The Princess of Wales wants to stay cancer-free. What does this mean?
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Catherine, Princess of Wales, has announced she has now completed a course of preventive chemotherapy.
The news comes nine months after the princess first revealed she was being treated for an unspecified form of cancer.
In the new video message released by Kensington Palace, Princess Catherine says she’s focused on doing what she can to stay “cancer-free”. She acknowledges her cancer journey is not over and the “path to recovery and healing is long”.
While we don’t know the details of the princess’s cancer or treatment, it raises some questions about how we declare someone fully clear of the disease. So what does being – and staying – “cancer-free” mean?
What’s the difference between being cancer-free and in remission?
Medically, “cancer-free” means two things. First, it means no cancer cells are able to be detected in a patient’s body using the available testing methods. Second, there is no cancer left in the patient.
These might sound basically the same. But this second aspect of “cancer-free” can be complicated, as it’s essentially impossible to be sure no cancer cells have survived a treatment.
It only takes a few surviving cells for the cancer to grow back. But these cells may not be detectable via testing, and can lie dormant for some time. The possibility of some cells still surviving means it is more accurate to say a patient is “in remission”, rather than “cancer-free”.
Remission means there is no detectable cancer left. Once a patient has been in remission for a certain period of time, they are often considered to be fully “cancer-free”.
Princess Catherine was not necessarily speaking in the strict medical sense. Nonetheless, she is clearly signalling a promising step in her recovery.
What happens during remission?
During remission, patients will usually undergo surveillance testing to make sure their cancer hasn’t returned. Detection tests can vary greatly depending on both the patient and their cancer type.
Many tests involve simply looking at different organs to see if there are cancer cells present, but at varying levels of complexity.
Some cancers can be detected with the naked eye, such as skin cancers. In other cases, technology is needed: colonoscopies for colorectal cancers, X-ray mammograms for breast cancers, or CT scans for lung cancers. There are also molecular tests, which test for the presence of cancer cells using protein or DNA from blood or tissue samples.
For most patients, testing will continue for years at regular intervals. Surveillance testing ensures any returning cancer is caught early, giving patients the best chance of successful treatment.
Remaining in remission for five years can be a huge milestone in a patient’s cancer journey. For most types of cancer, the chances of cancer returning drop significantly after five years of remission. After this point, surveillance testing may be performed less frequently, as the patients might be deemed to be at a lower risk of their cancer returning.
Measuring survival rates
Because it is very difficult to tell when a cancer is “cured”, clinicians may instead refer to a “five-year survival rate”. This measures how likely a cancer patient is to be alive five years after their diagnosis.
For example, data shows the five-year survival rate for bowel cancer among Australian women (of all ages) is around 70%. That means if you had 100 patients with bowel cancer, after five years you would expect 70 to still be alive and 30 to have succumbed to the disease.
These statistics can’t tell us much about individual cases. But comparing five-year survival rates between large groups of patients after different cancer treatments can help clinicians make the often complex decisions about how best to treat their patients.
The likelihood of cancer coming back, or recurring, is influenced by many factors which can vary over time. For instance, approximately 30% of people with lung cancer develop a recurrent disease, even after treatment. On the other hand, breast cancer recurrence within two years of the initial diagnosis is approximately 15%. Within five years it drops to 10%. After ten, it falls below 2%.
These are generalisations though – recurrence rates can vary greatly depending on things such as what kind of cancer the patient has, how advanced it is, and whether it has spread.
Staying cancer-free
Princess Catherine says her focus now is to “stay cancer-free”. What might this involve?
How a cancer develops and whether it recurs can be influenced by things we can’t control, such as age, ethnicity, gender, genetics and hormones.
However, there are sometimes environmental factors we can control. That includes things like exposure to UV radiation from the sun, or inhaling carcinogens like tobacco.
Lifestyle factors also play a role. Poor diet and nutrition, a lack of exercise and excessive alcohol consumption can all contribute to cancer development.
Research estimates more than half of all cancers could potentially be prevented through regular screening and maintaining a healthy lifestyle (not to mention preventing other chronic conditions such as heart disease and diabetes).
Recommendations to reduce cancer risk are the same for everyone, not just those who’ve had treatment like Princess Catherine. They include not smoking, eating a nutritious and balanced diet, exercising regularly, cutting down on alcohol and staying sun smart.
Amali Cooray, PhD Candidate in Genetic Engineering and Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research) ; John (Eddie) La Marca, Senior Research Officer, Blood Cells and Blood Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research) , and Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, WEHI (Walter and Eliza Hall Institute of Medical Research)
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Mediterranean Diet… In A Pill?
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Does It Come In A Pill?
For any as yet unfamiliar with the Mediterranean diet, you may be wondering what it involves, beyond a general expectation that it’s a diet popularly enjoyed in the Mediterranean. What image comes to mind?
We’re willing to bet that tomatoes feature (great source of lycopene, by the way, and if you’re not getting lycopene, you’re missing out), but what else?
- Salads, perhaps? Vegetables, olives? Olive oil, yea or nay?
- Bread? Pasta? Prosciutto, salami? Cheese?
- Pizza but only if it’s Romana style, not Chicago?
- Pan-seared liver, with some fava beans and a nice Chianti?
In fact, the Mediterranean diet is quite clear on all these questions, so to read about these and more (including a “this yes, that no” list), see:
What Is The Mediterranean Diet, And What Is It Good For?
So, how do we get that in a pill?
A plucky band of researchers, Dr. Chiara de Lucia et al. (quite a lot of “et al.”; nine listed authors on the study), wondered to what extent the benefits of the Mediterranean diet come from the fact that the Mediterranean diet is very rich in polyphenols, and set about testing that, by putting the same polyphenols in capsule form, and running a randomized, double-blind, placebo-controlled, crossover clinical intervention trial.
Now, polyphenols are not the only reason the Mediterranean diet is great; there are also other considerations, such as:
- a great macronutrient balance with lots of fiber, healthy fats, moderate carbs, and protein from select sources
- the absence or at least very low presence of a lot of harmful substances such as refined seed oils, added sugars, refined carbohydrates, and the like (“but pasta” yes pasta; in moderation and wholegrain and served with extra sources of fiber and healthy fats, all of which slow down the absorption of the carbs)
…but polyphenols are admittedly very important too; we wrote about some common aspects of them here:
Tasty Polyphenols: Enjoy Bitter Foods For Your Heart & Brain
As for what Dr. de Lucia et al. put into the capsule, behold…
The ingredients:
- Apple Extract 10.0%
- Pomegranate Extract 10.0%
- Tomato Powder 2.5%
- Beet, Spray Dried 2.5%
- Olive Extract 7.5%
- Rosemary Extract 7.5%
- Green Coffee Bean Extract (CA) 7.5%
- Kale, Freeze Dried 2.5%
- Onion Extract 10.0%
- Ginger Extract 10.0%
- Grapefruit Extract 2.5%
- Carrot, Air Dried 2.5%
- Grape Skin Extract 17.5%
- Blueberry Extract 2.5%
- Currant, Freeze Dried 2.5%
- Elderberry, Freeze Dried 2.5%
And the relevant phytochemicals they contain:
- Quercetin
- Luteolin
- Catechins
- Punicalagins
- Phloretin
- Ellagic Acid
- Naringin
- Apigenin
- Isorhamnetin
- Chlorogenic Acids
- Rosmarinic Acid
- Anthocyanins
- Kaempferol
- Proanthocyanidins
- Myricetin
- Betanin
And what, you may wonder, did they find? Well, first let’s briefly summarise the setup of the study:
They took volunteers (n=30), average age 67, BMI >25, without serious health complaints, not taking other supplements, not vegetarian or vegan, not consuming >5 cups of coffee per day, and various other stipulations like that, to create a fairly homogenous study group who were expected to respond well to the intervention. In contrast, someone who takes antioxidant supplements, already eats many different color plants per day, and drinks 10 cups of coffee, probably already has a lot of antioxidant activity going on, and someone with a lower BMI will generally have lower resting levels of inflammatory markers, so it’s harder to see a change, proportionally.
About those inflammatory markers: that’s what they were testing, to see whether the intervention “worked”; essentially, did the levels of inflammatory markers go up or down (up is bad; down is good).
For more on inflammation, by the way, see:
How to Prevent (or Reduce) Inflammation
…which also explains what it actually is, and some important nuances about it.
Back to the study…
They gave half the participants the supplement for a week and the other half placebo; had a week’s gap as a “washout”, then repeated it, switching the groups, taking blood samples before and after each stage.
What they found:
The group taking the supplement had lower inflammatory markers after a week of taking it, while the group taking the placebo had relatively higher inflammatory markers after a week of taking it; this trend was preserved across both groups (i.e., when they switched roles for the second half).
The results were very significant (p=0.01 or thereabouts), and yet at the same time, quite modest (i.e. the supplement made a very reliable, very small difference), probably because of the small dose (150mg) and small intervention period (1 week).
What the researchers concluded from this
The researchers concluded that this was a success; the study had been primarily to provide proof of principle, not to rock the world. Now they want the experiment to be repeated with larger sample sizes, greater heterogeneity, larger doses, and longer intervention periods.
This is all very reasonable and good science.
What we conclude from this
That ingredients list makes for a good shopping list!
Well, not the extracts they listed, necessarily, but rather those actual fruits, vegetables, etc.
If nine top scientists (anti-aging specialists, neurobiologists, pharmacologists, and at least one professor of applied statistics) came to the conclusion that to get the absolute most bang-for-buck possible, those are the plants to get the phytochemicals from, then we’re not going to ignore that.
So, take another list above and ask yourself: how many of those 16 foods do you eat regularly, and could you work the others in?
Want to make your Mediterranean diet even better?
While the Mediterranean diet is a top-tier catch-all, it can be tweaked for specific areas of health, for example giving it an extra focus on heart health, or brain health, or being anti-inflammatory, or being especially gut healthy:
Four Ways To Upgrade The Mediterranean
Enjoy!
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High Histamine Foods To Avoid (And Low Histamine Foods To Eat Instead)
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Nour Zibdeh is an Integrative and Functional Dietician, and she helps people overcome food intolerances. Today, it’s about getting rid of the underdiagnosed condition that is histamine intolerance, by first eliminating the triggers, and then not getting stuck on the low-histamine diet
The recommendations
High histamine foods to avoid include:
- Alcohol (all types)
- Fermented foods—normally great for the gut, but bad in this case
- That includes most cheeses and yogurts
- Aged, cured, or otherwise preserved meat
- Some plants, e.g. tomato, spinach, eggplant, banana, avocado. Again, normally all great, but not in this case.
Low histamine foods to eat include:
- Fruits and vegetables not mentioned above
- Minimally processed meat and fish, either fresh from the butcher/fishmonger, or frozen (not from the chilled food section of the supermarket), and eaten the same day they were purchased or defrosted, because otherwise histamine builds up over time (and quite quickly)
- Grains, but she recommends skipping gluten, given the high likelihood of a comorbid gluten intolerance. So instead she recommends for example quinoa, oats, rice, buckwheat, millet, etc.
For more about these (and more examples), as well as how to then phase safely off the low histamine diet, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Further reading
Food intolerances often gang up on a person (i.e., comorbidity is high), so you might also like to read about:
- Gluten: What’s The Truth?
- Fiber For FODMAP-Avoiders
- Foods For Managing Hypothyroidism (incl. Hashimoto’s)
- Crohn’s, Food Intolerances, & More
Take care!
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Tips for Improving Memory
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Q&A with 10almonds Subscribers!
Q: Any tips, other than supplements, for improving memory?
A: So many tips! Certainly enough to do a main feature on, so again maybe we’ll do that in another issue soon. Meanwhile, here are the absolute most critical things for you to know, understand, and apply:
- Memory is a muscle. Not literally, but in the sense that it will grow stronger if exercised and will atrophy if neglected.
- Counterpart of the above: your memory is not a finite vessel. You can’t “fill it up with useless things”, so no need to fear doing so.
- Your memory is the product of countless connections in your brain. The more connections lead to a given memory, the more memorable it will be. What use is this knowledge to you? It means that if you want to remember something, try to make as many connections to it as possible, so:
- Involve as many senses as possible.
- When you learn things, try to learn them in context. Then when your mind has reason to think about the context, it’ll be more likely to remember the thing itself too.
- Rehearsal matters. A lot. This means repeatedly going over something in your head. This brings about the neural equivalent of “muscle memory”.
- Enjoy yourself if you can. The more fun something is, the more you will mentally rehearse it, and the more mental connections you’ll make to it.
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Lose Weight, But Healthily
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What Do You Have To Lose?
For something that’s a very commonly sought-after thing, we’ve not yet done a main feature specifically about how to lose weight, so we’re going to do that today, and make it part of a three-part series about changing one’s weight:
- Losing weight (specifically, losing fat)
- Gaining weight (specifically, gaining muscle)
- Gaining weight (specifically, gaining fat)
And yes, that last one is something that some people want/need to do (healthily!), and want/need help with that.
There will be, however, no need for a “losing muscle” article, because (even though sometimes a person might have some reason to want to do this), it’s really just a case of “those things we said for gaining muscle? Don’t do those and the muscle will atrophy naturally”.
One reason we’ve not covered this before is because the association between weight loss and good health is not nearly so strong as the weight loss industry would have you believe:
And, while BMI is not a useful measure of health in general, it’s worth noting that over the age of 65, a BMI of 27 (which is in the high end of “overweight”, without being obese) is associated with the lowest all-cause mortality:
BMI and all-cause mortality in older adults: a meta-analysis
Important: the above does mean that for very many of our readers, weight loss would not actually be healthy.
Today’s article is intended as a guide only for those who are sure that weight loss is the correct path forward. If in doubt, please talk to your doctor.
With that in mind…
Start in the kitchen
You will not be able to exercise well if your body is malnourished.
Counterintuitively, malnourishment and obesity often go hand-in-hand, partly for this reason.
Important: it’s not the calories in your food; it’s the food in your calories
See also: Mythbusting Calories
The kind of diet that most readily produces unhealthy overweight, the diet that nutritional scientists often call the “Standard American Diet”, or “SAD” for short, is high on calories but low on nutrients.
So you will want to flip this, and focus on enjoying nutrient-dense whole foods.
The Mediterranean Diet is the current “gold standard” in this regard, so for your interest we offer:
Four Ways To Upgrade The Mediterranean Diet
And since you may be wondering:
Should You Go Light Or Heavy On Carbs?
The dining room is the next most important place
Many people do not appreciate food enough for good health. The trick here is, having prepared a nice meal, to actually take the time to enjoy it.
It can be tempting when hungry (or just plain busy) to want to wolf down dinner in 47 seconds, but that is the metabolic equivalent of “oh no, our campfire needs more fuel, let’s spray it with a gallon of gasoline”.
To counter this, here’s the very good advice of Dr. Rupy Aujla, “The Kitchen Doctor”:
Interoception & Mindful Eating
The bedroom is important too
You snooze, you lose… Visceral belly fat, anyway! We’ve talked before about how waist circumference is a better indicator of metabolic health than BMI, and in our article about trimming that down, we covered how good sleep is critical for one’s waistline:
Visceral Belly Fat & How To Lose It
Exercise, yes! But in one important way.
There are various types of exercise that are good for various kinds of health, but there’s only one type of exercise that is good for boosting one’s metabolism.
Whereas most kinds of exercise will raise one’s metabolism while exercising, and then lower it afterwards (to below its previous metabolic base rate!) to compensate, high-intensity interval training (HIIT) will raise your metabolism while training, and for two hours afterwards:
…which means that unlike most kinds of exercise, HIIT actually works for fat loss:
So if you’d like to take up HIIT, here’s how:
How (And Why) To Do HIIT (Without Wrecking Your Body)
Want more?
Check out our previous article about specifically how to…
Burn! How To Boost Your Metabolism
Take care!
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It’s On Me – by Dr. Sara Kuburic
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This isn’t about bootstrapping and nor is it a motivational pep talk. What it is, however, is a wake-up call for the wayward, and that doesn’t mean “disaffected youth” or such. Rather, therapist Dr. Sara Kuburic tackles the problem of self-loss.
It’s about when we get so caught up in what we need to do, should do, are expected to do, are in a rut of doing… That we forget to also live. After all, we only get one shot at life so far as we know, so we might as well live it in whatever way is right for us.
That probably doesn’t mean a life of going through the motions.
The writing style here is personal and direct, and it makes for quite compelling reading from start to finish.
Bottom line: if ever you find yourself errantly sleepwalking through life and would like to change that, this is a book for you.
Click here to check out It’s On Me, and take control of what’s yours!
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Lifespan vs Healthspan, And The Spice Of Life
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Great newsletter. Am taking turmeric for inflammation of hips and feet. Works like magic. Would like to know how it works, and what tumeric is best combined with – also whether there any risks in longterm use.❞
Glad you’re enjoying! As for turmeric, it sure is great, isn’t it? To answer your questions in a brief fashion:
- How it works: it does a lot of things, but perhaps its most key feature is its autoxidative metabolites that mediate its anti-inflammatory effect. This, it slows or inhibits oxidative stress that would otherwise cause inflammation, increase cancer risk, and advance aging.
- Best combined with: black pepper
- Any risks in long-term use: there are no known risks in long-term use ← that’s just one study, but there are lots. Some studies were prompted by reported hepatotoxicity of curcumin supplements, but a) the reports themselves seem to be without evidence b) the reported hepatoxicity was in relation to contaminants in the supplements, not the curcumin itself c) clinical trials were unable to find any hepatotoxicity (or other) risks anyway. Here’s an example of such a study.
You might also like our previous main feature: Why Curcumin (Turmeric) Is Worth Its Weight In Gold
❝This push for longevity is appealing but watching my mother in her nineties is a life I’m not looking forward to. Healthy longevity, yes, but longevity for the sake of a longer life? No thank you.❞
Yes, you’re quite right, that’s exactly the point! Assuming we live to die of age-related conditions (i.e., we do not suffer a fatal accident or incident in our younger years), those unfun last years are coming whether they come at 75 or 95. Or earlier or later, because that can absolutely happen too!
For example: nearly 10% of Americans over 65 have difficulty with self-care
As a rule, and we’ve covered some of the science of this previously, having at least 4 out of 5 of the “big 5” lifestyle factors (diet, exercise, sleep, low-or-zero alcohol, not smoking) not only extends life, but specifically extends the healthspan, i.e. the count of healthy life-years that precedes final age-related decline.
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