Once upon a time, a diagnosis of breast or prostate cancer meant either lengthy and aggressive medical treatment or reconciling oneself to the idea that the cancer will grow and grow until it kills you. But might the idea that, if left untreated, these cancers will always kill you be nothing more than a fairy tale?
This month’s release of historically non-aggressive guidelines suggest, for some cancers anyway, it just might.
- The American Urologic Association (AUA) now recommends that certain men with prostate cancer should be offered the option of surveillance rather than treatment.
- The US Preventive Services Task Force (USPSTF) now recommends less frequent mammograms. The old recommendations were for an annual mammogram starting at age 40. The new recommendations are to start at age 50, and only get screened every other year.
A Kinder, Gentler Approach
The AUA has recognized that in treating prostate cancers that are unlikely to ever spread, doctors may have subjected hundreds of thousands of American men to unnecessary procedures and suffered needless complications, including loss of bladder control and sexual function. This is the rationale for less aggressive care. Nevertheless, the AUA worries that few people will take this safer option.
Cancer cell surrounded by immune system cells
The USPSTF has recognized that by treating tiny, early stage breast cancers so aggressively, doctors may also have unknowingly subjected hundreds of thousands of American women to unnecessary procedures, leading to needless complications including disfigurement and even death, all the while assuming they were saving people’s lives.
Years ago, I asked one of Hawaii’s top breast surgeons what the natural course of a tumor were a patient to refuse treatment and let nature take its course. He told me he had never seen a study to answer that question so, unfortunately, he had absolutely no idea. Now, with support of USPSTF, more surgeons will hopefully share this honest appraisal with their patients and encourage them to re-prioritize their lives in order to pursue a healthier mode of living.
Your Body’s Best Defense: A Vigilant Immune System
We’ve all gotten used to the idea that cancer is universally devastating and that technology is the only hope for salvation. Our bodies have little defense, the thinking went, against this most evil of villains. Andrew Weil was one of the first to challenge this mythology, and in 2000 his book Spontaneous Healing cited several instances of patients who’s cancers spontaneously regressed. It’s now well accepted that our bodies may be busy slaying cancerous cells all the time. (The medical term for this is immunosurveillance.)
Unfortunately, we still have no way of identifying which cancers the immune system can and will catch and which it won’t.
With further study, we may learn that regression is the natural course for many early or non-aggressive cancers if we successfully support our immune system function with good sleep, exercise, stress reduction, and of course a healthy diet built around natural, authentic cuisine.
We’ve learned a lot about cancer in the past 20 years, but by and large we’re still in the Dark Ages. We have yet to fully understand and appreciate a healthy immune system’s role as a shield against incipient (and potentially also more advanced) cancers.
Bottom line: high tech solutions can be useful in a fight against cancer, but supporting your immune system with real food and a healthy lifestyle is the best way to live happily ever after.
Recommended reading on the fascinating topic of Immunosurveillance:
Cancer immunoediting: from immunosurveillance to tumor escape. Nat Immunol. 2002 Nov;3(11):991-8.
Abstract: The concept that the immune system can recognize and destroy nascent transformed cells was originally embodied in the cancer immunosurveillance hypothesis of Burnet and Thomas. This hypothesis was abandoned shortly afterwards because of the absence of strong experimental evidence supporting the concept. New data, however, clearly show the existence of cancer immunosurveillance and also indicate that it may function as a component of a more general process of cancer immunoediting. This process is responsible for both eliminating tumors and sculpting the immunogenic phenotypes of tumors that eventually form in immunocompetent hosts. In this review, we will summarize the historical and experimental basis of cancer immunoediting and discuss its dual roles in promoting host protection against cancer and facilitating tumor escape from immune destruction.
Tumor immunoediting and immunosculpting pathways to cancer progression. Semin Cancer Biol. 2007 Aug;17(4):275-87.
Abstract: Recent studies have suggested that a natural function of the immune system is to respond and destroy aberrant, dysfunctional cells by a process called immunosurveillance. These studies also suggest that the tumors that arise despite immunosurveillance have been immunosculpted by the immune system. The purported abilities of tumors to induce immune tolerance and suppression, the increased pathogenic behavior of the tumor cells following exposure to immune effectors and the loss of immunogenicity (i.e. immunoediting) often observed in advanced stage tumors could be the result of immunosculpting. In some cases, these immunosculpting features may be permanent and irreversible. However, in other cases, reversible epigenetic mechanisms may underlie the immune resistant tumor phenotype. Regardless, these immune-induced alterations could contribute to cancer pathogenesis. Understanding the mechanisms by which tumors evade immunity will be important for disease prevention and therapeutics.
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Very interesting topic!
I suppose most of us are just programmed to think that to have any chance of surviving cancer we must undergo rigorous and debilitating treatments.
I agree that we can all help ourselves by maintaining a healthy diet and lifestyle, but I do feel that many people are not aware that fruit and vegetables in particular start to lose their nutritional content as soon as they are picked.
So we need to promote FRESH healthy options.
Does anyone else agree?
I found this site because I wondered about the natural progression of cancer—what happens to a body when it gets cancer and decides against treatment? Is there a general wasting away? Are there different bodily responses to different types of cancer (I know there are, but what are the symptoms)? Why isn’t anyone studying this? Is it because people who get cancer want treatment? Are any of us willing to just take the disease to its natural progression? All those years that went by in history when there was no chemo or radiation—who studied and wrote about it during those times? Am I strange for wanting to know this? Might knowing this help the scientists and researchers find more types of cures and get them to focus more on prevention? So many questions, I know. But there are also so many questions about treatment, health care costs, protocols, medications, natural cures, and even the mind-body connection.
I have had several patients with cancer who declined treatment. Two with lung cancer, one with salivary gland cancer, and one who had metastatic cancer to the spine from an unknown source. The man with salivary gland cancer also had renal cancer and both of these cancers did very little to him for fifteen years. He is now 86 and progressively weak and dying and is not having any pain so its hard to say if it’s from the cancer. The man with metastatic cancer to the spine died quickly and had a lot of pain in his back. One man with lung cancer died in 3 years, the other lived with it for more than 10 and then moved away so I don’t know what happened.
In the days before chemo and radiation there was also no way to know anyone had cancer in its early stage, so we don’t know very much about the natural course of cancer. There’s no research funding if there’s no product to sell, so I don’t think there will be much progress in this area any time soon. I can say that I have never seen anyone who follows a traditional diet develop cancer.