These two books have informed me about health and wellness:
The Emperor of All Maladies, a Biography of Cancer – Siddhartha Mukherjee.
I am not an expert in medical practices and blessed to have avoided being a patient of this family of diseases. But I have friends and family who have suffered, and some have passed; I thought it could help me better understand the science and current treatment practices that I see. The author is an acclaimed medical doctor and author – his writing style is technical yet clear and straightforward, complemented by historical events and real-life examples.
In 2010 (published date of this book), an estimated six hundred thousand Americans, and more than 7 million humans around the world died of cancer. In the United States, one in three women and one in two men will develop cancer during their lifetime.
The recorded history of this family of diseases goes all the way back to the earliest writings and descriptions from 2000 years ago. Early treatments involved crude types of surgeries that provided short term relief in a few cases. 19th century discoveries about the structure of cells provided some early insights. It took later discoveries about the role of certain viruses; the structure of chromosomes and genes that began to uncover the mechanisms that drove cancer cells to divide. To a large degree cancer arises from harmful genetic mutations, whether driven by viral disruptions or the introduction of carcinogens into the system.
At some point, carcinogens were linked to cancer cases. The history of establishing the links between smoking and incidences of cancer took many decades after smoking initially became popular in the early 1920s. It took literally 60 years to establish well-documented links and convince the populace and government agencies to act against industry sponsored advertising.
Cancer screening methods are described, including Pap Smears (discovered by George Papanicolaou, a Greek cytologist at Cornell University) and mammograms.
I had no appreciation for the scope of research and clinical trials that were conducted through universities and large research hospitals, funded through federal grants as well as large fundraising efforts. Clinical trials were generally initiated to prove new treatment options. They were also used to track the efficacy of existing treatment efforts. Widespread surgical applications were supplemented by the development of targeted molecular drug treatments (chemotherapy) and radiation designed to target and kill cancer cells, coupled with stem cell transplants to restore the immune systems after treatment.
Progress in prevention and treatment has been steady but very slow, as cancer cells have many defenses against traditional treatments, including accelerating mutations that preserve future generations of these cells. While many cancer mortality rates have decreased, some cancers, such as pancreatic and brain cancers, still show increasing mortality rates.
US cancer rates and trends: how have cancer rates and mortality changed over time? | USAFacts
I have a greater appreciation for the science and research that has gone into fighting this disease, and the care of physicians for their patients, even now when I visit a cancer treatment center. Well done all.
The Long Version: The Emperor of All Maladies – Welcome
Outlive The Science and art of Longevity. -Peter Attia, MD
The author is a physician and a researcher in longevity, and he has assembled a wealth of background information on the prevention of disease and physical deterioration related to the aging process. The premise of the book rests on the evolution of medical care and treatment from what he defines as Medicine 2.0 to Medicine 3.0. Medicine 1.0 was pre-science. Dr. Attia’s concept of Medicine 2.0 is our current, largely reactive healthcare system that focuses on treating symptoms and late-stage chronic disease. In contrast, Medicine 3.0 is a proactive and personalized approach that emphasizes preventing chronic diseases and conditions by using advanced diagnostics, predictive lab work, and individualized protocols to optimize the quality of life-rather than just extending lifespan. Longevity, however, is not merely restricted to the number of years that a person lives, but to ensure that the number of years are spent in good health, and free from major diseases and disability. Lifespan: The number of years you live. Healthspan: The number of years that you live in good health.
Dr. Peter Attia And The Advent Of Medicine 3.0
100 years ago, when lifespans were much shorter, the primary causes of death were accidents, injuries, and infectious disease. In the 21st century, aside from accidental death, most people will die from of the chronic diseases of aging as he describes, the four horsemen: heart disease, cancer, neurodegenerative disease, or type 2 diabetes and related metabolic dysfunction. He covers in some detail the early diagnosis, testing and preventative measures which can forestall the progression of these conditions. Fortunately, these conditions do not arise overnight. The emergence of the Four Horsemen can therefore be prevented – or their progression stopped – through proactive measures such as treatments and lifestyle adjustments.
Peter on the four horsemen of chronic disease – Peter Attia
Exercise and stability Dr. Attia describes exercise as the most powerful longevity drug. “Study after study has found that regular exercisers live as much as a decade longer than sedentary people. Poor cardiorespiratory fitness carries a greater relative risk of death than smoking”!! And of course they stay in better health – they extend their healthspan.” He argues that the predicted loss of muscle mass with age literally puts our lives at risk, especially from falls which often result in debilitating injuries. For this reason, he puts great emphasis on weight training to promote increased muscle mass. These support increased functionality for lifting, carrying and balance.” Strength training, especially with heavy weights, stimulates the growth of bone. “It takes much less time to lose muscle mass than to gain it.. Even if a person has been training diligently, a short period of activity can erase many of those gains.” So, the best advice is to stay with it over the long term.
Nutrition and eating patterns: He covers many of the nutrition trends that have arisen over time, and his practice boils it down to more simple principles; “The correlation between poor metabolic health and being overnourished is very high. For most patients, the goal is to reduce energy intake while adding lean mass. This means we need to find them (patients) ways to consume fewer calories while increasing their protein intake, and to pare with proper exercise. This is the most common problem we are trying to solve around nutrition.” “From the standpoint of efficacy to lose weight, caloric restriction is the winner, hands down.”
Studies are mixed about whether a long-term restricted calorie diet can prolong lifespan, though it is certainly good for your ongoing health if composed of a proper balance of nutrients. He touches on the use of alcohol (generally a no) and various nutrition schemes that favor protein over carbohydrates / fats (on the whole generally good). Various fasting approaches are also discussed. The key is to maintain a proper nutritional balance and avoid overeating when breaking fasts.
Sleep and mental health: Each night when I go to sleep, I die. And the next morning, when I wake up, I am reborn. -Mahatma Gandhi. Seven and a half to eight and a half is a recommended sleep cycle, we all fall down on that. And finally mental health, the author shares his own mental health challenges and treatments, a good honest revelation.
In any case, my commitment to running and racing has provided an ongoing focus on training and health. Setting a goal does that every time.
The Long Version: Outlive The Science and art of Longevity. -Peter Attia, MD – Welcome
