Lauren Cara - A Holistic Health & Wellness Blog.+Add.Feed Info1000FOLLOWERS
Dr Lauren Cara Macdonald is a health & wellness blogger, doctor, stage 4 cancer patient, trainee yoga instructor, and all-round positivity and life enthusiast. Her blog offers up a big dollop of Health & Wellness - all in the name of maximum Aliveness.
I thought I’d write another post on my favourite subject, “Gut Health”, but this time I’ve gone into the science behind why I’ve been banging on about the importance of looking after your gut microbiome for the past few years. I hope it’s helpful for anyone not yet up-to-speed on this fascinating area of research.
Over the past few months several human studies have supported the idea that our intestinal bacteria (the gut microbiome) plays a significant role in determining whether cancer patients respond to certain treatments. In the latest research study, Dr. Wargo (a doctor and research scientist in the USA), revealed that the composition of a patient’s gut can significantly influence whether someone responds to the type of cancer immunotherapy I’ve been receiving for the past 22 months (pembrolizumab, an anti-PD1). Interestingly, what seemed to matter most in the studies wasn’t the level of a specific gut microbe, but rather the overall diversity of the gut microbiome. Let’s take a look at the evidence so far…
Where My Obsession With My Gut Health Began
Prior to 2015 I’d never considered the state of my gut microbiome. I hadn’t tried kefir, I didn’t take a regular probiotic and I’d never experienced the joys of eating Jerusalem artichokes (you’ll know what I mean if you’ve tried them!). Then in October 2015 I was diagnosed with stage IV melanoma, a cancer which is notoriously chemotherapy and radiotherapy resistant, and which previously had a 5-year survival rate of around 15%. Fortunately, a new immunotherapy drug was approved by the NHS at the beginning of 2016, just six weeks after I’d received the stage IV diagnosis. Although this was incredible news – and the idea of a “game-changing cancer drug” made for sensational headlines – it transpired that only a small group of patients had responded to the treatment during the clinical trials. The drug I was about to start had a response rate of around 30-40% (meaning patients had their tumours stabilise or shrink) with only 15% having a complete response (achieving no evidence of disease). I was determined to find myself in the latter group so I began researching how I could swing the odds in my favour.
My research began by examining the gut-brain axis, specifically the gut microbiome and its impact on health. I then looked at the way in which stress and anxiety could be impacting on my immune system. This lead me to further explore the growing field of psychoneuroimmunology and the research highlighting the value of mind-body therapies. It soon became apparent that there was a huge area of medicine that had been largely ignored during my medical degree. I felt relatively knowledgeable about “the mind” due to my Psychology degree and “the body” due to my medical degree, but there was a gap in my knowledge at the interface between the body and mind. I became fascinated by the gut-brain axis and, specifically, the impact the gut microbiome has on both mental and physical health.
Prior to becoming a stage IV patient, I’d already had four operations over the past 18 months in an attempt to “cure” me and prevent the cancer from spreading. Along with conventional surgery, I’d also addressed my diet, started juicing, added in supplements and began a regular yoga practice. But nothing seemed to be helping. The cancer kept coming back, again and again. Over Christmas 2015 I could visibly see new tumours growing above my right breast and a scan had already confirmed I had tumours in my lung and adrenal gland. Consequently I started looking for other ways in which I could support my body to either fight cancer cells directly or slow down/prevent angiogenesis (the formation of new blood vessels – which helps “feed” tumours).
The Initial Gut Microbiome And Immunotherapy Research (2015)
Shortly after I started looking at the the gut-brain axis I came across some research which had just been published by the University of Chicago (back in November 2015). They’d found that by introducing a particular strain of bacteria into the gut of mice with melanoma, they were able to boost the ability of the animal’s immune system to attack tumour cells. The combination of oral doses of “good bacteria” and infusions with anti-PD-L1 immunotherapy nearly abolished tumour growth. Around the same time another group of researchers compared the effects of bacterial transfer (via fecal transplant) against immunotherapy (anti-PD-L1). They found that introducing the bacteria was just as effective as treating mice with anti-PD-L1 alone – resulting in significantly slower tumor growth. Furthermore, combining the benefits associated with the “good bacteria” with anti-PD-L1 treatment dramatically improved tumour control.
Turning My Attention To My Gut Health Before Starting Immunotherapy
Given these two fascinating studies I decided to do everything I could to get my gut in the best possible shape before starting immunotherapy. During one of my appointments I mentioned the research to my Oncologist (and explained my intention to diversify my microbiome) but, understandably, he was hesitant to support my plan. The microbiome is, of course, inordinately complex – with trillions of bacteria working in tandem to produce multivariate responses. Although the research in the initial mouse studies had been promising, it might have been the case that altering the gut microbiome in humans would have a different outcome – an idea that has recently been supported by a study which found that certain chemotherapies used to treat colorectal cancer actually become toxic to patients in the presence of certain gut bacteria.
Despite my Oncologist’s reservations, I set about diversifying my gut bacteria in the hope that I might help to push myself into the “complete responder” group. Along with having a diverse microbiome, I knew it was also important to have the right cocktail of bacteria. I didn’t have much to go on – just those two initial mouse studies – so I purchased probiotics which contained the specific bacteria which had helped the mice to survive (Bifidobacterium – although the probiotic I took actually contained several other strains too). I also changed my diet to include as many pre- and probiotics as possible.
Key Diet Changes
I know I’ve shared lots of blog posts about this subject during the past two years, but just to remind you once again…
The best way to keep your gut microbiome healthy is to make sure you’re getting a healthy mix of probiotics and prebiotics in your diet.
Although taking a probiotic supplement is also helpful, there are plenty of studies that suggest oral probiotics struggle to make a huge difference to the microbiome (compared to the impact of fecal transplants).
Simply changing our diets to include plenty of fibre, reducing refined sugars and not eating processed foods, can help improve the balance of bacteria in the gut.
You can easily load up on probiotics by eating certain foods (e.g. sauerkraut, kefir, miso, apple cider vinegar, sourdough bread).
Prebiotics are things like garlic, leeks, chicory root, Jerusalem artichokes, asparagus and under-ripe bananas.
Research also suggests that omega-3 fats (found in oily fish) affect the microbiome in positive ways.
It’s a great idea to try and fast for at least 12 hours overnight too. There’s lots of evidence to suggest this helps support a healthy gut microbiome.
The Latest Research (2017)
Dr Wargo teamed up with Gopalakrishnan and other researchers to collect faecal samples from more than 100 people with advanced melanoma before they began treatment with anti-PD-1 immunotherapy drugs. The scientists found that those who had the most diverse gut microbes were most likely to respond to the immunotherapy. The type of microbe was also linked to differences in responses to treatment. For example, people whose guts contained a lot of bacteria from a group called Clostridiales were more likely to respond to treatment. A second study showed that people who received antibiotics to treat infections shortly before or after starting immunotherapy did not respond as well to PD-1-blocking therapies. The researchers also found that the presence of the bacterium Akkermansia muciniphila was linked to better responses to immunotherapy. Responders had a far greater density of killer T cells – which are largely responsible for attacking cancer. The researchers found that the presence of the Faecalibacterium and Clostridiales bacteria seemed to account for the difference in T cell density. When these bacteria were given to cancer patients via a fecal matter transplant, they were more likely to respond to treatment and live longer without their tumour recurring or worsening.
The Microbiome: The Future Of Cancer Treatment?
I am under no illusion that the only reason I’m sitting here writing this post is because I’ve been on the receiving end of cutting-edge cancer treatment. I started immunotherapy in January 2016 and by August 2016 my scans revealed “no evidence of disease”. During the previous 10 months I’d become *OBSESSED* with looking after my gut but, of course, I have no way of knowing whether this made any difference to how I responded to immunotherapy. It might have been that I would have responded in exactly the same way, whether or not I’d changed my diet and started taking a daily probiotic supplement. Having said that, the 2015 studies and the new 2017 human studies suggest a big role for gut microbes in determining the cancer-killing potential of immunotherapies. Yet there are still plenty of questions, namely how, exactly, certain bacteria may help the immune system to fight cancer and if there are side-effects or potential dangers of manipulating the microbiomes of cancer patients. It will be fascinating to follow this research in the future. WATCH THIS SPACE!
I hope I’ve inspired you to look after your gut health – whether you are a fellow cancer patient or just someone looking to support their health and wellbeing.
Sending you lots of love and good health.
Please make sure you tell your own doctor before you start taking a daily probiotic – especially if you are undergoing cancer treatment.
After becoming completely exhausted whilst working full time in the hospital this summer, I decided to give myself another career break for a few months (until I finally finish cancer treatment at the end of 2017). Despite the blood, sweat, tears and shingles, I’m pleased I went back to work when I did as it finally enabled me to complete my F2 training and now puts me in a position to locum as and when I have the energy. In the meantime I’ve been enjoying a mixture of relaxing down-time along with embracing my new ticket to worldwide travel (my yoga teacher qualification) – plus still having treatment at The Royal Marsden every three weeks.
My Recent Adventures
Just to get you up to speed on the past few months… For those of you following my Instagram account (dr_laurencara), you’ll have seen I shared my recent stay at Sen Wellness Sanctuary in Sri Lanka. Although the sanctuary is primarily a kundalini yoga and ayurvedic centre, the lovely owner Sam, who has become a dear friend over the past few years, invited me out to experience the retreat but also practice teaching vinyasa/yin styles of yoga. Below are a few photos from my trip – the first one being of my beautiful friend and kundalini teacher, Candace, who I learned so much from during my time at the sanctuary. If anyone is currently stuck in a job that no longer serves them, if you are stressed and exhausted and feeling empty – just take a look at this stock-broker turned kundalini teacher for inspiration!
After a month in this beautiful healing setting I can honestly report I felt healthier and more energised than I have in years. The food was amazing, the people were inspiring and the energy within the sanctuary itself was pretty incredible. I can’t recommend the experience enough.
After my trip to Sri Lanka I returned to London for a busy week of CT scans and treatment. Fortunately my scan was once again clear – pushing me beyond the one year NED mark! (yay!). Following this wonderful news I then spent a wholesome week at Vale De Moses, a secluded yoga retreat in the foothills of Portugal. The combination of eating fresh vegetarian food, practicing yoga daily, embracing a slower pace of living, and having limited wifi provided me with another chance to fully rest and recharge in the most beautiful setting.
My final adventure involved joining my friend, Julia, for her first ever yoga retreat down in St Ives. The five day retreat run by Julia and Jo (the team behind By The Sea St Ives) was a combination of vinyasa and yin yoga, nutritious, wholesome food (plus a little bit of wine), surfing, and hiking. I was also invited to speak to the guests about Gut Health which I absolutely loved.
What can I say… the last few months have been pretty epic!
Celebrating One Year Of No Evidence Of Disease
Although I didn’t throw any kind of one year “cancer free” party (or celebrate in any way come to think of it), I think you’ll agree that I’ve been busy living life to the full and celebrating in my own way. I’ve also finally started to make plans for 2018, something I’d have never have done during the first year after my stage IV diagnosis.
Back then the average survival for patients with stage 4 metastatic melanoma was still considered to be less than a year – due to it being a notoriously aggressive and chemo-resistant form of cancer. In fact just a few years ago, maybe just one in 20 patients with stage IV would survive beyond five years. Therefore I found myself living life in three month blocks between my scans. I found it easier to try and live as mindfully as possible, living each day as though it was my last. As soon as I started worrying about the future I’d immediately ruin the present moment.
None Of This Would Have Been Possible Without Immunotherapy!
Despite the abysmal statistics for stage IV melanoma patients during the past few decades, the statistics are finally starting to be re-written and that’s all down to immunotherapy. Pembrolizumab, the drug I’ve been receiving for the past 18 months, is one of the first generation of immunotherapy drugs. It was designed to release the “brakes” that inhibit the immune system from attacking cancers. In the early trials 24% of patients diagnosed stage IV had an overall response to therapy (meaning tumours partially or completely shrank). Fortunately, that’s exactly what happened to me. After my 6th infusion (around 4 months into treatment), several large visible tumours beneath the skin on my chest began to shrink. By my second set of scans – around 6 months into my 2 years of treatment – all the tumours in my body were gone.
Celebrating NED (Rather Than Being “Cured”)
The reality is that while the cancer is no longer detectable, it’s certainly possible that traces of the cancer remain and could potentially return one day in the future. I think I’ll forever be slightly concerned about the fact cancer cells may have crossed into my brain, largely because of a swollen lymph node at the back of my head which appeared just before I started treatment (and then later disappeared). But I guess for now we can say I’ve been in “complete remission” for over a year – which is pretty bloody amazing especially given the situation 18 months ago.
Just to clarrify:
Cure means that there are no traces of cancer after treatment and the cancer won’t come back.
Remission means that the signs and symptoms of cancer are reduced. Remission can be partial or complete. In a complete remission, all signs and symptoms of cancer have disappeared.
Obviously the hope with immunotherapy is that when your body has learned to identify your form of cancer, it remains vigilant against it. This seems to be the case for the growing number of patients who have had progression-free survival following immunotherapy. This summer results were published showing 42% of subjects with metastatic melanoma who received pembrolizumab were still alive four years into the study (and the study is ongoing). Some 13% of the subjects who received my drug had a “complete response” (like me).
Remaining Side Effects
I feel like I’ve had a pretty easy ride with my treatment compared to many cancer patients. My only real symptoms have been that I get very tired sometimes and I’ve developed vitiligo on my neck and jaw. And that’s it. However, immunotherapy is far from a guaranteed “get out of side effects free” card. My course of treatment has gone relatively smoothly, but the side effects for some – from fever to colitis to pancreatitis – can be so severe that they’re unable to continue treatment. Additionally not everyone repsonds and in some rare cases people die from the side effects of the immune system being ramped up and going out of control. Just this summer trials were halted in which pembrolizumab was being tested in conjunction with some other immune-boosting drugs to treat multiple myeloma – citing an increased risk of death.
The other side of this coin is that some patients don’t respond to immunotherapy and scientists are now trying to work out what is it about the subsets of patients who respond that makes them different. Obviously it probably depends largely on the extent and spread of disease at the time of starting treatment, but it also appears to involve other factors. One of these factors might be my favourite subject on this blog – gut health.
Gut Health And Immunotherapy
Earlier this year the results of the first study looking at the relationship between the gut microbiome and immunotherapy response in patients was published. Gopalakrishnan et al. found that those who responded to a PD1 checkpoint inhibitor (my drug) had a greater diversity of gut bacteria and larger volumes of a specific type of bacteria than those who did not respond. I know I write about this subject all the time across my blog, but please, please, if you are a newly diagnosed cancer patient take the time to do everything you can to support your gut health (from certain dietary changes to adding in a daily probiotic, or even considering a 12 week programme). You never know – it might make the difference between responding to treatment or not.
The Future Of Cancer Treatment
Recent clinical trials and research continue to show that immunotherapy holds promise for other forms cancer, including breast, lung, ovarian, pancreatic and myeloma. However, not all cancers or patients respond to this treatment. Fortunately another emerging area of research is CAR-T cells. This is when scientists genetically engineer a patients T-cells (the fighters of the immune system) to home in on the patient’s cancer and then grow millions of the modified cells in the lab. When the cells (now called chimeric antigen receptor cells, or CAR-T cells for short) are returned to the patient, they are much better equipped to hunt down and kill the cancer cells. Basically, we are seeing a new generation of cancer treatments that harness the body’s own innate cancer-killing machinery – how cool is that?!
Right now I have some very loose plans for the latter part of 2017 and 2018 – but nothing is firmly set in stone. I think a huge lesson I’ve taken away from this experience is learning to live each day as it comes and not take anything for granted. I doubt I’ll ever go back to making a “5-year plan”, simply because none of us ever know what is round the next corner.
Wishing you all lots of health, healing and happiness.
I’ve always been fascinated by the mind, it’s what led me to study Psychology before eventually going on to study Medicine. However, during neither of my degrees did I really consider the enormity of the overlap in the two subjects – namely, that the mind has the power to help heal the body, but also make it physically diseased in the first place. I guess this is because western medicine was traditionally shaped by systems of thought that emphasised the opposite – that the mind and body are separate entities. Yet it now seems so blindingly obvious that they are in fact deeply entwined. The emerging field of psychoneuroimmunology (“psycho” for psychology; “neuro” for neurology, or nervous system; and “immunology” for immunity) is finally providing scientific support for this idea. On a personal level, I also feel as though I’ve had first-hand experience of psychoneuroimmunology via my own cancer journey.
Introducing The Mind-Body Connection
A growing body of scientific research suggests that our mind can play an important role in healing our body, as well as help us to stay healthy in the first place. Recent research has examined how emotions impact our physiology and, as you might expect, emotions such as chronic stress, loneliness, and sadness have been found to cause inflammation, hormone imbalances, impaired immunity, high blood pressure, and illnesses ranging from heart disease and cancer, to anxiety and depression. Conversely, states of calmness, mindfulness and happiness have profound positive benefits, from improved sleep and energy, to better cancer survival rates, and longer telomeres (the end pieces of DNA that shorten as we age).
Although I don’t buy into the idea that the mind can cure the body of cancer simply with positive thinking (this is something I’ve seen peddled on various cancer forums and which actually makes me really angry because it suggests the countless number of people who’ve died from this disease somehow failed to think positively enough), I do now recognise there is a significant role for thoughts and emotions in recovering from illness and preventing disease.
Stress And Cancer
I’ve always felt that I developed cancer at such a young age (and with no family history) due to experiencing two years of chronic stress prior to my diagnosis. I went through two messy relationship break-ups during that time, had to move out of my house, sofa-surfed with friends whilst revising for my medical school finals, moved into a new house with a bunch of strangers from Gumtree, and started work as a junior doctor on a busy ward. After years of flooding my body with the stress hormones cortisol and adrenaline, I was permanently exhausted, and likely put my body at risk of developing cancer. Of course, this can be debated and I’ll never know whether the chronic stress I experienced did contribute to my disease, but there is increasing scientific evidence supporting this idea.
When a person is exposed to a stressful event, their sympathetic nervous system – the system responsible for the ‘fight-or-flight’ response – is triggered, in turn increasing production of a molecule called nuclear factor kappa B (NF-kB) which regulates how our genes are expressed. NF-kB translates stress by activating genes to produce proteins called cytokines that cause inflammation at cellular level – a reaction that is useful as a short-lived fight-or-flight reaction, but if persistent leads to a higher risk of cancer, accelerated aging and disorders like depression.
The Placebo Effect: An Example Of The Mind-Body Connection
When it comes to learning about the mind-body connection and its relationship to our health, it can be difficult to choose a starting place amongst the vast and growing body of research. However, one of the best places to start is probably with the placebo effect. The placebo effect is fascinating because it unlocks the power of the mind; the biological changes observed in the body after administration of a placebo (for example a pill containing no active drug) are not triggered by the placebo itself, but rather by our mind, and our psychological response to these “fake” treatments.
The power of the placebo can be traced back to a landmark study by the late psychologist Robert Ader in the 1970’s. Ader was trying to condition taste-aversion in rats. He’d give them a saccharine drink and, at the same time, inject them with Cytoxan, a drug that suppresses the immune system, but also makes you feel sick. And it worked. The rats learned to hate the sweet drink, which they linked with nausea. Yet, when Ader kept forcing the rats to drink it, they experienced something worse than a mere distaste for saccharine. They started dropping dead, one by one. The reason? Their immune system had “learned” to fail by repeated pairing of the drink with the cytotoxic drug. Incredibly, the drink alone turned off their immunity and they succumbed to infection.
It also turns out that the placebo effect is more powerful than was once thought. In June 2017 a review of five studies, involving 260 patients, found that “open-label” placebos – those that patients know contain no active medication – can improve symptoms in a wide range of conditions.
Healing The Body By Utilising The Mind
It makes sense that if the mind can contribute to making the body sick, it can likely also support its healing. This idea is perhaps best illustrated by the emerging scientific evidence which has examined the impact mind-body activities like yoga and meditation have on human physiology. Eastern traditions of healing (Traditional Chinese Medicine originating in China, and Ayurvedic Medicine from India) have been focussed on this idea for more than 3,000 years.
Interestingly, research has revealed that people who practice activities which originated from these eastern healing systems often show a decrease in production of NF-kB and cytokines, leading to a reversal of the pro-inflammatory gene expression pattern and a reduction in the risk of inflammation-related diseases and conditions.
More needs to be done to understand these effects in greater depth, for example how they compare with other healthy interventions like exercise or nutrition. But this research provides an important foundation to build on to help future researchers explore the benefits of mind-body activities.
Leading on from this idea, I just want to take a moment to reiterate that I am in no way suggesting that it is possible to heal yourself from cancer by channelling some kind of cosmic energy through the mind! Self-healing with regards to cancer in particular, is an incredibly controversial idea and one that as doctor I don’t believe is plausible. Many people with cancer or incurable diseases are made to feel like failures because they eat well, meditate, believe in God or divine energy, but yet can’t heal themselves. Ultimately some diseases are terminal, no matter what you think or feel. In these cases, traditional medicine (surgery, drugs or radiotherapy) provide the only potential chance of recovery, or at least a prolonged survival.
The Future Of Mind-Body Medicine
Aside from cancer, there are plenty of conditions which I believe can be healed, or even cured, by utilising the power of the mind. Non-traditional healing methods are slowly gaining acceptance within the medical world and there is finally more research being done in this area. Whereas meditation was once considered by doctors to be “mumbo jumbo”, opinion has shifted and people now understand its benefits, the science, and how it can empower patients to be active participants in their healing.
Ultimately the emerging field of Mind-Body Medicine emphasises an individuals whole being, acknowledging that emotional, mental, social, and spiritual dimensions are all important factors in wellbeing, health and healing. However, more research needs to be carried out in this area to enable medical professionals to guide patients towards potentially helpful adjunct healing modalities – rather than leaving patients to be drawn towards expensive, alternative “cures”.
In the meantime I highly recommend any activities which calm the mind, lower cortisol levels, and (hopefully) enable the body to do what its equipped to do; heal. Check out these posts for some ideas:
Over the past few years I’ve received countless emails from people asking exactly what diet changes I’ve made since I was first diagnosed with cancer (in Feb 2014). Although it’s true that I’ve made certain changes, I’m always a little cautious about sharing them, mainly in case people think that because I’m a doctor that must mean the specific changes I’ve made are based on overwhelming scientific evidence. Although I’ve researched “cancer and nutrition” in detail, trawling through countless medical journals and review papers, I’m still not an expert in this field or a qualified nutritionist. Additionally, from what I’ve come across, there is still very little scientific evidence supporting the use of specific diets in cancer treatment anyway. The changes I’ve made to my diet have largely been in an attempt to nourish my body as much as possible, boost my immune system, and (*potentially*) help my body to fight cancer cells.
The Problem With Extreme “Cancer Diets”
Don’t get me wrong, for a little while right at the beginning, I definitely did get sucked into the idea that certain foods or diets might be able to rid me of cancer. I was guilty of dabbling with a few questionable/ridiculous diets (anyone for ground flaxseeds mixed with cottage cheese??!) but fortunately it wasn’t long before the medic inside of me woke up and put a stop to my nonsense. Yet the fact that I was sucked in at all shows just how easy it is for common sense to go AWOL when faced with cancer. For most cancer patients, changing their diet is as much a mental process as a physical act. It enables you to feel like you’ve got some control over a petrifying situation and I know I also felt comforted by the idea that nature might, just might, “cure all” (rather than toxic chemotherapy or other drugs).
Additionally there’s simply so much information available on the internet about “diet and cancer” that it’s almost impossible to avoid it as a newly diagnosed patient (who can often be found googling “cancer cures” at 2am). Without randomised controlled trials in this area (of which there have been very few – although I’m currently awaiting the results of an interesting one looking at watercress) it is difficult to separate fact from fiction. Ultimately, this can leave us patients, our friends and our families confused and vulnerable to inaccurate (and sometimes downright dangerous) information.
Cancer And Certain Diet Myths
The alkaline diet is one of the most popular “anti-cancer” diets. Fans of this diet believe that an acid diet encourages cancer formation, and that an alkaline diet is therefore the solution. The reason that acidity is seen as an issue is because while healthy cells get the majority of their energy from oxygen respiration, cancerous cells tend to inefficiently use glucose at a higher rate than healthy cells. This consumption of glucose results in acidic waste products, and consequently a higher acidity around cells which use this mechanism. BUT… THE FACT IS THIS: acidity is a consequence of the cancer rather than the cause. Therefore, an alkaline diet CANNOT affect cancerous cells. This is because tissue acidity is tightly regulated by our incredibly clever bodies (because otherwise we would die) and this cannot be altered simply by changing the food you put into your mouth.
Another anti-cancer diet I’ve seen tooted time and time again is the “no sugar diet“. Although there’s an established link between being obese or overweight and developing certain types of cancer, the suggestion that sugar “feeds” cancer is an over-simplification of some complicated biology. Yes it’s true that glucose is a sugar, but it is one required by every cell in the body to function, whether cancerous or not. Ultimately all carbohydrates, whether from vegetables or chocolate, are broken down to glucose for the body to then utilise for energy. The reason that the “no sugar diet” has become so popular is because cancer cells require sugars to grow – and their glucose intake is a lot higher than that of healthy cells (this is known at the Warburg effect). The hyperactive glucose consumption of cancerous cells results in a vicious cycle of continued stimulation of cancer development. However, all the cells in the body require “sugar” to survive so it’s impossible to rid yourself of glucose, no matter what you eat. There’s also no evidence that proves eating a low-sugar diet cures cancer.
The final diet which has limited evidence for curing cancer is the ketogenic diet. The ketogenic diet is a high fat, low carbohydrate, and typically a protein-restricted diet. Normally what we eat is composed of macronutrients: carbohydrates, proteins, and fats. The carbohydrates are things like bread, pasta, cakes and some of the fruits and vegetables that we commonly eat. Protein is found mainly in meat and dairy products. High-fat foods are things like bacon, peanut butter, creams, avocados, coconut milk etc. The average diet is about 50-75% carbohydrates and, thus, this is the energy currency that our bodies use. Contrasting with this, in a ketogenic diet about 90% of what a person eats is fat. There is very little protein and almost no carbohydrates. This simulates a fasting state in the body where instead of carbohydrates being used, the body uses ketones for energy. Some people claim this altered state can starve cancer, yet, there is very little evidence to support this idea (except perhaps for patients with brain tumours but, once again, the evidence is limited). There is some evidence, however, that a ketogenic diet can reduce inflammation in the brain and can help treat strokes and other neurological conditions like epilepsy. Among theories about the mechanism behind the ketogenic diet is that the mix of high-fat, low carbohydrates, and reduced protein intake may reduce firing of excitatory brain cells that can make the brain vulnerable to seizures. Unfortunately implementing this diet is a huge undertaking. It can incredibly challenging (and a little disgusting) to force such high fat foods into your body on a daily basis. I know my brother and his girlfriend tried the ketogenic diet as part of a study during her degree (Nutrition BSc) and they couldn’t maintain it for more than a few weeks.
How I Changed My Diet After My Diagnosis
During the first 12 months after I was diagnosed I went ALL OUT with my diet. I stopped eating anything sweet (chocolate, cakes, ice cream etc), juiced as though my life depended on it (daily – if not twice a day – so at least I got my moneys worth from my ridiculously expensive masticating juicer – it’s an Omega Vert in case you were wondering), added ground flaxseeds to everything, nibbled on raw garlic, made myself eat shiitake mushrooms with nearly every evening meal (despite not liking the texture), and washed all these foods down with gallons of green tea and chaga mushroom coffee. Then the cancer returned, making me a stage IV cancer patient, and I figured my mostly plant-based, highly restrictive diet wasn’t eliminating cancer cells and also wasn’t making my life that much fun. To add insult to injury I was also spending a fortune on my “anti-cancer diet”.
Given that my experiment didn’t “cure” me of cancer, I eventually relaxed my diet and simply integrated a few of my new healthy habits into my daily life. Fortunately, somewhere along the way (about four months after starting immunotherapy), I slowly began to journey from a stage IV cancer patient with aggressive tumours that kept popping up in various parts of my body, to someone with No Evidence of Disease.
What I Eat Now
I’ve pretty much reverted to eating exactly like I did before I got cancer. If I fancy a pizza, I have a pizza; if I fancy a bowl of ice cream, I eat the ice cream; if I fancy wine, I’ll have (red) wine (which apparently has anti-cancer properties anyway). Having said that, I now let myself be guided by what my body wants (I guess thats what people call “intuitive eating“) and my body invariably wants to be fed healthy, nourishing foods. The things I make sure to eat include:
Isothiocyanates (ITCs) found in leafy greens have been reported to help the body at a cellular level. The main ones I’ve added in to my diet (pretty much every day in a green juice) are kale, spinach and watercress. In addition to isothiocyanates, cruciferous veggies like broccoli also contain sulforaphanes and indoles – two types of antioxidants that protect the structure of DNA. The evidence is so strong that a pharmaceutical company in the UK, Evgen Pharma, is now designing drugs using sulforaphane. The drugs have been shown to kill cancer cells and improve the prospects of stroke patients.
Most mornings I have a handful of blueberries, raspberries, strawberries and pomegranate seeds, mixed with a spoonful of greek yogurt, a drizzle of almond butter and some mixed seeds. The ORAC scores of nearly all berries are very high, making them some of the best antioxidant foods.
I make sure I eat plenty of carrots and sweet potatoes (carrots in my daily juices and sweet potatoes as wedges). This is because there’s some evidence that the beta-carotene found in orange foods is an essential nutrient for immune functioning, and given that I’m on an immune-boosting drug, it seems logical to try and give my immune system a helping hand with these foods.
Several studies have linked higher mushroom intake to a reduced risk of breast cancer in premenopausal women. It has also been proposed that various mushrooms, such as shiitake, chaga, turkeys take and lion’s mane, may also help fight cancer. However, there is still no conclusive evidence that any type of mushroom can prevent or cure cancer.
The jury is still out on whether turmeric and ginger are “potent anti-cancer foods” but I still add them to all my juices. Make sure you add some black pepper to help with turmeric absorption.
Gut health! My favourite subject Most of my blog posts seem to have been dedicated to this subject so I won’t go into too much detail here. The main foods I’ve kept in my diet are sauerkraut, kefir, apple cider vinegar, and cultured yoghurt. I try and have at least two of these foods everyday.
Have you tasted Pip and Nut’s Almond Butter? Not only is it pretty much the most delicious thing you will ever taste, it’s also a great source of protein, fibre and healthy fats. I also try to make sure I have a few brazil nuts every day as they are a great source of selenium.
Udo’s Choice Oil
I try to add a few tablespoons of this oil into my food at some point during the day (either on my breakfast, drizzled on salads or simply neat if I’ve forgotten to add it to a meal – it doesn’t taste too bad). This oil has the ideal ratio of Omega-3:Omega-6’s. I also try to get plenty of Omega’s by eating oily fish a few times a week. Omega-3 fatty acids exert anti-inflammatory effects and might help the body to fight cancer.
Matcha Green Tea
Matcha contains the highest percetange of polyphenolic compounds (catechin, gallocatechin and EGCG). EGCG has been reported to be linked to the modulation of multiple signaling pathways, finally resulting in the downregulation of expression of proteins involved in the invasiveness of cancer cells. It’s an acquired taste but I’ve grown to love it. Pukka Teas do a mild version that comes in teabags if you can’t handle the intensity of the powdered form.
The Take Home Message
I know this is really boring and not what you want to hear, but there really isn’t any one diet or food that will “cure” cancer. If there is (and I’m yet to come across it in my research) please, please let me know…
Using nutrition to support cancer treatment basically boils down to the age-old adage of eating a well balanced diet, enjoying your food, and not eating too much junk. The reality is that cancer is complex illness, and simple “cures” shared online should be treated with scepticism. Having said that, I truly believe that eating healthily has a role in cancer treatment – I just don’t think it will provide the sole “cure”. Personally I didn’t ever receive any diet advice from my healthcare team during my “cancer journey” and apparently this is not uncommon. This lack of nutritional advice for cancer patients in the UK needs to be addressed. In my opinion, we need a holistic approach to treating cancer and nutrition (along with exercise and stress reduction techniques) should be as much a part of cancer treatment as medicine and surgery.
I hope that this info helps anyone who is currently going through cancer treatment or just wants to live a healthier life. Remember, I’m not an expert in this field – these are just diet changes that felt right for me.
Organisations like Cancer Research UK have patient guides that are worth checking out for reliable information. Unfortunately, they aren’t as sexy as those offered up by online “wellness gurus” – but at least you know they’re based on real facts rather than far-fetched theories.
I’ve recently fallen in love with the practice of ‘Yin yoga’, so much so that I’m contemplating signing up for a Yin Teacher Training later this summer. Yet prior to my 200 hour Vinyasa/Ashtanga training a few months ago, I’d never stepped foot inside a Yin class. My initial cancer diagnosis had previously been the catalyst for me to start a regular yoga practice – and I’d automatically been drawn to the strength and energy of vinyasa. Once I found this style, I just stuck with it. As I flowed through each pose I loved how strong and healthy I felt – completely at odds with the cancer that was rapidly growing inside my body. I’d often catch myself quietly whispering encouragement to my heart, my limbs, my lungs; “we are too strong to die, we are going to get through this”. Together; mind and body.
Wisdom Of The Ancients: Yin and Yang
These stronger yoga styles (vinyasa, ashtanga, hot yoga, power yoga etc) are all considered primarily ‘yang’ as they are more focused on generating immense amounts of heat and energy within the body. The ancient Taoists claimed that all things, both animate and inanimate objects, can be broken down into primarily yin or yang characteristics. This process of breaking things down into two primary forces provided a context where the theory and notion of balance could be better understood. Yang is commonly expressed as extreme heat and energy. It’s also seen as the sun, and consists of male energy. In contrast, Yin is commonly expressed as cooling and passive. It is also considered to be reflected by the moon, and consisting of feminine energy.
Coming Back Into Balance
Since I’ve returned to work I’ve found it difficult to maintain a daily, energetic vinyasa practice. I leave the house at 7am so there isn’t much time to practice in the morning (my preferring time) and I often finish too late to get to a studio for a class. Plus I’m often shattered after work – I simply haven’t got the same amount of energy that I had a few months ago.
During my yoga training we had a number of Yin classes scattered throughout our timetable complementing the hours upon hours of vinyasa and ashtanga we were doing. The Yin classes focused more on slowing down the body, enhancing awareness and mindfulness, enabling us to make space to recover, repair and reflect.
What Exactly Happens During A Yin Class?
Although Yin has many of the same goals and objectives as any other yoga style; it directs the asana practice deeper into the connective tissues. Rather than moving rapidly from one pose to another, during a Yin class you slowly fold into a shape, soften your muscles, and find stillness – usually for 2-5 minutes. The opening of these deeper tissues often results in a physical sensation that can be a little uncomfortable to begin with whilst you fight against the tension. It’s all about breathing deeply into these areas and gently encouraging the muscle fibres and fascia to stretch a little more. Yin also tends to involve props so you are likely to use blocks, bolsters, and blankets – all of which support you as you relax into the poses.
Time To Slow Down & Release Tension
With all the extra time in each pose it’s easy to get caught up with your thoughts to begin with. In my first few classes I’d often end up thinking “how much longer do I have stay in this pose?” or “I think I’ll make ***** for dinner tonight”, but with practice I’ve been able to let go of these thoughts and find peace within each pose. I now love the feeling of my muscles surrendering to gravity and my mind fully relaxing. As you can tell, I’m a huge convert – I’ve found that Yin helps me to maintain a healthy balance in both my yoga practice and in my life. I hope I’ve inspired you to give it a go if you haven’t yet tried it
“Peace is the result of training your mind to process life as it is, rather than as you think it should be.” ~ Dr. Wayne Dyer
Anyone who is currently in remission from cancer, in the midst of cancer, or has a close family member or friend with cancer, sadly knows this term only too well. ‘Scanxiety’ essentially refers to the anxiety generated by follow-up scans (MRIs, CTs etc) which are used to collect new information about your hidden inner world every few months.
For anyone who thankfully hasn’t yet been touched by cancer, scanxiety is not dissimilar to the apprehension you experience whilst waiting to find out if you’ve passed an exam – you just need to multiply that ‘I’m-so-nervous-I’m-going-to-vomit’ feeling by about 100. Because sadly this kind of exam isn’t like any type of school exam or driving test – one which you’ll get the chance to retake and potentially pass another time. If you fail a follow-up scan (especially badly enough), it might well be game over in the long run.
My Experience With Scans
Personally I’ve had a mixed experience with scans; over the last nine months I’ve gratefully been on the receiving end of three incredibly positive scans, but it’s not always been happy news. Unfortunately I found out I’d progressed to stage 4 (meaning the cancer had returned and had spread to other areas in my body) via a phone call after one particular routine scan at the end of 2015. At the time I’d gone back to work in a GP surgery and I answered a call on my mobile between patients. It turned out that it was someone from the administration department at the hospital telling me about the ‘urgent biopsies’ that had been requested due to my scan results.
Scan results? What scan results? I was due to see my Oncologist the following day and my parents were currently driving from Devon to Brighton in order to be with me for the results. Yet, unfortunately, here I was being told that it was highly likely that the cancer had returned (and spread), whilst I was at work and very much on my own. The non-medical person on the end of the phone also had absolutely no idea what my scans had shown or which organs I was having biopsied which inevitably left me thinking the worst. I left work immediately, convinced that I was riddled with cancer. Needless to say, that was not a good day.
I did have another negative scan back in March 2016 (which showed that the tumours were still growing), but at least I received that news when I was slightly more prepared. For starters I already knew that I had tumours in my body (and that there was only around a 30% chance that the treatment would get rid of them). On this occasion I also received the bad news whilst sitting in a hospital room with my oncologist and my mum – instead of via a phone call whilst at work. Having said that, no matter who is by your side (or where you are) when you get the results, scans are always going to be life changing, one way or another. It’s essentially like having a life sentence read out to you by a judge/oncologist. Naaaat so much fun.
Dealing With Scanxiety
Although I’ve got much better at coping with my ever-looming scans, once I’m within the two week window period (which is where I am now) I inevitably feel the anxiety creeping in. I tend to start thinking about cancer more often, my sleep gets increasingly disturbed, I break out in spots, and I generally feel more exhausted and on edge. And because the mind-body connection is so incredibly powerful, I also start getting all sorts of aches and pains in my body. This month I’ve had terrible headaches (? a brain tumour – FYI: I’m 100% sure that looking at brain tumours on scans all day at work is fuelling this particular symptom), whereas previously I’ve been convinced a dull ache beneath my ribs meant that the cancer had spread to my liver (fortunately it hadn’t). These symptoms also seem to miraculously disappear following my scan results. I like to think of myself as a pretty chilled person but I definitely feel myself losing the plot a little around scan time!
I can’t help but wonder how on earth other more tightly wound people manage to cope with the stress of scans. I’m not surprised that several studies have revealed that follow-up scans can trigger classic symptoms of post-traumatic stress disorder in cancer patients and survivors. Of course it is completely normal to experience anxiety due to scans, but the key is to be able to take steps to prevent these emotions from causing unnecessary distress. As a result, over the last few years, I’ve developed a few tricks for trying to keep myself sane before scans. Here is a list of things that sometimes work for me:
Recognise That Worry Stops Nothing
My top tip around scan time is to just keep reminding yourself that worrying about the scan achieves nothing. I used to waste so much precious time and energy worrying about the potential outcome – until I realised that it was just draining me further. Try to remember that the results will be the same whether you worry about them beforehand or whether you don’t. I know it’s easier said than done, but try not to worry.
Trust The Universe
I really do believe that the Universe is in charge. As humans, we tend to believe that we know the path our lives should take and we think that it’s up to us to steer our lives in that direction. And that is true – but only up to a certain point. Sometimes you just need to surrender to the Universe – because once we surrender and trust that there’s a bigger plan for us, things start to feel a whole lot easier. I promise.
I know most of my posts mention ‘mindfulness’ somewhere within them, but it’s because it really works as a practice. Mindfulness essentially means focusing fully on whatever action you are doing – allowing yourself to be fully in the moment. Whether it’s brushing your teeth, looking at a sunset, or taking a yoga class, moments such as these slow us down and give us the chance to experience some much-needed inner peace.
Please don’t take this the wrong way. I think the first instinct, for both patients and friends/family, is often to try and come up with a positive spin. Personally my pet hate is when people tell me to “think positive!” prior to a scan. Many cancer patients feel under pressure to try and buffer potential bad news with a dose of positivity – but any positivity has got to come from the heart. There’s no point faking positivity in front of people if it’s not true, surely that’s just more stressful? Having said that, whilst positive thinking alone can’t cure cancer, I do believe that attitude is critical to getting through the process and growing as a person. It’s a daily note to self: I’m going to beat this. I know plenty of people find them really annoying but I LOVE an affirmation. I regularly save ‘gems’ that I see whilst scrolling on social media and then look back over them when I need a boost.
Please don’t take this the wrong way either. I’m definitely not against remaining positive but I think it’s important to remain a realist too. As highlighted in her book “Bright-Sided”, Barbara Ehrenreich explains, “We need to brace ourselves for a struggle against terrifying obstacles – both of our own making and imposed by the natural world. And the first step is to recover from the mass delusion that is positive thinking”. Essentially she raises the question ‘at what point does positivity become a form of denial?’. I try to remain pretty neutral prior to my scan results – I don’t let myself get my hopes up that I’ll automatically be granted another clear scan but I also don’t freak out that I’m going to be riddled with disease. I know people claim you can ‘think cancer away with positivity’, but I’m not part of that camp.
Although I’ve been trying to live a more minimal lifestyle over recent years – 1) because you REALLY can’t take all that junk with you to your grave and 2) because our consumerist society is destroying our planet – I do usually treat myself to something special (usually a piece of jewellery, a trip away, or even just some extra luxurious bubble bath) before and/or after a scan result. Whether it’s good news or bad news, it helps a little
Let Yourself Be Supported
As I learnt the hard way, having people who love and care for you beside you during your scan results appointment is crucial. I feel desperately sad for anyone who has to go through cancer treatment alone. If you know any neighbours or friends who are currently in this situation please, please offer to go along to their scans/appointments/treatments with them. It won’t take much out of your day and it will likely mean the world to them.
I’ll let you know the outcome of my scans (body and brain) next week…
It’s National Sun Awareness week here in the UK and I feel it’s my duty to highlight just how dangerous that longed-for “suntan” [read: sun damage] could be at some point in the future. I basically REALLY don’t want any of you going through the same ordeal I’ve been going through for the past few years (and it can, in theory, be prevented).
What Is Skin Cancer?
First things first: Skin cancer (or malignant melanoma if you are using medical lingo) KILLS. Every single day people of all ages and skin tones die from skin cancer. It is one of the most aggressive, sneaky cancers around – and it loves nothing more than to spread to internal organs (particularly the liver, lungs and brain). There are still some people who believe that it’s “only skin cancer'” and, therefore, not a big deal – but these people are sadly incredibly ignorant. Believe me, skin cancer is one nasty beast. In the last few years I’ve undergone four major surgeries and I’m still having infusions of a semi-toxic drug (and have been for the past 18 months). I might well be “cancer-free” at this moment in time, but it’s been one hell of a rough ride to get to this point…
I’ve read a few articles in the press about me which have incorrectly claimed, “Lauren never sunbathed due to her pale skin”. Unfortunately this isn’t true and I must take some responsibility for this situation. If I’m honest I loved having a sun-kissed tan in my late teens and early 20’s and I also enjoyed plenty of sports outside (surfing etc) – so I was by no means someone who hid away from the sunshine all summer and yet was unlucky enough to get melanoma anyway (sadly there are plenty of stories like that too). Having said that, I didn’t sunbathe that often (I’d get bored pretty quickly) and I always made sure to wear high factor sunscreen.
Although I’ve got freckles and a few moles on my body, my melanoma didn’t actually originate from a pre-existing mole – that’s another incorrect claim that I’ve read about in the press and one that I’m keen to expel. Instead this is what happened: One evening I was rubbing moisturiser into my legs after a bath and I noticed a tiny, strange-looking pink’ish blemish/lump just above my right knee. It was slightly raised and had tiny blood vessels visible on its surface. I left it for a few weeks and although it didn’t grow in size, it did start itching occasionally. I went to see my GP and expressed my concerns – I’d recently passed by medical school final exams and ironically one of our final practical exams had been a malignant melanoma case. I asked out-right if he thought it could be melanoma but I was reassured that it was likely benign. However I was asked to return if it changed at all. It didn’t change and it didn’t grow any larger. Yet it didn’t disappear either. It remained firmly there on my knee for another six months – right up until I was shaving my legs one day in the shower and I caught it with my razor. This resulted in it bleeding profusely – and caused me to urgently return to my GP. From that moment on, things went a little something like this:
As I said at the beginning of this post, I really, really hope that my story can help prevent you or any of your loved ones going through this. Skin cancer has a cure rate of around 90% if it’s caught early…
What To Look Out For
Keep in mind the ABCDE of warning signs:
A: Asymmetry. If you were to draw a line through any skin blemish/mole/lump, do both sides match in color and shape? If not, it could be a sign of melanoma.
B: Border. Benign marks tend to have smooth, defined borders, while malignant moles might be uneven with rough edges.
C: Colour. If your mark looks dappled or has multiple colors, it could be a sign of melanoma. Benign moles and sunspots tend to be solid and brown.
D: Diameter. Malignant marks tend to be bigger in size, but the best rule of thumb is to monitor your mole or sunspot and see if it grows. If so, it’s time to get it checked out by a GP.
E: Evolving. Again, whilst they might darken and fade with sun exposure, most benign marks stay the same over time. If you notice any changes in a sunspot/mole/patch of skin, you should get it checked out to be on the safe side.
Know Your Skin
A dermatologist will be able to give you a thorough exam (there are plenty of private clinic available if you can’t get a referral through your GP), but it’s definitely worth knowing how to give yourself the once-over at home so you can keep an eye out for warning signs.
After you’ve finished reading this post I’d love you to stand butt-naked in front of a mirror and twirl around until you’ve got a good idea of any marks or moles on your body. This will help you to notice if something is new or changing. Plus it’s good to get naked and admire your beautiful body occasionally anyway
The Bottom Line
When in doubt, see a doctor!
I really should have trusted my gut instinct and pushed harder for a dermatology referral and biopsy the first time I presented to my GP. I had a bad feeling about that weird little lump – that’s what led me to see my GP in the first place. Of course we’re all human and it’s inevitable that cancers will occasionally get missed by doctors (I’m a doctor myself and I also wasn’t sure whether I was definitely dealing with a melanoma or not). Try and get in tune with your body. If you have an overwhelming feeling that something isn’t quite right, trust your instincts and show it to a doctor – and keep showing it until they listen to your concerns.
By all means continue to enjoy the sunshine and all the joy it brings, just please, please, please respect the rays too. I’ll write another post on my favourite sun protection products later this week. ♡
Through this blog I’ve slowly become more open about discussing my personal struggles with anxiety and depression (something I experienced for the first time as a result of my cancer diagnosis). Yet, in the past, I’ve rarely spoken face-to-face with family or friends about these darker emotions – let alone anyone else. Whilst I’ve had no problem describing the physical side effects of my various medical and surgical treatments, any anxiety or sadness has often remained my dirty little secret. My boyfriend (who is currently living in Sydney for a year – a situation which likely fuels some of these emotions) occasionally receives a “crisis call” from me when things are really bad, but often I’ll try and ride out any negative feelings on my own. Yet slowly I’ve come to recognise that this kind of weird, secretive behaviour is not OK – and fortunately things are changing around here…
Changing The Conversation Around Mental Health
Over the last few months I’ve found myself increasingly opening up to friends and family when I’m feeling a bit blue or anxious (I did it today and it felt like a weight had been lifted off my shoulders). Whereas in the past I declined any therapy or counselling when it was offered to me following my diagnosis, if I could go back in time, I’d definitely accept it now. This is because I now recognise the value of opening up to people during tough times.
But plenty of people are still not talking about their mental health. Mental health disorders are skyrocketing globally: between 1990 and today, people suffering from depression or anxiety increased roughly 50% (to over 600 million people). Antidepressant use has exploded, but simultaneously depression, anxiety disorders, PTSD, OCD, phobias (and suicide) keep climbing. We all know the new forces conspiring to make us more miserable: from rising global economic inequality to constant digital/work/media connection.Sadly the World Health Organization (WHO) has forecasted that by 2030 the largest health risk across the world will be depression (not obesity).
I guess it’s the very British “stiff upper lip” approach to dealing with problems that has often caused us to suffer in silence in the UK. Sadly, it’s this reluctance to talk about mental health that continues to fuel the stigma and contributes to sufferers feeling ashamed and isolated. This is why mental health initiatives, like Heads Together – set up the Duke and Duchess of Cambridge and Prince Harry, is so important in helping to change the conversation about mental health. The wonderful Bryony Gordon has also become a hugely successful author following the release of Mad Girl – a book which details her battle with depression and obsessive compulsive disorder (OCD). She now also heads up the podcast MadWorld – and her first guest was Prince Harry who, for the first time, spoke openly of his mental health issues following the death of Princess Diana.
Fortunately, prior to being diagnosed I hadn’t experienced much in the way of mental health issues. I considered myself an optimistic, care-free, happy person (something I’ve gratefully inherited from my mum). Yet we all have our bad days (or weeks or even months) and cancer definitely made me experience the full spectrum of human emotions.
My Experience With Anxiety & Depression
Gratefully sometime last year (even before I’d received the good news that my cancer had buggered off) my anxiety and depression seemed to dissipate. I think I essentially journeyed through all the stages of grief and eventually emerged from the experience – changed, but not broken. I then continued living life with gratitude (filling it to the brim with epic trips, wonderful people, yoga and meditation). The strategies I’d learnt to cope with the stress of cancer eventually led me to complete my yoga teacher training in India, where I met some of the most inspirational people I’ve ever crossed paths with, and I felt at my strongest (both physically and mentally) when I got back in March.
I then decided to try returning to work and things started to unravel a little… In order to complete my final four months as a junior doctor I’ve had to move into a spare room back in a city where I barely know anyone, I’m working 50 hours a week, I’ve become too exhausted to go to any yoga classes in the evenings, I have to jump on a train to London to squeeze in blood tests, infusions and scans around work, and to top it all off I went and developed shingles a few weeks ago which has absolutely floored my energy levels.
Needless to say, the I’m-so-happy-I-can’t-stop-crying-during-this-yoga-class state that I found myself in a few months ago has definitely faded. BUT… I’m determined not to lose it completely. Whereas a few years ago I had no idea how to look after my mental health, I now have a few strategies up my sleeve for dealing with challenging times:
Supporting Mental Health During Challenging Times:
For me this has got to come in at number one – there’s simply no better tool for dealing with hellish times! I honestly don’t think I’d have got through the last few years without having a monumental break down if it wasn’t for learning to live one day at a time. It’s easy to get into a pattern of worrying unnecessarily about all the negative possibilities that may emerge in the future. All this negative cycle does is reinforces any sadness and worsens your mood. The key is to keep bringing yourself back to the present moment as much as possible – and always, always take the time to BREATHE.
A huge lesson I’ve learnt over the last few years is that even when things feel like they will never get better, they generally do. It’s important to remind yourself that life involves constant change and that you won’t always feel this rubbish. Be patient and do your best to look after yourself in the meantime – eat well, exercise and get a good amount of sleep (I know I need eight hours to feel my best).
Adding In Omega 3’s
Research has shown that depressed people often lack a fatty acid known as EPA. Get omega-3’s through walnuts, flaxseed and oily fish like salmon or tuna.
It’s really easy to shut yourself away when you are going through a bad patch – but that’s the worst thing you can do. Getting support from people who love you is an key aspect in lifting your mood. Tell people you trust that you’re feeling down and that you’d appreciate their understanding and support.
As the above point highlights, it’s important to reach out to family and friends when life feels impossibly tough – but it’s also crucial that you don’t find yourself saying yes to events or activities that you know you don’t want to do. I now try and tune into my gut instinct – that feeling of “I want to say no to this event” and use the time to do something nourishing for myself instead.
Doing Something Kind For Yourself
This leads on from the point above. Establishing what’s important, simplifying and prioritising helps to restore some much needed balance. Over the last few weeks I’ve been playing my favourite music, I’ve bought myself fresh flowers (peonies are back in season!), I’ve booked in for a massage, and I’ve started making future plans to look forward to. Right now I feel like I need to spend plenty of time at home recharging, but it’s good to have fun plans on the horizon. For more self-care ideas check out my blog post here.
Identifying Any Triggers
Sometimes when you are feeling overwhelmed, you can’t “see the wood for the trees”. In this situation it’s a good idea to write down the things that are bothering you – it could be unpaid bills, a lack of positive experiences, social isolation or a unfulfilling job. Then write down some practical things that you can do to deal with them. For example, find ways to pay the bills, plan a holiday, and start making changes to your CV in preparation for a new job.
Exercising – Or At Least Going For A Walk
A big meta-analysis on 1.1 million people recently re-confirmed the powerful connection between regular exercise and mental health: people in the lowest third for aerobic fitness levels were 75% more likely to have received a depression diagnosis than those in the top third. The endorphins which are produced during exercise essentially help to lift your mood. It can be difficult to stay motivated when depressed so vigorous exercise such as running can be tough to maintain. However, even moderate exercise like a brisk walk has been shown to improve mood. Yoga is also great! I might not be able to attend a class as often as I’d like after work but I’m still squeezing in 20 minutes of home practice a few times a week.
Tuning Out The Internet
Powering down from social media can be really helpful. For a few days, a few hours, or even just a few minutes, put your phone on airplane mode and focus on something completed unrelated.
Writing It Down
I’ve found this blog to be an incredibly cathartic outlet over the past year. If you don’t have a blog, a diary or journal is basically the same thing. A journal can work in two ways. You can use it as a release – where you share your darkest thoughts, no holds barred – because you don’t need to worry that anyone will judge you for them. Alternatively another good way to use a journal (I prefer this way) is to write at least five things down every day that you are grateful for. This forces us to think more positively and can help to remind us that things are (generally) not that bad. (Although I’ve got to say it, stage 4 cancer was THAT BAD).
Choosing Positive Language
This really simple tool was incredibly helpful for me. I have a tendency to moan and be a negative when things are going wrong so I now always try and alter the language I use to give a situation a positive spin. An easy way to do this is to ask yourself, “What have I learnt from this?” or “How am I growing?”.
Reading Self-Help Books
I have a confession to make: I have a minor addiction to what might be described as self-help books – as well as meaty memoirs about human survival. Some books to consider reading include: Big Magic, The Year of Magical Thinking, The Happiness Project, Tiny Beautiful Things: Advice On Love & Life, Wild, and The Opposite Of Loneliness.
“Perhaps many things inside you have been transformed; perhaps somewhere, someplace deep inside your being, you have undergone important changes while you were sad.” ~Rainer Maria Rilke
And Above All Please Remember:
Whilst sadness is an emotion that everyone experiences (and is usually caused by certain events), depression is a constant feeling of sadness which has a negative impact on your life and needs to be addressed. The key is whether or not sadness is paired with other factors of depression, such as; loss of energy, trouble concentrating, lack of pleasure from activities, difficulty sleeping, disruption in eating patterns, feelings of hopelessness or worthlessness.
If you have any of these symptoms, please don’t put off visiting a mental health professional, even if you’re not sure you need to. People are often not keen to try antidepressants but cognitive therapy can be extremely useful in counteracting depression in the first instance. A counsellor can help you to understand your current thought patterns and identify any harmful or false ideas and thoughts that you have that can trigger depression or make it worse. The aim is to change your ways of thinking to avoid these ideas as well as help your thought patterns to be more realistic and helpful.
The world is only going to get more “mental”: more stressful, with more relentless digital and media overload. Remember that ultimately your mental health is just as important as your physical health. Please take good care of yourself.
This is something I’ve wanted to write about for a little while now. Over the past five years we’ve seen an explosion in the ‘wellness’ scene in the UK – something that was pretty much inevitable given the ‘wellness’ industries that have sprung up in cities like LA and Sydney during the last decade. And so, better late than never, the glossy world of wellness arrived on our shores. And that can only be a good thing, right?
Well… yes and no. Given the skyrocketing levels of chronic disease and mental illness across the globe something certainly needs to be done to address this issue. But, from where I’m standing, the world of wellness is a little off centre at the moment. As legitimate science and good intentions become increasingly subverted by vested interests and corporate business, the question arises: is it time we put down our green juices and reconsider the way we view ‘wellness’?
The Wellness Explosion
The global wellness sector is now worth an eye watering $3.7 trillion (making it nearly three times larger than the $1 trillion worldwide pharmaceutical industry) – and it’s forecasted to keep rising. However, it wasn’t always this way. One of the most striking things about the wellness landscape today is how little-known practices that would have been considered way ‘out there’ five years ago, are now some of the hottest mainstream trends – the word ‘trend’ being key here. Whilst the idea of ‘wellness’ started off from humble, hippie beginnings it has slowly morphed into its current, relatively superficial incarnation (think £150 yoga leggings, £8 juices, £20 yoga classes etc). It is a huge shame because at its core, the idea of wellness is revolutionary – it just seems to have lost its way.
In order to truly get to grips with the concept of wellness – and how it can and should be supporting people (of all economic backgrounds) – we need to go back to its roots.
The Origin Of ‘Wellness’
Original wellness concepts can be found deep in history, over thousands of years ago. Traditional Eastern medicine (e.g. Indian Ayurveda) respected and aimed for balance of human body, mind and spirit and perceived human health from a holistic perspective. These traditional healthcare systems emphasised lifestyle choices – nutrition, physical activity, sleep, moderation, development of positive thoughts and emotions through prayer or meditation. It all sounds incredibly familiar, right?
Yet it took a while for these ancient ideas to cross over into modern, western society. It all started with an American doctor by the name of Dr Halbert L. Dunn who first published a book called ‘High-Level Wellness‘ back in 1961. Whilst the book received little attention at first, his ideas on mind, body and spirit were later popularised by doctors like Dr John Travis in the 1970’s. Dr Travis essentially caused a revolution in the concept of health: thinking beyond traditional medicine’s more reactive, illness-centered model, to pioneer new concepts based on self-responsibility, where the goal was a more comprehensive ‘total wellness’ of body, mind, emotions and spirit. Go Dr Travis!!!
Wellness: In A Nutshell
So, just to recap….
Wellness is basically just the opposite end of the spectrum from illness – not only the absence of illness, but the opposite altogether. Where illness is typified as an element of the body or mind not functioning properly, wellness is those elements of body or mind functioning to their optimum level. If you put sickness at one end of the spectrum and wellness at the other, ‘normalness’ would sit in the middle – not ill, but not thriving. And we all want to thrive, right?
The Problem With The Current Wellness Industry
I recently watched a documentary in which Dr Travis was interviewed and I felt as though he was expressing my exact thoughts on the wellness industry. He said in the nearly four decades of activism and authorship on the subject of wellness, he has seen the term go from being a positive, holistic, all-encompassing idea, to one that has been hijacked by corporate greed. He highlighted that you can’t really package and sell wellness – instead it’s a concept that you need to learn about and grow within.
The Elite World Of Wellness
Sadly we seem to be increasingly crafting a wellness industry that caters for the top 1% of the population. Although wellness is, in theory, accessible to all (think going for a run outside in nature, yoga at home using free online classes, free meditation apps, healthy simple home-cooked food etc), this isn’t “sexy” wellness so it doesn’t get much coverage in the media. Instead healthy living has become a status symbol, with consumers opting to flaunt their passion for wellness through boutique fitness classes, increasingly expensive ‘athleisure’ clothing, exotic ‘superfoods’, and five star health and wellness holidays.
I’ll give you an example of something I’ve personally witnessed…
The hospital I visit every few weeks is in a swanky part of London (an area I wouldn’t visit otherwise). Between my blood tests and my treatment I generally have a few hours to kill so I often head off to explore the area. In the few years I’ve been lurking amongst the glossy blondes and loafers/jeans brigade, I’ve witnessed a growing number of healthy cafes and ‘wellness centres’ (posh gyms). And because I’m nosey (and I’m a sucker for the original concept of ‘wellness’), I’ve poked my head into most of these new places. Yet I’ve never stayed more than a few minutes. This is primarily because I can’t afford to lurk for too long (well I guess I could but the idea of splashing out £15 on a slice of avocado on toast makes me like a total mug), but also because I genuinely feel a bit uncomfortable – it all just feels a little bit too fake and inauthentic. I popped into one particular wellness centre near my hospital recently (to enquire how much a drop-in yoga class would be), only to be told it was members only – and membership started at £150 a month. £150!!!!! WTF! What are they doing to people in there??
Better ‘Wellness’ For All
One of the key themes within Dr Travis’ ‘wellness’ concept was the idea of interconnectedness and wellness for all. Sadly the wellness industry has become so focused on making money that it doesn’t seem to consider the bigger picture – the way in which our nation is becoming increasingly unwell with rising chronic illness and mental health problems. The wellness industry is uniquely positioned to play a critical role in leading efforts to ensure that people worldwide have access to the best services, products, and information that promote health and wellbeing – but it needs to become more accessible for all. And we can all play a part in this. It’s not OK that we have become so focused on the “self” that we’ve lost the ability to look sideways and see how our neighbour is doing.
The Future: Heart-Centred Wellness
Fortunately there are an increasing number of ‘wellness’ social enterprises which have emerged to give to back to their local communities – and plenty of yoga studios now also offer a concessions rate for ‘community’ classes. Rather than focusing solely on profit, we need to bring more wellness to people that can’t currently afford it. After all, wellness advice hasn’t really changed that much over the years – it still comes down to eating well, sleeping well, resting well, moving well, and supporting each other – and these things should be made available to everyone. Ultimately we need to reclaim wellness from the tightening grip of big business and turn it into the act of empowerment it once was.
For those of you who’ve been following my blog since its incarnation in 2016, you’ll know that I’ve developed a slight obsession with my gut health. This is because over the past few years scientific evidence has revealed that events going on within the gut, and specifically within the microbiome, have a dramatic effect in terms of virtually every important metabolic process that occurs within the human body.
For those of you not yet up to speed, here’s a quick recap of why I’m so impressed by this area of science (and the foods I eat to support my gut):
What Is Your Microbiome?
The microbiome is the unique eco-system of more than 100 trillion microbes (bacteria) that are living on and in your body. If this sounds alarming or gross, stay with me! Each of us has a unique and varied collection of living bacteria, which is the result of our history (i.e. antibiotic use), our diet/lifestyle (i.e. how many vegetables we eat), and the environment we live in.
The Microbiome And Health
Whilst new scientific discoveries are being made almost daily, the area I’m most impressed by is the research on the gut’s link to the immune system – apparently 70-80 % of our immune tissue resides in our digestive system and can be supported by good gut health. Also key is the role gut microbes play in regulating the degree of inflammation in the body, with inflammation being linked to diseases such as Alzheimer’s, coronary artery disease, diabetes and cancer. Meanwhile, an incorrect balance or absence of certain bacteria has been linked to an inability to lose weight or maintain weight loss. The gut has also been termed the “second brain” because it plays a critical role in mental and emotional functioning, directly influencing levels of stress, anxiety and depression, as well as memory, decision-making and learning. Pretty amazing, right?
Supporting The Microbiome
I know in the past I’ve shared what to look out for in a daily probiotic, but along with having a diet high in fibre and low in sugar, it’s also crucial to eat plenty of pre and probiotics in order to maintain optimal gut health.
Foods Rich in Prebiotics
While there has been much attention given in recent years to the importance of probiotics, we are only just beginning to see an expansion in the medical literature clarifying the importance of prebiotics. Prebiotics are the non digestible, plant fibers found in certain foods (inulin being the main prebiotic compound). By arriving undigested in your gut, prebiotics enable the bacteria in your gut to feed, multiply, and fully populate your gut.
The best prebiotic foods to include in your diet are:
Jerusalem artichokes (full of inulin – but be warned – they have a nickname *fartichokes* for a reason!)
Replenishing With Probiotics
Probiotics are the living bacteria that restore and renew our microbiome. They reduce inflammation in the intestines, improve the quality of the gut and help bolster our existing colonies. Fermented foods are natural probiotics which help diversity the flora living in your gut. It’s best to introduce fermented foods into your diet slowly (eg. 1 tbsp per meal) as some people may experience excess gas and bloating while the environment of the gut adapts to the change. Be aware that ‘pickled’ does not equal fermented. Pickled foods are preserved in liquids like vinegar or brine, usually with added sugars. They do not contain “live” organisms. Also try not to go overboard on fermented drinks. For example, kombucha only contains a very small amount of probiotic so it’s not something you’d want to drink everyday.
Fermented foods to include in your diet include:
Gut Health And The Future Of Medicine
Ultimately the new findings on “gut health” have opened up vast areas of opportunity for lifestyle modification so that people can support their own health and, hopefully, prevent disease. In the not-too-distant-future I predict that doctors will start addressing and supporting a person’s unique microbiome in the treatment of nearly all diseases. Watch this space!