This week's weblog post is a review of our annual conference past times the wonderful Joan Faria from empowerednutrition.org.uk...
My weblog is a footling dissimilar this calendar month every bit it’s non my musings on a item nutrition or wellness issue. Instead, I thought I’d convey you lot a review of the this year’s conference on integrative approaches to cancer which took house inwards London on Sabbatum 25 Nov 2017. I know a few people who would have got liked to have got attended the conference but couldn’t brand it. volition hold out releasing a video of the event, but every bit it was a long twenty-four sixty minutes menstruation making for a lot of video-watching, this is my shorter summary! There was plainly a lot to a greater extent than discussed than I have got room for, but what I have got written hither are the points too issues that struck me every bit beingness most meaning from the day. Nevertheless, it’s a much longer post than usual, so experience gratis to dip inwards too out. I hope you lot relish it.
The championship of the conference was “Starting the Conversation – exploring ways inwards which integrating conventional cancer aid too lifestyle medicine tin improve outcomes”. The aim was to hash out how nosotros tin span the gap betwixt conventional handling too other approaches so that people with cancer tin do goodness from the best of both. This involves communication too opened upward dialogue betwixt practitioners from both approaches – thus starting the conversation!Sophie Sabbage, writer of The Cancer Whisperer
That the conference opened with Sophie (not a practitioner but a patient, albeit an inspirational one) reflected how of import it is to seat the patient at the really centre of the handling process. In her park incredibly eloquent way, Sophie described that when she was diagnosed with phase 4 lung cancer, she wanted to do absolutely everything she could to assist herself, so she seat together a squad involving complementary practitioners every bit good every bit her conventional medical team. However, she found the scaremongering on both sides really unhelpful; the option practitioners warned her of the harm conventional treatments would do to her torso whilst the medics were sceptical of the validity of whatever complementary or lifestyle approaches. There are oft elements of arrogance too self-righteousness on both sides, which only serve to promote fearfulness too disempowerment inwards the patient. In Sophie’s case, the get-go sign of a span betwixt the 2 approaches came from her TCM practitioner, who likened the cancer inwards Sophie’s torso to terrorists inwards a house, too described conventional treatments every bit the SAS taking the terrorists out, with complementary too lifestyle therapies too so taking aid of the theatre too the innocent civilians inwards it.
Sophie referenced Dr Bernie Siegel’s volume “Love, Medicine too Miracles”, inwards which he defines “exceptional patients”. “Exceptional patients turn down to hold out victims. They educate themselves too locomote specialists inwards their ain care. They interrogation the Dr. because they desire to sympathize their handling too participate inwards it. They demand dignity, personhood, too control, no thing what the course of educational activity of the disease.” This made me cry, because it was 1 of the get-go books that I read when I was diagnosed, too made me resolve to hold out an special patient, something that oft kept me going when I felt despair creeping upward on me. She also dealt with 1 of conventional medicine’s criticism of option therapies, that they promote imitation hope. Sophie said that in that location is no such thing every bit imitation hope, because “Hope does non brand promises; it just hopes.” False hopelessness is a to a greater extent than unsafe thing. The concluding thing that rang truthful with me was that lifestyle therapies are a wonderful way of claiming some semblance of powerfulness inwards the human face upward of powerlessness. I recollect that the consummate loss of command that results from cancer too its handling tin oft hold out underestimated past times those who have got non gone through it, too feeling that you lot are taking steps to assist yourself tin hold out incredibly validating too empowering.
If you lot have/have had cancer too haven’t come upward across Sophie before, too so I urge you lot to await her upward too read her book “The Cancer Whisperer”.
Dr Rupy Aujla of The Doctor’s Kitchen
Dr Rupy is an NHS GP too emergency medicine doctor, who came to a realisation of the benefits of nutrition too lifestyle through his ain experience of sick health. Knowing that doctors trained inwards the Great Britain aren’t educated inwards nutrition, he is aiming to alter this. He is using too adapting the concept of Culinary Medicine, which has been used inwards several medical schools inwards the USA since 2012. Medical students withdraw a serial of modules on nutrition inwards relation to item wellness conditions. Each module involves AV presentations, familiarisation with the associated research, too a hands on nutrient preparation session with a chef, a nutritional therapist too a medical Dr. based on improving the outcome inwards a existent case. Each module closes with eating the nutrient too a frank give-and-take amongst the pupil too professionals of the benefits too controversies of the nutritional approach nether consideration.
Dr Rupy has planned a airplane pilot of this at Westminster Kingsway College (which has a fine culinary school). It starts inwards Feb 2018 too has been accredited past times the Royal College of General Practitioners. The master copy long-term goals are to alter the medical curriculum too to educate GPs so that they tin have got a conversation with their patients almost lifestyle – food, sleep, exercise, meditation.
And excitingly, his vision for the hereafter is that every GP surgical physical care for inwards the Great Britain volition have got a community kitchen associated with it, with a chef too a nutritional therapist. Patients would hold out referred to it for back upward inwards changing their lifestyle – how wonderful would that be?!
Dr Malcolm Kendrick, GP too writer of “The Great Cholesterol Con”
Dr Kendrick described himself every bit “the maverick’s maverick”. Whilst working every bit a GP, he has managed to challenge some of the accepted ideas of our time, such every bit the human relationship betwixt LDL too cardiovascular affliction mortality. His verbalise was a really entertaining reflection on why alter is tedious to withdraw house inside the medical establishment. The medical institution is made upward non only of doctors, but also of pharmaceutical companies, the media, medical journals too more. As humans nosotros all have got strong motivating factors such every bit a postulate to conform, fearfulness (of non conforming or of beingness ridiculed) too peer pressure, too doctors are non immune to that. Beliefs are made inwards a dissever 2d too are too so really strongly held past times individuals – accepted beliefs tend only to alter with a alter of generation.
He explained the psychological theory of transactional analysis, which holds that each soul tin deed every bit either a parent, an adult or a kid inwards a given situation. Often the doctor-patient human relationship is stuck inwards a parent-child model. The Dr. may hold out paternalistic too tell the patient what to do; the patient acts every bit a kid too either meekly does every bit he/she is told or else is rebellious. This human relationship is non helpful! If both parties tin deed every bit adults, a conversation tin withdraw house inwards which the patient’s needs are valued too included. Dr Kendrick suggested using phrases such every bit “I experience you’re non understanding what I’m saying” to hold the patient’s seat every bit an adult.
Professor Robert Thomas, NHS oncologist too writer of “Lifestyle afterwards Cancer”
Professor Thomas is an NHS oncologist who has a special involvement inwards how lifestyle changes impact cancer outcomes. He is the editor of the website www.cancernet.co.uk, which provides evidence based recommendations on lifestyle alter for cancer.
He began past times discussing how chronic inflammation drives tumours to progress too metastasise. Pro-inflammatory factors include:
- Obesity
- Food intolerances
- Exposure to carcinogens
- A sedentary lifestyle
- Processed refined saccharify too the measure Western diet
whilst anti-inflammatory factors include:
- Exercise
- A diet rich inwards polyphenols
- Eating nuts
- Being happy
- God gut health
- The Mediterranean too macrobiotic diets are both anti-inflammatory
Conventional cancer treatments seat many women into the menopause, with an associated risk of osteoporosis. Dr Thomas said that the evidence is similar a shot in that location to back upward recommending item exercise types, such every bit squatting with weights, to improve established osteoporosis, rather than generic recommendations to exercise.
Dr Thomas’s evidence review of the human relationship betwixt refined saccharify too cancer is available here.
Gut wellness (probiotics were referred to specifically) is similar a shot recognised every bit fundamental for improving immunity, reducing chemotherapy side effects, improving reply to cancer vaccine therapies too reducing chronic inflammation. Probiotics too polyphenols have got a peculiarly meaning interaction: a higher intake of polyphenols encourage the growth of beneficial gut bacteria, too intake of probiotics results inwards improve absorption of polyphenols inwards the gut.
Exercise for those who are overweight may non Pb to weight loss past times itself, but has greater benefits, such every bit reducing inflammation, improving mood too (if outdoors) improving vitamin D status. For weight loss he recommended a combination of:
- Regular exercise (such every bit a walk earlier breakfast)
- 13 hours (minimum) overnight fasting – improves blood refined saccharify control, reduces inflammation too leads to a 30% reduction inwards recurrence charge per unit of measurement for women who have got had thorax cancer
- Reduce processed sugar
- Eat an anti-inflammatory diet with to a greater extent than polyphenolic compounds (ie lots of brightly coloured vegetables too fruits)
He discussed the clinical trials which he has carried out on the nutrient based supplement Pomi-T and the boom bed balm Polybalm (which protects against boom side effects caused past times the chemotherapy drug Taxotere).
Dr Rangan Chatterjee, NHS GP, functional medicine practitioner, BBC1’s Doctor inwards the House
Sadly, Dr Chatterjee wasn’t at the conference inwards person, but sent his video contribution of an interview with Robin Daly ( chair).
Dr Chatterjee is passionate almost lifestyle medicine, but recognises that the nether the electrical flow NHS model of 10 infinitesimal appointments, GPs are non equipped to provide lifestyle advice. However, he has a vision of GPs beingness able to refer to practitioners who are qualified to back upward lifestyle alter (such every bit nutritional therapists, exercise therapists etc), just every bit GPs refer to other specialists inside the NHS. The departure is that whilst GPs have got an understanding of the piece of work the NHS specialist do, they currently have got no preparation inwards what lifestyle medicine practitioners tin offer. To this end, he has developed a course of educational activity inwards Prescribing Lifestyle Medicine. This has been accredited past times the Royal College of General Practitioners too volition start inwards Jan 2018.
Evidence based medicine (EBM) is a philosophy honey to those inwards conventional medicine. It is oft used every bit a criticism of lifestyle practices when it is deemed that in that location is non plenty evidence to back upward their use. However, Dr Chatterjee reminded us than when the concept of EBM was get-go developed, it was said to be at the intersection of iii areas:
Research evidence- Patient preference
- Clinical expertise
Today, EBM has come upward to hateful inquiry evidence alone. If nosotros ignore patient preference too clinical expertise (ie what a practitioner has experienced working inwards practice) too so nosotros are non interpreting EBM correctly too are non evaluating what is best for the private patient.
Dr Chatterjee encouraged all practitioners to recognise that cheers to the meshwork patients are becoming experts inwards their ain condition. Practitioners should non hold out threatened past times this but encompass it too inquire patients what they have got found out almost their status so that they tin larn themselves every bit good every bit guiding patients through the information.
Lizzy Davies of CanExercise
Lizzy’s background is every bit an oncology too palliative aid nurse. She moved into piece of work every bit a cancer exercise therapist afterwards her mother’s cancer diagnosis. Conventional cancer handling oft leads to physical deconditioning, with a loss of musculus volume too an increment inwards fatty to musculus ration. Lizzy advises patients non to hold back for that deconditioning to occur but to start out an exercise programme during treatment. Exercise is condom during handling every bit long every bit it is tailored too progressed correctly.
Exercise programmes for people with cancer must hold out collaborative (also considering eating, sleeping, digestive wellness too restorative rest) too personalised (considering the type, volume too intensity of exercise that is appropriate too also the phase too type of cancer too the treatment).
Conversations around exercise tin hold out started simply, past times suggesting deep breathing, walking or gentle stretching. Ideally, the aim is for 150 minutes per calendar week of aerobic exercise too some resistance piece of work (using weights or torso weight) 2-3 times per week. Long-term follow upward (after 6-12 months) is useful to hold motivation.
CanRehab is an arrangement which provides preparation for exercise professionals (for illustration inwards gyms or fitness centres) inwards working with cancer.
The PREPARE programme is similar a shot beingness used inwards some NHS cancer handling centres to provide exercise programmes for cancer patients the aim beingness to trim functional decline during treatment. The programme is delivered past times a dietitian, a nurse specialist too an exercise therapist too is adapted weekly during treatment.
Claudia Manchanda, medical herbalist
Claudi led us on a whistlestop tour of just some of the applications of herbal medicine every bit part of an integrative cancer approach. She invited us to start a conversation with nature, so that nosotros increment our connectedness to nature. Herbal medicine, similar conventional medicine, is founded on the regulation “first do no harm” – but this refers to doing no harm to the globe too the sustainability of the plants every bit good every bit to the patient! Herbal medicine is an ancient do which recognises the individuality of each patient, fifty-fifty amongst those with the same type too phase of cancer. The person’s emotional province is also of import inwards deciding on a treatment. Cancer is oft regarded inwards terms of chronic jail cellular telephone deterioration, deficiency too toxicity. Claudia stressed the importance of using local herbs – everything nosotros postulate is provided for us inside our immediate environment.
H5N1 medical herbalist is highly qualified, having a minimum of 500 clinical hours too having a BSc grade or equivalent. They are also CRB checked.
Herbs refer to the medicinal parts of a flora or fungi. The whole is greater than the total of the parts – isolated chemicals from plants volition non have got the same upshot every bit the synergy provided past times the whole plant.
Particular herbs mentioned included:
Rosa centifolia – a tea of this lifts the spirits. It is used for grief too heartache. The tannins it contains assist to seal mucous membranes, for illustration inwards the gut
Vitex agnus castus– the effects are dose specific. It is really goodness inwards preventing fibrocystic thorax affliction from progressing to thorax cancer. It is progestogenic too lowers prolactin.
Feverfew – inhibits cancer jail cellular telephone sectionalisation too is generically an anti-inflammatory. Claudia oft suggests this instead of turmeric every bit feverfew is local. The feverfew flora was passed around the room.
Slippery elm – soothing, a demulcent on external too internal (eg from radiotherapy) burns.
Ginger – oft used every bit a carrier to withdraw other herbs to a certainly part of the body. It is warming when dried, but non when fresh. Extraction methods for herbs are significant.
Lion’s Mane mushrooms – for burns, chemo encephalon too cachexia
Mangosteen – prevents chemo resistance
Berberine – helps drugs to cross the blood encephalon barrier
Beware of drug-herb interactions. Perhaps the most famous is Hypericum perforatum (St John’s Wort) which induces the CYP3A4 liver enzyme too thus increases the clearance of drugs which are metabolised past times this pathway. Citrus paradis (grapefruit) and valerianainhibit the CYP3A4 enzyme too thus the concentration of drugs metabolised past times this enzyme tin accumulate inwards the body. Most mushrooms are aromatase inhibitors. Fomitopsis betulina from Hampstead Heath was passed around the room. This is an immune tonic, anti-inflammatory, anti-tumour, anti-parasitic, a prebiotic, anti-viral, too aromatase inhibitor, antiseptic too anti-angiogenic! Because mushrooms are potentially pathogenic, humans have got evolved to have got an immune reply to them. Beta-glucans inwards pathogenic too non-pathogenic mushrooms alike bind to macrophage receptors inwards the pocket-size intestine too involve cells from the innate too adaptive immune system. As a food, mushrooms postulate to hold out cooked. For work every bit an immune tonic, it is best to work a decocted tincture using both H2O too alcoholic extractions to acquire the total arrive at of activity. We are closely related to fungi too taking anti-fungals tin final result inwards kidney damage.
Liz Butler of Body Soul Nutrition
The experience of the nutritional therapists at Body Soul Nutrition is that nobody knows what is needed improve than the customer themselves – the therapist’s role is to guide clients to larn to hear to their inner wisdom. The 2 master copy aims of nutritional therapy for cancer are:
- To displace out of the stress reply too into the relaxation response.
- To do an surroundings inwards the torso which is hostile to cancer.
H5N1 cancer diagnosis too its handling oft puts people firmly inwards the stress response! Switching to the relaxation reply affects the seem of a number of genes involved inwards cancer. Creating an surroundings (and peculiarly the neoplasm microenvironment) which is hostile to cancer requires removing anything that is undermining normal part (such every bit toxins) too restoring anything missing that is required for normal part (eg nutrients).
Nutrition plans are ever personalise, but some full general principles grip truthful for most people. The diet would, amongst other things:
- be based on whole foods
- be rich inwards vegetables too (to a lesser extent) fruit
- be depression inwards carbohydrate
- contain plenty of salubrious fats
- contain moderate amounts of character protein
- contain lots of herbs too spices
- be anti-inflammatory – for most people this agency avoiding gluten or fifty-fifty all grains, caffeine, alcohol too perhaps dairy
- be pleasurable!
It is Liz’s experience that many people with cancer seem to have got experienced what tin only hold out described every bit a loss of connexion – with themselves, with other people too with something greater. Liz too her colleague Sarah Lumley are both HeartMath coaches too offering connexion coaching sessions to their clients inwards lodge to restore this lost connection.
Dr Robert Verkerk of Alliance for Natural Health International
Dr Verkerk’s verbalise was on keto-adaptation too dietary diversity.
He discussed the Blue Zones (areas inwards the public where in that location are statistically higher numbers of centenarians than elsewhere). In the Blue Zone inwards Sardinia, the population eats mainly flora poly peptide too mainly beast fats. Meat is only eaten 2-3 times per month. Caloric intake is high (about 2700 cals/day) but exercise is continual. We postulate to consider non just what nosotros swallow but how too when nosotros swallow it.
There is currently an involvement inwards depression saccharide high fatty (LCHF) diets, but these were originally investigated for their benefits inwards tackling obesity inwards the 19th century. Today nosotros sympathize that it humans’ normal evolutionary province is to work fatty accumulated inwards the torso for unloose energy when nutrient sources are scarce. We are also designed for cycles of feeding too fasting – non continuous eating every bit nosotros tin today. In lodge to work torso fatty for fuel nosotros postulate to have got metabolic flexibility – our bodies postulate to larn too hold out able to beta-oxidise (break down) fats for work every bit unloose energy every bit good every bit using glucose. In this way, nosotros may non swallow a ketogenic diet, but nosotros are keto-adapted; when carbs are scarce inwards the torso nosotros tin metabolise fatty into ketones which tin feed into the Kreb wheel to brand energy. He referred to this picture from Ditch the Carbs which humourously illustrates the mutual misconceptions around LCHF diets – they should withal hold out plant-based! There is a fearfulness that next a LCHF or ketogenic diet may final result inwards ketoacidosis, but this is much to a greater extent than mutual inwards type 1 diabetes. Dr Verkerk said that for nutritional ketosis, ketone levels should hold out inwards the arrive at 0.5-3.0 mmol/litre. The multifariousness of the vegetables nosotros swallow has reduced markedly inwards modern times. We tin only feed the world’s growing population if nosotros displace away from monocultures to a various nutrient supply. This does non involve biotech! Organic vegetable box schemes (Riverford Organic was mentioned) which provide heritage varieties of vegetables tin assist increment our dietary diversity. Dr Verkerk compared the needs of the ecosystem every bit a whole too the soil inwards item with the needs of the human gut microbiome.
Many people are non aware that most salad vegetables sold inwards supermarkets are hydroponically grown. H5N1 mineral feed may hold out added, but the nutrient density is far inferior to that inwards vegetables grown inwards organic soils. Organic nutrient should hold out regarded every bit a shape of “free from” agriculture, ie it is gratis from synthetic toxins but organic does non guarantee nutrient density. Know your nutrient source! Wholegrain carbohydrates which are processed (eg bread, noodles) have got a similar glycaemic index to white carbohydrates, because they are already broken downwards past times the processing.
Take habitation points:
- Keto-adaptation (not necessarily ketogenic diet) – <50g carbs/day too intermittent fasting
- Move lots, including patch fasting
- Diversify your plant-based diet
- Transform stress
- Find purpose inwards life.
Meleni Aldridge of Alliance for Natural Health International
Meleni is a Functional Medicine practitioner, with a background inwards psychoneuroimmunology. She introduced the concepts of Functional Medicine – that it looks at finding too dealing with underlying imbalances rather than only treating symptoms. This is a nifty forcefulness of FM too agency it tin easily adapt to comprise novel too emerging science. She oft uses a Functional Medicine Timeline with her clients to illustrate how life events have got triggered sick health. After seeing her, a customer volition have a “prescription” with recommended lifestyle interventions. They postulate non hold out complex but are personalised – she quoted 1 illustration inwards which the top recommendation was to slumber more. Other interventions mightiness hold out to do with light, air, relationships, community too love every bit good every bit nutrition, exercise, slumber too relaxation. The Institute of Functional Medicine was founded inwards 1991 past times Jeffrey too Susan Bland. The Cleveland Clinic inwards the U.S. is associated with it too has a long waiting listing due to its popularity amongst patients who recognise the value of what it offers.
Nutritional therapists inwards the Great Britain are trained in functional medicine principles.
Dr Catherine Zollman, GP too medical manager of Penny Brohn UK
Penny Brohn Great Britain advocates a whole soul approach to cancer. It involves edifice resilience inwards multiple areas inwards life (mind, body, spirit, emotions) so that if 1 expanse is nether stress in that location is plenty resilience elsewhere to cope. Penny Brohn Great Britain are working with NHS cancer services inwards the Bristol expanse to improve what is offered to patients. They deliver the Recovery Package afterwards cancer handling at local hospitals, run preparation courses for oncology teams too have got lately been working on a articulation contention on nutrition which has the understanding of infirmary dietitians, nutritional therapists from PB, oncologists etc. This references the novel World Cancer Research Fund booklet “Eat Well During Cancer”.
Susie Budd, chemotherapy nurse inwards Bristol, spoke almost how working with Penny Brohn Great Britain has provided benefits to patients including regaining control, empowerment too avoiding imitation hopelessness. There are weekly meetings for Bristol NHS cancer patients at Penny Brohn, involving talks, physical activity, guided meditation, treatments such every bit acupuncture too one-to-one consultations with PB doctors.
Dr Zollman finished past times observing that inwards the electrical flow crisis inwards healthcare in that location is a nifty chance for integrative aid – every bit in that location is inwards our ain wellness crises.
Mark Boscher of Herts MS Therapy Centre
There are 50 Multiple Sclerosis Therapy Centres inwards the reason offering Hyperbaric Oxygen Therapy (HBOT). These centres are all independent too have got their ain pricing construction too rules. Many offering HBOT to cancer patients every bit good every bit to MS patients, although non all have got the capacity to. Altogether MS Therapy Centres have got provided over iii 1000000 HBOT sessions so really condom procedures have got evolved.
HBOT involves breathing pure oxygen inwards a bedroom nether a maximum of 1 extra atmosphere of pressure. Pure oxygen at normal atmospheric pull per unit of measurement area provides five times to a greater extent than oxygen than air too helps charge upward reddish blood cells with oxygen. At extra pull per unit of measurement area the blood plasma becomes saturated. The MS Therapy Centres’ experience is that HBOT may assist 2 thirds of people. The centres also provide signposting to experts for questions regarding clients’ personal wellness conditions. Many select to work HBOT amongst a ketogenic diet when dealing with cancer.
At to the lowest degree 20 HBOT sessions are needed. MS Therapy Centres’ prices vary from £17.50 (in Herts) to £50. Herts offers a gratis trial. Contact mark@hmstc.net for to a greater extent than information.
Dr Damien Downing, President of the British Society for Integrative Oncology
By this phase the lawsuit was running belatedly due to the enthusiasm of speakers too audience alike, so Dr Downing was brief, but urging us to bring together the BSIO. Lay people are welcome at meetings every bit good every bit practitioners so long every bit it is understood that no personalised advice tin hold out given.
The eve concluded with a brief Q&A (a “conversation”). Topics included radiations from mobile phones too how this tin hold out ameliorated past times grounding. The panel were keen to emphasise that it is of import to bargain with the issues which you lot tin too non acquire stressed past times those which you lot can’t. were thanked for a superb conference.
