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David Servan-Schrieber on Cheating Death

David Servan-Schrieber was 31 when his world was turned upside-down. Ambitious and arrogant, with French blueblood coursing through his veins, he was a rising star in neuropsychiatry. But when a volunteer for a brain scan experiment didn’t show up, Servan-Schrieber slid into the scanner himself—and discovered a malignant tumor nestled deep in his brain. After surgery and chemotherapy, he asked his oncologist what he should change. “Nothing,” replied the oncologist. So Servan-Schrieber lived his life as he had before, eating a diet high in sugar and red meat, exercising little, and abandoning an earlier interest in meditation. A few years later, the tumor returned. This time, he used his medical training to investigate how best to prevent cancer, discovering that changes in diet, exercise, and stress management have powerful effects. The result was remission—and a bestselling book called Anticancer: A New Way of Life. —Jay Dixit

JD: Finding out you have cancer is among the things most of us dread most, along with hearing “I want a divorce,” or “Your child was in an accident.” How did you feel and what went through your mind when you first saw the tumor in your brain on the scan?

DSS: My first reaction was that this was not in the plans at all. I was 31; all I had done in my life was investing in the future. I’d been dedicating all the years to education, medical school, a PhD in cog neuro, training in psychiatry. These were very busy years with a lot postponed into the future. So it felt this is the nightmare that everything I had hoped for would never happen and I’d spent my life preparing for a future that would not exist.

JD: What was your emotional reaction?

DSS: I was scared, baffled, I was unable to think straight. I looked like Bush when he learned about the Twin Towers, complete disbelief, you don’t really feel, your mind just stops.

JD: So then what happened? What was your next couple of days like?

DSS: Something quite miraculous happened which sometimes happens in extreme situations of stress. It happens to athletes, during accidents, happens during trauma. I heard this voice in my head, but which was my voice that I’d never heard before, as I was lying there in bed trying to go to sleep but was unable to do so. I guess I was complaining, we all have this internal dialogue, this can’t be true, it’s unfair, it can’t be happening to me. And then the voice said of course it can happen to you, of course it’s fair, this is going to happen to every human being at one point or another, this is just happening to you earlier then for most, it’s going to be okay.

That was repeating, first to realize that it was not unfair, that I was not the only one. That it was possible to go through this experience whatever it was going to be, as many other human beings did before me, with a sense of peace. Whatever would happen, whether I would heal from this, or whether I would die, it would be okay either way.

JD: So then you felt it was going to be okay?

DSS: Well I didn’t feel that, the voice said that, the voice was reassuring.

JD: So how did you feel in reaction to the voice?

DSS: A sense of peace.

JD: So you believed the voice?

DSS: It was a voice that you don’t argue with. I don’t know how to say that. It was something of a spiritual, it made me understand maybe what Moses heard or whatever. It’s a voice that is so absolutely sure. You don’t argue with that.

JD: Up until that point, what was your experience? Were you a believer?

DSS: That’s why this is odd. I was a complete atheist. More that a nonbeliever, an atheist. I was adamantly opposed to religion.

JD: Did that change your views?

DSS: Eventually my views changed, I realized this capacity to connect to something larger than yourself is extraordinarily important aspect of the psyche. In retrospect I feel I was quite incomplete before.

JD: Why did you get cancer?

DSS: I don’t know. I did think about this a fair amount. I just don’t have an answer to that.  I think it was probably a mixture of many factors as it is for most people. I don’t think there’s a singer reason why we get cancer. Cancer is the tip of an iceberg, it’s what happens when there are more factors that are pushing for the development of cancers than there inhibitors of cancer

JD: What do you think the factors were in your case?

DSS: Exposure to chemicals, pesticides, electromagnetic fields from a variety of contacts, years in front of a computer screen, I started on computers when I was 19 and this was a time when they were cathode ray tubes, and that’s a flat screen, they have a stronger electromagnetic fields. It’s a combination of what I ate my inability to deal with stress very effectively.

JD: In retrospect, would you lead your lifestyle very differently as a young man? Do you think it was things you did?

DSS: There were a lot of things in my lifestyle I could have done differently that could have protected me. I think that’s the message for people. It doesn’t serve much of a purpose to blame myself for having cancer, to be thinking about the one thing that did it. I don’t think it makes sense. The message from this is I now know that there are many things you can include in your life that help strengthen your health against a variety of diseases, including cancer. And I didn’t do that. In fact, I took risks, I exposed myself to chemicals, didn’t take gloves, I inhaled things, never wore masks, I didn’t pay attention. In medical school, we were exposed to chemicals and labs; I was sort of a daredevil.

JD: If I were trying to get cancer, what would I do? How should I lead my life? What would I do?

DSS: Expose yourself to chemicals, car exhaust, diesel fumes, plastics, the chemicals of household products. Smoke. Drink. Don’t exercise. Eat McDonalds, eat fast food, make sure you don’t eat vegetables because they take too long to cook and they waste in the fridge so don’t buy them. Learn to manage your stress with alcohol and cigarettes instead of any other method, and don’t pay much attention to your personal life. That might do it.

JD: And you did most of those things?

DSS: I didn’t do that many, but I did not pay attention to my personal life very much.

JD: If I want to avoid cancer, what should I do?

DSS: That’s easier to answer. The number one thing is pay attention to what you eat. The food you eat every day 3 times a day plays on your biology like a pianist’s fingers on a keyboard. It doesn’t have a major effect on health, of course. You can could eat ice cream every day and nothing happens. You can eat pizza every day and nothing happens. You can eat McDonalds every day three times a day and nothing happens. But the things you start to do every day 3 times a day have a very profound effect on your biology over the mid to long term. You notice things after a few months. Definitely after a few years, and you can’t escape them after 10 or 30 years. So pay attention to what you eat. Reduce the things, like white sugar, white flour, omega 6 fatty acids, which includes red meat, and a number of dairy products. So that’s one thing.

And then add a number of anticancer foods, which are mostly vegetables and fruits. But that’s not enough to just eat fruits and vegetables. There are some that are much stronger anticancer foods then others, so include some of that and try to include them every day 3 times a day. That makes an enormous difference in your biology’s ability to resist disease.

JD: And besides food?

DSS: There’s physical activity which doesn’t even mean exercise. Women who walk 30 minutes 6 six times a week reduce by half their chance of relapse after breast cancer. So walking to work or biking to work, which is what I do now, I’ve done for years now, makes an enormous difference. Then learning how to manage stress differently, don’t manage stress with cigarettes and alcohol, learning how to manage stress in relationships at work, learning how to control your breathing, and your concentration.
And then learning how to avoid environmental contaminants that can help promote cancer.

JD: How do I do that?

DSS: Well you read my book and get a list (haha) some of the main contaminates are dry cleaning. It’s okay to do dry cleaning but make sure you air your garments for a couple hours before wearing them, for years I would put the plastic bag straight into closet so they’d keep the highest possible concentration of (some chemical) that I could inhale if I wore them. So avoid that and cosmetics and creams. We need to avoid some of the exposure to cleaning products that can be toxic. Try to use as much as possible white vinegar, baking soda, or ecologically safe cleaning products.

JD: What insight did your experience give you about the ability of people to manage their own health?

DSS: Good question! Nobody’s asked me that. I was quite surprised that most of my physician colleagues believed and still do (French national cancer institute) these people believe adamantly that most people do not want to change. Certainly when I was given the information about things I could do that would slow down cancer growth, I was quite willing to change. So it’s hard for me to imagine that I’m the only one in that situation. Ever since the publication of my book is now is up to 1 million copies in print, I’ve have gotten tons of testimonials of people saying that they have just waiting for someone to tell them what they could do and they’re appalled by the message they often get from their physicians. Not all of them. I have to say some are remarkable. Maybe physicians tell them there’s nothing you can do to slow down your cancer, just stay with your treatment. We’ll do screenings, if it does come back, we’ll detect it earlier. They have been appalled by this message, they felt tremendous comfort that to see that there is scientific information that could empower them to help themselves, the fact there’s been so many testimonials, it’s hard for to agree that people don’t want to change, that when given the information many people do want to change.

JD: What do you think the ordinary person to manage their own care and get the best advice possible?

DSS: Nowadays they need to get information as valuable as possible, that information about all of the scientific evidence that self-care makes a difference in terms of cancer, and then they seek help to implement that in their own lives. Mostly what they need is support from other people who have already done it. One of the best things to do is to find other patients who have walked that path. Get advice and support from them. It’s easier to do it as a group than to do it by yourself.

JD: Most people don’t want to put themselves in a position to question their oncologist, in an adversarial position, it’s too threatening. What made you question the advice you got from your oncologist about preventing relapse?

DSS: As a physician, who myself had condescension for this kind of self-help on the part of the patients, I have that same attitude, I knew where it came from. And I knew if there were aware things to do to help myself, I wouldn’t know about it. Because nobody invites us physicians for a week for free, give us a course on the benefits of yoga, jogging, broccoli, and garlic. And there are no ads medical publications about that, little support for good research on this. And when results are published, they don’t get much of echo in our journals.  And the contrary, that failed to show to show an effect and these get a lot of echo, perhaps because it can help us as physicians to know the things we do are important, the things patients do are not. I knew where it came from but just had to know.  I had to find this out myself. It was not adversarial whatsoever.  Because of course I did everything they wanted me to do as well.

JD: Should we be using doctors in a different way from the conventional model, in which we basically turn over our health care to them? Should we be doing something different then that?

DSS: I think that’ exactly right. We need to know that they proceed from a model that will quite effectively attack a tumor—but that as it stands now, and I hope it will change, I’m trying to be an agent of that change—they do very little to help your body do its part together with the treatment to fight the disease. They do not support the terrain, they only target the tumor. We need to know that, we need to recognize and acknowledge the great benefits of the work they do, but we also need to know that we can go further, out of the domain of expertise at this point , I think it will change. But at this point, it’s out of their domain of expertise.

JD: Do you think there’s a risk that some people hear your message or part of your message about these other interventions, like diet, exercise and behavioral, and they misunderstand and more likely to go to that as a first line of defense? Rather then going to mainstream medicine first? What would you say to those people who might misunderstand that? And might think this means they should go to alternative medicine first?

DSS: I try to be quite clear about that, in a book there’s a box about how to avoid charlatans. My advice is do not rely on the advice of anyone who tells you to avoid conventional treatment. There is no alternative to conventional treatment for cancer care today. Work with someone who’s willing to work together with conventional treatment, number 1. In the book, I say ten times, there is no alternative to conventional treatment. I myself was operated on twice, I had chemotherapy and radiotherapy. But that is an unavoidable part of getting the best care possible.

JD: What did you do in your case that mattered most for your health, in your opinion? After you got cancer?

DSS: I got surgery and chemotherapy and radiotherapy. And that saved my life. So I’m not dancing around that. Still, I do very firmly believe it would not have been enough. I know a lot of people who had the same tumor I had who are dead today. And I’ve been at it for 16 years.  I think the things I did on the side played an extraordinarily important role as well. Needless to say those people also did surgery, chemotherapy, and radiotherapy. And we all know that. Nobody is claiming the conventional treatment we have is a cure-all. It’s not antibiotics and neophomeniua, it helps for those side effects, it helps, it’s often not enough. Not always. For some people it is, but not always. We need to do better.

JD: Besides conventional therapies, what did you do that matted most to your health?

DSS: I think changing my diet was important. Regular physical activity and learning how to manage stress differently. The beauty is that all of that greatly enhanced my life. Many people will tell you they had learned all of that before they had cancer, or independently of cancer–it just made their lives better.

JD: There’s a feeling among some people that the idea getting cancer was the best thing that ever happened to me.

DSS: Some people. It’s always hard to say that because part of me still wishes I never had cancer. But a big part of me feels like it was a second birth. I was born to a new being completely. Which is more grateful, more appreciative, friendlier, more energetic, more enthusiastic about life, more aware. I’ve got to stop giving praise to myself! But a lot of that is true.

JD: Would you say you’re happier?

DSS: Definitely.

JD: Did being a doctor give you some advantage over the rest of us in navigating the system or at least questioning the advice you got?

DSS: Unfortunately, it gave me a huge advantage, because first I knew how much my colleagues did not know. When they said it doesn’t matter what you eat. I knew they did not know that. I had given this stock answer to people myself, not knowing what I was saying. That was immensely helpful. I had a much better bullshit detector. The second thing is, I was able to count through the scientific literature with perspective, because this is where most people get lost. They on the internet and they find a gazillion leads that seem promising, but it’s hard to know which ones are promising and which ones is just another dead end. As a physician and scientist, I’d spent years combing through the scientific literature; I had trained my eye to detect what has worked well and what may not be, what is solid evidence, what is not. I think that helped me tremendously to make sense of all that.

JD: When your bullshit detector went off, what was your reaction? Did you privately question it? Or did ever confront somebody and say you don’t know what you’re talking about, how could you say this to me when it’s wrong?

DSS: I confronted them gently. I said I know that this is an area you don’t have time to look into. I myself in your position, I’ve given this kind of advice because I hadn’t had time to look into it in-depth enough.  I know what your legitimate concerns are. You don’t want me to eat something that might counteract the benefits of treatment for example. So you’d rather me not do anything differently. But with my read of the literature on this topic, it’s possible to optimize the biology to resist cancer progression. I think I spent a lot more time then you looking at that, maybe we can agree that you do your part and I do my part. Most of them in fact heard that.

JD: You talked about how difficult it is when looking at scientific literature. For an ordinary person who doesn’t have a trained eye, what advice would you give?

DSS: Tell them to look for a trained eye that they can trust. There are some, Andrew Weil gives very reasonable advice; try to find a professional, perhaps someone in your community who has a good reputation. Most cancer patient groups have identified some with a good reputation who can give advice about nutrition, exercise, and stress management, about controlling your environmental contaminants better. Find someone who has a high standing in your community in that domain.

JD: Despair must be part of a natural response to learning one has a potentially fatal disease. Does that despair undermine the body’s ability to cope?

DSS: Great question. You must be writing this for Psychology Today. Most people ask me questions that are biologically oriented, not psychology oriented. What I was able to find in the medical literature is acute despair is normal and doesn’t have much impact on biology. However, prolonged despair, to me there’s no question scientifically, that prolonged despair affects the course of cancer. It affects cortical levels, neurepinephrein, the immune’s systems ability to fight infection, fights cancer progression, spread of metastacism and so on. It creates inflammatory terrartian towards products of cytokines.  Prolonged despair is well characterized biological phenomenon, as a chemical for promotion cancer growth. The reason I’m making this distinction. I wouldn’t want people to be afraid to cry. You hear these husbands who sort of panic when their wife with breast cancer breaks down into tears and they say don’t cry don’t cry you’re making the cancer grow. That’s not what happens. It’s the chronic sense of desperation, being stuck and powerless.  And in fact a good cry once in a while is a way to get beyond that chronic sense of despair, especially when it’s being heard by a mate or friend or intimate partner. In fact we have studies showing this kind of intimacy, which involves expressing and accepting the other person’s painful emotions.  This kind of intimacy is a strong protective factor against cancer growth.

None of these psychological factors cause cancer. But they have an affect on cancer growth.

JD: What’s your advice about how to manage stress? How to manage it without using cigarettes and alcohol?

DSS: I wrote a book about that called The Instinct to Heal.  Its about treating anxiety, stress, and depression without drugs or talk therapy.  My advice about that is the first line of defense against stress is physical exercise, that’s very clear. Even any kind of activity is good, but exercise is even better. Jogging 3 times a week has the same effectiveness as an antidepressant. But much more lasting benefits.

The 2nd thing is learning how to control the balance between the sympathetic and the parasympathetic nervous system, one being adrenaline based, and accelerator for phrenology, the other being a break, relaxation, digestion, and restoration. Learning how to do that is what yoga, chi gong and meditation are all about. The so-called relaxation response is about balancing the 2 branches. That’s the problem, that no one can make money off it. It’s so easy and so simple based purely on concentration of attention and breathing that it is not taught in medical school and it’s not part of our health system in spite of the well documented and powerful effects.

JD: What is your advice about drinking alcohol?

DSS: Drink it occasionally for enjoyment, to the point of social lubrication. I think it’s a wonderful addition to life. Don’t use it as a stress management method. The evidence is that red wine can have anticancer effects, But not beyond 1-2 glasses per day. Even that is a bit much, and that levels beyond that certainly contribute to the growth of cancer.

JD: Even if it’s red wine?

DSS: Yeah.

JD: What do you mean when you say “cancer lies dormant in all of us”? Are you suggesting that our default state is to develop cancer?

DSS: Yes. What I’m saying is that 100% of people have cancer cells in their body after the age of 50. Obviously that suggests we all have the potential for cancer. This could be taken as really bad news but I take it as really good news. What that shows is majority of people who don’t live cancer proves we have defenses in the cells of it ever becoming an illness.

JD: Do you think that since Asian cultures have a lower rate of cancer, is that proof of what were saying about diet and exercise or there some other different that accounts for it?

DSS: The only other factor that accounts for it is genetic, because after 1-2 generations in the West, they have the same cancer rates as Westerners. Therefore it’s lifestyle, and we better start looking at how we can change our lifestyles to reduce cancer, and all the diseases that go with cancer, because it’s the same processes create terrain for Alzheimer’s, arthritis, heart disease. They’re very similar.

JD: Do you think there’s a cancer personality? Which types of people are more likely to get cancer? Which types are more likely to avoid cancer or beat cancer?

DSS: The evidence for a cancer personality is weak. In my book I didn’t want to make a big deal out of that. A lot of people who still recognize themselves into those traits. The cancer personality is the personality that is likely to find itself in despair, it boils down to hopelessness. If there are personality traits that are prone to hopelessness. The scientific evidence in favor of a psychological link is about hopelessness, that’s very strong.

The big grip of personality is weaker.

Do you have a sense that your future circumstances will be better? (yes or no) Do you have a sense that you have the power to change your current circumstances if you don’t like them? If you say no to both these questions, then your chance of having cancer within three years is about double. So hopelessness. That’ independent of smoking obesity alcohol and all those other well known factors.

JD: Is a sense of control is part of avoiding hopelessness?

DSS: We know that every study that shows that people have a greater sense of control have less cardiovascular disease, less medical problems in general. So it is important.

JD: Is the traditional mainstream medicine hostile toward you, and if they are, why? Are people resistant to your message about diet/environment because of reasons like fear, disbelief, or feeling like you are undermining traditional medical approaches?

DSS: There is some sentiment of that type; I don’t think it’s the majority. Some physicians have legitimate concern that you expressed quite well earlier that if people start believing in those self-help approaches. Quite clearly broccoli, jogging is not going to compare with benefits from chemotherapy. It’s not the same.  They are concerned that people might over interpret what I’m saying. I think that’s a legitimate concern. The other is more difficult to explain with not too many words. Oncologists have a big problem because patients who come see them are not feeling sick most of the time. In fact it’s just like me; I was feeling quite fine in my life. The Oncologists tell them their sick even though they’re not.  In fact it’s the treatment that makes them feel sick. It’s the opposite of a cardiologist, with a heartattact and your going to die, his treatment saves your life, you’re grateful to him or her the rest of your life. The oncologist is going to make you suffer! That’s a difficult job. They’re quite hesitant to tack onto that recommendations that you’re ultimately going to have to cut sugar out of your diet, take time out of your busy schedule to exercise. Well you really should learn about yoga. They’re difficult messages to get through on top of the fact you’re making these people sick with your treatment. The evidence about benefits of broccoli or yoga as strong as it is is not as strong as chemotherapy or radiotherapy. So I can see why so many of them might want to focus only on that part that they have very strong data about and consider the rest optional or irrelevant.

JD: Where is the safety line between ‘evidence based medicine’ and ‘alternative therapy’?

DSS: When they replace conventional treatment. That’s the number one. Second, when the evidence of benefit is weak and the evidence of harm is strong. Some treatments might expose you to some dangers, like Chinese herbal treatments with herbs that may be contaminated. I would be careful about that. The evidence for benefit is not that strong, yet there’s been evidence of harm. If you’re going to pursue that, some people have greatly benefited, make sure that the provider has highly reputable. The other way in which it can hurt is that it’s very expensive for very little proof of benefit, it will you’ll feel despair if you blow all your money in a useless treatment.

JD: You’re a professor of psychiatry. Is the failure to meet basic psychological needs for ‘physical’ ailments part of what’s harming US medical care? Is the lack of empathy and lack of interactivity part of what’s turning people away from traditional medicine, even before they’ve exhausted the standard options as you did first?  You’ve mentioned a switch towards more ‘daily empathy’ after your diagnosis, and the effect it had on your patients.  How should we change how we train doctors or what we prioritize?

DSS: Obviously I believe that better training in understanding patients, and empathy, the key thing is when physicians hear those words they cringe because it means more time. But that’s really not the issue. I used to train internists and family doctors and interview techniques.  The key issue is people to feel you understand their needs. Once you feel they’ve understood their concerns, they’ll do anything for you.

JD: Do you think American culture is disproportionately exposing Americans to cancer?  Do international statistics validate that?  Is there any correlation between local diets and the particular types of cancer found?

DSS: No question, this is what scientific data shows. Every single place where American diet has spread has seen massive increases in obesity rates and a few years down the line in cancer rates. One of the disasters in Japan is increasing consumption of red meat and dairy products were seeing an enormous increase in obesity. It almost didn’t exist in Japan. Great increases in cancer that were extremely rare, prostate cancer in men and breast cancer in women. Same thing happening in china now. In Mexico, in the early 80s, 10% of Mexicans were overweight. 15 years later, after the introduction of American diet, to large areas of Mexico, rate went up to 70%.  Again it’s not what I think, It’s what the data show.

JD: “I learned that my choices, every day, could give meaning to my life, or detract from it.” Those types of expressions are found in religions like Buddhism.  What role does faith play in recovery?

DSS: You can assign that meaning to it or not. Giving meaning to your life is independent of religious belief; it’s about your own values. You’re aligning your life more tightly with your own values. It’s not a matter of religion.

If your values come from faith it will take on a religious aspect. What gives you more of a sense of doing what you’re meant to do every day.

JD: Who would you be today if he hadn’t gotten cancer?

DSS: It’s a scary thought! It’s hard to know. I don’t want to misjudge the young man I was. Maybe he would have wisened up anyway. There’s no question that it’s the challenges in our life, divorce, the loss of a child that makes us grow internally. I would have had other challenges, I don’t know. The danger would be for me to relate to arrogant and ambitious scientific researcher who would not have connected with the humanity of others and the growth I was able to derive from that.

JD: Have you said that cell phones will be the new cigarettes?

DSS: I didn’t say exactly that. The book’s publicist likes me to say that but I don’t. There’s a danger it might and we need to do more research in that area. The current evidence is concerning. To put it very briefly, the vast majority of studies that have looked at a link between cell phones and cancer did not find one. But the vast majority looked at a period of cell phone use for less than 5 years. If you had people smoke a pack of cigs a day for 5 years you would not see a link for lung cancer. And a few studies have looked at more then 10 years of cell phone use have found roughly a doubling of brain tumors on the side of cell phone use. So there’s serious concern because you would not even see that with cigarettes, it takes 15 to 30 years for lung cancer to develop.  I’m saying there’s legitimate concern and we need to invest massively in doing the right search which is not very hard to do. The only reason it’s not done is for the protection of commercial interests. Which I think that’s misplaced because the best interest protection of commercial interests is to find out. If theirs is no problem, then great. I would love nothing more than for cell phones not to be a problem. I love my cell phone like everybody else. If there is a problem, then I think it’s the best commercial investment to find out early, so that companies who will do that will develop greater trust from their customers. They will be the first do develop devices that will reduce negative health effects.

JD: What question should I have asked that I didn’t ask?

DSS: I ask that as a physician too. Sometimes they give you the pearl of the whole interview, plus they feel like you’ve listened to them better.

Maybe I should say one thing.

The core of my message is the concern one might have is that it gives people false hope. I understand that concern. I am a physician. I don’t like to give people false hope. But what my book is about is scientific evidence that there are many things you can do in addition to conventional treatments that will help with prevention of cancer or doing better with treatment if you have one. When we do not share that with people, then we’re giving them false hopelessness. I think that is unacceptable.