The Best Anti Cancer Diet

I get more questions about diet than anything else. People want to know if they should give up sugar, go paleo, fast, quit saturated fat or just eat whatever they want on the basis that it can’t make a whole lot of difference.

In a world where it’s now possible to make a living out of giving other people dietary advice it’s difficult to sort fact from fiction. Most of the ‘evidence’ is anecdotal; this person quit sugar and has never felt better; that person ‘went paleo’ and beat their allergies. There’s no question that some of these people have achieved what seems to be better health by changing the way they eat, but have they reduced their risk of cancer? And how will we know what the longer term impact of these diets is likely to be without experimenting on ourselves?

Well meaning people have sent me links to articles from Dr Mercola and David Avocado Wolf, along with contributions to a whole range of ‘natural health’ sites. My first reaction is always to google the author and to add the word ‘fraud’ to the search. What I find is not encouraging. Of course the conspiracy theorists then counter claim that these authors are being undermined by big pharma or food manufacturers with a vested interest. These claims are not without foundation. A recent, reputable article provided evidence that the sugar industry intentionally marketed saturated fat as the dietary bad guy in order to distract us from damaging findings about sugar:

How the sugar industry shifted blame to fat

There’s also reasonable and serious concern about the ethics involved in research. Much of it is sponsored by organisations with a vested interest in the outcome and you’ve got to wade through the academic language to read it, or rely upon someone else’s often inaccurate interpretation. What to do?

The best dietary advice I ever had came from my friend, Cat, who said, ‘You need to find out what works best for your body.’

It may well be that excluding certain types of foods has a big impact on your health. Someone close to me recently tried the FODMAP protocol with the support of a dietician and discovered a fructose intolerance. Yes, that means she can’t eat apples! Just about every healthy diet I’ve ever seen includes apples but for her they’re a disaster.

I’ve recently found a nutrition site that appears to be well researched and presents health information via clear, plain english videos:

Nutrition Facts

But even this site has nothing about intermittent fasting, which I believe is helping me to avoid recurrence and manage my weight. There’s also a problem with sites like this: It’s easy to become so overwhelmed with all of the advice that you just throw your hands in the air and break out the tim tams.

For those interested in my personal opinion on how best to avoid cancer I’m going to give you a summary. I offer it with the following disclaimers:

  1. While I have done everything I can to verify my choices using research I allow that future research might disprove anything I’ve read so far. I also allow that I have no way to verify the authenticity of any research. At some point you just have to decide to trust it. Also, I’m not a doctor.
  2. What works for me may not work for you. The two best measures of a diet are how well you feel on a day to day basis (this is fairly easy to determine) and how well you are over time (much more difficult).
  3. Diet is a major part of staying well but it is not the only factor. Please also consider your stress levels, your environmental exposure to things that may have a negative impact on your health, the quality of your sleep, the amount and type of exercise you get and the quality of the relationships you have with other people. These matter too.

Eating to reduce the risk of cancer

So here’s my current best advice for reducing the future risk of cancer and staying well. I hope it helps you to make some positive changes.

  1. Eat more plants than anything else
    A plant based diet consistently demonstrates a range of benefits to human health. Leafy greens are the only prebiotic proven to improve gut health and most of the food candidates for ensuring human health at a cellular level belong to this food group. Legumes show up as a major dietary component in every culture on earth that demonstrates unusual longevity. Fruits and vegetables are particularly important for forming healthy (non cancerous) cells, and for triggering the death of damaged (potentially cancerous) cells. Nuts and mushrooms are both returning impressive research results and most of us don’t eat enough of them. (Yes, I know fungi aren’t really plants but let’s put them in here anyway).
  2. Be wary of supplements
    It may be that your dietary intake of a particular micro nutrient is inadequate. In most cases that’s easy to fix. Add a food containing it to your diet. There seems to be a very relaxed attitude to supplements with most people considering them to be safe, but many can be toxic if you take too much of them and many can interact with medications in dangerous ways. You also need to be careful if you’re approaching surgery because a lot of popular supplements (e.g. fish oil) can cause excess bleeding. It’s almost impossible to get too much of a micro nutrient from food so if you think you’re lacking anything, try googling ‘natural sources of …….’ and improving your diet. Always discuss supplements with your doctor and when you’re asked ‘are you on any medication?’ make sure you disclose any regular supplements. We should be treating these pills with the same caution we apply to pharmaceuticals. Your doctor may prescribe a supplement as part of your recovery (particularly vitamin D) and you should make sure these are taken according to the dosage instructions. More is not better.
  3. Reduce animal protein
    I remain convinced that eating some animal protein each week is good for me, particularly for maintaining healthy levels of iron, B12 and essential amino acids. I’m also sure that I don’t need more that three or four serves a week. I’m also convinced that the profile of organically raised, grass fed meat is different and more nutritious than factory farmed and grain fed meat. There is research to support this view.
  4. Eat less food
    Most of us still eat too much. Just eating less can have a positive impact on our health and survival. I suspect it’s actually healthy for us to be hungry some of the time but with the modern availability of food, most of us can reach for something the second we feel any hunger. A meal should leave you feeling pleasantly satisfied, not stuffed like a pillow. If you’ve been conditioned to eat everything on your plate then it’s time to recover from the notion that overeating is somehow virtuous.
  5. Reduce or eliminate alcohol
    Sorry to say that the evidence for alcohol as a category one carcinogen is overwhelming. If you decide to drink then there is some evidence that resveratrol in red wine may help to reduce its carcinogenic impact, but you’d be better off eating red grapes or including some red wine vinegar in your diet and avoiding the wine.
  6. Pay attention to your body
    You may want to try some kind of protocol to determine if you have any food intolerances or you might prefer to just observe how you react to different foods. Either way it’s important to notice how you feel, and how your body reacts, after different types of food. Your bowels are a good indication of gut health and if you’re not seeing at least one well formed bowel movement every day your body is trying to tell you something. Same goes for bad breath, sallow skin, hives and rashes, acne and other physical symptoms. That’s not to say that all of these things are always caused by diet, but they may be. It’s also important to recognise that we are complex organisms and there are many different things affecting our body, including hormone levels, underlying health, regular medication and even the weather. I’ve met many people eating highly restrictive diets because they are certain they’ve had a reaction to something, once, a long time ago. A lot of self-diagnosed food intolerances aren’t real.
  7. Fast regularly
    The evidence for fasting having significant health benefits is, I think, compelling. It can lower human growth hormone (typically high in those at risk of cancer) and trigger cell autophagy (the body’s natural process for cleaning up damaged cells). I have two fast days each week where I eat only 500 calories as an evening meal. Apart from the milk in my morning coffee that’s all I have all day. I’ve also achieved a healthy weight using this method. Don’t fast without talking to your doctor first. It’s unsuitable for some people, particularly those on regular medication.
  8. Drink more water
    It’s critical to the optimal function of your body and you can raise low blood pressure within minutes just by drinking water. This is an excellent demonstration of how important it is to stay well hydrated. I often see sites that say we are inclined to confuse thirst with hunger, but I think this misses the point. Our bodies aren’t mistaken. There’s really no difference between hunger and thirst because a lot of our moisture comes from our food. Our ancient ancestors didn’t carry drink bottles and probably got a lot of their moisture from food. This is another reason to eat fresh fruit and vegetables (they have a high water content) and to have a big drink of water before you eat a meal.
  9. Prepare most of your meals from scratch using whole foods
    Takeaway and eating out are both fine from time to time (and may well fall under stress reduction if you just can’t manage cooking), but if they’re a regular part of your week it’s likely you’re eating far too much sugar, saturated fat and salt. There’s also a much higher risk of overeating because we tend to eat the serving rather than paying attention to our appetites. My preference is to use organic ingredients at home whenever I can and to prepare them fairly simply. I also avoid most processed foods. The additives in processed foods appear to have a negative impact on the human gut. Processed foods are also typically higher in sugar and saturated fat than home cooked meals.
  10. Don’t Panic!
    I sometimes wonder how much damage we do to ourselves with food anxiety. On the one hand, it’s great to feel like we’re making a difference to our health by eating well. On the other hand, we can quickly descend into guilt and worry after a weekend pizza or a few hours on a nutrition website. I think food, and sharing food with friends and family, should be one of the great joys of our life.

By paying attention to how I feel and how my body reacts to certain foods I’ve significantly reduced sugar and gluten in my diet and I eat well most of the time. I also enjoy eating out, eating takeaway, eating soft cheese and eating chocolate. Sometimes. Much less often than I used to. I’m still making improvements to my diet on a regular basis and doing some online research from time to time to see if there’s anything else I might add or subtract that will make a difference, but I’m not obsessive.

I hope this short summary is useful. My final advice is to take a long view when it comes to fashionable diets. They have always been around. They will always be around. Very few of them have stood the test of time and I see no reason to expect that will change. Use one of them if it helps you to eat well but don’t feel pressured. The truth is that we still don’t know nearly enough about how the human body interacts with what we eat, but we do know that eating well can make a big difference to our health, so let’s just focus on that.

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Onward!

I’ve changed my tag line.

I started this blog just over three years ago. Back then, I optimistically tagged it ‘staying positive following a triple negative breast cancer diagnosis’. I was convinced that having a positive attitude would help me to get through the physical and psychological mine field that lay ahead of me.

It did.

But here’s the thing; I’ve come to realise that as important as positive thinking can be, it can also be a trap. Cancer treatment is hard. There are times when it’s terrifying, and really, really sad. There are days when just getting out of bed is an achievement. If we’re too focused on staying positive it can actually become a source of anxiety and stress; we wonder if not being upbeat is undermining our recovery and then we get anxious about our anxiety and we spiral down from there.

I’ve noticed that a lot of people seem to have become very wealthy by telling us to ‘be positive’. There were days during my treatment when my response to this was ‘I’m positive I’ve got cancer!’ There were also days when people would compliment me on being brave, or courageous or even ‘inspirational’. What concerns me about the positive thinking movement is the tendency to pathologise normal, human emotions and to make us feel guilty for having them.

That’s not to say that having a hopeful outlook hasn’t helped me. I’m certain that it has. I just think it’s important to acknowledge that part of being human is experiencing all kinds of emotions and none of them are bad. Some of them are uncomfortable, even painful, but that’s because they’re a reflection of how we’re feeling about some very difficult circumstances.

If something awful happens then sadness is part of how we get through it.

I sometimes wonder to what extent the depression epidemic is linked to enforced cheerfulness. Surrounded by upbeat social media and the highlights of other people’s lives are some people left feeling that any kind of sadness is some kind of failure? It the pressure to be outwardly cheerful while inwardly suffering part of the problem? I think it could be.

I’ve also seen a kind of haze around breast cancer, where there’s an expectation that our ‘journey’ will somehow enrich and reward us with new insights and a relentlessly upbeat perspective. Perhaps we need to acknowledge that while those of us that survive will certainly be changed, not all of those changes are cause for celebration.

I am happy to be alive. I’m also sad about the loss of my breasts and the ongoing health issues caused by treatment. This doesn’t stop me from having a great life but I think it’s part of what needs to be acknowledged. Perhaps instead of being positive all the time we should aim for contentment. This feels less forced. I am not happy all the time but I am generally content. I do have things that make me sad from time to time but they don’t overwhelm me.

I find that acknowledging uncomfortable feelings when they occur, making room for them and sitting with them for a while allows me to honestly process those feelings. I also find that when I forget to do this and try to run away from them they just seem to get stronger. I used to try to distract myself from uncomfortable feelings and now realise it was an excellent way to suck the joy out of whatever activity I was using for distraction.

The great irony of welcoming all of my emotions as normal and healthy is that, on the whole, I am much happier. Giving myself permission to be frightened or angry or frustrated has allowed me to recognise that all of my emotions are part of the richness of being human and that how I respond to those emotions is up to me. I can be angry without taking it out on someone else. I can be sad without that sadness dragging me into depression. Most importantly, I can have all of these emotions and know that they won’t give me cancer.

Stress is definitely bad for me but there are few things more stressful than trying to pretend to be happy when I’m just not feeling it.

And so I’d like to apologise to anyone that thought this blog was a prescription for suppressing any emotions other than happiness. Positivity is, for me, about developing a hopeful attitude to the future. It’s not about being happy all the time.

The most important thing I can do with an emotional response is to ask myself if it’s helping me to live the kind of life I want to live. In this regard, emotions like fear can actually be really helpful. Remembering treatment and being frightened about recurrence is a great incentive to me; it reminds me that I’ve made a lot of changes to my life, including a better diet, losing weight, daily yoga and generally being more grateful and mindful. I honestly believe these changes will improve my odds of survival.

And even if they don’t, they will improve the quality of my life, so they are definitely worth doing either way.

My tag line now reads ‘living well following treatment for triple negative breast cancer’. You can still go all the way back to the beginning of this blog and read about my treatment and all of the things that have happened in the last three years. My focus from here on in will be on living well and staying well. I’m hoping I can find plenty of interesting things to write about.

Three Years Today!

It’s official.

Three years ago today my husband and I sat in a small office at Breast Screen with a doctor we’d never met and a counsellor I’d seen twice before to receive the news that I had triple negative breast cancer.

I was pretty sure before the appointment that I was going to receive a cancer diagnosis. I’d seen the three (later four) suspicious cloudy blobs on the ultrasound and read the concerned face of the doctor taking the multiple biopsies.

I’d cautiously and reluctantly read up on breast cancer but I’d never heard of triple negative breast cancer. I thought they’d tell me there was no urgency and that I had several weeks to think about what I wanted to do next. Instead the doctor asked if I had my usual doctor’s phone number on me so that I could get a referral to a surgeon as soon as possible.

“The cancer you have is much more aggressive than most breast cancers. You need to regard treatment as somewhat urgent. I wouldn’t leave it more than two weeks.”

My father died of bladder cancer at 58. I used to imagine how odd it was going to be to reach 58 and realise I was now the age that Dad was when he died. Suddenly 58 felt like a worthy goal rather than a curious milestone. I was convinced that I was going to die.

I wandered my garden sobbing. Not since my Dad’s death had anything been so upsetting. This was a kind of personal death. No more dancing through life as if it was going to stretch on and on for decades. No grandchildren. Perhaps not even being here for my daughter’s marriage. All of the joys of my future, suddenly squashed under the weight of a cancer diagnosis.

In a cruel twist of timing, my daughter was in China at the time, holidaying with her Dad and his partner and the love of her life. We had already had days of painful discussion about whether or not to let her know that there concerns about my Breast Screen results or whether to wait until she came home.

On the one hand, we didn’t want to spoil her holiday but with social media we knew that keeping it a secret was going to be impossible. My close friends were supporting me through the weeks of anxiety. (I still wonder why I didn’t just see my doctor and have the biopsy done privately! I would have had the results in days and not weeks. Shock.) Zoe was bound to pick up on the fact that something was wrong and to be very angry about not hearing the news before everyone else.

So I made the hardest phone call of my life.

With the experience of a police officer whose given death messages I told her plainly and quickly. There’s no point drawing this kind of conversation out. It just builds anxiety. Of course she wanted to get on a plane and of course I convinced her there was nothing she could do here. But how I wanted to hold her.

The next day she posted to Facebook: “I know I should say something deep and profound here but all I can think of is ‘fuck cancer’.”

It was a gift. I’d dug my own grave and was stretched out in the bottom of it. I was convinced that my father’s DNA, the stress of my previous occupation and the usual collection of unhealthy habits had collided.I was going to die. And then with one angry sentence my daughter turned me around.

I climbed out of the hole and decided to fight. I decided to do everything I possibly could to beat cancer and to stay well. I spent hours on the internet researching triple negative breast cancer. I read books about cancer treatment and dealing with chronic illness. I started this blog. I hoped that writing about treatment would help me to stay on track (it did) and that perhaps sharing my experiences would benefit other women (it has).

It can be difficult to find information about triple negative breast cancer that isn’t terrifying, so I also started a Facebook page and started sharing information about current research, along with small chunks of inspirational thinking that helped me to avoid falling into hopelessness.

Back then I compared fighting cancer to climbing a mountain. I’ve got a better analogy. Cancer is like suddenly discovering that the path you’ve been walking on is unstable. It collapses beneath you and you slide, quickly and dangerously, down to the bottom of a deep, dark pit. On the way down you get injured. The extent to which you get injured is partly determined by how you handle the fall. The rest is luck.

When you get to the bottom you have to make a decision: Stay and die or try to climb back out again. You know the climb will be long and difficult. You know there’s a risk you could back-slide, or wind up right back where you started. You don’t know whether to go back the way you came (because at least you know the risks) or to try climbing out using a different path. So many choices and none of them are clearly better.

As you climb you find there are other people on the same journey. Some of them shout out advice to you but you don’t know if their progress is any better than yours. Some of them fall past you and you never see them again. Some days you feel like you’ve made great progress and other days you slide back towards the pit, terrified that the slide will go all the way to the bottom again.

Your medical team fly in from time to time and drop supplies. Sometimes these make the climb easier and sometimes the weight of them makes you want to sit on the side of the slope and cry.

Way up ahead, towards the light, you can see researchers building bridges and stairs. If only you can stay climbing long enough to reach them.

More people slide past you on their way back down. You want to call out encouragement to them. You want to tell them not to give up and to climb and to keep climbing, but part of you knows that everyone has to make their own decision. There are no right answers.

Finally the edge of the cliff seems within reach, but you’re so tired. This is when a lot of people give up. You know that. It looked closer than it really is. It seemed within a days reach but that was weeks ago. The people that love you are up there in the light, calling down to you. They’ve been there the whole time. Even when you couldn’t hear them. So you keep going.

One day at a time.

Just keep going.

And then the ground starts to become less steep and your progress feels more certain. There are days when you can actually start to enjoy the scenery. Recovery seems possible, even likely, but you can’t trust it. You keep going.

I don’t know when I made it over the edge of that cliff. Was it today? Was it a few months ago when my doctor ordered my three year scans early and I got the news I was cancer free? I don’t know. I feel as if I’m out of the pit now and back on solid ground. Life gets back to being about gardens and friends and good food and laughter. We talk about cancer as if it’s history.

But here’s the truth.

Once you’ve had that path drop out from under you it’s unlikely you’ll ever trust solid ground. It seemed safe the first time around, just before you fell into the pit. You know now what other people don’t; the path can always drop away at any time. This was always the truth. Maybe this is what they mean by ‘ignorance is bliss’. We would all prefer not to know this.

And so we all make a decision. Do we stay frozen by fear or set out on the path again?

Slowly, slowly I have crept forward over the last year, testing the ground beneath my feet. Eventually I decided I will never be able to trust it. I also decided that it’s okay. Not trusting it has made me exquisitely aware of the beauty in the every day.

I sit here typing, sharing my thoughts with people I will never meet, watching the sun warm up the winter garden. There’s a heavy dew this morning and the light is refracting. When my daughter was tiny we would watch the rainbow sparkles and call them fairies.

Today has music and ageing cats and Graham’s sourdough. Today has laundry to fold and firewood and theme music. Later, we’ll head out to lunch with my very adult daughter and her lovely partner to celebrate his birthday. We’ll catch up with his lovely parents and eat great food and laugh.

Life goes on.

 

I am grateful for still being alive.

I am grateful for all of the people that helped me get here.

Thank you.

All of you.

Whether you’re someone on my medical team that provided primary care, one of the many amazing nurses that supported me or one of the cheerful receptionist that greeted me (never doubt the difference you make).

I am grateful to all of the people that contributed to my care and recovery; to the woman at the wig library, to the staff at the local restaurant (Reef) that cheered me on, to the stranger in the waiting room that said “You look great today!” when I had no hair, to the young woman behind the Coles checkout that cried and hugged me. To everyone that smiled and didn’t look away. Thank you.

Thanks to all my virtual friends, whether through this blog or Facebook or the BCNA site. Your support and humour has often been a candle in the night.

To all of my real world friends, old and new, that hugged me and held my hand and drove me to treatment and took me walking and fed me and loved me. I am truly blessed to have you all in my life. And to those that stepped back or moved away, I wish you every happiness and please know I understand.

Special thanks to my yoga teacher, Emma, and my massage therapist, Maryanne. You have both made significant contributions to my physical and emotional recovery.

To Mum, for being stronger than I knew you were and for stubbornly refusing to accept the possibility of my death. I love you.

To Zoe, for telling cancer where to go and for being my single greatest reason for living. For continuing to study hard and live well when you had every reason to fall in a heap. Mummy’s better now, Sweetheart. I love you more than all the leaves on all the trees.

And finally to Graham. I don’t know how I would have coped if this had been you and not me but I couldn’t have done it better.

For starting all of this with “You are not your breasts and nothing is more important to me than keeping you alive and if you have to lose them then that’s what we have to do.” For being the only person that could make me laugh when I’d given up on laughing. For helping me to really understand why a good marriage is so much better than being alone.

Most of all for this:

The night before my double mastectomy, when I asked you if you wanted to kiss my breast goodbye, you said, “No. I’m over them. They tried to kill you.”

And the next day when they took the binder off to check my wounds and I had horrible tubes sticking out of me with bags attached to collect the fluid and even the thought of it all made me gag, you didn’t leave the room and you didn’t flinch.

You’ve never flinched. You’ve grieved and you’ve worried for me but you’ve never looked at me as if I was damaged. I’m just Meg to you. I love you. I didn’t think I could love you more than I did when all this started. I was wrong.

I was going to use today to wrap this blog up and say goodbye. I thought it might be time to move on, but I’ve realised that owning the whole experience and integrating it is part of my recovery. It’s healthy to keep hold of the whole experience and to move forward informed by it. Life can be better after cancer.

On to the next thing.

Love to all.

I am deeply and humbly grateful. Thank you.

Meg

Can We Think Ourselves Sick?

I’ve written a lot about the power of positive thinking over the last three years. Both my own experiences and all of the research I’ve seen have convinced me that my state of mind plays a major part in my health. Focusing on staying calm and happy during treatment helped me to minimise the side effects and to recover quickly.

Not that I didn’t have my moments. I’m always quick to add that. I’ve had tears and black days too. I get concerned about some people getting caught in a kind of downward spiral, where they notice that they’re not feeling happy and then get anxious about not feeling happy and then anxious about being anxious…………You get the idea.

My understanding of being positive isn’t about pretending to be happy when I’m not, or denying my very normal, very human reactions to cancer and the treatment for it. I’ve had experiences that were shocking, frightening, disgusting, saddening and frustrating. In every case I made room for whatever I was feeling. I didn’t try to push it down behind a facade of cheerfulness.

It’s interesting to me that some people divide their emotions into the ‘good’ ones and the ‘bad’ ones. I think all emotions are human, and normal, and that we should expect to experience the entire spectrum of emotions when we’re dealing with trauma. The trouble starts when we try to fight with our own emotions, particularly if we dry to drown them in alcohol, bury them with food or distract them with some other unhealthy habit.

I breathe into my emotions. I experience them as they happen. I don’t try to push them away or to wallow in them. Sometimes making room for them helps them to dissipate and sometimes they hang around for a while. It’s all good. This is life.

I think of being happy as my default setting. I am capable of feeling the whole range of human emotions, and I do, but the emotion I feel more than any other is contentment. Life is good. Being alive is good! My two main practices for achieving this are mindfulness and gratefulness.

Being mindful is really just about being in the present moment rather than worrying about the past or the future. Today has all kinds of opportunities for me to do the things I enjoy. I know my mind will drift off into ‘what if’ and ‘if only’ but I gently bring it back to what’s in front of me. Sometimes this is as simple as just looking around me, paying attention to what I can see and hear and smell and feel and taste.

Being grateful has become a habit since I started recording seven things that I’m grateful for every Sunday. It’s surprised me how much this very simple practice has shifted my thinking. I’m much more inclined to focus on what I have and to appreciate the people around me.

All of this matters because we can think ourselves sick. There’s some fascinating research into this phenomenon, known as the “nocebo” effect because it’s the opposite of the placebo effect, where we have a therapeutic response to something just because we believe we will. Here’s a couple of examples:

  • Research has found that when many people who claim to have adverse effects to gluten are given it without their knowledge they do not experience any symptoms. Their ‘intolerance’ is a consequence of the nocebo effect, where they have a reaction to gluten because the expect to have one.
  • Doctors face a dilemma when conducting drug trials. They know that if they warn patients about possible negative side effects, patients are much more likely to report experiencing those side effects. They have an ethical obligation to warn patients but also very understandable reservations about the warning being the CAUSE of the symptoms.
  • The nocebo effect is so powerful that in one study of a drug used to treat prostate cancer only 15% of patients reported erectile dysfunction if they weren’t warned it was a side effect. If they were told it might be a side effect, 40% experienced erectile dysfunction.

I find this phenomenon amazing! One of the single greatest determining factors in our medical treatment is our own expectations!

I remember commenting to one of the nurses during chemotherapy that I was one of the lucky ones. I hadn’t had any vomiting. She asked me who my oncologist was and replied when I told her, “Oh yes, most of her patients don’t have any problems.” It was over a year later that it occurred to me that everyone was essentially getting the same drugs. So why were this doctor’s patients less likely to experience nausea?

I think it’s because she told me before I started treatment NOT to expect to feel nauseated. She told me that the new drugs were much better, to forget anything I’d seen on television about cancer treatment and to let her know if I felt unwell so that they could adjust my treatment. I was confident that I wouldn’t vomit. She seemed so certain.

The nocebo effect raises some very interesting issues in a climate where doctors are terrified of being sued for malpractice and where there seems to be an insistence on warning us repeatedly of the side effects of treatment. It’s possible that the worst thing to tell a patient is that their treatment might not go well.

Whenever I’m in a medical situation and I have to hear a list of risks I remind myself that ‘might’ also means ‘might not’ and that the criteria for reporting side effects in this country mean that even if one person experiences something it gets recorded. A treatment or a medication might have been taken by thousands of people with no side effects at all but one bad reaction and now everyone needs warning.

I wonder how often the rate of bad reactions starts to increase once the warnings are given.

Of course it’s not just medical professionals we need to be careful with. There’s friends and family too. I routinely (and probably rudely) interrupt people when they try to tell me about someone dying of cancer or some treatment that’s gone horribly wrong.

My own self talk gets a regular spring clean too, because how I think and what I think is every bit as important as eating well and getting regular exercise.

We can think ourselves sick.

Or well.

I choose well.

(For another great blog post on this subject pleas see When Words Hurt by the inspirational Shannon Harvey)

Funeral for a Friend

Anyone who was at our wedding remembers a very special moment when my husband and four of his childhood friends posed for a group photo. In their forties, they were still great mates. One of them, Nick, had flown in from New Zealand to surprise the others. He died suddenly doing what he loved a few years back.

This week we received the sad news that another of the five, Philip, had also passed. Philip was diagnosed with thyroid cancer in his late teens and told he wouldn’t live to see his 21st birthday. Tomorrow we’ll attend his funeral. He was 59.

Philip and his wife, Kathy, are a testament to the power of faith. Both deeply religious, they built a successful dental business and raised two beautiful children to be competent and compassionate adults. A good portion of Philip’s life was spent undergoing difficult and painful medical treatments. They prayed. They went to church. They believed that God would help him through.

I do not belive in God but in recent years I have come to believe in belief. Science keeps proving that state of mind can have a positive impact on longevity, quality of life and recovery from serious illness. For many people, religion helps them to find and maintain that positive state of mind.

I had a great conversation with an elderly friend recently. She’s been religious her whole life, and she’s also a great thinker and academic. The two seemed incongruous to me so I asked her about the paradox; how does such an intelligent person place so much faith in an imaginary being?
This is what she said.

“The biggest mistake that atheists make is assuming that people of faith are simple minded or delusional. Logically, I accept that there is no mythical being with a long beard that watches my every move and grants wishes to people that pray to him. I’m not a fool. God, for me, is a word that represents love and hope and all those intangible things that connect us to every living thing. My belief is a choice. I choose to believe because my life is better with these beliefs and I am a better person because of them. Every week I spend time with other people, thinking about how well my behaviour matches my values and being grateful for everything I have. Churches are full of people that don’t literally believe in God.”

It seems for some people that faith is not just about belief. It’s also about suspending disbelief.

I didn’t know Philip well enough to ever ask him if he literally believed in God. It doesn’t matter. On the few occasions that I met him and Kathy I was impressed by the depth of their faith and the significant impact it had made to the quality of their lives. They were better humans because of it.

There have been times in my life when I’ve been cynical about all religions, convinced that they were responsible for war and persecution. I now believe that this argument confuses cause and effect. Some humans will use religion as an excuse to behave badly and to incite others to do the same. But in the absence of religion, wouldn’t the same people simply find another excuse? Would a world full of atheists be a kinder and less violent world? I sincerely don’t think so.

I’m a skeptic. Most people confuse that word with ‘cynic’. A skeptic is someone that believes something based on evidence. I also think it includes being open to the possibility that something might be true where there is insufficient evidence to prove it either way. This is very different to the flawed argument I often see in relation to things unproven; that what is unproven is false, ineffective or useless. Something unproven may be all these things but it may also not be all these things. We just won’t know until there’s evidence.

Having seen the movie, The Connection; Mind Your Body, with expert after expert citing research into what’s known as ‘the mind-body connection’ I no longer doubt the significance of belief. The evidence is there. Our state of mind influences everything. It can switch dangerous parts of our DNA off and it can help us to defy the predictions of doctors.

That’s why I think we should support anyone’s decision to participate in religion.

I do have concerns about some of the dogma in most major religions but I also notice that many of them are evolving. There are now female clergy in previously all male positions. There are people of faith prepared to openly acknowledge that the texts upon which their religions are based are archaic and should be the starting point for discussion rather than than a rule book.

I don’t think it’s okay the threaten children with burning forever if they don’t comply and I do think young people should be taught to behave ethically for its own sake, and not because they fear the consequences.

And yet, when I spend time with adult friends whose faith is significant to them I am struck by a common theme. Regardless of which faith they belong to (and I have friends in most of them) their faith is a source of inspiration, comfort, guidance and community.

Tomorrow my husband will help to carry the coffin of one of his dearest friends. It will be deeply sad for him. Philip’s friends and family will take great comfort in the idea that he is now in a better place and finally free from all the pain and suffering that plagued his life. There will be a service. They will thank God for the long and happy life that Philip shared with his wonderful wife and children.

Credit where credit is due. Regardless of the beliefs of anyone else in the church, there can be no doubt that Philip’s faith, and the faith of his family, have kept him alive for many, many years beyond expectations. It will also be apparent that faith will provide those that loved him with deep consolation during their grief. It seems to me that these benefits make faith a very powerful force in our lives.

Farewell, Philip and thank you for being such a true friend to my husband. You will be greatly missed. Thank you for teaching me, through your undeniable example, about the power of faith.

I am not likely to join any organised religion. All of them have elements that I find difficult to reconcile with my own values. That doesn’t stop me from recognising that faith is powerful force. I believe in belief.

I will keep working on living a life of kindness, gratitude and being the best person I can be. I will keep being inspired by the natural world and the breathtaking spirituality I feel in a rainforest. I like A. C. Grayling’s observation that you don’t need to believe in a god to have a spiritual life.

I know that having this spiritual aspect to my life helps me to be well and helps me to continue to evolve, to test my behaviour against my values, to make mistakes and learn from them. I suspect this is what is supposed to be at the core of all religions.

Perhaps the final word goes to another religious friend who told me this when I asked her about her faith:

“God is another word for love. When you hear god just replace it with love. That’s how you can understand my religion.”

I’ll be doing that tomorrow during Philip’s funeral service. I’ll replace the word ‘god’ with ‘love’ because, when it comes right down to it (and at funerals, it really does come right down to it), love really is what it’s all about.

I will also spend time reflecting upon the power of faith and the benefits of religion. There can be no doubt that it’s a source of comfort, inspiration and love for many, many people.

My Top 13 Surprising Things About The Fast Diet

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Regular readers will know that I’ve been following The Fast Diet for some time now. Here’s the original post I wrote about it back in January.

https://positive3neg.wordpress.com/2015/01/19/is-there-a-fast-way-to-reduce-cancer-risk/

I’m all for people feeling comfortable in their own skin, whatever their size, and I think the whole diet industry conveniently ignores the data that says it’s your fitness that makes the most difference to your overall longevity, not your weight. I have friends that easily fit a size 14-16 who are very fit and healthy.

The problem for those of us with a high risk of breast cancer is that being overweight HAS been conclusively linked to higher risk. Maintaining a healthy weight is one of the best things we can do for our bodies. For those of us in the triple negative category it’s one of the best preventative steps we can take. There are no preventative medications available to us.

The trouble is that most diets are so misery-inducing you’d rather just eat what you want, be happy and carry the weight. I used to feel that way. I was never seriously overweight but I was carrying about 16 kilos more than I needed. Like most people I’d go through that cycle of deciding to diet, watching the weight creep off and then deciding that if I had to live that way I would rather be dead. (Of course I wouldn’t REALLY rather be dead! I smile now at how frequently I used to use that expression without really understanding what I was saying.)

Enter The Fast Diet. It’s based on good science, it’s become popular all over the planet, and it’s helped me to lose all of the weight I want and to keep it off. I thought it was time to give you all an update on the really surprising things about this way of eating.

I tried to limit this to ten things but I couldn’t.

So here’s the my top 13 surprising things about The Fast Diet:

1. It’s easy
Every other diet I’ve ever been on has been hard work. I’d be measuring portions or counting points or keeping diaries or craving ‘forbidden’ foods for months and months. I’d feel deprived and resentful. There are no banned foods on The Fast Diet and you only count calories on two days each week. The rest of the time you just eat a healthy diet with the occasional treat. Truth be told the first two weeks were hard work, but only on the two fast days. By week three it was just my new normal.

2. I can eat pizza!
I love pizza. I love melted cheese and crunchy pizza bases and everything that goes with it. I don’t want pizza every night but every so often I really want pizza. No problem. I’ve bought it. I’ve eaten it. I’ve still lost weight. We also love to eat out at fine dining restaurants and cheap, cheerful cafes. No problem. I can see why they call this ‘the foodies diet’. I have still eaten a healthy diet most days of the week but its so wonderful to enjoy good food without worrying about my weight.

3. I can’t eat pizza!
Well, I can, but I can’t finish it. One of the surprising things about this diet is that my appetite has been reduced on all seven days of the week. I’m just not as hungry as I used to be. I don’t know if this is because fasting teaches you that hunger is not life-threatening (and I suspect there’s some part of our lizard brain that makes us panic when we’re hungry), or because our stomach gets smaller and feels fuller with less food. I used to devour a medium sized pizza without a second thought. Now I really want to stop at half that amount. The great thing is that this is a choice. I’m full and I don’t want any more. It’s not because someone else is telling me I can’t have it. Bliss.

4. I don’t crave sugar or bread or biscuits….
I’m one of those people that used to get huge carbohydrate cravings. There’s been some recent research into the gut biome that’s discovered a bacteria that thrives on sugar. It can signal our brains and trick us into thinking we’re hungry, and that, in particular, we are hungry for the food it needs to survive. I suspect fasting either kills or reduces this bacteria. In any case, I no longer get cravings and I actually find myself not wanting sweet things. I know, right! I can walk past a packet of Tim Tams without a second thought. It’s a miracle!

5. I have more energy on fast days
I had expected to feel a bit lethargic on fast days and I’ve been really surprised by how energetic I feel. Once again, the first couple of weeks were hard work and I did feel weary. I had a headache and even some low level anxiety. But it passed. Now I find I have so much energy on a fast day that I need to plan to go to the gym or do some heavy work in the garden, or I’ll have trouble getting to sleep.

6. I need to drink a lot more water on fast days
I’m pretty sure the headaches in the first couple of weeks were at least partly due to dehydration. I also suspect that those sugar-eating bacteria were ramping up the chemicals as the fasting killed them off. I’ve realised that we get a good portion of our hydration from the food we eat, so on fast days I need to drink a lot more water. It’s also a great way to deal with hunger.

7. Hunger has an upper limit 
I thought that fasting would mean getting progressively hungrier as the day went on. I’m surprised to find that my hunger hits a peak at around 10.00am and then just hovers there for most of the day. I have a bit of a spike around 3.00pm to 4.00pm and if that’s really bad I’ll eat an apple and deduct those calories from my evening meal. Most of the time a drink of water and something to distract me will see the hunger pass really quickly.

8. There is no failure
If you’ve ever ‘been on a diet’ then you’ve also been off a diet. They’re notorious for making us feel like we’ve failed. I think the key to a lot of weight loss programs is that they get the credit for all the weight you lose and you get the blame for all the weight you don’t. The Fast Diet means eating normally for five days a week and just restricting your calories for two (or some other combination; see below). Unless you’re prone to binging or your diet is always unhealthy then I really think you can just eat normally for five days a week. Your appetite will naturally reduce over time. The best thing for me is that if I ‘come off’ the diet today I can just start my fast again tomorrow. And there’s always next week. I tend to bank fast days if I know I’m going to lunch with friends on a day when I’d usually fast but you can just as easily move the fast to one day later.

9. It’s really flexible
Once you understand the basic principles of fasting you can adapt it to suit what works best for you. My mum has lost a lot of weight just by eating her breakfast later each day and making sure she has nothing after her dinner. By narrowing the window of time during which she eats she’s effectively fasting each night. I’ve sometimes done two days in a row because the research on the anti-cancer benefits has focused on this type of fasting. Some people prefer to eat most of their calories in the morning and some prefer to eat them at night. Some split them into two meals. The surprising thing is how flexible this style of eating can be and how easily you can adapt it to what works best for you.

10. Fasting helps you learn what your body wants
When you’ve spent a day fasting you really notice how your body reacts to whatever you eat next. I’ve noticed that rice makes me bloated and that too much onion gives me heartburn. Because my hunger has been significantly reduced, I’m paying a lot more attention to making sure the food I do eat is nutritious. I’m back in touch with my body. It’s a good feeling.

11. Fasting has unexpected benefits
My eyes look bright and my hair is thick and shiny. Usually when you’re my age and you lose a lot of weight you expect it to age your face, but my skin looks great and I haven’t gone all wrinkly. I suspect this is because fasting triggers autophagy, the body’s ability to clean up dead and damaged cells. I’ve noticed that cuts and blemishes heal faster on fast days. I also noticed big steps forward in the healing of my mastectomy scars. It’s likely that fasting is also helping my body to kill off any potentially cancerous cells. It would be worth doing for that alone, even if I didn’t lose weight. This style of eating is also slightly contagious. Apart from my mum’s weight loss, my husband has also dropped an easy ten kilos, reducing his hereditary risk of heart attack.

12. I can eat this way for the rest of my life
The single biggest factor that has caused me to come off a diet in the past was the overwhelming sense of misery I felt, even if I lost weight. I once achieved the same weight I am now through Weight Watchers and then sustained it long enough to become a lifetime member. I was resentful of matchbox-sized serves of cheese and palm-sized serves of meat. I spent hours each day calculating points and feeling deprived when I couldn’t eat what I wanted and stay within my limits. I felt cheated by the realisation that the more weight I lost the less points I’d have so the less food I’d be allowed to eat. What’s surprised me about fasting is that I have easily lost weight without feeling deprived and I’ve kept it off. Some days I get to lunch time and realise I haven’t eaten yet. Incredible! I’m much more aware of the difference between thirst and hunger and I’m much more inclined to eat just enough rather than over eating. These are all of the things that Weight Watchers was trying to achieve but without the misery and constant feelings of deprivation.

13. I am really, really happy
I think some of this has to do with conquering sugar cravings without even trying and the beneficial effects that has on my blood sugar. I also suspect that not having nasty little bacteria messing with my brain helps and I am overjoyed to be at my target weight. But mostly this is about finally breaking out of that cycle of self-bullying, deprivation, anxiety and misery that is traditional dieting. I love food. I love eating good food. I don’t want to spend the rest of my life feeling anxious about what I put in my mouth. I don’t want to look in the mirror and insult myself for not being ‘strong enough’ or ‘committed enough’. The biggest surprise for me has been the way this form of eating has given me a great relationship with food and eating. I’ve lost 16 kilos and I’ve kept it off easily. I’m naturally choosing healthier foods because that’s what I feel like eating.

Oh, and did I mention that I’m also reducing my risk of cancer?

 

 

 

 

Lists of things not to say to cancer patients and why to ignore them

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Yesterday this article appeared on my Facebook wall:

http://www.mindbodygreen.com/0-11076/5-things-you-should-never-say-to-people-with-cancer.html

It’s another list of things you apparently should never say to someone with cancer. It seemed to me like a pretty negative article for a site that’s usually accused of being all rainbows and unicorns.

I was going to comment, suggesting that the author was still angry about her treatment and might like to give it some time before she offers advice. Cancer is hard. Anger is inevitable. I was a bit shocked by some of the comments on the article, and on the Facebook post. This poor woman got slammed.

Every so often someone suggests to me that I could attract more readers by promoting my blog, rather than just letting it grow quietly in this hidden corner of the garden. It’s even been suggested by close friends that I start a Youtube channel and upload videos of myself giving advice. When you see the comments on an article like this one you’ll understand why I don’t. There are some nasty people out there.

Perhaps the article should be called “5 things you should never say to me if I have cancer”. The first mistake this author made was assuming to speak for all of us.

I once wrote something similar about what I did or didn’t want people to say to me. Regular followers of this blog will remember it. By the time I’d had recurrence and more surgery I was just grateful for the friends that stuck by me. They could say whatever they wanted to me!

I think one of the reasons that some people leave our lives is that they’ve become so anxious about saying the wrong thing. Articles like this one don’t help. So let me apologise for my previous advice about what not to say and replace it with the following.

THINGS IT MIGHT BE GOOD TO SAY TO SOMEONE WITH CANCER:

1. How are you feeling today?

This is preferable to a general ‘How are you?’ because it’s specific to the present and allows you to then offer help if needed.

2. What can I do to help?

Or just find something to do to help. I had two friends turn up and weed the garden. Other people dropped off frozen meals or drove me to treatment. It was all appreciated.

3. I don’t know what to say.

Just say it. Be honest. Be authentic. You’ll probably get a response like “Yeah, I know. Me neither.” and then you can have a conversation about something else.

4. What would you like to talk about?

Sometimes the answer will be ‘cancer’ and sometimes the answer will be ‘anything but cancer’ but people will appreciate you asking.

5. Would you like a cuddle?

We’re not contagious or toxic and affection can be wonderful for helping to cope with pain – just not if you’ve got a cold or flu because catching a cold can kill someone on chemo.

6. Please let me know if you want me to go. I won’t be offended.

Sometimes treatment is exhausting and we find company tiring.

7. You look great!

I think the protocol for this one is simple. If I’ve clearly gone to some effort with my appearance then tell me how great I look. That was the whole point of making all that effort. If I’m just hanging around the house in my track suit then probably best not to comment.

8. I love you.

This never gets old. And you don’t want to regret not saying it.

Most importantly, don’t abandon us if you can possibly avoid it. Some people are going to. They’ll find it too difficult or confronting. They’ll find it brings up memories of someone they loved that died of cancer. They’ll want to protect themselves from the possibility of having to weep at our funerals and comfort our loved ones so they’ll suddenly or gradually distance themselves.

Please know that it’s your friendship that matters, and our friendship for you includes always remembering that people sometimes make mistakes, and sometimes say things that might upset us, but if we remember their love for us it really doesn’t matter.

Friendship also means you might need to remember  that cancer will make us sad and angry and oversensitive and sometimes hard to be around. We might take offence at the smallest thing. It’s really our problem and not yours. Just hang in there and say whatever you like.

By all means say, “I understand that you’re upset but it’s not okay to talk to me like that.” Cancer does not give us licence to behave badly. It just gives you a reason to forgive us when we do.

Most of all, ignore the lists of things to say and things not to say. Some people hate any comment on their appearance, some people don’t want to be asked about help, some people might be angry that you don’t know what to say. Some won’t. We’re all individuals. Nobody speaks for all of us. That’s why my list includes the word ‘might’.

At some point there are no ‘wrong’ things to say to us. We’re just so happy that you’re still in our lives.