In 2004 a 41-year old elementary school teacher, Vicki Peterson was referred to me after a biopsy of a pea-sized lump in her breast revealed cancer (Vicki collaborated with my memory on this blog and said she “was proud” to be identified). Diagnostic studies and another biopsy diagnosed the cancer as Stage 4 with spread to a single area of her pelvic bone. Workup showed the cancer to be “triple negative,” which in 2004 meant that the cancer would both likely grow faster and be less responsive to treatment.
Vicki’s parents suggested a second opinion from an internationally recognized medical center near their home.
Her second opinion oncologist had compassionately and thoroughly explained that aggressive treatment in her situation was futile. They stressed that chemotherapy should focus on maintaining the highest quality of life for as long as possible. Cure was out of the question.
Vicki returned to discuss the second opinion recommendations and plan on-going care. Through quietly streaming tears, she voiced single-minded determination:
“This is unacceptable. My daughter begins kindergarten in a month and she needs me. I want to see her graduate from high school. I can’t give up. What can you do?”
For the record, the second opinion’s recommendation was clear-headed, kind, and reasonable given the facts. Recommending aggressive treatment in futile situations is misguided and does not represent the best care. Vicki’s odds of survival were at best, very slim.
If she had been resigned to the second opinion’s assessment of her situation, I would have followed their plan. Given the eventual outcome, this is a humbling admission. But in light of Vicki’s resolve, I was convinced there was enough realistic hope to justify aggressive treatment. Treatment seemed reasonable because all the “known” cancer could be addressed with relatively limited surgery and radiation therapy.
She began an extensive course of chemotherapy, followed by intensive radiation therapy and surgery for the original mass.
Before starting her treatment, Vicki asked what might have been a life-saving question, “Is there anything else I can do?”
There are hundreds of scientific studies suggesting that the standard American diet increases the incidence and growth of several kinds of cancer.
The book, The China Study1, had just been published the year Vicki was diagnosed. We talked about the highly significant correlation the research had found between animal protein and increased cancer risk. We also discussed data suggesting that certain phytonutrients seem to rev up our immune system to enhance its ability to kill cancer cells.
I stressed it was uncertain whether changing her diet would make a significant difference in her case. Since 2004, the evidence for such beneficial diet changes has increased, but it is certainly not a silver bullet for every cancer.
But Vicki was seeking every advantage and quickly changed her diet, focusing on eating phytonutrient rich foods. Following the findings in The China Study, she avoided meat and dairy.
She endured nearly two years of aggressive cancer therapy, including two extra courses of radiation therapy to new areas of bone metastasis. Her last treatment was in October 2007. She remains cancer free.
Vicki’s battle with cancer ignited her enthusiasm for her job as a sixth grade science teacher and her intense appreciation for life. Her daughter, Olivia, graduated from high school in the spring of 2018.
When advising a healthier diet with “still healthy” people (although only 12% of American adults are metabolically healthy), I have frequently heard the gentle rebuke, “Doc, you have to die of something.” It is almost as if life is a gift that’s worth more if treated with careless nonchalance.
But when discussing the options with cancer patients, such a “devil may care” attitude was absent, replaced with a heightened intentionality.
Vicki’s triumph over breast cancer is inspirational. She, like many other cancer patients, has learned how much every day counts. What have my patients taught me?
Life is precious. We can best glimpse just how precious when we act with intentional kindness to ourselves and our fellow travelers, whatever the situation.
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