Tuesday, January 28, 2014

THE MINDFUL REVOLUTION

Cancer Support Community-Benjamin Center offers MBSR free of charge to people affected by cancer.  Visit  http://bit.ly/CSCMB2

TIME Magazine: Monday, February 3
By Kate Pickert

The raisins sitting in my sweaty palm are getting stickier by the minute. They don't look particularly appealing, but when instructed by my teacher, I take one in my fingers and examine it. I notice that the raisin's skin glistens. Looking closer, I see a small indentation where it once hung from the vine. Eventually, I place the raisin in my mouth and roll the wrinkly little shape over and over with my tongue, feeling its texture. After a while, I push it up against my teeth and slice it open. Then, finally, I chew--very slowly.


I'm eating a raisin. But for the first time in my life, I'm doing it differently. I'm doing it mindfully. This whole experience might seem silly, but we're in the midst of a popular obsession with mindfulness as the secret to health and happiness--and a growing body of evidence suggests it has clear benefits. The class I'm taking is part of a curriculum called Mindfulness Based Stress Reduction (MBSR) developed in 1979 by Jon Kabat-Zinn, an MIT-educated scientist. There are nearly 1,000 certified MBSR instructors teaching mindfulness techniques (including meditation), and they are in nearly every state and more than 30 countries. The raisin exercise reminds us how hard it has become to think about just one thing at a time. Technology has made it easier than ever to fracture attention into smaller and smaller bits. We answer a colleague's questions from the stands at a child's soccer game; we pay the bills while watching TV; we order groceries while stuck in traffic. In a time when no one seems to have enough time, our devices allow us to be many places at once--but at the cost of being unable to fully inhabit the place where we actually want to be.

Mindfulness says we can do better. At one level, the techniques associated with the philosophy are intended to help practitioners quiet a busy mind, becoming more aware of the present moment and less caught up in what happened earlier or what's to come. Many cognitive therapists commend it to patients as a way to help cope with anxiety and depression. More broadly, it's seen as a means to deal with stress.

But to view mindfulness simply as the latest self-help fad underplays its potency and misses the point of why it is gaining acceptance with those who might otherwise dismiss mental training techniques closely tied to meditation--Silicon Valley entrepreneurs, FORTUNE 500 titans, Pentagon chiefs and more. If distraction is the pre-eminent condition of our age, then mindfulness, in the eyes of its enthusiasts, is the most logical response. Its strength lies in its universality. Though meditation is considered an essential means to achieving mindfulness, the ultimate goal is simply to give your attention fully to what you're doing. One can work mindfully, parent mindfully and learn mindfully. One can exercise and even eat mindfully. The banking giant Chase now advises customers on how to spend mindfully.

There are no signs that the forces splitting our attention into ever smaller slices will abate. To the contrary, they're getting stronger. (Now arriving: smart watches and eyeglasses that will constantly beam notifications onto the periphery of our vision.) Already, many devotees see mindfulness as an indispensable tool for coping--both emotionally and practically--with the daily onslaught. The ability to focus for a few minutes on a single raisin isn't silly if the skills it requires are the keys to surviving and succeeding in the 21st century.

REWIRING YOUR BRAIN
With Tiny Bits of raisin still stuck in my teeth, I look around at the 15 other people in my MBSR class, which will meet every Monday evening for eight weeks. My classmates cite a wide variety of reasons they have plunked down $350 to learn about meditation and mindfulness. One 20-something blond woman said back-to-back daily work meetings meant she couldn't find time to pause and reset; she had been prescribed the anti-anxiety drug Klonopin. A mother on maternity leave said "being present" with her infant seemed more important than ever, but she was struggling. One man, a social worker, said he needed help dealing with the stress of working with clients trying to get their lives on track.

Although I signed up to learn what mindfulness was all about, I had my own stressors I hoped the course might alleviate. As the working parent of a toddler, I found life in my household increasingly hectic. And like so many, I am hyperconnected. I have a personal iPhone and a BlackBerry for work, along with a desktop computer at the office and a laptop and iPad at home. It's rare that I let an hour go by without looking at a screen.

Powering down the internal urge to keep in constant touch with the outside world is not easy. At the start of each two-hour MBSR class, our teacher, a slight woman named Paulette Graf, hit two small brass cymbals together to indicate we should begin meditating. During this agonizingly frustrating period, which lasted up to 40 minutes, I would try to focus on my breath as Paulette advised, but I felt constantly bombarded by thoughts about my family, random sounds in the room and even how I would translate each evening's session into this story.

One evening, we were introduced to mindful walking. In our small meeting room, we formed a circle and paced together. "Feel your heel make contact with the floor, then the ball of your foot," said Paulette. "One foot, then the other." Anxious feelings about planning the week ahead and emails in my inbox that might be waiting for replies crept into my head even though my phones were off and tucked away. Mindfulness teachers say this kind of involuntary distraction is normal and that there's no point in berating ourselves for mentally veering away from the task at hand. Rather, they say, our ability to recognize that our attention has been diverted is what's important and at the heart of what it means to be mindful.

Some of this may sound like a New Age retread of previous prescriptions for stress. Mindfulness is rooted in Eastern philosophy, specifically Buddhism. But two factors set it apart and give it a practical veneer that is helping propel it into the mainstream.

One might be thought of as smart marketing. Kabat-Zinn and other proponents are careful to avoid any talk of spirituality when espousing mindfulness. Instead, they advocate a commonsense approach: think of your attention as a muscle. As with any muscle, it makes sense to exercise it (in this case, with meditation), and like any muscle, it will strengthen from that exercise.

A related and potentially more powerful factor in winning over skeptics is what science is learning about our brains' ability to adapt and rewire. This phenomenon, known as neuroplasticity, suggests there are concrete and provable benefits to exercising the brain. The science--particularly as it applies to mindfulness--is far from conclusive. But it's another reason it's difficult to dismiss mindfulness as fleeting or contrived.

Precisely because of this scientific component, mindfulness is gaining traction with people who might otherwise find mind-body philosophies a tough sell, and it is growing into a sizable industry. An NIH report found that Americans spent some $4 billion on mindfulness-related alternative medicine in 2007, including MBSR. (NIH will release an update of this figure later this year.) There's a new monthly magazine, Mindful, a stack of best-selling books and a growing number of smartphone apps devoted to the concept.

For Stuart Silverman, mindfulness has become a way to deal with the 24/7 pace of his job consulting with financial advisers. Silverman receives hundreds of emails and phone calls every day. "I'm nuts about being in touch," he says. Anxiety in the financial industry reached a high mark in the 2008 meltdown, but even after the crisis began to abate, Silverman found that the high stress level remained. So in 2011, he took a group of his clients on a mindfulness retreat. The group left their smartphones behind and spent four days at a resort in the Catskills, in upstate New York, meditating, participating in group discussions, sitting in silence, practicing yoga and eating meals quietly and mindfully. "For just about everybody there, it was a life-changing experience," says Silverman.

The Catskills program was run by Janice Marturano, a former vice president at General Mills who began a corporate mindfulness initiative there and left the company in 2011 to run an organization she started called the Institute for Mindful Leadership. (About 500 General Mills employees have participated in mindfulness classes since Marturano introduced the concept to the company's top managers in 2006, and there is a meditation room in every building on the company's Minneapolis campus.) Marturano, who ran a well-attended mindfulness training session at Davos in 2013 and wrote a book called Finding the Space to Lead: A Practical Guide to Mindful Leadership, published in January, says most leaders she encounters feel besieged by long work hours and near constant connectivity. For these people, there seems to be no time to zero in on what's important or plan ahead.

There's evidence they're correct. Researchers have found that multitasking leads to lower overall productivity. Students and workers who constantly and rapidly switch between tasks have less ability to filter out irrelevant information, and they make more mistakes. And many corporate workers today find it impossible to take breaks. According to a recent survey, more than half of employed American adults check work messages on the weekends and 4 in 10 do so while on vacation. It's hard to unwind when your boss or employees know you're just a smartphone away. Says Marturano: "The technology has gone beyond what we are capable of handling."

It might seem paradoxical, then, that Silicon Valley has become a hotbed of mindfulness classes and conferences. Wisdom 2.0, an annual mindfulness gathering for tech leaders, started in 2009 with 325 attendees, and organizers expect more than 2,000 at this year's event, where participants will hear from Kabat-Zinn, along with executives from Twitter, Instagram and Facebook. Google, meanwhile, has an in-house mindfulness program called Search Inside Yourself. The seven-week course was started by a Google engineer and is offered four times a year on the company's Mountain View, Calif., campus. Through the course, thousands of Googlers have learned attention-focusing techniques, including meditation, meant to help them free up mental space for creativity and big thinking.

It makes sense in a way. Engineers who write code often talk about "being in the zone" the same way a successful athlete can be, which mindfulness teachers say is the epitome of being present and paying attention. (Apple co-founder Steve Jobs said his meditation practice was directly responsible for his ability to concentrate and ignore distractions.) Of course, much of that world-class engineering continues to go into gadgets and software that will only ratchet up our distraction level.

But lately there's been some progress in tapping technology for solutions too. There are hundreds of mindfulness and meditation apps available from iTunes, including one called Headspace, offered by a company of the same name led by Andy Puddicombe, a former Buddhist monk. Puddicombe, 40, co-founded Headspace in the U.K. in 2010 and opened a new office in Los Angeles in 2013 after attracting venture capital. The company offers free content through an app and sells subscriptions to a series of web videos, billed as a "gym membership for the mind," that are narrated by Puddicombe and explain the tenets of mindfulness and how to meditate.

"There's nothing bad or harmful about the smartphone if we have the awareness of how to use it in the right way," says Puddicombe. "It's unplugging by plugging in."

THE SCIENCE OF DESTRESSING
Jon Kabat-Zinn, the father of MBSR, doesn't look like the kind of person to be selling meditation and mindfulness to America's fast-paced, stressed-out masses. When I met him at a mindfulness conference in April, he was dressed in corduroys, a button-down shirt and a blazer, with wire-rimmed glasses and a healthy head of thick gray hair. He looked more like the professor he trained to become than the mindfulness guru he is.

But ultimately, a professor may prove more valuable than a guru in spreading the word on mindfulness. The son of an immunologist and an artist, Kabat-Zinn, now 69, was earning a doctorate in molecular biology at MIT in the early 1970s when he attended a lecture about meditation given by a Zen master. "It was very moving. I started meditating that day," he says. "And the more I meditated, the more I felt like there was something else missing that science could say in terms of, like, how we live as human beings."

By 1979, Kabat-Zinn had earned his Ph.D. and was working at the University of Massachusetts Medical Center studying muscle development and teaching anatomy and cell biology to medical students. On a meditation retreat that year, he had a revelation. What if he could use Buddhism-based meditation to help patients cope with conditions like chronic pain? Even if he couldn't alleviate their symptoms, Kabat-Zinn speculated that mindfulness training might help patients refocus their attention so they could change their response to pain and thereby reduce their overall suffering.

With three physicians, Kabat-Zinn opened a stress-reduction clinic at UMass based on meditation and mindfulness. "It was just a little pilot on zero dollars," he says.

Almost immediately, some of the clinic's patients reported that their pain levels diminished. For others, the pain remained the same, but the mindfulness training made them better able to handle the stress of living with illness. They were able to separate their day-to-day experiences from their identity as pain patients. "That's what you most hope for," says Kabat-Zinn, "not that you can cure all diseases, but you could help people live in a way that didn't erode their quality of life beyond a certain point." Eventually Kabat-Zinn's program was absorbed into the UMass department of medicine and became the MBSR curriculum now used by hundreds of teachers across the country.

In the years since, scientists have been able to prove that meditation and rigorous mindfulness training can lower cortisol levels and blood pressure, increase immune response and possibly even affect gene expression. Scientific study is also showing that meditation can have an impact on the structure of the brain itself. Building on the discovery that brains can change based on experiences and are not, as previously believed, static masses that are set by the time a person reaches adulthood, a growing field of neuroscientists are now studying whether meditation--and the mindfulness that results from it--can counteract what happens to our minds because of stress, trauma and constant distraction. The research has fueled the rapid growth of MBSR and other mindfulness programs inside corporations and public institutions.

"There is a swath of our culture who is not going to listen to someone in monks' robes, but they are paying attention to scientific evidence," says Richard J. Davidson, founder and chair of the Center for Investigating Healthy Minds at the Waisman Center, at the University of Wisconsin at Madison. Davidson and a group of co-authors published a paper in the prestigious Proceedings of the National Academy of Sciences in 2004 that used electroencephalography to show that Buddhist monks who had logged at least 10,000 hours of meditation time had brains with more functional connectivity than novice meditators. The monks also had more gamma-wave activity, indicating high states of consciousness.

Of course, most people will never meditate at the level of a monk. But neuroscientists have shown that even far less experienced meditators may have more capacity for working memory and decreases in mind-wandering.

Many of the studies on mindfulness and meditation have been funded by individual private donors and have not met the highest scientific standards, leading the NIH to declare in 2007 that future research had to be "more rigorous." Perhaps to this end, the NIH has funded some 50 clinical trials in the past five years examining the effects of mindfulness on health, with about half pertaining to Kabat-Zinn's MBSR curriculum alone. The NIH trials completed or now under way include studies on how MBSR affects everything from social-anxiety disorder to the body's immune response to human papilloma virus to cancer-related fatigue. Altogether, in 2003, 52 papers were published in scientific journals on the subject of mindfulness; by 2012, that number had jumped to 477.

MINDFULNESS GOES MAINSTREAM
Tim Ryan, a democratic Congressman from Ohio, is among those pushing to use more federal funds for mindfulness research. Stressed and exhausted, Ryan attended a mindfulness retreat led by Kabat-Zinn in 2008 shortly after the election. Ryan turned over his two BlackBerrys and ended the experience with a 36-hour period of silence. "My mind got so quiet, and I had the experience of my mind and my body actually being in the same place at the same time, synchronized," says Ryan. "I went up to Jon and said, 'Oh, man, we need to study this--get it into our schools, our health care system.'"

In the years since, the Congressman has become a rock star among mindfulness evangelists. His book A Mindful Nation was published in 2012, and Mindful, launched in May 2013, put Ryan on the cover of its second issue after he secured a $1 million federal grant to teach mindfulness in schools in his home district. Ryan has hosted meditation sessions and a mindfulness lecture series on Capitol Hill for House members and their staffs. The effort, says Ryan, is all about "little candles getting lit under the Capitol dome."

Elizabeth Stanley, an associate professor at Georgetown, is trying to do the same for those in uniform. Stanley was an Army intelligence officer deployed to the Balkans in the early 1990s. After she left active duty, Stanley enrolled in a doctoral program at Harvard and pursued an MBA at MIT--at the same time--planning a career studying national-security issues.

But as the demands of two graduate programs combined with leftover stress from her time deployed, Stanley found herself unable to cope. "I realized my body and nervous system were constantly stuck on high," she says. She underwent therapy and started practicing yoga and mindful meditation, eventually completing both of her degree programs as well.

"On a long retreat in 2004, I realized I wanted to pull these two sides of me together and find a way to share these techniques with men and women in uniform," Stanley says. She teamed up with Amishi Jha, a neuroscientist at the University of Miami who studies attention, and together they launched a pilot study with private funding that investigated whether a mindfulness program could make Marines more resilient in stressful combat situations. The findings were so promising, according to Jha, that the Department of Defense awarded them two $1 million grants to investigate further, using an MBSR-based curriculum Stanley developed called Mindfulness-Based Mind Fitness Training. Stanley has been involved in two additional mindfulness studies with Marines since, and Jha has been awarded $3.4 million more in federal grants to study how mindfulness training affects stress among other populations, including undergraduates facing exams and accountants slogging through tax season.

Educators are turning to mindfulness with increasing frequency--perhaps a good thing, considering how digital technology is splitting kids' attention spans too. (The average American teen sends and receives more than 3,000 text messages a month.) A Bay Area--based program called Mindful Schools offers online mindfulness training to teachers, instructing them in how to equip children to concentrate in classrooms and deal with stress. Launched in 2010, the group has reached more than 300,000 pupils, and educators in 43 countries and 48 states have taken its courses online.

"It was always my intention that mindfulness move into the mainstream," says Kabat-Zinn, whose MBSR bible, Full Catastrophe Living, first published in 1990, was just reissued. Lately, the professor has also been spreading the gospel abroad. On a November trip to Beijing, he helped lead a mindfulness retreat for about 250 Chinese students, monks and scientists. "This is something that people are now finding compelling in many countries and many cultures, and the reason is the science," he says.

LISTENING TO LIFE
The MBSR class I took consisted of 21 hours of class time, but there was homework. One week, we were assigned to eat a snack mindfully and "remember to inhale/exhale regularly (and with awareness!)," according to a handout. Since we were New Yorkers, another week's assignment was to count fellow passengers on a subway train. One student in my class said he had a mindfulness breakthrough when he stopped listening to music and playing games on his phone while riding to work. Instead, he observed the people around him, which he said helped him be more present when he arrived at his office.

After eight weeks, we gathered one Saturday for a final exercise, a five-hour retreat. We brought our lunches, and after meditating and doing yoga, we ate together silently in a second-floor room overlooking a park. After the meal, Paulette led us into the park and told us to walk around for 30 minutes in a meditation practice known as aimless wandering. No phones and no talking. Just be present, she said.

As I looked across a vast lawn, I easily spotted my fellow MBSR students. They looked like zombies weaving and wandering alone through groups of friends and families lounging on picnic blankets or talking and barbecuing. I saw a group of 20-something men playing Frisbee, young kids riding bikes and a pair of women tanning in the sun.

I had lived close to this park for three years and spent hundreds of hours exploring it, but what struck me as different on the day of the retreat were the sounds. I noticed the clap, clap of a jogger's sneakers going by on a paved path. I saw a group playing volleyball on the lawn, and for the first time, I heard the game. The ball thudded when it hit the grass and whapped when it was being served. The players grunted when they made contact. Thud, whap, grunt. Whap, whap, thud. I heard a soft jingling, and I knew just what it was. A dog with metal ID tags came up behind me and passed by. Jingle, jingle.

After the prescribed half hour, we returned to our meeting room with Paulette. We had a brief group discussion about how we could continue our mindfulness training through other classes, and then we folded our chairs and put them away in a closet. Silently, we eased down a set of stairs and out the front door. I made it all the way home before I turned on my phones.

In the months since, I haven't meditated much, yet the course has had a small--but profound--impact on my life. I've started wearing a watch, which has cut in half the number of times a day I look at my iPhone and risk getting sucked into checking email or the web. On a tip from one of my MBSR classmates, when I'm at a restaurant and a dining companion gets up to take a call or use the bathroom, I now resist the urge to read the news or check Facebook on my phone. Instead, I usually just sit and watch the people around me. And when I walk outside, I find myself smelling the air and listening to the soundtrack of the city. The notes and rhythms were always there, of course. But these days they seem richer and more important.

 
 

Monday, January 27, 2014

MAKING MUSIC VIDEOS HELPS YOUNG CANCER PATIENTS CONNECT

Reuters Edition: U.S.
by Genevra Pittman

MONDAY, Jan. 27, 2014 (HealthDay News) -- Jefri Franks says one of the things that helped her 12-year-old daughter Heather cope with the challenges of having cancer was music therapy -- in particular, making a music video.

"I was relieved during the time she was doing the video because she had something she had to do and enjoy," Franks said. "She was busy in a good way. I think she got to tell her story the way she wanted to."

A new study from Indiana University appears to back up what Franks learned more than a decade ago. Researchers found that adolescents and young adults undergoing cancer treatment in the hospital who participated in a music therapy program that included writing song lyrics and producing videos increased their ability to cope and boosted their resilience.

For the study, published online Jan. 27 in the journal Cancer, researchers tested a music therapy intervention in 113 patients, aged 11 to 24, who were undergoing stem cell transplants for cancer. The treatment involves infusions of healthy stem cells that help replace diseased ones.

"The kids are usually very sick during stem cell transplants. They require a lot of supportive care," said study co-author Joan Haase, a professor of pediatric oncology nursing at the Indiana University School of Nursing. "Depending on the type of transplant, up to 50 percent of these kids undergoing stem cell transplant don't survive, so being able to say how they feel about that is important."

The patients were randomly assigned into either a therapeutic music video-making group or to a comparison group in which everyone received audio books. There were six sessions over three weeks.

The music therapist's role was to offer structure and support, and to help the young patients reflect on their experiences and identify what was important to them, said study lead author Sheri Robb, an associate professor at Indiana University School of Nursing and editor of the Journal of Music Therapy.

"It may seem counterintuitive to be asking kids to do things during this time, but in actuality it's helping them to move through their treatment in a better way," Robb said. Music therapists encouraged their patients to tap into important parts of their lives, including their spirituality, family and other relationships, she explained.

The phases of the intervention included writing song lyrics, making sound recordings, collecting video images and storyboarding. Patients could work independently or involve family, friends and health care providers in their projects, the authors noted.

Haase said the therapeutic music video group reported significantly better "courageous coping" skills. Even 100 days after the stem cell transplant treatments, the music video group reported significantly better social integration and family-environment experiences.

Lisa Gallagher, a clinical music therapist at the Cleveland Clinic, said the study is well done.

"They did a lot of research into how to put this together, what measures to use," Gallagher said. "It's a tough population, adolescents who have this type of stem cell transplant. It is a high-risk treatment and so anything that can be done for patients who undergo this is great."

Working with a therapist to create music videos may help young cancer patients feel better about themselves and their situation, a new study suggests.

Teenagers and young adults who made the videos reported feeling more supported by family and friends and coped with their cancer in more positive ways.

"They're going through an experience that their peers don't really understand a lot of times," Joan Haase said. She worked on the study at the Indiana University School of Nursing in Indianapolis. "There's a lot of issues that they deal with."

Finding a way to express their feelings - and share how they feel with people around them - might help them work through those issues, the researchers found.

They studied 113 young people, ages 11 to 24, who were being treated for cancer with intravenous infusions of stem cells. Most of them had leukemia or lymphoma.

The preparation for those infusions is grueling. First, patients have to go through chemotherapy or radiation to wipe out cancerous cells. During the treatments, their immune systems become very weak and they can be in the hospital for weeks at a time, with symptoms like nausea and mouth sores.

All of the patients in the study met with a music therapist six times over about three weeks while they were in the hospital. Half were randomly assigned to work with the therapist on making a music video - writing lyrics, recording a song and selecting art - and the others listened to audiobooks instead.

The music video program was designed so that young people would be most involved in the project at the beginning and end, and have less demanding parts to work on while their symptoms were at their worst.

"It really targeted them writing, having an opportunity to write about what's important to them," said co-author Sheri Robb, also from Indiana University.

"A lot of these kids as they're going through treatment, they tend to not talk about these things," Robb told Reuters Health.

At the end of the study, young people in the music video group could invite their family and friends to a video premiere.

The researchers found that directly after making the videos, young people were coping with their cancer in a positive, optimistic way more often than those who had listened to audiobooks. A few months after treatment, they felt more support from doctors, friends and family and reported a better family environment than the other patients, based on their responses on questionnaires.

Making a music video didn't affect young people's distress related to their illness, however, or their use of more negative coping mechanisms, the researchers wrote in Cancer.

Brad Zebrack, who has studied adolescent cancer survivors, said the findings suggest the video project helped build on young people's internal resources and improve their self-confidence.

"It's not so much the cancer that stresses them, it's the fallout," Zebrack, from the University of Michigan in Ann Arbor, told Reuters Health.

"One of the biggest challenges they face is the social isolation. Having to spend a lot of time at home, not being able to be with their friends for a lot of time. The disruption of cancer comes at a time in life when that type of social interaction is so important."

But, he added, "We know that most people bounce back. Most people are resilient."

Zebrack, who was not involved in the new research, said the benefits of working with a music therapist are likely to extend to young people with any kind of cancer, not just those receiving stem cell transplants.

Music therapists are increasingly considered part of standard care at children's hospitals, the researchers noted.

But most people in their late teens and 20s with cancer are treated in private oncology groups, which typically don't have a social worker or therapist on staff, according to Zebrack.

"The big challenge is how we can move this type of intervention from the hospitals and the academic treatment centers out into the community and out into the places where more young adults are treated," he said.
 

SOURCE: bit.ly/1jJpr1Q Cancer, online January 27, 2014.

Monday, January 13, 2014

CNN INTERVIEW WITH DR. DAVID AGUS: A SHORT GUIDE TO A LONG LIFE

Cancer Support Community provides free-of-charge psychosocial support for those affected by cancer.  CSC does not give medical advice; however, it does provide education for its members from experts in the medical and complementary fields. This past Sunday, January 12, 2014 Fareed Zakaria interviewed Dr. David Agus, one of the world's leading cancer specialists.  Dr. Agus discussed prevention.  While CSC membership is composed of those who are already dealing with cancer diagnoses, there is, of course, keen interest in preventing recurrence.  The following is a transcript of this interview.  To see the original source, visit http://cnnpressroom.blogs.cnn.com/2014/01/12/mideast-violence-on-cnns-fareed-zakaria-gps/


ZAKARIA:  The best way to tackle cancer, heart disease, diabetes and all these other diseases that plague the modern world is prevention.  So says my next guest who has a list of ways to ward off these dangerous illnesses.  Perfect for your new year's resolutions.  David Agus is one of the world's leading cancer specialists, he is the author of a new book "A Short Guide to a Long Life."  He was Steve Jobs' doctor, among other things.  David joins me.

DAVID AGUS, PROFESSOR OF MEDICINE, UNIV. OF SOUTHERN CALIFORNIA:  Thank you so much.

ZAKARIA:  So, what struck me about this is you really feel strongly about this whole idea that if you just take some simple preventative tasks, you can reduce the possibility of many of these very bad diseases, heart attacks, even cancer, so give us like your three or four rules for how to reduce your likelihood of getting cancer and a heart attack.

AGUS:  So, first of all, it's not me and my belief.  These are the data.  All I'm doing is trying to put the data in a format that people can understand.

ZAKARIA:  And the data of these are double blind studies.  You're very rigorous about that.  You are not just taking one study.

AGUS:  No, these are the real data that at certain point, it needs to become normative behavior.  Right?  When data hits a critical mass that it's incontrovertible what the conclusion is we need to act on them as a society.  So the first is something very simple.  And it's called movement over time.  In 1953 in the British Transit Authority there were 26,000 workers.  Half were the bus drivers that sat 90 percent of the day and half the ticket takers that walked up and down these double-decker buses.  They weighed the same, smoked the same and lived in the same environment, yet dramatically lower heart disease and cancer in the ticket takers.

ZAKARIA:  The guys who were walking up and down.

AGUS:  Walking up and down.  But we've become a society of bus drivers, of sitters, right?  The more important you are in the company the closer your parking space is to your office.  The richer you are ...

ZAKARIA:  So, I – you know, I know you have these views.  And so, I think to myself, OK, I try to exercise mostly every day, probably about 30 to 40 minutes.  You say that's not enough.  That if you're sitting around the rest of the day it's like you're smoking cigarettes.

AGUS:  Exactly.  Sitting for five hours ...

ZAKARIA:  What are we supposed to do?

AGUS:  Well, you're supposed to get up every half hour and walk for four or five minutes.

ZAKARIA:  Just four or five minutes?

AGUS:  Four or five minutes.  That's it.  Your body was designed to move.  Your lymphatics that control your immune system have no muscle.  So, it's the rhythmic contractions of the muscles in your legs when you walk that actually make your body work.

ZAKARIA:  OK.  Get off your X.

AGUS:  The second preventative strategy is, you know, a very simple one.  Is that 2,000 years ago, Hippocrates said you take the bark of the willow tree, and chew it and pain and fever go away.  And this is a compound that if you take it every day over the age of 40 you reduce the death rate of cancer by 37 percent.  It's called a baby aspirin.  Baby aspirin blocks inflammation.  Inflammation is at the root of cancer, heart disease and neurocognitive decline.  Dramatic data, we as a society don't act on it.  If everybody over the age of 40 took a baby aspirin we've had a dramatic effect on life expectancy in this country, but we don't do anything about it.

ZAKARIA:  You also like statins.

AGUS:  I like statins also, because statins have an anti-cancer effect and they can delay heart attack and stroke, even in people with a normal cholesterol.  So very important that we think in those terms and that we actually think preventatively there.  And I say it out of weakness, not strength.  Now, you alluded to the fact that I was involved in Steve Jobs' care.  I know that most people with advanced cancer will die of the disease and I have to look at someone in the eye a couple of times a week and say I've got no more drugs for your cancer.  I don't want to do that anymore.  So, what we have here is a list of 65 rules of things to do and not to do that can prevent disease that are based on data.

ZAKARIA:  Now, so you've - you say, you know, aspirin, statin, movement, but it's interesting, aspirin and statin are really the only as far as I could tell, medicine-like things that you recommend.  For the most part you look at this whole industry of vitamins and supplements and you think it's all bogus?

AGUS:  I don't think it's all bogus.  I know it's all bogus.  The data have shown and the biggest study came out several weeks ago, the data have shown in now over 65 separate studies there has yet to ever be a benefit in a normal individual with vitamins or supplements.  Ever.  Yet, if a man takes vitamin E, he has a higher rate of prostate cancer.  If smoker or former smokers take beta carotene and vitamin A, the significantly higher rate of lung cancer or death.  If a woman takes high dose of vitamin D increased bone fracture rate.  So I look at those data, significant harm potentially.  No benefit clearly, yet we spend more ...

ZAKARIA:  The kids shouldn't have these gummy bear vitamins?

AGUS:  I've never seen a kid with scurvy or rickets or beriberi.  No, don't take gummy bear vitamins.  Eat real food.  It's the key.

ZAKARIA:  You are against juicing.  Explain why.  This is fascinating because a lot of people think they're being very healthy by having, you know, something in the morning.

AGUS:  But we're a society of shortcuts.  Right, you get a juice, I'm going to get all my vegetables and my nutrients, because it's too hard to eat fruits and vegetables.  So in 1746 James Lennis (ph), head of the British Royal Navy, and he has limes on his ship.  And back then you were at sea for months at a time and you would get scurvy.  They won the battle at Trafalgar.  At the end of it, because his soldiers didn't get scurvy, at the end of it, he said I happened to sell the extracted limes to cure scurvy and it didn't work.

ZAKARIA:  So, they had been eating limes on the ship, but then he sells the juice of the limes and it doesn't work.

AGUS:  Yes, totally different.  As soon as you squeeze it or put it in a blender it oxidizes and degrades right away to byproducts.  And basically, all you're getting is a big bowl of sugar.  You're getting something with very high glycemic index.  Eat the real food.  Fruits and vegetables as good as you can get, juicing no benefit at all.  It's just lots of sugar.

ZAKARIA:  Wow.  When you talked about inflammation, I noticed, this is another piece that you focus on a lot, which is that if the body gets inflammations, if it gets the flu, this is not just - even if you get over the flu, this has a long-term negative effect.

AGUS:  And again, that's one of the things we have to think about in terms of public policies.  That if you got the flu, you skip the flu shot, you would survive most likely, although tens of thousands of people die.  A decade from now because of having the flu and the inflammation your rate of heart disease and cancer are elevated.  And so, we as a society say, you're welcome to get the flu shot or not, you get heart disease and cancer we will pay for it.

ZAKARIA:  What do you think is - you - one of the things we've talked about is, you've said to me that if, you know, you know all these people who are exposed to asbestos are going to get cancer, we could easily - if by putting them on a prevention program, we could actually make sure many of them don't develop cancer.  Have them take aspirin, have them take statins.  Why don't we do that?

AGUS:  Well, I think, you know, there's a liability issue here and whether that the Fukushima in Japan, whether that's the asbestos here in the United States, once you start to say, listen, you have been exposed to something that could cause a problem and I may have exposed you, you put yourself up for liability.  And so we need to change that.

ZAKARIA:  But ironically as a result of that you're not actually giving people the preventive ...
AGUS:  No question about it.  But, you know, the penetrance of getting cancer with asbestos exposure is probably going to be ten, 20 or 30 percent.  So, 70 percent of people you wouldn't have to pay anything. And so, it's a financial game.  And we've got to change that.  We need to change – and for the last decade our country has been about health care finance.  All of the talk in Washington.  We need to change it back to health.

ZAKARIA:  You were advising the Japanese government, including Prime Minister Abe on the Fukushima business.  What's the lesson you drew from that?

AGUS:  Well, I mean the lesson is, we know what happened and that we as a society have to learn from it.  You know, one of the problems is, we don't know who was exposed and to how much.  We don't have a blood test for radiation exposure.  So one of the things we have to start to develop is a triage tool.  We know dirty bombs will happen in the world.  Horrible to say, but it will happen.  And so we need to learn from every experience we have and get better.

ZAKARIA:  So when I listen to all these rules, and we've got how many of them?  60 something of them, the thing, of course, I think to myself is, how many of these do you actually follow?

AGUS:  Well, listen, I do as much as I can.  And the key is moderation.  The good is, I'm in charge of my health, I'm making the conscious decision of what I want to do.  And so, I really believe health will change from each of us, it will change from the ground up, not the top down.  We're in charge of ourselves.

ZAKARIA:  And the key is, do it now, do it regularly, don't wait for something to ...

AGUS:  No question about it.  We're reactive field medicine.  But at the same time, I want people to think about tomorrow, not just today.

ZAKARIA:  David, pleasure to have you on.

AGUS:  Great.  Thank you, Fareed.

Tuesday, January 7, 2014

CANCER STATISTICS REPORT: DEATHS DOWN 20% IN 2 DECADES

With the death rates declining for those with cancer according to the American Cancer Society, the services that Cancer Support Community offers have taken on a more urgent role in the cancer support landscape.  At CSC, people with cancer and their families can find free-of-charge classes, support groups, individual counseling and education to relieve stress and improve quality of life.  Call 310-314-2555 for more information or visit www.cancersupportcommunitybenjamincenter.org

American Cancer Society Article date: January 7, 2014   
By Stacy Simon

Annual statistics reporting from the American Cancer Society shows the death rate from cancer in the US has declined steadily over the past 2 decades. The cancer death rate for men and women combined fell 20% from its peak in 1991 to 2010, the most recent year for which data is available. “Cancer Statistics, 2014,” published in the American Cancer Society’s journal CA: A Cancer Journal for Clinicians, estimates the numbers of new cancer cases and deaths expected in the US this year. The estimates are some of the most widely quoted cancer statistics in the world. The information will also be released in a companion article, Cancer Facts & Figures 2014.

 A total of 1,665,540 new cancer cases and 585,720 deaths from cancer are projected to occur in the US in 2014. During the most recent 5 years for which there are data (2006-2010), cancer death rates decreased by 1.8% per year in men and by 1.4% per year in women. The combined cancer death rate has been continuously declining for 2 decades, from a peak of 215.1 per 100,000 in 1991 to 171.8 per 100,000 in 2010. This 20% decline translates to approximately 1,340,400 cancer deaths avoided during this time period.

Progress among middle-aged black men
The rates of new cancer cases and cancer deaths vary quite a bit among racial and ethnic groups. Death rates from 1991 to 2010 have declined more than 50% among black men aged 40 to 49 years, more than in any other group. Even so, black men continue to have the highest cancer death rates among all ethnic groups in the US. Asian Americans have the lowest rates.

“The progress we are seeing is good, even remarkable, but we can and must do even better,” said John R. Seffrin, PhD, chief executive officer of the American Cancer Society, in a statement. “The halving of the risk of cancer death among middle aged black men in just two decades is extraordinary, but it is immediately tempered by the knowledge that death rates are still higher among black men than white men for nearly every major cancer and for all cancers combined.”

The report calls for applying existing knowledge about fighting cancer across all segments of the population, especially groups in the lowest socioeconomic bracket, as a way to speed progress against cancer.

Lung, colon, prostate, and breast cancer
Lung, colon, prostate, and breast cancers continue to be the most common causes of cancer death, accounting for almost half of the total cancer deaths among men and women. More than 1 out of every 4 cancer deaths is due to lung cancer.

Among men, prostate, lung, and colon cancer will account for about half of all newly diagnosed cancers in 2014, with prostate cancer alone accounting for about 1 in 4 cases. Among women, the 3 most common cancers in 2014 will be breast, lung, and colon, which together will account for half of all cases. Breast cancer alone is expected to account for 29% of all new cancer cases among women.

However, the rate of newly diagnosed colon cancer has declined rapidly in recent years. New colon cancer cases have dropped by more than 4% per year from 2008 to 2010. This progress has been attributed in part to more people having colonoscopies, which can prevent cancer through the removal of pre-cancerous growths called polyps.

The rate of new lung cancer cases has also continued to decline as fewer people smoke. Lung cancer incidence rates began declining in the mid-1980s in men and in the late 1990s in women. The differences reflect historical patterns in tobacco use, where women began smoking in large numbers about 20 years later than men.

Citation: Cancer Statistics, 2014. Published early online January 7, 2014 in CA Cancer Journal for Clinicians. First author Rebecca Siegel, MPH, American Cancer Society, Atlanta, Ga.

Reviewed by: Members of the ACS Medical Content Staff

To see article in its original source visit http://www.cancer.org/cancer/news/news/cancer-statistics-report-deaths-down-20-percent-in-2-decades