Download Nutritional and Mind-body Interventions in Cancer and Chronic Illness

Nutritional and Mind-body Interventions in Cancer and Chronic Illness
Paul B. Schlosberg
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Copyright© 2008 By Paul B. Schlosberg
And MagPro Publishing http://www.MagPro.org
All rights reserved under International Copyright Conventions. Published in the United
States by MagPro Publishing
ISBN: TBD
Layout: Paul B. Schlosberg
Publisher: MagPro Publishing
Text Editing: John de Cuevas
First Edition: May 2008
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Contents
Preface
5
Chapter One Introduction
6
1.1
Building a Foundation of Health
6
1.2
Personal Connections to the Study
7
1.3
The Mind, Optimism, and Cancer
8
1.4
How This Book is Organized
11
Chapter Two Literature Review
2.1
The Mind and Cancer
13
2.1.1
Emotional Stress and Cancer
13
2.1.2
Is There A Cancer-Prone Personality Type? 16
2.1.3
The “Will To Live” and Cancer
17
2.1.4
Mindfulness And Cancer
18
2.1.5
Holistic Approaches
20
2.1.6
Kabat-Zinn: Mindfulness Meditation
20
2.1.7
Simonton: A Holistic, Psychosocial
Approach
23
Benson: The Relaxation Response
25
2.1.8
2.2
13
Nutrition and Cancer
26
2.2.1
Overview of Cancer and Physiology
28
2.2.2
What causes cancer?
29
2.2.3
Nutrition, Immunity, and Balanced Health
Systems
30
Inflammation and Cancer
32
2.2.4
4
Chapter Three
Conclusions and Future Considerations
38
Endnotes
44
Appendix A: Key Terms
49
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“When life has meaning, you can bear almost anything; without it, nothing is
bearable...the greatest tragedy is not death, but life without purpose."
Rick Warren
Preface
Although I have firm views on the use of both conventional and holistic medicine
in cancer, in this book, it is not my aim to attempt to persuade readers to make choices
based solely on these. It is my hope that readers make informed, intelligent decisions
true to their spirit, by weighing all of the best possible options, with the use of sound
judgment. With the exception of specific aspects that may be subjective in nature, the
following is based upon factual, research-based information. Although a disclaimer
is appropriate, the health solutions herein are preventive, researched, and generally
regarded as safe (GRAS); and, extensive references are provided for follow-up research.
I do not endorse particular treatments, conventional or alternative; however, unless
contra-indicated, I believe what is outlined can at least be used as a supplement to almost
any type of treatment. These evidence-based practices can not only enhance recovery but
also enhance one’s quality of life. Of course, it is imperative that one discuss any
possible changes in a health program with their chosen health professional.
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Chapter One: Introduction
“God, grant me the serenity to accept the things I cannot change,
The courage to change the things I can, and the wisdom to know the difference”
Rheinhold Niebuhr
1.1 Building A Foundation of Health
To be clear about the main perspective I take in this book, my view is similar to
that of the Chopra Center for Well Being in California, run by the renowned holistic
pioneer Dr. Deepak Chopra ― it is not my intention to treat cancer, rather to help a
person build a foundation of health. Dr. David Simon of the Chopra Center says, "We do
not believe our programs treat people with cancer. By this I mean that we are dedicated
to improving a person's quality of life by reconnecting body, mind, and spirit." 1
Although cancer is complex, many healthcare experts believe cancer is the result of the
modern "toxic" lifestyle: mismanaged stress, poor nutritional habits, overexposure to
toxic chemicals, and a sedentary lifestyle. The toxic lifestyle I refer to is unquestionably
one of stress: social and emotional stress, ecological stress, and physiological stress, with
much of the physiological stress resulting from poor diet. Additionally, I feel that
cancer represents, from an extreme standpoint, the problems we currently face in
American culture due to an erroneous overemphasis on acute healthcare solutions such as
dangerous pharmaceuticals and invasive surgeries (which, I admit, are often necessary),
rather than on more forward thinking, preventive, client-centered, self-healthcare
practices. This book is an exploration of mind and body coping skills in cancer, of how
embracing holistic practices such as nutrition, exercise, and mind-body modalities like
positive mental imagery, stress-reduction, emotional interventions, faith and spirituality –
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along with the use of either conventional or non-conventional treatments, can cultivate
greater patient empowerment and attentiveness to self-care. These practices also help
enhance one’s overall wellness and sense of dignity and integrity in the face of lifethreatening illness.
1.2 Personal Connections to the Study
There are significant reasons for my interest in mind-body health in the
prevention and treatment of cancer. I have lost two fathers to cancer: my natural father
died of oral cancer at age 34 when I was three, and my step-father died of esophageal
cancer at age 54, when I was 31; additionally, my mother is a survivor of breast cancer.
Moreover, it is likely that just about all Americans are affected by cancer either directly
or indirectly ― cancer is truly a major epidemic of the Western world. Cancer is
in process of, or has taken over heart disease as, our nation's number one killer. At least
one in three people we know throughout our lifetimes will develop cancer.2 My interest
in holistic treatments is due in part to my own experiences in traditional healthcare: I
have had debilitating health conditions, including numerous experiences with both
conventional and holistic medicine. From these experiences, I have come to believe that
the soul of our conventional healthcare system ― for example, authentic client-centered
care that elementally connects helpers and clients from a heart level ― if not already
damaged, is in jeopardy of becoming so due mainly to financial influences and to
corporatization, though there are other factors too. Thus, I feel we need a profound
change in our practice of healthcare to one that is far more mind-body-spirit oriented.
Below, I outline the experiences of prominent cancer educator, naturopathic
doctor and author Verne Varona, which I hope can help vividly illustrate my own
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experiences with cancer, and my reasons for researching and writing. In his recent book,
Varona poignantly reveals his experiences as a thirteen-year-old boy, watching his
mother dying from cancer. He writes, "his mother, at the age of thirty-five years lay on
her deathbed . . .” and seeing her lying comatose in the hospital. "Her vivacity and
shapely figure . . . had become lean and frail. She lay quietly still. The bright hazel eyes
which once had gleamed now darkened orbits of torment. The silence of her presence felt
deafening. Thirteen years of memories flooded his mind; she was a gifted dancer, painter
and poet and had struggled through a devastating divorce with a graceful resiliency
sustained by a faith as constant as the sunrise. . . ." 3
I cite the above to illustrate the devastating physical and emotional effects of
cancer, and of severe conventional cancer treatments. In his book, Varona also writes
about deaths of other family members from cancer, and then explains underlying reasons
for his research, "Helplessly, I watched their weight and appetite decrease as life
gradually slipped away. Deep beneath the exterior pretense of a tough and hardened
adult, I still carried my boyhood fear of the same fate. I reasoned that as most of my
family became sick, surely my turn was inevitable. Repeatedly I asked myself the same
questions: What factors caused them to become sick? What, if anything could prevent me
from becoming sick? Are we all just victims of some mysterious master plan, or do we
really have some choice in creating healthy, vital lives for ourselves?" 4
1.3 The Mind, Optimism, and Cancer
My concerns are similar to Varona’s: Do we have clear choices in creating our
own health? Do we have choices about how we are involved in our healthcare
treatments, and about whether we can face serious illness and even death with dignity and
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freedom from suffering? Like Varona’s mother, my step-father was a physically vital
man at age fifty-four, and within months he lost sixty pounds, his back and body charred
black, like a burn victim, from excessive radiation treatments. I witnessed his eventual
death from pneumonia because of a compromised immune system from treatments.
Certainly, I understand that his conventional treatment team did their best to help, but I
have to wonder, like Varona, particularly when I learn about success stories using holistic
treatments: Are there better ways for treating life-threatening illness? Is it possible to
optimize health through preventive practices, and in doing so perhaps live disease-free
lives, and avoid serious health problems like cancer?
An important related question, is why does one person with cancer live and yet
another with a similar diagnosis and treatment die? Dr. Carl Simonton, founder of The
Simonton Cancer Center in Malibu, California, argues that many causes of cancer are
well known, such as exposure to carcinogenic substances in the environment, genetic
predisposition, radiation, and dietary influences, among others. Simonton points out,
however, perhaps the basis of his work, that although all these factors are important and
play real roles in why people contract cancer, it is also true that large numbers of people
with these risk factors nevertheless do not contract cancer.5 Simonton writes: “A great
deal of time, energy, and resource have been poured into the search for the cause of
cancer, but one important fact is often overlooked: When exposed to known cancer
producing substances, most people still remain healthy.” 6 The heart of Simonton’s work
concerns intrinsic factors that have to do with the ways patients respond to major lifestressors that may have preceded their illness, as well as how they respond to the stress
particularly from life-threatening illness, also their general coping styles, and their overall
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emotional condition. Simonton believes these factors usually can be changed through
practice, and he has helped patients do so with much success at the Simonton center.7 A
growing body of research shows it is clear that the way we think directly affects our
immune system, which directly fights cancer. The National Cancer Institute states that
immune system functions like natural killer (NK) cell counts and lymphokine-activated
killer (LAK) cell activity destroy cancer cells.8 A mind-body study conducted by Dr.
Barry Bittman of the Mind-Body Institute with researchers from Loma Linda University,
(as well as other similar studies) shows that one’s mental state directly affects the levels
of NK cells and LAK cells in the blood.9
Thus, not only is this book a study of physical health, but also an exploration
of the human mind and spirit. Throughout the study, I hope to better understand the
extremes of illness, and perhaps most importantly, understand the human potential for
triumph over catastrophic illness. Rather than succumb to demoralization, perhaps
people can learn to explore illness the way Henry Thoreau explored reality, desiring to
"live deeply and suck the marrow out of life," 10 that is, to embrace human existence by
exploring how life-threatening illness helps one not only triumph emotionally, but also
build a more meaningful relationship with oneself, one's loved ones, and one's peers.
Paradoxically, though it may be difficult to conceptualize, experiencing and
understanding illness (and healing) can help one who suffers from cancer create a more
meaningful and empowered existence.
I certainly agree with Simonton that the mind and particularly an optimistic
attitude is one of, if not the, most important keys to fighting cancer. I think Simonton
would probably agree that attitude and optimism alone do not fight cancer; that optimism
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put into practice is key. And, this I believe, in part, is where overall health practices, and
nutritional practices specifically, are of particular importance.
1.4 How This Book is Organized
In the first half of the book, I explore the mind and cancer, including possible
reasons for roadblocks to optimism and their origins, ways to stimulate positive
outlook, and constructive actions toward emotional wellness that can be taken in a cancer
diagnosis. From the standpoint of both integrative mind and body health, it means
strengthening the body's defenses. From a psychological and emotional perspective, it
means exploring the roots of stress, emotional conflict, and gaining greater selfawareness. This includes cultivating a positive attitude, improving one’s emotional
resiliency, and becoming open to new ideas for developing self-help skills. Of great
importance also is gaining insights to the tendency to succumb to the demoralization and
fear that often occurs during cancer.
When I refer to cultivating the mind and an optimistic attitude, I am not referring
to a pollyanna mentality. For example, prominent mind-body researcher Lisa Aspinwall
at the University of Maryland studied cancer patients and found that optimists spent more
time than pessimists studying severe risk, health education materials. What it likely
means is that optimists do not have their heads in the clouds or in denial, but rather are
concerned, well-organized, and mobilized to take action. To me, this is exactly the
perspective one needs to be able to modify health practices to fight cancer.11
The second half of the book covers the practice of nutrition and its importance in
preventing and fighting cancer. Nutrition and its relationship to cancer cannot be
overstated. In fact, the American Cancer Society, as cited in Brown and Trivieri, “now
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states that as many as a third of all cases of cancer in the United States could be avoided
if we as a nation adopted healthier eating habits.” 12
Sound nutrition strengthens the body’s defenses, specifically immunological
function. Even though western conventional medicine has created a separation between
mind and body, the two in fact are not separate: in conjunction with a positive mental
attitude, attention to nutrition is a critical for enhancing and building the body's
immunological response. In my view nutrition is, or should be, considered a mind-body
discipline. The reason is that integrating nutrition into one's lifestyle and reaping the
known physiological benefits of good diet are dependent upon an initial change in mental
perspective and corresponding change in health practices. In other words, one needs to
relearn habits and reframe ways of looking at healthcare in order to make crucial changes
to diet and develop new ways of managing stress.
From my research and experience, I have concluded that holistic approaches to
cancer are useful, important, perhaps even critical. Cancer is unquestionably a complex
problem with dozens if not hundreds of biological, psychological, social, and spiritual
influences. At times cancer's onset may seem inexplicable; however, I know from
personal experience that people will continue to be healed with mind-body selfhealthcare practices. And if this is so, why are not more Americans willing to attempt,
and at least be made more aware of, such practices as nutrition or positive mental
imagery, particularly when their implementation is harmless, and research shows their
extremely beneficial impact on overall health? 13 I will explore this dilemma.
This is an introduction to prevention of cancer, and an introduction to the holistic
support of cancer treatment, nutrition, and mind-body health; an orientation for anyone
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with cancer, or for one with a loved one with cancer, or for those who would like to learn
more. Although the topics are targeted at cancer, they are applicable for generally
improving overall health and wellness. The information is useful for people who would
like to become better educated about what may be one of our most important social
health problems, and about their own health and wellness in general.
Chapter Two: Literature Review
2.1 The Mind and Cancer
“Cancer is a curious thing.
Childless women get it,
And men when they retire.
It’s as though they needed an outlet
For that foiled creative fire.”
W.H. Auden
2.1.1 Emotional Stress and Cancer
In this section, I identify important questions to initiate research and further
exploration into cancer, stress, and the mind; then, provide some underlying theory, and
finally, offer discussion of practical mind-body practices that may be useful in the holistic
support and prevention of cancer.
Important questions, though certainly not exhaustive are first, does stress ― or
perhaps more prosaically, the way one copes with stress ― contribute to cancer
development? Do particular personality characteristics cause, or contribute to, the
development of cancer? What is mindfulness, and do mindfulness and self-awareness
play roles in coping with cancer? Additionally, how large a role does the mind play in
cancer prevention? And how large a role do the physical practices and actions, for
example, health habits and health behaviors, play? The answers are not simple, because
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an overlap exists, and the mind and thoughts guide one’s actions and behaviors.
Currently, a growing body of research seems to indicate that the physical aspects
of preventive health, such as nutrition, exercise, and the avoidance of toxic environmental
substances, do contribute to cancer prevention.14 However, we probably know more
about, or are at least currently better able to draw relationships concerning, the physical
aspects of cancer than we know about the psychological or “mind” aspects of cancer.
According to Cassileth, "the fact is that there are no data that show that [using mind-body
interventions, such as meditation and emotion management] has any direct effect on
disease." She adds, however, that there are measurable physiological effects, including
the reduction of heart rate and blood pressure, and relaxation of the musculoskeletal
system.15
For the purposes of this writing, I take the view – admittedly, a leap of faith – that
being emotionally healthy at least plays a role in fending off or avoiding cancer; and thus,
the converse: that an emotional problem or pathology may contribute to cancer’s
development. Cancer is an extreme condition, and it would seem to require an extreme
measure of non-wellness to cause it. This concept has been the driving force of
behavioral health researchers aiming to prove that the mind is influential in cancer.
I focus on preventive health and promoting the viewpoint that relatively simple
and basic but powerful mind-body skills such as self-awareness, cognitive behavioral
self-dialogue, meditation, breathwork, and optimism are influential in cancer prevention.
Changing one’s thoughts, and as an effect, also one’s self-care and wellness practices, are
powerful steps, and in some cases may prevent or even reverse cancer.16 In one example,
a study by Ornish revealed preliminary findings that holistic lifestyle changes including
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emotional support, relaxation, diet, and exercise can prevent, slow, or perhaps even
reverse prostate cancer in some men. 17 18
Overall, the practitioners I discuss believe firmly in holistic practices, or would
not be devoting their lives to promoting and teaching them. My views are similar to
theirs, even though current research may not necessarily substantiate the practices’
overall validity. Mind-body medicine has been practiced for thousands of years, and
whole-person care has always been recognized intuitively and empirically. Anecdotal
stories of successes and triumphs over cancer have existed from time immemorial.
Moving toward the future, modern health science will be able to corroborate the
usefulness of mind-body practices. Thus far, though, there is a lack of "meta" holistic
research available. Large-scale funding is limited in preventive health, unlike
the abundance of pharmaceutical-based research funding available. Even though
integrative healthcare is growing at a dramatic pace, there is still a tremendous amount of
resistance from the conventional system as a whole, from the insurance and
pharmaceuticals industries, to doctors and psychiatrists, as each is threatened by the
growth of holistic medicine.
Northrup, an innovator merging traditional medicine with holistic medicine
(including nutrition, homeopathy, and energy medicine), cited in a recent writing an
example of the medical community’s overall apathetic stance toward holistic research
and treatment in cancer. Taxol, an expensive drug costing around $5000 per course of
treatment, received much publicity because it lengthened the life of ovarian cancer
patients by several months. Interestingly, according to Northrup, a holistic medicine
study published in the prestigious medical journal Lancet revealed that women going to a
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support group lived eighteen months longer than those who did not. However, for
reasons I have mentioned, the study was not given much attention. Northrup concluded
that if holistic cancer support were a drug, it would be unethical not to use it in every
instance of the disease. 19
2.1.2 Is There A Cancer-Prone Personality Type?
Controversy surrounding holistic mind-body approaches to cancer centers on
whether or not particular personality characteristics contribute to cancer’s
development. The debate goes far back historically, at least as far as the second century
when the Greek physician Galen attributed cancer to a melancholy disposition. Similarly,
in contemporary times, people who support and practice the holistic therapies
concurrently often support the notion of a cancer personality type, believing the
development of cancer is in fact influenced by certain personality traits and
characteristics. However, again, the theory is difficult to prove.
Temoshok attempted to prove the cancer personality theory in the 1990’s at the
University of California at San Francisco, positing a Type C personality, indicating that a
cancer-prone person suppresses emotions, is often hostile, is a people pleaser, and has
poor self-concept. Temoshok’s research followed along with others attempting similar
work that linked health conditions to various stress-prone personality types. For
example, Friedman and Rosenman's hard-driving hostile Type A personality is correlated
with cardiovascular problems, and its opposite, the Type B personality, alternately, is one
who is relaxed and handles stress well.20 The “helpless-hopeless” type identified by
Seligman is one in which repeated failures become a learned response, which Seligman
called "learned helplessness." Seligman’s work was expanded to cancer research by
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Schmale, and a study by Schmale and Iker of sixty-eight women predisposed to cervical
cancer showed that, based upon either their hopefulness or hopelessness potential, they
could predict which ones would or would not contract cancer. 21 Temoshok and the others
mentioned have developed significant followings; yet, unfortunately, recent findings
show conflicting results making things less clear.
2.1.3 The “Will To Live” and Cancer
The idea of a cancer personality type raises the notion of the influence of an
individual’s "will to live" in cancer. Most of us recognize intuitively that when people
have a strong will to live they have better chances for survival. For example it is
common practice in my experience for doctors to say to the loved ones of patients
who are holding on to life, "Oh, he has a tremendous will to live," or the converse, "well,
it was her time, she simply lost her will to live."
Simonton has found that valuable indications of the will to live are peoples’
health habits, practices, and behaviors in response to their illness. Many of the cancer
patients Simonton studied were given decent prognoses to live a number of additional
good years of life, but Simonton still found, for example, “lung cancer patients who
refused to stop smoking, liver cancer patients who wouldn’t cut down on alcohol, and
others who wouldn’t show up for treatment regularly.” 22 He also found that many cancer
patients that did live a long time against odds would frequently make comments such as
“I can’t die until my son graduates from college,” or “They need me too much at work,”
or “I won’t die until I’ve solved the problem with my daughter.”23 Developed through
years of research and practice, Simonton’s work today includes motivation, education,
mind-body, and psychosocial interventions to encourage patients’ attitudes, and to
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improve their health behaviors. He claims his successful research outcomes support his
thesis. 24
2.1.4 Mindfulness and Cancer
An important intervention for preventive, holistic approaches to cancer is the use
of mindfulness. Mindfulness meditation is a way of being present to one’s body,
thoughts, and feelings without judging, criticizing, or rejecting what one discovers.25 At
times mindfulness is practiced as a sitting meditation; at others a daily living meditation,
and form of self-therapy; or, a combination of both. A better description may be that it is
a holistic, integrated way of living. Somewhat humorously, it has also been stated that
mindfulness can perhaps be viewed as the opposite of mindlessness.
Mindfulness meditation expert Kabat-Zinn explains that mindfulness meditation,
in general or in the treatment of cancer, is not a pie-in-the-sky, strange, or exotic
ideology. He believes that mindfulness meditation is about learning to be well regardless
of one’s physical situation. “You can be unbelievably healthy no matter what is wrong
with you,” says Kabat-Zinn. “It’s not like you have cancer and have to be done with that
before you can be well. And one way of being well is through meditation. . . . Meditation
is about knowing what’s on your mind. . . . The real meditation is how you live your life,
not how you sit in a chair. It is about how intimate you are with yourself in the
moment.”26
Though often more broad in scope, the use of mindfulness meditation in cancer
support typically involves four aspects: emotion management, reducing symptoms from
cancer, the reduction of the symptoms associated with the treatments, and pain
management. As Kabat-Zinn describes it, mindfulness is parallel in certain respects
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to self-awareness. In the art of preventive cancer care, self-awareness and mindfulness
are significant to help gain better awareness of emotions, and for influencing the mind,
thoughts, and feelings. Mindfulness meditation increases awareness of inner emotional,
psychological, and sensory experiences, and is similar to taking an inner psychological
and spiritual inventory. It can help one learn to develop a better perspective and more
realistic expectations about one’s daily life. For example, an important sign of a toxic
lifestyle, including the poor health practices (codependent and addictive health behaviors)
that typically spur lifestyle-related health problems, is the inability to maintain realistic
boundaries, limits, and sense of capabilities.
The following example illustrates the above point concerning the relationship of
mindfulness to overall health. A substantial number of Americans suffer from bloodsugar and metabolic imbalances, including pre or type II diabetes, which are suggested to
be linked to cancer. A type II diabetic with sugar metabolism problems needs to
moderate sugar consumption. Yet people with this condition unfortunately go
beyond limits due to compulsivity; they typically may deny, either privately or
outwardly, how many carbohydrates are being consumed.
In another scenario, an overstressed workaholic believes he or she can work
compulsively, perhaps sixty or seventy hours per week or more, though clearly ignoring
good health practices and not paying sufficient attention to other important life priorities.
Though these individuals likely have good intentions, one aspect of the problem, perhaps,
is they are not mindful enough about the consequences, or unrealistic about how their
actions contribute to their toxic lifestyle. These examples succinctly illustrate possible
lifestyle factors connected to the development of cancer and other chronic illnesses. In
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part, the answer has to do with a cultural need for improved health education, and for
greater attentiveness to mindfulness and self-awareness, in general.
In the various phases of cancer, mindfulness meditation can be utilized in unique
ways. For example, in the initial phase of cancer, immediately following diagnosis,
mindfulness and self-awareness can be a useful tool, because learning to calm the mind is
extremely difficult with the emotional upheaval typically occurring during this phase. As
Byers explains, when first diagnosed, patients' initial reaction is often shock, frequently
causing what Byers describes as “a systemic [emotional] breakdown.” She says there is
an initial shock because cancer and the treatments cause both medical and psychological
trauma. Byers says the cancer patient’s perspective is, “your body feels like it has
betrayed you . . . all these years you have been living and doing all these wonderful
things, and you feel like, now, how could it betray you?” 27 Seng says, "For some people,
finding out they have cancer and [or] going through very difficult cancer treatment can
lead to post-traumatic stress disorder symptoms. . . . Other cancer patients may have had
post-traumatic stress from earlier traumatic events, and aspects of having cancer makes
them experience symptoms again.”28 The use of mindfulness meditation, and expressive
techniques such as writing about the trauma, and other self-awareness techniques, are
shown to be effective for dealing with trauma associated with cancer. 29
2.1.5 Holistic Approaches
In the following sections, 2.1.6 through 2.1.8, I overview the work of successful
mind-body cancer practitioners. Each involves the practice of mindfulness and selfawareness in holistic cancer support and prevention, in similar, yet unique ways.
2.1.6 Kabat-Zinn: Mindfulness Meditation
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The Mindfulness Based Stress Reduction program (MBSR) ― emanating from
ancient eastern Buddhist traditions and developed by Jon Kabat-Zinn, Professor of
Medicine Emeritus at the University of Massachusetts Medical School ― originated in
the U. S. at the University’s medical center in Worcester, where it is currently
practiced.30 Kabat-Zinn also spearheads research on mindfulness at the center, in
conjunction with the MBSR program. Currently, MBSR is offered in over 200 U. S.
hospitals, and is the focus of a number of research studies at the National Center for
Complementary and Alternative Medicine (NCCAM).
Through MBSR, Kabat-Zinn has put forth an exceptional effort to spread the
ancient East’s message to the modern West of mindfulness and its connections to
physical health and life-threatening illnesses including cancer. Kabat-Zinn’s work blends
science, health, and spirit. Rooted in Eastern health and spiritual practices, Kabat-Zinn’s
use of mindfulness meditation fundamentally involves directing one’s attention to the
here and now.
I am fascinated to learn that the purposes of modern psychotherapeutic
interventions in part have similar aims to those of mindfulness; it is inspiring and
enlightening to find that the standard goals of modern psychotherapy have correlations
with Kabat-Zinn’s wisdom, which comes from the ancient study of meditation and
healing.31 Two examples, Gestalt Therapy, a form of therapy developed by Fritz Perls,
and Dialectical Behavior Therapy (DBT), a cognitive therapy developed by Marsha
Linehan, are Western psychotherapeutic practices extensively implementing the use of
mindfulness.32 33 However, these are merely two among others. In fact, the preeminent
psychological theorists of the twentieth century particularly theorists of humanistic
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psychology ― for example, Carl Jung, Abraham Maslow, Carl Rodgers, and Alfred
Adler ― are influenced deeply by mindfulness and Eastern thought, of learning to focus
on the present.34 The practice of mindfulness and awareness take numerous forms,
including: attentiveness to thoughts in meditation; to a higher power in prayer; to
feelings, emotions, desires, in self-awareness and self-analysis; to other's actions
and feelings during acts of interpersonal communication; to one’s own actions; and,
attentiveness to self-care. But, to simplify, the essence is what Kabat-Zinn teaches as
learning a fundamental change of how to "be" rather than "do" as a way of centering the
mind. Also, at times, learning how to be while doing, because one must take action in
daily life – for example, create, connect, work, and construct.
Cancer patients come to Kabat-Zinn’s MBSR Program along with others suffering
from severe conditions like heart disease, arthritis, diabetes, kidney disease, or chronic
pain. During daily MBSR sessions, patients are taught to use meditation to cope with the
psychological and physical effects of stress. They learn how to become mindful of their
emotional states, primarily the emotions fear and anger which, in excess, are particularly
destructive to health. During the program, through the daily practice of hours of
meditation, patients begin to shift their awareness away from lingering negative,
destructive mental patterns to a more relaxed state of being. Kabat-Zinn says that
although meditation is sometimes difficult to put into words because the mind is so vast
and can seem “mysterious and vague,” the practice of meditation really is quite simple. 35
In MBSR three basic types of meditation are implemented: sitting meditation, either in a
straight-backed chair or on the floor; a body scan meditation lying on a mat on the floor;
and standard hatha yoga postures, similar to those found at any neighborhood yoga class.
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Group discussion and one-on-one counseling are also integral to the program.
MBSR patients find that mindfulness and self-awareness are about learning to live
life, whether sitting in mindfulness meditation, or performing one’s normal daily
activities, from an internalized perspective with intention rather than being motivated
mainly by external cues, desires, needs, and wants. It is the imbalanced over-focus on
externalization that creates a hyper-stressed physiology. MBSR is founded upon the
concept that encouraging internalization, reflection, and self-awareness promotes greater
relaxation, and mental and physical wellness. Csikszentmihalyi in part sums up the
mental and psychological aspects of this more internalized lifestyle:
There are two main strategies we can adopt to improve the quality of life. The
first is to try making external conditions match our goals. The second is to change
how we experience external conditions to make them fit our goals better. . . . The
solution is to gradually become free of societal rewards and learn how to
substitute for them rewards that are under one's own powers. This is not to say
that we should abandon every goal endorsed by society; rather, it means that, in
addition to or instead of the goals others use to bribe us with, we develop a set of
our own. 36
2.1.7 Simonton: A Holistic, Psychosocial Approach
Simonton implements a holistic cancer program incorporating lifestyle
management, emotional support, and a specific form of meditation and imagery for
cancer patients, which, according to his own research, is quite successful. Simonton
outlines and discusses this research and practice in Getting Well Again.37 In
Simonton's practice, the cancer patient in meditation envisions his or her cancer cells, and
24
next imagines pac-men gobbling them up. Simonton believes that part of the strength of
his techniques stems from the concept of empowerment (a foundational tenet of each of
the practitioners mentioned in this book). When a patient feels empowered, beautiful
things can occur at every human level: physical, emotional, and spiritual. When a cancer
patient begins to find hope, energy, vitality, and self-confidence blossom, and the
immune system becomes mobilized for action, halting cancer cell proliferation.
It seems a testament to the success of Simonton’s work that he is one of the
biggest influences upon the use of imagery and holistic, psychosocial treatment in cancer.
His work has spurred the use of imagery, and its study, in many major cancer centers and
universities across the U. S., and a review of forty-six studies conducted from 1966 to
1998 by the American Cancer Society found that guided imagery was highly effective in
managing stress, anxiety, depression, pain, and the side effects of chemotherapy.
There have been few studies evaluating programs such as Simonton’s, or the use
of holistic and psychosocial interventions in cancer. According to a report issued by the
United States Congress Office of Technology Assessment (OTA), with an advisory panel
including notables such as Andrew Weil, C. Norman Shealy, and Jeanne Achterberg 38,
among others, three studies have been performed to assess survival rates using imagery
and psychosocial interventions. One study was done on Siegel’s ECaP program, a
program influenced by Simonton’s.39 According to the report, “the study found a small,
but not statistically significant increase in survival time among ECaP participants
compared to nonparticipants.” 40
Another study was done on Spiegel’s psychosocial cancer program at Stanford
University, using psychotherapy, group support, and self-hypnosis for women with breast
25
cancer.41 According to the OTA report,
There was a significant difference in survival time between the two groups:
women who underwent psychotherapy lived an average of 36.6 months after
randomization to the intervention, while women in the control group lived an
average of 18.9 months following randomization. . . . Spiegel and his colleagues
also found that psychotherapy significantly reduced anxiety, depression, and pain
among participants. The investigators suggested that involvement in the support
group may have allowed patients to better mobilize their resources, to improve
compliance with conventional treatment, or to improve their appetite and diet
through reduced depression. They also suggested that patients who learned selfhypnosis for pain control may have been better able to remain physically active. 42
2.1.8 Benson: The Relaxation Response
Benson is well known for promoting a technique called “the relaxation response,”
a phrase he coined in the 1970's. The relaxation response is mantra meditation, or the
repetition of a word, phrase, or thought, to encourage a deep, mind-body-spirit healing
state of relaxation. Benson acknowledges that repetition is not the only way to elicit
physiological benefits of the relaxation response. Benson says, "The relaxation response
can be elicited by a number of meditative techniques, such as diaphragmatic breathing,
repetitive prayer, qi gong, yoga, progressive muscle relaxation, jogging—even
knitting."43 Benson claims that mind-body medicine, which consists of stressmanagement, diet, and exercise, is the third leg holding up the other two legs of a threelegged stool of healthcare. The other two legs are surgery and medicine, the more
conventional, acute forms of care. The relaxation response is holistically integrated with
26
psychosocial interventions for cancer patients at the Benson-Henry Institute at the
Massachusetts General Hospital.
2.2 Nutrition and Cancer
"Let food be thy medicine and medicine be thy food”
Hippocrates
As mentioned in the introduction, one of the most important goals of this book is
to help cancer patients and all seekers of wellness learn to develop a foundation of health.
This foundation will optimize the chances for preventing cancer, or perhaps slow or
reverse it. I follow Quillen’s suggestion, urging those dealing with cancer to “focus on
the parts of [the] body that are working properly, not on the cancer.” 44 The scientific
links between physiological health and diet are becoming clearer as we continue to
develop scientific research in the relatively new area of human nutrition.
One of the most important threads for health-building is learning ways to enhance
immunity. In my view, proper diet and nutrition, though only one aspect of a
comprehensive approach, is perhaps the most direct one because we must eat regularly
for survival, in normal circumstances three to six times per day; thus, the importance of
food choices cannot be overstated. I do not think it is a stretch to say that in certain
respects, nutrition is black and white ― meaning that just about every food we put into
our body affects us in either an enhancing or depleting way.
Research shows links between immunity and cancer, as well as links between
immunity and diet. Yet it is somewhat more difficult to show a direct relationship
between cancer and diet, though we see evidence from existing studies, and scores of
additional ones in progress. It is generally accepted that various components of the
immune system such as T Cells, and NK cells, cytokines, prostaglandins, good
27
eicosanoids, and other physiological sub-structures are involved in the elimination of
malignant cell proliferation; and we do know that specific aspects of nutrition influence
these components of the immune system (explored below). It has become widely
accepted that a strong immune response offers better chances to ward off cancer, and
nutrition improves this factor. According to Quillen, the average person has cancer six
times in the body within a lifespan, but roughly sixty percent of the time it is warded off
by a healthy immunological response. Quillen explains that a number of nutritional
supplements are known to bolster immunity including colostrum, whey extracts, aloe
extracts, Essiac tea, and others.45
The conventional approach, treatment, and overall philosophy for cancer
originates in part from Pasteur, one of the forerunners of conventional medicine in the
early twentieth century. 46 Pasteur concluded that many of the diseases we experience are
caused by exogenous pathogens. In other words, Pasteur put forth that, "the state of
health or disease was not a measure of the integrity of the immune system, but rather of
the strength of the invading microbe." 47 Pasteur developed the "germ theory" of
medicine, which according to Seaward is now the leveraging idea for modern medicine's
use of antibiotics, immunizations, and use of pharmaceuticals in general to treat disease.
48
Pasteur influenced the development and use of vaccines. Today a number of top
pharmaceutical companies are using vaccines for cancer treatments, including drug
vaccinations as treatments for cervical cancer, and melanoma, among others. Major
pharmaceutical corporations are now implementing cancer vaccination programs,
including a leading one of Pasteur’s name: The Sanofi-Pasteur Corp.
According to Seaward, in the early 1900s Pasteur was challenged by the French
28
scientist and philosopher, Claude Bernard. Bernard argued it was not, as Pasteur
believed, the strength of invading microbes that determined disease, though that was
certainly a factor. Perhaps more importantly, the strength of an individual's interior
milieu, or, internal system, determines whether or not one can fend off invading
pathogens, and ultimately fend off diseases such as cancer. Bernard’s views represent
those of holistic, integrative, and alternative medicine, and those promoted in this book.
2.2.1 Overview of Cancer and Physiology
Following, I provide a brief overview of what cancer is, and how cancer develops
at the cellular level. Cancer, in fact, is not one, but a group of over 100 conditions. In
various forms, cancer is defined, basically, as uncontrolled cellular growth. When human
cells divide and grow they form tumors, though some tumors are benign and do not cause
major threats to health. However, dangerous tumors which grow unchecked are
considered to be malignant. Malignant tumors are dangerous because they attack and
injure healthy cells, tissues, and organs; and when they spread from their initial tumor
site, they are metastatic. The body has internal mechanisms to control rapid cell division
and growth; however, for various reasons, if metastasis is uncontrolled, it will invariably
lead to serious disease and death.
Though there are many types of cancers, all cancers generally fit into one of the
four following main categories:
Carcinomas – cancers of the soft tissues, organs, and the tissues that surround the organs
Sarcomas – cancers of the hard tissue such as bone, also cartilage, muscle, and fat
Leukemias – cancers of the blood
Lymphomas – cancers of the lymphatic system, over twenty different forms of lymphoma
29
exist 49
2.2.2 What Causes Cancer?
Most theories about the origin of cancer point to its being either a genetic
mutation or a virus ― correlating with Pasteur’s theories. However, it is now recognized
that the cancer process is also advanced by “genetic, immune, behavioral, and/or
psychosocial factors.” 50 By psychosocial, this likely includes environmental and
preventive factors, including nutritional. 51 It is recognized that only a small number of
the known forms of human cancers are caused by viruses. Most forms of cancer are
caused by genetic mutations. Codes in the genes of cellular DNA of individual cells
provide instruction for healthy cells to grow and divide at just the right times for positive
physiological advancement, tissue repair, and development ― or, wellness. To me, an
important question is: Are these genetic mutations inherent, or are they affected by
external cues such as diet, environmental, and psychological factors? I wonder, if cancer
is typically caused by genetic mutations, does it also mean that genes are necessarily preprogrammed, or unalterable? Interestingly, many researchers believe that genes, in fact,
are also alterable by lifestyle behaviors.
Perhaps more importantly, however, it is commonly accepted among preventive
health researchers and practitioners that people typically do not need to change their
genes, but instead need to optimize the expression of those genes. The field of
nutrigenomics is devoted to this study and practice of understanding genetic patterns, and
creating nutritional solutions to optimize genes’ expression.52
The breakdown of wellness in cancer occurs for various reasons, some which are
known and some not. It is recognized that damaged DNA provides incorrect instructions
30
for cellular division and excessive growth, resulting in the development of tumors. The
normal system of checks and balances at the cellular level are the oncogenes, giving
instructions for cell growth, and suppressor genes, which give instructions to halt cell
growth. Both of these genes usually work effectively for maintaining
homeostasis; however, in cancer, suppressor genes are faulty. When they become faulty
and cancer develops, the next line of defense is the immune system. As mentioned, it is
known that cancerous cells frequently exist in the body but in a healthy individual the
healthy immune system is able to control them. As mentioned, NK cells are one of the
body's main fighters in this internal battle. Others include T Cells, and cytokines
(chemical messengers). The overall conceptualization of the seek and destroy system is
called immune surveillance theory. 53, 54
2.2.3 Nutrition, Immunity, and Balanced Health Systems
Next, I look at important considerations for improving the immune system
through nutrition, and through the use of balanced health systems. Human physiology is
complex, and thus an extensive list of nutritional suggestions exist to improve immunity.
Seaward outlines many of them.55 I do not provide his complete list here, but among the
most important are: consuming a good supply of antioxidants including beta-carotene,
vitamins C and E, and selenium; getting a sufficient supply of fiber for colon health and
suppression of appetite; drinking plenty of clean water for cellular and tissue hydration;
decreasing ingestion of pesticides, fungicides, herbicides, and fertilizers from foods or
other sources; consuming an adequate supply of complete proteins for cell, hormone, and
tissue building; eliminating, if not entirely, as much as possible the consumption of junk
and highly processed foods, and eating foods in their natural forms; decreasing the
31
consumption of antibiotics and hormones; consuming substantial amounts Omega-3 fish
oils which are recognized to decrease cellular inflammation (which, along with
inflammation’s role in cancer, will be discussed in more detail below); decreasing the
intake of saturated fats; decreasing trans fatty acids; being sure to vary the color of
produce, eating sufficient yellow, green, and orange vegetables and fruits, or, mixed
carotenoids which are known to possess different functions. 56
Without question, an important concept concerning nutrition and cancer is the
paradigm of balance. Balance may seem simple in definition, though is hardly so in
conceptualization and practice. The roots of the study of balance and health emanate from
ancient cultures, for example, the ancient Greeks had a deep respect for the need for
balance and harmony with natural laws, a primary consideration being food and herbs
and their effects on health. Hippocrates, the father of medicine, initiated a field of
medicine called humorism. Humoristic medicine is the theory that health depends upon
balance among the four humors: blood, black bile, yellow bile, and phlegm. Today,
Hippocrates’s humor theory is recognized as incorrect. Nonetheless, his idea of balanced
health systems is still respected, particularly in integrative medicine.
Around the same time, in the Eastern part of the world, Traditional Chinese
Medicine (TCM) sprang from the concept of balance. TCM was founded upon an
elemental conceptualization of balance the Chinese called Yin and Yang. Yang
symbolizes active, expansive forces of nature, and Yin symbolizes the passive, and
contractive. 57 However, in TCM nothing is either totally Yin or Yang, as they are
relative, interdependent, and dynamic. Today, TCM is thousand of years old, is still
thriving and in wide use.
32
Though not necessarily highly valued by modern, conventional practitioners, it is
quite clear that the body works in the amazing synergistic balance, or, homeostasis,
which was supremely valued by the ancient Greeks and Chinese. These ancients
recognized intuitively that the body possessed its own wisdom for healing.
Many internal systems (and perhaps an argument can be made that most physiological
systems) are based upon a delicate homeostasis, which the ancients knew was effected
by food and nutrition.
Through modern science, we have come to realize that one particular system is
extremely important: the balance between glucose (sugar) and insulin in the blood.
Blood sugar is the cells’ primary source of fuel for creating ATP which powers every cell
of the body. The development of ATP occurs in the mitochondria, the powerhouse of the
cell. Blood sugar must constantly be maintained within a certain range ―- normal
fasting levels are approximately 70 mg/dl to 100 mg/dl ― for maintaining proper energy
levels, and for human survival. The body has its own built-in mechanism for this: the
pancreas releases the hormone insulin for the purpose of maintaining even blood-sugar,
and to shuttle glucose into the cells. Imbalances in the glucose-insulin system are
thought to play a role in inflammation, and cancer. Below I explore how maintaining
balance in the diet can help maintain glucose-insulin homeostasis, and strengthen one’s
resistance to cancer.
2.2.4 Inflammation and Cancer
Generally, it is important to study underlying, fundamental systems in order to
find solutions to problems; health is no exception. One of these receiving much attention
recently is the concept of inflammation and its relationship to disease; also,
33
inflammation’s connections to diet and obesity. Inflammation and obesity’s connection
to lifestyle related conditions including cancer, heart disease, diabetes, arthritis, among
others, are well-documented. According to Sears, when specific bodily systems are out
of balance (such as the glucose-insulin system), cellular inflammation is a result and
lifestyle-related health conditions including cancer, diabetes, hypertension, arthritis,
among others, are the long-term result.58
Sears has devoted his life to researching inflammation, and created a system for
treating cellular inflammation with food and nutrition, urging that food’s effect upon the
body and the cells is as powerful as drugs. His nutritional system, "The Zone Diet", is
about reducing “silent inflammation” through blood sugar stabilization created by
balanced nutrition. Silent inflammation is exactly the same as we typically know
inflammation ― as in pain, swelling, or rheumatoid arthritis ― but less severe, though
perhaps more dangerous because it is below the threshold of detection, at a cellular level.
Silent inflammation can remain undetected for many years until it eventually causes the
lifestyle conditions mentioned, including cancer.
Nutritional prescriptions are superior to the current medical approaches to cancer
because these methods target the problem before it appears. Sears states: "After spending
some 30 billion on the war against cancer, our government hasn't made any headway into
finding a reliable cure for the disease or a surefire way to prevent it. With all the
hype, the primary treatments for cancer still remain the big three: burn, cut, or poison.
Although these rather barbaric approaches can potentially extend a patient's life span,
they're not an ideal prescription for a good quality of life." 59 Whereas other dietary
programs such as Atkins, Pritikin, or South Beach are extreme as they espouse low-
34
carbohydrate, high carbohydrate, low-fat, or another extreme, which is what the
American public seems to want, The Zone Diet seems boring because it is formulated
upon the concept of "moderation." It is neither too low carbohydrate, nor too high
carbohydrate; neither too low fat, nor too high fat, and so on. Dietary balance and
moderation reduce silent inflammation primarily by controlling the hormone insulin.
Moderation is the key to balancing insulin, as well as to balancing critical related
hormone and biochemical systems including the hypothalamus, pituitary, adrenal system
(the HPA axis); also, cortisol, epinephrine, norepeniphrine, adrenalin, and noradrenalin;
and, the key fat-storage hormones, leptin and ghrelin.
Sears outlines aspects of the immunological system that are part of the
inflammation response and that bring into play specific hormone interactions.60
According to Sears, when foreign invaders attack the body, the body calls into action five
different groups: 1. chemical mediators (including histamine, bradykinin, and serotonin),
2. complement systems (which is very complex, made up of twenty proteins),
3. eicosanoids (bad ones include prostaglandins, and leukotrienes), 4. cytokines, and
5. immunological attack cells (including macrophages and neutrophils). These are
activated by pro-inflammatory cytokines, and the release of cytokines is stimulated by
pro-inflammatory eicosanoids.61 This immunological and inflammatory response is a
chain reaction which begins at stage one (above), and progresses through stage five. It is
the balancing of these anti-inflammatory hormones (including good eicosanoids,
prostaglandins, and cytokines) with pro-inflammatory ones (bad eicosanoids) that
ultimately maintains homeostasis and wellness. Eicosanoids, prostaglandins, and
cytokines can be either pro or anti-inflammatory depending upon the type.
35
Though a complex system, one simple example of a common chemical mediator
that people are familiar with is histamine. Histamine is inflammatory because in the
presence of foreign attackers (allergens) its job is to dilate blood vessels. Functions of
histamine are to call other components of the immune system into play to get to the injury
site and other quick response defensive measures such as effect the lung passages, and
release of fluids from the nose. 62
Inflammation and silent-inflammation are actually different. However, their
difference is primarily only in intensity. Inflammation, symbolized by 4 classic signs:
redness, swelling, heat, pain, and silent-inflammation are caused by exactly the same
mechanisms, it's just that silent-inflammation is below the threshold of pain, which is
why it is so dangerous. Sears created a test marker, which he named the silent
information profile, or SIP, that he believes is the best way to quantify this silent
inflammation. The SIP is the ratio of AA/EPA, or, the ratio of dangerous, inflammatory
arachadonic acid, AA, to the health promoting anti-inflammatory fatty acid eicosapentoic
acid, EPA. 63 Both arachadonic acid and eicosapentoic acid are clearly controlled by our
food choices: fish oils rich in omega 3 fatty acids are shown to increase EPA levels, and
diets heavy in animal fats, particularly from grain-fed cattle, increase levels of AA.
In the field of nutrition, Sears has perhaps done the most to research and promote
the concept of cellular inflammation and its relationship to disease as well as its
causation: diet and lifestyle. His work started in the 1980s and set off a firestorm of
interest and activity. However, before that, one significant event to spark this wave was
the discovery of aspirin as a powerful non-steroidal anti-inflammatory
(NSAID). Researcher John Vane won the Nobel Prize for this work on aspirin and
36
inflammation in 1971. 64
It has become common practice for physicians to suggest aspirin as an over the
counter remedy for preventing heart attacks, as arterial and vascular inflammation are
clearly understood as significant in coronary heart disease. Aspirin is shown to reduce
risk factors for heart attacks, which is the reason it is referred to as the "miracle drug."
However, less well known are its dangerous side effects such as excessive blood
thinning, hemorrhaging in the brain, tinnitus, and more. 65
What we have learned from studying aspirin is that a serious underlying
condition of low-grade inflammation is occurring. Unfortunately, rather than treat the
source of the problem, modern healthcare practitioners typically treat the symptom by
using aspirin, steroids, or other anti-inflammatory drugs. They do so rather than
attempting to understand what the ancient Chinese knew intuitively thousands of years
ago: that lifestyle creates what is described in TCM as "Yang excess," or an inflammatory
condition.66
The underlying problem of low-grade or silent inflammation, which is very much
a condition of the developed world, emanates from our toxic lifestyle. Consider the
following statistics:
• 70 million Americans suffer from arthritis, twice as many as did in the 1980's
• 50 million Americans suffer from allergies, doubling since the 1980's
• 64 million Americans have cardiovascular disease
• An estimated 15 million Americans have eczema
• 1 million Americans have inflammatory bowel disease 67
When a health topic appears on the cover of Time Magazine, it is usually a big-
37
time ordeal. A recent article titled "The Secret Killer: The Surprising Link Between
Inflammation and Heart Attacks, Cancer, Alzheimer's and other Diseases" graced the
cover, stating that, "suddenly inflammation has become one of the hottest areas of
medical research." The article indicates that a test called the C reactive protein (CRP) is
a common procedure in primary care medicine today, and a marker of inflammation; the
article explains that, "CRP is a molecule produced by the liver in response to an
inflammatory signal." 68
Most of the major pharmaceutical companies, including Pfizer, for example, are
launching research and development efforts to target inflammation. Tepper, president of
research and development at Millennium Pharmaceuticals in Cambridge, MA reveals
that, "virtually our entire research and development effort is now focused on
inflammation and cancer." 69
A special report published by the American Medical Association showed links
between chronic inflammation and breast cancer, stating, "Inflammation induced by
infections or irritants has been linked to a substantial proportion (one sixth to one third)
of incident cancers worldwide” and further, “Compelling evidence for a link between
inflammation and breast cancer comes from preclinical and epidemiologic observations
suggesting that non-steroidal anti-inflammatory (NSAIDS) protect against the
development of breast cancer" 70
However, in my view conventional healthcare erroneously treats the symptom
rather than the problem. To illustrate, if one mistakenly dumps acid on the floor of a boat
and it eats away the floorboards, causing the boat to fill up with water, though it may
work temporarily, the long-term answer is not endlessly running from one hole to the
38
other trying to seal them. Rather, one would first remove the cause of the holes (the
acid), ensure it does not happen again (by sealing the container from which it
spilled), and then patching up the holes. By using pharmaceuticals in inflammation and
cancer, we are patching the holes but not removing the acid so to speak, the dietary or
environmental causes of inflammation. To help manage this problem at its root, blending
the modern science of inflammatory markers and the wisdom of Eastern practices,
nutritionist Monica Reinagel has created a system, an inflammatory foods database that
rates the levels of inflammation in common foods. 71 72
Chapter Three: Conclusions and Future Considerations
In closing, my belief in integrative, holistic interventions is only enhanced by
doing research on cancer. Yet simultaneously, perhaps ironically, I have also developed
a deeper respect for the importance of conventional medicine. The reason is I can now
see clearly the enormous challenges that exist for someone diagnosed with cancer; in
many instances, a cancer patient would have no option but to use acute conventional
measures in order to survive. Interestingly, it is also why I have become more steadfast to
learn about and promote preventive health: as I now realize the devastating repercussions
of cancer and harsh treatments, I have a greater sense of purpose to help individuals
avoid getting into the situation of cancer to begin with.
I am in support of preventive, holistic interventions, again, emphasizing the
following important point: whether or not one chooses to use severe conventional cancer
treatments designed to, as Sears says, "burn, cut, or poison," 73 proper care for health, and
whole-person care is critical in order to build a foundation of health. I think common
sense says that a cancer patient needs to cultivate such a foundation of health in order to
39
fight cancer and improve chances for survival no matter which type of cancer he or she
faces. Fortunately, it seems that science is moving in a positive direction to substantiate
this. Nonetheless, basic intelligence additionally says it is true.
Regardless of any deterring political or financial influences, the healthcare
establishment is moving in the direction of whole person care. LaTour says, “It’s
amazing how far the cancer community has come in accepting that cancer is a
multidimensional disease and a journey with dual paths—one purely medical, the other
addressing the more obtuse parts of our lives (our souls, hearts, spirits, and minds)—and
that these two aspects of our humanness may interact in ways that we are only beginning
to understand” 74 Similarly, Finestone states that the common mantra for holistic cancer
care, and ideally, for all care is to “treat the patient, not the disease” 75
To encapsulate the main theme here, four important tenets are crucial in holistic
cancer care, or any care. They are, according to Berman, first that the relationship
between the patient and caregiver is paramount, including positive communication,
listening, attention, and intention. Second, that the healing process is based upon, as
Finestone stated above, "whole-person" treatment, meaning that client's mind, body, and
spirit are all acknowledged aspects of the therapeutic process; and among the most
important dimensions of this, according to Berman, are a person's moods, attitudes,
beliefs, culture, environment, and spiritual beliefs, integral components of health
psychology. Thirdly, integrative, holistic care is a blending of many healthcare
modalities; and a practitioner must constantly remain aware of a "bigger picture" of care,
and be prepared to work interdependently with allied practitioners. Finally, holistic care
places self-healthcare in very high regard; that is, the need for client empowerment and
40
the teaching of a preventive lifestyle, including diet and healthy behaviors. 76
Regardless of whether I have been able to convey a compelling argument in this
book, I am nonetheless convinced that the mode of healthcare espoused by Berman
above, if adamantly adhered to, will offer a cancer patient greater chances to beat cancer
than if ignored. This is true, I believe, with the implementation of either conventional or
alternative treatments. I am convinced that the interviewed case studies, as supplement to
this book, are strong pieces of evidence of the strength of this process. 77
Certainly, at least part of the reasons why the interviewees have survived, even
thrived, in their plight with cancer is because of their devotion to wellness and healing,
including their ability to remain flexible in the face of adversity, a willingness to change
problematic health behaviors, and, eagerness to engage whole-heartedly in the clienthelper relationship. This last point is significant. Simple, time-tested, wisdom tells us,
and intuitively we know that, "no man is an island" 78; in the Book of Psalms, it says that
God, "guides the humble in what is right." 79 Unquestionably, each of the interviewees
considers him or herself fortunate to have been able to work with a gifted healer like
Mincolla. In part because of the synergy of the client-helper relationship, including each
patient’s ability to reach out for support and assistance, they did not allow the tendency of
demoralization to overcome them, offering success in their ultimate life and death battle.
Additionally, without question, the perspective one takes facing an extreme illness
makes a substantial difference in the experience he or she has with it. A golden rule of
cognitive behavioral psychology, and stress-management, (also, Niebuhr's quote in the
introduction), is that we do not always have control over circumstances, though I would
add, we usually have far more control than we think we do. However, we always have at
41
least some measure of control over how we respond, which is how we must choose to
focus our psychic energies.
This is why holistic wellness practices such as mindfulness and diet are so
important: initiating them allows a cancer patient to know they are participating in
something to challenge their condition – they are not helpless. For example, Feuerstein
writes of his battle against brain cancer, "My neurosurgeon told me that the prognosis
was not good. The tumor was a type that had tentacles that could spread to many parts of
my brain. He suggested I get my affairs in order. At age fifty-two, I probably had less
than a year to live." Yet Feuerstein reached into his soul, writing emphatically, "I decided
to live longer than that." 80 Feuerstein decided that he would make an empowering
decision and not be a passive spectator in the deadly game of brain cancer. His attitude
must have taken great courage. What Feuerstein likely realized is that life is
temporary, we all eventually leave this world – in the end each of us must face our own
decisions and live with how we have handled the crises along the way. Feuerstein is
alive and well today and is professor of medical and clinical psychology and preventive
medicine at the Uniformed Services University of the Health Services in Bethesda, MD.
I wonder, Is it partly his attitude that saved him? He certainly would not have changed
his health behaviors without a can-do attitude. This is the same attitude that the patients
in my video have taken, and perhaps one important reason they are still alive.
Yet there is also another important adage: sometimes the spirit is willing but the
flesh is weak. The physical aspects of cancer are real, and at times strength of spirit only
goes so far. We also need the best care, both preventive and acute, to challenge disease.
We need tactics from a psychological and mind-body perspective including support
42
groups, counseling, techniques for relaxation, meditation, and guided imagery. We need
to cleanse the body of toxins to allow nature’s healing process to work, to strengthen the
internal forces of immunity by providing nutrition for building healthy cells and tissue
(anabolic processes); and, to prevent the breakdown of healthy body tissue (catabolism).
A diverse diet of vegetables, fruits, healthy fats, complete proteins, and whole grains will
encourage a Yin condition, and reduce inflammation. Every nutrient in the diet including
the macro and micronutrients, are vitally important. We must also reduce or eliminate
contaminants in foods to maintain the Yin condition, such as excess sugars,
carbohydrates, and fats, and antibiotics, pesticides, fungicides, steroids, and toxic metals,
among others. Cancer is extreme, and causes extreme demands upon the body ―
therefore one should approach cancer similar to the way an athlete would approach a
grueling event, every detail must be covered to improve risk factors.
In a significant section of the book, I questioned whether there is such thing as a
“cancer personality.” If there is, then it would likely mean there are set traits that would
be either unchangeable or very difficult to change that would predispose one to the risk of
contracting this disease, or influence the way one handles it psychologically and
emotionally. Based upon my review of studies in psychology and integrative health, as
well as my intuitive sensibility, I believe likely there are stress-prone personality
characteristics that would seemingly increase peoples’ risks for chronic illness; though I
am unsure if it would apply specifically to cancer, or to any other disease. My guess is
rather that the influence of personality applies more globally to diseases in general than to
one specific disease such as cancer, though I may be wrong. I am an optimist, however,
and believe that in most instances each of us is born with inherent potential, God-given
43
abilities for change. In my view, each person has an innate ability to manage how they
respond to stressors. Of course, some have a naturally easier task than others; also, some
have an easier task of facilitating self-improvement than others.
If I were to attempt to base my views solely upon existing research, it would be
difficult, because the research is conflicting. For instance, according to the researchers
like Simonton, Temoshok, LeShan, and others, positive correlations exist between
personality and cancer, including one’s sense of self, feelings of empowerment, ability to
release anger, and so on.
However, at the same time, interestingly, recent studies also show no connections
between cancer and personality. A study in Japan with a research team led by Tsubono
showed no correlation between four measures for personality. A metric called the
Eysenck Personality Questionnaire was used, accounting for extroversion-introversion,
neuroticism, psychoticism (cruelty, intolerance, and aggressiveness), and truthfulness
(“faking” good in order to please others).81 According to DeNoon, referring to prior
studies such as Simonton’s, and Temoshok’s, and others, that showed positive
correlations between personality and cancer, “These studies had various weaknesses.
They tended to focus on small numbers of people. And they often failed to control for
important cancer risk factors, such as smoking.” 82
What can be made of the seeming incongruencies? Conflicting reports seem to be
a trend in science in general and may or may not have to do with the sharp political
divisions, as well as financial interests that exist today concerning the outcomes of
research. Therefore, it is often difficult for researchers and students to discern truth from
fallacy.
44
In closing, cancer and personality is certainly an interesting topic for debate. Yet
I have clearly indicated in this book that besides the standard conventional treatments, in
my view, the most interesting research is concerning self-awareness, mindfulness,
meditation, cognitive behavioral processes, imagery, and holistic interventions such as
diet and exercise, in regards to cancer. This, I believe, is where the crux of our time,
energy, and research dollars should be allocated in future healthcare endeavors.
Endnotes
1
Simon, D. 1999. Return To Wholeness: Embracing Body, Mind, and Spirit in the Face of Cancer. New
York, NY: John Wiley & Sons. 1999, 35.
2
Quillen, P. 2005 (4th Edition). Beating Cancer With Nutrition: Combining the Best of Science and Nature
For Full Spectrum Healing In The 21st Century. Carlesbad, CA: Nutrition Times Press, 24.
3
Varona, V. 2001. Nature's Cancer Fighting Foods: Prevent and Reverse the Most Commoon Forms of
Cancer Using the Proven Power of Great Food and Easy Recipes. Paramus, NJ: Reward Books, ix-xii.
4
Ibid, xiii.
5
Simonton, O. C. 1988.Getting Well Again. New York, NY: Bantam Books, 36.
6
Ibid, 41.
7
Ibid, 98.
“The Immune System: Key Players.” Cancer.org. 14 December 2006. The American Cancer Society. 28
November 2007
<http://www.cancer.org/docroot/ETO/content/ETO_1_4X_The_Immune_SystemKey_Players.asp?sitearea=ETO>
8
9
Bittman, B. & Berk, L. & Felten, D.L. & Westengard, J. Jan. 2001. Original Research: Composite Effects
of Group Drumming Music Therapy on Modulation of Neuroendocrine-Immune Parameters in Normal
Subjects Journal of Alternative Therapies in Health and Medicine. Vol 7, Issue 1, 38.
10
Thoreau, H.D. 2004. Walden: A Fully Annotated Edition. New Haven: Yale University Press, 88.
11
Aspinwall, L.G., & Brunhart, S.M. 1996. Distinguishing optimism from denial: beliefs predict attention
to health threats. Personality and Social Psychology Bulletin, Vol 22, 993-1003.
45
12
Brown, S.E. & Trivieri, L. Jr. 2006. The Acid Alkaline Food Guide: A Quick Reference To Foods &
Their Effect On pH Levels. Garden City Park, NY: Square One Publishers, 1.
13
Zablocki, E. June, 2004. Integrative Care Mind-Body Methods Aid Cancer Patients. Townsend Letter
For Doctors and Patients.
14
Gentry, M. 2000. Stopping Cancer Before It Starts: The American Institute For Cancer Research’s
Program For Cancer Prevention. New York: St. Martin’s Press.
Wallace, K. “Meditation May Add Support During Cancer Treatment.” CNN.com. 1 October 1999.
Cable News Network. 31 December 2007
<http://www.cnn.com/HEALTH/cancer/9910/01/bcam.cancer.meditation.wmd/index.html>
15
16
These statements have not been evaluated or substantiated by the American Medical Association or any
other leading governmental health organization.
17
Ornish, D. et al. 2005. Intensive Lifestyle Changes May Affect The Progression of Prostate Cancer.
Journal of Urology, Vol 174, 1065-70.
Mercola, J. “Can A Vegetarian Diet Improve Your Prostate Diagnosis?” Mercola.com. 27 August 2005.
Dr Mercola. 31Decmeber 2007
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>
18
19
Neimark, J. 1997 Jan/Feb. On The Front Lines of Alternative Medicine. Psychology Today.
20
Friedman, M. & Rosenman, R.H. 1974 Type A Behavior and Your Heart. New York: Knopf Publishing.
21
Schmale, A.H. 1972. Giving Up as a Final Common Pathway to Changes in Health. Advanced
Psychosomatic Medicine, Vol 8, 20-40.
22
Simonton, O. C. 1988.Getting Well Again. New York, NY: Bantam Books, 5.
23
Ibid.
24
Simonton, O. C. 1988.Getting Well Again. New York, NY: Bantam Books, 11-13.
25
Zabat-Zinn, J. 2005. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. New
York: Hyperion.
“Cancer Patients Can Be Well Just As They Are: Jon Kabat-Zinn Shares Mindfulness Meditation At
Cancer Center.” Cancerwise.org. March 2005. Cancerwise: Journal of the UTexas MD Anderson Cancer
Center. 28 January 2008.
<http://www.cancerwise.org/March_2005/display.cfm?id=42F070C2-129A-44E38DAE0A1BA923C864&method=displayFull&color=green>
26
46
27
Byers, J. Personal interview. 18 December 2007.
“Post Traumatic Stress Disorder Seen in Some Cancer Patients: Nurses Can Step In to Help Ease
Symptoms” Cancer.org. July 2002. The American Cancer Society. 11 March 2008
<http://www.cancer.org/docroot/NWS/content/NWS_1_1x_PostTraumatic_Stress_Disorder_Seen_in_Some_Cancer_Patients.asp>
28
29
Pennebaker, J.W. 1990. Opening Up: The Healing Power of Confiding in Others. New York: William
Morrow Co.
30
Zabat-Zinn, J. 2005. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. New
York: Hyperion.
31
Germer, C.K. & Siegel, R.D. & Fulton, P.R. 2005. Mindfulness and Psychotherapy. New York: The
Guilford Press.
32
Zhang, Y. 2004. Zen and Psychotherapy. UK: Trafford.
33
Germer, C.K. & Siegel, R.D. & Fulton, P.R. 2005. Mindfulness and Psychotherapy. New York: The
Guilford Press.
34
Kabat-Zinn, J. 2005. Wherever You Go, There You Are: Mindfulness Meditation In Everyday Life. .New
York: Hyperion.
35
Olson, R.P. 2002. Religious Theories of Personality and Psychotherapy: East Meets West. Binghampton,
NY: Haworth Press.
36
Csikszentmihalyi, M. 1990. Flow: The Psychology of Optimal Experience. New York: Harper Perennial.
43,19.
37
Simonton, O. C. 1988. Getting Well Again. New York, NY: Bantam Books.
38
Dr. Andrew Weil is founder of the Program in Integrative Medicine of the College of
Medicine,University of Arizona and a foremost authority on holistic health. Dr. C. Norman Shealy is a
worldwide expert in pain management and holistic medicine. Dr. Jeanne Achterberg is an internationally
recognized scientist and expert in the field of mind-body medicine, holistic cancer research and treatment.
39
The ECaP program is the renowned Exceptional Cancer Patient program that treats cancer patients using
holistic mind-body treatments. The program was developed by Dr. Bernie Siegel and Dr. Barry Bittman in
1978 and affiliated with Yale University.
Stevens, R. “Unconventional Cancer Treatments” Princeton.edu. September, 1990. Report issued by the
Office of Technology Assessment, United States Congress. 25 March 2008 <
http://www.princeton.edu/~ota/disk2/1990/9044.html>
40
41
Spiegel, D. & Bloom, J. & Kraemer, H.C. et.al. 1989. Effect of Psychosocial Treatment on Survival of
Patients With Breast Cancer. Lancet Vol 2, 8668, 888-891.
42
Ibid.
47
43
Benson, H. May/June 2001. Mind-Body Pioneer: The Connection Between Your Mind and Body
is Stronger Than You Think. Psychology Today.
44
Quillen, P. 2005 (4th Edition). Beating Cancer With Nutrition: Combining the Best of Science and Nature
For Full Spectrum Healing In The 21st Century. Carlesbad, CA: Nutrition Times Press, 7.
45
Ibid, 10.
46
Tiner, J.H. & Denman, M.L. 1999. Louis Pasteur: Founder of Modern Medicine. MI: Mott Media.
47
Seaward, B.L. 2004. Managing Stress: Principles and Strategies For Health and Well-Being. Sudbury,
Massachusetts: Jones and Bartlett Publishing, 45.
48
Ibid, 45.
“Types of Cancer” MDAnderson.org. The MD Anderson Cancer Center. 20 February 2008.
<http://www.mdanderson.org/patients_public/about_cancer/display.cfm?id=411A240D-77B9-11D4AEC300508BDCCE3A&method=displayFull>
49
50
Straub, R. O. 2002. Health Psychology. New York, NY: Worth Publishers, 419.
51
Ibid.
52
Kaput, J. (edit.) 2006. Nutritional Genomics: Discovering the Path to Personalized Nutrition. Hoboken,
NJ: Wiley Science Publishing.
53
Ibid, 422.
54
Stuhler, G. & Walden, P. 2002. Cancer Immune Therapy: Current and Future Strategies. Wiley
Publishing, 96.
55
Seaward, B.L. 2004. Managing Stress: Principles and Strategies For Health and Well-Being. Sudbury,
MA: Jones and Bartlett Publishing, 479.
56
Ibid.
57
Pitchford, P. 2002. Healing With Whole Foods: Asian Traditions and Modern Nutrition Berkeley, CA:
North Atlantic Books, 49.
Sears, B. 2005. The Anti-Inflammation Zone: Reversing the Silent Epidemic That’s Destroying Our
Health. New York: Harper Collins.
58
59
Ibid, 261.
60
Ibid, 228.
48
61
Ibid, 228.
62
Ibid, 228.
63
Ibid, 227-8.
64
Jeffreys, D. 2004. Aspirin: The Remarkable Story of a Wonder Drug. New York, NY: Bloomsbury, 233.
“Cerebral Vascular Disease.” Lef.org. June, 2004. The Life Extension Foundation. 24 March 2008
<http://www.lef.org/protocols/prtcl-031.shtml>
65
66
Mincolla, M. 1995. The Tao of Ch’i: Healing With The Unseen Life Force. Pennyroyal Press, 134.
67
Chilton, F.H. 2006. Inflammation Nation: The First Clinically Proven Eating Plan to End Our Nation’s
Secret Epidemic. New York, NY: Fireside Publishing, 3-4.
68
Gorman, C. & Park, A. February 23, 2004. “The Secret Killer: The Surprising Link Between
Inflammation and Heart Attacks, Cancer, Alzheimer’s, and Other Diseases.” Time Magazine.
69
Ibid.
70
Ness, R.B. & Cauley, J.A. February 18, 2004. Antibiotics and Cancer: What’s The Meaning of This?
Journal of the American Medical Association. Vol. 291, 7, 880-881.
71
Reinagel, M. 2006. The Inflammation Free Diet Plan: The Scientific Way to Lose Weight, Banish Pain,
Prevent Disease, and Slow Aging. New York, NY: McGraw-Hill.
The anti-inflammatory foods database can be viewed in Reinagel’s book (see previous citation), or at the
website, www.nutritiondata.com.
72
Sears, B. 2005. The Anti-Inflammation Zone: Reversing the Silent Epidemic That’s Destroying Our
Health. New York, NY: Harper-Collins, 261.
73
74
LaTour, K. 2003. The Other Side of Healing: Healing Means Integrating Issues of The Heart And Soul
Into The Cancer Experience. Cure Magazine. Fall Issue.
75
Ibid.
“What is Integrative Medicine?” The New Medicine. The Public Broadcasting Service. 24 April 2006
<http://www.pbs.org/thenewmedicine/interview.html>
76
77
Schlosberg. P. 2008. From Illness To Wholeness. Unpublished mini-documentary, thesis. Lesley
University.
Donne, J. 1999. “Devotions Upon Emergent Occasions.” Devotions Upon Emergent Occasions and
Death’s Duel. Ed. Motion, A & Walton, I. New York, NY: Random House, 103.
78
49
79
King David. “Psalm 25” Life Application Study Bible: New International Version. Wheaton, Ill: Tyndale
House Publishers, Inc., 850.
80
Feuerstein, M. & Findley, P. 2006. The Cancer Survivor’s Guide: The Essential Handbook to Life After
Cancer. New York, NY: Marlowe and Company, xx.
81
Tsubono, Y., Tsugi, I. et. al. June 2003. Personality And The Risk of Cancer. Journal of The National
Cancer Institute. Vol 95, Number 11, 799-805.
DeNoon, D.J. “No Such Thing As A ‘Cancer Personality’: Personality Types Unrelated to Risk of
Developing Cancer.” Webmd.com. 3 June 2003. WebMD. 19 February 2008
<http://www.webmd.com/cancer/news/20030603/no-such-thing-as-cancer-personality>
82
Appendix A: Key Terms
carcinoma, cytokines, dialectical behavior therapy (DBT), endogenous, exogenous,
homeostasis, imagery, immune surveillance theory, immunity, leukemia, lymphokineactivated killer cells, lymphoma, malignant, metastasis, (NKC) natural killer cells, nonsteroidal anti-inflammatory (NSAID), oncogenes, sarcoma, silent inflammation profile
(SIP), suppressor genes, t cells, tumor, visualization