doses of 1,2-dimethylhydrazine (DMH) at one-week intervals. The rats continued to be fed with a standard pellet diet, and supplemented throughout the remaining experimental period with one of the following (mixed in the diet): red chilli (0.015% (wt/wt); cumin seeds (1.25% (wt/wt); or black pepper ( 0.5% (wt/wt). After 32 weeks, the incidence and number of tumors in the colon were found to be significantly higher in the rats administered DMH and/or red chillis, compared to those administered DMH and cumin or black pepper. No tumors were found in the control animals that did not receive DMH. The levels of fecal bile acids and neutral sterols in 24-hour fecal samples were significantly lower in the DMH plus chilli group, whereas the excretion of fecal bile acids and neutral sterols was significantly higher in the DMH plus cumin and DMH plus black pepper groups. The authors conclude that chilli supplementation promotes colon carcinogenesis, whereas cumin or black pepper suppresses colon carcinogenesis in the presence of the procarcinogen 1,2-dimethylhydrazine.
