Latest news and research on all cancers and treatments, updated several times a week, plus 10,000-item data base of these
I have three morbidities, of which the bladder cancer one is in remission. The other two are, for now, of more importance to me. So I am not now posting here as to heretofore. However, I list below a synopsis of what I believe are the important tools for anyone who has cancer concerns.
1. If you wish to know my detailed advice about cancer, see the first two references above: Click here to Survive Longer Here for Anti-Cancer Program
2. A briefer summary is of what I do, based on the best evidence:
b. exercise (which pumps the lymph system, the immune system, around the body): I walk for about 1.5 hours/day (10,000+ steps/5 miles); and 2-3 times a week I do simple resistance exercises plus 3 bursts of 20 seconds high intensity exercises (now on a stationary cycle, previously sprints) with 2 minutes of slow between
c. keep your waist below half your height, fat, especially visceral (waist), enhances inflammation and is a cancer enhancer.
d. Food effects our genes: so no alcohol, sugar/fast carbs, or meat - I now attempt to do a ketogenic diet (total carbs below 50g/day), with avocado and coconut oil to keep my fat intake high; an egg/day; and fish once/day for protein. I've recently embarked on a "Fasting Mimicking Diet" 5days/ month, as it is reported to reduce ageing/increase immune function (but probably best not done unless well clear of any evidence of cancer). Organic may be best.
e. Little fruit now, as I keep my sugar intake low - mainly berries/red-and-black currents
f. Veggies: broccoli, cauliflower, mixed leaves, spinach, mushrooms, onions, sweet peppers, chilli peppers (as a big salad at lunch-time)
g. Good oral hygiene - after breakfast and dinner, flossing and using a non-fluoride toothpaste. Gum disease is a major source of inflammation, a cancer stimulant; and cardio-vascular problems.
h. Good night's 8-hour sleep every night
i. Good, and daily, defecation. I now use a squat stool – enables me to squat on the toilet, similar to 3rd world countries, as this enables better elimination. The microbiome, mainly the gut bugs, is a major source of health/illness/immune system and the bug balance influences this. Research is in its early stages as to how to improve this, but good throughput seems to improve things.
j. Filtered water
k. I no longer take many supplements (having taken lots, on and off) - mainly just hemp oil or flaxseed oil - having found none seem to relate to any of my health/cancer measurements (except, sometimes, badly).
l. I monitor my body composition daily, my cancer with molecular cancer markers every month, checking in with the consultants if they go above 'normal' for 2 or more months.
m. Do a diary (who, time, date, place) of your medical visits, questions to ask, answers, advice.
3. I still monitor health news sites, from which I used to extract those I considered of most importance for cancer and posted here on my blog. I recommend you subscribe to one or more of these to ensure you know of the latest developments.
d. Create a Google Alert for your particular cancer (or anything for that matter). I have ones for bladder cancer, pancreatic cancer, hypertension, and kidney disease.
g. A good website for alternative treatments is The Truth About Cancer - though I find it not as authoritative as Cancer Active
Bear in mind that there is considerable evidence that cancer is related to lifestyle, so improving that is important. It helps the clinical treatments be more effective and reduces the side-effects. Plus even if a cancer patient goes into remission, they are always at greater risk of cancer again than those who've never had cancer in the first place.
Note several things about the information and advice that your doctor will give you. Diagnosis is not an exact science. That different people respond differently to both the same diagnosis and treatments. That doctors advise, patients decide (that’s why the doctors get you to sign a form, to say that it is your decision, not theirs). And that survival times (the prognosis) are at best averages, based at best on historical patients and treatments - whereas hopefully there are constant improvements which ought to improve the average survival times; many people live much longer than the average.
There are many cautionary reports to underline my view that the experts themselves do not always agree, and much of what they proffer may not be based on research, for example:
Science struggles with opinion and prejudice in guiding clinical practice
· by Special Correspondent, MedPage Today
SAN ANTONIO -- Although most oncologists would probably say that clinical trials should be the gold standard for determining the standard of care, the world of clinical medicine still doesn't always work that way.
That was the message delivered by Norman Wolmark, MD, chairman of the National Surgical Adjuvant Breast and Bowel Project (NSABP), in an impassioned, bitingly humorous lecture here at the San Antonio Breast Cancer Symposium.
In his talk, he discussed the NSABP's 50-plus-year history and the challenges posed by what he called "the three tyrannies" that distort treatment decisions in oncology.
The "tyrannies": anecdote, social media, and the editorial.
Wolmark, who holds senior appointments at Drexel University and Allegheny General Hospital in Pittsburgh, recounted the often-tortuous history of the National Cancer Institute-supported clinical trials cooperative group that had been largely responsible for changing how breast cancer can be treated and prevented including:
· Establishment of lumpectomy plus radiation over radical mastectomy as the standard surgical breast cancer treatment
· First demonstration that adjuvant therapy could affect the natural history of breast cancer, increasing survival rates
· First large-scale demonstration of tamoxifen's preventive effects in breast cancer
He outlined the ups and downs faced by NSABP and his mentor and predecessor as NSABP chairman, Bernard Fisher, MD, who faced professional ridicule and backlash for disproving the efficacy of the Halsted radical mastectomy. That included federal investigation by the Office of Research Integrity and Congressional hearings, eventually ending with vindication both medically and legally.
Wolmark said that since joining Fisher and NASBP in 1973, "there have been three sources of tyranny we've experienced when carrying out clinical trials." He quipped that he had originally planned to stay a year, "but overstayed my welcome."
"We would be subjected to the tyranny of the professorial pulpit. Of individuals taking their retrospective anecdotal case series and convincing their colleagues that their outcomes were superior to anybody else's," he said.
It wasn't just William Halsted, but others too -- since in those days the retrospective case series was the standard method of reporting data and the radical mastectomy was unassailably believed to be the operation that should be performed for breast cancer.
He said that clinical trials removed the bias or tyranny of the individual and that Fisher deserves much of the credit for mainstreaming clinical trials as a way of applying the scientific method to oncology.
"Even later, in the era when clinical trials were available, there would still be dominant surgeons who reported their own cases and convinced others that this was the standard of care because their results were better than anyone else's based on this," Wolmark said.
The advent of social media has brought a new type of tyranny into medicine, he said, one that physicians may be ill prepared to deal with in medical decision-making.
He mentioned a study commissioned by Memorial Sloan Kettering Cancer Center that theWall Street Journal reported on in September. It analyzed thousands of Internet posts in leading cancer forums and other online communities and found, according to the newspaper, that "women with breast cancer were typically distrustful of scientific data and even of their own physicians." Moreover, it found that many of these posts touted aggressive treatment such as double mastectomy despite a lack of supporting evidence from clinical trials."
"For breast cancer patients, the online narratives, advice and anecdotes they heard from other women tended to 'displace the voice of science and medical experts,'" noted the article.
"If you believe this study, then science is devalued," Wolmark told MedPage Today in an interview.
Through the unfiltered Internet and social media, he said, the opinions of individuals who've made personal decisions can appear, in the eyes of patients at least, as the standard of care.
He said that one-third of women younger than 40 years old who had breast lesions that could be treated with breast conservation were opting for unilateral and even contralateral mastectomies, and although it is the right of all patients to make their own medical decisions, those decisions should be based on reliable sources rather than distorted perspectives.
Citing the backlash suffered by NSABP concerning the use of tamoxifen years ago, he said that while the problem isn't new, the catalyst of social media has certainly accelerated it dramatically, and has helped to empower the uniformed.
"There needs to be the presence of scientific credibility in these social media vectors," he said.
As for the tyranny of the editorial, "No matter how much time and effort you put in doing a clinical trial and bringing the data to fruition and publishing it and being convinced there's an effect you can have, an editorial [in a peer-reviewed journal] can minimize the value of the effect," Wolmark said.
"They'd much rather read the distilled version of the study than the actual study," he remarked.
Still, not every editorial gets it wrong, he noted in his talk. He showed a slide with quotes from an editorial by Gabriel Hortobagyi, MD, published in 2005 as "Trastuzumab in the Treatment of Breast Cancer" in the New England Journal of Medicine.
"The results are simply stunning ... Clearly, the results reported in this issue of the Journal are not evolutionary but revolutionary... Trastuzumab and the two reports in this issue will completely alter our approach to the treatment of breast cancer."
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