After Cancer, What Next?
By Dee Atkinson MNIMH
There is nothing quite like personal experience to really focus the mind. For years I have worked with cancer patients, both during and after their treatment, but it isn’t until you have been there yourself that you can really understand the emotions, hopes and fears that come with this diagnosis.
The usual pattern is that, having completed a round of conventional treatment, the patient is given a date (normally in three to six months time) for a follow up with their oncologist and from having been seen regularly for treatments, they are suddenly left to their own devices. Things are back to normal. Except that they aren’t. This is often when all the fears and doubts come racing in and it is often the time the patient starts to come to terms with what has happened to them.
When I found myself in just this position in Feburary 2014, having been through 6 months of aggressive treatment - surgery followed by chemotherapy and massive doses of herbs and supplements - I finally realised how complex the ‘what next ‘ question is.
The default mode is to try and forget about the bad experience and get back to ‘normal’ as soon as possible. But there are some big questions here. What is the new ‘normal’ and if we go back to where we were before, will all of this come back?
These thoughts go through the mind of every cancer patient. The conventional treatments for cancer are all managed for you, but once they are over you have to start trying to work out what the ‘new you’ should look like.
Conventional cancer treatments are logical, linear and driven by statistics. They take a very ‘left brain’ approach and tend to only travel down one road to the hoped for outcome. This removes much personal choice and we are pushed into not deviating from the surgery/drugs/radiation route. Thoughts that the food we eat might influence or support outcomes, or that other treatments could support us, are usually firmly quashed.
So, when we emerge from this bubble and normal life returns, we are given little, if any, advice on diet, lifestyle and how to manage, with “Go and have a holiday…” being a frequent bit of advice. Many patients know they should address some of the issues they knew they had before the diagnosis, but it all too often gets put on the back burner.
Some patients are puzzled: they were already practising healthy living, they ate well, exercised and were unstressed, but they still got ill. How could this have happened?
There is often no easy answer here. Our specific cancers are not necessarily the result of anything we did or did not do. Personally, I think stress was a huge driver in my case, but it was so well hidden and I was so able to cope that no one from the outside would have known that stress was a problem.
We can all learn from these big health issues. We can all drill down to the foundations, the building blocks, of our bodies - the very bedrock of our health -and then start the process of reconstructing.
When one emerges from treatment it is important to take a long hard look at the terrain. By this I mean everything that makes up your environment and your lifestyle. The analogy I often use is one about gardening: having pulled out all the weeds and treated the soil, you need to continually keep weeding and nurturing the soil.
Our bodies, having been battered and effectively poisoned through treatment, now need nurturing and support to recover. Often the plan of having a healthier lifestyle can feel as if we are being ‘deprived’ of some of life’s treats - chocolate, cakes and alcohol to name but a few.
Try instead to frame your thoughts in a different way and focus on how well your body has done over the last months. Try to put together a plan that allows for some treats, but that rewards your body with all the healthy things it needs to regenerate and recover.
But what difference can I make now?
It’s all about Epigenetics. In a nutshell, this is the principle that genes respond to external stimuli such as food, toxins, environment, stress and exercise and, in turn, act to either suppress or promote the increase or decrease of enzymes and proteins that dramatically affect a person’s wellbeing. The obvious next step in thinking, from this point, is that lifestyle changes can dramatically influence an individual’s health.
We know that only a small amount of cancers are due to genetic conditions and that most cancers may be due to environmental/ lifestyle situations. If we understand this, we may be able to influence outcomes. Having been through cancer myself, I think that this is the single most hopeful and empowering thought, but also the most challenging. As anyone who has tried to stick to a diet knows, it is easy to start on the path, but very, very tough to stay on it.
Sometimes knowing ‘why we should do it’ helps to keep us on the right track. As well as understanding the possible influence one can have by managing lifestyle and environment, I always talk to my patients about the need to try and down regulate inflammation in the body, manage the immune response and make sure that one is eliminating wastes properly. Carefully prescribed herbs and supplements can go a long way towards supporting these situations.
A word here about supplements. These I consider to be supplemental to the diet. They are in no way a replacement for a healthy well balanced diet. However, it is not only what we eat which is important, but what we are able to absorb. Many cancer patients have impaired absorption and all of this needs to be considered when planning diet and supplement regimes. I intend to write more about this in the future.
General Diet Principles
Anyone who has worked with me will know that I am not an advocate of extreme, unsubstantiated or even slightly mad, diet plans. Much of this is common sense, some of it is backed up by research and all of it is based on my clinical experience – indeed I practice this myself and use it in clinic. It is important to remember that we are all individuals and, as such, some people need to put more emphasis on different areas. Diagnostic tools, such as blood tests, can tell us a lot about how we should be managing our diet going forward. Anyone who has been told they are borderline diabetic understands how important having this information is and how it helps with managing their diet.
Let’s go Mediterranean
The important thing to remember here is that the true Mediterranean diet is about eating locally grown and, if possible, organically grown produce. Wild vegetables, such as dandelion leaf, can be included and common vegetables too, like cabbage, cauliflower and broccoli. You can also think about using dark green leaves and bitter leaves, such as endive and radicchio.
1: Eat lots of vegetables, both as juices and lightly steamed. Leafy veg that grows above ground is generally more nutritious and less starchy than ones that grow below ground.
2: Eat organically as much as possible. Box schemes can be a cost effective way of doing this.
3: Cook your own food and use ‘whole’ foods instead of processed or pre chopped/prepared foods.
4: Try and avoid fried, smoked and chargrilled foods.
5: Eat only organic free range eggs.
6: Eat very little red meat and, when you do, make sure it is organic. Venison and free range/organic game are best.
7: Eat small amounts of organic chicken and poultry.
8: Eat wild cold water fish and organic salmon at least once weekly.
9: Cook with olive oil or coconut oil.
10: Try and limit dairy. Use organic cheese and milk only and preferably goats and sheep’s products rather than cows dairy. Beware of hidden sugars in flavoured yogurts, even organic ones. Yogurt made from coconut milk is a good option which you can flavour with berries and stewed fruits.
11: Use plenty of nuts, seeds, beans and pulses. Try sprouting them yourself, giving you a ‘living’ food.
12: Flavour food with herbs and spices. Ginger, chilli, turmeric and black pepper all have medicinal values as do most culinary spices and herbs.
13: Avoid alcohol except for special occasions. A glass of red wine is the least harmful choice.
Foods that can be of positive benefit
Many foods have cancer protective compounds in. These are easy to include in your diet.
Beta glucans: oats, mushrooms, onions, nutritional yeast
Carotenoids: beetroot, carrots, kale, red peppers, sweet potatoes
Ellagic acid: pomegranates, raspberries, strawberries, cranberries, blackberries
Epigallocatechingallate (EGCG): green tea
Fibre: all fruit and vegetables, psyllium husks, whole oats, whole grains such as barley, brown rice
Indoles and isothicyantes: cabbage, broccoli, kale, brussel sprouts
Isoflavones: fermented soy (tempeh, miso), alfalfa sprouts
Limonene: citrus peel and juice (cut up and dry organic peel and add to your herbal teas)
Lycopene: Tomatoes and other red fruit and vegetables
Omega 3 fatty acids: fish, flax seed oil, linseeds, walnuts
Polyphenols: black and green tea, rooibos tea
Selenium: Brazil nuts, salmon, garlic, shiitake and maitake mushrooms (store mushrooms outside fridge for full benefit)
Food and inflammation
Certain foods promote inflammation in our bodies. Cancer is, in part, an inflammatory response and we know that some chronic inflammatory conditions, such as inflammatory bowel disease, can increase cancer risk. Our Western diet, which can be full of omega 6 vegetable oils, factory farmed meats, battery eggs, white flour and far too much sugar (an average of almost 150l;b per person per year!), is highly inflammatory. Mediterranean and Asian diets which contain more vegetables and lots of herbs and spices, tend to be less inflammatory.
Fermented foods and good bacteria
Our gut health is central to our immune response. Making sure we have the right balance of good healthy bacteria in our gut is important to one’s overall health. Supplementing with probiotics can be helpful, but in the long term including some fermented foods in the diet is the key to a healthy gut. As far back as Roman times, fermented foods like sauerkraut and fermented fish pâté, were consumed and, in a recent visit to South Korea, which has one of the healthiest diets in the world, I ate many different pickled and fermented foods. Research has shown that homemade fermented foods, ie: food that has not been pasteurised, have far more ‘good’ bacteria in them. Fermented foods like kefir, sauerkraut and kombucha are easily made at home.
Eating enough fibre is also key to encouraging good bacteria in the gut. Fibre has been shown to reduce some types of cancer, improve blood cholesterol levels and help manage diabetes and gastric disorders. Fibre is either soluble or insoluble. Soluble fibre such as grains, oats and psyllium seed husks are water soluble and can be fermented and converted into short chain fatty acids. These short chain fatty acids are used as energy sources or ‘messengers’ to communicate with the enzymatic systems of your body.
Insoluble fibres, which are mainly cellulose, provide a surface for bacteria to attach to, they absorb water and the healthy bacteria flourish. This all makes for a soft, bulky, healthy stool, thus preventing constipation and giving a more regular bowel movement. A diet rich in fibre, both soluble and insoluble helps to remove waste matter and toxins from the body
A word about soya
There is much discussion and misinformation about soya products, especially in relation to oestrogen sensitive cancers. The research is very mixed and the products that are looked at are usually GMO soya beans, non-organic and probably processed in a non traditional way. I feel that small amounts of fermented non GMO soya such as miso, tempeh and natto is safe.
Cancer and sugar
Many natural medicine practitioners will tell you to reduce sugar, but will not really explain why. Knowledge is power and is motivating. Cancer cells thrive when there is an absence of oxygen and they switch to using sugar as fuel. High sugar levels in the blood create a rise in insulin levels, which causes the release of hormones that encourage the growth and blood supply of cancer cells. When we eat sugar we get a rapid rise in blood sugar, leading to insulin release, and this triggers release of IGF (insulin growth factor) which is strongly associated with cancer.
It is important to know that sugar is often ‘hidden’ in foods. Fructose, sucrose and supposedly healthy sugars like honey, stevia, maple syrup, coconut sugar and xylitol are all still sugars.
White flour in cakes pastries, biscuits, pasta and breads and baked potatoes are high on the GI (glycemic index) as well has having a high glycemic load (a measure of how much glucose is generated by a certain food). These foods will impact on insulin response, leading to high insulin levels.
If you have been treated for cancer refrain from drinking alcohol. If you have had breast cancer or an oestrogen positive cancer, you should know that alcohol can raise oestrogen levels. There have been a number of studies showing that women who drink after treatment for breast cancer have a much higher rate of reoccurrence.
Live life and live long
Cancer is an odd twist of fate for many of us. The dice roll just didn’t go well that day. When we pull through and walk out the other side of treatment we are different. That day when the chemo wears off and you have your first joyous unscrambled head and ‘in the moment’ feeling (only those who have been there will know what I mean), it is wonderful. Life is good.
It is important to hold that thought, let go of the fear and try to embrace the positive. Talking therapies, exercise and the closeness of friends and family can all help.
Time and again I hear patients say that now they have finished their treatments they just want to get back to normal. I want to gently suggest that going ‘back’ is not something any of us should consider. Instead, learn new techniques and new ways of being and go forward, confidently, as the new you.
Here's a typical day's fruit and veg intake for me. You can see my morning smoothie and juice ingredients standing by as well as my lunchbox and veggies prepared ready for steaming in the evening.