clean scan...now what?

This post fulfills a promise that was offered by Cynthia, aka LivinginNH. Today I took the ride down to Dana Farber to meet with Dr. David Rosenthal, Medical Director, Zakim Center for Integrative Therapies. Dr. Rosenthal talked about a "three legged stool", that is 3 issues that I need to address in minimizing the probability of recurrence: diet, exercise, and anxiety minimization.

Diet
Dr. Rosenthal recommended 10 servings daily of fresh fruits and vegetables. After I reminded him that it was winter, and we live in New England (60" of snow this season and counting), he suggested that most people who work find it difficult to get to 10 serving of fruits and vegetables daily. He told me that many of his working patients put a variety of either fruits or vegetables (not both as mixing fruits with vegetables doesn't taste good) in the blender in the morning, mix the mash with ice and put it in a thermos. Then they could eat the mash all day. He also gave me a list of recommended fruits and vegetables. Instead of duplicating the list, I'll just say that the list focuses on dark colors. He also recommended avoiding red meat, and processed sugar. Fish is preferable to poultry. I had read a book that recommended also avoiding white flour and pesticides. Dr. Rosenthal stated that "the evidence for eliminating white flour is unconvincing", and he was on the fence regarding pesticides. That is, he thought it would be generally a good idea, but did not recommend avoiding certain produce if you could not find an organic source (using red grapes as an example). In summary, Dr. Rosenthal recommended a diet that maximizes flatulence.

Exercise
The doctor recommended a minimum of 180 minutes per week of exercise, mixing strength training with cardiovascular, with more of the latter. He said that we could kill 2 birds with one stone while engaging in exercise such as tai chi, qi gong, and yoga.

Minimizing Anxiety
The Zakim Center has programs in Reiki, massage, and acupuncture. He mentioned an active clinical trial that they are doing with acupuncture, and that they had to "fake" acupuncture for the control group.

Upon my return home, I focused my debrief with Cynthia on the notion that we could satisfy both the exercise and anxiety minimization requirements with lots and lots of sex. (I think she bought it...)

The doctor recommended dietary supplements of 0.5 - 1 gram of omega 3 fish oil, and 2000 IU of vitamin D-3. He also recommended 2 books: "Eat, Drink, and Be Healthy" by Walter Willett and "Relaxation Revolution: Enhancing Your Personal Health Through the Science and Genetics of Mind Body Healing" by Herbert Benson and William Proctor.

I presented the list of chinese herbs on John's blog to Dr. Rosenthal. He reviewed the list, consulted with a TCM colleague, and sent me the following reply via email before I had arrived home:

Pleasure meeting you.
This response is from one of my TCM clinicians. He is a PhD as well.

The listed herbs are generally commonly used herbs in TCM, especially "Bai Hua She She Cao" and "Ban Zhi Lian" have been used for anti-cancer agents. There are many lab and animal studies suggest their anti-cancer properties. The combination is safe to use if patients are not on chemotherapy. Although this combination has been widely used with chemotherapy together in China but specific clinical evaluation regarding interactions have not been reported. I can see this combination to be used in post chemotherapy patients who have completed primary treatment and on follow-up.

My best to all,

Rick