25 February 2013

Why cheat?

Many years ago my friend George Jelinek remarried. During her speech his wife Sandy commented that as she came to first know George, she realised he had a strong commitment to eating well. After a while she felt she knew him well enough to ask if he ever cheated on the diet. His answer surprised her. “Why would I do that?” He seemed almost incredulous. "Why would I cheat on something that was so good for me?"

Yet for many it is not so simple, and "cheating" is a real and challenging issue. I wrote of this years ago as it seemed pivotal to Lifestyle Medicine. There is so much to gain by eating well, exercising and meditating regularly, and so on; yet the problem is that to receive those benefits, we actually have to do these things! So “why cheat?”

The article of years ago drew a huge collection of well thought out, intelligent responses. Insightful. So it seems timely to go “Out on a Limb” and share them with a new audience and ask for your own insights. But first

Thought for the Day
Watch your thoughts, they become your words
Watch your words, they become your actions
Watch your actions, they become your habits
Watch your habits, they become your character
Watch your character, it becomes your destiny
                                                          
So, do you cheat on what is good for you? My guess is we all do to some degree. So how often? Why? What follows are actual quotes from others responding to this question. What do their respsonses trigger in you? What insights do you have into why people cheat? Feel free to add your insights to the Comment section, and widen the conversation.

There is not one single answer.  

Firstly we are all weak creatures who find it difficult to commit and stay committed.

Second, we have different personality types, some seek and live comfortably within strict (Black & White guidelines) such as those who are drawn towards fundamentalist religions.  Others find this approach very restrictive.

Third, there is ego involved, with a common human tendency when told what to do and how to do it, there is an urge to do the opposite.

The Doctor will make me better



The doctor will make me better was my initial attitude.  Capped with this was also the attitude of the local health professionals who, with the exception of a few, were very much against us.

Feeling undeserving

Some people are not aware of the fact that they feel on a deep level that they do not deserve to be well, or to recover, "because it might be Gods will that I die."

Enjoying being sick



Some I met seemed to like being sick and attended the group sessions just to regale everyone with the story of how bad this cancer really is, they would come for a few weeks and then return at the start of a new session to tell the whole story again.

Self Love



I think it's quite simple.  Yet not very.  From my limited yet consistent observations of people facing serious illness and other life challenges, it all comes down to Self Love.  Capital S.  Capital L.

Knowledge and Experience helps



Knowledge has been a key to everything.  As time has progressed I have learnt more and adapted it a little to suit myself and I find these changes to my life very satisfying.  I started to feel the benefits in well being and happiness, and with time, healing.  When medical tests (MRI) confirmed this healing it was wonderful.

Maintaining this lifestyle does require discipline, it is a marathon.  Support from friends and family is indispensable.  Time passing also helps enormously as understanding develops and benefits accrue.  Belief in what you are doing is essential and knowledge supports belief.

Link with parents



I think people do internalize a relationship of self-care from their early relationships with parents and if this has been fraught in a variety of ways - neglectful, persecutory, narcissistically inclined - then it is very difficult for people to take up the response-ability to do this self care for themselves.

As is obvious, virtually all patients are up against mainstream beliefs, the full force of cultural wisdom, and the beliefs of everyone they know.  My oncologist told me "We can't cure you;  we aim to keep you as well as possible for as long as possible".  There are very few beacons which say "You can do this!"

The lack of deep, visceral, belief creates a distressing inner tension and turmoil; it is incredibly hard to remain positive.


It took me two full years of hard, conscious, work to acquire that deep-seated belief.  At the course you said, "This stuff works, folks, but you've got to actually do it".  I wrote that down, but I didn't really need to, because it was burned into my brain.

I used those simple words of your on many, many occasions.  Not to spur me on to action (for I've never been short on action!), but to reassure myself, because the issue for me has always been belief.

Trying too hard



I tried so hard that I nearly lost all, for my trying was not born of inner conviction, but rather was simply drawing on precious reserves of nervous energy.  Juices, meditation sessions, healthy meals - all were done in order to tick the list.  But of course it didn't stop there - exercise, daily sun bathing, growing vegies, researching, reading (to spur myself on) etc etc etc.  It all became something of a nightmare because I was trying so hard.  I would stand in the kitchen and feel myself go woozy and overwhelmed, just with this sense of trying so hard.

I suspect that it is much more common for you to deal with people who don't comply because of all sorts of reasons other than the one of trying too hard!! Trying too hard leads to exhaustion, and consequently rejection of the thing that causes the exhaustion.  So from my perspective, then, I feel that there needs to be some awareness around our drivers.  That an exploration of the emotional/subconscious journey can perhaps be as critical to survival as diet and meditation.  Obviously, the more self-awareness, the more understanding of why we do or don't 'comply'.

Finding balance



There is a happy 'ending'.  I am now joyfully exploring the world of balance, and am excited at the prospect of finding a completely new way of being, one that is built neither on hopelessness nor teeth-gritting determination, but on a more peaceful, healthful, going-with-the-flow.  It is already a much more beautiful place to be and, surprise, surprise, it is no harder from this position to 'comply' than it is from the position of whip-whip drive-drive gotta-do gotta-do.

Join the conversation; add your reactions/insights to the Comment section below.

RELATED BLOG

Go with the flow or intervene

RESOURCES

BOOK: You Can Conquer Cancer – the fully rewritten version that goes deeply into the detail of the lifestyle changes and how to follow them

NEWS
Two great events coming soon, the Surviving Cancer night as featured in last week’s blog, and the Holistic Cancer Congress that I will be speaking at in Auckland on March 16 and 17.


Holistic Cancer Congress

I will be speaking at this exciting and innovative conference that is open to all those affected by cancer including practitioners, health professionals and oncologists. The Congress will highlight the latest developments in holistic cancer research, treatment and prevention.

Leading experts in their field will share their knowledge and experience of using a holistic approach to the treatment of cancer, which combines the best of medical science and contemporary holistic healthcare, and includes treating the emotions, mind spirit and body.

 There is a special “mates rates” offer of NZ$295 for those who register through my blog -- a saving of $200 off the normal delegate fee of NZ$495. Click here

Those who are unable to attend the conference can watch it online for US$99 (normally US$299). This will also provide online access to the 2012 Holistic Cancer Congress that brought cutting edge information on holistic health from leading experts. Click here

Surviving Cancer - Come and be inspired, be informed and support the Gawler Foundation

St Michaels on Collins, 120 Collins St , Melbourne

Tuesday March 5th from 6.30 to 8.30pm, No bookings necessary just come!






18 February 2013

Cancer survivors? Cancer thrivers!!!

This is your personal invitation to be inspired, to be informed, to support cancer survivors generally and the self-help options specifically.

In the centre of Melbourne, on Tuesday, the 5th of March from 6.30 to 8.30pm, three remarkable cancer survivors will join me to talk about how we not only managed to survive against the odds, but to actually thrive in the process. The flier is attached at the end of this post.

Now there is a great notion. Not just a cancer survivor, a cancer thriver! So this week, continuing the theme of what is happening in the world of cancer, let us go “Out on a Limb” and discuss what it is to thrive amidst adversity, and meet some great “thrivers”. But first,

Thought for the Day
            Keep your goals and dreams just beyond your reach 
           And your integrity beyond reproach
                                           Richard Carmona, MD; 17th Surgeon General of the United States

Jess Ainscough, Scott, Stephens, Ruth McGowan. They all challenge the popular notion of what it is to have cancer. Vibrant, active, up-beat, full of life. How do they do it, given they have all faced life-threatening cancers and still in some sense live under that shadow?

One thing is for sure, their attitudes, their way of coping, their way of thriving, did not happen by chance or some stroke of good luck. Each of them in their own way has worked hard, continues to work hard, to be a cancer survivor, a cancer thriver.

Sure there are the common factors; taking nutrition and what they eat very seriously, developing a positive state of mind and working on the power of their minds, and of course meditating heaps; but then there are the individual variations, the personal touches that bring their individuality to the healing equation.






Jess is young and dynamic; on a mission to reach out and help thousands through her Wellness Warrior website, blog and Wellness Warrior Lifestyle Transformation Guide.














Scott is such a “bloke”, with the freshness
and openness of a real Australian man that
warms everyone’s heart and opens them to
his remarkable understandings and insights
into what it takes to heal and to be well.













Then Ruth, with the maturity that comes from
being a mayor amidst the devastation of the
Black Saturday fires. Who has known a brother
thrive through a long and difficult cancer; felt
the pain of his death, felt the powerful urge to
do all she can to survive and thrive through
her own challenges.






As a final bonus, Peter Roberts will be joining us with
his wonderful harp. Peter will play during the light
supper being served from 6.30 to 7.00pm before we
begin the talking, and then he will join me to lead a meditation.










Then there is You Can Conquer Cancer, my old book recently invigorated by a complete re-write and with a life of its own. Happily on this occasion, Dr Francis Macnab, that extraordinary psychologist and Minister of the Uniting Church’s St Michaels on Collins, will re-launch the new edition.

Takes me back to 1984 when Weary Dunlop, that famous doctor from Changi, Patron of the Cancer Council, long-term supporter of my work and someone I was privileged and proud to call a mentor and friend, launched the first edition.

Now the hope is that this new edition of You Can Conquer Cancer can be re-translated into the 13 languages the old one is in and maybe some new ones, and sell another 250,000 copies at least.

Over 120,000 people will be diagnosed with cancer in Australia this year. That is way too many people. We all need to do what we can to help those who are basically well to stay that way, to follow a healthy lifestyle and avoid developing cancer.

Then for those who do develop cancer, we need to help them to understand that they have a crucial role, quite possibly the most important role in their own recovery.

So tell the family, tell your friend and your colleagues. Tell them about the new book, maybe give them a copy. Share the flier attached to this blog with all you can. If you live within easy distance of Melbourne come and show your support for the cancer survivors, the cancer thrivers. Come and learn what you can do for your own health, healing and wellbeing. Entry is a modest $20, $15 concession.

The evening is in the beautiful St Michaels church at 120 Collins St and if you have not been in there before, it is one of Melbourne’s beautiful treasures. And all proceeds are going to the Gawler Foundation (everyone involved is donating their time).

See you there! The flier is attached at the end of this post.

RELATED BLOGS
A new year, a new way of living

The completely new You Can Conquer Cancer is released

Recovering from cancer is possible


RESOURCES

BOOK: You Can Conquer Cancer

CDs: The Gawler Cancer Program

What to do when someone you love has cancer

ON-LINE: The Wellness Warrior - Jess Ainscough

The Wellness Warrior Lifestyle Transformation Guide.

Wellness Activist and 'Cancer Thriver' Kris Carr writes in the Huffington Post about Her Crazy Sexy Kitchen

LIFESTYLE-BASED CANCER SUPPORT PROGRAMS: The Gawler Foundation


NEWS
Reclaiming Joy –A new book with a related theme.

Recently I was asked to write a foreword for a great book I can highly recommend. This is an anthology of stories from members of a group of thrivers managing cancer and other difficult circumstances. But it is way above what some of these books have been. This one is insightful, quirky, compelling. Well worth a read!

Here is the foreword I wrote for it which I hope inspires you to read it.

Truth is a rare and wonderful commodity. Eloquent truth even rarer, even more wonderful.
The truth is that chronic illness takes everyone affected by it through a wide range of thoughts, feelings and emotions.

Now, there are some people affected by chronic illness who become preoccupied with ‘being positive’. Or is it more accurate to say preoccupied with their own notion of what it is to be positive? Usually this version of being positive means ‘putting on a brave face’, ‘grinning and bearing it’, attempting to be ‘up’ all the time.

Some in fact do make a reasonable pretence of this fa├žade. It can serve as a relief to those around them. ‘She is taking it so well’. ‘He is so brave’. Yet underneath, the nagging doubt. ‘How is she really?’

Well, the cost of being sunny all the time, is to ignore the truth and deal with the consequences.

The truth is that chronic illness involves ups and downs, highs and lows. Acknowledging this, rather than pretending it is not so, is actually easier, more energy efficient, more likely to lead to comfort and ease amidst the swings.

The truth leads to freedom. Freedom to feel as you do, freedom to be genuine, freedom to be authentic. The consequence of living the truth is that this state enables one to recognise difficulties, feel them, and rather than be stuck attempting to deny them, be free to do something useful in response.

So Reclaiming Joy is a wonderful book filled with eloquent truth. The contributors, all of whom share the common thread of chronic illness, speak personally and openly about their range of experiences—the good, the bad and the ugly! But then they also discuss their attempts to find practical solutions. Many of these attempts are successful and will have general and immediate relevance to a wide range of the community.

The book also offers insight, good humour and real positivity. This is not a book of wishful thinking. Wishful thinking is where you hope for the best and do nothing about it.

This is a book of positive thinking—where you hope for the best and do a lot about it!
My wish is that this book is read widely. In a time where so much chronic illness is around us, even affecting us personally, Reclaiming Joy offers insight, hope and real possibilities. Eloquent truth. A real blessing.

Dr Ian Gawler OAM
Author of Peace of Mind & You Can Conquer Cancer
Yarra Junction

Reclaiming Joy: Living well with chronic illness, by Ruth Winton-Brown

The book is most easily ordered by emailing Ruth Winton-Brown on: rwintonbrown@yahoo.com.au






11 February 2013

Ian Gawler Blog: Twenty years and what has changed?

What if you were to read something, thought it to be from current time, and then found out it was 20 years old? I have to confess with being a little down-hearted with the place of the “patient” in current cancer management. And the slow pace of progress.

I had occasion to re-read a piece I wrote for the Australian Doctor (the main newsletter of GPs in Australia) 20 years ago - in 1993. As far as I can tell, there is only one significantly different detail after all these years. See if you can spot it!

But first

Thought for the Day
“Science progresses not because scientists change their minds,
but rather because scientists attached to erroneous views die,
and are replaced”
                                Dr. Otto Warburg, Nobel Prize winner in medicine in 1931,
                                    quoting from Dr. Max Planck, originator of quantum theory, 1858~1947

Cancer patients find strength in self-help approach. Ian Gawler

Quoted from the Australian Doctor, 3rd September, 1993.

How can doctors best help people affected by cancer? How much can cancer patients do to help themselves? What should they avoid and what reasonable options are open to them? What should you recommend?

If a new anti-cancer drug was shown to double the lifespan of women with advanced breast cancer, would it be negligent not to recommend it?

The Lancet in 1989 reported Spiegel’s (1) well designed, widely acclaimed study that proved that attending a support group once a week for a year doubled such women’s survival time, so how can it be ignored?

People affected by cancer can be helped to learn how to become long-term survivors. Many are missing out on this opportunity.

As a veterinarian and a recovered cancer patient I have spent the past 12 years conducting cancer support groups. During this time more than 10,000 people have attended the weekly and residential programs that my wife Grace and I founded and continue to develop at the Gawler Foundation in rural Victoria.

We never say we can cure cancer. Our self-help program’s stated intention has been to help cancer affected people improve their quality of life and contribute wherever possible to their own survival. People learn to live well and to die well.

The self-help approach augments conventional therapies and, at the very least, plays a vital role in meeting the human needs of patients.

There is a widespread feeling that doctors need to attend better to the psychological and spiritual needs of their patients(2). We have a system that has been doing this effectively for more than 12 years and happily share it.

When we began our work in 1981, this whole area was unexplored. Now support groups are coming into most cancer hospitals and patients are seeking the self-help options.

Our approach is to encourage cooperation and communication between doctors and patients. Best results are obtained when doctors work with patients and their families in partnership.

The patient has the right to remain at the head of this partnership. They also have the right to give away this authority away if they choose. A doctor does not have the right to assume this authority without the patient’s conscious permission.

Similarly, people affected by cancer have the right to informed debate and choice. We do not recommend unproved remedies. We are convinced the community is best served by reasoned debate.

Many patients feel that elements of the medical profession – more often specialists than GPs – are inordinately biased against innovative or alternative therapies.

The furious and often emotional debate over vitamin C is a great example. While many patients report its benefits, the debate rages(3) .

The Foundation’s aim is to provide information that is available in a balanced way, encouraging individuals to take responsibility for their own decisions.

The crucial question is: why do some patients recover when others with the same illness do not? I am confident that this is more than just good luck. It is what I am most interested in studying and what new patients are interested to learn about.

We can learn from successful patients, just as we would learn from successful sporting or business people.

My own history, which is often misquoted, offers an example of the complex history of a long-term survivor.

In 1975, as a young veterinarian, and athlete, aged 24, I had my right leg amputated because of osteogenic sarcoma.

Later that year, inoperable secondaries were confirmed in the right inguinal and mediastinal lymph nodes. In those days, I was told available chemotherapies were of no value and radiotherapy would be palliative at best. The prognosis of 3-6 months was considered reasonable.

I turned to diet and meditation.

Importantly, my wife fully supported my view that cancer could involve a failure of my body’s immune system. If we could find a way to re-activate it perhaps I could recover.
We initially followed the Gerson diet(4) . This was exceedingly rigorous and created many problems.

These days, we advise against using the Gerson diet as it is far too demanding in a home setting. However, I do believe it has enough merit to warrant serious study.

I feel sure that nutritional factors helped me a great deal. Many patients report the positive benefits associated with changing their diet.

There is a good body of evidence to indicate that nutrition can alter the outcome of cancer. Numerous animal studies confirm the proposition, but studies in humans have been more limited.

I also began meditation with Dr Ainslie Meares. Dr Meares believed that prolonged meditation could reduce cortisol levels, improve immune function and so lead to recovery(5).

For that first 3 months my tumours remained static. Then severe sciatic pain forced me to try acupuncture (2 treatments only), then palliative radiotherapy, (3 treatments to my lower lumbar region only). The pain continued to be severe but was then relieved by injections of a mistletoe extract administered by a GP interested in natural therapies.

By March 1976, I was suffering severe weight loss (though 1.8m I weighed 54 kg), jaundice, night sweats and hydronephrosis of the right kidney (on IVP). The pain was again severe.
At this point my surgeon considered my prognosis to be a couple of weeks.

My wife and I then left for 4 weeks with faith healers in the Philippines. This was a truly extraordinary experience which challenged all my preconceptions and experience of surgery.

Importantly I came home 6 kg heavier, with no pain and feeling “I had turned the corner”.
In the next 6 months, while my general health improved, the cancer itself continued to spread and grow. I maintained the modified diet and meditation while my wife did many hours of massage for me. We also investigated many natural therapies.

By late 1976 I had massive secondaries on my sternum, my left lung, lumbar spine, mediastinal and inguinal lymph nodes. Remarkably, I was free of pain and otherwise unaffected by this widespread cancer. However, I reconsidered the medical options.

I was offered experimental chemotherapy based on “Adriamycin”, Vincristine and methotrexate.

I completed the first round of this protocol in 2 and a half months but there was little change in my tumour sizes. I then elected to cease treatment despite warnings of a rapid rebound.

We returned to the Philippines for 3 months, travelling then to India. In May 1977, the holy man Sai Baba told me: “ You are already cured, don’t worry”.

This was another major turning point, as it helped me to dispel doubts and be fully confident of recover.

I had no more medical treatment but continued, fully committed, to the self-help regimen as described.

By June 1978 all visible lesions had subsided. Tests in Adelaide confirmed that there was no evidence of active cancer, but I did have TB.

I responded rapidly to standard TB treatment, and my case was reported by Meares(6).

Grace and I moved to Yarra Junction, Victoria in 1980. We have had 4 children since chemotherapy.

Obviously this is a complex history. I am often asked what cured me, and I reply that it was a combined result.

I have no doubt that the medical treatment on its own would have been unsuccessful. My recovery demanded a great deal of effort from both myself and my wife.

In 1981, my wife and I began an innovative cancer support-group based on our experiences. At that time little was being offered to people affected by cancer who wanted to help themselves. Patients were being left to fend for themselves. Hope was often denied and the myth of cancer as a death sentence prevailed.

We were keen to redress these painful problems and felt we had something important to offer. The main ingredients of our approach were (and still are) good nutrition, developing a positive state of mind, meditation, and mutual support.
Our patient-based programs gained wide interest.

In 1983 we founded the non-profit non-denominational charitable organization The Gawler Foundation to extend this work and left our veterinary practice.

 In 1984 I detailed our approach in You Can Conquer Cancer(7).  The book was launched by Sir Edward “Weary” Dunlop who remained a strong supporter of our work.

In the same year, being keen on scientific evaluation, I unsuccessfully approached the Peter McCallum Cancer Institute in Melbourne and the Victorian Anti-Cancer Council for help with research. Like many self-help groups, our resources were limited and we could get no outside assistance at that time.

In 1987, we began developing our own extensive in house database with a view to follow-up research, In the same year I was awarded the Order of Australia Medal for services to the community and published a detailed account of our meditation and positive thinking methods in Peace of Mind(8).

In 1988 on the ABC Couchman across Australia, Professor Ray Lowenthal challenged us to present our fifty best cases for assessment. We readily agreed, but the proposal lapsed when Professor Lowenthal was unable to secure funding for the research from The Australian Cancer Foundation.

We are now cooperating on research projects with Monash and Deakin Universities, have helped fund a major study with the Royal Melbourne Institute of Technology and continue with our own in-house research projects.

We welcome medical visitors to our programs and many have attended as patients, partners or observers. These people see what can be accomplished.

Remarkable transformations occur when people attend an active cancer support group. We focus first on living well and peace of mind. The hope, energy and vitality in our groups is truly amazing and quite inspiring.

People learn to communicate, to balance their lives, to clarify their goals and to work effectively towards them.

We use strategies in our programs to help people avoid guilt and find the peace of mind that is the focus of our work.

Many doctors, often unintentionally, place potentially damaging pressures on patients and, importantly, on their partners and families. We experience this often when people complain that their self-help efforts receive no support from their doctors or, worse, are attacked by them. They feel misunderstood, unsupported and alienated.

If doctors are noticing negative feelings being directed towards them by their patients, it is often because they do not listen. They would do well to sit and take an interest in them as people.

This is another key ingredient to a successful support system. We provide the time to speak and to be listened to.

Spiegel’s study shows meditation and a positive attitude help patients cope with the consequences of their disease. Doubling the lifespan by attending a support group is a powerful effect.

A good summary of the mass of literature on this subject is in The Psyche and Cancer(9).

After a 10 year study of women with breast cancer, Pettingale (10) found survival was best predicted by the patient’s attitude.

After a 7 year study, Levy(11)  found cancer survival time was best predicted by the expression of joy at baseline testing.

On the basis of psychological interviews before biopsy, Wirshing(12)  was able to predict accurately when women’s breast lumps would be proved to be benign or malignant.

Ramirez(13)  found life-threatening events were significantly associated with recurrences of breast cancers.

Another excellent series of review articles is contained in the report “Can psychological therapy improve the quality of life of patients with cancer?”(14)

In another controlled prospective study, Fawzy(15)  reported on 6 weeks of structured group intervention for patients with malignant melanoma. Distress decreased, coping increased, and, significantly 6 months later, immune function was measurably enhanced.

Professor Lowenthal says that in my book You Can Conquer Cancer I do not provide evidence for the claim that cancer patients have a typical psychological profile and are unable to cope with stress appropriately. But the cancer personality is widely recognised by many patients and scientists. (16, 17)  It certainly warrants further major study.

Professor Lowenthal says that “ taken overall science has made only a modest impact on the problem of cancer…Even where effective treatments can be offered, to many patients the potential side-effects of surgery, radiotherapy, and chemotherapy are perceived as unacceptable relative to their possible benefits.” He says doctors should “offer cure in some cases, comfort in all”.

Clearly patients being recommended orthodox treatments need more psychological support to cope with both the disease and the treatment.

The argument would seem to be about how to provide comfort effectively. There is a need to investigate new areas and techniques for solutions to cancer.

Hope is the starting point and it needs to be backed by effective techniques.

A normal progression in science is for observation to precede evidence. Having recovered personally from such a critical condition, having observed our techniques transform the lives of so many others and being aware of the bulk of recent supportive, scientific evidence, my wife and I know that our self-help approach has a lot to offer.

Many doctors do encourage their patients to include self-help techniques as part of their healing equation. We believe good doctors always have done so, and hope more doctors will have the confidence to support patients and families effectively in these self-help efforts.

References

1. Spiegel et al, The Lancet, 1989, ii:888-91.
2. Lowenthal R M, The Medical Journal of Australia, 1989, 151:710-15.
3. Pauling & Moerte. Special Report, Nutrition Reviews, 1986, 44:1, 28-31
4. Gerson, M. A Cancer Therapy – results of 50 cases, The Gerson Institute, Bonita, 1958.
5. Meares, A. The Medical Journal of Australia, 1983, June, 583-84.
6. Meares, A. The Medical Journal of Australia, 1978, 2:433.
7. Gawler, I. You Can Conquer Cancer, Hill of Content, Melbourne, 1984.
8. Gawler, I. Peace of Mind, Hill of Content, Melbourne, 1987.
9. Kune, GA and Bannerman, S. The Psyche and Cancer, University of Melbourne, 1992.
10. Pettingale et al. The Lancet, 1985, 1:750-751.
11. Levy et al. Psychosomatic Medicine, 1988, 50:520-28.
12. Wirshing et al. Journal of Psychosomatic Research, 1982, 26:1-10.
13. Ramirez et al. British Medical Journal, 1989, 291-293.
14. Greer, S. British Medical Journal, 1989, 59:149-51.
15. Fawzy et al. Archives of General Psychiatry, 1990, 47:729-35.
16. Bagenal et al. The Lancet, 1990, 336:606-10.
17. Bagenal et al. The Lancet, 1990, 336:1186-88.


Lovingly typed by my wife Ruth Gawler.

So there it is. After 20 years one thing has changed but not much else. Maybe there is more research to quote. Maybe the community is keen for a more Integrated approach to the management of cancer. Maybe there are more groups, more centres offering some form of self-help program; but I suggest I could have submitted this same article to the Australian Doctor last week and they would have taken it to be reasonably fresh. What do you think? Any comments?

So in the next few weeks I plan a series of posts to examine what is going on in oncology, and what is the place of the patient in the management of cancer. Next week, Surviving Cancer - a tribute to the long term survivors and a feature to mark the inspiring event coming to melbourne on March 5th - see below.

RELATED BLOGS
Recovery from cancer is possible

RESOURCES
You Can Conquer Cancer. Fully revised/re-written edition now in the bookshops or available on-line from the Gawler Foundation.

NEWS

1. Surviving Cancer
Hear, learn and be inspired as four remarkable cancer survivors share their stories and insights

Date: Tuesday 5th March. Light supper and book signing from 6.30pm; 7 – 8.30pm

Venue: St Michaels on Collins, 120 Collins St, Melbourne

Cost: $20, with concession for Health care cards and students $15

Enquiries: St Michaels: 03 96545120

Bookings: Not necessary; pay at the door on the night

All proceeds from the evening will support the work of The Gawler Foundation.

To download the flier, click here

2. Meditation in the Forest: Yarra Junction; March 22nd - 28th, 2013
Ready to join Ruth and myself, take some time out and experience deep natural peace - amidst the majestic forests of the Upper Yarra Valley.

This retreat will take you deep into the essence of meditation - the direct experience. As well as being restful and regenerative, in this retreat I will be introducing and guiding a structured series of breathing exercises that enhance concentration, deepen meditation and facilitate healing and wellbeing. There are only a couple of places left.

For details and to book, click here


04 February 2013

Ian Gawler Blog: Do supplements shorten lifespan?

Could taking a daily multivitamin and multimineral pill shorten your life? Not many in the public would seem to think so given that these pills are the most common form of supplements taken in the world. Yet several large studies from 5 to 10 years ago were pretty clear; such pills could take up to 7 or 8 years off your life!

Now a new study from Melbourne throws new light on the question – a must read for health practitioners and people generally. But first

Thought for the day
Dream the impossible. 
Know that you are born in this world to do something wonderful and unique. 
Do not let this opportunity pass by. 
Give yourself the freedom to dream and think big.
                                                                Ravi Shankar

The right question to begin with is why take a generalised multivitamin/multimineral supplement at all? For most the answer would seem to start with their knowledge that the quality of our food has been degraded by commercial growing practices. Then there is the environmental pollution we all face, coupled with the stresses and strains of a modern, busy life. Fast food, junk food, eating in a rush, eating what happens to be there. Lots of concerns, and then the hope that extra vitamins and minerals taken via a pill will at least compensate, maybe even be good for us.

Seems like a reasonable proposition. But then in 2003 large meta-analyses (the collated results of many individual studies) began to be published and continued to appear over the next 5 years with findings that showed a shorter life span was associated with popping these particular pills.

Needless to say there was a big discussion. Advocates of supplementation came out strongly, claiming the individual studies had a range of flaws. Poor sample selection was discussed, the health of those studied and synthetic vitamins were blamed (chemically produced vitamins rather than naturally derived versions). 

At the centre of it all, Vitamins A and E seemed to be the main culprits, but to my knowledge no manufacturer has come forward and offered to produce a multivitamin/mineral supplement without A and E. Of course, some people may well benefit from specific supplements such as selenium, iodine, iron, magnesium, vitamins D and B12 etc; but that is where specific advice from a doctor trained in nutritional medicine or a good naturopath comes into their own and may well need to be consulted.

In 2009, with a good deal of input from my colleague Prof George Jelinek, I co-authored a discussion paper focussed on the key articles available at the time, (to view, click here) and concluded the following:

1. Food is the best source of human nutrition. 

2. People eating a healthy diet and living a healthy lifestyle are rarely likely to need nutritional supplements. 

3. There is strong evidence that taking supplements of vitamins E and A shortens life. 

4. More research is needed in this field. 

5. There may be a case for a multivitamin/mineral supplement that does not contain vitamins E or A.

In the new edition of You Can Conquer Cancer, which includes recommendations on food and supplements for people who are basically healthy, as well as for those with cancer, I commented further:

“I know of no studies being published regarding the long-term use of Vitamins A and E by people affected by cancer, and maybe they are OK short term, but the caution (for those who are well and take them long-term) needs to be stated”.

However, what we do know (as reported in a July 2012 blog), is that a study in 2011 found that for women with breast cancer who consistently used multivitamins before and after diagnosis and ate more fruits and vegetables, as well as being more physically active had better overall survival. As well, these researchers concluded multivitamin use along with the practice of other health-promoting behaviours may be beneficial in improving breast cancer outcomes in select groups of survivors. Since that blog, more research relating to cancer has come to light, so next week I will update that specific area.

But now we have a new, large meta-analysis involving twenty-one studies which generated a total pooled sample of 91,074 people. The people studied were all independently living adults (not having cancer), their average age was 62 years, a general supplement was taken daily, and the average duration of supplementation was 43 months (so not a very long time for this type of trial). 

The results?
Across all the studies examined, there was no demonstrable effect of multivitamin-multimineral supplementation on all-cause mortality. However, there was a trend for a reduced risk of all-cause mortality across primary prevention trials. Multivitamin-multimineral supplementation had no effect on the risk of dying due to vascular causes or cancer. 

The Conclusion? The researchers state: multivitamin-multimineral treatment has no effect on mortality risk.

So what to do?
If you are well, stick with point one and two from Plan A above, – as much as possible, rely upon good food – it needs to be organic to qualify – and a healthy lifestyle. If travelling or under stress, a general supplement may make sense until things are back in balance again. 

If you are recovering from injury or illness, a high quality general supplement from natural sources may make sense, but food is still number one. Good supplements will never make up for bad food. And juices are a great way to add extra nutrients to your diet from natural, well balanced sources. 

RESOURCES
1. The reference for this latest article:  McPherson H et al;  Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials.  Am J Clin Nutr February 2013 97: 437-444

2. You Can Conquer Cancer. The new edition has an extra chapter on nutrition and much more detail on the whys and hows of healthy eating – for wellness or for recovery.

3. CDs Eating well, Being well: Details the Wellness Diet 

Eating for Recovery: Details recommendations for those with cancer. This Cd builds on the previous one, so people with cancer are advised to study both.

RELATED BLOG

Multivitamins and cancer

NEWS
Lord Maurice Saatchi, co-founder of the famous advertising agency Saatchi and Saatchi, recently supported his beloved wife through a tough and fatal cancer. Now he wants the English laws regarding cancer research to be changed to allow for more sensible experimentation in cancer research. Citing the lack of progress in this field, and the tough treatments he saw his wife endure unsuccessfully, he is a powerful advocate for a new approach. Not for the faint hearted, but a compelling interview on the BBC, December 2012. For a transcript or to view the interview – link here.