A new crisis: cancer in young people

The COVID pandemic has received so much attention, it is amazing these latest and deeply disturbing cancer statistics are not all over the press. 

Between 1990 and 2009 and averaged all across the world, early-onset cancer has increased by an incredible 79.1%. The number of early-onset cancer deaths has increased by 27.7%. 

79% and 27%!!! 

If that is not as significant as a pandemic, it is hard to imagine what is???

So this week, what are the facts, and what are behind them? What the …. is going on amongst our younger people, but first 

   Thought for the day

      Regardless of who we are,

      The main purpose of our life, 

      You could call it the heart of being human, 

       Is to be happy. 

       All of us share the same wish, the same right 

       To seek happiness and avoid suffering.

       If you look closely, 

       You can see there are two kinds of happiness.

       One is based on physical comfort or pleasure of the senses

       The other is based on a deeper mental contentment

                            H.H. the Dalai Lama

Early onset cancer is defined as cancer in adults under 50 years of age – or sometimes as cancers in those 18 to 25. So what this recent major study published in the British Medical Journal of Oncology is saying, is the amount of cancer in the world’s younger people is going up at an unprecedented rate.

Now you might imagine the obvious question would be: “What is causing this?” Yet most of the academic commentary I have read so far is emphasising the need to increase early detection! 

The exclamation mark is an attempt to highlight how odd this seems. Surely the need is to find out what is causing the problem and to correct it, rather than aim to diagnose and treat (given diagnosis and treatment is of course what is needed for people currently afflicted).

To be fair, the actual article did state:

Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers.

Encouraging a healthy lifestyle could reduce early-onset cancer disease burden.

However, for me there are 2 important observations:


1. Cancer is largely a lifestyle issue and the rates of cancer are going up way too rapidly in younger people. The impact of this as the years go on will be disastrous both for the people involved (as both patients, family, friends and colleagues), and for the medical system attempting to help them (a system and a workforce that seems to be buckling under ever increasing pressures).

2. Lifestyle is the cornerstone for the prevention of cancer and all the other chronic, degenerative diseases that create so much havoc, but are demonstrably preventable. 

So then two questions: 

1. Why are people around the globe drawn so strongly to an unhealthy lifestyle? 

2. And given how much so many of us know about the impact of lifestyle, why is it so many of us are find it easier to follow an unhealthy lifestyle as compared to a heathy lifestyle? 

Consider this… when it comes to exercising, do you find it easier to do some regularly, or to put it off?


When it comes to meditating, do you find it easier to do some regularly, or to put it off?

When it comes to most lifestyle factors, do you find it easier to do some regularly, or to put them off?

Now this is not about shaming or blaming, but we do need to observe there is a real crisis. How do we help ourselves and our communities to be drawn to a healthy lifestyle and sustain that?

So over to you:

It would be wonderful to hear from those of you who do maintain a healthy lifestyle. Whether that has been for a long time and you find it easy, or have gone through personal struggles to turn things around, what works for you and those close to you? 

Given up smoking, cut back on alcohol, change your dietary patterns??? How did you do it? What was easy or difficult? How have those around you reacted?

How are you going maintaining a healthy lifestyle?

Please add your experiences into the Comment section below:

Comments need to be cleared, so they may take a while to appear on the blog, but maybe your own experiences or insights can help someone else… 

 

REFERENCE:

Zhao J, Xu L, Sun J, et al   Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019. BMJ Oncology 2023;2:e000049. doi: 10.1136/bmjonc-2023-000049

 Lifestyle Medicine Cancer Retreats

Good friends and ex-colleagues Liz Stillwell and Sandy Clinton will be presenting their next 5 day Residential Cancer Retreat later in October this year - 2023

Designed specifically for men and women with a cancer diagnosis this is a research-based integrative medicine lifestyle approach supporting conventional medicine cancer treatments and best cancer outcomes – based on the philosophies and teachings of the Gawler Cancer Foundation, and echoed worldwide in various centres in Canada, US and the UK. 

Liz and Sandy now offer 2 retreats per year at the Yarra Valley Living Centre, (previously The Gawler Cancer Foundation) warmly hosted by Brahma Kumaris.

Next Retreat: 27th – 31st October 2023

    

Teaching sessions include Meditation, anti-cancer Nutrition, effective use of the Mind, Imagery, Spirituality and living with Purpose, Healthy Emotions, Exercise and healthy Support.

The daily Programme includes Daily Meditations & Qi gong, walking (and rest time) with fresh delicious whole food plant-based meals – all within a beautiful peaceful natural bushland setting.

Enquiries: please email us - cancerbalanceandwellbeing@gmail.com 

Facilitators: Liz Stilwell & Dr Peter Johnston (see overleaf) 

Retreat Co-ordinator: Sandy Clinton 

Harpist: Michael Johnson

Plus: Recovery stories When diagnosed with cancer, hearing real stories of real people making real recoveries inspires our belief and builds our faith in what is truly possible – and helps hold us to our intentions to maintain a healthy lifestyle focus. This retreat is for people who choose to take an active role in their health and wellbeing

 

Liz Stilwell: Retreat Facilitator

Liz has an extensive 35 years in Health – Occupational Therapy in Psychiatry, then counselling, clinical hypnosis and N.L.P in private practice. She trained with The Gawler Cancer Foundation in 2004 leading 12 week Lifestyle change programmes for cancer, Mindfulness meditation courses, and counselled many people with cancer at The Gawler Cancer Foundation City branch - specialising in processes for trauma recovery, anxiety, depression and insomnia - her approach influenced by her meditation practice.

Liz later facilitated monthly Cancer Retreats and co-facilitated MS retreats. And for 5 years, Liz assisted Drs Ian and Ruth Gawler in leading annual Meditation Retreats in the Coromandel Peninsula, NZ. Liz advocates strongly for a life created and directed by the heart believing our physical health is strengthened by emotional wellbeing. She has a deep lifelong interest in spirituality and works as a spiritual carer in palliative care.

Peter Johnston:

Peter is an accredited practising dietitian with a Masters in Nutrition and Dietetics and a PhD in Human Genetics. Peter is also a fellow of the Australasian Society of Lifestyle Medicine and has completed health coaching training with Well Start Health. He has been exclusively plant-based since 1991 after learning of the health, environmental and ethical benefits. Peter runs a private practice: Perfect Human Food Consulting, offering individual consultations, public speaking, webinars, workplace health programs, and residential reboot programs. Peter is a member of the advisory council for health charity Doctors For Nutrition. He is also a partner with Melbourne Lifestyle Medicine which offers a range of programs including residential retreats. He has expertise in the prevention, treatment and reversal of chronic diseases through the use of whole food plant-based diets and the holistic approach of lifestyle medicine. He enjoys empowering people across all life stages to attain optimal health. Peter has attended and spoken at numerous national and international conferences.

Sandy Clinton:

Sandy joined The Gawler Cancer Foundation in 2006 and has deepened her interest and appreciation for the mind-body connection since then. She has assisted hundreds of people in the Client Services role with TGCF which gave her a unique insight into the challenges people face when diagnosed with a chronic illness and wanting to improve and maintain their wellbeing. This led her to train as an Ageless Grace ® Educator, and she rejoices in delivering this brain health fitness program as often as possible. Sandy takes true joy in supporting the journey of discovery participants experience during retreats.

  

Michael Johnson:

A concert performer and composer, Michael has worked for many years in the field of therapeutic support through music. His tranquil harp music has been a significant part of the retreats at the Gawler Foundation for over thirty years. He is a Music & Mindfulness co- ordinator at Delmont psychiatric Hospital and Road Trauma Support services Victoria and leads seminars, workshops and Inservice sessions for businesses for staff professional development. For over 20 years, Michael has been resident composer at the Royal Botanic Gardens Melbourne, organising the Harp in the Gardens concerts and Harp Meditations.

Meditation and Mindfulness to receive medical rebates?

Who will be the first health insurer in Australia to provide medical rebates for the therapeutic application of meditation and mindfulness? Currently, very few providers in the USA or elsewhere provide reimbursement for these widely used treatments. 

Recent research has added to compelling, existing evidence that reinforce the fact it may well be time; mindfulness-based stress reduction has been found to be as effective as a commonly used antidepressant drug for treating anxiety disorders. 

"Our study provides evidence for clinicians, insurers, and healthcare systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders,” says Elizabeth Hoge, MD, the lead author. 

So this week we look at this new evidence, and what it means for individuals and the medical system – including medical rebates and Allevi8, but first

  

   Thought for the day

           Wisdom without compassion 

           Feels no pain

                    Gary Snyder

Significant recent research published this year in JAMA Psychiatry demonstrated guided mindfulness-based stress reduction program was as effective as use of the gold-standard drug - the antidepressant drug escitalopram - for patients with anxiety disorders. 

Researchers at Georgetown University Medical Center have found mindfulness-based stress reduction is as effective as a common antidepressant drug for treating anxiety disorders.

Anxiety disorders can be highly distressing; they include generalized anxiety, social anxiety, panic disorder and fear of certain places or situations, including crowds and public transportation, all of which can lead to an increased risk for suicide, disability and distress and therefore are commonly treated in psychiatric clinics. 

Drugs that are currently prescribed for the disorders can be very effective, but many patients either have difficulty getting them, do not respond to them, or find the side effects (e.g., nausea, sexual dysfunction and drowsiness) a barrier to consistent treatment. 

Standardized mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR), can decrease anxiety, but prior to this study, the interventions had not been studied in comparison to effective anti-anxiety drugs. 

Of note, approximately 15% of the U.S. population tried some form of meditation in 2017.

"A big advantage of mindfulness meditation is that it doesn't require a clinical degree to train someone to become a mindfulness facilitator. Additionally, sessions can be done outside of a medical setting, such as at a school or community center."

For this study, MBSR was offered weekly for eight weeks via two and a half-hour in-person classes, a day-long retreat weekend class during the 5th or 6th week, and 45-minute daily home practice exercises. 

Patients' anxiety symptoms were assessed upon enrollment and again at completion of the intervention at 8 weeks, along with post-treatment assessments at 12 and 24 weeks after enrollment. 

The patients were relatively young, with a mean age of 33 and included 156 women, which comprised 75% of the enrollees, mirroring the disease prevalence in the U.S.

Both the MBSR and the drug treatment groups saw a statistically equivalent reduction in their anxiety symptoms. 

The drop in the severity of their anxiety was significant – around 30%.

The researchers added, "It is important to note that although mindfulness meditation works, not everyone is willing to invest the time and effort to successfully complete all of the necessary sessions and do regular home practice which enhances the effect," 

"Also, virtual delivery via videoconference is likely to be effective, so long as the 'live' components are retained, such as question-and-answer periods and group discussion."

Hoge points out many phone apps do offer guided meditation, but researchers are yet to assess how apps compare with the full in-person, weekly group class experience. However, the researchers did conduct a second phase of the study during the pandemic that involved moving the treatments to an online, videoconference which will be the focus of future analyses. The researchers also hope to explore the effects of MBSR on sleep and depression.

RELEVANCE

1. This study adds to the evidence base in support of the Allevi8 app being used in therapeutic settings for anxiety disorders. Our app includes live components - direct interaction is available with experienced meditation teachers.

2. The evidence supporting health funds reimbursing meditation and mindfulness programs is now compelling. My guess is it will not be long before companies are adding these rebates as an edge to attract and retain new members. In the process, they are likely to make significant cost savings…

 

Mindfulness and sleep – more research

Also this year, research been published by Gao and colleagues exploring the benefits mindfulness might offer to those with sleep disorders. 

This study demonstrated a mechanistic link between mindfulness practice and increased emotional nonreactivity, decreased worry, and a reduction in reported sleep disturbances, suggesting that app-based mindfulness training may be a viable option to help individuals who report worry interferes with their sleep.

NOTE The Allevi8 app also features a sleep section

REFERENCES

1. Hoge AE et al. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults with Anxiety Disorders. JAMA Psychiatry, 2023;80(1):13–21. DOI: 10.1001/jamapsychiatry.2022.3679

2. Gao M et al. Targeting Anxiety to Improve Sleep Disturbance: A Randomized Clinical Trial of App-Based Mindfulness Training. Psychosomatic Medicine 84(5):p 632-642, June 2022.