Sunday, 26 August 2012

Rog T's Cancer Blog - Understand your enemy

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 present.

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 know.

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 diagnosis.

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 material".

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.

No comments: