This is going to be a busy work week for me, so I probably won’t be able to spend much time doing research and writing. I have some extra translating work to do, which is good for our household budget, of course…

But I will continue to find time for my daily readings. Here are some of the most interesting ones:

A “Guardian” article titled “Coping with cancer: you, me and the big C.” Three different stories about cancer…three different perspectives: http://goo.gl/CKq9P Well-written and moving. And a mention of curcumin in the first one, too. 

A “Mail and Guardian” article on cancer-busting foods: http://goo.gl/AXlM8 I love looking at food lists. You never know what you might find in ’em. 🙂 To my surprise, this particular one mentioned margarine as “a healthy option.” Say whaaaaat? I’ve always avoided margarine like the plague. How can it suddenly be a “healthy” choice??? Any thoughts?

But this article intrigued me mainly because it lists Rooibos tea among the cancer fighters. I hadn’t even heard of this tea until recently. But now, whenever I’m home in the afternoon, I like to have a cuppa. Well, this article states that Rooibos tea boosts glutathione levels. Hmmm. That triggered a vague memory in the back of my mind: isn’t it bad to boost glutathione levels in myeloma? I tried looking that up but found way too much information for the little free time I have. However, I did find this: according to Dr. James Berenson’s 2004 “Biology and management of multiple myeloma,” glutathione levels are increased in melphalan-resistant myeloma cells. Increasing one’s glutathione levels would therefore appear not to be a good idea for those on melphalan. But what about the rest of us? Should I stop drinking this tea? Does anyone here have any thoughts/advice/etc.? Help! 🙂

While I was looking for more info on glutathione and myeloma, I came across this 2009 study, which shows that myeloma patients have reduced levels of antioxidants: http://goo.gl/f7zYs Now, that’s INTERESTING, and I quote: MM is closely associated with oxidative stress and reduced antioxidant capacity. Aha. Food for thought…

More than 60% of Americans get their health information online, according to this Science Daily article: http://goo.gl/fC9RP But How might information accessed online affect individual health decisions? In my case, A LOT! 🙂

P.S. Today’s blog photos were taken in a vineyard behind the Castello di Brolio, near Gaiole in Chianti, on Saturday.

Today’s post is based mainly on what I remember from the meeting with Prof. Gertz, Mayo Clinic (see previous posts), and on my fabbbbbulous friend DB’s notes. By the way, DB, thanks for going to the meeting with me! 🙂

A patient-friendly approach. Since Prof. Gertz kindly offered to meet with patients after lunch (a yummy lunch, incidentally), many of us stayed on until mid afternoon. And many of us had brought our test results/the results of a loved one.

I remember one man in particular. He’d brought his father’s test results. Since I didn’t write down any of this (I merely translated the back and forth Italian-English-Italian with Prof. Gertz…), the main thing I remember is that the father’s Bence Jones protein level had gone up in the past 7-8 months.

After looking at the father’s test results and asking a few questions such as “how does your father feel?” “does he have any symptoms?” and “how are his bones doing?” (the son’s answers: 1. fine; 2. no; 3. we don’t have the x-ray results yet), Prof. Gertz said that the only thing that concerned him a bit was the Bence Jones increase. And of course one would need to see the x-rays. But, he added, if the x-rays are okay, then this would be a “smoldering” situation, which means the father should be monitored carefully but not treated…not right now, that is. He added that if the father were one of his patients, he’d have him redo his tests in two months. On hearing that, the son looked absolutely stunned. He told me that his father was beginning treatment in a couple of days (last Tuesday, in fact). Prof. Gertz told him that, in his opinion, that wasn’t necessary. Why start treatment and begin having symptoms, he added? The son was clearly very distressed and at a loss as to what to do…

I wonder what happened last Tuesday…did the father go ahead with treatment? I hope not, but I guess I’ll never know.

The fact that I translated most of these informal, individual encounters gave me the opportunity to observe a true Master at work. I’m referring to Prof. Gertz, of course (and I wouldn’t say this if I didn’t mean it). He looked at every single test result (in Italian, to boot!), then he asked the patient/caregiver direct questions in a very gentle, professional way. If needed, he looked at the test results again. And then he said what he thought should be done…in a very simple, humble manner…

This is exactly what I think a specialist should do. First, ask how we’re feeling, then look at all our test results, ask relevant questions based on the tests and finally say what s/he thinks we should do. It is important to look at the WHOLE picture, in other words. Not just at one test. And it’s equally important to find out how the patient FEELS. 

I like Prof. Gertz’s cautious, gentle approach, one that clearly focuses on quality of life…

Causes of myeloma. While he acknowledged that there is a familial link in a tiny percentage of cases (1-2%, as I recall), he said that all the other causal links are weak. Basically, he said, “we just don’t know.” So I’m officially giving up. And anyway, I’d rather do research and focus on a treatment regimen that will keep me stable (or better!)…

Okay, I need to go get ready now. We’re about to go off to meet up with a couple of friends. Then we’re driving to a Tuscan town called Gaiole in Chianti, near Siena. I hope to get some good photos to post on the blog. It’s such a gorgeous sunny warm day…Sooo, I hope you all have a super weekend! Ciao! 🙂

P.S. today’s photo is of a greenfinch (though it’s quite yellow, eh, so I’m not certain about that); I took it in a park just outside of Florence. 

I thought I’d focus today on the discussion we had about statistics. A woman (the blog reader who told me she wished she’d known about curcumin earlier) said that when she was diagnosed with smoldering myeloma, her doctor told her that she had only three years to live. Even though I was almost rendered speechless, I managed to translate what she’d said.

Without batting an eyelid (I’m sure he hears this kind of stuff all the time), Prof. Gertz answered that statistics are useful mainly to doctors when they get together at congresses et similia. But, he added, statistics are simply of NO USE to patients. (Have you read Harvard Professor Stephen Jay Gould’s excellent essay on statistics? If not, click here: http://goo.gl/jzMkK).

He kept shooting examples at us, one after the other. The ones I remember, more or less, are these: 1. Statistics tell us that the average man is taller than the average woman. How tall is your sister? 2. Statistics tell us that the average European male makes € 40000 a year. (Turning to Vittorio) How much does Vittorio make?

Precisely. Statistics are a waste of time, as far as we’re concerned. And that’s one of the most important things I heard during this patient doctor meeting. Even before I read the above-mentioned essay and even though my brain has always refused to understand anything related to numbers and math, I have always felt (hoped?) there was something terribly wrong with myeloma statistics.

Example: in 2007 I read a Science Daily article on an Ohio University study that linked the stress hormone norepinephrine to the development of myeloma: http://goo.gl/BUHti While the entire article is very interesting, this particular paragraph is relevant to our discussion: In this latest study, the researchers looked at a different type of cancer – multiple myeloma. One of several types of cancers of the blood, multiple myeloma strikes nearly 20,000 Americans each year, killing at least half that many annually. Patients diagnosed with this disease normally survive only three to four years with conventional treatments.

Three to four years…

I shared this dismal statistic with Stefano who replied by quoting a sonnet by the Roman poet Trilussa (see my November 24 2007 post for the original text written in the Roman dialect). Here is my rough translation of the sonnet: You know what statistics is? It’s something you use to make a general count of the people who were born, who get ill, who die, who go to jail, who get married. But for me the peculiar statistic is the one dealing with percentages, because then the mean always remain the same for everyone, even for someone who has nothing. Let me explain, from the way they count in statistics nowadays, it appears that you eat one chicken per year: and, even if you can’t afford to buy a chicken, you are part of the statistic anyway, because there is someone else who eats two chickens. Spot on.

Whenever we happen upon any myeloma statistics, we should always remember Trilussa and his chickens. Or Stephen Jay Gould, and the fact that he survived 20 years after his diagnosis, exceeding his 8 month median survival by a factor of thirty.

We are individuals, not numbers. What do you think?

P.S. the photo is of my daffodils…

First of all, I’d like to mention that day before yesterday I wrote Prof. Gertz a quick note, telling him I’d written my first post about the meeting in Campi Bisenzio. He kindly wrote back, letting me know that my post was, and I quote, very accurate. Later that day, he sent me the newly published study about the Australian MGUS and SMM clinical trial results. How about that? I was blown away…still am. Thank youuuuu!

Ok, back to the meeting. Prof. Gertz also talked about heavy and light chain myeloma. The heavy chains (G and A) can be measured, as we know, in the blood; the light ones (kappa and lambda) in the 24-hour urine test that we know all too well…sigh.

While it’s not THE disease, the protein can be used as a good marker, as a sort of gauge for treatment, he said. As for kappa and lambda, they can occasionally spill into the kidney, damaging the kidney filter. 15% of myeloma patients have kidney damage, which can be measured via serum creatinine and the Blood Urea Nitrogen (BUN) test. As for heavy chains, G and A are too big to get into the kidney, so those patients don’t have kidney damage.

Then he spoke about BONE issues. As we know, there are two types of bone cells, osteoblasts, which build bone, and osteoclasts, which destroy it. As we get older, it’s normal to have an increase in osteoclast activity (I read that bone mineral loss begins after age 30…). What is NOT normal is what happens to myeloma folks. Myeloma produces chemicals that activate osteoclasts. Result: our bones lose minerals and become increasingly porous and brittle. He then spoke about the drugs that can help us when this occurs, such as Zometa, but since we all know about bisphosphonates, I didn’t take any notes.

Then he gave us the following scenario: let’s say our garden is full of weeds, but instead of using a 15 or even 30 ml mixture of a certain (toxic, clearly) weed killer, we spray a 250 ml mixture all over it. What will happen? Obviously, the entire garden will die. But hey, we can’t live without the garden. We need our white cells to fight infections, blablabla. So we have to be amazingly careful with quantities…(unless we’re facing a stem cell transplant, in which case things are different…you have to avoid melphalan until the stem cells are collected etc. etc. etc.).

At that point he went through the different classes of “weed killers”: 1. corticosteroids such as dexamethasone; 2. alkylating agents such as melphalan. These two classes started being used 50 years ago to treat myeloma patients. And for a long time, there was little else available. He highlighted the fact that Dex by itself, in high doses, is able to kill a whole bunch of myeloma cells. In fact, if my notes are correct, 50% of all the myeloma cells in 50% of all multiple myeloma patients. But that 50% of patients would pay a terribly high price for this MM cell “massacre,” including (and here the good professor had us chuckling, especially when he listed the first three options): never ever sleep again, fight with anyone in sight, eat all the time, develop a bunch of allergies and problematic side effects such as diabetes and high blood pressure…I forget what else, but the list went on and on. So that’s not really a good option, he said. 

But nowadays we have a bunch of new drugs from which to choose. Let’s begin with 3. immunomodulatory drugs, such as thalidomide and its various descendants. He said that lenalidomide (Revlimid) is replacing thalidomide because of the irreversible peripheral neuropathy caused by the latter. But Rev has problems of its own: it can cause skin problems, diarrhea and leg cramps and can also have a negative effect on blood counts.

4. Proteasome inhibitors, such as Velcade and carfilzomib (the latter is being tested in investigational studies; 25, according to the clinical trial website). These block the “garbage disposal” = the proteasome in the myeloma cell, he said. What happens, therefore, is that the garbage starts building up inside the cell, which eventually gets “stuffed,” says “poof” and dies. (Okay, Prof. Gertz didn’t say some of this. “says “poof” and dies” is mine. 🙂 ) Great image. Incidentally, lest we forget!, curcumin is also a proteasome inhibitor… 🙂 Let’s see, what else? Prof. Gertz pointed out that the problem with Velcade is that it damages the nerves in the feet, whereas carfilzomib doesn’t. And of course, neither does curcumin (the references to curcumin are mine, of course, not the professor’s…).

5. He also spoke about a new, only oral proteasome inhibitor called MLN-9708. The goal, he said, is to have oral drugs, which are easier on, and more convenient for, the patient than intravenous drugs. I checked the clinical trials website, and MLN-9708 is currently being tested in six trials. Not a huge number, eh. Here’s an easy-to-read summary given by the Myeloma Beacon: http://goo.gl/64r6w

6. The second new drug he spoke about was Bendamustine, whose worst side effect, he said, are low blood counts (I actually read that there are a bunch of other unwelcome side effects, including nausea, fatigue, vomiting, diarrhea, fever, constipation, loss of appetite, cough, headache, unintentional weight loss, difficulty breathing, rashes, and stomatitis, as well as immunosuppression, anemia, and low platelet counts! Hmmm). Interesting history behind this drug. It was developed by East Germans and essentially ignored by the rest of the world for years…At any rate, I read this morning that it’s an alkylating agent…a nitrogen mustard (yeah, that’s right, mustard gas…sends shivers through me, I have to admit). Uhm…It’s being tested in 23 clinical trials right now…

And he also spoke of the importance of trying drug combinations, because of the issue of myeloma cell resistance. Again, we all know what that’s all about, so I didn’t bother taking any notes…

At that point the question and answer session began, and I took over from Vittorio. That means that I don’t have any more written notes. But I still have some good stuff…from what I remember, from the conversations we had at lunch (I was sitting right next to Prof. Gertz) and from my friend DB’s notes. I still haven’t mentioned what was said about curcumin, e.g. But that’ll have to wait until tomorrow…otherwise this post would be (again) too long. Besides, I have some work to do in the garden…while the sun is still up and about…Soooo…ciaooooooooo! 

P.S. The above photo is of some flowers (these are daisies, and you can catch a glimpse of my pansies, too) I’ve begun planting in our rather bare-looking yard. Spring has arrived! 🙂

I really enjoyed meeting Prof. Gertz on Saturday (see previous post). A down-to-earth, sensible, approachable doctor who explained difficult concepts in a way that was easy for everyone to understand. I’m happy to say I learned some new things, and I also learned how to look at myeloma in a slightly different way…

As for my translation of the question and answer session, I think it went well enough. If I couldn’t think of a word in either language, I’d simply pause and ask for help. When that happened, I guess here and there I made a few funny faces, since I could hear people giggling. In such an informal setting, that wasn’t a problem, of course (I mean, my making funny faces). During the lunch break, an elderly lady (with myeloma) grabbed my hand and told me never to stop smiling my beautiful smile. Sooo nice! Oh, and I also met another blog reader. She came up to me before the meeting began, introduced herself and told me she’d wished she’d known earlier about curcumin (hah, she’s not the only one! So do I! But, better late than never…). And others later asked for my blog’s URL, so I hope they will get in touch with me at some point…

Before jumping into the meeting, I wanted to mention that Prof. Gertz didn’t use slides. I was surprised to hear that, but he told me that he uses slides only at official gatherings such as congresses. During patient-doctor meetings and when he meets with his own patients, he prefers to draw his own charts and figures (see photo; that long thing poking through the bone  and going into the bone marrow from the top right is a biopsy needle, by the way…brrrr…). He wants the patient/s to pay attention to what he’s saying, without being mesmerized by slides. Makes a lot of sense to me, and it adds to my appreciation of this doctor. Ok, now let’s have a look at his presentation (which Vittorio translated, so I was able to take great notes): 

He said that if we buy a soup bone at the market and cut through it, the part inside the bone is called the bone marrow. Okay, so we all know that. But then he compared the bone marrow part to a “garden.” A healthy person’s “garden” contains the following stuff:

• 60% of the garden produces white cells, which we need, of course, to fight off infections and whatnot.
• 20% produces red cells that carry the oxygen our body needs. RBC is where our hemoglobin “lives,” he said.
• 10% produces platelets, the cells that clot our blood.
• less than 10% produces what he called “boutique crops,” that is, things that are not important for our discussion, such as eosinofils, macrophages etc.

And then we have a final 1%. And that’s the plasma cells. In a healthy individual, that percentage NEVER changes, from age 1 to 81. It’s always 1%. With all the stuff I’ve read over the years, I didn’t know (or remember) that interesting little fact…hah. 

Plasma cells. They’re important for our immune system. They produce huuuuuge amounts of antibody proteins that fight infections of all types. But in 4 out of 100000 people, the plasma cells become malignant. Their numbers keep increasing (= “uncontrolled growth”). And so our “garden” is invaded by myeloma cells, which he compared to “weeds.” As the weeds keep growing, they begin choking the normal cells. The red blood cells get hit the hardest…

And in fact 75% of all MM patients are anemic, which means they feel very tired and, e.g., can’t climb a flight of stairs…

Then the weeds begin spreading to what he called the “casing” = the area around the garden (that is, the bone). They begin to form “clusters” both in the garden and in the casing. Even the strongest bones can become weak, as a result. The clusters, he said, have the consistency of “raw liver,” so it’s easy to see that when our bones can break easily when they contain too much “raw liver.” He then talked about compression fractures in the spine and about how painful those are. He showed the movements that are the most painful for patients at this stage: movement from side to side, spine flexion. Even getting up off a chair or coughing and sneezing can cause a lot of pain. And so on.

80% of multiple myeloma patients have bone pain.

But how does a doctor figure out that a patient might have multiple myeloma? Anemia and back pain could be caused by lots of different things. Besides, some patients don’t have any anemia or bone pain. They are the ones with low amounts of weeds in their garden…the ones without symptoms…These are the MGUS or SMM folks…

Well, normal plasma cells make antibodies. Malignant plasma cells also make antibodies. However, the latter produces large numbers of antibodies, which increases the amount of protein in our blood = one way to reach a diagnosis of multiple myeloma. In addition, malignant plasma cells produce only ONE type of protein. The monoclonal protein. Bingo.

However, the problem isn’t the protein, he said. The problem is the cells that make the protein that damages the bone marrow: the plasma cells. 

Another important note. Prof. Gertz said that if, over time, the protein is declining, then the number of cancer cells is also declining. If it’s stable, then the plasma cells are also stable. So this confirms what I’ve thought for a while: if everything is stable, it’s pointless to have any invasive tests. That’s the main reason I haven’t had a bone marrow biopsy since my third one (2007); my haematologist agrees with me, by the way.

Since it’s getting a bit long, I’d like to finish today’s post with the following gem (by the way, this won’t be the last post I’ll be writing about the meeting. As I mentioned, I took copious notes during the first part, when I wasn’t “on stage,” so I still have some interesting stuff up my sleeve…):

Prof. Gertz asked us what we do when our garden is full of weeds. Well, we go to a garden store and get a weed killer, right? (Uhm, truth be told, I don’t use any weed killers in my garden…they’re all waaaaaay too toxic, and my garden is 100% organic…I’d rather have a few weeds than a bunch of toxic herbs!)

Well, he pointed out, in a similar manner, when you go to an oncologist, you want your tumor cells removed. Therefore, he added, oncologists are nothing but “glorified gardeners.”

Gotta love this guy! 🙂

First, the good news. Actually, this simply confirms what I (well, all of us) already knew: my numbers are stable. Rock solid. You see, I went to see my doctor yesterday. I should point out that this is my family doctor, not my hematologist. But this guy is absolutely brilliant, a genius, one of those rare people who knows a lot about…well…everything. I trust his judgment as much as I trust my hematologist’s. And, since it’s faster and easier to go to my family doctor than to my hematologist, that’s what I did this time.  

After comparing my most recent test results to older ones, he smiled and remarked, “i numeri sono fermi,” which basically means that nothing has moved…that all my markers are stable. In fact, he added, some of them haven’t been this good in years. 

😀

Okay, now for the second part of my post. So what am I going to be doing on Saturday morning in Campi Bisenzio (Florence, Tuscany, Italy)? Well, you see, in a moment of pure madness (I have never done anything like this!), I agreed to help my friend Vittorio translate part of the patient-doctor meeting with Prof. Morie Gertz who, among many other things, is Chair of the Department of Internal Medicine at the Mayo Clinic in Rochester, MN. You might remember that he was interviewed by the “Atlantic,” see my Feb 27 post titled “The patient’s environment matters.” 

My main role will be translating the question and answer session (back and forth between the two languages) as well as translating for Prof. Gertz (Italian to English). Vittorio and I will also take over for each other whenever one of us gets tired. Phew, I’m tired already! 😉

Oh wait, I have another important bit of info: Prof. Gertz has kindly offered to stay with us on Saturday afternoon, too (instead of going sightseeing in Florence…Now, that’s dedication!!!). Super. It will very interesting to spend some informal, quiet time with him…

Soooo, if you happen to be in this area and would like to attend, have a look at the agenda etc.: http://goo.gl/uZz25 

A blog reader (thanks, Ron!) gave me an interesting bit of news this morning, but I had to leave for work and didn’t have time to share it with you. Now that I’m back home again, here goes…

First, though, I’d like to thank my friend “Sherlock.” Shortly after we met (via my blog…a great way to meet great people, btw! 🙂 ), she insisted that I have my vitamin D levels checked, which turned out to be verrrrrry low. Thanks to her, I went to see an endocrinologist and began taking a vitamin D supplement. Boyohboy, based on everything I keep reading about vitamin D, am I glad that I listened to Sherlock. Sooooo incredibly glad! I take my vitamin D drops every morning…

But let me get back to what Ron sent me this morning. It’s an abstract on the importance of vitamin D especially for IgG kappa folks (what’s that all about? I guess we’ll have to wait for the full study to be published…uff), and it’s going to be presented at a conference next month in Dijon, France: http://goo.gl/QIXkU

Discussion: Vitamin D could be considered as an effective prognostic factor and treatment of MM, especially in patients with monoclonal IgG kappa immunoglobulin.

Okay, it’s getting late over here. Almost time for dinner…Soooo, ciao for now! 🙂

P.S. I began writing about vitamin D in 2009 (perhaps even earlier). Click here if you’d like to read some of what I have collected throughout the years on vit D, including the 2009 Mayo vit D-myeloma study, which showed that MM patients with low vitamin D levels have poorer outcomes: http://goo.gl/TSqoE Hey, if you haven’t done so already, please have your “D” levels checked! 

Today I’d like to post the link to a very interesting article published recently in the “Myeloma Beacon”: http://goo.gl/jIhKJ

Here’s my own experience, which I’ve written about on the blog: in 2005 (= the year of my SMM diagnosis; progression from MGUS, diagnosed in 1999) I had chronic, painful yeast infections. This infection business had actually begun a few years before, as I recall (without checking my medical history documents), but in 2005 it definitely got worse…Couldn’t get rid of the blasted things…Took truckloads of antibiotics in many shapes and forms and strengths, to no avail (except more misery). 

The infections disappeared not too long after I began taking curcumin (January of 2006), and they haven’t come back since. I must say, this was an unexpected and most welcome side effect of the wondrous yellow stuff…

Now, I recall reading somewhere that recurrent infections can be a symptom of progression…where was that? Ah yes, here it is. In the International Myeloma Working Group “Criteria” (2003): http://goo.gl/Fq1BS No, that’s not it. I read something more specific…somewhere else…but I don’t have the time to check it out right now.

Ah wait, here’s a possibly relevant study (“Blood,” 2008): Our observation of an association between MM/MGUS and specific prior bacterial or viral infections suggest that these infectious conditions may be a potential trigger for MM/MGUS development or a manifestation of underlying immune disturbances due to undetected MM or late-stage MGUS. Recurrent infections largely of bacterial origin (septicemia, meningitis, and pneumonia) are often part of the natural history of MM. (Full text: http://goo.gl/AnLLy) Ok, not yeast infections, which, however, definitely have a bacterial origin…

This 2008 study seems to counter what we just read in the Beacon article, doesn’t it? I mean, the former states that infections could be possible triggers both for MGUS and MM, the latter that infections did not increase an MGUS patient’s risk of progressing to multiple myeloma. Well, I suppose many things can change in 3-4 years…

So…which is it, eh? Food for thought…

By the way, many thanks to Dr. James R. Berenson for providing the link to the Beacon article (on Facebook)…

A week or so ago, a friend sent me this “Atlantic” article, published in its July/August 2011 issue: http://goo.gl/jd1ow I found it absolutely fascinating, even though I can’t help but disagree with some parts of it (you can imagine which…). I just hope that some day those who vehemently and, in my opinion, blindly oppose any sort of “alternative” approach will learn to soften their unyielding positions and become more open-minded…like Dr. Gertz, a Mayo Clinic hematologist (see page 3)…

Lots of food for thought in this article. Here are a few of my random favorites:

• YOU MIGHT THINK the weight of the clinical evidence would close the case on alternative medicine, at least in the eyes of mainstream physicians and scientists who aren’t in a position to make a buck on it.
• In many cases, the drugs used to treat the most-serious cancers add mere months to patients’ lives, often at significant cost to quality of life.
• THE MEDICAL COMMUNITY knows perfectly well what sort of patient-care model would work better against complex diseases than the infectious-disease-inspired approach we’ve inherited. That would be one that doesn’t wait for diseases to take firm hold and then vainly try to manage them with drugs, but that rather focuses on lowering the risk that these diseases will take hold in the first place. “We need to prevent and slow the onset of these diseases,” says Blackburn. “And we know there are ways to do that.” Aside from getting people to stop smoking, the three most effective ways, according to almost any doctor you’d care to speak with, are the promotion of a healthy diet, encouragement of more exercise, and measures to reduce stress. [Blackburn = Elizabeth Blackburn, a biologist at the University of California at San Francisco and a Nobel laureate. ]
• Studies by her and others have shown that stress is linked to the shortening of telomeres, and shorter telomeres are in turn linked to aging and cancer. “We tend to forget how powerful an organ the brain is in our biology,” Blackburn told me. “It’s the big controller. We’re seeing that the brain pokes its nose into a lot of the processes involved in these chronic diseases. It’s not that you can wish these diseases away, but it seems we can prevent and slow their onset with stress management.” Numerous studies have found that stress impairs the immune system, and a recent study found that relieving stress even seems to be linked to slowing the progression of cancer in some patients.
• Numerous studies have found that stress impairs the immune system, and a recent study found that relieving stress even seems to be linked to slowing the progression of cancer in some patients.
• Hippocrates put it this way: “It is more important to know what sort of person has a disease than to know what sort of disease a person has.”
• Many medical students start out with a healer mentality, but few retain it. “It gets beaten out of you by the system,” says Brian Berman, noting a study showing that medical students score progressively lower on empathy tests the further they get into their training. Berman himself was a conventional M.D. until, at age 33, he took up the study of traditional Chinese medicine—which, like many alternative approaches, is largely focused on patients’ lifestyles, feelings, and attitudes, and which emphasizes stress reduction, healthier eating, and regular exercise, as well as encouraging the patient to believe in self-healing. “I saw how much more I could do to help people,” he says. “For the first time since medical school, I felt like a healer again.”
• randomized trials have by and large failed to show that alternative treatments work better than placebos.
• To be approved by the FDA, a drug has to do better than a placebo in studies—but most approved drugs do only a little better, and for many drugs the evidence is mixed.
• “The randomized trial is a very high bar,” he says. “Eighty percent of what I do here isn’t based on randomized-trial data.” [“he” = Dr. Morie Gertz, Mayo Clinic]
• The beneficial effects of alternative therapies on Mayo Clinic patients, he says, have been observable in shorter hospital stays, in lower levels of self-administered painkillers, and in reduced tissue inflammation, which is a general indicator that the immune system is better holding its own. [“he” = Keith Lindor, a liver specialist & also dean of the Mayo Clinic’s medical school.]

Okay, I’d like to end with a personal experience, which is (sort of) relevant. Last week my yukky cough returned. Ugh. No wonder, since I’ve been exposed to chronic germ factories all winter = my students, who cough and sneeze almost non-stop (and sometimes even come to work with a high fever, hellooooo!!!). In fact, given my almost non-existent immune system, I’m really surprised that I haven’t gotten the flu (yet!). Could that be because of my Nigella sativa intake? No idea. Anyway, back to the point: THE COUGH. It soon blossomed into what I normally judge as “a cough that needs antibiotics”: yellow phlegm and a low-grade fever.

But I decided instead to try Manuka honey with a high MGO. I mean, I felt okay, and this occasional cough, similar to what I had last fall but not as violent, didn’t stop me from being active. So I figured, “oh why not? I’ll try it…and keep a close eye on my symptoms.” After a few days, what I was coughing up wasn’t yellow anymore. No kidding. Even I was impressed. Now, I’m not suggesting that this honey will work for everyone. Last year, in fact, it didn’t work for me (although I should mention that I ran out of the high MGO honey and had to take a low MGO one). Boyohboy, though, it would be amazing if I could avoid taking antibiotics…at least on occasion!

And so my question of the day is: do I need to see the results of a randomized controlled clinical trial before taking Manuka honey as soon as I feel a cough coming on?

I think you know my answer…