Sunday, June 14, 2009

Pura Vida! Blue Zones, Lifestyle and a Must Read Book

I recently returned from 12 days in Costa Rica, one of the planet’s blue zones - 5 spots on the globe where people frequently live well past 100. Blue zones are defined by the longevity of their people, and several lifestyle characteristics, among which are family, a plant based diet, constant physical activity, social engagement, a positive attitude and no smoking.

These characteristics are mirrored in a book that I highly recommend called, Anticancer - A New Way of Life, by Dr. David Servan-Schreiber. Since cancer makes us feel completely helpless, it's important to take control whenever possible. One area we have control over is our lifestyle. For those who are sick, recovering, or just want to live healthy, this book is a must read. It has become a bible for me.

Since I was diagnosed again in 2006, I made several lifestyle decisions specifically aimed at how to best heal myself of metastatic disease. I spent about a year researching and developing my own treatment plan and implementing the advice of several alternative doctors and nutritional counselors. When I read “Anticancer,” I learned that not only was I on the right track, but I found tons of scientific evidence for what has become for me “A New Way of Life.”

Dr. Servan-Schreiber is himself a 15 year cancer survivor. While working as a research scientist on brain imaging, he was confronted with his worst nightmare: brain cancer. Having spent a year researching why some people get cancer and other people don’t, his book is full of sites to scientific studies that make any skeptic want to pass on the french fries. The premise of the book is to take control of these 4 areas of our lives: 1. our environment; 2. our diet; 3. our state of mind, and 4. our relationship with our bodies to stimulate our immune systems so that we can heal ourselves.

So who has time to revamp their lifestyle? It’s not as hard as you think. My favorite part of the book is chapter 8, The Anticancer Foods – not because I can cook, but because I love to eat. In fact, I usually don’t cook at all. Who has time? Most of the time I buy healthy foods and I warm them up. Thankfully, "Anticancer" is not all about sacrifice. I was thrilled to learn the scientific justification for eating dark chocolate and drinking red wine! See pages 127-128. The book points out how healthy food decisions can not only prevent cancer, they can prevent most other major diseases as well. Dr. Servan-Schreiber’s website has a blog component that addresses countless topics about fighting cancer and healthy living. My little blog can’t possibly add to the landscape that he has provided.

There’s a saying in Costa Rica, home of a blue zone, and the cleanest, most environmentally green spots on Earth. The saying is, “Pura Vida!” It means “pure life,” or “the good life.” It is used to say hello, goodbye, how’s it going, going fine, what’s up, good to see you, and other positive expressions connecting us to one another. It’s my new favorite motto. If it were a little shorter, I would name my new kitten, “Pura Vida!” It represents to me, living life the way that we were designed to live it: as healthy, happy residents of this planet, free of disease and capable of managing the stress of daily living in a complex world. I wish this for us all. Pura Vida!



On the One Yard Line

There's always that mix of feelings that creep over me when I go to Johns Hopkins to have a follow up PET/CT scan and a consultation with Dr. Georgiades: anticipation, nervousness, excitement, and the need to take deep breaths. On June 2nd, I received some great news:

Not only have all the ablated tumors shrunk in size, but they are also "dimmer" on the PET/CT, which means that the cancer has been killed and the inflammation caused by the radiofrequency ablations (RFAs) is disappearing. In fact, some of the tumors aren't even "lighting up" on the test at all! One such tumor is the one that was ablated during the last RFA that I had on March 3rd. Because of a small pneumothorax - collapse of the lung - during the procedure, Dr. Georgiades wasn't sure that he got the whole thing, which was one of the main reasons for this follow up appointment. Oh, and there's more: The test also showed that no new tumors have appeared, and the tiny little spots that were too small to characterize haven't grown. To me, this was the best news of all. Because no one knows how my disease spreads, we can't tell if, during these last two years of growth, all the cancer has revealed itself, or if there's more. We still don't know that, but worse case scenario, it looks as though we've stopped the growth. Best case scenario is that maybe, possibly, hopefully, we've killed it all. I'm happy and extremely grateful either way.

The plan is for me to have another PET/CT in September, when we can see if more tumors become even dimmer or stop lighting up due to the healing process. After I left Johns Hopkins that day, I felt that I not only made a touchdown, but that I had won the whole damn game! That's the way it is with cancer, every good report feels like a Super Bowl win. But the reality of metastasis is that we're never really out of the game. The season never ends.

After I got home, I started thinking about this, and I wrote this question to Dr. Georgiades:
I know that the terms, "cancer free," "cured," and "remission" will never be appropriate for someone like me. But do you think that someday I might be able to say that I'm "tumor free?"
Here is what he wrote back:
The problem is that even our best tests are not 100% accurate. We are following your disease with PET/CT, which is indeed the best test in this case, but its accuracy is about 92-95%. If and when one day the PET/CT is entirely negative (and given the way things are going now, there is a good chance it may happen) what we can say is: Based on our best test there is no evidence of viable tumor. Irrespective of that, however, we will need to follow up for life because of the possibility of a new lesion showing up.
That's Dr. Georgiades' diplomatic way of saying, "We really can't ever say 'tumor free' either, but things are looking good." That's ok, "no evidence of viable tumor" is good enough for me.