The Legacy of the Saber Tooth Tiger: A Few Unkind Words About Stress

BY RALPH BLUM

Whatever the problem—heart, cancer, diabetes—stress is arguably Public Enemy #1 for half of what ails this nation. And when it comes to immune system health, stress rings cash registers. Advertising budgets dedicated to pushing the stress button are worth what Ted Turner would call “serious cash money.” The root briar of an estimated 20 billion dollar a year volume of advertising, stress is Big Business.

It is now more or less common knowledge that the most potent immune system suppressor is stress. Especially chronic stress—the kind suffered by all of us from the moment are diagnosed with prostate cancer. So manufacturers of specialty foods, supplements, herbs and minerals are climbing onto the bandwagon and claiming that their products are “immune system boosters.” However, if you look carefully you will see that 90% of their claims are laced with hedge-your-bet qualifying terms like “might,” “perhaps,” “could” and “can sometimes.” This is the stuff that scams are made of these days.

So when you don’t know whether your job is being abolished, and you are seeing your savings dwindle to nothing, and your anxiety over your children’s future is keeping you awake at night, and then, on top of all that, you are diagnosed with prostate cancer, how can you hope to cope with this kind of chronic stress barrage? What can you do that will genuinely assist your immune system to function efficiently?

The three tried and true stress busters are simple enough. They are diet, exercise, and meditation. You don’t have to pump iron or run marathons, or subsist on tofu, berries, and leafy greens. But in order to fight cancer successfully, you do need to eat a healthy diet and find a type of exercise you enjoy. And, at least as important, you need to find some kind of meditation that you can live with—it can be as little as fifteen minutes a day!—because it does reduce the stress that inevitably ramps up with a cancer diagnosis.

If you’re interested, you might check into the fairly new field of Psychoneuroimmunology. You’ll learn about the legacy of the saber tooth tiger, and how to distinguish the activity of the adrenal system from that of the immune system. Because there are two distinct conditions: there’s growth and there’s protection, but you can’t have both at the same time. And when any threat mobilizes the body with the old “fight or flight” response, the adrenal (stress) hormones directly repress the action of the immune system. Result: almost every major illness has been linked to chronic stress.

It is now fairly well established that what goes on in our minds absolutely affects our bodies.  There is no question that our thoughts and our beliefs generate a cascade of chemicals that can act to either harm us or heal us. So my best recommendation to you is to believe wholeheartedly that whatever treatment you decide on will be totally successful. And when the stress gets to you, you don’t have to sit crossed-legged on the floor and repeat a mantra provided by a guru in the Himalayas. Just turn on some relaxing music, breathe slowly and deeply, and imagine yourself walking on a beach, or in a forest—whatever works for you—and see yourself relaxed and healthy. Relieving the chronic stress of living with prostate cancer is arguably taking a long step on the road to recovery.

Romancing the Immune System

BY RALPH BLUM

Mark Scholz, MD, recently posted a blog reporting that harnessing the immune system to fight cancer is a rapidly advancing area of research and new drug development. As I don’t have Dr. Scholz’s scientific background, my take on how to utilize the immune system revolves more around mind-body-interaction—how our thoughts and beliefs can influence immune function, and how we can contribute in subtle yet significant ways to our own recovery process.

As I understand it, the immune system is the body’s equivalent of the Department of Homeland Security. Its primary task is to provide constant surveillance and, when necessary, seek out “terrorists”—defective and cancerous cells—and destroy them. However, when immune surveillance breaks down or is compromised, it is usually as a result of environment pollutants, poor diet, lack of exercise, and an array of emotional suppressors.

We can’t do too much about environmental pollutants, so apart from finding a medical team you can trust, and improving your diet and exercising regularly, I suggest, somewhat tentatively (I’m aware that mind-body communication is not a hot topic with most guys!), that you at least consider the possibility that what you believe and think and feel might manifest in your body.

There is a significant amount of anecdotal evidence to support the whole mind-body-connection theory. Pioneering research by neuropharmacologist Candace Pert, Ph.D., demonstrated that the mind and body are one interconnected system that carries information—via messenger molecules known as peptides and neuropeptides—from the brain to the body and then back again in a continuous feedback loop. Bernie Siegel, MD, summed up the whole amazing process in three words when he famously said, “Feelings are chemical.” And Deepak Chopra went one step further: “Every cell in your body is eavesdropping on your thoughts.”

Emotional-Chemical Text Messages

Whoa! I thought, what does all this mean? What it seems to mean is that we have a simple choice: through this complex interconnected system we can either send our immune system messages that evoke a positive biochemical response, or we can send messages that downgrade or even suppress immune function.

The most potent immune suppressor is prolonged emotional stress—unrelieved grief, unresolved anger and resentment, persistent feelings of fear, anxiety and hopelessness. All these toxic conditions, in varying degrees, transmit negative Emotional-Chemical Text Messages to the immune system.

On the other hand, we can choose to “romance” the immune system by sending it loving thoughts, messages of hope and peace and, above all, our gratitude for the amazing job it performs, and for all the good things in our lives. And we can further support it by staying, as much as we can, in the present moment—by letting go of past regrets and grievances and refusing to squander energy worrying about the future.

Laughter—the Best Medicine

My favorite immune booster and also God’s favorite music (or so I’ve heard), is laughter. Here’s how the Discovery Channel Web site describes the impact of laughter on the immune system: “When we laugh, natural killer cells which destroy tumors and viruses increase, along with Gamma-interferon (a disease-fighting protein), T-cells (important for our immune system) and B-cells (which make disease-fighting antibodies). Laughter may well be the ultimate antioxidant.”

Everyone I know who has done well in the cancer wars has, to some degree, supported their immune system by sending it positive messages. Three thousand years ago, King Solomon declared: “A joyful heart is good medicine, but a broken spirit dries up the bones.” As Dr. Scholz pointed out, the “wet part of the bones, otherwise known as the marrow, is the place where the immune system originates.” Score one for King Solomon!

So I do my best to avoid stressful situations. I eat sensibly and exercise at least semi-regularly.  Above all, I laugh a lot, indulge in loving thoughts, and keep a editorial eye on the content of the Emotional-Chemical Text Messages I’m sending my immune system.

Harnessing the Immune System to Fight Cancer

BY MARK SCHOLZ

Using the immune system to fight cancer is a rapidly advancing area of research. The immune system (as it relates to fighting cancer) is made up of three components: 1) regulatory cells (T_Regs), 2) killer cells, and 3) detector cells otherwise known as dendritic cells.  Dendritic cells activate the killer cells and help them “home in” on the cancer. 

Over the last 30 years, immune treatments have proven disappointing time after time due to a failure to address the immune system’s natural propensity of self-regulation. Self-regulation—inhibition of immune over-activity—is a normal aspect of immune function that prevents diseases such as lupus or multiple sclerosis. 

However, recent research reveals that some cancers, prostate cancer being one of them,  “cloak” themselves from immune attack by “kidnapping” T_Reg cells and using them as a shield to diminish or  inhibit killer cell activity.  This new understanding provides a good explanation of why the immune system fails to attack and eliminate cancer. Rather than being a type of weakness, immune inactivity is a type of blindness. 

Two new treatments, one that is already FDA approved and another that is in Phase III trials, are designed to counteract this blindness; they are Ipilimumab and Provenge.  Ipilimumab is a new drug from Bristol Myers that blocks an “on/off switch” on the surface of T_Reg cells. When the switch is in the on position T_Reg activity is up-regulated, suppressing the immune system. When the switch is locked in the off position by Ipilimumab, the inhibitory action of the T_Reg cells is taken off line. Ipilimumab was approved by the FDA in March 2011 to treat advanced melanoma. Preliminary studies of men with advanced prostate cancer have shown some dramatic results. In addition, Dr. Eugene Kwon from the Mayo Clinic has reported surprisingly good results against advanced prostate cancer using small doses of Ipilimumab in conjunction with hormone blockade. Presently two phase III trials of Ipilimumab in advanced prostate cancer are ongoing.*

Provenge was FDA approved to treat advanced prostate cancer in 2010 after two separate phase III trials showed that Provenge-treated men lived 20% longer than men treated with a sham infusion. Provenge works by providing a cancer “scent” (via a common cancer protein called PAP) to activate the dendritic cells and enable them to better home in on the cancer. Provenge is the ultimate individualized therapy because dendritic cells are filtered from the blood of each patient and exposed to PAP in the laboratory.  Each patient’s own activated dendritic cells are then reinfused back into the blood stream.

As exciting as both these intelligently designed therapies are as stand-alone treatments, the irresistible next step is to use them together. It is natural to assume that the effectiveness of a well-tolerated treatment like Provenge will be further enhanced when used in combination with a therapy like Ipilimumab that will keep the regulatory defenses of the T_Reg cells in check. I contacted Bristol Myers this week to inquire about the status of research into the effectiveness of a Provenge/Ipilimumab combination. I was assured that such a study is in the works and anticipated to become a reality in the near future. 

*Prostate Oncology Specialists is conducting two Ipilimumab trials in advanced prostate cancer.  Parties interested in participating in one of these trials in Marina del Rey, may contact Jennifer at (310)827-7707 or jennifer@prostateoncology.com. Additionally, you may visit http://ResearchForProstateCancer.com