Whole-Person Cancer Care
Why lifestyle-based therapies — including nutrition, exercise, acupuncture, and other alternative practices — are becoming essential components of traditional cancer treatment.
When I was a kid, my dad spent a lot of time in the bathroom. He didn’t have a large intestine, so things moved through him fast. The loo was his home inside our home.
He lost his colon, piece by piece, at his other home, Saint Marys Hospital in Rochester, Minn., where he sought treatment for a rare genetic condition that causes polyps to grow in the intestinal tract. Every year, his gastroenterologist would do a series of scopes and cut the polyps out. A couple inches of intestine usually went as well. Eventually he had no colon left.
My dad didn’t seem to mind the hospital or the bathroom. He loved to read, and both places gave him ample opportunity. My mom, my brother, and I found the whole situation unfortunate, but also something to tease him about. Leave it to my dad to get the world’s least romantic disease, one that entailed an annual colonoscopy.
We joked, that is, until his Peutz–Jeghers syndrome (PJS) was reclassified as a hereditary cancer disorder. It turns out the gene mutation that triggered those annoying but benign polyps also increased his cancer risk manyfold.
My dad didn’t have a lot of time to ruminate on his new circumstances. Just as PJS was getting reclassified as a cancer syndrome, his lungs proved the point. He was diagnosed with stage 4 lung cancer that same year.
He died six months later, and he left a legacy: I have PJS, too.
Cancer, Then and Now
My dad was diagnosed 20 years ago by the calendar, but light years away in terms of cancer research. Back then, the disease was considered primarily genetic, and genes were viewed as an immutable part of our biological architecture: The only cancer-prevention strategy was to cross your fingers and hope you didn’t get it. If you did get it, the only treatment options were chemo and radiation, so you crossed your fingers again and hoped they worked.
Today, we know that genes are only a part of the picture, and that there is a lot we can do in our daily lives to prevent cancer. Even more promising, many of the strategies that help prevent cancer can also help combat the disease if it crops up.
“It seems like the big, bad cancer-cell story is just that — a story among stories. It holds up when viewed from certain angles, but it doesn’t hold up when viewed from every angle,” says Michelle Gerencser, MS, a nutrition consultant in North Logan, Utah, who specializes in cancer nutrition and nutritional immunology.
While most medical protocols for curing cancer are still based on the timeworn theory that the disease is a genetic mutation, Gerencser says, that theory is no longer supported by contemporary research.
There are plenty of reasons to question the genetic hypothesis: Cancer can be triggered by smoking or viruses like human papillomavirus (HPV) and Epstein-Barr. Conversely, the damaged nucleus from a cancer cell can be injected into a healthy cell and not turn the healthy cell cancerous. Genes may play a role, but they don’t tell the whole story.
So what does?
Almost all cancer experts agree on one factor: inflammation.
“Inflammation is fertilizer for cancer,” says Colin Champ, MD, a radiation oncologist and assistant professor at the University of Pittsburgh Cancer Institute. He notes that pathologists often find inflammatory cells near cancerous sites on pathology slides. “The more inflammation people have, the more likely they are to get certain cancers.”
Many factors fuel inflammation, including toxic exposures and chronic stress. But one of the biggest drivers is imbalanced nutrition — consuming too much nutritionally bankrupt food and not enough whole, unprocessed fare.
Researchers have also examined other potential triggers for cancer: mitochondrial function, microbial DNA, even the effect of our thoughts and beliefs on the immune system.
We still don’t know if cancer is the result of one, some, or all these things. We do know, however, that it’s a condition that involves multiple changes in health over time, and that the environment and our daily habits and behaviors are important factors.
As such, there’s good reason to think that the nutrition and lifestyle choices we make can improve our chances of avoiding the disease — and minimize its progress if it does take hold.
Significant research in recent years has shown that lifestyle interventions and complementary therapies can help prevent and heal cancer. Most practitioners, however, insist that these are not replacements for conventional therapies — the two approaches are often most powerful when used together.
“There are plenty of lifestyle approaches that show promise,” says Champ, who’s a strong advocate for paleo-style nutrition to support cancer patients. But he’s firm about employing a multipronged plan. He dreads hearing from patients who had a treatable cancer a year earlier but refused standard treatment in favor of a ketogenic or vegan diet — and have recently learned the cancer has spread.
Acknowledging that cancer has environmental and lifestyle components does have a downside: a temptation to blame the victim. “We’re a society that likes to assign guilt,” says Cheryl Johnson, an oncology massage therapist and president of the National Alliance of Medical Massage and Bodywork. “We want to say that patients ‘did something wrong’ or ‘made bad lifestyle choices.’ But illness is not a punishment.”
For my part, I was diagnosed with cancer in 2012 and was shocked at how quickly I slipped into self-blame. Was cancer brewing because I hadn’t meditated or exercised enough? Was I doomed because of my genes? No, no, and no. But it took time to realize this — as well as to wrestle back the frightening idea that torrents of stressful thoughts might make me even sicker.
Rather than continuing to accuse myself, I soon started to focus on the degree to which I controlled my situation. I fell back on my health-journalist training and set out to learn about everything I could do to prevent cancer’s recurrence. I’ve kept up the high-risk screenings that I get for PJS, while researching every other means of cancer prevention and support, much of which I’ve integrated into my daily life. Here are some of the practices with the strongest research backing.
Exercise: Keep Moving
A wide body of research shows that movement has a powerful, positive impact on cancer prevention and treatment. The National Institutes of Health is especially laudatory of exercise’s positive effects, highlighting studies that show exercise can lower insulin and estrogen, both of which have been linked to cancer development and progression. Exercise also can reduce inflammation, improve immunity, and alter how the body handles bile acids that have been linked to gastrointestinal cancers.
A 2008 study published in the American Journal of Chinese Medicine found that qigong improved symptoms, side effects, and quality of life for cancer patients. And studies show that regular exercise of any kind lowers breast-cancer risk in women by up to 20 percent, while decreasing breast-cancer-specific mortality risk.
“The improvement in the quality of life that exercise provides is well known. For some reason, we often forget that exercise can provide the same benefits for the cancer patient,” writes Champ on his website, CaveManDoctor.com. “Living longer is great, but living longer and feeling better is a whole different level of happiness.
“Cancer treatment is no walk in the park. It is clearly a physically and emotionally taxing time,” he continues. “However, whether it is during treatment or after, maybe we should take more walks in the park — and vigorous ones at that.”
Nutrition: Eat Your Plants
With the recent surge of research on nutrition and cancer, it’s tempting to believe in magic-bullet foods and miracle diets — but paths that lead to cancer are multiple and overlapping, and every body, and every cancer, is different. There’s no one “right” anticancer diet.
“Don’t listen to anticancer claims that tell you what to eat,” says Gerencser. The right nutritional approach will be based on an individual’s specific needs, she adds, not on “one study, or on doing what someone else did.”
Although there’s no one magic diet, some approaches are more effective than others. While no integrative oncologist encourages consuming crates of doughnuts, most will emphasize the need to eat more plants. The antioxidants, phytonutrients, and fiber in dark leafy greens, vegetables, and deeply hued berries are unmatched in their capacity to fight inflammation and support overall health. (For more on this, see “Cancer-Fighting Diets,” below.)
Experts also tend to agree on a couple of other tenets for cancer prevention and support during treatment:
- Ditch the sugar. Low-glycemic dietary protocols help keep insulin and inflammation in check. These protocols emphasize proteins and fats — avocados, extra-virgin olive oil, nuts, seeds, and grassfed meats — and steer clear of foods that spike blood sugar, including processed grains and sweet fruits.
Still, experts note that even blood-sugar regulation is highly individual.
“I have clients with perfectly low blood sugar who eat white rice three times a day,” says Gerencser. “Then I have other clients who seem to become prediabetic from just looking at a sweet potato.”
She encourages experimentation with starches and fruits to test your tolerance, rather than blindly following any one protocol. Pay attention to whether certain foods tank your energy, and, above all, monitor your efforts with blood work. Regardless, cutting out high-sugar processed foods and beverages is key.
- Fast intermittently. A 2016 meta-analysis found that periodic fasting — even brief fasts of 16 to 18 hours — improves insulin resistance and supports mitochondrial health. (For more on fasting, see “The Insulin Connection,” next page, and “The Case of Intermittent Fasting“.)
“Fasting isn’t fun,” says Thomas Seyfried, PhD, professor of biology at Boston College. “But it works really well.” Fasting stimulates a cellular process called autophagy, which destroys junk cells and clears their debris, he explains. Researchers theorize that this process helps eliminate malfunctioning cells that might otherwise become cancerous.
Acupuncture: Go With the Flow
Many hospitals now offer alternative or complementary treatment options for battling cancer. Chief among them is acupuncture.
Research backs its effectiveness in relieving cancer-treatment side effects, including radiation-related hot flashes, dry mouth, peripheral neuropathy, and fatigue. A 2017 report published in Current Oncology found that acupuncture significantly reduced gastrointestinal symptoms from chemotherapy.
“It’s not a magic bullet and it doesn’t work for everyone,” says M. Kay Garcia, DrPH, LAc, associate professor at the University of Texas MD Anderson Cancer Center in Houston. “But for many patients, it works when nothing else does.”
Acupuncture tends to be inexpensive, especially compared with pharmaceutical options. And for some patients, it can provide as much pain relief as opioids do, with fewer side effects.
Studies emphasize acupuncture’s utility in relieving side effects of treatment, but show it can be part of a preventive strategy, as well.
“Cancer is usually the result of a lot of imbalance that has been going on for a while,” says Tomás Flesher, LAc, owner of Three Treasures Natural Healing in Minneapolis.
“We often hear people say, ‘It just came out of nowhere,’ but it didn’t really.”
The body is a collection of dynamic energies, Flesher explains. Acupuncture practitioners often compare these energies, called chi (pronounced “chee”), to a river in the body: When it’s high, everything flows as it should; when it’s low, debris gets stuck, causing illness.
Acupuncture works to balance those energies before disease sets in.
“What’s interesting about acupuncture and other energy medicine,” Flesher says, “is that they seek to influence the changes that are happening in the body way before they manifest symptomatically.” (For more, go to “Acupuncture: Getting to the Point“.)
The Best of the Rest
Acupuncture is one of the most common alternative interventions, but it’s not the only one. While clinical evidence for other therapies lags behind public demand, the anecdotal evidence that they work is strong.
The following are a few less-studied, but often effective, therapies.
- Oncology massage: Cancer patients are like the athletes of the medical world — their treatment schedule is physically taxing, and massage can mitigate the side effects. It helps reduce anxiety, support relaxation, and boost immunity.
“After a medical massage, cancer patients often express appreciation for being reminded that they still can feel good in their body,” says Johnson. “I don’t know if it’s a physical response or a psychosomatic effect, but if they feel better, that’s really what it’s all about, isn’t it?”
Oncology massage may feel a lot like conventional massage, but therapists are specially trained to work around active treatment sites and modify touch for each client’s needs. They also help patients tap into their bodies’ intrinsic self-healing wisdom.
“I don’t interpret what I do as ‘me healing someone,’” says Nissa Valdez, a holistic and oncology massage therapist in Minneapolis. “The person’s body is already set up to do that on its own. I’m there to help them be closer to parts of themselves, so they can heal themselves.”
Patients in active treatment should check with their oncologists first to make sure massage is safe. (If they’re in the middle of a course of radiation, for example, it could feel miserable.) They should seek only certified therapists.
“The bottom line is to find someone experienced to work with,” says Valdez. “Even if someone has been your massage therapist for 15 years, if he or she hasn’t worked with someone with cancer, I’d think twice about continuing.” (The Society for Oncology Massage website, http://www.s4om.org, offers a list of certified practitioners.)
- Music therapy: Now used at most integrative cancer centers around the country, music therapy may help reduce acute, cancer-related pain, according to a 2017 study published in the Clinical Journal of Oncology Nursing. A 2017 survey of integrative interventions during breast-cancer treatment found that many doctors recommended music therapy — which typically involves listening, singing, and improvisational dancing — for anxiety and depression during treatment. In addition to boosting mood and relieving pain, singing and movement often help cancer patients express difficult emotions.
Board-certified music therapist Sara Fisher works in three Denver-area hospitals. She doesn’t need research findings to know that music therapy works. She relies on the feedback of those who work most closely with the patients: nurses.
“A nurse will grab me and say, ‘You need to go work your magic on so-and-so. They just got a tough diagnosis and they won’t talk to anybody, but they’ll talk to you,’” she says.
- Psychoneuroimmunology: Though only recently named, the connection between emotional and spiritual experiences and the immune system has been recognized in some cultures for hundreds of years.
“The idea of immune surges that lead to immediate healing has been around since the 13th century, or the beginning of recorded cancer,” says researcher Kelly Turner, PhD, author of Radical Remission: Surviving Cancer Against All Odds.
Turner began her career as a thera-pist working with cancer patients. After encountering hundreds of terminal patients who had exhausted conventional treatments but then found their cancer in inexplicable remission, she started studying their cases by asking them what they believed helped them heal.
“When we think about cancer, we think of a problem with the physical body,” Turner explains. “So, I expected people to tell me what they did to their bodies.”
But most patients recounted emotional changes — how they’d forgiven an ex-spouse or found antidotes to their boredom. Some were confident that watching four minutes of funny cat videos a day had made a difference. Others told her that gardening or burning ceremonies or having a weekly “girls’ night” had helped put them into remission — because these things helped them come into the present moment.
“Our emotional state impacts our immune system, often instantly,” says Turner. “It’s immunotherapy — just the natural version.”
Turner identified eight common factors in radical remission cases: Survivors took control of their health, deepened spiritual connections, overhauled their diets, used herbs and supplements, got more social support, increased positive emotions, followed their intuition, and found strong reasons for living. Of these, only two were physical: changing diets and taking herbs and supplements.
The rest were emotional and spiritual, and the details, highly individual. Whatever connected a person with the present moment — whether growing dahlias or playing with dogs — seemed to do the most good.
“Cases like these are plentiful,” says Turner. “They’re just severely underreported. The real problem is that we’re not studying them, and we should study everyone who has healed from cancer.”
The New Anticancer Life
My genes predispose me to cancer, but I don’t live in abject terror.
I feel empowered because the research of the past 20 years tells a new and different story. I know that I can talk to my genes through food and lifestyle medicine. I balance my energy with acupuncture and yoga. I avoid dairy and eat more vegetables in a day than I used to eat in a week. I still don’t meditate, but I’ve embraced the spiritual outlet that works for me: dumb action movies. I relax on a deep cellular level (and thrill like an 11-year-old boy) whenever I watch Vin Diesel race across Siberia in a Dodge Charger.
The cancer that came for me in 2012 has (blessedly) remained at bay. I’ve got some suspicious spots in the rest of my body, so I embrace my PJS-screening protocol, and I watch and wait. Every year, like clockwork, I drink a giant jug of laxative and get a colonoscopy, while my long-suffering gastroenterologist tolerates my efforts to fight him off — kung-fu style — each time I go under anesthesia. Then I go home, chug a low-glycemic green smoothie, and cue up an action film.
Cancer is a multidimensional disease. I want a multidimensional plan of attack.
The Insulin Connection
The pancreas secretes the hormone insulin every time we eat. Insulin’s main role is to escort glucose into our cells, where it can be used for energy.
No matter what we eat, the pancreas releases insulin, but it releases more of it when the foods are sweet. When the body produces substantial amounts of the hormone for too long, cells stop responding, becoming insulin resistant.
“High insulin levels and insulin resistance are closely linked to mitochondrial damage,” says Jason Fung, MD, coauthor of The Complete Guide to Fasting. “Damaged mitochondria might be the underlying problem with cancer cells.”
Too much insulin may cause another problem, too. “Insulin is a growth factor, and cancer is uncontrolled growth, so anything that causes growth can make things worse,” he explains.
Brief periods of fasting can help lower insulin levels and reduce insulin resistance. Nutritionist Michelle Gerencser, MS, notes that it can produce beneficial metabolic changes in as little as 13 hours (which can include sleep time). So, if you stop eating at 7 p.m. and don’t resume again until 8 a.m., you can help restore lower insulin levels.
Low-glycemic foods — dark leafy greens and vegetables, grassfed meats, and low-sugar fruits like berries — also keep insulin in check and help reduce inflammation.
Eating more plants and less sugar, while avoiding processed foods and beverages, is the foundation of all cancer-fighting diets. From there, the best approach is the one that works best for you.
So how do you know what that is? When you try a new anticancer food protocol, work with your healthcare provider to test your inflammation and blood-sugar levels after a few weeks. When your blood sugar and fasting insulin are well controlled and your inflammatory markers are low, you’ve likely found an effective food plan.
You can also use your current health status or treatment protocol as a guide. You might generally eat an anti-inflammatory diet, for example, but if you enter active treatment and your platelets are low, you might want to temporarily kick up the sesame oil and tahini, both high in inflammatory omega-6 fats, to help the platelets recover.
These are three of the top nutrition protocols you can use to prevent and heal from cancer.
- What it is: A 100 percent plant-based diet that eliminates meat, dairy, and honey.
- Benefits: Plants and more plants supply a load of phytonutrients, antioxidants, and fiber.
- Challenges: Blood sugar can be harder for some to control on a vegan diet. It’s critical to get enough healthy fats for blood-sugar regulation and to avoid processed foods like faux meats.
- What it is: A nutrition protocol that focuses on grassfed meats and wild-caught fish, high-quality fats and oils, and as many plants as you can eat; avoids dairy, cereal grains, legumes, potatoes, and refined sugar.
- Benefits: A diet rich in healthy fats and lean protein helps keep blood sugar under control. The omega-3 fats in grassfed meat and coldwater fish like salmon are anti-inflammatory. The absence of sugar keeps insulin well-regulated.
- Challenges: There’s a tendency to overconsume meat and neglect vegetables. Consuming meat from factory-farmed animals, which contains fewer omega-3s and more omega-6s, can promote inflammation. Healthful paleo eating means sticking with grassfed and wild-caught protein, in modest amounts.
- What it is: A metabolic therapy that requires getting 75 to 80 percent of daily calories from fat, 10 to 15 percent from protein, and 5 to 10 percent from carbohydrates. Periods of fasting also boost nutritional ketosis, a state in which your body burns fat for energy.
- Benefits: Tightly restricting glucose while increasing fat intake forces the body to switch from burning glucose to burning fat; this improves mitochondrial health and puts stress on tumor cells. (Fasting also puts stress on tumor cells.)
- Challenges: It’s hard to eat so much fat and so few carbs. If you decide to adopt a full ketogenic protocol, it’s best done under the care of an experienced health practitioner. And if you do not have cancer, most researchers advocate avoiding prolonged periods of ketosis, as it can lead to phytonutrient deficiencies. “It may be good to go in and out of nutritional ketosis for general health and cancer prevention, but it may not be optimal for those using it for clinical management of existing disease,” says Dominic D’Agostino, PhD, assistant professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida. He suggests intermittent fasting and low-glycemic-index diets as a good alternative.
Health and Wellness Associates
Dr Anne Sullivan