Two stages of cancer prevention with green tea.

Cancer chemoprevention is a new and important medical science in its own right. On the occasion of my presentation entitled "Natural agents and cancer chemoprevention" at the 90th AACR Meeting in 1999, I summarized our recent results on cancer prevention with green tea. In this article, the present status of clinical trials supported by the Chemoprevention Branch of the National Cancer Institute in the United States is first described by way of introduction. Although various natural products are now under investigation in phase I clinical trials, green tea has, perhaps, the greatest potential for further development. In order to expand our understanding of the effects of tea polyphenols and green tea, I review their ability to inhibit growth and cause apoptosis of cancer cells, their distribution into target organs and their other cancer-preventing properties. In addition, the paper focuses on the significance of reducing tumor necrosis factor alpha (TNFalpha) gene expression in cells and TNFalpha release from cells as essential activities for cancer prevention. As for the amounts of green tea effective in cancer prevention, I present two results from our Research Institute: a prospective cohort study with over 8000 individuals in Saitama Prefecture revealed that the daily consumption of at least ten Japanese-size cups of green tea resulted in delayed cancer onset, and a follow-up study of breast cancer patients conducted at our Hospital found that stages I and II breast cancer patients consuming over five cups per day experienced a lower recurrence rate and longer disease-free period than those consuming fewer than four cups per day. Thus, I propose here, for the first time, the two-stage approach to analyzing cancer prevention with green tea: cancer prevention before cancer onset and cancer prevention following cancer treatment. As an additional example of cancer prevention with natural agents, kava, a daily beverage in Fiji, is mentioned. All the evidence reminds us of the significance of alternative medicine in practical cancer prevention.