Wednesday, July 18, 2007

Additional thoughts about the WHEL Study results

This posting contains some of my initial additional thoughts in regards to the WHEL Study results (see my earlier 7/18 posting, too).

I have been waiting for these results almost since the inception of the study. It has been a long wait, and I am grateful beyond words that I am still here to comment on the outcomes. Did I expect different results? Did I hope for different results? Simple as can be, yes and yes. I do not know yet how the media will handle these results, and subsequently how the cancer survivor community and general public will react. However, I will repeat myself here (and if I knew how to bold my font I would do it here, too) - this is NOT the time to throw the baby out with the bathwater.

I want to enlighten or remind everyone of the original definitions of the word "diet":
(1) A way of life
(2) A day's journey

These are the images I keep in mind in contrast to what I hear or read about the constant obsession Americans have with the "diets" they continually seek out to lose weight. In fact, I believe the collective societal definition for the word diet these days has unfortunately evolved to become synonymous with "disordered eating".

As a Registered Dietitian who is a survivor of the childhood cancer neuroblastoma and has had two separate primary breast cancer diagnoses in 1984 and 1995, I made the simple decision after my most recent breast cancer diagnosis to seek a diet and lifestyle that would optimize my odds for long-term recovery and also increase my quality of life. (It has actually been a lifetime journey with even more focus after my 1995 diagnosis.) At that point, I sought out the best advice available at the time about what was known and what was not known about diet, lifestyle, and cancer survivorship from many researchers, including my friend and colleague Cheryl Rock, PhD, RD, the co-principle investigator on the WHEL Study, as the basis for what I have chosen to do these past 12 years to optimize my odds for long-term survival and enhanced quality of life.

By all accounts, I have been successful. So much so, that my oncologist (who knows I have been speaking around the country during this time) actually shyly asked me a few years ago if I gave him any credit for my success during my speaking engagements. I always tell my audience that I am not a research study, but a "case study" of n=1, an individual, a single data point. Thus I know full well that the complete answer(s) to why I survived this long (with 9+axillary nodes and positive deep inner-mammary nodes behind the sterum also) will never be known. However, my answer to him was that I tell audiences I am very likely successful because I have combined the best of all treatments, meaning conventional medicine and all the self-help strategies in the area of complementary medicine (CAM) for which there were clues pointing to potential benefit plus strategies that made sense to me, or somehow resonated with my soul, even before much research had been started, let alone completed in this wide open field of CAM.

I have had the high honor of being invited to speak to the American Society of Breast Surgeons' annual meeting both in 2005 and again this year in 2007. I would like to share what I thought was the most helpful information I gave the surgeons. It was a handout I developed for them to duplicate for their patients that addresses the quandries and questions cancer survivors often ask themselves (and seek advice about from their health professionals). It gets at both the root and the big picture of why I am not (too) distressed about the results of the WHEL study. Optimizing life after cancer is much, much more than just 'diet' in terms of what we eat; it truly is a day's journey, a way of life.

Here is what I gave them to give to their patients who are asking "How can I help myself?":

Lifestyle Changes for Achieving Wholeness and Wellness after Breast Cancer

By Diana Dyer, MS, RD - Author, A Dietitian's Cancer Story

The following suggestions have been learned through my personal experiences and put into the acronym “Help Myself”. However, they are not all inclusive nor in any particular order. I invite you to use some of them as a starting point to find your own unique recovery path to wholeness and wellness after your cancer diagnosis when you are ready to ask the question “What can I do now to help myself?”

H – Help someone or some cause (i.e., do something that adds meaning to your life)
E – Exercise daily doing something you love to do (move more!)
L – Learn to enjoy new whole foods (not processed foods or “junk”) and new recipes
P – Plant a garden (even a small one) to increase your intake of plants plus exercise

M – Meditate or learn some other form of stress management
Y – Yield gently to the changes in life. Although some are frightening, many can open doors to newfound opportunities, health, and wellness
S – Size down the portions of most foods
E – Enjoy more water and green tea
L – Lose weight (if needed) very gradually
F – Find a Registered Dietitian (RD) to be an advisor and cheerleader for recovery


Combining such actions with the best conventional cancer treatment options that were available for me is what I have done, promoted, and called "active hope" for the past 12+ years. There are no guarantees in life at all, plus I recognize that there is more than one path to the mountain top, but doing all of the above has been my best shot for the best possible outcome(s) and has finally led to peace with my 57 years of a cancer survivorship journey.

To cancer survivors everywhere, I continue to send you all my best wishes for health, healing, and "active hope",

Diana Dyer, MS, RD


Anonymous said...

Diana, thanks for two informative posts on the results of this study.

I write about Alzheimer's and dementia research at The Tangled Neuron (, and often am baffled by the conflict between evidence from trials like this and anecdotal evidence. It seems that diet and lifestyle measures that work for one person (a case study of n=1 as you put it) or a small group of people are not supported by clinical research.

The persons with dementia I know who are doing well have adopted many of the lifestyle changes you suggest. Perhaps the combination of these measures brings about subtle and/or complex changes that are difficult to measure in a clinical study.

I'd be interested to hear any more thoughts you and your readers might have about what weight you give results of clinical studies when making personal health decisions.

Anonymous said...

I can't help but wonder if what KINDS of fruits and vegetables have something to do with it. I hear time and time again from people "I don't like cabbage, brussell sprouts, etc" but "I DO like corn, etc" the later being not as nutritious as the prior. I do your diet, exercise etc EVERY day (except 1 day a week I have "treat" day and even then it may be a homemade pie etc) and so many people tell me they couldn't do the diet (also eat EVERYTHING on the diet and rotate it and or buy seasonally). Thoughts or comments?