27 July 2015

Important information you really need to know – and share

Most who read this blog will be aware I am in the midst of an extended meditation retreat. However, after a fairly intense 3 weeks, during a free day two new pieces of research came to my attention that I feel must be addressed. They highlight a situation that has caused me increasing distress over recent years.

Fact is this is information you may will benefit from knowing and reflecting upon well in advance as the evidence shows people who are unfortunate enough to get into this situation, in the heat of the moment often make the wrong choice with serious, adverse consequences. Please do share this information with those you care for,

But first

     Thought for the day

            There is no way to not do this practice                              perfectly

            It is just this…
            Sitting; 
            Open;
            Spacious; 
            Aware;
            In the present moment.
            Just this

                         From the retreat


It is hard to say how often I have heard this, but it is very common. “We could try some chemotherapy…. “

Patients with end-stage cancer often receive chemotherapy, under the assumption that it will improve their quality of life or may even extend survival. However, 2 new major pieces of research have found quite the opposite – quality of life was worse with no benefit to overall survival.

For years it has been disturbing to watch as people in reasonable health but with advanced cancer were doing OK, only to be offered chemo. Often the statement was “You are doing so well now, why don’t we try some chemo”.

Understandably, it is extremely difficult for many people to resist this offer. Commonly it comes with big pressure from family and friends who, according to experience that is backed up by research, are like many patients and mistakenly believe the chemo will extend life as well as improve quality of life.

However, the American Society for Clinical Oncology recently identified end of life chemotherapy as one of the “top five” practices that could improve patients’ care and reduce costs, if stopped. This is confirmed by these two important research findings which themselves confirm earlier research.

The first, in the British Medical Journal concluded chemotherapy given to terminally ill cancer patients months before death was associated with no improvement in survival times, higher levels of intensive medical care (cardiopulmonary resuscitation, mechanical ventilation, or both) in the last week of life, higher probability of dying in an intensive care unit and less chance of dying in preferred place of death, like at home.


This is something we need to know of well in advance, because in the heat of the moment - at the end of life, people often opt for chemo and suffer unnecessarily.

Not to say chemo is not useful at other times, but there is a need to be very selective late in life.

In fact, the statistics show most chemo is given palliatively.


The lead researcher Dr. Prigerson believes that the use of chemotherapy at the end of life, and conversation about it, needs reforming. "The term palliative chemotherapy is disingenuous," she told Medscape Medical News in an interview. "There is a negative side to chemotherapy; it makes you sicker."

The second piece of research just published in JAMA Oncology adds more vital information. Lead author Prof. Holly G. Prigerson from Cornell said "If this so-called palliative chemotherapy is given to improve their symptoms, then these data should give them pause that it's not going to help."

Of particular significance, these findings indicate that patients with good performance status (this is medical speak for being reasonably well) were the ones most likely to receive chemotherapy near the end of life, she said in an interview.

"In our study, 100% of the patients who were feeling well and asymptomatic were being given chemotherapy," Dr Prigerson explained. "So the question is, why? Why would a person who was functioning well be given chemotherapy?"

Charles D. Blanke, MD, and Erik. K. Fromme, MD, suggest "If an oncologist suspects the death of a patient in the next 6 months, the default should be no active treatment. Let us help patients with metastatic cancer make good decisions. Let us not contribute to the suffering that cancer, and often associated therapy, brings, particularly at the end.”

EDITORIAL COMMENT
For years I have seen people adversely affected by this and now it seems a much needed correction may be coming...


I first wrote of this in 2006 when research began to emerge that reflected what was being observed amongst people in our groups (one short article and one longer, highly referenced one that was used as a basis for presenting at 2 major medical conferences that same year. They are on my website in the Information section and are still relevant - links below).

People who were managing their situation well with lifestyle therapies – good nutrition, positive thinking, meditation, working on their emotional health, relationships and state of mind, were being told they were doing much better than expected, so “Why don’t we try some chemo now? Do you want it?” Hard to resist in the climate we live in.

But then people would often be overrun by the side-effects. Eating well became problematic, meditation harder, state of mind affected, harder to be positive. And one medical intervention commonly led to another, often leading to tough last days.

So please share this information. While it may not be what some would like to hear, and maybe it is not a popular topic for conversation, it distresses me deeply to observe how often people who are managing advanced cancer well go into chemotherapy, only to be wiped out by it and die in difficult circumstances.

By contrast, there have been many people who have managed symptoms really well and died well, having carried through with the lifestyle approach and finding the stability and comfort that comes with consistent meditation.

Of course it would be wonderful if everyone survived cancer. But is highly possible to die well from it, in good circumstances, feeling that life has been completed. When this happens it makes it so much easier and better for family and friends as well.

Please share  ….

REFERENCES
Wright A A et al, Associations between palliative chemotherapy and adult cancer patients’ end of life care and place of death: prospective cohort study, BMJ 2014;348:g1219

Prigerson HD et al, Chemotherapy Use, Performance Status, and Quality of Life at the End of Life, JAMA Oncol. Published online July 23, 2015. doi:10.1001/jamaoncol.2015.2378

Chemotherapy: how much does it contribute to 5 year survival?  

Cancer, lifestyle and chemotherapy: A documented examination of the benefits and side effects of lifestyle factors and chemotherapy.


NEWS
The retreat goes well and I will write something of that at a future time. Many useful things to share coming from it…

NOTICEBOARD

NEXT MEDITATION RETREAT

Meditation Under the Long White Cloud   24 - 28 October 2015

7 day retreat at Mana Retreat Centre, Coromandel Peninsula, New Zealand



         Take time out from the busyness of everyday life; spend time with your self
      Slow down, reflect, contemplate – regain perspective, vitality, balance and clarity
Deepen your understanding and experience of mindfulness, contemplation and meditation.

The special focus of this meditation retreat will be the theory and practise of contemplation

Full details, CLICK HERE



SPECIFIC CANCER RESIDENTIAL PROGRAMS

CANCER and BEYOND     October  2015     Monday 12th to Friday 16th 

Five Day Residential Follow-up Program at the Gawler Cancer Foundation in the Yarra Valley




FULL DETAILS  Click here 



MIND-BODY MEDICINE and CANCER    November  2015    Tuesday 10th to Saturday 14th

         Five day Residential program in the beautiful surrounds of Wanaka, New Zealand
            - an easy drive from Queenstown airport and very accessible for Australians



FULL DETAILS Click here




13 July 2015

Mind-Body Medicine and cancer

Cancer is best regarded as a potentially reversible, degenerative disease that is fuelled by inflammation. 


Everyone diagnosed with cancer needs to know this because it is within their potential to convert “potentially reversible” into “actually reversed”.

This week we reaffirm how this is possible and remind ourselves of how we can help others; maybe even save a life or two.

Also news of the next Mind and its Potential Conference coming up 27 -28th October in Sydney. This is a fabulous annual event and one I heartily recommend. With me having spoken at the conference several times, and being a conference partner, you can register before July31st and save 20% on the fees (around $4 - 500) - see the details and necessary code below, along with some news of my retreat, but first


         Thought for the day

            When your fear touches someone’s pain
            It becomes pity.

            When your love touches someone’s pain
            It becomes compassion.

                       Stephen Levine


For anyone wanting to use the best of their own potential to overcome cancer, the answer is surprisingly simple. The fact is that Lifestyle Medicine offers the real hope of reversing the very nature of the cancer process.

Lifestyle Medicine teaches how to activate a highly therapeutic, highly anti-inflammatory, highly regenerative process. 


However, experience tells us that putting this “simple” fact into action, is often not so easy. The challenge is that to get the best out of what Lifestyle Medicine has to offer, means changing one's lifestyle, changing one's habits.

To have any real prospect of accomplishing this people need inspiration, good information, a clear sense of direction, and on-going support, but most of all they need to be in a good state of mind.

Lifestyle Medicine enables us to benefit from those things that are within our own capacity to take control of.

What we eat and what we drink. And how much we eat and drink. How much we exercise; how we manage our relationships and spiritual lives, and crucially how we manage our minds.

What choices we make and what state of mind we follow those choices through in – grumpy resistance or a welcoming embrace.


The mind is the focal point for Lifestyle Medicine. 

For it is the mind that decides what we do. Indeed, it is the mind that changes everything.

So this is where the more specific benefits of Mind-Body Medicine are called for. Mind-Body Medicine enables us to reverse destructive states of mind – the adverse impacts of stress, unhealthy habits and ways of thinking. Mind-Body Medicine also provides the means to move through any times of apathy or stagnation, and to benefit from all the constructive, healing powers of a mind well directed and engaged.

Mind-Body Medicine is at the heart of a healthy, healing lifestyle.

People have been telling me for over 30 years that they believe stress was a major factor that brought their cancer on. Certainly, for anyone who was not stressed beforehand, a diagnosis of cancer is of itself a major potential cause of stress. Some studies indicate that over 50% of people develop Post Traumatic Stress Disorder after a cancer diagnosis.

If stress is left unrecognised, and worse untreated, then it means anything positive that is done will be undermined.



Happily, there is so much that can be done once we address the mind.

And the key?

Learn how to embrace whatever we do. Not just go along with. Not just put up with. Not even just tolerate. No, much more than this. Embrace. Welcome. Commit. Persevere. Develop resilience. Engage wholeheartedly. Flourish.

For these are the attributes of long-term survivors, and these are attributes that can be learnt.

Most people who first come to a cancer lifestyle-based program, are somewhere along a spectrum of engagement with what will really help them that ranges from ignorant indifference to full on commitment.

Good news. Once one knows what works; once one has been convinced that this Lifestyle Medicine stuff does actually work, then one can learn and be supported to put it into place. The trick is to begin.

So how to be convinced that Lifestyle Medicine works? 

Evidence in medicine is based upon what comes out of the research and what is known from clinical experience.

Through over 30 years of work with the Gawler Foundation (where most people know that these days I only work as a consultant, not on staff or on the Board) and all the wonderful colleagues there, more clinical experience has probably been gathered in this field than at any other centre in Australia, quite possibly around the world.

Add to this all the exciting new research that is building rapidly to confirm so much of what has been learnt through all that clinical experience, and there are grounds for a high degree of confidence.

So what to do?
Many who read this blog and are dealing with cancer are well on-track. The issue is to stay there. To not be worn down by our own old habits or the influence of society, friends or even family.

Getting well from cancer and staying well requires life-long healthy habits. Sadly, there are so many vested influences in the commercial world that seem bent on us continuing to be good consumers and to maintain unhealthy habits, that staying well can be a challenge. 

This is another good reason to go on retreat at least once each year. Take time out, sit back a little. Reflect. How am I going? Am I on track?

Of course, a retreat can be inspiring, informative, regenerative; but this need to re-assess, to be reminded of what we know and to be supported to keep on track, is one of the high points of attending a retreat.

For those new to this, for someone you might like to help – to inspire, to inform, to get started on the road to healing, the best thing I suggest is to offer You Can Conquer Cancer. A book is easy. And this book contains all the information people need to get started (many people have told me how they simply read the book, did it all and got well). People can dip in and out of it at their own pace and find out whether this is something they can commit to for themselves.

Truth is, as I am sure we all know, what we are talking of is not for everyone. But maybe a word at the right time, maybe a book at the right time, might just get someone started. Might just help someone to save their life…

RELATED BLOG
Cancer Self-help Residential Program - a photographic essay

RESOURCES
BOOK
You Can Conquer Cancer This is an ideal introduction for anyone affected by cancer who is interested to know what they can do to help themselves, or how they can help the one they love.

CDs or Downloads
The Gawler Cancer Program: Outlines how cancer develops and how this self help approach can help the healing.

What to do when someone you love has cancer: Essential listening providing clear guidance for those supporting people affected by cancer, whether family, friends or health professionals.


NOTICEBOARD

NEXT MEDITATION RETREAT

Meditation Under the Long White Cloud   24 - 28 October 2015

7 day retreat at Mana Retreat Centre, Coromandel Peninsula, New Zealand



         Take time out from the busyness of everyday life; spend time with your self
      Slow down, reflect, contemplate – regain perspective, vitality, balance and clarity
Deepen your understanding and experience of mindfulness, contemplation and meditation.

The special focus of this meditation retreat will be the theory and practise of contemplation

Full details, CLICK HERE



SPECIFIC CANCER RESIDENTIAL PROGRAMS

CANCER and BEYOND     October  2015     Monday 12th to Friday 16th 

Five Day Residential Follow-up Program at the Gawler Cancer Foundation in the Yarra Valley


This program is specifically designed for those with cancer along with their support people who have attended a previous Gawler Cancer Foundation program or equivalent such as with Sabina Rabold, CSWA, Cancer Care SA, CanLive NZ, or with the Gawlers themselves.

A unique opportunity to meet with like-minded people once again, to consolidate what you already know, to learn more from the combined knowledge, experience and wisdom of Ian and Ruth, to reaffirm your good intentions, and to go home refreshed and revitalised.

FULL DETAILS  Click here 



MIND-BODY MEDICINE and CANCER    November  2015    Tuesday 10th to Saturday 14th

         Five day Residential program in the beautiful surrounds of Wanaka, New Zealand
            - an easy drive from Queenstown airport and very accessible for Australians


This program is open to anyone affected by cancer.

While the focus of this program is on therapeutic meditation and nutrition, the power of the mind and emotional health, ample time will be given to answering any questions you may have relating to the Gawler program - exercise, positive thinking, healing, balancing medical options, successful ways of dealing with setbacks, sustaining your good intentions and the relevance of finding meaning in life to healing and recovery.

Health professionals interested to learn more of this work are also welcome to attend.

FULL DETAILS Click here




NEWS
Many know by now that I am on an extended meditation retreat in France which began July 1st. We have just emerged from the last 10 days spent in silence which for me has been a very stabilising, settling time. Starting to feel as if the busyness of daily life has been left well behind and can ease into the retreat schedule.

There are several hundred on the retreat at present, with more arriving, especially in August where the numbers will swell to over 1,000. It is wonderful to receive teachings directly from such a great meditation master as Sogyal Rinpoche, and already I have realised new ways that should be helpful to present meditation in the retreats Ruth and I present. And there is nothing like having a good block of time to deepen your own practice.

What a treat to be on retreat!