Cancer Prevention & Treatment

Woodlands Healing Research Center

Family, Environmental & Preventive Medicine

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Cancer Prevention & Treatment

Date: 06/29/2006

“There is no scientific evidence that food or other nutritional essentials are of any specific value in the control of cancer.”

AMA Declaration, 1949

“We must act on facts, and on the most accurate interpretation of them, using the best scientific information. That does not mean we must sit back until we have 100% evidence about everything. Where the state of the health of the people is at stake, the risks can be so high and the costs of corrective action so great, that prevention is better than cure. We must analyze the possible benefits and costs of action and inaction. Where there are significant risks of damage to the public health, we should be prepared to take action to diminish those risks even when the scientific knowledge is not conclusive, if the balance of likely costs and benefits justifies it.”

Richard Horton, Editor in chief, Lancet, July 1988

Prevention is the most important and most reliable cancer-fighting tool available. There is, indeed, much we can do to prevent this dreaded disease. Cancer prevention means preventing a first cancer episode and/or preventing a recurrence after successful treatment of a cancer. Creating and maintaining a healthy and strong immune system is the cornerstone to cancer prevention and treatment. Such measures that accomplish this effort include:

· Diet and Nutrition

· Exercise

· Maintaining a Healthy Weight

· Avoidance of Chemical Toxins and Radiation in the Home and the Environment

· Stress Reduction and Building Emotional/Spiritual Health

American Cancer Society Guidelines for Cancer Prevention

We will begin our discussion of cancer prevent with the American Cancer Society (ASC) 1996 Advisory Committee’s Guidelines on diet, nutrition, and cancer prevention with healthy food choices and physical activity. The ACS guidelines are very conservative as they choose to wait for long-term definitive studies proving or disproving many recommendations for cancer prevention. Such course of action will take years and probably decades before those answers are found. Consequently, we have chosen to editorialize the ACS guidelines based on our opinions of the scientific literature on cancer prevention and immune system augmentation. You may then choose which and how many recommendations you want to incorporate into your health maintenance and cancer prevention program.

The ACS affirms (are we whole heartedly agree) that dietary practices and physical exercise along with smoking cessation, avoidance of occupational cancer causing substances and early detection are important factors in the prevention of cancer and cancer death. The details of their recommendations are as follows:

· Choose most of the foods you eat from plant sources

Ø Eat five or more servings of vegetable and fruits each day.

Ø Include vegetables in every meal and choose fruits and vegetables for snacks.

Ø Include grain products as whole grains instead of processed (white) grains

Ø Choose beans as an alternative to meat

The evidence of eating increased vegetables and fruits to reduce the risks of colon cancer is strong. Evidence is present, but less strong for such cancers as breast and prostate.

· Limit your intake of high fat foods, particularly from animal sources.

Ø Replace fat rich foods with fruits, vegetables, grains and beans

Ø Eat smaller portions of the high fat foods

Ø Choose baked and broiled foods instead of fried foods

Ø Select non fat and low fat milk and dairy products

Ø Select lean cuts of meat

Ø Eat smaller portions of meats

Ø Choose beans, seafood, and poultry as an alternative to beef, pork and lamb

Ø Select baked and broiled meats, seafood and poultry, rather than fried

High fat diets have been associated with an increase in the risk of cancers of the colon, rectum, prostate, breast and uterus.

· Crucifers- are vegetables that contain special cancer fighting nutrients (indoles and sulforaphanes) that offer some cancer protective effects, especially breast cancer (Zeligs, J of Medicinal Foods, 1998 and Michnovica, J Natl Cancer Inst, 1997). Crucifer foods include broccoli, cabbage, cauliflower, Brussels sprouts, mustard greens, collards, turnips, watercress and bok choy. Eat them raw or lightly steamed but avoid over cooking as heat destroys these special cancer-fighting nutrients. Broccoli Sprouts have 20-50 times more of these cancer fighting phytochemicals than the adult broccoli spears- use them liberally! Try for one serving of these crucifers per day for optimal cancer prevention.

· Allium Vegetables- include garlic, onions, leeks, chives and shallots. They are loaded with selenium and sulfur rich amino acids and may be cancer protective in general and reduced breast cancer in rodents (Advances in Experimental Medicine and Biology, Vol 4.1, 1996).

· Capsicum Vegetables- include green/red peppers and Chile peppers have a cancer protective phytonutrient (Carcinogenesis, Vol 16, 1995).

· Fish Oil & Omega 3 Fatty Foods- Although high amounts of saturated fats and hydrogenated (trans) fats are associated with cancer; certain good, healthy fats (omega-3 fats) appear to be cancer protective (Nutrition Research, Vol 9, 1989; NCI Study, 1990; Bougnoiux P, BJ Cancer, 1994). Foods that contain these good omega 3 fats include cold-water fish, beans, raw nuts and flaxseeds/oil. Fish oil studies reveal anti-tumor effects by suppressing tumor growth and by tumor killing activity. Fish oil has been found to suppress both breast and colon cancer tumor cell growth and spread (Rose DP, J. Natl Cancer Inst, 1995 and Kontogiannea M, J Surg Res, 2000).

· Lignans- slow down cancer spread and act as anti estrogens. Lignan containing foods include flaxseed, whole grains (oats and rice), legumes (lentils, peas, beans), walnuts and seeds.

· Soy Foods- the effects of soy phytoestrogens on cancer are still being investigated and controversial. The National Cancer Institute is promoting soy’s role in protecting against breast and prostate cancer (JAMA, Vol 275, 1996). There are some conflicting results and can be explained by the fact that isoflavones are selective as to where in the body they are a “pro-estrogen” and where they act as an “anti-estrogen.” They may also be pro or anti estrogen depending on the dose-At low doses isoflavones have an estrogen-like stimulating effect, while at higher doses it appears to have anti estrogen effects. In the absence of any estrogens, genistein in low doses has a weak pro estrogen effect on breast cancer cells in a test tube (Hsieh, Cancer Res, 1998).

However, in that same test tube, when adding higher doses of genistein, it inhibits the growth of breast cancer cells (Zava, Nutr Cancer, 1997 and Peterson, Cell Growth Diff, 1996). That being said, in over 150 test tube studies, genistein has been found to inhibit the growth of cancer cells (Messina, Adjuvant Nutrition in Cancer Treatment Symposium, 1995 and Fotsis, Baillieres Clin Endocrinol Metab, 1998). Soy phytoestrogens inhibit the proliferative effect of both estrogens and xenoestrogens (chemicals that act like estrogens in the promotion of breast cancer) (Herman, J Nutr, 1995 and Verma, Nutr Cancer, 1998). An Italian test tube study found that the combination of genistein and the chemo drug Adriamycin showed an increased, synergistic effectiveness in halting human breast cancer cell growth (Monti, E, Anticancer Res, 1994).

Of the 25+ animal studies performed with soy, roughly 65% of them revealed a cancer preventing effect of soy (Messina, Nutr Cancer, 1994).

Epidemiological studies that have looked at the amount of soy in the diet and the incidence of breast cancer have reported that soy may be protective against cancer (Persky, J Nutr, 1995).

One case controlled study of 144 pairs of Australian women with newly diagnosed early breast cancer found three was a substantial reduction in breast cancer risk among women with high intake of phytoestrogens (Ingram, Lancet, 1997). In somewhat contradiction to these studies, other human studies have shown the soy isoflavones can stimulate the growth of normal breast tissue (McMichael-Phillips, Am J Clin Nutr, 1998 and Petrakis, Cancer Epidemiol Biomarkers Prev, 1996). Another human study revealed soy consumption decreased total estrogen and the estrogen metabolites that may be cancer stimulating (Xu, Cancer Epidemiol Biomarkers Prev, 1998).

Although encouraging, the human studies on soy and cancer are small, preliminary and are by no means conclusive. There are no well-controlled randomized human trials evaluating soy and female cancers. Soy rich foods also improved prostate health by blocking production of the testosterone (J Endocrinology, Vol 147, 1995).

The following precautions concern high dose soy intake:

· High doses (200 mg/d) of soy isoflavones may inhibit thyroid function.

· High doses (100-200 mg/d) of soy isoflavones can decrease estrogen levels in the premenopausal women. This may be good in women with an estrogen dominant state but may be undesirable in a women with a low estrogen state (Kronenberg, Menopause, 1999)

· High soy diet was shown to interfere with coumadin (warfarin) therapy in patients with high cholesterol and after by pass surgery (Gaddi, Curr Ther Res Clin Exp, 1989).

· Soy beans can be difficult for some to digest and cause gas and stomach upset

· Soy contains high amounts of phytates that can block to absorption of calcium, magnesium, iron and zinc. Fermented soy products such as tempeh and miso have reduced amounts of phytates due to the fermentation process. Eating soy with meat or fish reduces the mineral blocking effect of phytates.

· Some express concerns about high dose processed soy products and recommend just using the fermented types (tempeh and miso) and soy sprouts until more is known about the effects of high dose soy (Fallon and Enig, Health Freedom News, 1995).

Forms and Doses of Soy: Soy powders, soluble in juice or milk, that list amounts of isoflavones per serving are now available in health food stores. Different products contain different amounts of isoflavones; be sure to check labels. Some experts recommend 40 to 80 milligrams of soy isoflavones a day.

Soy Food	Amount	Isoflavones (mg)
Textured soy protein granules	¼ cup	62
Roasted soy nuts	¼ cup	60
Tofu	½ cup	35
Tempeh	½ cup	35
Soy beverage powders	1-2 scoops	25-90 varies with products
Regular soy milk	1 cup	30
Low fat soy milk	1 cup	20
Roasted soy butter	2 tbsp	17
Cooked soybeans	½ cup	150
Soy isoflavones pills	Varies with product, check labels
Fermented soy isoflavones pills	Contains lower amounts but may be better absorbed

Nutritional Supplementation

“The proper mix of nutritional therapy and conventional treatments gives cancer patients a fighting chance.”

Patrick Quillin, Ph.D., R.D.

Dosage recommendations are geared toward our recommended prevention doses. In no way does this discussion imply that any of these are treatment recommendations for your individual condition. Treatment doses of these antioxidants should be individualized to each person’s unique biochemistry and medical condition under the supervision of a health care provider knowledgeable in this area of targeted pharmacological nutritional therapy.

Antioxidants

There is currently much controversy over the role of antioxidants when used together with standard cancer therapy like chemotherapy and radiation. Many medical and radiation oncologists recommend that their patients not take antioxidants while undergoing chemotherapy or radiation. Lets look at the facts concerning antioxidants before we rush to harsh conclusions. Antioxidants in general reduce the risk of cancer, improve over 100 health conditions, improve health and well-being, prevent and/or lessen the side effects of chemotherapy and help in cancer healing and recovery (Moss, R, Comprehensive Cancer Care 2000, Virginia). In a review of 130 studies on antioxidant (Vitamins C, E and Beta carotene), 120 of them documented their protective effects in cancer prevention (Block G, Nutr Reviews, 1992). Roughly 100 test tube studies and 100 animal studies have demonstrated that antioxidants protect the healthy tissues and cells of the body while allowing the cancer tumor cells to become more vulnerable to the effects of chemotherapy and radiation (Shimpo K. Am J Clin Nutr, 1991 & Okunieff P, Am J Clin Nutr, 1991 and Simone, Comprehensive Cancer Care 2000, Virginia). There are only a few human studies that have looked at antioxidants in cancer treatment and there are no human studies that have found antioxidants to decrease or interfere with the effectiveness of chemotherapy or radiation therapy!

· Oncologist at West Virginia Medical School found that a once a day vitamin plus the following antioxidants of Vitamin A (40,000 IU), Vitamin B6 (100 mg), Vitamin C (2000 mg), Vitamin E (400 IU) and Zinc (90 mg) decreased bladder cancer recurrence by ½ (Lamm, DL, J Urol, 1994)

· A study involving 18 patients with lung cancer, including 5 in the advanced stage, were treated with standard chemotherapy and radiation. They were also given megavitamin and antioxidant therapy that included 3-800 IU of Vit E and 2000-5000 mg of Vitamin C. 8 of the 18 had a 6 year survival (44%) compared to the normal 1% expected survival at 30 months with conventional therapy alone (Jaakkola K. Anticancer Res, 1992).

· A non randomized trial of 129 cancer patients (included breast, ovary, uterus, cervix and other cancers) receiving conventional cancer treatments were studied. A control group of 31 patients who did not receive additional nutritional support lived an average of less than 6 months. The other 98 patients received large doses of vitamins and antioxidants (Vit C @ 12+ grams/d, B3 @ 1.5-3 g/, B6 @ 250 mg/d, Folic Acid 5-10 mg/d, Vit E 800 IU, Beta-carotene2 25-50,000 IU, Selenium 200-500 ug, Zinc 220 mg, CoEnzyme Q10 @ 300mg/d). Of these 98, 19 patients lived 10 months (75% improvement over the group who did not get nutritional therapy with their regular cancer therapy), 47 patients lived an average of 6 years and 32 patients who lived more than 10 years. (Hoffer A, J Orthomol Med, 1990, 1993, 1996).

The following discussion reviews the most common antioxidants that are used in supplementation form.

· Vitamin A- Enhances cancer cell death in test tube experiments and lessens the harmful effect of the chem. Drug Adriamycin on the heart. It has been tested in Japanese clinical cancer trials. Recommended doses in the non-pregnant women would be 5000-10,000 units per day. Vitamin A is fat-soluble and can accumulate in the body. High doses can be toxic, especially in liver and kidney disorders.

· Vitamin C- In September, 1999 an article published in the journal Cancer Research fueled the antioxidant controversy by concluding that Vitamin C interferes with chemotherapy. However, what the Memorial Sloan Kettering study actually found was that, in a test tube, more vitamin C went into cancer cells than normal cells. The researchers then falsely concluded that Vitamin C was bad for cancer. Vitamin C acts as both an antioxidant and pro-oxidant and once inside a cancer cell it can increase the effectiveness of chemotherapy, NOT decrease it! In a review of 90 epidemiological studies revealed the vast majority found statistically significant preventive effects of vitamin C in cancer. (Block, G. Am J Clin Nutr, 1991). Vitamin C also protects normal cells from the toxic effects of Adriamycin (Fujita K. Cancer Res, 1982), prolongs the lives of test animals, and enhances the drug cisplatin effects. In a test tube, Vitamin C enhances the effectiveness of chemo drugs against brain cancer cells (Prasad KN. Proc. Natl Acad. Sci, 1979). In a human study, 50 cancer patients were divided into two groups- both received radiation therapy but only one group also received 5 grams of Vit C per day. After one month, 87% of the vitamin C group had a complete response to therapy but only 55% of the radiation only group achieved similar results (Hanck, AB. Prog Clin Biol Res, 1988). In a test tube, Vitamin C has been shown to inhibit cancer cell growth (Bram S, Nature, 1980; Park CH. Can Res, 1980; Noto V. Cancer, 1989; Gardiner N. Pros. Leuk, 1988). One case report documented the beneficial effects of intravenous (IV) Vitamin C: A 70 yr old man with metastatic kidney cancer was treated with 30 grams of IV vitamin C per day- after 6 weeks he was found to be disease free (Riordan HD. J. Orthomol Med, 1990). In another case report, a 42 yr old man with sarcoma was treated with high doses of IV vitamin C resulting in complete remission after 17 years of follow up (Campbell A. Oncology, 1991). Although Vitamin C is certainly not the “hidden cure for cancer, we adamantly share Dr. Quillin’s opinion that “Vitamin C supplements can be helpful in slowing cancer, while making medical therapy (chemotherapy and radiation) more of a selective toxin against the cancer and protecting healthy host tissue.”

· Vitamin E- Another recent animal study on Vitamin E added to the antioxidant controversy. Researchers at the University of North Carolina found that mice fed antioxidant-depleted diets had reduced brain tumor growth (Salganik, J Carninogenesis, May 2000). In other studies, Vitamin E has shown to reduce genetic mutations in head and neck cancer, reduces cancer deaths overall by 40%, reduces the toxicity of Adriamycin, and augmented the effects of the cancer drugs bleomycin, 5FU and cisplatin. Vitamin E is not a dual antioxidant/pro-oxidant like Vitamin C and the mice research at the University of North Carolina needs to be looked at seriously. Human trials are being planned to re-examine the findings. Typical doses of Vitamin E are 200-1200 IU/day.

· Beta Carotene and Other Carotenoids- Beta carotene reduces the harmful effect of Adriamycin on the heart and also reduces the general toxicity of the chemo drugs cisplatin and L-PAM. However, we do not recommend taking a beta-carotene supplement by itself without taking other balanced carotenoids in combination with it. Isolated beta-carotene supplementation has been shown to be potentially harmful in smokers and alcohol drinkers (NEJM, 1994, Omenn GS, Cancer Res, 1994; Rowe, Lancet, 1996). An example of a balance carotenoids supplement would be: beta carotene, 5000 IU; alpha carotene 1-3 mg; gamma carotene 1 mg; lycopene 5+ mg; lutein 6+ mg; zeaxanthin 0.5+ mg; cryptoxanthin 1+ mg. Don’t forget the food sources of these carotenoids as nature has already made them in the best possible combinations. The cancer drug methotrexate decreases the absorption of carotenoids. Furthermore, high carotenoids may decrease Vitamin E levels and it should be supplemented if you are taking a carotenoids supplement.

· Selenium- Has been shown to reduce the toxic effects of adriamycin, cisplatin without interfering with their cancer killing ability. It is toxic to leukemia cells in a test tube. Typical doses range from 100-400 micrograms/day with an average dose of 200 micrograms/day.

· Pycnogenol- is an antioxidant found in pine bark and red grape skins (red wine and purple grape juice) and is 20 times more powerful than vitamin C and 50 times more powerful than vitamin E. One report noted that pycnogenol slowed the mutation of cancer cells (Brown, S & White, D. International Symposium on Pycnogenol, France, 1990). We are unaware of any human trial of pycnogenol in cancer treatment. Typical doses range from 25 to 100 mg per day.

· Resveratrol- is discussed in the food section above. Supplemental dose is 1000 mg once or twice per day.

· Lipoic Acid- is an antioxidant found in small amounts in spinach, broccoli, beef, yeast, kidney, and heart. Our bodies also make lipoic acid. It is unique in that this antioxidant is active in both the water and fat compartments of our bodies. Other antioxidants are active in one place alone, i.e. Vitamin C in the water based tissues and Vitamin E in the fat based tissues. Furthermore, it recycles and potentates other antioxidants such as Vitamin C and E. Currently there are no established recommended doses. Typical doses for health maintenance and disease prevention are 30-100 mg per day. Higher doses have been used in diabetic nerve problems (300-900 mg per day). It should be dosed 2-3 times per day because it has a short life in the body (just like Vitamin C). We are unaware of any human cancer trial using this supplement for therapy.

· Coenyzme Q10 (Ubiquinone)- is an antioxidant that increases energy production in the cells, especially heart cells. Its most useful applications are in heart conditions. It may reduce the heart toxicity from the chemo drug Adriamycin (Folkers K, 1981 and Okuma, 1984). One small study suggests possible benefits in breast cancer. Of 32 women given CoQ10 in doses of 90-400 mg per day along with other antioxidants and essential fatty acids, 6 had partial remission and 1 had complete remission. At the end of 2 years, all 32 women were still living (four deaths would have been expected given the natural course of breast cancer), (Lockwood K, Biochem Biophys Res Commun, 1994). Typical doses range from 30-100 mg per day. We recommend a product in a gel cap with oil inside as this type of preparation increases absorption by 50% (50 mg in an oil gel cap = 75 mg in a dry powder capsule).

Phyto-nutrients (Herbal Therapies)

Broccoli Extract (DIM & I3C)- Indole-3-carbinol (I-3-C) is a naturally occurring constituent of many plant foods. Oral administration of I-3-C has been shown to manipulate estrogen metabolism in humans in a possibly beneficial manner. I-3-C increases the 2/16-hydroxyestrone ratio, a ratio found to be predictive of breast cancer risk in some prospective studies. Animal and in vitro studies have identified a number of other possibly beneficial effects of I-3-C and its metabolites, including inhibition of estrogen binding and modulation of oncogene expression. A chemopreventive effect of I-3-C has been demonstrated in a number of animal models. Some chemical carcinogenesis models have found a tumor promoting effect of I-3-C, however. Epidemiological studies support the hypothesis that high intakes of I-3-C may have broad chemopreventive effect. Preliminary human trials have demonstrated that I-3-C is well tolerated and has a sustained estrogen modifying effect. I-3-C is a good candidate for clinical trial in women at increased risk of developing breast cancer. (Altern Med Rev 2001:6(6):580-589)
Curcumin (Tumeric)- Curcumin is a herb that is used as a spice. Current research focuses on its antioxidant ability, liver protection effects, anti-inflammatory effects and anti-cancer effects. Animal studies and test tube studies clearly demonstrate curcumin's ability to inhibit tumor cell growth. It has been shown to specifically inhibit colon and prostate cancer cells (Hanif R, J. Lab Clin Med 1997 and Dorai T, Prostate 2001). No toxicity of curcumin has been found. One study found the curcumin interfered with the effectiveness of chemotherapy in a test tube involving breast cancer cells. Thus curcumin may be best used for prevention and treatment without concurrent chemotherapy (Somasundaram, et al. Cancer Research, 2002).
Green Tea- Green tea appears to inhibit the spread of prostate cancer in several ways. Research from scientists at the University of Wisconsin and Case Western Reserve University in Cleveland backs up previous research that showed green tea polyphenols, also called GTP, stopped the development of prostate cancer and its growth by explaining how they do this. The researchers found in a study of mice that the green tea polyphenols targeted the molecular pathways that controlled the proliferation and spread of prostate tumor cells to stop them dead in their tracks. The polyphenols did something else, too. They also starved the cancerous prostate tumors by inhibiting the growth of the blood vessels that feed them. Green tea may be the No. 1 drink for your good health. In addition to its cancer-fighting benefits, it's also been shown to reduce heart disease risk. The study findings were published in the Journal Cancer Research.
Medicinal Mushroom Extracts- There are several mushrooms that have been used medicinally for their immune enhancing activity. The food value and healing qualities of mushrooms have been known for thousands of years. Fungi were the first sources of antibiotics such as penicillin, erythromycin and tetracycline. The medicinal mushrooms include Shiitake, Maitake, Reishi, Cordyceps and Coriolus. These mushrooms contain immune enhancing "glycan" molecules specifically named alpha-glucan (AHCC), beta-glucan, proteoglycans (PSK), and arabinogalactans. Mushroom extracts have been shown to increase NK cell activity of the immune system. NK cells are the chief immune cells which attack and destroy tumor cells in the body. One study found an 80% tumor regress in animals when treated with extracts of maitake, shiitake and reishi extracts (National Cancer Center, Japan, 1995). Shiitake (AHCC) has been shown to prolonged survival in a group of 126 patients with liver cancer (Abstract, Japan, 1992) and increased tumor regression in patients with lung, breast, stomach, esophagus and colon cancer (Abstract, Japan, 1996). Maitake (beta glucan) was studied in 165 patients with advanced cancers revealing clinical benefits of >50% in breast, lung, liver cancers and <50% benefits in leukemia, prostate, brain, stomach and bone cancers. This study also revealed "superior" inhibition of tumor growth with maitake (80%) compared to chemotherapy (45%) (Nanba, Japan, 1995). Coriolus (PSK extract) was found to prolong survival in post-operative gastric cancer, colon cancer and lung cancer (small cell) (Wong, J of Intern Med Res, 1994). Other cancers that have been shown to be benefited by PSK include head/neck cancer, esophageal cancer, and breast cancer. In summary, mushroom immunoglycans are clinically proven to help extend survival and improve quality of life in cancer. They are non-toxic and safe for long-term use. They are well suited for comprehensive cancer management, especially when used in conjunction with conventional therapies such as chemotherapy and radiation, for indeed, all of the best clinical results with PSK were in conjunction with standard therapy.

Useful Resources:

Books

Beating Cancer With Nutrition, Patrick Quillin, PhD, RD. Nutrition Times Press, Inc. 1998.
How to Prevent and Treat Cancer With Natural Medicine, by Michael T. Murray, Riverhead Books (September 1, 2002)
The Breast Cancer Prevention Program, Samuel Epstein, MD and David Steinman. Macmillan Press. 1997
Dr. Gaynor’s CANCER Prevention Program. Mitchell Gaynor, MD & Jerry Hickey, R. Ph. Kensington Books. 1999.
The Journey Through Cancer, Jeremy Geffen, M.D. Crown Publishers, 2000.

Tapes

· Positive Imagery For People with Cancer. Emmitt Miller, MD. (Available at Woodlands or via Source Cassetttes, 1-800-52-TAPES)

Internet

· Woodlands Healing Research Center (www.woodmed.com)- refer to our Web Links section on Cancer

· Ralph Moss Home Page (http://www.ralphmoss.com)

· Cancer Decisions.com (Alternative and Complementary Treatment Strategies from Ralph Moss, Ph. D. (http://www.cancerdecisions.com)

· American Cancer Society (www.cancer.org)

Daily Survival Kit for Serious Illness

Adapted from Thomas L. McDermitt, “A long-time cancer patient and skeptic”

You don’t have to agree with all of this all of the time. But if it generally speaks to you, try to read all or parts of it every day, or have it read to you. Part of the help is in the doing, regardless of your attitude or emotions on that day. On some levels the help is gradual and often not externally evident.