Activating the Mind/Body Connection

BY RALPH BLUM

Once you have found a medical team you trust, and have decided which treatment option is best for you (and that may be no immediate treatment), the single most important thing you can do is take an active role in your own recovery.  Respected psychiatrist and cancer researcher Dr. David Spiegel wrote, “Medicine has focused so much on attacking the tumor that it has tended to ignore the body coping with the tumor, and the social and psychological variables that influence the somatic response to tumor invasion.”

As your immune system is the most powerful defense your body has against cancer, it is your task to do everything you can to support it. We all know that exercise and proper diet contribute to general good health and, therefore, to a healthy immune system. And most cancer survivors agree that vitamins and herbal supplements support maximum immune function and have made them a part of their recovery program. But your task doesn’t stop there.

Research in the field of psychoneuroimmunology attests to the central role our emotions play in supporting our immune system and promoting healing. What you think and feel can directly impact your health. And it is generally agreed that the most potent immune suppressor is chronic emotional stress that floods the body with adrenaline and cortisone derivatives that interfere with the immune system’s ability to seek out and destroy cancer cells. Of course this is a Catch 22, because a cancer diagnosis inevitably triggers a roller coaster of negative emotions—fear, anger, anxiety, resentment, grief, despair—all of which, when held onto, act to suppress the immune system. You can’t expect to prevent these negative feelings. The trick is to acknowledge them, and then refuse to get stuck in them.

Blood tests have shown strikingly improved immune function among people who emote, and even those who confide their feelings to a diary show better immune function. Having an intimate group of supportive friends, or simply meeting with others in a support group once a week can improve your chance of recovery. Practicing simple meditation and visualization (there are dozens of pre-recorded guided imagery and relaxation tapes available) supports your immune system and promotes healing. And then there’s my favorite immune booster: laughter. When you laugh, natural killer cells increase, as do T cells and B cells that make disease-fighting anti-bodies. So whatever other supplements you take, be sure to include laughter.

Above all, the will to live, a sense of optimism, and your belief in your chosen treatment play a huge role in your recovery.  Combining the will to live with hope—the deeply confident expectation that you can beat this cancer—has a profound healing effect.

Moyad / Scholz Mid-Year Update

BY MARK SCHOLZ, MD

Warfare is a common analogy often used to describe the fight against cancer. The “soldiers,” when using this type of example, would be surgery, radiation and hormone therapy. The “spies” are the body scans and blood tests that are used to determine the strength and location of the invading enemy. But who is the mastermind, the “general” who determines the overall strategy for winning the war?

With most types of cancer, medical oncologists are charged with the responsibility for supervising care. Medical oncologists are board-certified internists with subspecialty cancer training. Surprisingly however, with prostate cancer, it is usually the patient—with some educational input from the surgeons and radiation doctors—who ends up selecting treatment for himself.

Placed squarely in the driver’s seat, patients are therefore in desperate need of understandable, unbiased and up-to-date information about prostate cancer. The good news is that the pace of technological progress is accelerating, bringing numerous improvements to patient care. The bad news is the monumental task of sorting through endless mountains of information, more accessible than ever via the Internet.

The PCRI already hosts an annual September conference that is designed to help patients tackle this daunting challenge. However, given that new information is coming out so quickly, the PCRI has decided to inaugurate a “Mid-Year Update,” a half-day educational conference chaired by Drs. Mark Moyad and Mark Scholz, that is designed to bring patients the most recent information about prostate cancer management.

This year’s update, scheduled for Saturday afternoon, April 11^th and to be held at the Los Angeles airport Marriott, will feature presentations by Dan Margolis MD, a leading expert in MRI imaging from UCLA, and Fabio Almeida MD, a leading expert on the latest breakthroughs in PET imaging. Dr. Mark Scholz will review the controversial topic of using testosterone and estrogen therapy in men and women. Doctor Mark Moyad will speak on the most recent studies relating to diet and supplements. An interactive question and answer forum chaired by doctors Moyad and Scholz will complete the day.

Further details about the conference are available at www.pcri.orgwww.pcri.org or by calling the PCRI office at (310) 743-2116.

BUYER BEWARE

BY RALPH BLUM

According to Thomas Stamey, MD, a leading expert on prostate cancer and the man who developed the PSA test, “When the final chapter of this disease is written, it will prove that never in the history of oncology will so many men have been so over-treated for one disease.”

Why is this? One reason is financial. As a seasoned observer of the multi-billion dollar prostate cancer industry told me, “Your prostate is worth what Ted Turner would call ‘serious cash money.’” In a time of spiraling healthcare costs it is worth noting that biopsies alone have become a billion dollar a year business, and far too many of them are performed on men in their 70s and 80s with disease that would never become clinically significant in their lifetimes. But a positive biopsy puts them immediately at risk for serious infections and unnecessary radical treatment. Why? Because both doctors and patients over-react to the information the biopsy test supplies.

Although prostate cancer is typically a non-life-threatening disease, most men find it hard to believe that any kind of cancer can remain dormant for years. So they are highly motivated to get rid of it, and the quick fix of surgery seems like the most attractive option. Furthermore the urologist who performs the biopsy is a surgeon so that, providing the cancer is still contained in the gland, it is natural that his treatment of choice would be surgery.

Another reason so many men rush into surgery without, apparently, taking into account that even the most talented surgeon cannot promise a cure, let alone know if he can save the nerve bundles that control erections, is all the marketing hype surrounding robotic surgery.  So far there has been no proof that robotic surgery has better results than a regular prostatectomy when both are performed by equally skilled surgeons, but many men are lured by the glamor of “the robot that can operate.” As Paul Levy, former head of Beth Israel Deaconess Medical Center in Boston, once said, “The easiest population to market in this country is the group of men worrying about the functioning of their penis.”

The psychological impact of a cancer diagnosis is overwhelming, and the emotional appeal of “cutting it out” drives far too many frightened and vulnerable men toward surgery although, in many cases, no immediate treatment is necessary. According to Stamey, prostate cancer is a disease all men get if they live long enough. “Our job now,” he said, “is to stop removing every man’s prostate who has prostate cancer. We originally thought we were doing the right thing, but we are now figuring out how we went wrong. Some men need prostate treatment but certainly not all of them."

So in what Stamey calls “this heavily screened country,” it is up to each of us to take the time to do some research and not let either fear or marketing hype dictate our treatment decisions.

Your Best Helper

BY RALPH BLUM

A prostate cancer diagnosis impacts both you and your partner. Although you are the one whose body is being attacked by cancer cells, the diagnosis is shocking and frightening for your partner, too. You are both under enormous stress and usually experiencing the same tidal wave of emotions, including the devastating fear that you might die, and fear of how whatever treatment you choose will affect both your work life and your intimate life.

As you struggle to cope with selecting the best treatment, and to get a handle on your own fears, maintaining good communication with your partner is essential for both your sakes. Most men are conditioned not to talk about their fears, and you may fall into the trap of trying to remain upbeat, of hiding how threatened and anxious you really feel.

While it is helpful to remain as positive as you can, it is even more important to talk openly and honestly with your partner about the potentially devastating psychological and emotional consequences, as well as the life changing physical consequences of your prostate cancer treatment, and about how it is going to affect your relationship.  And if one of your main fears is of becoming impotent, it may be helpful for you to understand to know that the physical side of your relationship is seldom as huge an issue for your partner.

There are many ways in which your partner can help you besides giving you love and support. Having someone who cares at your side at the doctor’s office, listening to the many complex treatment options and being able to discuss with you afterwards the risks and undesirable side effects. is enormously helpful. Just be aware that it helps your partner, too, to be involved in the choices you make.

Your partner can help you decide which doctor should perform your treatment, drive you to doctor’s appointments, and pick up any medications you need at the pharmacy. Record keeping is another important task your partner can help with—by keeping a folder at home with all your test results, reports and X-rays, so that if you need to consult another doctor for a second opinion you will have everything you need to take with you. Your partner can also help you gently break the news to your family that you have prostate cancer and what your diagnosis means.

 

So if you are one of those guys who think that asking your partner for help is somehow "unmanly," get over it!  You don’t do any favors to someone you love by pretending that you’re feeling fine when you’re not.  Ask for any help you need and you and your partner will both benefit. You are in this together.