Jenni Russell

The Times

Gerry Gajadharsingh writes:

“I tend to raise my eyebrows when I hear about a patient having had their cancer treated (surgery, radiotherapy, chemotherapy) and then being told to “carry on as normal” by their specialists after treatment, assuming their cancer is in remission. I am sure many of them become fearful of the cancer returning (I would be as well) and some of them want to become more proactive in reducing their risk of the cancer returning or them developing other medical conditions, as this article refers to.

Research is now stacking up that “lifestyle choices” has a major impact on our health and wellbeing. Even if cancer is in remission the risk of other diseases developing is higher as well as a host of other symptoms that affect quality of life, such as fatigue, and neuropathy. It is evident that cancer therapy accelerates the aging process in cells, it is thought through the mechanism of shortening our telomeres, the caps at the end of our chromosomes (our genetic material).

It’s when our telomeres wear down (shorten — as they do naturally with age — our genetic material unravels, gets diseased and dies.

It is now straight forward to measure telomere length, a simple blood test. If yours show a shortening i.e. you are biologically older than your actual chronological age, then perhaps you’ll want to engage in the lifestyle changes that can reduce this process. Or then again maybe you don’t.”

New research on cancer survivors shows that the right diet and exercise can add years to life

It was not the most cheering article I read over Christmas but it was one of the most arresting. Cancer survivors have more than recurrence to worry about. New research shows that they age faster and die younger than their peers even when their disease has been successfully treated.

The consequences go beyond those that many survivors already know: the fatigue that around half experience, or the lasting peripheral nerve damage that affects up to 40 per cent of chemotherapy patients. The new evidence, published last month in one of the BMJ’s journals, came from a survey of more than 1,200 research papers and found that the treatments that save lives also damage people at a physiological level, restricting their bodies’ ability to heal and permanently affecting their health and longevity.

Ex-patients like me are more likely to develop heart and lung disease, osteoporosis, thyroid problems, inflammation, delayed healing, secondary cancers and general frailty, and they do so at younger ages than the general population. The consequences are worst for those who have had childhood cancers. Their life expectancy is 30 per cent lower than the norm.

The researchers want to see much more work done on the long-term side effects of cancer treatments, but the epidemiological evidence is clear; cancer therapies cause accelerated ageing by damaging cells. Chemotherapy and radiation between them hasten cell death and shorten the telomeres, the caps at the end of our chromosomes that protect them from damage. It’s when our telomeres wear down — as they do naturally with age — that our genetic material unravels, gets diseased and dies.

This is unwelcome news to all ex-cancer patients who had no idea that these invisible side effects existed and that we might have a lot less fun to look forward to than we’d hoped. It raises the question that affects everybody, not just those who have been ill: is there anything we can do to slow cell death and reverse telomere decay? Fortunately, the answer is yes, and it goes beyond fasting and green tea.

Elizabeth Blackburn, an American molecular biologist and co-author of The Telomere Effect, won a Nobel prize for her discovery of how telomeres work. The pace of biological ageing varies hugely between individuals. Telomere shortening happens very slowly in some people, so their years of healthy, productive life are long. In others the pace is rapid and disease hits early.

Blackburn and the researchers who followed in her path discovered that our telomeres are directly affected by our levels of stress, social support, exposure to violence, bullying or childhood trauma, our attitudes, diets and exercise habits. She demonstrated the direct biological underpinning of the mind-body connection.

Just 15 minutes’ exercise can buffer the effects of stress on the body

Blackburn found that the mothers of chronically ill children had shortened telomeres. The longer they had been carers, and the more stressed they felt, the shorter those telomeres were. People who were generally pessimistic, angry or frightened had shorter telomeres too. In a study of British civil servants, the most cynical and hostile men were 30 per cent more likely to have short telomeres. The recently divorced had significantly shorter telomeres than the single or long-term married. But some lifestyles and strategies worked in the opposite direction, lengthening telomeres and increasing the supply of telomerase, which maintains them.

Stress does not always affect telomeres negatively; how it is handled does. Care-giving mothers who could cope with their role — perhaps they had enough money or supportive friends — had normal telomeres. In one study the carers of dementia patients who meditated for 12 minutes a day for two months saw their telomerase rise by 43 per cent. The control group, who listened to music, saw theirs rise by just 3 per cent.

Exercise boosts telomeres but 45 minutes of vigorous exertion three times a week is enough. Varying what you do appears to help, though; people who exercise in different ways have longer telomeres. At moments when people are under severe stress, Blackburn says that just 15 minutes of aerobic exercise is enough to buffer the effect on your body.

The importance of Blackburn’s work is to quantify how all the things that we know or feel are good for us have a direct effect on our cells. Close communities, long-term friendships, kindness, relaxation, sex with trusted partners and whole-food diets, particularly a high intake of omega 3, all have measurable and important effects.

There is further powerful evidence of the lifelong effects of following simple rules for health in the Caerphilly study of 2,500 men in the Welsh town, which began in 1979. All participants were given five guidelines: walk two miles or cycle ten, five days a week; maintain a low body weight; eat a healthy diet; avoid smoking; don’t drink to excess.

The good news is that for those who followed all five, the results were impressive. They developed heart disease 12 years later than their peers and dementia six years later, and cut their chances of cancer by two thirds and diabetes by half that. The bad news was that only 25 men, 1 per cent of the total, sustained all five, perhaps because it was hard to see the long-term advantages of discipline.

We know better now. Forty years ago, we didn’t understand clearly how to mitigate the general damage of living and until last month most people were oblivious to the specific damage of cancer treatment; now, for many of us, there is a much greater incentive to try. And it’s not all deprivation. Less cake and brandy, more friends and dancing: here’s to long lives from 2018.