Breast cancer: a twenty-year apprenticeship

Have you ever had a period in your life where, despite the fact that everything looks the same on the outside, you know that everything has changed on the inside and will never be the same again?

Of course you have! Everyone who goes through cancer diagnosis knows how that feels. The terms BC and AD take on a new meaning: before cancer and after diagnosis.

I wasn’t expecting to feel the same way when I signed up to do an MSc with CNELM in December 2015; I knew it was going to be tough but I didn’t expect it to completely rock my world. It was a patient, pedantic and often painful process that not only threatened to burst the seams of my already well-stuffed life but also revolutionised the way I see my work. There were so many days that I wanted to give up but, like going through the refiner’s fire, it also tested my commitment to and my belief in the work I do. The more I studied, the more clear I became about the vital role of nutrition in cancer, both in terms of prevention and survival. More than that, achieving a ‘first’ for my assignment on breast cancer, genes and nutrition gave me the permission I’ve been looking for: the right to say that I am a breast cancer specialist.

I’ve spent the past twenty years looking at human health and nutrition through a breast cancer lens. It started as a selfish pursuit and became a kind of calling. For much of this time the view was out of focus: our understanding of where food fits in to the cancer equation has been slow to build, more intuited than informed, and lacking in evidence. An incomplete understanding of the origins and mechanisms of cancer has been the main reason for that blur. So, as the last few years have brought a series of breakthroughs in our grasp of the behaviour of tumours, the tumour microenvironment and the processes that lead to cells turning rogue in the first place, it has become easier to see where nutrients (and toxins) may be having an effect – and where specific diet and supplement interventions may be able to work alone and alongside conventional medicine:

• to reduce side-effects during treatment;
• to potentiate treatment, allowing lower drug doses;
• to put cancer cells under metabolic stress and threaten their survival;
• to switch on the body’s autophagy cell destruction process to make up for the deactivation of the apoptosis cell destruction process typical in cancer;
• to modify key survival enzymes and cell repair processes;
• to manage levels of oxidative stress and inflammation;
• to galvanise immune system response;
• to repair epigenetic DNA damage driving cancer growth and
• to improve the wider cellular microenvironment thus reducing risk of recurrence.

There’s nothing vague and woolly about that: it’s both exciting and daunting. The sheer scale of the things I read and tried to distil into coherent ideas last year was overwhelming: the range of views, the complex lines of enquiry and the diversity of research projects are too much to hold in one brain. As I came back down to earth after my period of studying I spent a long time panicking, wondering how on earth I was going to translate what I’d learned into clinic. Gradually, I realised that specialisation was the answer. Which is why I’ve decided to focus not just on cancer, but on breast cancer. It’s the only way I can continue to live a normal life and make a meaningful contribution without feeling like Sisyphus on a bad day.

My studies made it clear that breast cancer is, indeed, a personal problem. I explored my own genes in order to understand how food, lifestyle and environment interact with individual mutations to increase risk, and how those risks could be modified. I got to grips with the way in which idiosyncratic nutrient requirements or deficiencies may fuel inflammation or compromise our ability to prevent damage to mitochondrial and DNA structures, leading to cancerous changes. I read how our hormonal environment, directly influenced by lifestyle and diet, could accelerate the cancer process. Research analysis helped me understand how the large-scale studies favoured by conventional medicine are often a waste of time and money when disease patterns are so chaotic and diverse. Clinical case studies taught me how to assess individual foibles in clinic and through functional and genetic testing, and then supply the right nutrients to correct the imbalance.

While early diagnosis and intervention is still the most important factor aside from prevention, I no longer see cancer as some random, inexplicable, omnipotent cellular aberration that cannot be stopped. When cancer happens, it is always bad luck, but in some cases that is down to exposure to a virus or toxin that couldn’t have been avoided, and in others it is the  inevitable and predictable outcome of living beyond our psychological and physiological means, with all the biochemical chaos that ensues. Breast cancer tends to fall into the latter category, even when there’s a genetic component. Which means that finding out your own specific diet and lifestyle risk factors is an important part of promoting recovery and avoiding recurrence.

I’m not trying to pretend that I have all the answers, but I do believe that we are on the verge of a new cancer paradigm. The scientific and medical discoveries happening now are incredibly exciting, if only because they signal the end of hateful chemo- and radiotherapy regimes. The increase in cancer survival in the last twenty years has been slower than anyone would like (especially if you exclude earlier diagnosis), but the huge number of approaches that have been trialled has led scientists to a much greater understanding of the disease. It’s likely that the next twenty will see the concepts that are currently under research – immunotherapy, targeted drugs, oxygen therapy, metabolic therapy etc – merging into an integrated standard of care, and no longer viewed as alternative or complementary. What excites me most about that is the idea of treatment working with and augmenting our bodies’ own healing potential, rather than against it.

Last year marked the twentieth year of my survival and the end of my apprenticeship. I’m finally ready for the real work! If you’d like to explore what that means for you then please get in touch.