Nutritional and Mind-body Interventions in Cancer and Chronic Illness

Paul B. Schlosberg

Copyright© 2008 By Paul B. SchlosbergAnd MagPro Publishing http://www.MagPro.org

All rights reserved under International Copyright Conventions. Published in the United States by MagPro Publishing

ISBN: TBD

Layout: Paul B. SchlosbergPublisher: MagPro PublishingText Editing: John de Cuevas First Edition: May 2008

2

Contents

Preface 5

Chapter One Introduction 6

1.1 Building a Foundation of Health 6

1.2 Personal Connections to the Study 7

1.3 The Mind, Optimism, and Cancer 8

1.4 How This Book is Organized 11

Chapter Two Literature Review 13

2.1 The Mind and Cancer 13

2.1.1 Emotional Stress and Cancer   13

2.1.2 Is There A Cancer-Prone Personality Type? 16

2.1.3 The “Will To Live” and Cancer 17

2.1.4 Mindfulness And Cancer 18

2.1.5 Holistic Approaches 20

2.1.6 Kabat-Zinn: Mindfulness Meditation 20

2.1.7 Simonton: A Holistic, PsychosocialApproach 23

2.1.8 Benson: The Relaxation Response 25

2.2 Nutrition and Cancer 26

2.2.1 Overview of Cancer and Physiology 28

2.2.2 What causes cancer? 29

2.2.3 Nutrition, Immunity, and Balanced HealthSystems 30

2.2.4 Inflammation and Cancer 32

3

Chapter Three Conclusions and Future Considerations 38

Endnotes 44

Appendix A: Key Terms 49

4

“When life has meaning, you can bear almost anything; without it, nothing is bearable...the greatest tragedy is not death, but life without purpose."

Rick Warren

Preface

Although I have firm views on the use of both conventional and holistic medicine

in cancer, in this book, it is not my aim to attempt to persuade readers to make choices

based solely on these.  It is my hope that readers make informed, intelligent decisions

true to their spirit, by weighing all of the best possible options, with the use of sound

judgment. With the exception of specific aspects that may be subjective in nature, the

following is based upon factual, research-based information.  Although a disclaimer

is appropriate, the health solutions herein are preventive, researched, and generally

regarded as safe (GRAS); and, extensive references are provided for follow-up research. 

I do not endorse particular treatments, conventional or alternative; however, unless

contra-indicated, I believe what is outlined can at least be used as a supplement to almost

any type of treatment.  These evidence-based practices can not only enhance recovery but

also enhance one’s quality of life.  Of course, it is imperative that one discuss any

possible changes in a health program with their chosen health professional.

5

Chapter One: Introduction

“God, grant me the serenity to accept the things I cannot change,The courage to change the things I can, and the wisdom to know the difference”

Rheinhold Niebuhr

1.1 Building A Foundation of Health

To be clear about the main perspective I take in this book, my view is similar to

that of the Chopra Center for Well Being in California, run by the renowned holistic

pioneer Dr. Deepak Chopra ― it is not my intention to treat cancer, rather to help a

person build a foundation of health.  Dr. David Simon of the Chopra Center says, "We do

not believe our programs treat people with cancer.  By this I mean that we are dedicated

to improving a person's quality of life by reconnecting body, mind, and spirit." 1 

Although cancer is complex, many healthcare experts believe cancer is the result of the

modern "toxic" lifestyle: mismanaged stress, poor nutritional habits, overexposure to

toxic chemicals, and a sedentary lifestyle.  The toxic lifestyle I refer to is unquestionably

one of stress: social and emotional stress, ecological stress, and physiological stress, with

much of the physiological stress resulting from poor diet. Additionally, I feel that

cancer represents, from an extreme standpoint, the problems we currently face in

American culture due to an erroneous overemphasis on acute healthcare solutions such as

dangerous pharmaceuticals and invasive surgeries (which, I admit, are often necessary),

rather than on more forward thinking, preventive, client-centered, self-healthcare

practices.  This book is an exploration of mind and body coping skills in cancer, of how

embracing holistic practices such as nutrition, exercise, and mind-body modalities like

positive mental imagery, stress-reduction, emotional interventions, faith and spirituality –

6

along with the use of either conventional or non-conventional treatments, can cultivate

greater patient empowerment and attentiveness to self-care.  These practices also help

enhance one’s overall wellness and sense of dignity and integrity in the face of life-

threatening illness.

 1.2 Personal Connections to the Study

There are significant reasons for my interest in mind-body health in the

prevention and treatment of cancer.  I have lost two fathers to cancer:  my natural father

died of oral cancer at age 34 when I was three, and my step-father died of esophageal

cancer at age 54, when I was 31; additionally, my mother is a survivor of breast cancer. 

Moreover, it is likely that just about all Americans are affected by cancer either directly

or indirectly ― cancer is truly a major epidemic of the Western world. Cancer is

in process of, or has taken over heart disease as, our nation's number one killer.  At least

one in three people we know throughout our lifetimes will develop cancer.2 My interest in

holistic treatments is due in part to my own experiences in traditional healthcare: I have

had debilitating health conditions, including numerous experiences with both

conventional and holistic medicine.  From these experiences, I have come to believe that

the soul of our conventional healthcare system ― for example, authentic client-centered

care that elementally connects helpers and clients from a heart level ― if not already

damaged, is in jeopardy of becoming so due mainly to financial influences and to

corporatization, though there are other factors too. Thus, I feel we need a profound

change in our practice of healthcare to one that is far more mind-body-spirit oriented.

  Below, I outline the experiences of prominent cancer educator, naturopathic

doctor and author Verne Varona, which I hope can help vividly illustrate my own

7

experiences with cancer, and my reasons for researching and writing. In his recent book,

Varona poignantly reveals his experiences as a thirteen-year-old boy, watching his

mother dying from cancer. He writes, "his mother, at the age of thirty-five years lay on

her deathbed . . .” and seeing her lying comatose in the hospital. "Her vivacity and

shapely figure . . . had become lean and frail.  She lay quietly still. The bright hazel eyes

which once had gleamed now darkened orbits of torment. The silence of her presence felt

deafening. Thirteen years of memories flooded his mind; she was a gifted dancer, painter

and poet and had struggled through a devastating divorce with a graceful resiliency

sustained by a faith as constant as the sunrise. . . ." 3

  I cite the above to illustrate the devastating physical and emotional effects of

cancer, and of severe conventional cancer treatments. In his book, Varona also writes

about deaths of other family members from cancer, and then explains underlying reasons

for his research, "Helplessly, I watched their weight and appetite decrease as life

gradually slipped away.  Deep beneath the exterior pretense of a tough and hardened

adult, I still carried my boyhood fear of the same fate.  I reasoned that as most of my

family became sick, surely my turn was inevitable.  Repeatedly I asked myself the same

questions: What factors caused them to become sick? What, if anything could prevent me

from becoming sick?  Are we all just victims of some mysterious master plan, or do we

really have some choice in creating healthy, vital lives for ourselves?" 4

 1.3 The Mind, Optimism, and Cancer

My concerns are similar to Varona’s: Do we have clear choices in creating our

own health? Do we have choices about how we are involved in our healthcare

treatments, and about whether we can face serious illness and even death with dignity and

8

freedom from suffering? Like Varona’s mother, my step-father was a physically vital

man at age fifty-four, and within months he lost sixty pounds, his back and body charred

black, like a burn victim, from excessive radiation treatments.  I witnessed his eventual

death from pneumonia because of a compromised immune system from treatments. 

Certainly, I understand that his conventional treatment team did their best to help, but I

have to wonder, like Varona, particularly when I learn about success stories using holistic

treatments: Are there better ways for treating life-threatening illness? Is it possible to

optimize health through preventive practices, and in doing so perhaps live disease-free

lives, and avoid serious health problems like cancer?

An important related question, is why does one person with cancer live and yet

another with a similar diagnosis and treatment die? Dr. Carl Simonton, founder of The

Simonton Cancer Center in Malibu, California, argues that many causes of cancer are

well known, such as exposure to carcinogenic substances in the environment, genetic

predisposition, radiation, and dietary influences, among others. Simonton points out,

however, perhaps the basis of his work, that although all these factors are important and

play real roles in why people contract cancer, it is also true that large numbers of people

with these risk factors nevertheless do not contract cancer.5 Simonton writes: “A great

deal of time, energy, and resource have been poured into the search for the cause of

cancer, but one important fact is often overlooked: When exposed to known cancer

producing substances, most people still remain healthy.” 6 The heart of Simonton’s work

concerns intrinsic factors that have to do with the ways patients respond to major life-

stressors that may have preceded their illness, as well as how they respond to the stress

particularly from life-threatening illness, also their general coping styles, and their overall

9

emotional condition. Simonton believes these factors usually can be changed through

practice, and he has helped patients do so with much success at the Simonton center.7 A

growing body of research shows it is clear that the way we think directly affects our

immune system, which directly fights cancer. The National Cancer Institute states that

immune system functions like natural killer (NK) cell counts and lymphokine-activated

killer (LAK) cell activity destroy cancer cells.8 A mind-body study conducted by Dr.

Barry Bittman of the Mind-Body Institute with researchers from Loma Linda University,

(as well as other similar studies) shows that one’s mental state directly affects the levels

of NK cells and LAK cells in the blood.9

Thus, not only is this book a study of physical health, but also an exploration

of the human mind and spirit. Throughout the study, I hope to better understand the

extremes of illness, and perhaps most importantly, understand the human potential for

triumph over catastrophic illness.  Rather than succumb to demoralization, perhaps

people can learn to explore illness the way Henry Thoreau explored reality, desiring to

"live deeply and suck the marrow out of life," 10 that is, to embrace human existence by

exploring how life-threatening illness helps one not only triumph emotionally, but also

build a more meaningful relationship with oneself, one's loved ones, and one's peers.

Paradoxically, though it may be difficult to conceptualize, experiencing and

understanding illness (and healing) can help one who suffers from cancer create a more

meaningful and empowered existence.

I certainly agree with Simonton that the mind and particularly an optimistic

attitude is one of, if not the, most important keys to fighting cancer.  I think Simonton

would probably agree that attitude and optimism alone do not fight cancer; that optimism

10

put into practice is key.  And, this I believe, in part, is where overall health practices, and

nutritional practices specifically, are of particular importance.

1.4 How This Book is Organized

In the first half of the book, I explore the mind and cancer, including possible

reasons for roadblocks to optimism and their origins, ways to stimulate positive

outlook, and constructive actions toward emotional wellness that can be taken in a cancer

diagnosis.  From the standpoint of both integrative mind and body health, it means

strengthening the body's defenses. From a psychological and emotional perspective, it

means exploring the roots of stress, emotional conflict, and gaining greater self-

awareness. This includes cultivating a positive attitude, improving one’s emotional

resiliency, and becoming open to new ideas for developing self-help skills. Of great

importance also is gaining insights to the tendency to succumb to the demoralization and

fear that often occurs during cancer.

When I refer to cultivating the mind and an optimistic attitude, I am not referring

to a pollyanna mentality.  For example, prominent mind-body researcher Lisa Aspinwall

at the University of Maryland studied cancer patients and found that optimists spent more

time than pessimists studying severe risk, health education materials.  What it likely

means is that optimists do not have their heads in the clouds or in denial, but rather are

concerned, well-organized, and mobilized to take action.  To me, this is exactly the

perspective one needs to be able to modify health practices to fight cancer.11

The second half of the book covers the practice of nutrition and its importance in

preventing and fighting cancer. Nutrition and its relationship to cancer cannot be

overstated. In fact, the American Cancer Society, as cited in Brown and Trivieri, “now

11

states that as many as a third of all cases of cancer in the United States could be avoided

if we as a nation adopted healthier eating habits.” 12

  Sound nutrition strengthens the body’s defenses, specifically immunological

function.  Even though western conventional medicine has created a separation between

mind and body, the two in fact are not separate: in conjunction with a positive mental

attitude, attention to nutrition is a critical for enhancing and building the body's

immunological response. In my view nutrition is, or should be, considered a mind-body

discipline. The reason is that integrating nutrition into one's lifestyle and reaping the

known physiological benefits of good diet are dependent upon an initial change in mental

perspective and corresponding change in health practices. In other words, one needs to

relearn habits and reframe ways of looking at healthcare in order to make crucial changes

to diet and develop new ways of managing stress.

  From my research and experience, I have concluded that holistic approaches to

cancer are useful, important, perhaps even critical.  Cancer is unquestionably a complex

problem with dozens if not hundreds of biological, psychological, social, and spiritual

influences.  At times cancer's onset may seem inexplicable; however, I know from

personal experience that people will continue to be healed with mind-body self-

healthcare practices.  And if this is so, why are not more Americans willing to attempt,

and at least be made more aware of, such practices as nutrition or positive mental

imagery, particularly when their implementation is harmless, and research shows their

extremely beneficial impact on overall health? 13 I will explore this dilemma.

This is an introduction to prevention of cancer, and an introduction to the holistic

support of cancer treatment, nutrition, and mind-body health; an orientation for anyone

12

with cancer, or for one with a loved one with cancer, or for those who would like to learn

more.  Although the topics are targeted at cancer, they are applicable for generally

improving overall health and wellness.  The information is useful for people who would

like to become better educated about what may be one of our most important social

health problems, and about their own health and wellness in general.

Chapter Two: Literature Review

2.1 The Mind and Cancer  

“Cancer is a curious thing.Childless women get it,

And men when they retire.It’s as though they needed an outlet

For that foiled creative fire.”

W.H. Auden

2.1.1 Emotional Stress and Cancer  

In this section, I identify important questions to initiate research and further

exploration into cancer, stress, and the mind; then, provide some underlying theory, and

finally, offer discussion of practical mind-body practices that may be useful in the holistic

support and prevention of cancer.

Important questions, though certainly not exhaustive are first, does stress ― or

perhaps more prosaically, the way one copes with stress ― contribute to cancer

development?  Do particular personality characteristics cause, or contribute to, the

development of cancer?  What is mindfulness, and do mindfulness and self-awareness

play roles in coping with cancer? Additionally, how large a role does the mind play in

cancer prevention? And how large a role do the physical practices and actions, for

example, health habits and health behaviors, play?  The answers are not simple, because

13

an overlap exists, and the mind and thoughts guide one’s actions and behaviors.  

Currently, a growing body of research seems to indicate that the physical aspects

of preventive health, such as nutrition, exercise, and the avoidance of toxic environmental

substances, do contribute to cancer prevention.14 However, we probably know more

about, or are at least currently better able to draw relationships concerning, the physical

aspects of cancer than we know about the psychological or “mind” aspects of cancer.

According to Cassileth, "the fact is that there are no data that show that [using mind-body

interventions, such as meditation and emotion management] has any direct effect on

disease." She adds, however, that there are measurable physiological effects, including

the reduction of heart rate and blood pressure, and relaxation of the musculoskeletal

system.15

  For the purposes of this writing, I take the view – admittedly, a leap of faith – that

being emotionally healthy at least plays a role in fending off or avoiding cancer; and thus,

the converse: that an emotional problem or pathology may contribute to cancer’s

development.  Cancer is an extreme condition, and it would seem to require an extreme

measure of non-wellness to cause it.  This concept has been the driving force of

behavioral health researchers aiming to prove that the mind is influential in cancer.

  I focus on preventive health and promoting the viewpoint that relatively simple

and basic but powerful mind-body skills such as self-awareness, cognitive behavioral

self-dialogue, meditation, breathwork, and optimism are influential in cancer prevention. 

Changing one’s thoughts, and as an effect, also one’s self-care and wellness practices, are

powerful steps, and in some cases may prevent or even reverse cancer.16 In one example,

a study by Ornish revealed preliminary findings that holistic lifestyle changes including

14

emotional support, relaxation, diet, and exercise can prevent, slow, or perhaps even

reverse prostate cancer in some men. 17 18

Overall, the practitioners I discuss believe firmly in holistic practices, or would

not be devoting their lives to promoting and teaching them. My views are similar to

theirs, even though current research may not necessarily substantiate the practices’

overall validity. Mind-body medicine has been practiced for thousands of years, and

1 Simon, D. 1999. Return To Wholeness: Embracing Body, Mind, and Spirit in the Face of Cancer. New

York, NY: John Wiley & Sons. 1999, 35.

2 Quillen, P. 2005 (4th Edition). Beating Cancer With Nutrition: Combining the Best of Science and Nature

For Full Spectrum Healing In The 21st Century. Carlesbad, CA: Nutrition Times Press, 24.

3 Varona, V. 2001. Nature's Cancer Fighting Foods: Prevent and Reverse the Most Commoon Forms of

Cancer Using the Proven Power of Great Food and Easy Recipes. Paramus, NJ: Reward Books, ix-xii.

4 Ibid, xiii.5

? Simonton, O. C. 1988.Getting Well Again. New York, NY: Bantam Books, 36.6

? Ibid, 41.7

? Ibid, 98.

8 “The Immune System: Key Players.” Cancer.org. 14 December 2006. The American Cancer Society. 28 November 2007<http://www.cancer.org/docroot/ETO/content/ETO_1_4X_The_Immune_System-Key_Players.asp?sitearea=ETO>

9 Bittman, B. & Berk, L. & Felten, D.L. & Westengard, J. Jan. 2001. Original Research: Composite Effects

of Group Drumming Music Therapy on Modulation of Neuroendocrine-Immune Parameters in Normal

Subjects Journal of Alternative Therapies in Health and Medicine. Vol 7, Issue 1, 38.

10 Thoreau, H.D. 2004. Walden: A Fully Annotated Edition. New Haven: Yale University Press, 88.

11 Aspinwall, L.G., & Brunhart, S.M. 1996. Distinguishing optimism from denial: beliefs predict attention

to health threats. Personality and Social Psychology Bulletin, Vol 22, 993-1003.

12 Brown, S.E. & Trivieri, L. Jr. 2006. The Acid Alkaline Food Guide: A Quick Reference To Foods & Their

Effect On pH Levels. Garden City Park, NY: Square One Publishers, 1.

15

whole-person care has always been recognized intuitively and empirically. Anecdotal

stories of successes and triumphs over cancer have existed from time immemorial.

Moving toward the future, modern health science will be able to corroborate the

usefulness of mind-body practices. Thus far, though, there is a lack of "meta" holistic

research available.  Large-scale funding is limited in preventive health, unlike

the abundance of pharmaceutical-based research funding available. Even though

integrative healthcare is growing at a dramatic pace, there is still a tremendous amount of

resistance from the conventional system as a whole, from the insurance and

pharmaceuticals industries, to doctors and psychiatrists, as each is threatened by the

growth of holistic medicine.

Northrup, an innovator merging traditional medicine with holistic medicine

(including nutrition, homeopathy, and energy medicine), cited in a recent writing an

example of the medical community’s overall apathetic stance toward holistic research

13 Zablocki, E. June, 2004. Integrative Care Mind-Body Methods Aid Cancer Patients. Townsend Letter

For Doctors and Patients.

14 Gentry, M. 2000. Stopping Cancer Before It Starts: The American Institute For Cancer Research’s

Program For Cancer Prevention. New York: St. Martin’s Press.

15 Wallace, K. “Meditation May Add Support During Cancer Treatment.” CNN.com. 1 October 1999. Cable News Network. 31 December 2007 <http://www.cnn.com/HEALTH/cancer/9910/01/bcam.cancer.meditation.wmd/index.html>  

16 These statements have not been evaluated or substantiated by the American Medical Association or any

other leading governmental health organization.

17 Ornish, D. et al. 2005. Intensive Lifestyle Changes May Affect The Progression of Prostate Cancer.

Journal of Urology, Vol 174, 1065-70.

18 Mercola, J. “Can A Vegetarian Diet Improve Your Prostate Diagnosis?” Mercola.com. 27 August 2005. Dr Mercola. 31Decmeber 2007 <http://www.mercola.com/2005/aug/27/can_a_veggie_diet_improve_your_prostate_cancer_prognosis.htm>

16

and treatment in cancer. Taxol, an expensive drug costing around $5000 per course of

treatment, received much publicity because it lengthened the life of ovarian cancer

patients by several months. Interestingly, according to Northrup, a holistic medicine

study published in the prestigious medical journal Lancet revealed that women going to a

support group lived eighteen months longer than those who did not. However, for

reasons I have mentioned, the study was not given much attention. Northrup concluded

that if holistic cancer support were a drug, it would be unethical not to use it in every

instance of the disease. 19

2.1.2 Is There A Cancer-Prone Personality Type?

Controversy surrounding holistic mind-body approaches to cancer centers on

whether or not particular personality characteristics contribute to cancer’s

development.  The debate goes far back historically, at least as far as the second century

when the Greek physician Galen attributed cancer to a melancholy disposition. Similarly,

in contemporary times, people who support and practice the holistic therapies

concurrently often support the notion of a cancer personality type, believing the

development of cancer is in fact influenced by certain personality traits and

characteristics. However, again, the theory is difficult to prove.  

Temoshok attempted to prove the cancer personality theory in the 1990’s at the

University of California at San Francisco, positing a Type C personality, indicating that a

cancer-prone person suppresses emotions, is often hostile, is a people pleaser, and has

poor self-concept. Temoshok’s research followed along with others attempting similar

work that linked health conditions to various stress-prone personality types. For

19 Neimark, J. 1997 Jan/Feb. On The Front Lines of Alternative Medicine. Psychology Today.

17

example, Friedman and Rosenman's hard-driving hostile Type A personality is correlated

with cardiovascular problems, and its opposite, the Type B personality, alternately, is one

who is relaxed and handles stress well.20  The “helpless-hopeless” type identified by

Seligman is one in which repeated failures become a learned response, which Seligman

called "learned helplessness."  Seligman’s work was expanded to cancer research by

Schmale, and a study by Schmale and Iker of sixty-eight women predisposed to cervical

cancer showed that, based upon either their hopefulness or hopelessness potential, they

could predict which ones would or would not contract cancer. 21 Temoshok and the others

mentioned have developed significant followings; yet, unfortunately, recent findings

show conflicting results making things less clear.

2.1.3 The “Will To Live” and Cancer

The idea of a cancer personality type raises the notion of the influence of an

individual’s "will to live" in cancer.  Most of us recognize intuitively that when people

have a strong will to live they have better chances for survival.  For example it is

common practice in my experience for doctors to say to the loved ones of patients

who are holding on to life, "Oh, he has a tremendous will to live," or the converse, "well,

it was her time, she simply lost her will to live." 

Simonton has found that valuable indications of the will to live are peoples’

health habits, practices, and behaviors in response to their illness. Many of the cancer

patients Simonton studied were given decent prognoses to live a number of additional

good years of life, but Simonton still found, for example, “lung cancer patients who 20 Friedman, M. & Rosenman, R.H. 1974 Type A Behavior and Your Heart. New York: Knopf Publishing.

21Schmale, A.H. 1972. Giving Up as a Final Common Pathway to Changes in Health. Advanced

Psychosomatic Medicine, Vol 8, 20-40. 

18

refused to stop smoking, liver cancer patients who wouldn’t cut down on alcohol, and

others who wouldn’t show up for treatment regularly.” 22 He also found that many cancer

patients that did live a long time against odds would frequently make comments such as

“I can’t die until my son graduates from college,” or “They need me too much at work,”

or “I won’t die until I’ve solved the problem with my daughter.”23 Developed through

years of research and practice, Simonton’s work today includes motivation, education,

mind-body, and psychosocial interventions to encourage patients’ attitudes, and to

improve their health behaviors. He claims his successful research outcomes support his

thesis. 24

2.1.4 Mindfulness and Cancer

An important intervention for preventive, holistic approaches to cancer is the use

of mindfulness. Mindfulness meditation is a way of being present to one’s body,

thoughts, and feelings without judging, criticizing, or rejecting what one discovers.25 At

times mindfulness is practiced as a sitting meditation; at others a daily living meditation,

and form of self-therapy; or, a combination of both. A better description may be that it is

a holistic, integrated way of living. Somewhat humorously, it has also been stated that

mindfulness can perhaps be viewed as the opposite of mindlessness.

Mindfulness meditation expert Kabat-Zinn explains that mindfulness meditation,

in general or in the treatment of cancer, is not a pie-in-the-sky, strange, or exotic

22 Simonton, O. C. 1988.Getting Well Again. New York, NY: Bantam Books, 5.

23 Ibid.

24 Simonton, O. C. 1988.Getting Well Again. New York, NY: Bantam Books, 11-13. 25 Zabat-Zinn, J. 2005. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. New

York: Hyperion.

19

ideology. He believes that mindfulness meditation is about learning to be well regardless

of one’s physical situation. “You can be unbelievably healthy no matter what is wrong

with you,” says Kabat-Zinn. “It’s not like you have cancer and have to be done with that

before you can be well. And one way of being well is through meditation. . . . Meditation

is about knowing what’s on your mind. . . . The real meditation is how you live your life,

not how you sit in a chair. It is about how intimate you are with yourself in the

moment.”26

Though often more broad in scope, the use of mindfulness meditation in cancer

support typically involves four aspects: emotion management, reducing symptoms from

cancer, the reduction of the symptoms associated with the treatments, and pain

management. As Kabat-Zinn describes it, mindfulness is parallel in certain respects

to self-awareness. In the art of preventive cancer care, self-awareness and mindfulness

are significant to help gain better awareness of emotions, and for influencing the mind,

thoughts, and feelings.  Mindfulness meditation increases awareness of inner emotional,

psychological, and sensory experiences, and is similar to taking an inner psychological

and spiritual inventory. It can help one learn to develop a better perspective and more

realistic expectations about one’s daily life. For example, an important sign of a toxic

lifestyle, including the poor health practices (codependent and addictive health behaviors)

that typically spur lifestyle-related health problems, is the inability to maintain realistic

boundaries, limits, and sense of capabilities. 

The following example illustrates the above point concerning the relationship of

26 “Cancer Patients Can Be Well Just As They Are: Jon Kabat-Zinn Shares Mindfulness Meditation At Cancer Center.” Cancerwise.org. March 2005. Cancerwise: Journal of the UTexas MD Anderson Cancer Center. 28 January 2008.<http://www.cancerwise.org/March_2005/display.cfm?id=42F070C2-129A-44E3-8DAE0A1BA923C864&method=displayFull&color=green>

20

mindfulness to overall health. A substantial number of Americans suffer from blood-

sugar and metabolic imbalances, including pre or type II diabetes, which are suggested to

be linked to cancer. A type II diabetic with sugar metabolism problems needs to

moderate sugar consumption. Yet people with this condition unfortunately go

beyond limits due to compulsivity; they typically may deny, either privately or

outwardly, how many carbohydrates are being consumed. 

In another scenario, an overstressed workaholic believes he or she can work

compulsively, perhaps sixty or seventy hours per week or more, though clearly ignoring

good health practices and not paying sufficient attention to other important life priorities. 

Though these individuals likely have good intentions, one aspect of the problem, perhaps,

is they are not mindful enough about the consequences, or unrealistic about how their

actions contribute to their toxic lifestyle. These examples succinctly illustrate possible

lifestyle factors connected to the development of cancer and other chronic illnesses. In

part, the answer has to do with a cultural need for improved health education, and for

greater attentiveness to mindfulness and self-awareness, in general.

In the various phases of cancer, mindfulness meditation can be utilized in unique

ways. For example, in the initial phase of cancer, immediately following diagnosis,

mindfulness and self-awareness can be a useful tool, because learning to calm the mind is

extremely difficult with the emotional upheaval typically occurring during this phase.  As

Byers explains, when first diagnosed, patients' initial reaction is often shock, frequently

causing what Byers describes as “a systemic [emotional] breakdown.” She says there is

an initial shock because cancer and the treatments cause both medical and psychological

trauma.  Byers says the cancer patient’s perspective is, “your body feels like it has

21

betrayed you . . . all these years you have been living and doing all these wonderful

things, and you feel like, now, how could it betray you?” 27 Seng says, "For some people,

finding out they have cancer and [or] going through very difficult cancer treatment can

lead to post-traumatic stress disorder symptoms. . . . Other cancer patients may have had

post-traumatic stress from earlier traumatic events, and aspects of having cancer makes

them experience symptoms again.”28 The use of mindfulness meditation, and expressive

techniques such as writing about the trauma, and other self-awareness techniques, are

shown to be effective for dealing with trauma associated with cancer. 29

2.1.5 Holistic Approaches

In the following sections, 2.1.6 through 2.1.8, I overview the work of successful

mind-body cancer practitioners.  Each involves the practice of mindfulness and self-

awareness in holistic cancer support and prevention, in similar, yet unique ways. 

2.1.6 Kabat-Zinn: Mindfulness Meditation

The Mindfulness Based Stress Reduction program (MBSR) ― emanating from

ancient eastern Buddhist traditions and developed by Jon Kabat-Zinn, Professor of

Medicine Emeritus at the University of Massachusetts Medical School ― originated in

the U. S. at the University’s medical center in Worcester, where it is currently

practiced.30  Kabat-Zinn also spearheads research on mindfulness at the center, in

conjunction with the MBSR program. Currently, MBSR is offered in over 200 U. S. 27 Byers, J. Personal interview. 18 December 2007.

28 “Post Traumatic Stress Disorder Seen in Some Cancer Patients: Nurses Can Step In to Help Ease Symptoms” Cancer.org. July 2002. The American Cancer Society. 11 March 2008 <http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Post-Traumatic_Stress_Disorder_Seen_in_Some_Cancer_Patients.asp> 29 Pennebaker, J.W. 1990. Opening Up: The Healing Power of Confiding in Others. New York: William

Morrow Co.

22

hospitals, and is the focus of a number of research studies at the National Center for

Complementary and Alternative Medicine (NCCAM).

Through MBSR, Kabat-Zinn has put forth an exceptional effort to spread the

ancient East’s message to the modern West of mindfulness and its connections to

physical health and life-threatening illnesses including cancer. Kabat-Zinn’s work blends

science, health, and spirit.  Rooted in Eastern health and spiritual practices, Kabat-Zinn’s

use of mindfulness meditation fundamentally involves directing one’s attention to the

here and now.

I am fascinated to learn that the purposes of modern psychotherapeutic

interventions in part have similar aims to those of mindfulness; it is inspiring and

enlightening to find that the standard goals of modern psychotherapy have correlations

with Kabat-Zinn’s wisdom, which comes from the ancient study of meditation and

healing.31 Two examples, Gestalt Therapy, a form of therapy developed by Fritz Perls,

and Dialectical Behavior Therapy (DBT), a cognitive therapy developed by Marsha

Linehan, are Western psychotherapeutic practices extensively implementing the use of

mindfulness.32 33  However, these are merely two among others.  In fact, the preeminent

psychological theorists of the twentieth century particularly theorists of humanistic

psychology ― for example, Carl Jung, Abraham Maslow, Carl Rodgers, and Alfred

30 Zabat-Zinn, J. 2005. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. New

York: Hyperion.

31 Germer, C.K. & Siegel, R.D. & Fulton, P.R. 2005. Mindfulness and Psychotherapy. New York: The

Guilford Press.

32 Zhang, Y. 2004. Zen and Psychotherapy. UK: Trafford.

33 Germer, C.K. & Siegel, R.D. & Fulton, P.R. 2005. Mindfulness and Psychotherapy. New York: The Guilford Press.

23

Adler ― are influenced deeply by mindfulness and Eastern thought, of learning to focus

on the present.34 The practice of mindfulness and awareness take numerous forms,

including: attentiveness to thoughts in meditation; to a higher power in prayer; to

feelings, emotions, desires, in self-awareness and self-analysis; to other's actions

and feelings during acts of interpersonal communication; to one’s own actions; and,

attentiveness to self-care.  But, to simplify, the essence is what Kabat-Zinn teaches as

learning a fundamental change of how to "be" rather than "do" as a way of centering the

mind. Also, at times, learning how to be while doing, because one must take action in

daily life – for example, create, connect, work, and construct. 

Cancer patients come to Kabat-Zinn’s MBSR Program along with others suffering

from severe conditions like heart disease, arthritis, diabetes, kidney disease, or chronic

pain. During daily MBSR sessions, patients are taught to use meditation to cope with the

psychological and physical effects of stress. They learn how to become mindful of their

emotional states, primarily the emotions fear and anger which, in excess, are particularly

destructive to health. During the program, through the daily practice of hours of

meditation, patients begin to shift their awareness away from lingering negative,

destructive mental patterns to a more relaxed state of being. Kabat-Zinn says that

although meditation is sometimes difficult to put into words because the mind is so vast

and can seem “mysterious and vague,” the practice of meditation really is quite simple. 35

In MBSR three basic types of meditation are implemented: sitting meditation, either in a

straight-backed chair or on the floor; a body scan meditation lying on a mat on the floor;

34 Kabat-Zinn, J. 2005. Wherever You Go, There You Are: Mindfulness Meditation In Everyday Life. .New York: Hyperion.

35 Olson, R.P. 2002. Religious Theories of Personality and Psychotherapy: East Meets West. Binghampton, NY: Haworth Press.

24

and standard hatha yoga postures, similar to those found at any neighborhood yoga class.

Group discussion and one-on-one counseling are also integral to the program.

MBSR patients find that mindfulness and self-awareness are about learning to live

life, whether sitting in mindfulness meditation, or performing one’s normal daily

activities, from an internalized perspective with intention rather than being motivated

mainly by external cues, desires, needs, and wants. It is the imbalanced over-focus on

externalization that creates a hyper-stressed physiology. MBSR is founded upon the

concept that encouraging internalization, reflection, and self-awareness promotes greater

relaxation, and mental and physical wellness. Csikszentmihalyi in part sums up the

mental and psychological aspects of this more internalized lifestyle:

There are two main strategies we can adopt to improve the quality of life. The

first is to try making external conditions match our goals. The second is to change

how we experience external conditions to make them fit our goals better. . . . The

solution is to gradually become free of societal rewards and learn how to

substitute for them rewards that are under one's own powers. This is not to say

that we should abandon every goal endorsed by society; rather, it means that, in

addition to or instead of the goals others use to bribe us with, we develop a set of

our own. 36

2.1.7 Simonton: A Holistic, Psychosocial Approach

Simonton implements a holistic cancer program incorporating lifestyle

management, emotional support, and a specific form of meditation and imagery for

cancer patients, which, according to his own research, is quite successful.  Simonton 36 Csikszentmihalyi, M. 1990. Flow: The Psychology of Optimal Experience. New York: Harper Perennial.

43,19.

25

outlines and discusses this research and practice in Getting Well Again.37 In

Simonton's practice, the cancer patient in meditation envisions his or her cancer cells, and

next imagines pac-men gobbling them up.  Simonton believes that part of the strength of

his techniques stems from the concept of empowerment (a foundational tenet of each of

the practitioners mentioned in this book).  When a patient feels empowered, beautiful

things can occur at every human level: physical, emotional, and spiritual.  When a cancer

patient begins to find hope, energy, vitality, and self-confidence blossom, and the

immune system becomes mobilized for action, halting cancer cell proliferation.

It seems a testament to the success of Simonton’s work that he is one of the

biggest influences upon the use of imagery and holistic, psychosocial treatment in cancer.

His work has spurred the use of imagery, and its study, in many major cancer centers and

universities across the U. S., and a review of forty-six studies conducted from 1966 to

1998 by the American Cancer Society found that guided imagery was highly effective in

managing stress, anxiety, depression, pain, and the side effects of chemotherapy.

There have been few studies evaluating programs such as Simonton’s, or the use

of holistic and psychosocial interventions in cancer. According to a report issued by the

United States Congress Office of Technology Assessment (OTA), with an advisory panel

including notables such as Andrew Weil, C. Norman Shealy, and Jeanne Achterberg 38,

among others, three studies have been performed to assess survival rates using imagery

and psychosocial interventions. One study was done on Siegel’s ECaP program, a

37 Simonton, O. C. 1988. Getting Well Again. New York, NY: Bantam Books.

26

program influenced by Simonton’s.39 According to the report, “the study found a small,

but not statistically significant increase in survival time among ECaP participants

compared to nonparticipants.” 40

Another study was done on Spiegel’s psychosocial cancer program at Stanford

University, using psychotherapy, group support, and self-hypnosis for women with breast

cancer.41 According to the OTA report,

There was a significant difference in survival time between the two groups:

women who underwent psychotherapy lived an average of 36.6 months after

randomization to the intervention, while women in the control group lived an

average of 18.9 months following randomization. . . . Spiegel and his colleagues

also found that psychotherapy significantly reduced anxiety, depression, and pain

among participants. The investigators suggested that involvement in the support

group may have allowed patients to better mobilize their resources, to improve

compliance with conventional treatment, or to improve their appetite and diet

through reduced depression. They also suggested that patients who learned self-

hypnosis for pain control may have been better able to remain physically active. 42

38 Dr. Andrew Weil is founder of the Program in Integrative Medicine of the College of Medicine,University of Arizona and a foremost authority on holistic health. Dr. C. Norman Shealy is a worldwide expert in pain management and holistic medicine. Dr. Jeanne Achterberg is an internationally recognized scientist and expert in the field of mind-body medicine, holistic cancer research and treatment.

39 The ECaP program is the renowned Exceptional Cancer Patient program that treats cancer patients using holistic mind-body treatments. The program was developed by Dr. Bernie Siegel and Dr. Barry Bittman in 1978 and affiliated with Yale University.40

? Stevens, R. “Unconventional Cancer Treatments” Princeton.edu. September, 1990. Report issued by the Office of Technology Assessment, United States Congress. 25 March 2008 < http://www.princeton.edu/~ota/disk2/1990/9044.html> 41 Spiegel, D. & Bloom, J. & Kraemer, H.C. et.al. 1989. Effect of Psychosocial Treatment on Survival of Patients With Breast Cancer. Lancet Vol 2, 8668, 888-891.

27

2.1.8 Benson: The Relaxation Response

Benson is well known for promoting a technique called “the relaxation response,”

a phrase he coined in the 1970's. The relaxation response is mantra meditation, or the

repetition of a word, phrase, or thought, to encourage a deep, mind-body-spirit healing

state of relaxation.  Benson acknowledges that repetition is not the only way to elicit

physiological benefits of the relaxation response.  Benson says, "The relaxation response

can be elicited by a number of meditative techniques, such as diaphragmatic breathing,

repetitive prayer, qi gong, yoga, progressive muscle relaxation, jogging—even

knitting."43 Benson claims that mind-body medicine, which consists of stress-

management, diet, and exercise, is the third leg holding up the other two legs of a three-

legged stool of healthcare.  The other two legs are surgery and medicine, the more

conventional, acute forms of care. The relaxation response is holistically integrated with

psychosocial interventions for cancer patients at the Benson-Henry Institute at the

Massachusetts General Hospital.

2.2 Nutrition and Cancer

"Let food be thy medicine and medicine be thy food”Hippocrates

As mentioned in the introduction, one of the most important goals of this book is

to help cancer patients and all seekers of wellness learn to develop a foundation of health.

This foundation will optimize the chances for preventing cancer, or perhaps slow or

reverse it.  I follow Quillen’s suggestion, urging those dealing with cancer to “focus on

42 Ibid.

43 Benson, H. May/June 2001. Mind-Body Pioneer: The Connection Between Your Mind and Body

is Stronger Than You Think. Psychology Today.

28

the parts of [the] body that are working properly, not on the cancer.” 44 The scientific

links between physiological health and diet are becoming clearer as we continue to

develop scientific research in the relatively new area of human nutrition. 

One of the most important threads for health-building is learning ways to enhance

immunity. In my view, proper diet and nutrition, though only one aspect of a

comprehensive approach, is perhaps the most direct one because we must eat regularly

for survival, in normal circumstances three to six times per day; thus, the importance of

food choices cannot be overstated. I do not think it is a stretch to say that in certain

respects, nutrition is black and white ― meaning that just about every food we put into

our body affects us in either an enhancing or depleting way.  

Research shows links between immunity and cancer, as well as links between

immunity and diet. Yet it is somewhat more difficult to show a direct relationship

between cancer and diet, though we see evidence from existing studies, and scores of

additional ones in progress.  It is generally accepted that various components of the

immune system such as T Cells, and NK cells, cytokines, prostaglandins, good

eicosanoids, and other physiological sub-structures are involved in the elimination of

malignant cell proliferation; and we do know that specific aspects of nutrition influence

these components of the immune system (explored below). It has become widely

accepted that a strong immune response offers better chances to ward off cancer, and

nutrition improves this factor. According to Quillen, the average person has cancer six

times in the body within a lifespan, but roughly sixty percent of the time it is warded off

by a healthy immunological response. Quillen explains that a number of nutritional 44 Quillen, P. 2005 (4th Edition). Beating Cancer With Nutrition: Combining the Best of Science and Nature

For Full Spectrum Healing In The 21st Century. Carlesbad, CA: Nutrition Times Press, 7.

29

supplements are known to bolster immunity including colostrum, whey extracts, aloe

extracts, Essiac tea, and others.45

  The conventional approach, treatment, and overall philosophy for cancer

originates in part from Pasteur, one of the forerunners of conventional medicine in the

early twentieth century. 46 Pasteur concluded that many of the diseases we experience are

caused by exogenous pathogens.  In other words, Pasteur put forth that, "the state of

health or disease was not a measure of the integrity of the immune system, but rather of

the strength of the invading microbe." 47  Pasteur developed the "germ theory" of

medicine, which according to Seaward is now the leveraging idea for modern medicine's

use of antibiotics, immunizations, and use of pharmaceuticals in general to treat disease.

48 Pasteur influenced the development and use of vaccines. Today a number of top

pharmaceutical companies are using vaccines for cancer treatments, including drug

vaccinations as treatments for cervical cancer, and melanoma, among others. Major

pharmaceutical corporations are now implementing cancer vaccination programs,

including a leading one of Pasteur’s name: The Sanofi-Pasteur Corp.

According to Seaward, in the early 1900s Pasteur was challenged by the French

scientist and philosopher, Claude Bernard. Bernard argued it was not, as Pasteur

believed, the strength of invading microbes that determined disease, though that was

certainly a factor. Perhaps more importantly, the strength of an individual's interior

45 Ibid, 10.

46 Tiner, J.H. & Denman, M.L. 1999. Louis Pasteur: Founder of Modern Medicine. MI: Mott Media.

47 Seaward, B.L. 2004. Managing Stress: Principles and Strategies For Health and Well-Being. Sudbury,

Massachusetts: Jones and Bartlett Publishing, 45.

48 Ibid, 45.

30

milieu, or, internal system, determines whether or not one can fend off invading

pathogens, and ultimately fend off diseases such as cancer. Bernard’s views represent

those of holistic, integrative, and alternative medicine, and those promoted in this book.

2.2.1 Overview of Cancer and Physiology

Following, I provide a brief overview of what cancer is, and how cancer develops

at the cellular level. Cancer, in fact, is not one, but a group of over 100 conditions. In

various forms, cancer is defined, basically, as uncontrolled cellular growth.  When human

cells divide and grow they form tumors, though some tumors are benign and do not cause

major threats to health. However, dangerous tumors which grow unchecked are

considered to be malignant.  Malignant tumors are dangerous because they attack and

injure healthy cells, tissues, and organs; and when they spread from their initial tumor

site, they are metastatic.  The body has internal mechanisms to control rapid cell division

and growth; however, for various reasons, if metastasis is uncontrolled, it will invariably

lead to serious disease and death. 

  Though there are many types of cancers, all cancers generally fit into one of the

four following main categories:

Carcinomas – cancers of the soft tissues, organs, and the tissues that surround the organs

Sarcomas – cancers of the hard tissue such as bone, also cartilage, muscle, and fat

Leukemias – cancers of the blood

Lymphomas – cancers of the lymphatic system, over twenty different forms of lymphoma

exist 49

 2.2.2 What Causes Cancer?49 “Types of Cancer” MDAnderson.org. The MD Anderson Cancer Center. 20 February 2008.<http://www.mdanderson.org/patients_public/about_cancer/display.cfm?id=411A240D-77B9-11D4-AEC300508BDCCE3A&method=displayFull>

31

Most theories about the origin of cancer point to its being either a genetic

mutation or a virus ― correlating with Pasteur’s theories.  However, it is now recognized

that the cancer process is also advanced by “genetic, immune, behavioral, and/or

psychosocial factors.” 50 By psychosocial, this likely includes environmental and

preventive factors, including nutritional. 51  It is recognized that only a small number of

the known forms of human cancers are caused by viruses.  Most forms of cancer are

caused by genetic mutations.  Codes in the genes of cellular DNA of individual cells

provide instruction for healthy cells to grow and divide at just the right times for positive

physiological advancement, tissue repair, and development ― or, wellness.  To me, an

important question is: Are these genetic mutations inherent, or are they affected by

external cues such as diet, environmental, and psychological factors? I wonder, if cancer

is typically caused by genetic mutations, does it also mean that genes are necessarily pre-

programmed, or unalterable? Interestingly, many researchers believe that genes, in fact,

are also alterable by lifestyle behaviors.

Perhaps more importantly, however, it is commonly accepted among preventive

health researchers and practitioners that people typically do not need to change their

genes, but instead need to optimize the expression of those genes. The field of

nutrigenomics is devoted to this study and practice of understanding genetic patterns, and

creating nutritional solutions to optimize genes’ expression.52

The breakdown of wellness in cancer occurs for various reasons, some which are

50 Straub, R. O. 2002. Health Psychology. New York, NY: Worth Publishers, 419.

51 Ibid.

52 Kaput, J. (edit.) 2006. Nutritional Genomics: Discovering the Path to Personalized Nutrition. Hoboken,

NJ: Wiley Science Publishing.

32

known and some not. It is recognized that damaged DNA provides incorrect instructions

for cellular division and excessive growth, resulting in the development of tumors.  The

normal system of checks and balances at the cellular level are the oncogenes, giving

instructions for cell growth, and suppressor genes, which give instructions to halt cell

growth.  Both of these genes usually work effectively for maintaining

homeostasis; however, in cancer, suppressor genes are faulty.  When they become faulty

and cancer develops, the next line of defense is the immune system.  As mentioned, it is

known that cancerous cells frequently exist in the body but in a healthy individual the

healthy immune system is able to control them.  As mentioned, NK cells are one of the

body's main fighters in this internal battle.  Others include T Cells, and cytokines

(chemical messengers). The overall conceptualization of the seek and destroy system is

called immune surveillance theory. 53, 54

 2.2.3 Nutrition, Immunity, and Balanced Health Systems

Next, I look at important considerations for improving the immune system

through nutrition, and through the use of balanced health systems. Human physiology is

complex, and thus an extensive list of nutritional suggestions exist to improve immunity.

Seaward outlines many of them.55 I do not provide his complete list here, but among the

most important are: consuming a good supply of antioxidants including beta-carotene,

vitamins C and E, and selenium; getting a sufficient supply of fiber for colon health and

suppression of appetite; drinking plenty of clean water for cellular and tissue hydration;

53 Ibid, 422.

54 Stuhler, G. & Walden, P. 2002. Cancer Immune Therapy: Current and Future Strategies. Wiley

Publishing, 96.

55 Seaward, B.L. 2004. Managing Stress: Principles and Strategies For Health and Well-Being. Sudbury, MA: Jones and Bartlett Publishing, 479.

33

decreasing ingestion of pesticides, fungicides, herbicides, and fertilizers from foods or

other sources; consuming an adequate supply of complete proteins for cell, hormone, and

tissue building; eliminating, if not entirely, as much as possible the consumption of junk

and highly processed foods, and eating foods in their natural forms; decreasing the

consumption of antibiotics and hormones; consuming substantial amounts Omega-3 fish

oils which are recognized to decrease cellular inflammation (which, along with

inflammation’s role in cancer, will be discussed in more detail below); decreasing the

intake of saturated fats; decreasing trans fatty acids; being sure to vary the color of

produce, eating sufficient yellow, green, and orange vegetables and fruits, or, mixed

carotenoids which are known to possess different functions. 56

Without question, an important concept concerning nutrition and cancer is the

paradigm of balance. Balance may seem simple in definition, though is hardly so in

conceptualization and practice. The roots of the study of balance and health emanate from

ancient cultures, for example, the ancient Greeks had a deep respect for the need for

balance and harmony with natural laws, a primary consideration being food and herbs

and their effects on health. Hippocrates, the father of medicine, initiated a field of

medicine called humorism. Humoristic medicine is the theory that health depends upon

balance among the four humors: blood, black bile, yellow bile, and phlegm.  Today,

Hippocrates’s humor theory is recognized as incorrect. Nonetheless, his idea of balanced

health systems is still respected, particularly in integrative medicine. 

Around the same time, in the Eastern part of the world, Traditional Chinese

Medicine (TCM) sprang from the concept of balance. TCM was founded upon an

56

? Ibid.

34

elemental conceptualization of balance the Chinese called Yin and Yang.  Yang

symbolizes active, expansive forces of nature, and Yin symbolizes the passive, and

contractive. 57 However, in TCM nothing is either totally Yin or Yang, as they are

relative, interdependent, and dynamic.  Today, TCM is thousand of years old, is still

thriving and in wide use.

Though not necessarily highly valued by modern, conventional practitioners, it is

quite clear that the body works in the amazing synergistic balance, or, homeostasis,

which was supremely valued by the ancient Greeks and Chinese. These ancients

recognized intuitively that the body possessed its own wisdom for healing.  

Many internal systems (and perhaps an argument can be made that most physiological

systems) are based upon a delicate homeostasis, which the ancients knew was effected

by food and nutrition.

Through modern science, we have come to realize that one particular system is

extremely important: the balance between glucose (sugar) and insulin in the blood.

Blood sugar is the cells’ primary source of fuel for creating ATP which powers every cell

of the body. The development of ATP occurs in the mitochondria, the powerhouse of the

cell. Blood sugar must constantly be maintained within a certain range ―- normal

fasting levels are approximately 70 mg/dl to 100 mg/dl ― for maintaining proper energy

levels, and for human survival. The body has its own built-in mechanism for this: the

pancreas releases the hormone insulin for the purpose of maintaining even blood-sugar,

and to shuttle glucose into the cells. Imbalances in the glucose-insulin system are

thought to play a role in inflammation, and cancer.  Below I explore how maintaining 57 Pitchford, P. 2002. Healing With Whole Foods: Asian Traditions and Modern Nutrition Berkeley, CA:

North Atlantic Books, 49.

35

balance in the diet can help maintain glucose-insulin homeostasis, and strengthen one’s

resistance to cancer.

2.2.4 Inflammation and Cancer

Generally, it is important to study underlying, fundamental systems in order to

find solutions to problems; health is no exception.  One of these receiving much attention

recently is the concept of inflammation and its relationship to disease; also,

inflammation’s connections to diet and obesity. Inflammation and obesity’s connection

to lifestyle related conditions including cancer, heart disease, diabetes, arthritis, among

others, are well-documented.  According to Sears, when specific bodily systems are out

of balance (such as the glucose-insulin system), cellular inflammation is a result and

lifestyle-related health conditions including cancer, diabetes, hypertension, arthritis,

among others, are the long-term result.58

Sears has devoted his life to researching inflammation, and created a system for

treating cellular inflammation with food and nutrition, urging that food’s effect upon the

body and the cells is as powerful as drugs.  His nutritional system, "The Zone Diet", is

about reducing “silent inflammation” through blood sugar stabilization created by

balanced nutrition.  Silent inflammation is exactly the same as we typically know

inflammation ― as in pain, swelling, or rheumatoid arthritis ― but less severe, though

perhaps more dangerous because it is below the threshold of detection, at a cellular level.

Silent inflammation can remain undetected for many years until it eventually causes the

lifestyle conditions mentioned, including cancer.

Nutritional prescriptions are superior to the current medical approaches to cancer

58 Sears, B. 2005. The Anti-Inflammation Zone: Reversing the Silent Epidemic That’s Destroying Our Health. New York: Harper Collins.

36

because these methods target the problem before it appears. Sears states: "After spending

some 30 billion on the war against cancer, our government hasn't made any headway into

finding a reliable cure for the disease or a surefire way to prevent it.  With all the

hype, the primary treatments for cancer still remain the big three:  burn, cut, or poison. 

Although these rather barbaric approaches can potentially extend a patient's life span,

they're not an ideal prescription for a good quality of life." 59 Whereas other dietary

programs such as Atkins, Pritikin, or South Beach are extreme as they espouse low-

carbohydrate, high carbohydrate, low-fat, or another extreme, which is what the

American public seems to want, The Zone Diet seems boring because it is formulated

upon the concept of "moderation." It is neither too low carbohydrate, nor too high

carbohydrate; neither too low fat, nor too high fat, and so on. Dietary balance and

moderation reduce silent inflammation primarily by controlling the hormone insulin.

Moderation is the key to balancing insulin, as well as to balancing critical related

hormone and biochemical systems including the hypothalamus, pituitary, adrenal system

(the HPA axis); also, cortisol, epinephrine, norepeniphrine, adrenalin, and noradrenalin;

and, the key fat-storage hormones, leptin and ghrelin.

Sears outlines aspects of the immunological system that are part of the

inflammation response and that bring into play specific hormone interactions.60

According to Sears, when foreign invaders attack the body, the body calls into action five

different groups: 1. chemical mediators (including histamine, bradykinin, and serotonin),

2. complement systems (which is very complex, made up of twenty proteins),

59 Ibid, 261.

60 Ibid, 228.

37

3. eicosanoids (bad ones include prostaglandins, and leukotrienes), 4. cytokines, and

5. immunological attack cells (including macrophages and neutrophils). These are

activated by pro-inflammatory cytokines, and the release of cytokines is stimulated by

pro-inflammatory eicosanoids.61 This immunological and inflammatory response is a

chain reaction which begins at stage one (above), and progresses through stage five. It is

the balancing of these anti-inflammatory hormones (including good eicosanoids,

prostaglandins, and cytokines) with pro-inflammatory ones (bad eicosanoids) that

ultimately maintains homeostasis and wellness. Eicosanoids, prostaglandins, and

cytokines can be either pro or anti-inflammatory depending upon the type.

  Though a complex system, one simple example of a common chemical mediator

that people are familiar with is histamine.  Histamine is inflammatory because in the

presence of foreign attackers (allergens) its job is to dilate blood vessels.   Functions of

histamine are to call other components of the immune system into play to get to the injury

site and other quick response defensive measures such as effect the lung passages, and

release of fluids from the nose. 62

Inflammation and silent-inflammation are actually different. However, their

difference is primarily only in intensity.  Inflammation, symbolized by 4 classic signs:

redness, swelling, heat, pain, and silent-inflammation are caused by exactly the same

mechanisms, it's just that silent-inflammation is below the threshold of pain, which is

why it is so dangerous.  Sears created a test marker, which he named the silent

information profile, or SIP, that he believes is the best way to quantify this silent

inflammation. The SIP is the ratio of AA/EPA, or, the ratio of dangerous, inflammatory 61 Ibid, 228.

62 Ibid, 228.

38

arachadonic acid, AA, to the health promoting anti-inflammatory fatty acid eicosapentoic

acid, EPA. 63 Both arachadonic acid and eicosapentoic acid are clearly controlled by our

food choices: fish oils rich in omega 3 fatty acids are shown to increase EPA levels, and

diets heavy in animal fats, particularly from grain-fed cattle, increase levels of AA.

In the field of nutrition, Sears has perhaps done the most to research and promote

the concept of cellular inflammation and its relationship to disease as well as its

causation: diet and lifestyle. His work started in the 1980s and set off a firestorm of

interest and activity. However, before that, one significant event to spark this wave was

the discovery of aspirin as a powerful non-steroidal anti-inflammatory

(NSAID).  Researcher John Vane won the Nobel Prize for this work on aspirin and

inflammation in 1971. 64

  It has become common practice for physicians to suggest aspirin as an over the

counter remedy for preventing heart attacks, as arterial and vascular inflammation are

clearly understood as significant in coronary heart disease.  Aspirin is shown to reduce

risk factors for heart attacks, which is the reason it is referred to as the "miracle drug."

However, less well known are its dangerous side effects such as excessive blood

thinning, hemorrhaging in the brain, tinnitus, and more. 65

What we have learned from studying aspirin is that a serious underlying

condition of low-grade inflammation is occurring. Unfortunately, rather than treat the

source of the problem, modern healthcare practitioners typically treat the symptom by

63 Ibid, 227-8.

64 Jeffreys, D. 2004. Aspirin: The Remarkable Story of a Wonder Drug. New York, NY: Bloomsbury, 233.

65 “Cerebral Vascular Disease.” Lef.org. June, 2004. The Life Extension Foundation. 24 March 2008 <http://www.lef.org/protocols/prtcl-031.shtml>

39

using aspirin, steroids, or other anti-inflammatory drugs. They do so rather than

attempting to understand what the ancient Chinese knew intuitively thousands of years

ago: that lifestyle creates what is described in TCM as "Yang excess," or an inflammatory

condition.66

  The underlying problem of low-grade or silent inflammation, which is very much

a condition of the developed world, emanates from our toxic lifestyle.   Consider the

following statistics:

• 70 million Americans suffer from arthritis, twice as many as did in the 1980's

• 50 million Americans suffer from allergies, doubling since the 1980's

• 64 million Americans have cardiovascular disease

• An estimated 15 million Americans have eczema

• 1 million Americans have inflammatory bowel disease 67

  When a health topic appears on the cover of Time Magazine, it is usually a big-

time ordeal.  A recent article titled "The Secret Killer: The Surprising Link Between

Inflammation and Heart Attacks, Cancer, Alzheimer's and other Diseases" graced the

cover, stating that, "suddenly inflammation has become one of the hottest areas of

medical research." The article indicates that a test called the C reactive protein (CRP) is

a common procedure in primary care medicine today, and a marker of inflammation; the

article explains that, "CRP is a molecule produced by the liver in response to an

inflammatory signal." 68

66 Mincolla, M. 1995. The Tao of Ch’i: Healing With The Unseen Life Force. Pennyroyal Press, 134.

67 Chilton, F.H. 2006. Inflammation Nation: The First Clinically Proven Eating Plan to End Our Nation’s

Secret Epidemic. New York, NY: Fireside Publishing, 3-4.

40

  Most of the major pharmaceutical companies, including Pfizer, for example, are

launching research and development efforts to target inflammation.  Tepper, president of

research and development at Millennium Pharmaceuticals in Cambridge, MA reveals

that, "virtually our entire research and development effort is now focused on

inflammation and cancer." 69

  A special report published by the American Medical Association showed links

between chronic inflammation and breast cancer, stating, "Inflammation induced by

infections or irritants has been linked to a substantial proportion (one sixth to one third)

of incident cancers worldwide” and further, “Compelling evidence for a link between

inflammation and breast cancer comes from preclinical and epidemiologic observations

suggesting that non-steroidal anti-inflammatory (NSAIDS) protect against the

development of breast cancer" 70

  However, in my view conventional healthcare erroneously treats the symptom

rather than the problem.  To illustrate, if one mistakenly dumps acid on the floor of a boat

and it eats away the floorboards, causing the boat to fill up with water, though it may

work temporarily, the long-term answer is not endlessly running from one hole to the

other trying to seal them.  Rather, one would first remove the cause of the holes (the

acid), ensure it does not happen again (by sealing the container from which it

spilled), and then patching up the holes.  By using pharmaceuticals in inflammation and

68 Gorman, C. & Park, A. February 23, 2004. “The Secret Killer: The Surprising Link Between

Inflammation and Heart Attacks, Cancer, Alzheimer’s, and Other Diseases.” Time Magazine.

69 Ibid.

70 Ness, R.B. & Cauley, J.A. February 18, 2004. Antibiotics and Cancer: What’s The Meaning of This?

Journal of the American Medical Association. Vol. 291, 7, 880-881.

41

cancer, we are patching the holes but not removing the acid so to speak, the dietary or

environmental causes of inflammation.  To help manage this problem at its root, blending

the modern science of inflammatory markers and the wisdom of Eastern practices,

nutritionist Monica Reinagel has created a system, an inflammatory foods database that

rates the levels of inflammation in common foods. 71 72

Chapter Three: Conclusions and Future Considerations

In closing, my belief in integrative, holistic interventions is only enhanced by

doing research on cancer.  Yet simultaneously, perhaps ironically, I have also developed

a deeper respect for the importance of conventional medicine.  The reason is I can now

see clearly the enormous challenges that exist for someone diagnosed with cancer; in

many instances, a cancer patient would have no option but to use acute conventional

measures in order to survive. Interestingly, it is also why I have become more steadfast to

learn about and promote preventive health: as I now realize the devastating repercussions

of cancer and harsh treatments, I have a greater sense of purpose to help individuals

avoid getting into the situation of cancer to begin with.

  I am in support of preventive, holistic interventions, again, emphasizing the

following important point: whether or not one chooses to use severe conventional cancer

treatments designed to, as Sears says, "burn, cut, or poison," 73 proper care for health, and

whole-person care is critical in order to build a foundation of health. I think common

71 Reinagel, M. 2006. The Inflammation Free Diet Plan: The Scientific Way to Lose Weight, Banish Pain,

Prevent Disease, and Slow Aging. New York, NY: McGraw-Hill.

72 The anti-inflammatory foods database can be viewed in Reinagel’s book (see previous citation), or at the website, www.nutritiondata.com.

73 Sears, B. 2005. The Anti-Inflammation Zone: Reversing the Silent Epidemic That’s Destroying Our Health. New York, NY: Harper-Collins, 261.

42

sense says that a cancer patient needs to cultivate such a foundation of health in order to

fight cancer and improve chances for survival no matter which type of cancer he or she

faces.  Fortunately, it seems that science is moving in a positive direction to substantiate

this. Nonetheless, basic intelligence additionally says it is true. 

Regardless of any deterring political or financial influences, the healthcare

establishment is moving in the direction of whole person care. LaTour says, “It’s

amazing how far the cancer community has come in accepting that cancer is a

multidimensional disease and a journey with dual paths—one purely medical, the other

addressing the more obtuse parts of our lives (our souls, hearts, spirits, and minds)—and

that these two aspects of our humanness may interact in ways that we are only beginning

to understand” 74 Similarly, Finestone states that the common mantra for holistic cancer

care, and ideally, for all care is to “treat the patient, not the disease” 75

To encapsulate the main theme here, four important tenets are crucial in holistic

cancer care, or any care. They are, according to Berman, first that the relationship

between the patient and caregiver is paramount, including positive communication,

listening, attention, and intention.  Second, that the healing process is based upon, as

Finestone stated above, "whole-person" treatment, meaning that client's mind, body, and

spirit are all acknowledged aspects of the therapeutic process; and among the most

important dimensions of this, according to Berman, are a person's moods, attitudes,

beliefs, culture, environment, and spiritual beliefs, integral components of health

psychology.  Thirdly, integrative, holistic care is a blending of many healthcare

74 LaTour, K. 2003. The Other Side of Healing: Healing Means Integrating Issues of The Heart And Soul

Into The Cancer Experience. Cure Magazine. Fall Issue.

75 Ibid.

43

modalities; and a practitioner must constantly remain aware of a "bigger picture" of care,

and be prepared to work interdependently with allied practitioners.  Finally, holistic care

places self-healthcare in very high regard; that is, the need for client empowerment and

the teaching of a preventive lifestyle, including diet and healthy behaviors. 76

  Regardless of whether I have been able to convey a compelling argument in this

book, I am nonetheless convinced that the mode of healthcare espoused by Berman

above, if adamantly adhered to, will offer a cancer patient greater chances to beat cancer

than if ignored. This is true, I believe, with the implementation of either conventional or

alternative treatments.  I am convinced that the interviewed case studies, as supplement to

this book, are strong pieces of evidence of the strength of this process. 77  

Certainly, at least part of the reasons why the interviewees have survived, even

thrived, in their plight with cancer is because of their devotion to wellness and healing,

including their ability to remain flexible in the face of adversity, a willingness to change

problematic health behaviors, and, eagerness to engage whole-heartedly in the client-

helper relationship.  This last point is significant. Simple, time-tested, wisdom tells us,

and intuitively we know that, "no man is an island" 78; in the Book of Psalms, it says that

God, "guides the humble in what is right." 79 Unquestionably, each of the interviewees

76 “What is Integrative Medicine?” The New Medicine. The Public Broadcasting Service. 24 April 2006 <http://www.pbs.org/thenewmedicine/interview.html>

77 Schlosberg. P. 2008. From Illness To Wholeness. Unpublished mini-documentary, thesis. Lesley

University.

78 Donne, J. 1999. “Devotions Upon Emergent Occasions.” Devotions Upon Emergent Occasions and Death’s Duel. Ed. Motion, A & Walton, I. New York, NY: Random House, 103.

79 King David. “Psalm 25” Life Application Study Bible: New International Version. Wheaton, Ill: Tyndale

House Publishers, Inc., 850.

44

considers him or herself fortunate to have been able to work with a gifted healer like

Mincolla.  In part because of the synergy of the client-helper relationship, including each

patient’s ability to reach out for support and assistance, they did not allow the tendency of

demoralization to overcome them, offering success in their ultimate life and death battle.

Additionally, without question, the perspective one takes facing an extreme illness

makes a substantial difference in the experience he or she has with it.  A golden rule of

cognitive behavioral psychology, and stress-management, (also, Niebuhr's quote in the

introduction), is that we do not always have control over circumstances, though I would

add, we usually have far more control than we think we do.  However, we always have at

least some measure of control over how we respond, which is how we must choose to

focus our psychic energies.

  This is why holistic wellness practices such as mindfulness and diet are so

important: initiating them allows a cancer patient to know they are participating in

something to challenge their condition – they are not helpless.   For example, Feuerstein

writes of his battle against brain cancer, "My neurosurgeon told me that the prognosis

was not good.  The tumor was a type that had tentacles that could spread to many parts of

my brain.  He suggested I get my affairs in order.  At age fifty-two, I probably had less

than a year to live." Yet Feuerstein reached into his soul, writing emphatically, "I decided

to live longer than that." 80  Feuerstein decided that he would make an empowering

decision and not be a passive spectator in the deadly game of brain cancer.  His attitude

must have taken great courage.  What Feuerstein likely realized is that life is

temporary, we all eventually leave this world – in the end each of us must face our own 80 Feuerstein, M. & Findley, P. 2006. The Cancer Survivor’s Guide: The Essential Handbook to Life After

Cancer. New York, NY: Marlowe and Company, xx.

45

decisions and live with how we have handled the crises along the way.  Feuerstein is

alive and well today and is professor of medical and clinical psychology and preventive

medicine at the Uniformed Services University of the Health Services in Bethesda, MD. 

I wonder, Is it partly his attitude that saved him?  He certainly would not have changed

his health behaviors without a can-do attitude.  This is the same attitude that the patients

in my video have taken, and perhaps one important reason they are still alive. 

  Yet there is also another important adage: sometimes the spirit is willing but the

flesh is weak.  The physical aspects of cancer are real, and at times strength of spirit only

goes so far. We also need the best care, both preventive and acute, to challenge disease.  

We need tactics from a psychological and mind-body perspective including support

groups, counseling, techniques for relaxation, meditation, and guided imagery.  We need

to cleanse the body of toxins to allow nature’s healing process to work, to strengthen the

internal forces of immunity by providing nutrition for building healthy cells and tissue

(anabolic processes); and, to prevent the breakdown of healthy body tissue (catabolism).

A diverse diet of vegetables, fruits, healthy fats, complete proteins, and whole grains will

encourage a Yin condition, and reduce inflammation. Every nutrient in the diet including

the macro and micronutrients, are vitally important.  We must also reduce or eliminate

contaminants in foods to maintain the Yin condition, such as excess sugars,

carbohydrates, and fats, and antibiotics, pesticides, fungicides, steroids, and toxic metals,

among others. Cancer is extreme, and causes extreme demands upon the body ―

therefore one should approach cancer similar to the way an athlete would approach a

grueling event, every detail must be covered to improve risk factors.

In a significant section of the book, I questioned whether there is such thing as a

46

“cancer personality.” If there is, then it would likely mean there are set traits that would

be either unchangeable or very difficult to change that would predispose one to the risk of

contracting this disease, or influence the way one handles it psychologically and

emotionally. Based upon my review of studies in psychology and integrative health, as

well as my intuitive sensibility, I believe likely there are stress-prone personality

characteristics that would seemingly increase peoples’ risks for chronic illness; though I

am unsure if it would apply specifically to cancer, or to any other disease. My guess is

rather that the influence of personality applies more globally to diseases in general than to

one specific disease such as cancer, though I may be wrong. I am an optimist, however,

and believe that in most instances each of us is born with inherent potential, God-given

abilities for change. In my view, each person has an innate ability to manage how they

respond to stressors. Of course, some have a naturally easier task than others; also, some

have an easier task of facilitating self-improvement than others.

If I were to attempt to base my views solely upon existing research, it would be

difficult, because the research is conflicting. For instance, according to the researchers

like Simonton, Temoshok, LeShan, and others, positive correlations exist between

personality and cancer, including one’s sense of self, feelings of empowerment, ability to

release anger, and so on.

However, at the same time, interestingly, recent studies also show no connections

between cancer and personality. A study in Japan with a research team led by Tsubono

showed no correlation between four measures for personality. A metric called the

Eysenck Personality Questionnaire was used, accounting for extroversion-introversion,

neuroticism, psychoticism (cruelty, intolerance, and aggressiveness), and truthfulness

47

(“faking” good in order to please others).81 According to DeNoon, referring to prior

studies such as Simonton’s, and Temoshok’s, and others, that showed positive

correlations between personality and cancer, “These studies had various weaknesses.

They tended to focus on small numbers of people. And they often failed to control for

important cancer risk factors, such as smoking.” 82

What can be made of the seeming incongruencies? Conflicting reports seem to be

a trend in science in general and may or may not have to do with the sharp political

divisions, as well as financial interests that exist today concerning the outcomes of

research. Therefore, it is often difficult for researchers and students to discern truth from

fallacy.

In closing, cancer and personality is certainly an interesting topic for debate. Yet

I have clearly indicated in this book that besides the standard conventional treatments, in

81 Tsubono, Y., Tsugi, I. et. al. June 2003. Personality And The Risk of Cancer. Journal of The National

Cancer Institute. Vol 95, Number 11, 799-805.

82 DeNoon, D.J. “No Such Thing As A ‘Cancer Personality’: Personality Types Unrelated to Risk of Developing Cancer.” Webmd.com. 3 June 2003. WebMD. 19 February 2008 <http://www.webmd.com/cancer/news/20030603/no-such-thing-as-cancer-personality>

Appendix A: Key Terms

carcinoma, cytokines, dialectical behavior therapy (DBT), endogenous, exogenous,

homeostasis, imagery, immune surveillance theory, immunity, leukemia, lymphokine-

activated killer cells, lymphoma, malignant, metastasis, (NKC) natural killer cells, non-

steroidal anti-inflammatory (NSAID), oncogenes, sarcoma, silent inflammation profile

(SIP), suppressor genes, t cells, tumor, visualization

48

my view, the most interesting research is concerning self-awareness, mindfulness,

meditation, cognitive behavioral processes, imagery, and holistic interventions such as

diet and exercise, in regards to cancer. This, I believe, is where the crux of our time,

energy, and research dollars should be allocated in future healthcare endeavors.

Endnotes

49