Cancer is the big scare everywhere across society and the scare gets bigger the older one gets.  Depending on  who you listen to, between 30 and 60% of cancers could be prevented by diet and lifestyle, that is : don’t smoke

: don’t drink too much alcohol, preferably none, but at least no more than a couple of drinks/day  with  two days no drinking per week

: exercise twenty to thirty minutes/day where your heart rate is elevated.  Just brisk walking will do it, but not wandering around the office for a couple of minutes at a time!

: reduce  intake of meat, dairy and fish as far as you can manage

: increase intake of whole fruit, vegetables, whole grains and beans as far as you can manage

: don’t eat junk or processed food, that is take away or food like substances that make up most of the aisles in the supermarket.  Processed food to me is anything made in a factory, with lots of ingredients.

: maintain a healthy body weight: that is a Body Mass Index of 25 or less.  This will probably seem thin to you as our perceptions of what is normal body weight is growing as the size of the  waistline of most people is growing.  There are attempts to sugarcoat being overweight as being ok.   The bottom line is on a population basis, the more weight we carry, the greater our risk of getting cancer (and diabetes and heart disease and stroke and respiratory  illness and arthritis and other joint problems and so on!)

The great thing is if we change our diet to a diet that decreases our chances of getting cancer we get to eat food that looks like this!

Rather than foods that look like this:

And we know that besides tasting great every mouthful of the top picture is doing us good and every mouthful of the bottom picture is increasing our chance of getting sick, reducing our quality of life and dying before we should.

The American Institute of Cancer Research ten recommendations for cancer prevention are:

Recommendations for Cancer Prevention

These ten recommendations for cancer prevention are drawn from the WCRF/AICR Second Expert Report. Each recommendation links to more details. (go to the American Insitute of Cancer Research to be able to get the links)

1. Be as lean as possible without becoming underweight.
2. Be physically active for at least 30 minutes every day. Limit sedentary habits.
3. Avoid sugary drinks. Limit consumption of energy-dense foods.
4. Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.
5. Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats.
6. If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day.
7. Limit consumption of salty foods and foods processed with salt (sodium).
8. Don’t use supplements to protect against cancer.
9. * It is best for mothers to breastfeed exclusively for up to 6 months and then add other liquids and foods.
10. * After treatment, cancer survivors should follow the recommendations for cancer prevention.

*Special Population Recommendations

This is not the advice of some crazed fringe vegan but mainstream health promotion.  Why are they saying this?  Because the science is saying it and has been for 30 – 50 years.    All that is happening now is that the mechanisms as to how eating more plants and less animal products actually work, in terms of reducing our risk of cancer and other diseases is becoming clearer.   This is where things can get very confusing and their can be claim and counter claim.  As Dr John McDougall says, ” what do we care about the intricacies of the mechanism or the pathway?  Tell us what works”    One of Dr McDougall’s favourite sayings is, “Its the food!”

There is agreement on these broad mechanisms in relation to why eating animals  and animals products increased our risk of cancer and why eating more whole plants decreases our risk of getting cancer  which may be of interest:

• animal foods increase inflammation in our body and plant foods decrease inflammation.  We are all producing cancer cells all of the time, but for them to grow into a problem, these cells need nutrients and therefore a blood supply.  One of the functions of inflammation is to bring a supply of blood.  We want to have the lowest level of inflammation in our bodies consistent with good health
• we have heard a lot about protein over our life.  One of the avenues being explored for treating and preventing cancer is the  restriction of two animo acids which are found in high concentrations in animal products and in lower concentrations in plants.  These animo acids are methionine and leucine.
• Animal products have hormones in them, the same hormones we have as we are animals.  These hormones can promote growth and cancer as we know is runaway growth of cells.  Two hormones implicated in this are Insulin growth factor 1 (IGF-1) and  oestrogen.  This is where milk,  cheese and yoghurt are such a problem as dairy cows are kept permanently pregnant to increase their milk production meaning there is elevated levels of oestrogen in the milk.  Increased oestrogen contributes greatly to increased risk of breast cancer.

MISINFORMATION

Instead of the clear and simple steps that anyone can take as outlined above that are set out by the American Institute of Cancer Research the information in media here in Australia, in relation to cancer consists of misinformation.  The main messages are:

• screening (this link is to a brilliant interview with Peter Gotzschke founder and director of the Cochrane Collaboration, which is the most respected voice in relation to best practice in the medical field-if you don’t look at another link in this blog, look at this one) is crucial-notice it is not one of the preventative measures listed by AICR.  It could be argued that screening is not prevention but early detection, but screening is heavily promoted in Australia as prevention of dying of cancer.    There is a  growing appreciation that for many cancers screening does more harm than good (anxiety, false positives, finding cancers that are not a problem, unnecessary treatments, complications and known negative outcomes from treatment)
• Cancer is  a mystery but a solution is just around the corner-it is a long corner- it has been coming for 20-30 years and we still haven’t got around it yet!
• genetics will solve the problem.  The genetic pathways are not that specific and there are multiple associations with different parts of genetic material, making targetting pathways not realistic.  Our genetic instructions don’t work like the water supply to our house, where you can turn off the tap or put a stopper in a pipe and that’s it- no more water.   The genetics, the expression of those genes and the multiple pathways of that expression, mean that there are multiple ways to get to the same destination.  This multiplicity and complexity is not well understood even by the experts!
• drugs are the answer and  the next big breakthrough with a drug is just around the corner

This misinformation leaves people feeling frightened and powerless and a bit like the song, Cancer by Joe Jackson, with the lyric, “everything gives you cancer, there’s no cure, there’s no answer”.

This misinformation leaves people thinking, “why do anything as there is nothing you can do”.    In fact there is plenty you can do.  A cancer diagnosis is not just bad luck,  there is a 30-60% chance it is a result of misinformation.

Cigarette smoking is an example of  what can be achieved by governments through price and  information campaigns.    Where is the campaign around red meat consumption?  Where is the  campaign around processed meat consumption?  Where is the campaign around dairy?

The health and well being of the population doesn’t matter, well at least not more than votes!

IS MEDICAL CARE PALLIATIVE CARE?

The  definition of palliative care in Oxford dictionary.

“Relieving or soothing the symptoms of a disease or disorder without effecting a cure.”

This is essentially what modern medicine is: a misguided attempt to “relieve orsoothe the symptoms of a disease or disorder without affecting a cure”. Why misguided?   Misguided, as medical treatment doesn’t go to the cause of the problem: the food we eat.   Misguided, as it is obvious that erecting a fence at the top of the cliff, is better than having teams of ambulances and paramedics at the bottom to take away and treat the injured, who are repeatedly falling over the cliff.  Even better than the fence, of course, is promoting our sense of balance and care for our life, so that we don’t fall over the cliff.

For us to feel a sense of balance and care for our life, we have to feel that we have power to influence what is going to happen. Unfortunately, more and more of our life is being taken into, the realm of experts. I have seen this within my own field of social work, where like all fields there is the imperative to follow ‘best practice’.  Unfortunately best practice in my field, just means saying, ” I am practicing motivational interviewing and cognitive behaviour therapy.”   Putting aside the question as to whether there is any evidence, that these therapeutic models are any more effective than any others, there is no need within my field, to establish proficiency or training in these models, to make the claim that the practitioner is engaging in best practice.  I would contend, that there is no evidence that these models are any more effective than others, due to the problem of research bias. The more something is researched, the more it gets researched, in a self perpetuating cycle. The other thing that has been happening in social work and many fields, is the standardised, technological response. This is elevating the social worker to the position of expert, who diagnoses the problem and applies a dose related intervention. This sounds a lot like the medical model doesn’t it! This is because lower status professions attempt to gain ground by mimicking higher status professions, like medicine.

On the Health Report, on Radio National, I hear discussions about ‘shared care’. This is the way medicine should be done and I am sure many medical professionals are doing this, but unfortunately there are many barriers from the patient’s side and the Dr’s side. Shared care is about the Dr or health professional sharing power and information and having an open discussion about the costs and benefits of each course of action, taking into account the patients particular values and goals.

My experience of Drs is thankfully limited, as fortunately through genes, good management and probably good luck as well, I don’t get sick.  Unfortunately, even from my limited experience, I have examples of the opposite of shared care. Thirty odd years ago, after my wife died of a heart attack, I naturally had a heightened concern about heart attack!   I spoke to my Dr about the Pritikin Diet, a diet which has now been proven, that if followed, would reduce heart attack dramatically. His response? “That is too extreme, no-one will ever stick to it”. This attitude continues to be one of the reasons large numbers of people die unnecessarily.   When asked why they don’t talk to patients about eating less animal products and junk food and more beans and vegetables, they often say, “people won’t do it”.    Yet Drs will talk to people about giving up smoking and cutting back their alcohol.   Somehow food is a no go zone.  One of the “pleasures” of life that can’t be messed with.

In relation to my Dr thirty years ago, saying people won’t stick to it, I have been sticking to it for the last 12 years! The phrase “sticking to it” is actually unhelpful, as it implies it is something that has to be endured. To the contrary, I have found it highly enjoyable, for the same reasons many other people, also find it highly enjoyable.

That is, it not just that I don’t get sick, I feel well: high energy and feel alive. I am making the diet more ‘extreme’ all of the while. As mentioned in a previous blog, I have recently dropped oil of any kind from what I eat.

At first sight, what I eat would seem extreme to many people.   As Dr Caldwell Esseltyn says, “how extreme is it to have your chest sawn open?”, which is the other likely option. Heart disease can be prevented and reversed with a whole foods plant based diet. 

My recent experience on the periphery of my mother in laws journey with lung cancer, is that there were examples of shared care and there were examples of more traditional medical care: that is we know what’s best for you, you will be the passive recipient of our treatment and we won’t talk to you about the downsides of any treatment that we decide to give you.

This is the other reason that medical care as palliative care is misguided: there are always downsides to any treatment. There is also a general progression: treatment leads to more treatment, drugs lead to more drugs.   In an ideal world, we would be active consumers of medical care, like we are in relation to other products and services.

When we look at the majority of medical treatment it fits the palliative picture.

Almost any time we take a drug/medication we are in palliative territory, with the major exception that I can think of, being anti-biotics.   With anti-biotics, we take a drug, to attack the bacteria, which is causing the illness. Pretty straightforward, except for thinking about the health of our immune system (which can be greatly improved by eating plants, exercise and attitude) and why on this particular occasion, it was not able to ward off the bacteria causing the disease.   This is not even thinking about the rush we often have, to take anti-biotics, when we don’t actually need them, thereby weakening our immune system.   Factory farming is already a big enough threat in terms of infectious diseases, by the use of anti-biotics without ourselves also participating in increasing the risk. (taking anti-biotics unnecessarily-Health report, Radio National) weakens the immune system by wiping out the good bacteria in our gut. These bacteria produce chemicals which boost our immune system.

Standard medical treatments which fit the palliative model are:

Drugs for blood pressure/cholesterol

Drugs for diabetes

Anti-depressants and other mental health drugs

Drugs for rheumatoid and even osteo-arthritis

Drugs for digestive problems like acid reflux, constipation, irritable bowel syndrome, ulcerative diverticulits and so on

Drugs for auto-immune diseases such as Lupus and so on

We tend to think about palliative care as the care that we get at the end stage of life, the care that will ease our passing from this world. If we rely only on standard medical treatment and don’t address the causes of our illness, we are entering the end stage of our life. This may be at age 25, but it is still the end stage.   And just like when we think of palliative care now for those that are dying, as ever increasing medication, every increasing disability, with ever decreasing quality of life, so it will be for us, if we rely only on standard medical care. Of course there is a place for standard medical care, but expect true shared care, where we are in the driver’s seat of decisions about what treatments, we are going to have and we take responsibility for what steps we are going to take to prevent, reverse or manage our illness.

Many people have faith in the Dr, the drugs and the technology. It is good to look at the evidence and one way to do this, is to do what I have suggested before. Look around at the friends, family, workmates in your circle and see what is happening to them over time. Are they cured? Vital, energetic, alive?

The evidence from the research is clear, that the effectiveness of many of these drugs and even heart surgery is questionable, but the effectiveness of a whole foods plant based diet is unequivocal.   Add moderate exercise, even just daily walking for 30 – 60 minutes and we are in a good place.