It’s been a while since I last posted, mostly because real life has moved to the foreground again. I’m back at work regularly, and my days are once more filled with actual science, plus the usual mundane details: getting service contracts for instruments approved, making sure that my students are able to go to the right conferences, putting together documents for upcoming grant submissions. Meanwhile, and somewhat to my surprise, I’ve become something of a go-to person for cancer-related questions. This is both good and bad.
Good, because I get a lot of satisfaction from believing that my experience — and by extension, this blog — may make things easier for other people. Bad, because cancer talk is exhausting, and it strains my newly-developed protective mechanisms when discussing other people’s health issues.
For those readers interested in preventing cancer or doing one’s utmost to fight it, I refer them to a new book that just came out titled “After Cancer Care” by Drs Lemole, Mehta, and McKee. Their basic premise is that if you were unfortunate enough to have a heart attack in the United States, you would leave the hospital with appointments to meet a nutritionist, a physical therapist, etc…, all covered by insurance. And after a generation of experience, we’re certain that compliance with these programs significantly decreases the chances of having a second heart attack.
In contrast, when cancer patients go into remission (or in my case, complete their first line treatment), you’re sent home with an appointment in 3 or 6 months later to run some tests to see if the cancer has come back. This isn’t a very productive arrangement, which almost seems designed to increase a patient’s anxiety. A theme throughout my blog has been that I don’t want to sit around waiting for this tumor to come back: I want to improve my odds as much as possible.
This book in many ways is the academic, professional version of my blog, with detailed and well-researched advice on nutrition, nutraceuticals, exercise, and stress-management techniques. I found it extremely helpful, although occasionally the advice got over-board and evangelical. You would need some pretty convincing evidence before I throw away my non-stick pans, or tear up my wall-to-wall carpet, just because these products may release chemicals that may increase inflammation that may promote cancer growth.
Nitpicking aside, it’s a fine book, and I’m 100% behind their basic impulse. That is, how can we fight most effectively against cancer with simple, easy to implement lifestyle changes? Unlike some other cancer books I’ve read, the patient stories are all generally positive and encouraging, which is another big plus.
What do survivors have in common?
Another theme running through this blog is a general reverence for long term cancer survivors, and a scientific attempt to identify the common strategies, mindsets, and approaches that are most successful. The authors share my interest in this theme, and cite a study by Kelly Turner, published in Radical Remission, which analyzes over 1,000 cases of statistically improbable positive clinical outcomes among cancer patients. She finds a number of common themes, including:
- Radically changing your diet
- Taking control of your health
- Following your intuition
- Using herbs and supplements
- Releasing suppressed emotion
- Increasing positive emotions
- Embracing social support
- Deepening your spiritual connection
- Having strong reasons for living
My prognosis in the grand scheme of things is quite good, and I don’t think I need a statistically improbable outcome to have a happy ending, but still, this seems like a pretty good playbook. Or, mixing my metaphors, it always helps if you can stack the deck (hat tip to my friend John).
I’ve gone pretty much vegetarian at this point, except for a moderate amount of fish and pork, so as to not offend my wife’s Chinese sensibilities. Simple sugars and high glycemic loads have been entirely eliminated. Also, there’s a neat literature emerging that the diabetes drug metformin is protective against brain tumors. I’m not ready to start taking it off-label, but I have arranged my meals so as to minimize blood sugar variance as much as possible. Tumor cells thrive on high sugar diets, and many tumors including glioma can use insulin as a growth factor, so intuitively sugar level spikes and insulin spikes should be avoided. We’ve also cut out all processed meats and processed foods in general. Alas, my daughter Quinn, the carnivore, has suffered most of all. She misses her breakfast sausage dearly.
Taking control of your health:
Loads of examples from this blog to support this idea, but probably most obvious is that I work out 2-4 times per day now. No one has the slightest clue what the best dosage of exercise is for cancer patients, but my reasoning is that its advantage comes largely from (1) mobilizing immune cells, (2) encouraging them to communicate and survey the relevant tissues, (3) minimizing pockets of hypoxia and inflammation, and (4) simultaneously controlling blood sugar levels. I may not be completely right, but I don’t think I’m going to be very far wrong on this one when all is said and done.
In any case, my hypothesis is that it’s advantageous to workout in multiple, short bursts to get your heart rate up, dilate your vessels, and nudge your immune cells along. To this end, I get into the pool at UMSL at every opportunity, and I splurged and started using a Concept2 indoor rower at home. They have an active online community and prizes for users that reach 1, 2, 5 million meters rowed, etc. I’m currently at 231,069 meters rowed since July, and I’m hoping to join the million meter club before the one-year anniversary of my diagnosis in mid-April.
Following your intuition:
I’m not completely sure what the authors mean by this, but I note that within minutes of hearing my diagnosis, I was recording a voice memo for Carolyn promising her that I would stay positive and upbeat and do everything humanly possible to survive this. This is the essence of my overall anti-cancer strategy, and I think most fair observers would consider this to be an intuitive response, since it certainly wasn’t detached, analytical, or based on empirical data.
Using herbs and supplements:
Ganoderma, baby aspirin, loads of green tea and turmeric, melatonin, etc. I’m all over this one. The interesting question is whether the herbs and supplements are the key, or whether the mindset that seeks out alternative and complementary treatments is the real advantage.
Releasing suppressed emotion:
The blog has been extremely useful for this, whether it’s getting over the nightmare that was graduate school, or airing out morbid intrusive thoughts, or helping well-wishers understand the right way to approach cancer patients.
Increasing positive emotions:
This is similar to the one immediately above. I note that a recurring theme of this blog is the list of fourteen essential goals I set out as a counter-balance to bad thoughts. Presently, three of the fourteen have been accomplished, although I expect that number to increase in the short term.
Embracing social support:
Deepening your spiritual connection:
Meditation / visualization has been remarkably valuable, and if some authority were to promise me that cancer was gone and would never return, I would continue meditating three times daily, like I am now.
Having strong reasons for living:
The Simontons say that every cancer patient claims to have strong reasons for living, but not all of them act like it. When I first read that, I was dismayed and asked myself whether I was fooling myself that I had a strong will to live. After almost six months, I think the verdict is in, and yes, I am acting like I have strong reasons to live.
The key, outlined in After Cancer Care, and exemplified in the list of nine common traits of successful cancer patients is establishing some sort of control over your situation. You can’t change your diagnosis or your tumor genetics (and it’s counter productive to ruminate on either of those points), but there are many things you can do to improve your odds. For me, simply having something I could actively do to help myself was a turning point in my outlook on cancer.
For those readers interested in these sorts of issues, I strongly recommend After Cancer Care. In part, this is the book I wish someone had put in my hands the day I was diagnosed. On the other hand, I’ve always had to learn things the hard way, so perhaps there was value for me in figuring all this out on my own…