Paris in spring, Bali in winter. How ‘bucket lists’ help cancer patients handle life and death
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In the 2007 film The Bucket List Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades.
Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common.
You can read articles listing the seven cities you must visit before you die or the 100 Australian bucket-list travel experiences. https://www.youtube.com/embed/UvdTpywTmQg?wmode=transparent&start=0
But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life is regret for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret.
The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness.
In a study published this week, we spoke to 54 people living with cancer, and 28 of their friends and family. For many, a key bucket list item was travel.
Why is travel so important?
There are lots of reasons why travel plays such a central role in our ideas about a “life well-lived”. Travel is often linked to important life transitions: the youthful gap year, the journey to self-discovery in the 2010 film Eat Pray Love, or the popular figure of the “grey nomad”.
The significance of travel is not merely in the destination, nor even in the journey. For many people, planning the travel is just as important. A cancer diagnosis affects people’s sense of control over their future, throwing into question their ability to write their own life story or plan their travel dreams.
Mark, the recently retired husband of a woman with cancer, told us about their stalled travel plans:
We’re just in that part of our lives where we were going to jump in the caravan and do the big trip and all this sort of thing, and now [our plans are] on blocks in the shed.
For others, a cancer diagnosis brought an urgent need to “tick things off” their bucket list. Asha, a woman living with breast cancer, told us she’d always been driven to “get things done” but the cancer diagnosis made this worse:
So, I had to do all the travel, I had to empty my bucket list now, which has kind of driven my partner round the bend.
People’s travel dreams ranged from whale watching in Queensland to seeing polar bears in the Arctic, and from driving a caravan across the Nullarbor Plain to skiing in Switzerland.
Nadia, who was 38 years old when we spoke to her, said travelling with her family had made important memories and given her a sense of vitality, despite her health struggles. She told us how being diagnosed with cancer had given her the chance to live her life at a younger age, rather than waiting for retirement:
In the last three years, I think I’ve lived more than a lot of 80-year-olds.
But travel is expensive
Of course, travel is expensive. It’s not by chance Nicholson’s character in The Bucket List is a billionaire.
Some people we spoke to had emptied their savings, assuming they would no longer need to provide for aged care or retirement. Others had used insurance payouts or charity to make their bucket-list dreams come true.
But not everyone can do this. Jim, a 60-year-old whose wife had been diagnosed with cancer, told us:
We’ve actually bought a new car and [been] talking about getting a new caravan […] But I’ve got to work. It’d be nice if there was a little money tree out the back but never mind.
Not everyone’s bucket list items were expensive. Some chose to spend more time with loved ones, take up a new hobby or get a pet.
Our study showed making plans to tick items off a list can give people a sense of self-determination and hope for the future. It was a way of exerting control in the face of an illness that can leave people feeling powerless. Asha said:
This disease is not going to control me. I am not going to sit still and do nothing. I want to go travel.
Something we ‘ought’ to do?
Bucket lists are also a symptom of a broader culture that emphasises conspicuous consumption and productivity, even into the end of life.
Indeed, people told us travelling could be exhausting, expensive and stressful, especially when they’re also living with the symptoms and side effects of treatment. Nevertheless, they felt travel was something they “ought” to do.
Travel can be deeply meaningful, as our study found. But a life well-lived need not be extravagant or adventurous. Finding what is meaningful is a deeply personal journey.
Names of study participants mentioned in this article are pseudonyms.
Leah Williams Veazey, ARC DECRA Research Fellow, University of Sydney; Alex Broom, Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney, and Katherine Kenny, ARC DECRA Senior Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Vitamin Solution – by Dr. Romy Block & Dr. Arielle Levitan
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A quick note: it would be remiss of us not to mention that the authors of this book are also the founders of a vitamin company, thus presenting a potential conflict of interest.
That said… In this reviewer’s opinion, the book does seem balanced and objective, regardless.
We talk a lot about supplements here at 10almonds, especially in our Monday Research Review editions. And yesterday, we featured a book by a doctor who hates supplements. Today, we feature a book by two doctors who have made them their business.
The authors cover all the most common vitamins and minerals popularly enjoyed as supplements, and examine:
- why people take them
- factors affecting whether they help
- problems that can arise
- complicating factors
The “complicating factors” include, for example, the way many vitamins and/or minerals interplay with each other, either by requiring the presence of another, or else competing for resources for absorption, or needing to be delicately balanced on pain of diverse woes.
This is the greatest value of the book, perhaps; it’s where most people go wrong with supplementation, if they go wrong.
While both authors are medical doctors, Dr. Romy Block is an endocrinologist specifically, and she clearly brought a lot of extra attention to relevant metabolic/thyroid issues, and how vitamins and minerals (such as thiamin and iron) can improve or sabotage such, depending on various factors that she explains. Informative, and so far as this reviewer could see, objective and well-balanced.
Bottom line: supplementation is a vast and complex topic, but this book does a fine job of demystifying and simplifying it in a clear and objective fashion, without resorting to either scaremongering or hype.
Click here to check out The Vitamin Solution, and upgrade your knowledge!
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How to Think More Effectively – by Alain de Botton
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Our brain is our most powerful organ, and our mind is an astonishing thing. So why do we sometimes go off-piste?
The School of Life‘s Alain de Botton lays out for us a framework of cumulative thinking, directions for effort, and unlikely tools for cognitive improvement.
The book especially highlights the importance of such things as…
- making time for cumulative thinking
- not, however, trying to force it
- working with, rather than in spite of, distractions
- noting and making use of our irrationalities
- taking what we think/do both seriously and lightly, at once
- practising constructive self-doubt
The style is as clear and easy as you may have come to expect from Alain de Botton / The School of Life, and yet, its ideas are still likely to challenge every reader in some (good!) way.
Bottom line: if you would like what you think, say, do to be more meaningful, this book will help you to make the most of your abilities!
Click here to check out How To Think More Effectively, and upgrade your thought processes!
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Purpose – by Gina Bianchini
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To address the elephant in the room, this is not a rehash of Rick Warren’s best-selling “The Purpose-Driven Life”. Instead, this book is (in this reviewer’s opinion) a lot better. It’s a lot more comprehensive, and it doesn’t assume that what’s most important to the author will be what’s most important to you.
What’s it about, then? It’s about giving your passion (whatever it may be) the tools to have an enduring impact on the world. It recommends doing this by leveraging a technology that would once have been considered magic: social media.
Far from “grow your brand” business books, this one looks at what really matters the most to you. Nobody will look back on your life and say “what a profitable second quarter that was in such-a-year”. But if you do your thing well, people will look back and say:
- “he was a pillar of the community”
- “she raised that community around her”
- “they did so much for us”
- “finding my place in that community changed my life”
- …and so forth. Isn’t that something worth doing?
Bianchini takes the position of both “idealistic dreamer” and “realistic worker”.
Further, she blends the two beautifully, to give practical step-by-step instructions on how to give life to the community that you build.
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CBD Against Diabetes!
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝CBD for diabetes! I’ve taken CBD for body pain. Did no good. Didn’t pay attention as to diabetes. I’m type 1 for 62 years. Any ideas?❞
Thanks for asking! First up, for reference, here’s our previous main feature on the topic of CBD:
CBD Oil: What Does The Science Say?
There, we touched on CBD’s effects re diabetes:
in mice / in vitro / in humans
In summary, according to the above studies, it…
- lowered incidence of diabetes in non-obese diabetic mice. By this they mean that pancreatic function improved (reduced insulitis and reduced inflammatory Th1-associated cytokine production). Obviously this has strong implications for Type 1 Diabetes in humans—but so far, just that, implications (because you are not a mouse).
- attenuated high glucose-induced endothelial cell inflammatory response and barrier disruption. Again, this is promising, but it was an in vitro study in very controlled lab conditions, and sometimes “what happens in the Petri dish, stays in the Petri dish”—in order words, these results may or may not translate to actual living humans.
- Improved insulin response ← is the main take-away that we got from reading through their numerical results, since there was no convenient conclusion given. Superficially, this may be of more interest to those with type 2 diabetes, but then again, if you have T1D and then acquire insulin resistance on top of that, you stand a good chance of dying on account of your exogenous insulin no longer working. In the case of T2D, “the pancreas will provide” (more or less), T1D, not so much.
So, what else is there out there?
The American Diabetes Association does not give a glowing review:
❝There’s a lot of hype surrounding CBD oil and diabetes. There is no noticeable effect on blood glucose (blood sugar) or insulin levels in people with type 2 diabetes. Researchers continue to study the effects of CBD on diabetes in animal studies. ❞
~ American Diabetes Association
Source: ADA | CBD & Diabetes
Of course, that’s type 2, but most research out there is for type 2, or else have been in vitro or rodent studies (and not many of those, at that).
Here’s a relatively more recent study that echoes the results of the previous mouse study we mentioned; it found:
❝CBD-treated non-obese diabetic mice developed T1D later and showed significantly reduced leukocyte activation and increased FCD in the pancreatic microcirculation.
Conclusions: Experimental CBD treatment reduced markers of inflammation in the microcirculation of the pancreas studied by intravital microscopy. ❞
~ Dr. Christian Lehmann et al.
Read more: Experimental cannabidiol treatment reduces early pancreatic inflammation in type 1 diabetes
…and here’s a 2020 study (so, more recent again) that was this time rats, and/but still more promising, insofar as it was with rats that had full-blown T1D already:
Read in full: Two-weeks treatment with cannabidiol improves biophysical and behavioral deficits associated with experimental type-1 diabetes
Finally, a paper in July 2023 (so, since our previous article about CBD), looked at the benefits of CBD against diabetes-related complications (so, applicable to most people with any kind of diabetes), and concluded:
❝CBDis of great value in the treatment of diabetes and its complications. CBD can improve pancreatic islet function, reduce pancreatic inflammation and improve insulin resistance. For diabetic complications, CBD not only has a preventive effect but also has a therapeutic value for existing diabetic complications and improves the function of target organs❞
…before continuing:
❝However, the safety and effectiveness of CBD are still needed to prove. It should be acknowledged that the clinical application of CBD in the treatment of diabetes and its complications has a long way to go.
The dissecting of the pharmacology and therapeutic role of CBD in diabetes would guide the future development of CBD-based therapeutics for treating diabetes and diabetic complications❞
~ Ibid.
Now, the first part of that is standard ass-covering, and the second part of that is standard “please fund more studies please”. Nevertheless, we must also not fail to take heed—little is guaranteed, especially when it comes to an area of research where the science is still very young.
In summary…
It seems well worth a try, and with ostensibly nothing to lose except the financial cost of the CBD.
If you do, you might want to keep careful track of a) your usual diabetes metrics (blood sugar levels before and after meals, insulin taken), and b) when you took CBD, what dose, etc, so you can do some citizen science here.
Lastly: please remember our standard disclaimer; we are not doctors, let alone your doctors, so please do check with your endocrinologist before undertaking any such changes!
Want to read more?
You might like our previous main feature:
How To Prevent And Reverse Type 2 Diabetes ← obviously this will not prevent or reverse Type 1 Diabetes, but avoiding insulin resistance is good in any case!
If you’re not diabetic and you’ve perhaps been confused throughout this article, then firstly thank you for your patience, and secondly you might like this quick primer:
The Sweet Truth About Diabetes: Debunking Diabetes Myths! ← this gives a simplified but fair overview of types 1 & 2
(for space, we didn’t cover the much less common types 3 & 4; perhaps another time we will)
Meanwhile, take care!
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These Top Few Things Make The Biggest Difference To Health
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The Best Few Interventions For The Best Health
Writer’s note: I was going to do something completely different for today (so that can go out another week now), but when reflecting on my own “what should I focus on in the new year?” (in terms of my own personal health goals and such) it occured to me that I should look back on the year’s articles, to take our own advice myself, and see what most important things I should make sure to focus on.
In so doing for myself, it occured to me that you, our subscribers who like condensed information and simple interventions for big positive effects, might also find value in a similar once-over. And so, today’s main feature was born!
Sometimes at 10almonds we talk about “those five things that affect everything”. They are:
- Good diet
- Good exercise
- Good sleep
- Not drinking
- Not smoking
If we were to add a sixth in terms of things that make a huge difference, it would be “manage stress effectively” and a seventh, beyond the scope of our newsletter, would be “don’t be socioeconomically disadvantaged” (e.g. poor, and/or part of some disprivileged minority group).
But as for those five we listed, it still leaves the question: what are the few most effective things we can do to improve them? Where can we invest our time/energy/effort for greatest effect?
Good diet
Best current science consistently recommends the Mediterranean Diet:
The Mediterranean Diet: What Is It Good For?
But it can be tweaked for specific desired health considerations:
Four Ways To Upgrade The Mediterranean Diet
Other most-effective dietary tweaks that impact a lot of other areas of health include looking after your gut health and looking after your blood sugars:
Making Friends With Your Gut (You Can Thank Us Later)
and
“Let Them Eat Cake”, She Said (10 Ways To Balance Blood Sugars)
Good exercise
Most exercise is good, but two of the most beneficial things that are (for most people) easy to implement are walking, and High-Intensity Interval Training:
How To Do HIIT (Without Wrecking Your Body)
Good sleep
This means quality and quantity! We cannot skimp on either and expect good health:
Why You Probably Need More Sleep
and as for quality,
The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
Not drinking
According to the World Health Organization, the only safe amount of alcohol is zero.
See also:
Can We Drink To Good Health? (e.g. Red Wine & Heart Health)
and
Not smoking
We haven’t done a main feature on this! It’s probably not really necessary, as it’s not very contentious to say “smoking is bad for everything”.
WHO | Tobacco kills up to half its users who don’t quit
However, as a side-note, while cannabis is generally recognised as not as harmful as tobacco-based products, it has some fairly major drawbacks too. For some people, the benefits (e.g. pain relief) may outweigh the risks, though:
Final thoughts
Not sure where to start? We suggest this order of priorities, unless you have a major health condition that makes something else a higher priority:
- If you smoke, stop
- If you drink, reduce, or ideally stop
- Improve your diet
About that diet…
- Worry less about what to exclude, and instead focus on adding more variety of fruit/veg
- See also: Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- That said, if you’re looking for things to cut, sugar is a top candidate (and red meat is in clear second place albeit some way below)
When it comes to exercise, get your 10,000 daily steps in (actually, science says 8,000 steps is fine), and consider adding HIIT per our above article, when you feel like adding that in. As for that about the steps:
When it comes to sleep, if you’re taking care of the above things then this will probably take care of itself, if you don’t have a sleep-inconvenient lifestyle (e.g. shift work, just had a baby, etc) or a sleep disorder.
Take care!
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Gut-Healthy Labneh Orecchiette
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Labneh (a sort of yogurt-cheese made from strained yogurt) is a great probiotic, and there’s plenty of resistant starch in this dish too, from how we cook, cool, and reheat the pasta. Add to this the lycopene from the tomatoes, the ergothioneine from the mushrooms, and the healthful properties of the garlic, black pepper, and red chili, and we have a very healthy dish!
You will need
- 10 oz labneh (if you can’t buy it locally, you can make your own by straining Greek yogurt through a muslin cloth, suspended over a bowl to catch the water that drips out, overnight—and yes, plant-based is also fine if you are vegan, and the gut benefits are similar because unlike vegan cheese, vegan yogurt is still fermented)
- 6 oz wholegrain orecchiette (or other pasta, but this shape works well for this sauce)
- ¼ bulb garlic, grated
- Juice of ½ lemon
- Large handful chopped parsley
- Large handful chopped dill
- 9 oz cherry tomatoes, halved
- 9 oz mushrooms (your choice what kind), sliced (unless you went for shiitake or similar, which don’t need it due to already being very thin)
- 2 tsp black pepper, coarse ground
- 1 tsp red chili flakes
- ¼ tsp MSG or ½ tsp low-sodium salt
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Cook the pasta as you normally would. Drain, and rinse with cold water. Set aside.
2) Combine the labneh with the garlic, black pepper, dill, parsley, and lemon juice, in a large bowl. Set aside.
3) Heat a little olive oil in a skillet; add the chili flakes, followed by the mushrooms. Cook until soft and browned, then add the tomatoes and fry for a further 1 minute—we want the tomatoes to be blistered, but not broken down. Stir in the MSG/salt, and take off the heat.
4) Refresh the pasta by passing a kettle of boiling water through it in a colander, then add the hot pasta to the bowl of labneh sauce, stirring to coat thoroughly.
5) Serve, spooning the mushrooms and tomatoes over the labneh pasta.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Making Friends With Your Gut (You Can Thank Us Later)
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- “The Longevity Vitamin” (That’s Not A Vitamin)
Take care!
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