A Conundrum, Plus Two Great Vegetarian Recipes

Hello again, family and friends,

Have you ever had the feeling that the more you look into a subject, the more confused you become?  My quest to seek information regarding the relationship between lifestyle and chronic illness has been very much like that.  A recent addition to our knowledge base was the DVD "Forks Over Knives" which was loaned to us by our long-time friend, Don Koenigs.  This is a film that I highly recommend that everyone see!!  We watched it twice and took notes to make certain that we didn't miss anything.  You might not totally buy into the recommendations, but the evidence is so overwhelming that, at the very least, it will make you think twice about what you put into your mouth.  I won't give everything away because I believe it is important for each of you to take the time to watch the film.  Don't miss the bonus features.  They are short, but very powerful.  We've ordered a copy for ourselves and are happy to share with the "locals".

There were three points in the film that were new to me and really caught my attention.  The first is that dairy products were highly implicated as a major problem in the western diet, and not only from fat or cholesterol.  Cheese has had a bad rap, but I'd not heard much concern over low-fat or non-fat milk or milk products.  In fact, we have always heard how important calcium is in our diet, and when we think of calcium in food, we have been trained (brainwashed?) into thinking dairy.  On the other hand, we have one of the highest rates of dietary calcium consumption in the world, yet at the same time we have one of the highest rates of hip fractures.  The film claims that osteoporosis is not caused by a lack of dietary calcium, but rather caused by a chronic state of metabolic acidosis which is a direct result of our high intake of sugar and so much highly-processed foods in our diet.  This condition pulls calcium, a lot of calcium, from our bones to neutralize the acid, leading directly to osteoporosis.  There are other causes for loss in bone density and this condition should be monitored routinely through bone scans as we age and/or as we undergo certain medical treatments.  However, if changing our diet can reduce the odds of developing this potentially debilitating condition, isn't it worth a try?  

The second area of interest also concerns dairy products.  Cows' milk has about twice the level of casein, one of several milk proteins, than human milk.  Studies conducted by T. Colin Campbell, one of the doctors featured in the film, showed a direct correlation between the amount of casein consumed in our diet and the promotion of cancerous cell growth. Casein is also implicated in other human health problems. As stated in the film, cows' milk is good for calves, but perhaps not so good for humans. 

The third interesting point is something I probably should have known, but either overlooked or forgot.  Plants do not contain cholesterol and all dietary cholesterol comes from consuming animal products - meat, dairy products, and eggs.  High cholesterol has become a major indicator of deteriorating health and is a precursor to coronary heart disease.  An alarming number of American adults take statin drugs to control their cholesterol levels.  While no one should quit taking prescribed drugs without the advise of their physician, the film shows that dramatic reductions in cholesterol levels are possible by changing to and adhering to a strict vegetarian diet.

The other doctor featured in the film, Caldwell Esselstyn Jr., claims that Americans could prevent 75-80% of all lifestyle diseases - coronary heart disease, diabetes, obesity, and cancer by changing our diet.  His concern is that western medicine has become very accomplished at treating disease once it occurs, but is terrible at preventing disease.  Further, he clearly demonstrates how disease prevention and even disease reversal are both possible through diet alone.  It is very exciting to watch how he does this and to see the positive results on his patients.  If it were possible to prevent disease by convincing the majority of Americans to change their diet, many of the concerns regarding the high costs of healthcare to our nation would simply disappear. 

So, what should we eat?   The film presents a compelling argument for converting entirely to a whole foods plant-based diet.  And therein lies the conundrum.  I thought we had been doing very well modifying our eating habits.  We have cut way back on red meat with only occasional small amounts of grass-fed beef.  The little bit of chicken and few eggs we eat are organic.  We use almost exclusively organic low-fat or no-fat dairy products and have cut way back on our consumption of cheese.  Our main source of animal protein is seafood, and we still have a lot of fish, and some other seafood, in our freezer.  Should we or, better yet, could we go the rest of the way?  I think, after watching the film, we were leaning heavily in that direction. 

As they say on the TV infomercials, "but wait, there's more".  As I was researching Dr. Campbell's work, I came across another study. It is called the "Nurses Health Study" which was started in 1976 with nearly 122,000 registered nurses to study how nutrition relates to heart disease and, at that time, primarily breast cancer.  Nurses were chosen because it was felt they would be more honest with their nutritional and other lifestyle information.  In 1999, the project enrolled 116,000 more nurses plus 52,000 men in a Health Professionals Follow-Up study.  The study was expanded to look at risk factors for other common diseases.  I recently read an interview with Dr. Walter Willett, chairman of the Dept. of Nutrition at the Harvard School of Public Health, professor of  medicine at Harvard Medical School, and co-author of "Eat, Drink, & Weigh Less", who was instrumental in the Nurses Health Study.  He claims that adult weight gain turned out to be a major risk factor in many cancers.  In fact, he concludes, "In the U.S. (being) overweight is about equal to smoking in terms of its contribution to cancer rates". That totally blew me away!  The interview goes on to say that, besides the big four diet-related epidemics we have discussed previously, effects of diet were related to almost every condition studied, including cataracts, gallstones, infertility, kidney stones, and macular degeneration.  Wow!!!! 

According to the study, the type of fat and the quality of carbohydrates in the modern Western diet are the main culprits.  Dr. Willett's recommendation from this study is that we eat a low-glycemic diet centered on complex carbohydrates.  More specifically, "healthy whole-grain, high-fiber sources of carbohydrates, healthy vegetable oil, less red meat, more protein from nuts, beans and a modest amount of poultry and fish, plus plenty of fruits and vegetables.  While dairy is not essential, one or two servings per day are OK".  This contradicts the no-dairy position of the film, but still urges very low levels of dairy consumption.  Although not specifically stated, I seriously doubt that Dr. Willett would consider ice cream to be one of the acceptable daily servings.  Another reliable diet reference strongly suggests that all foods, whether plant or animal-based should be "as unaltered and unprocessed as possible".   Whew, this sounds a lot more like how we have been trying to eat.  I think I can live with that, at least until our fish supply is gone.  

Just in case, after seeing the film, you do decide to become a strict vegetarian, here are two recipes we really enjoy.  What the heck, they are both very good whether you are a vegetarian or not. 

Szechuan Noodle Toss  (thanks to Susan Holmes)

8 oz thin spaghetti (we use organic whole wheat)

2 large red bell peppers, julienned

4 green onions, cut diagonally in 1-inch pieces

1 medium clove garlic, crushed or very finely chopped

1 lb spinach leaves, washed, drained and cut or broken into 1-inch pieces

1 8 oz can sliced water chestnuts, drained

3/4 lb firm tofu, drained and cut into 3/4-inch cubes (we often use the whole pound)

1/4 cup low sodium soy sauce 

2 Tbs dark sesame oil

2 Tbs rice vinegar

1 1/2 tsp crushed red pepper flakes

1 tsp minced ginger root

1) Cook pasta according to package label.  Drain; rinse with cold water.  Drain again. Place in a large bowl and set aside.

2) In a large skillet, heat 2 Tbs salad (olive) oil. Add red bell peppers, green onions and garlic; saute' two minutes or until tender-crisp.  Stir in spinach.  Cover; cook 1 minute, or until spinach wilts.  Add pepper mixture to pasta.  Stir in water chestnuts and tofu.  Set aside.  

3) In a small bowl, combine remaining ingredients with 3 Tbs salad (olive) oil.  Add to pasta mixture; toss to coat.  Serve immediately or refrigerate and serve chilled.  Makes 6 servings.  

This recipe can easily be halved, but when the flavors combine, the leftovers are great.  We have served it alone, in bowls, as a complete meal. 

Vegetable Pulao (rice with vegetables; adapted from a recipe given to us by Paul Bless)

1-2 Tbs Olive oil

1 cup chopped onions

2 cinnamon sticks or 1/2 tsp ground cinnamon

4 whole cloves or 1/4 tsp ground cloves

2 cardamom pods or 1/2 tsp ground cardamom

2 bay leaves broken in half  

1/2 tsp cumin seeds or ground cumin

1/2 tsp turmeric

1/2 tsp curry

1 cup Basmoti rice (we have used organic brown Basmoti rice with mixed results)

1 2/3 cup water

1/2 to 1 tsp salt

1/2 to 1 tsp brown or raw sugar

2 cups vegetables (1 cup frozen peas and 1 cup chopped or thinly sliced carrots works well)

Saute' onions in oil over medium heat.

While cooking add spices.

When onion is soft, about 5 minutes, stir in 1 cup of Basmoti rice.  Stir and heat for 2-3 minutes.

Add water.  Stir in salt and sugar.  Cover and cook on low for 20 minutes.

Fluff rice and add vegetables.  Cover and heat on low 5 more minutes before serving. 

(When preparing this, we've found that it works better to saute' the onions with the spices in the larger amount of oil in a saute' or fry pan, then transfer to a pot with a tight-fitting lid when it's time to add the rice & water.)

We love the smell of this recipe while it is cooking and the house smells great for several hours afterward.  It is more of a side dish that goes very well with almost any preparation of poultry or fish.

Shalom,

    Barry and Kathy

A View From the South End of Our Island Looking East

 

A Revelation! and a Great Soup Recipe

Hello again from soggy, cool Petersburg,

Knowing that knowledge is power, a friend recommended that I read a highly-regarded, very complete book on cancer, Siddhartha Mukherjee's The Emperor of All Maladies, A Biography of Cancer, which is available at the public library.  Well, I did it!  It took me a month, but I finally completed the lengthy tome.  Regardless of its length and complexity, I don't regret having taken the time to work though it.  I learned a lot, and, for the most part, it was a fascinating book to read.  However, I feel that the book contains a lot more detail on the subject than the average person really needs or wants to know.  And, reading it, particular the sections on the mechanisms of cancer at the cellular level, brought back a lot of not-so-pleasant memories of a must-pass upper-division human physiology class I struggled with at Oregon State U. a very long time ago.  I think this is the last book on this subject I'll read for quite awhile.  

In a nutshell, cancer has been with us from the very beginning and is part of the human genome.  The book goes into great detail about the history of how cancer has been viewed over the millennia and how treatment has evolved, always with an eye toward eradicating the disease.  Variations of all of the primary treatments that are used today-- surgery, radiation, and chemotherapy--were in use early in the last century, although not nearly as effectively.  Perhaps the greatest revelation for me came right at the end where Siddhartha sums it all up by saying, "Oncogenes arise from mutations in essential genes that regulate the growth of cells.  Mutations accumulate in these genes when DNA is damaged by carcinogens, but also by seemingly random errors in copying genes when cells divide.  The former might be preventable, but the later is endogenous.  Cancer is a flaw in our growth, but this flaw is deeply entrenched in ourselves.  We can rid ourselves of cancer, then, only as much as we can rid ourselves of the processes in our physiology that depend on growth - aging, regeneration, healing, reproduction."  In other words, to eliminate cancer we would have to rid ourselves of nearly all of the processes which allow us to function as living beings.  Cancer is caused by malfunctions within our own bodies often triggered by products we have created.  It reminds me of that quote from Pogo, Walt Kelly's famous cartoon strip, "We have met the enemy and he is us". 

Regardless of how much we might hope otherwise, we need to learn to accept this disease as a permanent part of human life.  The prevalence of cancer has been exacerbated by our continued search for immortality.  Simply put, the longer we live, the greater the chance for cellular mutations.  This realization troubled me for several days, but then it dawned on me that there is another side to all of this.  If we recognize cancer as a normal part of human life, perhaps it will be much easier to accept it either in ourselves or in someone we know. 

Also on the plus side, along with a better understanding of the mechanisms of cancer come greatly improved methods for early detection and for targeting the errant pathways created by the mutations.  Thus, oncologists, working with scientists, are continuously developing much better ways of stopping cancer growth and development while minimizing collateral damage.  This works very well in a number of recently-discovered treatment methods and the survival rates for most, but not all, cancers are continuing to improve.  In addition to improved treatment methods, I still believe strongly in the material presented in previous posts which gives rise to the hope that we all have at least some control over the odds of developing cancer by adopting an anti-cancer lifestyle.  The key elements to reducing the chances of developing cancer are, of course, better diet, adequate exercise, stress management, and a maintaining a positive attitude.

At Ohmer Creek Campground

O.K. enough on that.  Except for a few lingering and very aggravating side effects from the ADT (hormone therapy), I am actually feeling better than I have for several years.  We are finally catching up with the many projects we had to put on hold while we were "south".  We are now to the point that we have been able to take advantage of the few nice days we have had this summer.  A boat ride here, a bike ride there, and lots of walks, interspersed with yard work and other outside projects.  We try to save the inside projects for rainy days, which, unfortunately, have been way too numerous this year.  Since I have yet to take my first charter of the season, we have had a lot more free time.  In fact, we had an in-depth discussion the other evening regarding the pros and cons of continuing the eco-tour business.  The jury is still out, but I have to admit that I don't miss either the high stress of planning a trip or the day-to-day grind on the water.  Besides, I have really been enjoying spending time with Kathy on land.  It will be even better if/when the weather improves and we feel more like doing some cruising on our own.  Hey, I'm not complaining.  I'll take high 40's to low 60's over 90's and 100's any day.  And, we have absolutely no threat of wild fires.  

As in previous posts, I'd like to leave you with a healthy recipe.  Kathy got this one from Kathy Emmenegger.  We have made this soup numerous times in the past few months and never get tired of it.  It contains many, many anti-cancer super foods, and there is something very comforting and healing about a good big bowl of chicken soup!  It makes a very fitting meal to go with the endless fall/spring weather we have been having. 

Chicken and Sweet Potato Soup from Foster's Market Cookbook

1 TB unsalted butter (we use regular butter or all olive oil)

1 TB olive oil

1 red onion, diced

2 shallots, thinly sliced

1 red bell pepper, diced

3 ribs celery, diced

6 garlic cloves, minced (or finely chopped)

8 cups chicken broth 

4 cups cooked (organic) chicken (we often boil the chicken and save the broth) 

2 sweet potatoes 1/2' pieces (we use the so-called yams for more color)

14 oz can diced tomatoes

1/2 tsp red pepper flakes (more or less to taste)

1 tsp dried marjoram

3 bay leaves

2 tsp salt

1 tsp black pepper

1 TB fresh marjoram & thyme to garnish (optional)

Salt & freshly ground pepper to taste

Melt butter and olive oil over medium-low heat in a large saucepan and add the onion and shallots.  Cook and stir about 15 minutes or until softened.  Add bell pepper and celery and continue to cook and stir about 5 minutes longer.  Add the garlic and cook about 2-3 minutes longer.

Add other ingredients except fresh marjoram, thyme, and salt and pepper.  Bring to a boil, reduce heat and simmer uncovered 1 hour.  Add salt and pepper to taste.  May add chopped spinach or kale (cook 3-4 minutes longer if adding kale).  

This soup is great with a good whole grain bread and a nice glass of pinot noir; especially when shared with good friends.  The leftovers are even better the next day.  Yum!!   

Shalom,

   Barry and Kathy

Field of Flowers

    

Recovery, Irresistable Smoked Salmon Recipe & Flowers Galore!

Dear friends and family members,

It is hard to believe that it has already been over 75 days since my last radiation treatment.  In some ways it seems like a lifetime, in other ways only a short while ago.  Regardless, I feel that I have recovered much faster than I'd anticipated.  I also continue to feel that all your positive energy and prayer has been responsible for much of the improvement.  Most of my stamina and strength are back and, perhaps best of all, I don't have to be within 5 minutes of the nearest facility.  Is it possible to put that kind of a constraint to normal activity out of one's mind?  I feel so good now, that I need to remind myself that I was very sick with side effects for a good part of my treatment. I don't want to lose sight of all those who cared for me and about me during that time.  I feel that part of my obligation is to attempt to continue to live an anti-cancer lifestyle worthy of all of that effort.

Lop the Loop - Erika and Brad Ran

Other signs of life returning to normal are that our boat is in the water, cleaned up and ready to go (even though we haven't gone anywhere because of the weather), and I'm back to walking several miles on most days.  My walking time for the local festival "Lop the Loop" walk/run on May 19, while not a blistering pace, was only 9 minutes slower than my best ever time for that 7K course.  Today I walked my favorite morning hike, which includes considerable elevation, in just over an hour, which is right on my long-time average for that course.  On alternate days we work out in a local fitness center.  One of my most pleasant surprises is that I no longer feel the mid-afternoon slump I have been dealing with for several years.  We are not sure if that is a sign that our healthier diet and regular exercise are helping to maintain a more consistent blood sugar level or that the progressing disease was having more of a negative effect on my health than I realized.  Except for the continued nagging side effects of the hormone therapy, on most days I feel good enough that I can almost entirely forget about our winter ordeal. 

Up on the roof

In previous posts I have talked a lot about the importance of those elements in our life that we can control, such as diet, exercise, and stress management.  Since then others have reminded me that there are other positive factors we can strive for to improve our overall health and well-being.  One of these is getting adequate sleep.  And, we can't underestimate attitude, which is a huge factor!!  As I was getting down the ladder from finishing pressure washing my shed roof the other day, it occurred to me that being a victim of cancer is not a given.  You can be a person with cancer, a cancer patient, or a cancer survivor all without being a cancer victim.  Being a victim is a choice, not a condition and I'm convinced that it is an individual's attitude that makes that difference. Will I still feel this way if I have a relapse?  I don't know, but in the meanwhile I plan to continue to live as normal and healthy a life as possible.   

After all we have posted about healthy eating, I can't write a blog post without at least a small section on diet.  We continue to explore  and look for individual foods and recipes that are available locally and work for us.  The latest on our list of super foods is kale.  Like many of its cousins, the greatest nutritional benefit comes out when it is lightly steamed.  It is also good in moderation in a tossed green salad or added to soups.

Below is an incredible recipe for smoked salmon that we came across some time ago mentioned on someone's FaceBook page.  It was described anecdotally rather than listed as a specific recipe.  We have experimented with it, modified it slightly, and it has become one of our favorites.  We both agree it can be considered healthy and it fits into the gourmet flavor category without requiring any fancy ingredients or special preparation.  

Gourmet Smoked Salmon Pizza

You can either make your own healthy wheat crust using the recipe below or we have used the pre-made whole wheat Boboli crusts which are available at most stores.  

Thinly slice and caramelize one red onion in olive oil (this makes the onion oh so sweet and yummy).
Coat the pizza crust with your favorite white Alfredo sauce.  

Liberally place thin slices of fresh garlic over the sauce. (We nearly cover the top)

Spread the caramelized onion evenly over the garlic.  

Add a liberal amount of flaked smoked salmon over the entire pizza.

Top it off with a healthy sprinkling of feta cheese.

Bake in a preheated oven according to either the directions on the crust package or the recipe below.
The smell of this pizza baking is almost irresistible.  Serve it hot.  It is even better at the table!

Easy Pizza Crust    

Soften 1 package or 2 1/4 tsp yeast in 1 cup warm water with a pinch of sugar

Let set until just bubbly.

Combine 3 1/2 cups (1 1/2 cups whole wheat, 2 cups white) & 1 tsp salt in a mixing bowl.

Make a depression and mix in 1/2 of yeast mixture.

Mix well.

Add other half of yeast mixture and 2+T olive oil

Mix well, knead, and cover for about 20 min.

Knead again and roll out to fit pizza pan.

Top with ingredients and bake at 425 for 20 minutes. 

That is about enough for one post, except to remind every one to enjoy each day to the fullest.  For those of you who live on our island, the wildflowers are spectacular this year, despite the rain.  The wild iris were budding last Sunday at Ohmer Creek and should be blooming by this weekend.  For me there are few things that relieve stress as much as a slow stroll through nature's garden in full bloom with camera in hand.  I like to look closely at each flower to observe the many small inhabitants as I pass by.  It is very easy for me to completely lose all track of time.  Most of all, just get out to enjoy the spectacle.  Rain or shine, you will be very glad you did.

Shalom,

      Barry and Kathy

Books, Documentaries, & Recipes--more food for thought

Check out this book:
One of the reasons for this post is to let our Petersburg friends know that the two copies of "Anti Cancer, A New Way of Life" by Dr. David Servan-Scheiber, which we ordered for the Petersburg Public Library, are now available to check out. 

We feel that the book is very worth your time.  We've  given several copies to friends/family and we know of several friends who have ordered the book on our recommendation.  If you belong to a book group, this is worth considering for one of your discussions.  (note from Kathy:  After reading the Introduction, sneak ahead and read pages 105 - 111 to jump start your "read")

We want to emphasize, again, that the author does not recommend alternative forms of treatment.  Instead, he emphasizes ways to make conventional treatment more effective. I can't help but think that if his recommendations are so effective in prolonging the life of cancer victims, how much benefit they could provide as preventative measures.

Unfortunately, the brain cancer, which started Dr. Servan-Scheiber on his quest for a better way to treat cancer, finally caught up with him.  He passed away last July at age 50, nearly 20 years after having been diagnosed, treated, and given a maximum of 6 years to live.  The fact that he was able to more than triple his life expectancy says a whole lot about the effectiveness of his recommendations for a better way to live.

Interesting Documentaries:
While you are at the library you might also consider checking out two excellent documentaries on how America's food choices have been and continue to be hijacked by both big business and the government. These limitations in healthy food choices are directly linked to the epidemics of cancer, heart disease, diabetes, and obesity plaguing our nation.  "Food, Inc." focuses on how big agribusiness dictates what we eat.  "Farmageddon" focuses more on how government disrupts the supply of healthy foods to consumers and co-ops.  One very good point that was made in "Food, Inc." is how much power consumers have to influence what is available to buy in grocery stores.  Now that virtually every item is bar-coded, we vote for the type of food we want every time we shop.  An example used is that a strong preference for milk free of Bovine Growth Hormone (rBST) prompted Walmart to quit selling hormone treated milk altogether.   

"Good" food should taste good. 
We have found a number of simple good-food recipes we really enjoy.  The black bean soup recipe below is one of our very favorites.  Carol McCabe shared it with us several years ago, and we've used it frequently ever since.  Ironically, there is nothing in it that isn't on our list of healthy foods.  Our version of the basic recipe has evolved over time, but we have yet to figure out a way to add anything, within reason, that negatively impacts the final result.  Thanks, Carol!

Black Bean Soup with Salsa Verde

Notes:  
     Along with a whole grain bread and green salad, this soup makes a very nice casual company lunch or dinner.

     We often double and sometimes even quadruple this recipe for a larger group.

Ingredients:
2  15.5 oz. cans black beans, drained (not necessarily rinsed)
1 1/2 cups organic low-sodium chicken broth (you can substitute vegetable or beef broth; we often settle for low-sodium bullion).
1 cup prepared medium salsa verde (adjust to taste - less if you want the soup less spicy; more if you want more zip)
1/4 cup packed cilantro leaves (optional, but really nice cooked in)
1 tsp. ground cumin
Garnishes:  tortillas, grated cheese, crumbled tortilla chips, sour cream, jalapenos, diced tomatoes, more cilantro, green onions,
Also, you can add beef, pork, or chicken for extra protein.  Use your imagination!

Puree all ingredients except garnishes.  Pour into saucepan and bring to a simmer.
The original recipe says to puree the soup.  Because we like more texture, we prefer to put the drained beans in the pot and smash them with a potato masher.  Then, we add the other ingredients intact and simmer the soup.
Simmer partially covered 5 - 7 min., stirring frequently, to blend flavors.
Serve with garnishes.  This is mostly a base - the garnishes really make it!!!
The basic recipe serves 2 hungry eaters with a bowl left over.

We often expand the recipe by adding a can of organic diced tomatoes and a can of low fat refried black beans.  For the last batch we made, I sauteed 1/2 cup diced onions, 1 finely diced fresh jalapeno, and 3 cloves of finely chopped garlic, then simmered them along with the other ingredients.  Yummy!!  

5-Minute Brussels Sprouts (from the worlds healthiest foods (whfoods.org).

Before finding and trying this recipe, I had absolutely no use for Brussels sprouts in any way shape or form.  As stated on the site, "Even if you have not been a fan of Brussels sprouts, I think you will love this Healthiest Way of Cooking Recipe.  It not only has great flavor, takes little time to prepare, but one serving provides 870% of the daily value (DV) for health-promoting vitamin K, 326% DV for vitamin C and 40% DV for vitamin A. And they only take minutes to prepare. Enjoy!"  

This recipe is delicious, but I suggest following the directions closely.  I tried to double the recipe once and it didn't turn out nearly as well. The sprouts were not fully cooked and cooking time is critical.  Also, I find that it takes considerably longer than indicated to clean and quarter a pound of Brussels sprouts.  Maybe I'm just slow?  I mix the dressing in a large serving bowl and then add the cooked sprouts directly to the dressing and mix it together while they are still hot.  These are also good cold with or on a green salad.  

 

Prep and Cook Time: 15 minutes?? (see above)

Ingredients:

• 1 lb Brussels sprouts
• Mediterranean Dressing
• 3 TBS extra virgin olive oil
• 2 tsp lemon juice
• 2 medium cloves garlic, chopped or pressed
• Sea salt and black pepper to taste
• Optional: 1 TBS dijon mustard, 1 TBS minced parsley (we add the mustard, but not the parsley)

Directions:

1. Fill the bottom of the steamer with 2 inches of water.
2. While steam is building up in steamer, cut Brussels sprouts into quarters and let sit for at least 5 minutes to bring out their hidden health benefits.
3. Chop or press garlic and let sit for at least 5 minutes to bring out their health-promoting properties.
4. Steam Brussels sprouts for 5 minutes.
5. Transfer to a bowl. Toss Brussels sprouts, while they are still hot, with the ingredients for the Mediterranean Dressing. (Mediterranean Dressing does not need to be made separately.) Serves 2 with leftovers. 
   

This  card was sent to Kathy several years ago.  We love it!

On another food-related subject, Kathy has expressed concern that some of my previous posts regarding drinking red wine are perhaps a little too flippant, and may sound like I am actually promoting red wine as a necessary part of an anti-cancer diet.  Nothing could be further from the truth.  What I am saying is that if you are going to drink alcohol anyway, red wine appears to be less damaging for you than other alcoholic drinks, and then only when consumed in moderation. 

The following is a synopsis of what I have gleaned from a number of sources regarding the relationship between alcohol and cancer.  If anyone else has additional or differing information, please feel free to add to this discussion.  

Alcohol in itself is not considered to be carcinogenic.  However, it can act as a co-carcinogen because it is a potent solvent and can aid in the distribution of free radicals across cellular boundaries.  These free radicals can cause disruption of cellular function which can, in turn, lead to mutation of the cellular DNA which is a prerequisite to cancer.  Also, as we all know, excessive use (abuse) of alcohol can greatly compromise the immune system and cause a number of other major health issues.  When the body's immune system is compromised, the ability to fight any disease, including cancer, is also compromised.   

On the other hand, red wine contains resveratrol, which is a very powerful anti-oxidant.  Apparently the fermentation process preserves and intensifies the resveratrol, because this component is not nearly nearly as plentiful in plain processed grape juice, even when made from the same grapes.  Red wine has considerably more resveratrol than white wine because the substance is found primarily in the skin of the grape.  Areas, such as the Mediterranean, where red wine is consumed regularly, have very low cancer rates.  However, these areas also consume the "Mediterranean diet", which, as we have discussed before, is chock full of anti-oxidant rich foods.  

The bottom line is, if you are concerned about cancer and if you are going to consume alcohol anyway, you are much better off limiting that consumption to a glass or two per day of red wine, preferably with a meal.  I guess it is debatable whether or not dark chocolate constitutes a meal.   

Shalom,

   Barry and Kathy   

For Men Only (and the Women who care about them)

Hello, from beautiful Southeast Alaska,

We are coming close to the end of this phase of our blog journey.  This post is a prequel, dedicated to answering the frequently asked questions, "How did you discover you had prostate cancer?" and "How did you go about getting treatment?"  

This is another very personal post, and I am writing it primarily because there is so much information I wish I had known about the disease or taken much more seriously earlier on.  It was not that the information wasn't available, it is just that for much of the last three years every time I researched a symptom, I determined, at least in my mind, that it represented a less serious alternative.  Is that a form of denial?  The post is quite lengthy and detailed, because I want to chronicle the early part of the journey for myself.  This was where I was most ignorant and stubborn and stumbled a number of times before diagnosis and finally the road toward cure.  

This is very serious stuff.  The statistics on prostate cancer are sobering, and, frankly, quite scary.  According to the U.S. National Institutes of Health, "It is estimated that 241,740 men will be diagnosed with and 28,170 men will die of cancer of the prostate in the U.S. during 2012".  With baby-boomers just beginning to enter the most vulnerable age group, the total number of cases diagnosed will almost surely increase.  Hopefully, with early detection and better treatment methods, the latter number will go down.  Regardless, the current odds are that about 1 in 6 men will be diagnosed with the disease during their lifetime.  If reading this helps just one person to avoid any of my mistakes and to obtain necessary treatment sooner, it is well worth it.

 First a brief update on my health.  I am feeling stronger each day and set-backs are much less frequent.  Another plus is that I am way less tired and can get through most days without a nap.  I really think our healthier diet is helping my energy level.  We are trying to exercise every day and stay on our anti-cancer diet as much as possible.  Participating in and completing the Circle of Life walk, honoring Mike Wittstock, last Saturday felt like a real triumph.  Seeing so many familiar faces and catching up with old friends was cathartic, in the emotional sense not in the medical sense, thank goodness.

Although we did not know it at the time, our journey with cancer started with a routine prostate specific antigen (PSA) test in April 2009.  (If you don't know about PSA, I hope you are either a man under age 40 or a woman.)  My PSA level was 5.2 ng/ml, up from 4.2 ng/ml at the health fair the previous spring.  The normal range for a man my age should have been 0-4.5 ng/ml.  A three-week course of Cipro knocked the level back down to 3.8 ng/ml, and my local physician diagnosed the problem as a mild case of prostatitis, an infection of the prostate.  We were both convinced that we had it beat.  However, the 2010 April health fair PSA reading was 7.41 ng/ml!  Something was going on!  Now, there are a number of reasons that the PSA level might increase that quickly, and cancer is just one of them, so my physician and I set about trying to determine the cause.  A digital exam determined that the prostate was somewhat enlarged and I told him that I occasionally felt some discomfort and sometimes had difficulty with urination, both symptoms of benign prostatic hyperplasia (BPH).  We decided to retest in a few weeks to see if the high level was an anomaly.  By June, the PSA level was back down to 6.32 ng/ml and dropped even further to 6.12 ng/ml by December.  We decided to wait to do a follow-up PSA and digital exam in about six months.  What I now know is that, while an elevated PSA level and a rapid increase in PSA do not necessarily mean you have cancer, they do signal prostate problems which should be evaluated by a specialist.  In fact, my local physician advised me to make an appointment with a urologist, which I never did.  Just too darn inconvenient from here, I guess. 

By the late winter and spring of 2011, both pressure and some pain were near-constant companions.  But, I was beginning the charter season and couldn't be bothered with another distraction.  I decided to live with it until the end of the season, promising myself that I would have it checked out when we went south in the fall.  I went in for another PSA test and a consultation with my physician in June, 2011.  He ordered a free PSA test along with the total PSA test.  A what??  I had never heard of a free PSA test.  This test is most appropriate for men with a total PSA between 4.1 and 10.0 ng/ml, the exact range I was in.  Apparently most of the PSA in the bloodstream is bound to proteins in the blood, while some remains "free".  A "normal" free PSA reading should be about 0.25 of total PSA.  If your total PSA level is high and the percentage of free PSA is also high, the increase is most likely the result of BPH.  A higher than normal PSA along with a low percentage of free PSA can indicate a higher probability of cancer.  My free PSA reading was only 0.10 of total PSA, which was by then back up to 6.8 ng/ml.  This level indicated a 56% chance of cancer.  Whoops!  Way past time to contact a urologist!  My physician told me there would be a urologist visiting from Juneau in November and I could schedule a biopsy then.  Kathy and I decided not to wait that long, and talked to our daughter and son-in-law who are both in the healthcare profession in the Portland area for recommendations.  Based on their resources' advice, we made an appointment with a well-known and trusted urologist, Dr. Janoff, with Urologic Consultants, in Portland, for late September.  After an initial exam and consultation we scheduled a biopsy for October 3.

We were in the USS Constitution Museum in Boston on October 10, when I got a call from Dr. Janoff himself.  It was a classic good news/bad news report.  The good news was that only two out of 12 biopsy cores were positive for cancer.  The bad news was that the two which were positive showed a very advanced stage of the disease.  We were told that we could continue on with our fall trip through the Canadian Maritimes, but to make an appointment to see him as soon as we got back to Oregon in early November, which, of course, we did.  He also said that he had reviewed my medical history and the ultrasound images taken during the biopsy.  Based on that information, he ruled out surgery as a treatment option, but told us he would get a second opinion, which he subsequently did. The second, even more-experienced surgeon, came to the same conclusion.  Surgery was out.
 

Detailed tissue and radioactive bone scans to determine if the cancer had spread were conducted as soon as we returned to Oregon.  Thankfully, there was no indication of cancer beyond the walls of the prostate.   Because surgery was not an option, Dr. Janoff referred me to Dr. Hansen, a highly-respected radiation oncologist at Providence St. Vincent Hospital in West Portland.  Jointly, we developed a treatment plan, and I received a hormone blocking injection from Dr. Janoff's staff on November 16.  The purpose of the injection was to cut off testosterone to shrink the prostate and starve the tumor until radiation therapy could be started.  We returned to Petersburg for the Holidays.  In mid-January we flew back down to Oregon to start treatment.  As they say, the rest is history and is well-covered in previous blog postings.

Mistakes Made and Lessons Learned:
The U.S. Preventive Services Task Force recently released a report recommending against men getting a PSA test to screen for prostate cancer.  I'll have to admit that I was distracted somewhat by early announcements of this report a year ago, particularly when it came to the value and reliability of the PSA test.  I asked my urologist about it, and he labeled this position as being somewhere between irresponsible and downright dangerous.  There is no doubt that the PSA test, which is most often accompanied by a digital rectal exam, can help detect prostate cancer.  In fact, these procedures, in combination, are the only non-invasive methods currently available to determine if a man has prostate cancer (this is of course if one considers a digital rectal exam and a poke in the arm to be non-invasive).  The problem is that many of the cancers that get detected are so small and slow-growing, they'll never be harmful, and doctors have a difficult time discerning the quick, harmful cancers from the slow, harmless ones.  Only a biopsy can differentiate between them.

That said, I feel that, based on my experience, any recommendation against getting your PSA level tested is a very big mistake.  An elevated PSA level was the first indication that I had a problem, and having that test and the follow-up tests very likely saved my life, as it has saved the lives of many other men.  An annual PSA test, along with an annual digital exam, after age 40 is still recommended by nearly all urologists as the best method for early detection of prostate cancer.  Much like the combination mammogram and self examination for breast cancer, it is not perfect, but does catch a lot of disease which would otherwise go undetected.  

I learned that one shouldn't concentrate on the PSA number itself.  Apparently there is no magic number that indicates a safe level.  Instead, one should monitor the change, particularly if the PSA level continues to increase over time.  This is referred to as velocity PSA and can be an indicator of a developing tumor. The fact that my PSA level varied pretty dramatically for a couple of years was confusing and one of the main reasons we (my physician and I, not Kathy and I) did not act more aggressively sooner.  That delay also turned out to be a mistake.

Would earlier diagnosis and treatment have resulted in a better outcome for me?  We don't really know and won't know for some time (see previous post).  I do believe that at the point the PSA started its dramatic rise, the tumor was just beginning to really take off, and an earlier start on treatment may have required fewer radiation sessions and possibly a better outcome.  Earlier treatment would also have relieved me of a year of discomfort, pain, and near constant worry.  Bottom line, if there is an indication of a problem, get it checked out, not only for yourself, but for your loved ones.

There are apparently many things which can effect the PSA number on a given day.  For example, having a digital exam, sex, or some trauma to that area within two days prior to a PSA test can greatly increase the numbers.  Therefore it is important to have the PSA test before a digital exam or wait several days after the digital exam to have it.  There are several prescription drugs which can decrease the numbers, so make sure your physician has a complete list of all of your medications and ask him to check for contraindications.  If an increase in PSA is indicated, one shouldn't wait too long to have it retested to determine if the first number was an anomaly.  This also provides a chance to catch a rapidly developing problem.  Perhaps the biggest lesson I learned is that there is an intermediate test, the free PSA test, which can indicate even more accurately the probability of cancer and the need for a biopsy.  Be sure to ask your doctor if it is appropriate for your condition.

The biopsy itself wasn't nearly as bad nor as painful as I expected, and I flew clear across the country, from Portland to Boston, the day after.  My fear of having the biopsy turned out to be much greater than the reality.  There was some minor pain, but I was well used to that by then.  Also, there was a bit of blood in my urine which lasted about three days.  I wish now that I hadn't waited nearly so long to schedule one.  Also, if you question the results of your biopsy for any reason, you can request that it be read again by another lab.  In fact, some medical institutions require that their own specialists reread the biopsy results before starting a treatment plan.

Keep in mind, one size does NOT fit all.  Each person is different, and each cancer is different.  If you are diagnosed with prostate cancer, you will have a lot of opportunities to outline a treatment plan that is best for you.  The good news is that there are many treatment options and there are increasingly more methods to choose from.  Also, successful treatment rates are improving all the time.  

A number of years ago when my father was first diagnosed with prostate cancer, his urologist recommended "watchful waiting" as a form of treatment.  I have learned through my research that watchful waiting is not treatment and is no longer considered a logical option in this country after cancer has been detected.  One very reputable urologist goes so far as to describe watchful waiting as a "death sentence".  If your urologist detects cancer and suggests watchful waiting, get a second opinion, quick.  

I found great comfort in being in a familiar area and close to family.  That is a big consideration if you need to be away for an extended period of time, as we were.  Thank you again, Rob and Susan.  Having your beautiful Orenco Station home available to us exactly when we needed it was a godsend. 

My few words just touch the tip of the iceberg regarding what is currently known and written about prostate cancer.  New information and a better understanding of the disease is becoming available all the time.  Face it, as stated earlier in the post, the odds are not in your favor so you might as well get to know what you are up against to become better prepared to deal the disease if or when it effects either you or a family member.

The very best reference that I have found on the specific subject of prostate cancer is Dr. Patrick Walsh's guide to surviving prostate cancer by Patrick C. Walsh, MD, and Janet Farrar Worthington.  The copy I have is the second edition.  Thank you again for the book, Bridget; it is an invaluable resource, which I plan to share with others.  The book is so detailed that it even spells out how you can make a digital rectal exam more comfortable for yourself - something I'd been wanting to know for 25 years.  USA Today describes the book as, "The ultimate book on the No 1. men's disease in the world....should be in every man's home."  I'll take that a step farther and say, "It should not only be in your home, it should be read from cover to cover."  

Please feel free to share any or all of the information contained in this post with friends and family who are entering the time of their life when prostate cancer becomes a concern. 

Every day is a blessing!!

Shalom,

    Barry and Kathy

What's Next & Food for Thought

Greetings Again, Friends and Family,

Note to Readers:  Because it pertains to lifestyle--ours and maybe yours--this is, perhaps, one of the more important posts we have written to date.  Over the past several months we have accumulated a lot of information about cancer in general, and prostate cancer in particular.  We are always open to sharing what we have learned with anyone who has questions or can benefit from the information.  We would also very much appreciate learning any information you would like to share with us.

So, while the following three paragraphs are more about our personal journey, the rest of the post is more specific about changes we have been making to implement an anti-cancer lifestyle.  We hope this healthy lifestyle information will be useful to you as well.

Now that we are back home, there is time to reflect a bit more on what we have gone through and what lies ahead.  On Thursday, April 26, I had appointments with my primary care physician and the lab, as I transitioned back to the Petersburg Medical Center for local care.  It is hard to express what a pleasure this experience was compared to dealing with the large size and complexity of the urban health care system.  I will receive a hormone blocker injection here in mid-July.  Beyond that, nothing is set in stone.  We will schedule appointments with my oncologist in Oregon for a routine follow-up visit sometime in late September or early October when we return south for our fall visit.  We will also schedule an appointment with my urologist in Oregon in mid-November for another hormone blocker--most likely a one-year implant. 

Since returning home I have been asked by several folks if I'm cured.  That is an excellent question to which I can honestly respond, "After what we have gone through, I certainly hope so".  However, the official answer is a bit more complicated, and we won't know for sure for at least two years.  The cancer I had was "highly differentiated".  Which means that the tumor was made up of cells that were very different from the prostate cells it had taken over.  Cancer can be very dangerous at that stage and, even though undetected by the scans, the probability of micro tumors having formed outside of the prostate is quite high.  That is the primary reason my treatment lasted so long, to treat both the prostate and the surrounding area.  We have faith that the radiation treatment of the margins got rid of any micro tumors that may have formed, but can't be certain at this time.

Most, but not all, prostate cancer cells require testosterone to reproduce.  As a result, I will remain on a testosterone blocker for the next two years.  This will greatly slow or stop the growth of any remaining tumors.  After that, I will discontinue the blocker, and they will closely monitor both PSA and testosterone levels.  An initial PSA "bounce" is expected as hormone levels return to normal.  A drop in the PSA level after the bounce will indicate that I'm cured.  If the PSA level stays high, or if it goes up, there will be more work to do.  If the cancer returns, the secondary treatment after radiation is called "salvage" and current methods of dealing with the return of prostate cancer after radiation have not been shown to be that effective.  However, new treatment methods are being developed all the time and in two years the cure rate for salvage treatment is sure to improve dramatically.  A logical question at this point is, "Why not just stay on hormone therapy forever?"  For one thing, that would entail a permanent life change and would take very careful consideration.  Also, because not all prostate cancer cells require testosterone to multiply, cancer could still grow, although it would likely take longer to become life-threatening.  Continuing hormone therapy for two years past radiation is the current method used to reduce the risk of the cancer recurring.  Stopping the therapy at that point provides a benchmark to evaluate the outcome of the treatments, and to determine whether additional treatment is necessary.

Is there anything I can do in the meantime to reduce the risk of the cancer returning?  Fortunately, the answer is yes.  Keep in mind that everyone has cancer cells in their bodies, but not everyone develops cancer.  If we avoid self-induced risk factors such as tobacco use, being around second hand tobacco smoke, or working around carcinogenic materials, there are six primary variables that determine whether or not a man develops prostate cancer.  These are race, genetics, age, diet, exercise, and stress.  Unintentional exposure to environmental contaminants can also be a factor, but the three main factors that a person can control are to eat a healthy diet, exercise regularly, and reduce stress. 

  

Diet:  I will have to admit that Kathy has been encouraging me to rethink my diet for a long time.  Much as a diabetic or heart attack victim finally wakes up to the need for a healthier lifestyle after-the-fact, it took the diagnosis of advanced prostate cancer to finally wake me up.  There is no way to know for certain if my penchant for sweets and fatty foods caused, or even contributed to, my cancer.  I do know that I wish I had taken diet more seriously starting at least 12 to 15 years ago, when the cancer most likely began to develop. 

Diet is such a big factor in the cause of cancer that a review of all data on epidemiology shows that "the principal difference between populations with the highest cancer rates and those with the lowest was their food".*  Simply put, certain foods tend to either feed tumors directly or contribute toward building the ancillary blood vessels necessary to supply a tumor.  Other foods tend to have the opposite effect.  When I first became convinced of the connection between diet and cancer and we started on a primarily anti-cancer diet several months ago, I joked that the diet is very simple--if it tastes good, spit it out.  That turned out to be untrue, and it did not take long to lose my craving for highly processed, overly sweet, or fatty foods.

It is no coincidence that the recommended diets to prevent all four lifestyle-induced epidemics of the western world--cancer, heart disease, obesity, and type-2 diabetes are so similar.  In fact, if you were to overlay the recommended diets to combat these four diseases, in a lot of respects it would be difficult to tell them apart.  In a nutshell, we have minimized our consumption of foods made with white flour, sugars, and corn syrup; fatty foods (particularly those high in omega 6 fatty acids); highly-processed foods; most fatty dairy products (particularly bulk cheeses); all processed meats; as well as feedlot beef and mass-produced chicken.  We have maximized our consumption of whole grains (cereals, breads, brown/basmati rice, etc.), fruits and vegetables (organic when available), wild fish, legumes, fat-free organic yogurt, and much smaller amounts of organic chicken and free-range, grass-fed beef.  We stray from the diet occasionally, but we don't feel deprived in any way on the basic healthy diet. 

 There are several cancer "super foods", which have been shown to reduce incidence of cancer to almost negligible levels where they are staples in a healthy regional diet.  We try to add at least some of them to our diet nearly every day.  These include, garlic, cruciferous vegetables (broccoli, brussel sprouts, cabbage, etc), turmeric (a key ingredient in curry), pomegranate (100% juice), olive oil, highly-colored berries, green tea, most soy products, and red wine (in moderation).  Dark chocolate is also good.  It turns out that there are synergistic benefits when some of these foods are combined with other foods.  Examples are: broccoli is more effective if eaten with hot mustard, horse radish, or wasabi (wasabi itself has anti-inflammatory properties); turmeric is much more effective if used in an dish which also contains olive oil and fresh-ground black pepper.  I like to think that a square of 72% cocoa Belgian dark chocolate paired with a 4-oz glass of a good merlot has tremendous synergistic benefits, both for the anti-oxidant food value as well as a great stress reliever. 

I'm not saying that if I stick to any particular diet, my cancer will not return.  In fact, it has been shown that diet is more effective in preventing cancer in the first place than it is in keeping cancer from recurring.  I certainly wish I'd been convinced of that before hand.  Regardless, if I can reduce the possibility of recurrence by even a small amount, it is more than worth it to me.  If nothing else, our risk of developing diabetes and heart disease, or becoming obese will diminish greatly, and we'll feel a lot better doing it.

  

Exercise: Moderate exercise is recommended to help prevent and to reduce the risk of recurrence of all cancers.  For some reason, as yet unknown, it requires even higher levels of regular exercise to show positive benefits toward reducing the recurrence of prostate cancer.  Achieving high enough levels of exercise to be beneficial will be a major challenge for a while, at least until my stamina has increased.  You all have permission to remind me to get out there and "just do it".

Stress:  Avoiding stress is very important because the adrenaline produced, particularly during continuous high stress levels, can actually create pathways which promote cancer growth.  If you find that you can't avoid stress in your life (most of us can't), mindfulness meditation and other forms of meditation and relaxation (such as yoga) are highly recommended methods of reducing stress.  To date, I've been very slow at working toward this.  I know from the literature that the potential benefits are great enough that I'm very encouraged to check it out.  In the meantime, I'll be content to put on some soft music, break off a small piece of dark chocolate, pour a small glass of red wine, sit back, relax, and contemplate the many blessings in our lives. 

Keep in mind that these lifestyle changes are to be considered in conjunction with, not as a substitute for, professional medical care.  As pointed out above, these changes will provide great benefits even if you don't have major medical issues.

 Peace and Love to all of you,

      Barry and Kathy

P.S.  We found the book listed below, and quoted in the text, to be very helpful to us.  It's easy to read, well-documented, contains encouraging anecdotal information, and has easy-to-understand color charts and graphs of the anti-cancer foods.  Take the opportunity to read the reviews on Amazon for a snapshot of the book.  We have purchased and/or recommended it to several of our family members and friends.  We will be ordering copies for the Petersburg Public Library.

* Anti cancer - a new way of life, by David Servan-Schreiber, MD, PHD, (p 106).