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Hello you lovely bunch!

I’m going to be taking part in several “challenges” throughout 2018 to raise money for The Royal Marsden Cancer Charity and I’d be incredibly grateful for your support. THE FIRST CHALLENGE IS COMING UP IN MARCH…

https://www.justgiving.com/fundraising/laurencaramacdonald

As most of you reading this probably already know, I received my last immunotherapy infusion in December 2017, two years after starting treatment every few weeks at The Royal Marsden Hospital in London. It’s not an over-exageration to say that I probably wouldn’t be here, very much alive and about to dust off my bike helmet, if it weren’t for the amazing cancer research going on at centres like The Royal Marsden.

I was incredibly fortunate to become one of the first patients in the UK to receive a new cancer drug (pembrolizumab) off-trial and it couldn’t have been approved by the NHS Cancer Fund at a better time for me. I was diagnosed with stage 4 melanoma in October 2015 and, for the first few months afterwards things looked pretty bleak. Once malignant melanoma metastases it’s notoriously aggressive and rarely responds to chemotherapy or radiotherapy -consequently, the 5 year survival for patients with stage 4 disease had been hovering around 10% for decades. To put things into perspective, the 5 year survival for someone with stage 4 breast cancer is around 20%.

Fortunately for me, some very clever cancer researchers had been working hard to develop “immunotherapy” drugs and around 30-40% of patients with my type of cancer seemed to be having some kind of positive response in the early trials. The NHS approved pembrolizumab for metastatic melanoma in January 2016 and I was lucky enough to have a complete response to the treatment within 7 months. I went on to complete a full 2 years of treatment (as it’s still unclear how long patients need to receive the drug for and also whether patients will enjoy ongoing remission once it’s stopped) and I’ve had No Evidence of Disease (NED) on my scans for the past 18 months. Yayyyyyyy!!

Moving forward, the hope is that I’ll remain “cancer free” but I’m taking things slowly, month by month. I go for scans at The Royal Marsden Hospital every 3 months so for now, I’m still very much a “cancer patient”. Having said that, since stopping treatment a few months ago, the side effects are finally waning, I’m feeling less tired and achey, and generally much more like my old self. Anyway, those minimal side effects have been a small price to pay for being alive!!!!

I CANNOT EXPRESS ENOUGH GRATITUDE TO ALL THE WONDERFUL STAFF AT THE ROYAL MARSDEN AND ALL THE AMAZING CANCER RESEARCHERS WORKING SO HARD BEHIND THE SCENES TO BEAT THIS DISEASE.

My first challenge is going to be a 100km cycle along The Great Ocean Road with Ben and Laura. We’ve heard it’s pretty hilly but incredibly beautiful. The next challenge I’ve got lined up is another cycle challenge with my mum (and potentially the rest of my family!) between London-Brighton (slightly less glamorous but also pretty tough!).

I’d be sooooooooo grateful if you could part with some (or ideally lots) of your hard earned pennies to give more people a chance of beating this disease.

Thank you so much in advance!

Lauren xx

(P>S> You can watch the challenges unfold over on my dr_laurencara instagram)

A little bit about The Royal Marsden Cancer Charity: The charity raises money solely to support The Royal Marsden, a world-leading cancer centre. The charity ensures nurses, doctors and research teams can provide the very best care and develop life-saving treatments, which are used across the UK and around the world. From funding state-of-the-art equipment and groundbreaking research, to creating the very best patient environments, we will never stop looking for ways to improve the lives of people affected by cancer.

The post I’m Fundraising For Cancer Research appeared first on LAUREN CARA.

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Hello you lovely bunch!

I’m going to be taking part in several “challenges” throughout 2018 to raise money for The Royal Marsden Cancer Charity and I’d be incredibly grateful for your support. THE FIRST CHALLENGE IS COMING UP IN MARCH…

https://www.justgiving.com/fundraising/laurencaramacdonald

As most of you reading this probably already know, I received my last immunotherapy infusion in December 2017, two years after starting treatment every few weeks at The Royal Marsden Hospital in London. It’s not an over-exageration to say that I probably wouldn’t be here, very much alive and about to dust off my bike helmet, if it weren’t for the amazing cancer research going on at centres like The Royal Marsden.

I was incredibly fortunate to become one of the first patients in the UK to receive a new cancer drug (pembrolizumab) off-trial and it couldn’t have been approved by the NHS Cancer Fund at a better time for me. I was diagnosed with stage 4 melanoma in October 2015 and, for the first few months afterwards things looked pretty bleak. Once malignant melanoma metastases it’s notoriously aggressive and rarely responds to chemotherapy or radiotherapy -consequently, the 5 year survival for patients with stage 4 disease had been hovering around 10% for decades. To put things into perspective, the 5 year survival for someone with stage 4 breast cancer is around 20%.

Fortunately for me, some very clever cancer researchers had been working hard to develop “immunotherapy” drugs and around 30-40% of patients with my type of cancer seemed to be having some kind of positive response in the early trials. The NHS approved pembrolizumab for metastatic melanoma in January 2016 and I was lucky enough to have a complete response to the treatment within 7 months. I went on to complete a full 2 years of treatment (as it’s still unclear how long patients need to receive the drug for and also whether patients will enjoy ongoing remission once it’s stopped) and I’ve had No Evidence of Disease (NED) on my scans for the past 18 months. Yayyyyyyy!!

Moving forward, the hope is that I’ll remain “cancer free” but I’m taking things slowly, month by month. I go for scans at The Royal Marsden Hospital every 3 months so for now, I’m still very much a “cancer patient”. Having said that, since stopping treatment a few months ago, the side effects are finally waning, I’m feeling less tired and achey, and generally much more like my old self. Anyway, those minimal side effects have been a small price to pay for being alive!!!!

I CANNOT EXPRESS ENOUGH GRATITUDE TO ALL THE WONDERFUL STAFF AT THE ROYAL MARSDEN AND ALL THE AMAZING CANCER RESEARCHERS WORKING SO HARD BEHIND THE SCENES TO BEAT THIS DISEASE.

My first challenge is going to be a 100km cycle along The Great Ocean Road with Ben and Laura. We’ve heard it’s pretty hilly but incredibly beautiful. The next challenge I’ve got lined up is another cycle challenge with my mum (and potentially the rest of my family!) between London-Brighton (slightly less glamorous but also pretty tough!).

I’d be sooooooooo grateful if you could part with some (or ideally lots) of your hard earned pennies to give more people a chance of beating this disease.

Thank you so much in advance!

Lauren xx

(P>S> You can watch the challenges unfold over on my dr_laurencara instagram)

A little bit about The Royal Marsden Cancer Charity: The charity raises money solely to support The Royal Marsden, a world-leading cancer centre. The charity ensures nurses, doctors and research teams can provide the very best care and develop life-saving treatments, which are used across the UK and around the world. From funding state-of-the-art equipment and groundbreaking research, to creating the very best patient environments, we will never stop looking for ways to improve the lives of people affected by cancer.

The post I’m Fundraising For Cancer Research (and I’d LOVE any donations – however big or small) appeared first on LAUREN CARA.

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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.

Lauren x

Please make sure you tell your own doctor before you start taking a daily probiotic – especially if you are undergoing cancer treatment. 

The post The Gut Microbiome, Cancer And Immunotherapy appeared first on LAUREN CARA.

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Hello friends!

Sorry I’ve been AWOL for the past few months.

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 Sri Lanka

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.

Portugal

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.

Cornwall

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.

Boosting Immunotherapy

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?!

My Future

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.

Lauren x

The post Life Beyond Stage IV: Celebrating One Year NED! appeared first on LAUREN CARA.

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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.

Self-Healing

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:

A Beginners Guide To Meditation

The Damage Stress Does To Your Body And What You Can Do About It

The post Exploring The Mind-Body Connection: Mood As Medicine appeared first on LAUREN CARA.

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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: Mindfulness

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.

Lifestyle Changes

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.

Reaching Out

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.

Saying No

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.

The post An Honest Discussion About Mental Health appeared first on LAUREN CARA.

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