What would you do if you get cancer?

[cTpa]

Hi guys,

I'm new here but I'm not new here. It's my first post and my sign in is fresh but I was following this forum couple of years now. I'm reading many threads from you about so many things as cold exposure, cr, training, healthy (mostly vegan) diet(s). On some answers I realize you do it for a fit body and mind, some do it for longevity but/and many of you/us are also doing it to not get an serious illness - I hope I summarized it right?

I can image some of you was/is already ill - but also for you my question remains. What have you /what would you do if it's serious / gets serious. The reason I'm asking for cancer is because I think for cardiovascular deseases there is more official research for what is good for you and what not. Maybe I'm wrong. 

I'm very exited to hear what your answers are... 

Best regards

cTpa

[Dean Pomerleau]

Hi cTpa,

Welcome to the CR Forums!

First off, I hope your question is just hypothetical and that neither you nor someone close to you is facing an actual cancer diagnosis.

If I or someone I loved got cancer, I'd research the heck out of the specific form of cancer they've been stricken with to see what if any diet, lifestyle or medical intervention have shown the most promise in battling the cancer. I'd then carefully way the pros and cons of each intervention (and combination) to figure out the course of treatment that has the best chance of success while factoring in constraints about quality of life.

As a specific example, when my 17-yo son was diagnosed with brain cancer, I looked into low-carb diets to see if they would be helpful. While there was some evidence they might provide modest benefit, we concluded that for him the quality of life hit he would take trying to follow a low-carb diet wasn't worth the modest potential benefit.

We did start him on a regime of a few over-the-counter supplements that might prove helpful (and probably not be harmful), but mostly relied on stardard care (surgery and radiation therapy) along with enrolling him in an immunotherapy trial. We declined chemo for similar quality of life reasons.

I don't think there is any one-size-fits-all solution to how to respond when you get a  cancer diagnosis since it depends so much on the type of cancer, not to mention the personal tradeoffs one is willing to make between quality of life vs. chance of a cure.

--Dean

[Sibiriak]

Excellent reply from Dean-- I agree entirely with his central point:

1 hour ago, Dean Pomerleau said:

I don't think there is any one-size-fits-all solution to how to respond when you get a  cancer diagnosis since it depends so much on the type of cancer, not to mention the personal tradeoffs one is willing to make between quality of life vs. chance of a cure.

Keeping that point mind,    I would definitely look into fasting as a possible adjunct to other therapies.   

See for example:

Metabolic Reprogramming by Reduced Calorie Intake or Pharmacological Caloric Restriction Mimetics for Improved Cancer Immunotherapy (2021)

Fasting mimicking diet as an adjunct to neoadjuvant chemotherapy for breast cancer in the multicentre randomized phase 2 DIRECT trial (2020)

Effects of short-term fasting on cancer treatment (2019)

Valter Longo --List of Scientific Articles

Edited April 1, 2021 by Sibiriak

[cTpa]

4 hours ago, Dean Pomerleau said:

Hi cTpa,

Welcome to the CR Forums!

First off, I hope your question is just hypothetical and that neither you nor someone close to you is facing an actual cancer diagnosis.

If I or someone I loved got cancer, I'd research the heck out of the specific form of cancer they've been stricken with to see what if any diet, lifestyle or medical intervention have shown the most promise in battling the cancer. I'd then carefully way the pros and cons of each intervention (and combination) to figure out the course of treatment that has the best chance of success while factoring in constraints about quality of life.

As a specific example, when my 17-yo son was diagnosed with brain cancer, I looked into low-carb diets to see if they would be helpful. While there was some evidence they might provide modest benefit, we concluded that for him the quality of life hit he would take trying to follow a low-carb diet wasn't worth the modest potential benefit.

We did start him on a regime of a few over-the-counter supplements that might prove helpful (and probably not be harmful), but mostly relied on stardard care (surgery and radiation therapy) along with enrolling him in an immunotherapy trial. We declined chemo for similar quality of life reasons.

I don't think there is any one-size-fits-all solution to how to respond when you get a  cancer diagnosis since it depends so much on the type of cancer, not to mention the personal tradeoffs one is willing to make between quality of life vs. chance of a cure.

--Dean

Hi Dean,

thank you for your answer. 

One of my young clients (Young female) has this situation. In the past there were several situations where I witnessed different reactions. I was shocked how less people do on their own and how much they rely (only!) On their personal doctor. And if you know the medicine principles you know it's going just by the book. I'm not saying that is bad but for a own life I'm surprised that this is enough for most of the people.

You were mentioning your son - I understand the decision completely. But would you do the same for yourself? I mean lifequality "over" surviving-chances? I know you can't put it that way, I suppose you have done a good balance between this two but as I can read out with more weight to the life quality side. What would it be for yourself - your own life?

 

Thanks.

 

Best

[Dean Pomerleau]

30 minutes ago, cTpa said:

You were mentioning your son - I understand the decision completely. But would you do the same for yourself? I mean lifequality "over" surviving-chances? I know you can't put it that way, I suppose you have done a good balance between this two but as I can read out with more weight to the life quality side. What would it be for yourself - your own life?

Good question. Like many around here I have a degree of self discipline and a willingness to delay gratification that is well above average. So I am willing and able to put up with diet and lifestyle interventions that most people would judge as too austere to be worth it if I believe that they could potentially help me live a longer and healthier life, whether I've been diagnosed with cancer or not.

But if it had been me rather than my son diagnosed with brain cancer, I'm not sure I would have done much differently. The median survival time for someone diagnosed with his form of cancer (glioblastoma multiform or GBM) is 8 months, and two year survival is ~15% (ref). By the time his cancer was discovered it had progressed to stage-4. The tumor deep in his brain was inoperable and had metastasized to several locations in his spinal chord.

In short, his diagnosis was basically a death sentence and so quality of life in the time he had remaining (which turned out to be 10 months) became paramount. Perhaps we could have stretched that by a couple months with chemo, but given the side effects, we didn't judge it to be worth it for him. I don't think I'd have made a different decision if it had been me.

As I said, it all depends on the type of cancer, how far it has progressed, one's tolerance for onerous interventions and how tenaciously one wants to cling to life.

--Dean

[cTpa]

4 hours ago, Sibiriak said:

See for example:

Metabolic Reprogramming by Reduced Calorie Intake or Pharmacological Caloric Restriction Mimetics for Improved Cancer Immunotherapy (2021)

Fasting mimicking diet as an adjunct to neoadjuvant chemotherapy for breast cancer in the multicentre randomized phase 2 DIRECT trial (2020)

Effects of short-term fasting on cancer treatment (2019)

Valter Longo --List of Scientific Articles

Thank you for your additional links. That is very interesting esp. Valter Longo!

9 minutes ago, Dean Pomerleau said:

Good question. Like many around here I have a degree of self discipline and a willingness to delay gratification that is well above average. So I am willing and able to put up with diet and lifestyle interventions that most people would judge as too austere to be worth it if I believe that they could potentially help me live a longer and healthier life, whether I've been diagnosed with cancer or not.

But if it had been me rather than my son diagnosed with brain cancer, I'm not sure I would have done much differently. The median survival time for someone diagnosed with his form of cancer (glioblastoma multiform or GBM) is 8 months, and two year survival is ~15% (ref). By the time his cancer was discovered it had progressed to stage-4. The tumor deep in his brain was inoperable and had metastasized to several locations in his spinal chord.

In short, his diagnosis was basically a death sentence and so quality of life in the time he had remaining (which turned out to be 10 months) became paramount. Perhaps we could have stretched that by a couple months with chemo, but given the side effects, we didn't judge it to be worth it for him. I don't think I'd have made a different decision if it had been me.

As I said, it all depends on the type of cancer, how far it has progressed, one's tolerance for onerous interventions and how tenaciously one wants to cling to life.

--Dean

Thank you, hopefully I'm not digging too deep in a private sector - I'm really interested in the decision making of ones own life. Your reference says it's a 15% 2-year-survival and as I can read out 6% for a 4 Year-period and if this ref is correct about 4% for a "whole" survival. If I read this, it means 15 of 100 so 1,5 of 10 so at least 1 of  6/7 people will live longer then 2 years (3x more then average), 1 out of 17 will live longer then 4 years (6x longer) and 1 of 25 will survive. That's a reason/chance to try it more drastical?

But I appreciate your answer and thank you for your time. 

 

Best 

cTpa

[Dean Pomerleau]

14 minutes ago, cTpa said:

reference says it's a 15% 2-year-survival and as I can read out 6% for a 4 Year-period and if this ref is correct about 4% for a "whole" survival.

Those survival rates are for all people diagnosed with GBM. People whose tumors are inoperable and in whom the cancer has already metastasized have a much lower survival rate, and the available chemotherapy options are extremely unpleasant and add only a couple/few months to mean survival.

I certainly wouldn't fault anyone for trying to maintain hope. But overtreatment in terminally ill cancer patients is a real problem, often serving the hospital's bottom line more than best interest of the patient and their family, IMO.

--Dean

[cTpa]

On 4/1/2021 at 6:18 PM, Dean Pomerleau said:

But overtreatment in terminally ill cancer patients is a real problem, often serving the hospital's bottom line more than best interest of the patient and their family, IMO.

--Dean

I agree - in most countries unfortunately. 

I thought the answer would be like yours in the crsociety.org forum but I wanted to ask directly. If any other additions would come, I would appreciate it (like fasting from Sibiriak).

Thank you.

[Clinton]

Here is an interesting Ted talk, about cancer requiring new blood vessel growth in order to grow.

Not sure how viable or effective an ‘anti-angiogenic’ diet would be to combat cancer; but this Dr. Seems to think it could work.

 

Edited April 3, 2021 by Clinton

[mccoy]

I agree basically with Dean, on the fact that there is such a degree of variability in cancer instances that it is impossible to answer a priori.

I remember my mother has had brain metastatic cancer which meant, as Dean rightly defined it, a death sentence. In these inoperable cases, the best strategy even in my view, a strategy that is sometimes overlooked, is pain relief and the quality of the small stretch of life left to the patient. To date, 30 years after, I still regret that things didn't go straight that way. 

In less serious cases, research and personal inclinations may govern the strategy. For example, I'm a follower of Longo's FMD which has been studied in conjunction with chemotherapy. I would research deeply that specific field and apply the combination(s) which seems more promising.

Some people are more inclined toward keto diets, which sometimes seem to be promising, but are not efficacious for all cancers.

Some other people may prefer to adopt a healthy vegan diet with the primary purpose of lowering IGF-1 ...

 

. 

[cTpa]

Thank you mccoy. 

Is there something else you would change (or do, what you already do) except your diet?

[drewab]

On 4/1/2021 at 2:43 AM, cTpa said:

Hi guys,

I'm new here but I'm not new here. It's my first post and my sign in is fresh but I was following this forum couple of years now. I'm reading many threads from you about so many things as cold exposure, cr, training, healthy (mostly vegan) diet(s). On some answers I realize you do it for a fit body and mind, some do it for longevity but/and many of you/us are also doing it to not get an serious illness - I hope I summarized it right?

I can image some of you was/is already ill - but also for you my question remains. What have you /what would you do if it's serious / gets serious. The reason I'm asking for cancer is because I think for cardiovascular deseases there is more official research for what is good for you and what not. Maybe I'm wrong. 

I'm very exited to hear what your answers are... 

Best regards

cTpa

Hi cTpa,

I think that your question is an interesting thought experiment and I believe it will lead to some interesting discussion in this thread. I was seriously ill (not from cancer) and did a complete 180 in my lifestyle just over a decade ago. On that note, if you are interested in reading about it you can do so here as I recently composed a long piece on 10 years of a WFPB (mildly CR'd) lifestyle: https://www.drmcdougall.com/forums/viewtopic.php?f=1&t=61699 To be clear about one thing, I eat a lot of food and in some ways may live more of an 'exercise-induced CR' lifestyle than being a true CRON-ie. Having said that, my bloodwork looks remarkably similar to those adhering to more conventional CR with more normal exercise regimes. Basically, a health crisis early in my life resulted in me going WFPB, engaging in exercise, cold exposure, heat exposure (sauna, steam room, etc.), taking up a meditation/mindfulness practice, tinkering with intermittent fasting, spending a great deal of time in nature, and so forth. Basically, if it's a longevity practice with robust data around it, I try to engage in it. 

I don't think a great deal would change if I were to get diagnosed with cancer as I think I've probably optimized a lot of what can be done. Having said that, I would almost certainly book a trip to True North Health Center for a medically supervised water-only fast as an intervention. As McCoy mentioned, doing regular rounds of Longo's FMD is probably something I would look to incorporate on a monthly basis. I would research the hell out of whatever condition I had and I also try to make peace with the fact that the outcome may be out of my hands (which I'm sure is easier said than done). I would also quit my job, spend every moment I could with family and friends, and try to see as much of this incredible world as I could. And if I was fortunate enough to survive, then I would resume working and contributing to society once again. I also would very seriously consider conventional medical treatment and would probably take advantage of it in some form. I'm certainly pro-medical establishment and think that an uber-healthy lifestyle is complementary to whatever current standard of care may be in place.

The type of cancer, age of diagnosis, survival rates, and so forth, would undoubtedly influence my decision making though. If I was diagnosed with stage IV pancreatic cancer, it would be much different than to be diagnosed with early-stage prostate cancer. I appreciate Dean's openness in sharing his experience here. 

 

[mccoy]

5 hours ago, cTpa said:

Thank you mccoy. 

Is there something else you would change (or do, what you already do) except your diet?

Maybe, I'd take rapamycin or rapa analogs, intermittent dosages, as already discussed elsewhere in this forum, once you have cancer the collateral effects of rapa wouldn't mind so much, probably.

[cTpa]

39 minutes ago, drewab said:

Hi cTpa,

I think that your question is an interesting thought experiment and I believe it will lead to some interesting discussion in this thread. I was seriously ill (not from cancer) and did a complete 180 in my lifestyle just over a decade ago. On that note, if you are interested in reading about it you can do so here as I recently composed a long piece on 10 years of a WFPB (mildly CR'd) lifestyle: https://www.drmcdougall.com/forums/viewtopic.php?f=1&t=61699 To be clear about one thing, I eat a lot of food and in some ways may live more of an 'exercise-induced CR' lifestyle than being a true CRON-ie. Having said that, my bloodwork looks remarkably similar to those adhering to more conventional CR with more normal exercise regimes. Basically, a health crisis early in my life resulted in me going WFPB, engaging in exercise, cold exposure, heat exposure (sauna, steam room, etc.), taking up a meditation/mindfulness practice, tinkering with intermittent fasting, spending a great deal of time in nature, and so forth. Basically, if it's a longevity practice with robust data around it, I try to engage in it. 

I don't think a great deal would change if I were to get diagnosed with cancer as I think I've probably optimized a lot of what can be done. Having said that, I would almost certainly book a trip to True North Health Center for a medically supervised water-only fast as an intervention. As McCoy mentioned, doing regular rounds of Longo's FMD is probably something I would look to incorporate on a monthly basis. I would research the hell out of whatever condition I had and I also try to make peace with the fact that the outcome may be out of my hands (which I'm sure is easier said than done). I would also quit my job, spend every moment I could with family and friends, and try to see as much of this incredible world as I could. And if I was fortunate enough to survive, then I would resume working and contributing to society once again. I also would very seriously consider conventional medical treatment and would probably take advantage of it in some form. I'm certainly pro-medical establishment and think that an uber-healthy lifestyle is complementary to whatever current standard of care may be in place.

The type of cancer, age of diagnosis, survival rates, and so forth, would undoubtedly influence my decision making though. If I was diagnosed with stage IV pancreatic cancer, it would be much different than to be diagnosed with early-stage prostate cancer. I appreciate Dean's openness in sharing his experience here. 

 

Hi Drewab,

thank you for your interesting addition. I was very hoping to get such information like yours. But a special thanks for your link. I'm very greatful to read such details and as your replier told you your personal "observations about calorie density and BMI" and the others are very interesting (for example stressing the body).

I'm curious - do you think it's a good idea to change your lifestyle this way (seeing your loved ones each moment and not to go to work)? It's a topic I'm very curious. There are some information that dying poeple always decide to do that and are greatful for this decision, right? But doesn't that mean you are already deciding your loss against the situation? I know it doesn't - but I'm still curious about the psychological effect on ones health of this decision. I do not disagree (nor do I agree).

Quote

I also try to make peace with the fact that the outcome may be out of my hands (which I'm sure is easier said than done)

I heard once about the spontaneous healing people (do you call it that way in english?) - they don't have many things in common but almost everybody had the following attitude: "i accept the diagnosis, but I don't agree on the outcome." - I think thats an interesting fact for the psychological (possible) effect, dont you think?

Thank you again.

 

Best

cTpa

[Clinton]

On 4/1/2021 at 1:18 PM, Dean Pomerleau said:

I certainly wouldn't fault anyone for trying to maintain hope. But overtreatment in terminally ill cancer patients is a real problem, often serving the hospital's bottom line more than best interest of the patient and their family, IMO.

--Dean

Powerful words.

Edited April 5, 2021 by Clinton

[Ron Put]

I believe it's really up to the patient to make an informed choice, as best as they can (if they can), if costs to others are not an issue.

Sometimes I wonder if in truly terminal cases the custom of hiding the truth, as in Japan and elsewhere, may be beneficial. Probably not, but again, everyone is different.

Dean, I am so, so sorry.

[Sibiriak]

Exercise—A Panacea of Metabolic Dysregulation in Cancer: Physiological and Molecular Insights   (2021)

 

Int J Mol Sci. 2021 Apr; 22(7): 3469.

PMID: 33801684

Steffen H. Raun,¹Kristian Buch-Larsen,^2,3Peter Schwarz,^2,3 and Lykke Sylow^1,4,*

 

Quote

Abstract

Metabolic dysfunction is a comorbidity of many types of cancers. Disruption of glucose metabolism is of concern, as it is associated with higher cancer recurrence rates and reduced survival. Current evidence suggests many health benefits from exercise during and after cancer treatment, yet only a limited number of studies have addressed the effect of exercise on cancer-associated disruption of metabolism.

In this review, we draw on studies in cells, rodents, and humans to describe the metabolic dysfunctions observed in cancer and the tissues involved. We discuss how the known effects of acute exercise and exercise training observed in healthy subjects could have a positive outcome on mechanisms in people with cancer, namely: insulin resistance, hyperlipidemia, mitochondrial dysfunction, inflammation, and cachexia. Finally, we compile the current limited knowledge of how exercise corrects metabolic control in cancer and identify unanswered questions for future research

 

.

Figure 2

Cancer is associated with adverse changes of metabolic important tissues, including skeletal muscle (myocytes), adipose tissue (adipocytes), and the liver (hepatocytes). Those changes include insulin resistance, hyperlipidemia, mitochondria dysfunction, inflammation, and muscle mass loss (cancer cachexia) and there is significant tissue crosstalk. Abbreviations: ATGL; adipose triglyceride lipase, HSL; hormone sensitive lipase, ROS; reactive oxygen species.

Figure 3

Illustration of the temporal metabolic benefits of exercise and molecular mechanisms. (A) One exercise bout elicits an acute and transient increase in muscle glucose uptake that is independent of insulin and persists in insulin-resistant subjects. (B) Insulin sensitivity (illustrated here as insulin-stimulated glucose uptake) is transiently enhanced for up to 48 h after the last exercise bout. (C) Repeated exercise training leads to longer-term adaptations, including increased expression of fat- and glucose-handling proteins and increased capillarization that improves insulin sensitivity and elevates muscle fat- and glucose-handling capacity. Abbreviations: AMP-activated protein kinase, FA; fatty acid, RAC1; Ras-related C3 botulinum toxin substrate 1, ROS, reactive oxygen species, TBC1D1; TBC1 Domain Family Member 1.

5. Unanswered Questions

The following knowledge gaps hinder optimal treatment of metabolic dysfunction in cancer and hamper our ability to harness the beneficial effects of exercise:

1. The optimal exercise regimen for benefitting metabolic regulation in cancer remains to be established.

2. The appropriate implementation of exercise into the oncological treatment of cancer must be determined.

3. It is important to establish whether an acute exercise bout fully stimulates insulin-independent glucose uptake into the exercising muscles in cancer patients. This will be vital information in the daily life for cancer patients, as improved glycemic control is associated with the effectiveness of cancer treatment and improved survival.

4. It would have real-life patient benefits to determine whether the insulin-sensitizing effect of one bout of exercise exists in patients with cancer and can be exploited in relation to the timing between exercise and meals to maximize glucose disposal, reduce hyperinsulinemia, and elevate muscle protein synthesis.

5. For cancer patients with cancer cachexia, it is important to determine whether exercise can treat the loss of muscle mass and improve strength and which exercise regimen is most effective.

6. Deeper knowledge of the molecular mechanisms by which exercise benefits metabolic regulation is needed to identify novel therapeutically drug targets. This is especially important in patients with cancer cachexia who are unlikely to easily exercise [260].

6. Conclusions

The evidence is clear that dysregulated metabolism is a common feature of cancer. It manifests as peripheral insulin resistance, hyperlipidemia, mitochondrial dysfunction, inflammation, and cachexia. Contemporary observational studies have shown that cancer survival depends on better metabolism management strategies, as metabolic dysfunctions are associated with reduced survival and increased cancer recurrence risks for most cancers. Exercise produces acute as well as longer-term metabolic benefits by improving insulin sensitivity, restoring hyperlipidemia, reducing inflammation, enhancing mitochondrial function, and increasing muscle mass and strength.

Thus, exercise could be an important strategy to improve metabolic function in cancer but randomized controlled trials in patients with cancer are warranted. The American College of Sports Medicine updated its exercise guidelines for cancer treatment of a variety of cancer health-related outcomes including fatigue, anxiety, depression, sleep, function, and quality of life [261]. Improved metabolic regulation could likely be added to that list in the future, yet, current evidence is limited and many exciting discoveries lie ahead.

Edited June 1, 2021 by Sibiriak