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Short ver­sion of this interview

Super­short ver­sion of this interview

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 2^nd 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.