Dr. Peter H.R. Green: The Relationship of Malignancies and Celiac Disease

Peter H.R. Green, M.D. is the author (with Rory Jones) of the book “Celiac Disease A Hidden Epidemic”. He is also the director of the Celiac Disease Center at Columbia University.

I’ve posted other blogs with exerpts from his book (here and here).  Here is a new one regarding cancer and celiac disease. 

High risk malignancies for patients with celiac disease include:

1. Thyroid cancer
2. Adenocarcinoma of the small intestine
3. Lymphoma
4. Esophageal cancer-mainly squamous
5. Melanoma
6. Malignancy in childhood

What is the risk? 

1. Long-standing celiac disease.  The greatest risk for malignancy is before a patient is diagnosed, expecially if the patient has long-standing celiac disease.
2. Believing you have “outgrown the disease.”  Celiac disease is a lifelong illness.
3. Not adhering to a gluten-free diet.  The continuing ingestion of gluten – i.e., noncompliance to the diet, either intentional or unintentional – is the major risk factor for malignancy.

Question:  What will happen if I eat one slice of pizza?  Answer:  You will rev up your immune system and no one knows the exact results of this.  It may make getting better difficult or impossible.  If you have one “hit” of gluten – as small as one-eigth teaspoon — you are going to get an inflammatory response and immune reaction that lasts a certain period of time — the half-life of the inflammatory mediators.  In other words, the inflammatory response and white cells called into the area will be active for a period of time and then fade off.  With persistent “hits” of gluten, the inflammation and response never fade and the intestine never has time to heal.

A gluten-free diet is considered protective against the development of malignancy.  While there is no evidence that a gluten-free diet will cure an established cancer, persistent gluten ingestion is one of the risk factors and may affect healing.

The risk factor is reduced after three to five years on a gluten-free diet, except in the case of non-Hodgkin’s lymphoma.  There, the risk persisted in several studies despite the gluten-free diet. 

Dr. Green has much more regarding celiac disease and malignancy in his book.  I’ve only shared part of it.  You can purchase his book at your local book store or at Amazon.  I recommend the book for anyone with celiac disease as an excellent resource for any questions you may have regarding the disease.