Is the Diet Working? - Tale of the Scale - February 4, 2009

Many of you have left comments or sent private emails regarding the diet that we have undertaken. I have provided very few details in response. The main reason is that I wanted to gather some evidence of its effect before making any declarations about its efficacy. Which is a mouthful of words to say, "Why recommend or describe something, when I don't know if it's doing any good?" So here's the BIG QUESTION:

Does the diet work?

For those eager to get to the bottom line, the answer will be disappointing:

I don't know.

The question is more complex than it might seem. How shall we define "working?" I'd have to assert that the number one effect we are seeking is that it slows or stops cancer progression, and delays or prevents cancer recurrence. (The two terms are described by Dr. X in this post.)

Now let's look at my personal timeline:
Symptom (tiny drop of blood in urine) February 10, 2008
Diagnosis (bladder cancer) March 31, 2008
Staging (TURBT #1 - T1 non-invasive, Grade 3) April 9, 2008
Cancer Free (verified microscopically) May 21, 2008
Started Diet August 1, 2008
Started Exercise November 24, 2008
TODAY - 8 months cancer free, 6 months on diet, 2 months on exercise (and still despising every minute)

In addition to surgery, diet, and exercise, I have engaged in a heavy program of prayer (don't discount it so easily), BCG treatments, vitamins (Dr. Lamm says not needed), and "magic powder" from the internet (PectaSol-C MCP). So what that means is IF the cancer does not come back (still unlikely, sad to say), or IF a recurrent cancer does not progress, it will not be possible to assign the cause. In other words, if something in the above list works, we won't know which one (or set of several, or even all of the above) is doing the trick! And don't forget we can't rule out divine intervention, either. The long and short of it is that I will never know if the diet works, or if it works alone or in combination with something else. If it does work, it could even be as simple as only one food added or avoided as a subset of the diet. There's just no way to know for sure.

What I do know is this - Changing your diet is affordable and easy to do, and therefore it's worth doing, because it COULD contribute to fighting your cancer battle. And if you don't have cancer, it COULD prevent you from getting it. So let's spend some time discussing how diet changes theoretically could make a difference. Some of this is logical conjecture, some supported by peer-reviewed and published science, and some supported anecdotally (which does not and should not count for scientific or medical opinion). This is why your doctors are forced to be non-committal about the possible benefits of diet changes regarding cancer. If they say anything at all about diet (unlikely) they will work along the lines of tried and true weight loss, heart disease, and blood pressure benefits.

Now that I am six months into diet and two months into exercise, and even though I can't demonstrate that it has been a factor in keeping the cancer at bay so far, still there are measurable results. For the past several years I have been wearing pants with waist size of 40 inches. Until a couple of years ago they fit OK. But since then I have been spilling over the top of them - the term for this, apparently, is Muffin Top, and for me it would be super-sized Muffin Top. I finally went out and bought a size 42 belt, and found even that was too small! Depressing. But in the last six months my pants have started to fit again. I pulled the unused belt out of the closet, and found that I could now use it, albeit on the very widest notch. Then a few months ago I had to tighten it a notch, and then another, and still another. Now my pants are a little bit too loose, and I have only 1 belt notch left before it becomes too big! So there we have some measurable data to support that the diet is doing something good.

In addition to the saga of the belt we have the tale of the scale. I have been taking weekly readings of weight, blood pressure, and heart rate for several years. The weight scale over the past year has shown some dramatic changes. The results are graphed below, and the numbers speak for themselves...

So what exactly is this diet, and where did it come from? We started our research with a recommendation from Crystal, my nurse advisor. She mentioned a book by Jordan Rubin. Some research on Amazon revealed several things. Mr. Rubin has written over a dozen books, and the Amazon reviews by purchasers are not flattering. Apparently he repackages the same material or subsets of it and markets the result as new and different. The consensus Amazon reviews were to stick with one book The Maker's Diet and one supplemental booklet The Maker's Diet Shopper's Guide. What Mr. Rubin does have going for him is that his radical dietary change reversed his near-terminal case of Crohn's disease, a wasting condition whereby foods are not absorbed from the intestines. His miraculous recovery is testimony that something worked. The problem is that what research he conducted was all retroactive by necessity (he was about to die, after all!) But this approach becomes scientifically inappropriate when you are looking for evidence to support the conclusion rather than developing a conclusion based on the evidence. Since I could not resist temptation and marketing, I ordered a third book of his. And therefore I am able to affirm the Amazon audience is correct. I furthermore suggest (with some evidence to my credit) that his newer publications not only repackage the original data, they are poorly organized, internally inconsistent (e.g. don't eat X while X appears in a subsequent recipe), and sparsely populated with additional data, most of which is based on conjecture rather than science. So while you can call Rubin's books the foundation of my personal diet, the best way to categorize my review of it would be "mixed." It may be worth reading, but not worth following to the letter. Unless you are into ritual washings and healing dance. (Just kidding on the dance)

So I looked for additional diet information. My friend Kathie suggested a book by Dr. David Servan-Schreiber
called Anti-Cancer - A New Way of Life. This book mixes some fascinating science regarding diet and cancer with a shockingly depressing world view. I felt like taking a shower after finishing it. Perhaps we can call this one a mixed review as well. On the upside, it led me to a third book by Beliveau and Gingras called Foods to Fight Cancer. This last book, beautifully illustrated, contained more hard science mixed in with a typical, modern, pro-evolution world view. At least it was not depressing. My diet is comprised from all three sources (and others cited therein), and it mixes them with common sense, affordability, ease of implementation, and some measure of my personal bias (despite my best efforts to be objective).
Here is the scientific/engineering approach to my diet:

1) Stop eating things that MIGHT trigger cancer, and
2) Convert your body from a friendly host to an unfriendly environment for cancer, and you accomplish this when you stop eating things that DO feed existing cancer, and start eating lots of things that cancer dislikes.
Rationale and actions for #1

Nobody knows what triggers cancer specifically. Smoking is a big problem for lung and bladder cancer, though it wasn't for me. Industrial chemicals (like clothing and hair dye) are another. Nobody knows exactly how. Other cancers are pretty much unknown causes. But one third of the population in Western countries will develop some form of cancer. Countries with primitive diets (less meat, more vegetables, no chemicals or hormones used in farming) have a much lower rate of cancer. Other nasty diseases are higher, due mainly to poor sanitation. So the key is to be sanitary while avoiding any added chemicals like fertilizers, insecticides, hormones, preservatives, colors, flavorings, etc. All should be avoided. The list includes processed foods like Cheez Whiz, most prepackaged food, sausage, etc. All are chock full of chemicals - not just preservatives, but also colorings, emulsifiers, clarifiers, stabilizers, flavor enhancers, and whatnot. Meat should be all natural, hormone free, and "vegetarian." Until mad cow disease devastated the Western beef supply, nobody realized that producers regularly fed cow parts to cattle and chicken parts to poultry, etc. Many people still don't know it. After mad cow, what's the fix? Feed the dead carcasses (after processing) to poultry! Don't believe it? Check out Mike Rowe's Dirty Jobs Animal Rendering episode. In order to save you money and keep the planet "more green" by recycling, dead animals have been added to the animal food supply for years. I had no idea. To avoid other chemicals your vegetables should be organic, whenever possible. And chemical preservatives of all kinds should be avoided. Artificial sweeteners (nutra-sweet, saccharine, whatever that yellow packet stuff is, sorbitol, xylitol, etc.) are no longer an option. Animals that eat other animals (or meat by-products) or their waste should be avoided. Pigs and shellfish are at the bottom of the food chain - they eat dead animal (for pork) and fish (for shellfish) carcasses, and they do at times eat poop - sometimes even their own! Bottom feeders like catfish should also be avoided. Fish to eat should have fins and scales. (One exception would be tilapia, which are used to eat the poop of other farmed fish). Because they are bottom feeders, pigs and shellfish have a higher input of residual industrial and farming chemicals, which are stored in the organs of cattle and poultry and fish, which are in turn fed to the bottom feeders. So pork and shellfish (both of which I love) have a higher probability of trace amounts of chemical content. And just to ruin your day, deep fat frying food creates some odd chemicals in the edges/crusts of things (the brown tasty bits), so fried foods should also be avoided.

Rationale and actions for #2

First, stop feeding the cancer! Sugar (glucose) is cancer's favorite food. Anything you eat that increases or spikes blood glucose is feeding cancer its vital nutrient. So more things on the avoid list are table sugar (sucrose), high fructose corn syrup (HFCS), bleached enriched wheat flour (which is in everything), corn starch, or any finely milled flour (even organic whole grain), high starch vegetables (potatoes, corn, yams). Processed foods also tend to spike glucose because they are composed of hyper-fine particles easily absorbed by our bacteria-free digestive tracts. The worst offender is HFCS which is also in everything. HFCS is to table sugar as opium is to poppies - as far as your blood glucose is concerned. That delicious donut, cake, or ice cream? Imagine it showering the cancer in a warm bath of nutrients to make it happy and encourage it to grow. Not so appetizing now, is it?

How to sweeten anything? Honey (in limited amount - no more than 2 tbsp per day), stevia (a leaf extract), and agave nectar do not tend to spike blood glucose. But agave nectar has some real problems for cancer. I no longer use it. And a bonus - butter is in (organic, of course) while margarine is out. Yay!

Also we need to eat things that attack the cancer on two fronts - direct assault (less acidic blood chemistry) and cutting the supply lines. Cancer cells send chemical signals to nearby food supply lines (capillaries) to divert them to its own evil uses. Some foods block or reduce the effectiveness of these chemical signals. So things we want to eat more of are from the several classes of foods that seem to correlate well to reduced cancer incidence. Rule to live by - raw is best, or only lightly cooked. Juicing is a poor option (more on this below). Citrus fruit, cabbage, broccoli, cauliflower, brussels sprouts, kale, garlic, onions, leeks, shallots, chives, turmeric (a prime spice in curry), red grapes, blueberries, blackberries, raspberries, strawberries, green tea, soy (tofu, miso, tempeh, or edamame), tomatoes, wild fish (not farmed - smaller fish are better), chocolate (in moderation = 1.25 oz per day, 70% cocoa mass or higher), red wine (in moderation = one 6 oz glass per day), and sweet potatoes (which are yellow and not yams which are orange). You may be eating a lot of these already, but they are probably drenched in sugar and/or cooked into mush. So they do no good.

And here also is where the chlorinated water comes in. It kills the natural flora (bacteria, etc.) in your intestines, preventing the full digestion of these foods and limiting the good that they can do in your system. We did two weeks of extremely limited dieting, avoiding vinegars and eating probiotic foods (natural ones, not the yogurt sugar stuff in the grocery). One can even take probiotic supplements to kick start your digestive system. This part is a bit gassy and uncomfortable until your system adjusts. Taking any of the good foods listed above as dietary supplements (pills or capsules, e.g. garlic, soy isoflavones, green tea extract, etc.) is tempting and it's the American way. Sadly these often end up being too much of a good thing, and at best supplements provide only one or two of the thousands of organic compounds found in the whole foods. So it's often the case that such supplements can do more harm than good.

That said, we take a few supplements, in small amounts, for things that are hard to get from our improved diet. One supplement we take regularly is Omega 3 fish oil, because good fish is hard to get here in Utah. I don't like the idea of juicing either (though I love juice), because one tends to consume way more juice (which is rich in natural fruit sugar) than one could reasonably eat of the raw fruit. A large glass of OJ, fresh squeezed, might be 5 or 6 oranges - way more than you would ever eat in a sitting. And you get all the sugar, little of the fiber, and none of the other good stuff. Also avoid even all-natural and organic processed juice drinks, jams, jellies, and frozen desserts. Even those with "no added sugar" are nearly always loaded with white grape juice to amp the "natural" sugar even more. You might as well be drinking Kool Aid.

All of this is a big change for most folks reading here, and it seems hard to do, but what's left is pretty good stuff. Our meals typically consist of one quarter protein (meat, fish, or eggs) and three quarters fruits and/or vegetables - organic. A standard American plate is at least half protein, one quarter or more starch (potato, which may as well be sugar), and an afterthought of vegetables (frequently overcooked), plus a sugary dessert, all accompanied by sugary (or chemically sweetened) coffee or tea, etc.

For me it was an enormous and unthinkable shift. I used to eat several sugary snacks daily, and salty snacks high in starch (more sugar equivalent), all loaded with preservatives, tons of bread (even whole wheat is made mostly with white flour), and gallons of diet sodas. Pork and shellfish? My favorites! Bacon at every meal! I often explained to my wife, "Fruit sucks. I will eat all the fruit you care to bake into a pie. With ice cream!" After I studied it, I discovered that my diet since infancy had created an ideal environment for cancer to take root, grow strong, and spread out. And I had no will power at all. Donuts at work? I'd take three instead of one. But now that I view sugar as a deadly poison, will power is no longer a problem. I can walk by donuts, or have an orange while others eat muffins without the slightest regret. And I only started the diet last August. Less than a year ago I would have flatly stated that such behavior was simply not possible.

And the jury is still out whether or not all of this diet change is too little too late. I figure avoiding the chemicals and eating the items in #2 above will help keep the cancer from coming back. If it does come back, avoiding the things that cancer loves and eating things that cancer dislikes will "make the cancer miserable," so it won't grow and thrive. Then the docs have a chance to get it before it gets me. That's the theory. There is some science behind most of it, but there's not a lot of money to be made in this approach from new drugs, etc. So you can see why much of it is not fully studied, peer reviewed, and published in accepted scientific journals.

Even though this is the info you've been asking for, it may well not be the stuff you really wanted or hoped to read. All of us want to believe we can continue our current habits/vices and the surgery and BCG will take care of everything. I'd suggest that's probably the primary reason why the 5 year recurrence of high grade bladder cancer is over 80%. I don't like those odds, and I am willing to do radical changes to improve them.

I challenge you to consider doing the same.


A Dived Ref said...


This is an excellent and well researched piece of work - thanks for putting this on your site. I need to re-read it a few times there are some really new bits in there I didn't know about.

No matter what you say - exercise still sucks - I'm sith you there :-)

An excellent post.


Hannah said...

So glad to read that you're still committed to the diet and exercise! I've found that white flour products taste pasty now (crackers? ew!) and I don't need to sweeten drinks anymore. In other words, I prefer to eat healthy! OF course, the big exception is ice cream or other desserts :) I just prefer my home made ice cream and desserts made with whole grains.

A great book about the meat/milk/eggs we eat is _The_Carnivore's_Dilema_. It's entertaining to read too!

Anonymous said...

Thanks for posting this. I really appreciate such intelligent input. I am about to have my second surgery for cervical cancer and am avoiding sugar like the plague.

I used to eat candy bars and ice cream daily (I thought since I wasn't overweight, and didn't have diabetes, I was fine). When I started hearing and reading about sugar's involvement in cancer, I was so grossed out I threw out all of my sugary stuff. Now I imagine these giant greedy cancer cells starving haha :-) When I feel weak (thankfully very rarely) I imagine all of my good cells who are working so hard, counting on me. It works :-)

Thanks again for the good read.

Zach said...

Hi Steve,

Thanks for all the great info throughout your blog, it has been very helpful. I really enjoyed this entry in particular because I've been thinking about the changes that I'm going to have to make. I'm a 33-year-old, male, non-smoker and was diagnosed last week with bladder cancer. It was a shock, and even had the urologist at a loss for words. The tumors are fairly extensive, and although it hasn't been biopsied or staged yet, the doctor believes they are probably non-invasive. I'm looking at TURBT surgery soon, followed by long-term BCG treatments, similar to your schedule. (Your detailed descriptions of BCG treatments has been especially helpful in my mental preparation.) I enjoy exercise and have been in pretty good shape my entire adult life. My diet is decent, but I have a sweet tooth and love to indulge in treats. Since my diagnosis, I've spent a lot of time puzzling over the cause of this cancer. Was it chemical exposure (I worked in a chem lab throughout grad school)? Environmental? Something brought on by my habits or behaviors? My sweet tooth? I realized I would drive myself crazy trying to pinpoint a cause that may well be dumb (bad) luck. I have been thinking much more carefully about my diet and I am working to improve it as much as I can. It was reassuring to hear that you didn't have trouble making the transition when eliminating sugars.

I'm still working through your posts, and I look forward to following your latest news.

Thanks again for sharing your experience.