Deepak Chopra and Intent

In the first post we discussed the possibility that higher health was possible, reaching beyond our current conception of wellness.  Such an advance depends on two things. The first, which isn’t new, is to comply with the current prevention measures that too many people ignore.  The words “diet, exercise, and stress management” roll off the tongue so easily that one can learn to ignore them. Yet recent research only confirms how damaging poor lifestyle choices are.

 

Even in the recent past prevention was focused on recognized lifestyle disorders like type 2 diabetes and heart disease, but now it is becoming clear that the body as a whole is being affected. Prevention has extended its reach to cancer, for example, and inflammation, although long seen as damaging to our tissues and organs, is being linked far more broadly to all kinds of possible disorders, including cancer. If you are not complying with prevention, there is mounting evidence that your choice to avoid exercise, ignore stress, and eat a diet high in calories and fat will lead to bad results over time.

 

The reason for this conclusion is more obscure than anyone ever supposed, and it leads to the second platform of higher health: working with your body’s intelligence.  The notion of the body’s intelligence is more than three decades old, and it is based on the discovery of “messenger molecules,” as they were originally called, floating chemicals that interconnect the brain with various parts of the body.  The average doctor and patient don’t think much about how cells communicate, yet three decades on, we know with a certainty that the human body is a vast process, not a structure.  Every cell’s outer membrane is a kind of antenna that constantly monitors what the rest of the body is doing, feeling, thinking, and processing. As the messages shift, so does the cell. The result is holistic and dynamic, which is to say, every part participates in the whole and no change can affect one cell without affecting all the others.

 

Here lies the real frontier of higher health. If you look on your body as a feedback loop within which are thousands of smaller feedback loops, the system must contain the following:

- Messages in and messages out

- Senders and controllers of information

- balancing mechanisms

- Flexible limits for action and reaction

 

The higher health amounts to gaining control over these parameters. They sound like abstractions, but they are the basis for how cells live, eat, and breathe. Forty years ago, cells didn’t do much else. But now we realize that cells are participatory – everything you do, they do. This includes your moods, beliefs, expectations, fears, and dreams. Your brain registers the subjective side of life, yet the inner world includes trillions of cells that do not speak or think verbally. They participate through the dynamics of biochemistry, non-verbally but just as present in the moment – or stuck in the past – as you.

 

In practical terms, when you take a bite of food or get on a treadmill, you are talking to your cells, sending messages back and forth. You are adding to a sense of control or subtracting from it (i.e., allowing random and habitual messages to dominate). You are going into balance or out of balance. You are becoming more flexible in your responses or less. Ultimately, you are responsible, at the level of self-awareness, for maintaining a complete world as it expands or contracts, goes in and out of crisis, confronts challenges, and so on.

 

The fact that every road leads to the body’s intelligence is crucial here, because it implies that you have more control (over input and output, balance and imbalance, flexibility or rigidity) than some mechanical agent like your genes or the involuntary nervous system.  Because the body is a process, structures come second. This is a big reversal, since medical education has always been first and foremost about structures (cells, tissues, hormones), and the goal has been to standardize diseases, fixing each one in a tight, isolated cause-and-effect scheme. But if you look at a key system like the immune system, once described as a battle ground between the body and invading germs, it becomes evident that all kinds of common things – being fat, losing your spouse, getting fired, having inflamed joints – are inescapably linked to how strong or weak your immune system is.

 

In short, holistic health has become inevitable. A piecemeal approach to wellness doesn’t fit how your body works. It is no longer “alternative” medicine that concerns itself with broad issues of holistic wellness. The need is universal, and the sooner we begin to lay down practical guidelines for living holistically, the closer we will come to higher health. In the next post I’ll cover some proposed guidelines.

 

(To be cont.)

 

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Wellness seems to have reached a plateau in America and other wealthy industrialized countries. The information about how to prevent many kinds of lifestyle disorders, including heart disease and type 2 diabetes, has been widely distributed. Longevity steadily increases. Advanced research on incurable diseases moves forward, if only by small increments.

 

You might think that the picture of health is clear. All we need is two things to achieve wellness for almost everyone: more compliance and a major leap in genetics.

 

The first is certainly true. America’s obesity epidemic isn’t improving because the information about how to reverse it didn’t lead to motivation. The same is true for the other standard points of prevention, such as a reduced fat diet, less red meat, more vegetables, lower salt and sugar, and more fiber. The government can jiggle the food pyramid, but that won’t matter as long as Americans haven’t stepped on to the pyramid in the first place. The same goes for exercise, since only a small minority of adults get even the minimum amount to promote good health.

 

But this post isn’t a scolding about compliance. It’s the second part of wellness – waiting for genetics to deliver amazing cures and new wonder drugs – that is not a promise likely to be kept. If we want to rise above the plateau where we find ourselves, we actually have to reverse the promise of genetics. Instead of waiting for science, each of us must learn to influence our genes in a new way.

 

Ten years ago, with the map of the human genome in hand, researchers ran eagerly after magic bullets, that is, simple treatments for fixing damaged genes or “bad” genes that were causing everything from cancer and type 1 diabetes to obesity and smoking, not to mention mental disorders like depression and free-floating anxiety, both of which are reaching epidemic proportions.

 

No one is talking about magic bullets anymore, for the genetic map, combined with imaging techniques like the MRI and CT scans, revealed the opposite of what everyone wanted to find. Instead of simple genetic connections, there are dozens and sometimes hundreds of genes involved in various disorders. Even to find fixed sets of these genes has proved elusive. Each individual seems to possess unique patterns of genetic influence.  Now medicine realizes that breast cancer, for example, isn’t one disease but dozens. Faced with such unforeseen complications, the hope for genetic cures, while still alive, has become ten times more complex.

 

Yet in a different way the human genome has opened the door for the higher health. We now realize that our genes are far more flexible, changeable, and easily influenced by lifestyle choices. This post is too short for me to detail how such a revolutionary change occurred in genetic thinking, so I will only point to the findings of Dr. Dean Ornish, the country’s most respected advocate for heart prevention, which indicate that improving your diet, exercise, and stress levels leads to improved genetic output from 400 to 500 genes.

 

This indicates that standard prevention has a real physiological basis, which is good news. Compliance is more than ever the wisest choice. But the new view of genetic flexibility points much further. You are in a constant conversation with every cell in your body, meaning that at the molecular level, every thoughts and action has consequences. It has become clear that genes are eavesdropping on every detail of life, including not just diet and exercise but your moods, beliefs, and every experience that registers in the mind.

 

In other words, you can be the controller of your body’s trillions of cells, and the control switch lies in consciousness. Higher health depends on taking advantage of this breakthrough idea.  Far beyond the placebo effect and psychosomatic illness, beyond faith healing and spontaneous remissions, the mind has unlimited potential for achieving a higher vision of wellness, as we’ll discuss in the next post.

 

(To be cont.)

 

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The United States remains the country that foreigners criticize the most and want to move to the most. Pursuing the American dream remains a potent motivator for every wave of immigration. It is also a constant theme among this year’s crop of Republican hopefuls, who criticize President Obama for tearing down national greatness and pride. Yet beyond hope and rhetoric there are some undeniable facts that counter our embrace of the American dream.

First, the dream was based on democratic equality. Yet the trend has been for certain votes — those cast by the rich, the influential, the corporate connected – to count more than the average citizen’s. In some quarters the dominance of lobbyists in Washington indicates that American democracy is for sale. However you view that proposition, there’s no doubt that Congress is stuffed with millionaires, lawyers, prosecutors, and soon-to-be-lobbyists.

Second, the American dream was based on opportunity. The Horatio Alger climb from rags to riches is our national archetype. But as it stands, other countries, mostly in Europe, offer greater social mobility, meaning that the ladder is harder to climb in America than we like to believe. As evidence we see income inequality that is skyrocketing, along with protests from the 99% that the 1% at the top have rigged the game in their favor.

Third, the American dream flourished in a melting pot of immigrant cultures. Each wave of immigrants arrived as strangers in a strange land, but by the second generation their children were assimilated into the cultural mainstream. Historians tell us that ethnic divisions have always been strong, despite the cultural ideal of the melting pot. Now, instead of pitched street battles between Irish and Italians fighting over jobs and power, we have social divisions baked into the cake, as it were. De facto segregation keeps African-Americans isolated in pockets of crime, drugs, and unemployment. Immigrants are looked upon suspiciously by the right wing. Selected ethnic groups, such as Muslims, are considered as almost permanent outsiders.

There are other ways in which the American dream has been undercut. If that dream includes the doctrine of peace, in reality we are the most militarized nation on earth. We develop the latest means of mechanized death, and lead the world in arms dealing. If the dream includes tolerance for all minorities, the almost rabid opposition to gay marriage and the barely disguised racism of voter ID laws cast doubt on that ideal.

What remains intact and most hopeful in the American dream is our flexibility, ingenuity, and willingness to change. Progress cannot be halted, and a new American dream is beginning to cohere. If the brightest trends bear fruit, this country is demographically at a great advantage over Europe, Russia, and China. As those societies grow old, America’s influx of immigrants assures that we will have younger workers. Some economists see American manufacturing being reborn as costs in China rise. This week General Motors regained its place as the largest auto maker in the world. The high price of oil has made the extraction of alternate fuel sources more viable. Becoming oil independent is an actual possibility, and motivated by the threat of global warming, the trend toward non-fossil fuels has a fighting chance.

The new American dream isn’t simply economic. Once we regain our optimism (a tall order but inevitable, I think) the basis for renewed prosperity is already in place: the GDP in 2011 was higher than before the recession began. Forward movement depends on keeping a progressive-minded President in place, but this post isn’t about that. It’s about realism as it intertwines with myth. The two aren’t enemies. It needs to be part of the progressive agenda to heal the old American dream while giving the new one all the encouragement we can.

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By Deepak Chopra, MD, FACP

 

Cancer is the most dreaded of all diseases, and ever since a “war on cancer” was declared forty years ago, massive research has made progress, although the battle is far from won. Very little of this research has been directed at prevention.  Advanced medicine, like the person on the street, has tended to think of cancer as something we have no control over: it happens to us or it doesn’t.

Visualization is courtesy of TheVisualMD.com

The reason for thinking this way can be seen under a microscope, which reveals that malignant cells are misshapen compared to normal cells. Disastrous mutations at the genetic level lead to abnormal cell division, causing cancer cells to become rogues in the body, multiplying without check, crowding out normal cells, and in general wreaking havoc by losing communication with the body’s fine-tuned intelligence.

 

Yet we may be seeing a revolution in our whole approach to cancer.  Some highly placed researchers now believe that 90-95% of cancers are preventable with drastic lifestyle changes. This represents a total reversal from what used to be taught in medical school, which held that only 5% of cancers could be traced to environmental factors like diet or chemical toxins. If the new view is correct, then for the first time we may have found an open road to ridding society of its most dreaded scourge.

 

To begin with, the genetic trail hasn’t led to a cure, only to greater and greater complications.  A disease like breast cancer, when examined at the genetic level, isn’t one disease but hundreds.  Yet at the opposite extreme, genetic mutations may be playing a much smaller part than anyone ever thought.  Craig Venter, who led a private effort to successfully map the human genome, neatly summarizes the situation:

 

“Human biology is actually far more complicated than we imagine. Everybody talks about the genes that they received from their mother and father, for this trait or the other. But in reality, those genes have very little impact on life outcomes. Our biology is far too complicated for that and deals with hundreds of thousands of independent factors. Genes are absolutely not our fate.”

 

In some cancers, inheritance certainly plays a major factor. For example, childhood cancer, of which the most common is a form of leukemia, has a simpler genetic profile than adult cancers. By targeting specific mutations, doctors who treat childhood cancer have raised their success rate from 20% to 80% in the past forty years. Children with cancer must undergo severe regimens of chemotherapy and radiation, but it’s no longer a case, as it once was, of killing the tumor before the treatment killed the patient.

 

For a vast majority of oncologists, targeting a malignant cell with chemo and radiation, along with surgery to remove the tumor, remains the mainstream approach.  The track of prevention is all but unknown to them.  There is no doubt that a cell has to mutate in order to become cancerous. Yet an inherited mutation isn’t the same as an acquired mutation, one that develops during the lifetime of the patient.  Let’s simplify the case and divide acquired mutations into two types: those that result from accident and errors on the part of a person’s DNA, and those that are linked to lifestyle.  The revolution that is looming in cancer is based on believing that the lifestyle link is so strong that it accounts for 90% or more of cancer occurrences.

 

Let’s pursue this line of reasoning with the expectation that doing everything you can to prevent cancer is clearly the best choice.

 

 

What medicine refers to as environmental and lifestyle factors include some familiar culprits:  overweight, lack of exercise, poor diet, smoking, overuse of alcohol, and overexposure to UV and other forms of radiation. Of all cancer-related deaths, it’s thought that 25–30% are due to tobacco; 30–35% are linked to diet; and about 15–20% are due to infections, many of them preventable.

 

What is cancer?

Cells in adults normally have tightly controlled patterns of growth. They divide in a regulated manner and have definite lifespans. Because of this, the number of cells in a healthy body remains roughly the same over time.

 

Cancer cells, however, display uncontrolled growth. The rate of division is faster in some cancers than in others, but in all cancers, the cells never stop dividing. In effect, they have infinite lifespans. Malignant tumors invade neighboring tissues and may metastasize, spreading to distant parts of the body. Cancerous tumors have the ability to produce activator molecules, such as vascular endothelial growth factor. Activator molecules induce the formation of new blood vessels to supply the tumor, allowing for cell reproduction and tumor growth.

 

Cancer is not one but hundreds of different diseases. Breast cancers, for instance, have individual characteristics and display different patterns of growth than lung cancers. That’s why a cancer that originates in the breast and metastasizes to the lungs is referred to as metastatic breast cancer, not lung cancer.

 

How does cancer begin?

Cancer begins when a cell undergoes a mutation: one or more of its genes are damaged or lost. A number of different mutations have to happen before the cell becomes a cancer cell. If a cell carries a mutation, it usually either destroys itself or is recognized as being abnormal by the immune system and killed. This is why cancer usually occurs in older people: there has been more time for mutations to occur and for exposure to cancer-causing agents.

 

Genes may be damaged by:

• Free radicals produced in the normal process of metabolism
• Carcinogens, such as radiation, chemicals, tobacco, and infectious agents
• Random errors in DNA replication
• Inherited mutated genes

 

Almost from time they first arise, cancerous tumors shed cells into the bloodstream. In fact, it’s estimated that a 1-cm tumor sheds more than a million cells into the circulatory system in just 24 hours. Most of these cells are killed by cells of the immune system or die due to injury, but some may survive. Traveling cancer cells may become stuck in a capillary and adhere to its lining. From there they penetrate into surrounding tissues or organs, where they may generate secondary tumors. Cancer cells may also penetrate into the lymphatic vessel and travel in the circulating lymph fluid until it becomes lodged in the small channels inside a lymph node.

 

Cancer prevention

That the vast majority of cancers are not caused by genetic defects means that in most cases we have the power to modify or eliminate most of the factors that lead to it.

 

Most of the known risk factors for cancer have one thing in common: they create chronic (long-term) inflammation in the body. Inflammation is a normal part of your body’s immune system response to injury. Problems arise when that inflammation becomes chronic. When that happens, levels of many potent inflammatory chemicals go up. These substances include cytokines (including TNF, IL-1, and IL-6), enzymes (such as COX-2 and 5-LOX), and adhesion molecules. All of these various chemicals have been linked to the development of cancerous tumors, and chronic inflammation precedes tumor growth in most types of cancer.

 

Solutions

Obesity, smoking, alcohol, infectious agents, and carcinogens in food and in the environment, have been shown to cause chronic inflammation in the body. The longer the inflammation continues, the greater the risk of cancer.

 

Maintain a healthy weight

There’s a clear link between obesity and cancer. It’s thought that, in the US, excess weight or obesity cause 14% of cancer deaths  in men and 20% of cancer deaths in women. Obesity is linked to many cancers, including cancers of the colon, breast, endometrium (uterine lining), esophagus, and kidneys.

 

Clearly, it’s important to keep your weight at a healthy level to help prevent cancer. It’s important for other reasons as well. You can also prevent the many co-morbidities of obesity, including diabetes, high blood pressure, cardiovascular disease, fatty liver disease, and osteoarthritis.

 

Exercise to protect yourself against cancer

Numerous studies have shown that being physically active exerts a protective effect against cancer. Regular exercise lowers levels of IGF-1, a cytokine implicated in tumor growth, and other cytokines in the bloodstream. Interestingly, it does this even if the person who exercises is overweight and remains overweight. The lower levels of these cancer promoters are one possible explanation for the protective effect of regular exercise.

 

Exercising regularly reduces a woman’s chances of getting breast cancer, possibly because doing so lowers blood levels of insulin and estrogen. Risk of colon cancer, too, is greatly reduced when you exercise, probably because being active decreases the amount of time it takes food to pass through the intestines. That means the colon is in contact with potential carcinogens for a shorter period of time.

 

Eat anti-cancer foods

It’s estimated that diet causes about one third of all cancer cases, almost as many as tobacco. Because cancer is so strongly associated with chronic inflammation, eating foods that fight inflammation can have a chemoprotective effect.

 

Chief among cancer-protective foods are fruits and vegetables. They contain numerous cancer-preventing, anti-inflammatory chemicals, including:

 

• Carotenoids, especially lycopene, found in watermelon, guava, grapefruit, and tomatoes
• Resveratrol, found in grapes, peanuts, and berries
• Quercitin, found in red grapes, citrus fruits, tomatoes, broccoli, and leafy green vegetables as well as tea and wine
• Sulforane, found in cruciferous vegetables such as broccoli

 

Cancer-fighting chemicals are found in teas and many spices, including:

 

• Green tea
• Turmeric
• Garlic
• Chilies
• Ginger
• Fenugreek
• Fennel
• Clove
• Cinnamon
• Rosemary

 

Whole grains contain potent antioxidants and are rich in fiber, which speeds the transit of food through the colon. Eating whole grains has been found to reduce the risk of colorectal cancer.

 

Don’t smoke or use tobacco in any form

In the US, 30% of cancer deaths  are due to tobacco. That smoking causes lung cancer is well known; it’s less known that tobacco use increases the risk for at least 14 different types of cancer. Smoking combined with drinking increases the risk of cancer synergistically. Smokeless tobacco, touted as a “safer” alternative, is responsible for 400,000 cases of oral cancer worldwide—4% of all cancers.

 

Drink alcohol only in moderation

If you drink alcohol, do so in moderation, if at all (two drinks a day for men, one a day for women). Chronic alcohol consumption is a risk factor for cancers of the upper respiratory and digestive tracts, including cancers of the mouth, throat, and esophagus, as well as for cancers of the liver, lung, and breast. Risk goes up with increasing consumption.

 

Avoid UV radiation

Skin cancer is extremely common and frequently fatal, if it isn’t caught in time. Both sunlight and artificial sources of UV radiation (like tanning beds) are dangerous. Avoid peak radiation hours during the day (10 am-4 pm) if possible. If you can’t avoid being out in the sun, wear a hat and cover exposed areas. Use a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15. And don’t use indoor tanning beds or sunlamps.

 

Get immunized

I realize that vaccination, once the pride of preventive medicine, has become a hot-button issue. There are popular movements that attribute many kinds of risks to being vaccinated. Let me simply give the accepted protocol here. Vaccination won’t be a priority in cancer prevention, but a thorough approach, as dictated by some oncologists, would target specific cancers through being immunized against them.  Human papillomavirus (HPV) is a sexually transmitted virus that can lead to cervical cancer. A protective vaccine is recommended for girls ages 11-12 and for girls and women ages 13-26 who haven’t completed the full vaccine series. Hepatitis B can increase the risk of developing liver cancer. All babies and some high-risk adults should be vaccinated.

 

For many people, these lifestyle changes are so drastic that adopting them will take time, patience, and knowledge.  The threat of heart attack, stroke, and diabetes hasn’t been potent enough to cause wide swaths of the public from giving up bad lifestyle choices. Now we find that cancer can be added to the list, so far as some researchers are convinced of the link between cancer and environment.

 

You aren’t called on to become a cancer expert. But weighing all the evidence, it’s clear which way the wind is blowing.  The likelihood that cancer is not enmeshed with lifestyle is diminishing year by year. Yes, cancer is immensely complicated, but everything you can do to support your body’s innate intelligence is a positive step in allowing that intelligence to block the cellular changes that create malignancy.  A decade from now, I expect that we will tune in and find that this ray of hope has become even brighter.

 

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