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On the Walking Path to Survival The mind-body connection leads one breast cancer survivor to race her way to better health 
Award-winning journalist Carolyn Scott Kortge was 58-years-old when, sitting alone in the sauna after a workout at her athletic club in Eugene, Ore., she decided to perform a routine breast exam. Kortge discovered a small, hard lump in her left breast and, that day, scheduled an appointment with her doctor. He was concerned enough to order an immediate lumpectomy. At 5 a.m. the next day, two hours before her surgery, she took an hour-long walk and focused on her breathing, repeating silent mantras like "I'm strong," "I'm calm," and "I'm well." It was an active meditation technique Kortge herself had previously extolled in her book "The Spirited Walker: Fitness Walking for Clarity, Balance, and Spiritual Connection" (HarperOne, 1998), inspired by her experiences as a competitive Masters racewalker. "The years I spent competing taught me how the mind and body work together," Kortge says. "Of course I was frightened that morning, but I knew that exercise would also help me to be more present, trusting and receptive." She also thought that a lumpectomy was the final solution - the doctors would cut it out and her problem would be gone. But on April 17, 2000, she received her diagnosis: Stage II breast cancer that had metastasized to the lymph nodes under her left arm. As a consequence, she would need further treatment, including eight chemotherapy treatments and six weeks of radiation. Kortge was crushed, confused and terrified. "It took me a little while to believe the diagnosis was real," she says. Over the next three days, she walked a lot in her favorite spots and finally came to the realization that by writing "The Spirited Walker," it was almost as if she'd created a guide for herself on how to make it through her cancer experience: Keep your feet on the ground, take one step at a time and keep moving forward. Kortge did exactly that, walking every single day throughout her treatment, even if it was just one mile. In addition, she modified her already healthy diet the best she could to support treatment, including limiting red meat and saturated fat, giving up her beloved wine and cutting out all soy products. Thanks to her good health, Kortge's oncologist was able to give her the type of aggressive chemotherapy that they would normally give to younger people, and she never needed the expensive drugs to boost her white blood cell count. "I got so much weaker during treatment,"Kortge says. "But at least I started from a really strong position." According to the American Cancer Society, there was an estimated 1,437,180 new cases of all types of cancer (excluding basal and squamous skin cancer) in 2008, resulting in an estimated 565,650 deaths. For women, the three most common forms of cancer, in order, are breast, lung and colorectal; for men, the three most common are prostate, lung and colorectal. For all types of cancer, the most important risk factor is genetics - nothing outweighs that, says Luis A. Diaz, MD, Assistant Professor of Oncology at the Ludwig Center for Cancer Genetics and Therapeutics at Johns Hopkins, Baltimore, Md. When it comes to poor nutrition and a sedentary lifestyle, it's more difficult to verify the correlation. But, says Diaz, it does appear that people who don't exercise and have a high-fat diet and a high BMI are more at risk for developing certain types of cancer, specifically those related to the industrialized world, such as pancreatic, colon, esophageal, gastric and prostate. And while breast cancer is hormonal in origin, some studies have shown that obesity increases the risk of developing the disease in post-menopausal women, and other lifestyle-links are currently under intense scrutiny. Regardless, eating well, moving more and maintaining an appropriate weight are certainly a step in the right direction when thinking about cancer prevention. "But there's no one thing you can eat that will 100 percent prevent you from getting cancer," says Dee Sandquist, MS, RD, a Spokesperson for the American Dietetic Association. "So the goal is to look at one's total diet." Sandquist recommends following the USDA Dietary Guidelines, including at least nine servings of fruits and vegetables a day. Along with whole grains, produce is great source of fiber, both soluble and insoluble, which may help reduce risk of colon cancer by absorbing inflammation-causing preservatives as it passes through the colon and reducing the amount of time fecal matter spends in the GI tract. Also eat beans and legumes, low-fat dairy and good fats from sources like olive oil, canola oil, avocado, nuts and seeds. In addition, she advises minimizing consumption of red meat, saturated fat, salt, alcohol and charred foods, as the cooking process can produce heterocyclic amines, a known carcinogen. And there's another food item that continues to be controversial, especially as it concerns the prevention of breast cancer. Some theories suggest that the estrogen-like substances (isoflavones) in soy may stimulate the estrogen receptors in breast cancer cells . However, according to James V. Lacey Jr., PhD, a cancer epidemiologist at the National Cancer Institute, Bethesda, Md., recent review articles and meta-analyses suggest that women who consume larger amounts of soy products may be somewhat less likely to develop breast cancer. "Additional studies that are specifically designed to tackle this question are needed before a firm conclusion can be drawn," Lacey says. In the meantime, Sandquist feels that it's safe to consume a serving of soy a day, although she advises against using supplements in the form of powders, tablets and drinks, because it's still unknown if soy isoflavones are safe in such high concentrations. For whole body health, she also recommends at least 30 minutes of exercise, five days a week; but upping it to 45 to 60 minutes may reduce risk of breast and colon cancers. According to Diaz, it's difficult to conduct studies that determine clear links between exercise and cancer because of a myriad of X factors - diet, the patient's initial health, honesty about sticking to the exercise regime, etc. "But my hope and my thought is that it's so," says Diaz, who always proscribes an aggressive exercise regime and healthy diet to his colon cancer patients after chemotherapy. Exercise improves blood flow through tissues, which may remove carcinogens and cause them to be excreted more readily. It also strengthens the immune system so that it's better able to fight off a variety of environmental insults. Kortge credits her commitment to walking for the fact that she is now in her eighth year of remission. She currently walks three or four miles a day, six days a week, lifts weights and is working on a second book called "Healing Walks for Hard Times" (Shambhala, 2010). She has also become a prolific public speaker and teaches numerous workshops on the healing nature of walking at places like California's Golden Door Spa, the Life Beyond Cancer Retreat at Miraval in Arizona and the Willamette Valley Cancer Center in Eugene, Ore., where she herself received treatment. "Some of my acquaintances in the cancer world would say that these opportunities to walk and teach are 'gifts' that I have received from cancer, but this is no gift," Kortge says. "It's an earned benefit. I'm not grateful for cancer, but I'm also not willing to pretend it never happened. Even under Code Orange conditions, there are books to be read, ideas to share, weeds to pull, meals to prepare, trails to hike, people to love. It's good to be alive." |
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