Friday, 14 December 2018

Genuine cause for optimism - Robin Daly

Our founder, Robin Daly, shares his thoughts following ‘Starting the Conversation’, the Yes to Life annual conference…



For well over a decade, Yes to Life has been working to give direct support to people in the UK with cancer who want to know what they can do to help themselves, how they can improve their odds and their wellbeing. This work is central to the charity and it includes operating our helpline of trained volunteers, commissioning thousands of personalised reports to deliver information on good treatment choices, giving small grants to support the purchase of integrative therapies, as well as the broader outreach of workshops and seminars to empower individuals.
Lifestyle Medicine, as it is now called, has come in from the cold. When Yes to Life was first established, any and all approaches outside of the orthodox methods of chemotherapy, radiotherapy and surgery were derided and often met with outright hostility. While this is still sadly true to some extent, a new wave of thinking is emerging within healthcare that places Lifestyle Medicine, and therefore Yes to Life, firmly at the centre of health agendas that are focused around patient choice, patient-centred care and self-management. Fourteen years after Yes to Life’s founding, our mission is beginning to find a wider audience, and our commitment to Integrative Medicine is at last receiving the validation it deserves.
Another important facet of the work of the charity is to drive the agenda for integration forward. Our key vehicle for this is our annual conference, which this year showcased some of the most inspiring examples of new developments in healthcare. Speaker after speaker built the ground for optimism about the future of medicine. By the end of the day, there was simply no escaping the fact that we are at the start of a new era, in which the narrow attitudes within the NHS that we have become so inured to, are at last showing the first signs of losing their ubiquitous hold, as a new generation picks up the banner of Lifestyle Medicine.
In the past, the NHS has maintained its credibility through insularity. Its record for acute care is justifiably high, but the balance in healthcare has swung massively towards the management of chronic conditions. In this, its performance has been lacklustre at best. Up until recently, unsupported statements about ‘the best healthcare system in the world’ were sufficient to win the approval of the masses, but increasingly, as the NHS’ performance has been set on the world stage, its shortcomings have become unavoidable.
The morning sessions of our conference were dedicated to bringing in some international perspective: what is working elsewhere, what can we learn from it? After ‘setting the scene’ for the day, Patricia Peat, Director of our partners Cancer Options, introduced Ashwin Mehta MD who leads the Integrative Medicine department of a large hospitals group in Florida. Amongst many interesting insights and comparisons, Dr Mehta was able to tell us how, simply by having the right professionals on site, readily to hand, a ‘third way’ opens up for ‘at risk’ patients. The ‘black and white’ rigidity that currently exists in the UK where you either ‘do nothing’ (aka ‘watchful waiting’, ‘active surveillance’) or you get treated in ways that are often highly damaging, physically, mentally, socially and in many other ways. It’s a brutal system that operates like an on/off switch, offering many people the choice of too little (the agony of waiting to get a diagnosis of cancer) or too much (prostate cancer treatment for example can often result in incontinence and impotence). Before being thrown into the nightmare of cancer treatment, those seen to be at risk are given the option to avoid or at least contain the development of cancer, by engaging in a range of non-toxic, healthy lifestyle approaches, whilst receiving the assurance of being carefully monitored. This is an enormous step forward that can avert many diagnoses completely, a win for both the public and the healthcare service.
Dr Abdul Slocum, from the ChemoThermia Clinic in Istanbul, gave us his perspective on the logic of adding relatively cheap integrative approaches to standard protocols. The striking results the clinic is achieving with hard to treat cancers are a testament to the validity of this approach, which relies on known techniques that massively undercut the astronomically expensive new products of the pharmaceutical industry, whilst challenging their best achievements.
The afternoon sessions were entirely focused on some of the most exciting developments and initiatives by individuals, organisations and the government, to overhaul our healthcare. Student doctors Ally Jaffee and Iain Broadley, dismayed by the lack of nutrition and lifestyle content in their training, set up Nutritank to remedy the situation. It has taken hold right across the UK, clearly meeting a much broader dissatisfaction with the direction of medicine. Their enthusiastic endorsement of Lifestyle Medicine brought spontaneous applause from our delighted audience, who have long been used to a tragic lack of support from the medical world for their lifestyle successes. 
Dr Marie Polley of Westminster University, a powerhouse for change and Chair of the Social Prescribing Network, spelled out the rapid development and take-up of Social Prescribing, and what this means to people on the ground: how it is creating genuinely helpful lifestyle options for the 20% of doctor visits for which the only resource previously available has been the completely unsuitable option of medication with drugs. 
In tandem with Social Prescribing, I was delighted to be able to present the very significant news concerning the evolution of Personal Health Budgets. It has been a very long time coming, but PHBs represent one of the first manifestations of genuine choice and patient-centred care. Through a jointly agreed budget, patients with long-term conditions get the freedom to spend in a way that generates the most benefit for them, and PHBs are already proving their merit both for patients and by reducing costs.
The event reached a high-energy conclusion as our inspired final presenter, Jon Liebling, spoke about the recent change in the law concerning cannabis as a medicine that he and the United Patients Alliance had worked so hard for, as well as their plans to move the agenda much further in the coming months.
Up until recently, the biggest drive for change towards integration came from the public and campaigning groups such as Yes to Life. This movement is now starting to meet the most forward-looking elements within our NHS in a shared vision for a future in which healthcare looks very different, a future in which much more than lip service is given to patient choice and patient-centred care. The coming year will see Yes to Life ramping up the pressure for change as well as building on the foundations already established for collaboration with other campaigners, with health professionals from all sectors, and with the NHS. It is truly heartening that we are beginning at last to see the fruits of our efforts to modernise healthcare, but this is no time for complacency - rather it’s the time to ‘step on the gas’.

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Friday, 7 December 2018

Review of the Yes to Life annual conference 2018 - Gill Smith

This week Gill Smith, author and blogger of Because You Can, shares her review of our annual conference which took place on 1st December…

I over-reached myself last Saturday to attend the Yes to Life annual conference 'Starting the conversation - Exploring the potential of Integrative Medicine' in London. I was utterly exhausted, but glad I went.
As their website says, Yes to Life empowers people with cancer to make informed decisions about their cancer care options. We provide information to guide people through the confusing options for care and lifestyle choices.
They don’t recommend foregoing NHS treatment and drug regimes, but want to increase knowledge of what complementary tests, treatments and supplements are available which may make conditions harder for cancer cells to thrive. This is very close to my heart as I soon realised that as a Stage 4 patient the NHS protocols were only expected to keep me alive for a very limited period. 
While there are many excellent books, charities and other organisations imparting this knowledge my frustration is that they seem to plough their own furrows rather than working collaboratively to bring greater awareness into public knowledge and trying to affect medical opinion. It is hard for cancer patients to get the knowledge they need, and complementary therapies are certainly not endorsed by GPs and oncologists and often their use is discouraged.
Other advanced countries take a different view and have better survival rates than the UK.
The Yes to Life conference brought several different perspectives into the room.
The morning session was chaired by Patricia Peat, Founder of Cancer Options and whose book The Cancer Revolution provides information about treatments and therapies available in the UK and around the world. 

Dr Ashwin Mehta updated us on developments in the US in integrative medicine, and the work of the Society for Integrative Oncology. From a country where doctors are financially incentivised to refer patients for chemotherapy, and “heads in beds” is seen as a healthy bottom line, this was welcome news.

Dr Abdul Slocum of the Chemo Thermia Oncology Centre www.chemothermia.comin Istanbul told us about the results they obtain with their combination of therapies. They use Metabolically Supported Chemotherapy which means they can use lower doses of chemotherapy to improve treatment results and reduce side effects. Additionally, they use other treatments tailored to the patient’s metabolism, including hyperthermia, hyperbaric oxygen therapy, off-label drugs and supplements and diet. Dr Slocum showed many examples of patients they had treated successfully. For anyone with cancer who has the financial resources and can travel to Istanbul this would be worth looking into.

The afternoon session focused on developments in the UK.
Ally Jaffee and Iain Broadley were so shocked at the tiny amount of nutrition and lifestyle education on the syllabus of medical schools that they were motivated to found Nutritank, www.nutritank.coman information and innovation hub for food, nutrition and lifestyle. They work at grassroots and interprofessional levels. There are currently over 15 Nutritank Societies in medical schools increasing the knowledge of nutrition and lifestyle amongst medical students, the student population and the wider community, and increasingly in schools. 

Dr Marie Polley told us exactly what Social Prescribing is, and progress being made to enable GPs and other frontline healthcare professionals to refer to a local link worker who can make referrals to support organisations, often in the voluntary and social sectors. https://www.socialprescribingnetwork.com/

One of the themes for the day running through several presentations was meeting the patient where they are, often using motivational interviewing, so that they can devise a treatment plan which will work for their individual needs.
Robin Daly’s session on developments in Personal Health Budgets showed an example of how this can work in practice for people with continuing healthcare needs. https://www.nhs.uk/using-the-nhs/help-with-health-costs/what-is-a-personal-health-budget/

The final presentation was from the very lively Jonathan Liebling. Political director of the United Patients Alliancehttps://www.upalliance.org/. Deliberately not using the c word (cannabis) in its title, the Alliance advocates for medical cannabis to be legal, and works closely with the Centre for Medical Cannabis https://thecmcuk.org/. Jonathan claims that there are currently 1.1m medical cannabis users in the UK, and that GPs on the frontline are supportive but can’t say so. With the increased prominence of the issue and the recent legalisation of medical cannabis he says that influential people now come to him, where previously he had been rejected. Jonathan was understandably very upbeat about recent changes, but it seems to me that progress towards patients actually being able to access medical cannabis is disappointingly slow and it is unclear when or if it will be licensed for use by cancer patients. But encouragingly Jonathan seems to have the ear of the right people.

Another theme for the day was that our health service needs to be more about health than treatment. In cancer that means the focus should be on healing the person, not just killing the cancer. This conference gave me hope that progress is at last being made towards this happening.

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You can purchase a copy of Gill’s book here.