The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
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There’s a lot more to breast cancer care than “check your breasts regularly”. Because… And then what? “Go see a doctor” obviously, but it’s a scary prospect with a lot of unknowns.
Dr. Simmons demystifies these unknowns, from both her position as an oncologist (and breast surgeon) and also her position as a breast cancer survivor herself.
What she found, upon getting to experience the patient side of things, was that the system is broken in ways she’d never considered before as a doctor.
This book is the product of the things she’s learned both within her field, and elsewhere because of realizing the former’s areas of shortcoming.
She gives a step-by-step guide, from diagnosis onwards, advising taking as much as possible into one’s own hands—especially in the categories of information and action. She also explains the things that make the biggest difference to cancer outcomes when it comes to eating, sleeping, and so forth, the best attitude to have to be neither despairing and giving up, nor overconfident and complacent.
She does also talk complementary therapies, be they supplements or more out-of-the-box approaches and the evidence for them where applicable, as well as doing some high-quality mythbusting about more prescription-based considerations such as HRT.
Bottom line: if you or a loved one have a breast cancer diagnosis, or you just prefer knowing this sort of thing than not, then this book is a top-tier “insider’s guide”.
Click here to check out the Smart Woman’s Guide To Breast Cancer, and take control!
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A Correction, And A New, Natural Way To Boost Daily Energy Levels
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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
First: a correction and expansion!
After yesterday’s issue of 10almonds covering breast cancer risks and checks, a subscriber wrote to say, with regard to our opening statement, which was:
“Anyone (who has not had a double mastectomy, anyway) can get breast cancer”
❝I have been enjoying your newsletter. This statement is misleading and should have a disclaimer that says even someone who has had a double mastectomy can get breast cancer, again. It is true and nothing…nothing is 100% including a mastectomy. I am a 12 year “thriver” (I don’t like to use the term survivor) who has had a double mastectomy. I work with a local hospital to help newly diagnosed patients deal with their cancer diagnosis and the many decisions that follow. A double mastectomy can help keep recurrence from happening but there are no guarantees. I tried to just delete this and let it go but it doesn’t feel right. Thank you!❞
Thank you for writing in about this! We wouldn’t want to mislead, and we’re always glad to hear from people who have been living with conditions for a long time, as (assuming they are a person inclined to learning) they will generally know topics far more deeply than someone who has researched it for a short period of time.
Regards a double mastectomy (we’re sure you know this already, but noting here for greater awareness, prompted by your message), a lot of circumstances can vary. For example, how far did a given cancer spread, and especially, did it spread to the lymph nodes at the armpits? And what tissue was (and wasn’t) removed?
Sometimes a bilateral prophylactic mastectomy will leave the lymph nodes partially or entirely intact, and a cancer could indeed come back, if not every last cancerous cell was removed.
A total double mastectomy, by definition, should have removed all tissue that could qualify as breast tissue for a breast cancer, including those lymph nodes. However, if the cancer spread unnoticed somewhere else in the body, then again, you’re quite correct, it could come back.
Some people have a double mastectomy without having got cancer first. Either because of a fear of cancer due to a genetic risk (like Angelina Jolie), or for other reasons (like Elliot Page).
This makes a difference, because doing it for reasons of cancer risk may mean surgeons remove the lymph nodes too, while if that wasn’t a factor, surgeons will tend to leave them in place.
In principle, if there is no breast tissue, including lymph nodes, and there was no cancer to spread, then it can be argued that the risk of breast cancer should now be the same “zero” as the risk of getting prostate cancer when one does not have a prostate.
But… Surgeries are not perfect, and everyone’s anatomy and physiology can differ enough from “textbook standard” that surprises can happen, and there’s almost always a non-zero chance of certain health outcomes.
For any unfamiliar, here’s a good starting point for learning about the many types of mastectomy, that we didn’t go into in yesterday’s edition. It’s from the UK’s National Health Service:
NHS: Mastectomy | Types of Mastectomy
And for the more sciency-inclined, here’s a paper about the recurrence rate of cancer after a prophylactic double mastectomy, after a young cancer was found in one breast.
The short version is that the measured incidence rate of breast cancer after prophylactic bilateral mastectomy was zero, but the discussion (including notes about the limitations of the study) is well worth reading:
Breast Cancer after Prophylactic Bilateral Mastectomy in Women with a BRCA1 or BRCA2 Mutation
❝[Can you write about] the availability of geriatric doctors Sometimes I feel my primary isn’t really up on my 70 year old health issues. I would love to find a doctor that understands my issues and is able to explain them to me. Ie; my worsening arthritis in regards to food I eat; in regards to meds vs homeopathic solutions.! Thanks!❞
That’s a great topic, worthy of a main feature! Because in many cases, it’s not just about specialization of skills, but also about empathy, and the gap between studying a condition and living with a condition.
About arthritis, we’re going to do a main feature specifically on that quite soon, but meanwhile, you might like our previous article:
Keep Inflammation At Bay (arthritis being an inflammatory condition)
As for homeopathy, your question prompts our poll today!
(and then we’ll write about that tomorrow)
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Toasted Chick’n Mango Tacos
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Tacos aren’t generally held up as the world’s healthiest food, but they can be! There’s so much going on in this dish today, healthwise, in a good way, that it’s hard to know where to start. But suffice it to say, these tacos are great for your gut, heart, blood sugars, and more.
You will need
For the chickpeas:
- 1 can chickpeas, drained
- 1 tbsp ras el-hanout*
- 1 tsp red pepper flakes
- ½ tsp MSG or 1 tsp low-sodium salt
- Extra virgin olive oil
*You can easily make this yourself; following our recipe (linked above in the ingredients list) will be better than buying it ready-made, and if you have strong feelings about any of the ingredients, you can adjust per your preference.
For the tahini sauce:
- ⅓ cup tahini
- 2 tbsp apple cider vinegar
- 2 tbsp finely chopped fresh dill
- ¼ bulb garlic, minced
- 1 tsp red pepper flakes
- ½ tsp black pepper, coarse ground
It may seem like salt is conspicuous by its absence, but there is already enough in the chickpeas component; you do not want to overwhelm the dish. Trust us that enjoying these things together will be well-balanced and delicious as written.
For the mango relish:
- ½ mango, pitted, peeled, and cubed
- 2 tsp apple cider vinegar
- 2 tsp cilantro, finely chopped (substitute with parsley if you have the “cilantro tastes like soap” gene)
- 1 tsp red pepper flakes
For building the taco:
- Soft corn tortillas
- Handful of arugula
- 1 avocado, pitted, peeled, and sliced
- ½ red onion, sliced
Method
(we suggest you read everything at least once before doing anything)
1) Heat a sauté pan with a little olive oil in; add the chickpeas and then the rest of the ingredients from the chickpea section; cook for about 5 minutes, stirring frequently, and set aside.
2) Combine the tahini sauce ingredients in a small bowl, stirring in ¼ cup water, and set aside.
3) Combine the mango relish ingredients in a separate small bowl, and set aside. You can eat the other half of the mango if you like.
4) Lightly toast the tortillas in a dry skillet, or using a grill.
5) Assemble the tacos; we recommend the order: tortillas, arugula, avocado slices, chickpeas, mango relish, red onion slices, tahini sauce.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Eat More (Of This) For Lower Blood Pressure
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we hit all five today! Yay!
- An Apple (Cider Vinegar) A Day…
- Coconut vs Avocado – Which is Healthier?
- Lettuce vs Arugula – Which is Healthier?
Take care!
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Can You Gain Muscle & Lose Fat At The Same Time?
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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 😎
❝Is it possible to lose fat and gain muscle at the same time, or do we need to focus on one and then the other, and if so, which order is best?❞
Contrary to popular belief, you can do both simultaneously! However, it’s not as easy as doing just one or the other, which is why most bodybuilders, for example, have a “building phase” and a “cutting phase”.
The reason it’s difficult is because of the diet. Growing muscle doesn’t just take protein and micronutrients; it takes energy as well, which must come from carbohydrates and/or fats. Therefore, it is tricky to eat enough to build muscle and to fuel the workouts that are required to build the muscle (you can’t hit the gym in a state of rabbit starvation* and expect to perform well at your workout), while at the same time not eating enough carbs/fats to have any excess to store as fat.
*So-called because rabbit-meat is very lean, such that when during times of famine, European peasants tried to subsist off mostly rabbits, their health quickly plummeted for lack of energy. It’s also been called “salmon starvation”, apparently, for the same reason:
In French it’s called “Mal de caribou” (caribou sickness), by the way. But you get the idea: eat too much lean protein without enough carbs/fats, and woe shall befall.
So, if you want to do both at once, you need to be incredibly on top of your macros, and the bad news is, only you (or a coach working directly with you) can work out what precise macros requirements your body has, because it depends on your body and your activities.
The easier “half-way house”
We will get to the “building phase” and “cutting phase” of bodybuilders, but first, here’s an option that’s very worthy of consideration, and it is: forget about your weight and just focus on health while incidentally doing regular resistance exercises and HIIT.
What will happen if you do this (assuming a healthy balanced diet, nothing special and without counting anything, but we’re talking at least mostly whole-foods, and at least mostly plants; the Mediterranean diet is great for this, as it is for most things) is:
- The dietary approach described will gradually improve your metabolic health if it wasn’t already good. If it was already good, it’ll likely just maintain it, rather than improve it.
- The resistance exercises will, if engaged with seriously (it has to be difficult to do, or your muscles won’t have any reason to grow), gradually build muscle. This will be very gradual, because you’re not eating for bodybuilding, nor optimizing your general lifestyle for same. Historically many women have feared lifting weights because they don’t want to “look like a weightlifter”, but the kinds of bodies that word brings to mind are not the kind that happen by accident (especially for women, with our different hormones guiding our bodies to a different composition); it takes a lot of single-minded dedication to specifically optimize size gains, for a long time.
- The high-intensity interval training (HIIT) will more rapidly improve your metabolic health, and unlike most forms of exercise, it will actually result in a gradual reduction of fat, if you have superfluous fat to lose. This is because whereas most forms of cardio exercise increase the heartrate for a while but then have a corresponding metabolic slump afterwards to make up for it, HIIT confuses the heart (in a good way) which results in it having to grow stronger, and not doing any compensatory metabolic slump:
How To Do HIIT (Without Wrecking Your Body) ← as well as the “how to”, this also gives some of the science behind it, too
This will, thus, result in gradual gain of muscle and loss of fat—or if you take it easier with the exercise, then you can easily settle into just maintaining your body composition as it is, but that wasn’t the question today.
So, there you have it, that’s how to do both at once! Now, if you want more dramatic results, then more dramatic methods are called for:
What bodybuilders (mostly) do
Matters of genetic predisposition and commonplace use of steroids aside, here’s how bodybuilders get that “lots of muscle, no fat” figure:
- First, get into “moderate” shape if not already there.
- Bulk up: eat amounts of food that will seem unreasonable to a non-bodybuilder; eating 2x or even 3x the “recommended” daily calorie amount is common; focus is typically on getting adequate (for bodybuilding purposes) protein while also carb-loading for workouts and getting at least enough fats for fat-soluble vitamins to work. In the gym, focus on doing sets of very few reps with the heaviest weights one can safely lift, while doing minimal cardio, and also sleeping a lot (9–12hrs per day), which is essential because this is putting a huge strain on the body and it needs a chance to recover and rebuild.
- Cut down: maintain protein intake (to at least mostly maintain muscles) while keeping carbs and fats low, doing cardio work (HIIT is still ideal) and running a calorie deficit for a short while (there is no use in trying to maintain a long-term calorie deficit; your body will try to save you from starvation by storing any fat it can and slowing your metabolism).
Phases 2 and 3 are then cycled, alternating every month, or every 6 weeks, or every 2 months or so, depending on personal preferences and scheduling considerations (bodybuilders will often have competitions they are working towards, so they need to time things to be at the end of a cutting phase to look their “best” by bodybuilder standards).
Disclaimer: bodybuilding is complex, and can be ruinous to the health if practised inexpertly, because of its extreme nature. We don’t recommend serious bodybuilding per se in general, but if you are going to do it, please consult with a professional bodybuilding coach, and do not rely on a few paragraphs from us that are intended only to give the most basic overview of how bodybuilders can approach the “gain muscle, lose fat” problem.
Want to know more?
We’ve written on some related topics previously; here’s a three-part series:
- How To Lose Weight (Healthily!)
- How To Build Muscle (Healthily!)
- How To Gain Weight (Healthily!) ← this one’s specifically about gaining healthy levels of fat, for any who want/need that
And also:
Can We Do Fat Redistribution? ← yes we can, but there are caveats
Take care!
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Black Bean Hummus Panini
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
A recipe for a sandwich? Try it once, and you’ll see why. Welcome to your new favorite!
You will need
- 1 cup cooked-and-rinsed black beans (canned is fine)
- ⅓ cup hummus (you can use our Hero Homemade Hummus recipe)
- 4 thin slices of eggplant (or more if you like it meaty)
- 4 sun-dried tomatoes
- 2 slices of your favorite bread (you can use our Delicious Quinoa Avocado Bread recipe)
- A little olive oil, ideally sprayable
Method
(we suggest you read everything at least once before doing anything)
1) Grill the eggplant slices until soft.
2) Spread hummus generously on one side of both slices of bread.
2) Add the black beans on top of one slice (the hummus will help them stay in place), followed by the sun-dried tomatoes and then the eggplant. Top with the other slice of bread, hummus-side down.
3) Coat (carefully, please) the inside of the panini press (both interior sides) with olive oil. If you don’t have sprayable oil, using a sheet of kitchen roll to apply the oil is a good way to do it without making a mess.
4) Grill the assembled sandwich, until the bread starts to brown and the insides are warm; this should take about 4 minutes.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Three Daily Servings of Beans?
- Chickpeas vs Black Beans – Which is Healthier?
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
Take care!
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Fast Diet, Fast Exercise, Fast Improvements
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Diet & Exercise, Optimized
This is Dr. Michael Mosley. He originally trained in medicine with the intention of becoming a psychiatrist, but he grew disillusioned with psychiatry as it was practised, and ended up pivoting completely into being a health educator, in which field he won the British Medical Association’s Medical Journalist of the Year Award.
He also died under tragic circumstances very recently (he and his wife were vacationing in Greece, he went missing while out for a short walk on the 5th of June, appears to have got lost, and his body was found 100 yards from a restaurant on the 9th). All strength and comfort to his family; we offer our small tribute here today in his honor.
The “weekend warrior” of fasting
Dr. Mosley was an enjoyer (and proponent) of intermittent fasting, which we’ve written about before:
Fasting Without Crashing? We Sort The Science From The Hype
However, while most attention is generally given to the 16:8 method of intermittent fasting (fast for 16 hours, eat during an 8 hour window, repeat), Dr. Mosley preferred the 5:2 method (which generally means: eat at will for 5 days, then eat a reduced calorie diet for the other 2 days).
Specifically, he advocated putting that cap at 800 kcal for each of the weekend days (doesn’t have to be specifically the weekend).
He also tweaked the “eat at will for 5 days” part, to “eat as much as you like of a low-carb Mediterranean diet for 5 days”:
❝The “New 5:2” approach involves restricting calories to 800 on fasting days, then eating a healthy lower carb, Mediterranean-style diet for the rest of the week.
The beauty of intermittent fasting means that as your insulin sensitivity returns, you will feel fuller for longer on smaller portions. This is why, on non-fasting days, you do not have to count calories, just eat sensible portions. By maintaining a Mediterranean-style diet, you will consume all of the healthy fats, protein, fibre and fresh plant-based food that your body needs.❞
Read more: The Fast 800 | The New 5:2
And about that tweaked Mediterranean Diet? You might also want to check out:
Four Ways To Upgrade The Mediterranean Diet
Knowledge is power
Dr. Mosley encouraged the use of genotyping tests for personal health, not just to know about risk factors, but also to know about things such as, for example, whether you have the gene that makes you unable to gain significant improvements in aerobic fitness by following endurance training programs:
The Real Benefit Of Genetic Testing
On which note, he himself was not a fan of exercise, but recognised its importance, and instead sought to minimize the amount of exercise he needed to do, by practising High Intensity Interval Training. We reviewed a book of his (teamed up with a sports scientist) not long back; here it is:
Fast Exercise: The Simple Secret of High Intensity Training – by Dr. Michael Mosley & Peta Bee
You can also read our own article on the topic, here:
How To Do HIIT (Without Wrecking Your Body)
Just One Thing…
As well as his many educational TV shows, Dr. Mosley was also known for his radio show, “Just One Thing”, and a little while ago we reviewed his book, effectively a compilation of these:
Just One Thing: How Simple Changes Can Transform Your Life – by Dr. Michael Mosley
Enjoy!
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Body Language (In The Real World)
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Forget What You Think You Know About Body Language
…unless it’s about a specific person whose habits and mannerisms you know intimately, in which case, you probably have enough personal data stored up to actually recognize patterns à la “when my spouse does this, then…”, and probably do know what’s going on.
For everyone else… our body language can be as unique as our idiolect
What’s an idiolect? It’s any one given person’s way of speaking/writing, in their natural state (i.e. without having to adjust their style for some reason, for example in a public-facing role at work, where style often becomes much narrower and more consciously-chosen).
Extreme example first
To give an extreme example of how non-verbal communication can be very different than a person thinks, there’s an anecdote floating around the web of someone whose non-verbal autistic kid would, when he liked someone who was visiting the house, hide their shoes when they were about to leave, to cause them to stay longer. Then one day some relative visited and when she suggested that she “should be going sometime soon”, he hurried to bring her her shoes. She left, happy that the kid liked her (he did not).
The above misunderstanding happened because the visitor had the previous life experience of “a person who brings me things is being helpful, and if they do it of their own free will, it’s because they like me”.
In other words…
Generalizations are often sound… In general
…which does not help us when dealing with individuals, which as it turns out, everyone is.
Clenched fists = tense and angry… Except when it’s just what’s comfortable for someone, or they have circulation issues, or this, or that, or the other.
Pacing = agitated… Except when it’s just someone who finds the body in motion more comfortable
Relaxed arms and hands = at ease and unthreatening… Unless it’s a practitioner of various martial arts for whom that is their default ready-for-action state.
Folded arms = closed-off, cold, distant… Or it was just somewhere to put one’s hands.
Lack of eye contact = deceitful, hiding something… Unless it’s actually for any one of a wide number of reasons, which brings us to our next section:
A liar’s “tells”
Again, if you know someone intimately and know what signs are associated with deceit in them, then great, that’s a thing you know. But for people in general…
A lot of what is repeated about “how to know if someone is lying” has seeped into public consciousness from “what police use to justify their belief that someone is lying”.
This is why many of the traditional “this person is lying” signs are based around behaviors that show up when in fact “this person is afraid, under pressure, and talking to an authority figure who has the power to ruin their life”:
Research on Non-verbal Signs of Lies and Deceit: A Blind Alley
But what about eye-accessing cues? They have science to them, right?
For any unfamiliar: this is about the theory that when we are accessing different parts of our mind (such as memory or creativity, thus truthfulness or lying), our eyes move one way or another according to what faculty we’re accessing.
Does it work? No
But, if you carefully calibrate it for a specific person, such as by asking them questions along the lines of “describe your front door” or “describe your ideal holiday”, to see which ways they look for recall or creativity… Then also no:
The Eyes Don’t Have It: Lie Detection and Neuro-Linguistic Programming
How can we know what non-verbal communication means, then?
With strangers? We can’t, simply. It’s on us to be open-minded, with a healthy balance of optimism and wariness.
With people we know? We can build up a picture over time, learn the person’s patterns. Best of all, we can ask them. In the moment, and in general.
For more on optimizing interpersonal communication, check out:
Save Time With Better Communication
…and the flipside of that:
The Problem With Active Listening (And How To Do It Better)
Take care!
Don’t Forget…
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Learn to Age Gracefully
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