For those of you who are regular readers and have read the previous posts on Cancer, you can skip this first paragraph.This is the latest installment in my occasional series about how I'm adjusting to living with a big C in my life. For those of you who aren't, here's a quick summary. I'm 50 years old and I last year had a prostate biopsy following two "slightly high" PSA tests - 2.8 & 4.1. The biopsy took ten tissue samples and one of these showed a "low grade cancer" which gives me a 3+3 on the Gleason scale. I'm now on a program of active monitoring. In early February, I got the results of the latest PSA test - down to 3.5 and an MRI scan which found absolutely nothing. I've no symptoms and sadly for a few people, if I'm gonna die soon, it won't be from Prostate cancer. Got the picture?
This blog is in effect Part II of the blog posted yesterday. That dealt with my feelings towards cancer from a mental and spiritual level. This blog deals with my attitude to the disease from a practical point of view and addresses my current strategy for dealing with it.
My father was an officer in the Royal Australian Air Force
during the second world war. He flew Wellington bombers, which at the
time were virtually obsolete in the North African and European
campaigns. He flew 40 missions and was shot down on the last mission of
his tour. He served time as a prisoner of war, then lead a successful
mass breakout from the camp in Bucharest.
When I was a small boy, he'd impart all manner of useful
information to me. How to make molotov cocktails, how to make nitro
glycerene, how to booby trap a door, how to write letters in secret
code, how to plan an escape from prison and how to disable a vehicle.
Fortunately, I've not had much need to call on these skills. My father
impressed the need to always understand your opponent, their strengths,
their weaknesses. He was rather keen on the story of Achillies, the
mythical greek figure, who was made invulnerable by being dipped in a
magic river. Unfortunately, where his mother held him, he had a weak
point and this was his undoing.
What has all of this got to do with cancer? Well as I see it as
my adversary, I followed my fathers advice. To fight something, one must
understand what you are fighting. As I've mentioned, I've been reading
everything I can on the subject. During my recent break, I picked up
perhaps the definitive book on the history of the disease "The Emperor of all Maladies : A biography of cancer" by Siddhartha Mukherjee.
Dr Mukherjee is a doctor working in the field of cancer research and
his book chronicles mans struggle against the disease over the years. It
is not an easy read, but as our struggle is not easy, it is worth the
effort. Of all the books I've read on the subject, there are only two
I'd say should be mandatory reading. This is one, and the other is "Anti cancer : A new way of life" by David Servan-Schrieber.
Both books are written by medically qualified doctors. Both will
increase your understanding of cancer immeasurably. They are however
very different. I read Anti Cancer first. I would suggest that you
actually read "The Emperor" first as I see "Anti Cancer" as part two,
filling in the holes Dr Mukherjee left out.
I don't think it would be possible to sum either book up
adequately in a blog, especially if you are a dyslexic punk rock
guitarist like me. But I will try. Perhaps the most interesting fact I
learned from Dr Mukherjee's book is that a cell becomes cancerous
following repeated mutations. Although cells can have thousands of
mutations without becoming cancerous, it appears that there are 13 or so
genes that if these mutate, the cell behaviour will change and
cancerous behaviour will start to occur. This behaviour involves some
genes being switched on and some being switched off. The genes which are
switched off are ones telling the cell when to die. The ones switched
on are the ones telling it to divide. These genetic changes are caused
by all manner of things, radiation, viruses, stress, exposure to
carcinogens and other processes which we don't fully understand at
There are also other factors to consider such as the bodies own
immune system and defences. These are designed to protect us against
rogue cells and threats. Cancerous cells subvert this process for their
own ends, once established. The book also details the history of the
treatment of cancer. I hadn't realised it, but the development of
chemotherapy started with the treatment of leukemia, as this was the
only cancer where you could actually measure the effects of treatments,
as you can count the number of cancerous cells in the blood.
The book explains the difficulties of treating cancer and how it
is an elusive foe, which has the ability to move around, hide and change
form. The book also explains the genetics of why some people are more
predisposed to cancers than others. Unfortunately some of us already
have some of the cancer forming genes activated (or de activated in some
cases). That means that far fewer other mutations need occur within
cells to trigger the outbreak of the disease.
What the book doesn't really help with is what us as victims or
potential victims can do to improve our chances of survival. This is
where "Anti Cancer" comes in. "The Emperor" lets us understand what we
are fighting. "Anti Cancer" gives us the tools and personal strategies
to improve our chances. It does not claim to be a cure or even a
prevention. What it does is it says "if you change your lifestyle
accordingly, you will increase your chances of survival if you have
cancer, and lessen your chances of contracting the disease".
The book looks at various studies into foods, exercise regimes
and de stressing regimes and their effect on the progression of the
development of cancers. The book looks at populations where cancer is
less prevelant and seeks to understand the factors that contribute to
this. It looks at studies into foods and drinks which seem to have a
beneficial effect. The book looks at the bell curve of survival. It says
"if the average survival rate for the cancer you have at the stage you
have it, is one year, that does not mean you have one year to live. It
means you may have a week, you may have two years". It says that for
such a prognosis, living two years in stead of one year is a good
result. Living three years is an even better result and so on. It looks
at ways to make your body more resilient.
"The Emperor" describes how as we age, our cells go through
successions of mutations. Most of these are harmless, but there are
thirteen or so, which seem to be ever present in cancerous cells. As an
example, smoking causes more frequent mutations in the lungs, therefore
smokers develop cancer more regularly than non smokers. This
relationship is well recognised and understood by the medical
profession. It is not so well understood by the man in the street. How
many of us realise that every time we smoke a cigarette, we stress out
the cells in our lungs. Every so often, one of these cells will mutate
and the more we smoke, the more likely they are to mutate. In effect, we
are rolling the dice every time we smoke. If we get three sixes, we get
a mutation. If that is one of the thirteen, it may be the one which
switches us on to lung cancer.
What "Anti Cancer" says is that if you don't want to get cancer,
you remove as many things as possible from your life which cause cancer.
It also says that you avoid things which cause inflammation, as this
feeds cancer. This means avoiding such things as Palm oil, which is high
in omega 6 oils, which promote inflammation. At the same time, taking
foods and drinks high in antoxidants which have been shown to slow down
the mutation rate. It also recommends exercise and relaxation, which
have been shown to have a beneficial effect on stress levels. Lowering
stress levels has been shown to be good for the immune system (as does
eating a well balanced diet).
The message is a sombre one in many ways. You can't completely
remove your chances of developing cancer. If you have it, you may be
able to increase your chances of surviveability by diet, exercise and
relaxation. "Anti Cancer" also stresses that you should work with your
doctors in your strategy, as the graveyards are full of people who have
ignored them and simply "gone organic" or followed charletans.
In my experience, the doctors will nod in a patronising manner
and say "well it won't do any harm and if it makes you happy it is not a
bad thing". For me, that is the most infuriating thing. I may be wrong,
but I get the feeling that they are not at all interested in lifestyle
changes as part of the strategy of survival. One of the most disturbing
things in "The Emperor" is the way different medical disciplines do not
work together in the fight. I think that every cancer victim in the UK
should be given access to nutritionalists familiar with the current
thinking on anti cancer strategies. With the internet, we have a huge
resource, where we could soon spot statistical trends for people
following "anti cancer diets".
As an example, I drink at least five cups of green tea a day, a
glass of pomegranite juice, I avoid dairy products and try and eat
tumeric and cooked tomatoes every day as these are recommended. If my
PSA levels and those of people in my position were measured against
those who do nothing, over 10-20 years, we could be in a position to see
whether my efforts were worthwhile and should be recommended as a
strategy. As no one has even bothered to ask me, no one will ever really
I have mentioned my friend Paul, who died of cancer in April, on
many occasions. Paul submitted himself to every medical treatment on
offer, but adopted none of the strategies advocated by the "Anti Cancer"
book. I cannot help but wonder, what would have happened had he chosen
to? I can never know, but as I mentioned, it is a cause of guilt for me
that I didn't try and persuade him to go down this route.
For most of the last months of his life, Paul survived on
milkshakes. These are high in calcium, which the books I've read seems
to indicate plays a big role in the formation of tumours. Paul carried
on smoking. The "anti cancer" book says "cut out the carcinogens". He
didn't drink the green tea and eat the cooked tomatoes. I can't say
whether he'd have lived a single second longer, if in April 2011, he'd
been advised to do all of these things and stuck religiously to the
advice. When Paul got his diagnosis, I was unaware of all of these
things. I only started to learn in November 2011, when I had my own
I still do some things which are "pro cancer". I probably drink
too much. I love barbeque'd food. I probably have slightly too much
processed meat and red meat (although I'm not sure what I can get away
with). There are other foods which I'm not even sure I should avoid. A
cancer nurse suggested avoiding eggs, so I have. My wife bought a
"prostrate cancer healthy cookbook" which makes no mention of eggs being
bad and includes recipes with them in. The nurse told me that eggs
contained high levels of hormones which could promote tumour
development. I've not seen much mention of this elsewhere in credible
I am near the start of my particular journey. I have much to
learn. My guess is that the majority of people who specifically read
these cancer blogs, either have the disease or know someone who has. The
thing which upsets me most of all, is that I believe that this should
be taught in schools as part of the sylabus. Many people know of the
government advice to eat five portions of veg a day. Most people don't
really know why. The reason most people don't is because they are a
little bit lazy. Processed, prepacked meals are less bother. I actually
thought I was living a healthy(ish) lifestyle before I was given my
diagnosis. I was shocked to find out how many things were bad for me.
Perhaps the oddest side effect of the new diet and the new regime
is my relationship with alcohol. With my new diet, I no longer get
hangovers. I suspect that cutting out much of the fat actually allows my
body to process alcohol more efficiently and better. I had a fair
skinful last night, but awoke feeling fine.
It is an odd thing to say, but I am pleased I was given my
diagnosis. I am pleased I had the PSA test, the biopsy and was given the
chance to address the issue. I hope the strategy I've adopted is the
right one. Even if it isn't it makes me feel stronger, which can only be
a good thing.