Monday, December 29, 2008

More time

There's a guy who used to play volleyball with my beach group--he was very good, better than pretty much anyone else who plays with us. (I am decidedly average, myself.) Unlike many people who give unwanted or unhelpful advice, he was good at pinpointing how someone could play better. One of his favorite comments was, "You have more time than you think you have."

He said it when a hard serve came over the net and someone (like me) spazzed toward it awkwardly, flailing and then shanking the ball far out of bounds. He said it when a low set sailed toward a post and someone (like me) jabbed at it, panicking, and hit the ball right into the net. He was always right, and it's one of the most helpful pieces of advice I've gotten. The better players have a lovely economy of motion, like Neo in The Matrix--realizing they have enough time to do what they need to do and do it calmly, which makes everything go better.

So why this volleyball reverie on a cancer blog? Because I'm going to assert that it's true for cancer, too: You have more time than you think you have. True as a philosophical statement, true on many levels. You have more time to make decisions in the very beginning--it's not necessary to rush into surgery in 3 days and rush into treatment after that. It's OK to take the time to make the decisions well. You may have more time in life than your diagnosis suggests, who knows; my aunt Sylvia lived for 11 years past her prognosis of 2. My grandma, who died of lung cancer, outlived her prognosis by a couple of years.

Perhaps most important, though, you have more time than you think you do right now. Cancer is easy to obsess over, but think of all the time it claims that way--time it takes away from living life.

It's a good mantra in general, I think. You have more time than you think you do.

Thursday, December 25, 2008

"Chaos" within a breast cancer cell

The New York Times publishes a short piece today about how cancer cells have their DNA rearranged in odd ways, and the graph below illustrates scientists' identification of that rearrangement in a breast cancer cell. I just think it looks cool.


Tonight, we watched It's a Wonderful Life, from beginning to end. I haven't watched it that way for a long time. You see all the awkward editing cuts, you spot the few ludicrous moments (she swoons!), you really notice details like "Ernie and Bert," and where the end-credit logo for thirtysomething came from.

And yet that Capra optimism, that sweet message, can't be dimmed by its sincerity and lack of ironic distance. It is a wonderful life, just having it; having the cold winter rain outside and the warm blankets inside; having the family members who make you want to pull your hair out, because they are family members whom you love dearly and want the best for; having trivial frustrations that feel large, like a bump on your tongue, and then walking with your dog by the marina at sunset and watching pink-gold light flood the masts.

During chemo, I would gaze at my own hand sometimes, waving my fingers and thinking about the complex miracle of chemistry and consciousness that made the bones move and the tendons stretch. Of course, I was thinking about how that stops, someday. And that's part of what makes life wonderful, too: that it hasn't stopped yet.

I'm not a religious person, though I was raised celebrating Christmas, and each year the holiday does become a bit removed, for me, from its religious intentions. But this year, when our whole country has decided to unmoor it from commerce, when my household is giving gifts of water buffaloes and debt reduction, when we're quiet and contemplative and watching It's a Wonderful Life on Christmas Eve, the meaning creeps back in.

So let me wish everyone out there--those who know me, those who don't, those who are dealing with active cancer right now, those who are fervently hoping or praying it doesn't come back, those who have lost loved ones, those who are holding on to them--a deeply enriching and peaceful Christmas. I hope you have a day in which you can be fully alive, and rejoice in it.

Sunday, December 21, 2008

What I Eat

I've promised many times to post my post-cancer diet. "Diet" is right and wrong; eating this way helped me lose almost 40 pounds (so far), but it's not about dieting the way our society tends to think of it, and it's not about being thin for vanity's sake. It's about a lifelong way of approaching food and nutrition so that these things are part of making me healthy (being thinner so that I don't have fat as a risk factor; exercising for even more risk reduction). It's about a changed relationship to food.

First and foremost, the idea is to eat as close to nature as possible. We hear all the time about the crazy toxins and contaminants in food. Even if you eat stuff right out of the garden, of course, who knows what jet fuels and refinery emissions have settled on your zucchini. So (as I ponder just below) no, there is no absolute control. However, we can do a whole lot by cutting down on overly processed foods, with their extra chemicals; and we can shift things so that most of the calories come from real nutrition, rather than from fillers or corn syrup.

The second major principle (really a cluster of principles) is about evidence-based practices--that is, using food in ways that solid research has shown to reduce cancer risk, specifically. Low fat (10-20% of calories only), high fiber (30-35g per day), lots of antioxidants (green tea, cinnamon, turmeric, cruciferous vegetables)--all of these have a central role.

It's funny, because at first it was enormously difficult for me to eat this way. Then it became a way of life. Then I kind of backslid, while teaching, out of laziness and a reversion to the "comfort foods" of old habit. Since my class ended, I've been pretty strict again (I tell Noah I'm "hitting the reset button") and it has been ridiculously easy. So it can be tough to start this kind of habit, but it's really not tough to maintain. (My comrade-in-cancer, though, who just finished chemo, utterly refused the nutritional oncology approach. As a trained chef, she has too much value for butter. I can certainly understand priorities. Who knows how long we have, and perhaps for some people a butter-less life is not as worth living!)

In any case, at long last, here's the basic outline. I'm skipping a lot of detail because the specifics of the diet are copyrighted by Rachel Beller, my nutritionist, but this will still tell you a lot.

3/4 c bran cereal (Nature's Path Smart Bran is my favorite; Fiber One has the most fiber)
3/4 c almond milk
1 c greek yogurt (fat free) w/1/2 t cinnamon
1 mini bran muffin

something like fruit (1/2 banana, some blueberries, etc.)

vegetables (e.g., salad) and lean protein (e.g., fish)
For example: large (3-4c lettuce + other veggies) salad with salmon, using plain balsamic vinegar as a dressing; or perhaps using a locally-made dressing called Galeo's miso caesar, which tastes amazing and is super low-fat. (Commercial nonfat dressings are a no-no because of chemicals.)

tomato soup (no cream) or gazpacho, raw veggies, etc.

vegetables, lean protein, salad, soup
For example: 2-3 lbs grilled veggies (asparagus, broccoli, chard), grilled halibut, side salad and miso soup

yogurt, popcorn, or something else

It's pretty plain when written out like this, but it really leaves a lot of flexibility in terms of preparations, seasonings; I can have Indian or Mexican or Italian or Chinese food this way, as long as I watch out for the fats and privilege veggies and fish above bread or cheese.

Anyway, at long last there is the basic diet, and I hope it is somewhat helpful for someone out there!

Wednesday, December 17, 2008


Watching a close family member deal with the early days of cancer treatment is reminding me of cancer's biggest lesson: You Are Not In Control.

Those first few days and weeks were mind-numbing (or head-spinning; or both). You don't have enough information to make decisions, but you have to make decisions immediately. You are tasked with quarterbacking your own medical care though you do not have the lifetime of learning and experience that your doctors have. You must choose between providers without knowing what defines quality, or how it's measured. There is absolutely no way to find a shortcut solution to the months of pain and fear and difficulty that await you; and once treatment starts and you're pumped full of poisons and you're thrown vehemently off balance by nausea or bone pain or sadness or dying cells, there is exactly nothing that you can do that restores that balance until time and healing take their own natural courses.

I have always been a person who saw exactly what I wanted in any situation, and could figure out pretty quickly how to attain it. I am not passive. I confront, I pursue, I accomplish.

But cancer doesn't care about any of this. It laughs at initiative, scoffs at competence. The most painful loss in cancer is the loss of belief in control. Unlike a body part, removed surgically and cleanly under anesthesia, control is ripped away painfully--bloody and ragged and unwilling.

Recovering from cancer restores some of the illusion of control, but I gotta tell you, it is now impossible to revert to the full belief. There are situations happening in my life--I so wish I could share them, but for so many different reasons, and to protect so many different people, I simply can't. But I face these difficult situations and all I can see is that every alternative is fraught and imperfect, and there is exactly nothing that I can do to sidestep all pain and trouble. Perhaps I'd have learned this lesson without cancer. But I learned it with cancer, and life just keeps reviewing the lesson.