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Diet, Lifestyle, Bodywork, Vipassana and Research Protocols for Basal Cell Carcinoma and Squamous Cell Skin Carcinoma

Douglas Benson, 2016 AHN Graduate

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Diet, Lifestyle, Bodywork, Vipassana and Research Protocols for Basal Cell Carcinoma and Squamous Cell Skin Carcinoma

Basal Cell Carcinoma (Definition by Mayo Clinic Staff): Basal cell carcinoma is a type of skin cancer. Basal cell carcinoma begins in the basal cells — a type of cell within the skin that produces new skin cells as old ones die off.

Basal cell carcinoma often appears as a waxy bump, though it can take other forms. Basal cell carcinoma occurs most often on areas of the skin that are often exposed to the sun, such as your face and neck.

It is thought that long-term exposure to ultraviolet (“UV”) radiation from sunlight is the cause of most basal cell carcinoma. Avoiding the sun and using sunscreen may help protect against basal cell carcinoma. (See Appendix A for information on prevention of basal cell carcinoma).

Squamous Cell Skin Carcinomas (Definition by Mayo Clinic Staff): Squamous cell carcinoma of the skin is a common form of skin cancer that develops in the squamous cells that make up the middle and outer layer of the skin.

Squamous cell carcinoma of the skin is usually not life threatening, though it can be aggressive in some cases. Untreated, squamous cell carcinoma of the skin can grow large or spread to other parts of your body, causing serious complications.

Most squamous cell carcinomas of the skin result from prolonged exposure to UV radiation, either from sunlight or from tanning beds or lamps. Avoiding UV light helps reduce your risk of squamous cell carcinoma of the skin and other forms of skin cancer.

Squamous cells are found in many places in your body and squamous cell carcinoma can occur anywhere squamous cells are found. Squamous cell carcinoma of the skin refers to cancer that forms in the squamous cells found in the skin. (See Appendix B for information on causes, risk factors and complications of squamous cell skin carcinoma).

Personal Background: Skin cancer is a personal issue for me. I was diagnosed with my first basal cell in my mid-twenties and thirty years later I have had over five dozen surgeries to remove basal cells and squamous cells and I have had dozens of rounds of topical chemotherapy (which has prevented the need for countless additional surgeries). Fortunately the surgery techniques have improved and the topical chemotherapy products available today require days instead of weeks of treatment. More importantly, today the general public has much better information available as to what can and should be done to protect oneself from damage from UV radiation from sunlight to prevent much of the incidence of basal cell carcinoma and squamous cell skin carcinoma. A number of years ago I was undergoing multiple surgeries per year. The last few years I have had no new carcinoma removed. I attribute this to multiple factors all of which are outlined below.

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I left the workforce in 2008 suffering from mental illness, addiction, major depression, severe anxiety, ADHD, OCD and PTSD. The truth was I had been sick for many years but like many people suffering the effects of trauma I buried it so deep that I was unaware that it had ever occurred. It took a lot of effort before I would even begin to acknowledge the years of trauma and what I felt were my innate defects that caused so much shame and led to so much suffering and addiction. Why is this relevant to a paper on skin cancer? Because PTSD, years of stress and a body living on high alert drains the immune system and that is why my Natural Killer Cells showed almost no activity. I was highly susceptible to cancer. After I left work, I spent the next two years in and out of psychiatric hospitals and rehabilitation facilities, always checking myself in at my own request. I wanted desperately to find wellness. I eventually did with a lot of effort.

Diet: After I found sobriety, I worked on changing every aspect of my life, searching for ways to build strength in all three legs of the stool—the mental, spiritual and physical. What I put into my body on a daily basis, food and drink, seemed key so I really focused on my diet. As a result, my diet had undergone a dramatic change over a number of years prior to my enrolling at the Academy of Healing Nutrition (enrolled 2015-2016). After returning home from my various treatment centers, I changed nearly everything about my life including how I thought about, approached, purchased and prepared food.

Today I purchase mostly whole ingredients and I make/prepare most of what I eat myself. It is so much easier to know what is going into your body this way. I eat most everything but I am very careful as to sourcing. Almost all of my meat and dairy comes from Amish farmers who pasture their animals and use no antibiotics or hormones. I ferment most of my dairy products (make my own yogurt and kefir). I eat meat but in small portions. I make bone stocks regularly (from bones of the animals whose meat I would eat—same for fish stock). I eat wild caught fish regularly (never farm raised). I limit my fruits (high in sugar) and try to eat organic fruits and vegetables. I do not limit my fats but make sure they come from healthy sources (same as for the bones for bone stock above). I am cautious about my intake of refined carbohydrates, especially sugar. I try to avoid corn syrup altogether. Elevated blood sugar stirs up inflammation in the body. A benefit of this lifestyle change is that I have lost over 60 pounds since 2011.

Two excellent books on the benefits of low carbohydrate/high fat diets (benefits include: (1) reduced inflammation throughout the body; (2) reduced risk of diabetes; and (3) increased brain health with corresponding reduced risk of dementia, Alzheimer’s and strokes; amongst others) are Grain Brain and Brain Maker, both by David Perlmutter, M.D.

David Perlmutter, in the books cited above, lists a number of inflammation markers that can be checked as indicators as to the level of inflammation in one’s system. The following markers are all cytokines: C-reactive protein (CRP), interleukin six (IL-6), and tumor necrosis factor alpha (TNF-a). I had my levels checked related to all three of these cytokines and they were negligible. My blood sugar levels were also very low. This indicates very low inflammation in my body.

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Supplementation: I first focus on supplementation as it relates to brain health. My family history has dementia, Alzheimer’s and strokes on both sides of the family. I want to do my best to avoid that for myself if that is in my control. Given the dramatic increases in these diseases in our society, I would want to bring this awareness to all of my clients. David Perlmutter in his book Brain Maker makes the case that he believes much of dementia and Alzheimer’s is avoidable through lifestyle changes including diet. He is a neurologist and nutritionist by training. He recommends the following daily supplements:

Probiotics 1 capsule taken on an empty stomach up to three times daily; look for a probiotic that contains 10-50 billion active cultures/capsule from at least ten different strains, including Lactobacillus acidophilus and bifidobacterium

Docosahexaenoic acid (DHA) 1,000 mg daily

Turmeric 500 mg twice daily

Coconut oil 2 tsp daily

Alpha-lipoic acid 600 mg daily

Vitamin D Recommends consult with your doctor on dosage. Generally suggests starting at 5,000 IU of vitamin D3 daily

Vitamin E 2,000 IU of vitamin E daily

Resveratrol 100 mg twice daily

In addition to the above supplements, I take two supplements specifically related to my skin both of which my dermatologist recommends. They are:

• Source Naturals’ Niacinamide B-3 1,500 mg #100 tablets

Niacinamide B-3: I provided my dermatologist with a research article from the Australasian Journal of Dermatology (2014) 55, 169-175, Nicotinamide and the skin by Andrew C Chen and Diona L Damian that outlined the benefits of taking daily doses orally at 500 mg or 1500 mg and topically at 5% concentration. On my next visit Niacinamide was for sale at the checkout counter and it was being recommended to patients with a history of basal cell carcinoma and squamous cell carcinoma. There is also considerable evidence to show that it benefits against non-cancerous changes due to aging.

• Ferndale Healthcare’s Heliocare #60 capsules

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Heliocare: a supplement derived from the rhizomes of a Central American fern, polypodium leucotomos. Medicine from the plant’s rhizomes is used to prevent certain skin problems including sunburn, eczema, psoriasis, vitiligo and skin cancer. It is also used for other cancers and Alzheimer’s disease. It is believed that polypodium leucotomos might have antioxidant effects. Antioxidants might prevent damage caused by excessive sun exposure. (From WebMD).

Direct Sun Protection: I have taken direct measures to protect myself from UV radiation from sunlight since my mid-twenties. I grew up on the water, belonging to a swim and racquet club, living on a lake (swimming, sailing, waterskiing, kayaking) and spending summers at the ocean. The damage from the sun was done by my early twenties. I had white blonde hair and blue eyes (Swedish descent)—the perfect prescription for skin cancer and cataracts.

For the past 30 years I have tried to remain out of the sun except for my direct time in the water (and I try not to be in the water when the sun is at it’s strongest during the day). I do my best to walk on the shady side of the street, to always wear a hat and to have as much of my skin covered as possible. UV protection is offered not only in eyewear today but also in clothing lines. I also make it a point to put on sunscreen every morning all year long. I make sure to cover the tops of my ears and inside the ears, two areas that are often missed and where many carcinoma are found. Two other areas that are often neglected and where many skin cancers are found are the back of the neck and the front of the upper chest where an open shirt often exposes skin. A very good habit is to every morning put protection over the entire face, scalp, ears, neck and upper chest as well as the arms and back of hands/arms to the extent they will be exposed. If the feet will be exposed they should always be treated. The skin on the feet is very thin and the feet and below the nail beds are vulnerable areas. Make sure your sun screen has not expired.

Dermatologist Recommended Brands of Sun Screen:

Elta MD Skincare UV Physical Broad-Spectrum SPF 41

Neutrogena Ultra Sheer Broad Spectrum SPF 45

Natural Killer Cell (not to be confused with Natural Killer T Cell or T Cell): A cell that can react against and destroy another cell without prior sensitization to it. Natural Killer (“NK”) cells are part of our first line of defense against cancer cells and virus-infected cells. NK cells are small lymphocytes that originate in the bone marrow and develop without the influence of the thymus. An NK cell attaches to a target cell, releases chemicals that breach its cell wall, and causes it to lyse (break up). (Definition from MedicineNet.com).

The blood test performed to evaluate NK cells analyzes activity and normal is considered between 7-125 LU30, with decreased activity < 7 LU30. The first time my blood was analyzed I barely registered activity. There was no overtly normal explanation to explain

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this (e.g., I do not have HIV which could help explain a low number). I believe the reason for the low number is years of PTSD and PTSD related stress. I believe my system has been on high alert for most of my life and it is just worn out. I have been working to address this overall stress response a number of different ways and will cover that next. To directly address the low NK cells I have been working with my New York Osteopath, John H. Juhl (www.drjuhl.com). He has compiled a list of Natural Killer Cell Activity Stimulators that I have included as Appendix A. I have personally tried three of the items listed in Appendix C and have moved my NK cell activity number significantly.

Note that these products have much in common with Ron Teeguarden’s Dragon Herbs Reishi Tinctures although Ron’s tinctures have not been evaluated specifically for their effect on NK cell activity. Antler-Shaped Reishi Drops are thought to be most supportive for the immune system because the Antler-Shaped Reishi is considered a potent immune-supportive form of Ganoderma for its powerful antioxidant and free radical scavenging properties.

Naltrexone and Low Dose Naltrexone (“LDN”) (from www.lowdosenaltrexone.org): Naltrexone was approved by the FDA in 1984 in a 50mg dose for the purpose of helping heroin or opium addicts, by blocking the effect of such drugs. By blocking opioid receptors, naltrexone also blocks the reception of the opioid hormones that our brain and adrenal glands produce: beta-endorphin and metenkephalin. Many body tissues have receptors for these endorphins and enkephalins, including virtually every cell of the body’s immune system. In 1985, Bernard Bihari, MD, a physician with a clinical practice in New York City, discovered the effects of a much smaller dose of naltrexone (approximately 3mg once a day) on the body’s immune system. He found that this low dose, taken at bedtime, was able to enhance a patient’s response to infection by HIV, the virus that causes AIDS. [Note: Subsequently, the optimal adult dosage of LDN has been found to be 4.5mg.] In the mid-1990’s, Dr. Bihari found that patients in his practice with cancer (such as lymphoma or pancreatic cancer) could benefit, in some cases dramatically, from LDN. In addition, people who had an autoimmune disease (such as lupus) often showed prompt control of disease activity while taking LDN.

How Does LDN Work? (From www.lowdosenaltrexone.org): Up to the present time, the question of “What controls the immune system?” has not been present in the curricula of medical colleges and the issue has not formed a part of the received wisdom of practicing physicians. Nonetheless, a body of research over the past two decades has pointed repeatedly to one’s own endorphin secretions (our internal opioids) as playing the central role in the beneficial orchestration of the immune system, and recognition of the facts is growing.

Witness these statements from a review article of medical progress in the November 13, 2003 issue of the prestigious New England Journal of Medicine: “Opioid-Induced Immune Modulation: .... Preclinical evidence indicates overwhelmingly that opioids alter the development, differentiation, and function of immune cells, and that both innate and

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adaptive systems are affected. Bone marrow progenitor cells, macrophages, natural killer cells, immature thymocytes and T cells, and B cells are all involved. The relatively recent identification of opioid-related receptors on immune cells makes it even more likely that opioids have direct effects on the immune system.” The brief blockade of opioid receptors between 2 a.m. and 4 a.m. that is caused by taking LDN at bedtime each night is believed to produce a prolonged up-regulation of vital elements of the immune system by causing an increase in endorphin and enkephalin production. Normal volunteers who have taken LDN in this fashion have been found to have much higher levels of beta-endorphins circulating in their blood in the following days. Animal research by I. Zagon, PhD, and his colleagues has shown a marked increase in metenkephalin levels as well. Bihari says that his patients with HIV/AIDS who regularly took LDN before the availability of HAART were generally spared any deterioration of their important helper T cells (CD4+). In human cancer, research by Zagon over many years has demonstrated inhibition of a number of different human tumors in laboratory studies by using endorphins and LDN. It is suggested that the increased endorphin and enkephalin levels, induced by LDN, work directly on the tumors’ opioid receptors — and, perhaps, induce cancer cell death (apoptosis). In addition, it is believed that they act to increase natural killer cells and other healthy immune defenses against cancer. In general, in people with diseases that are partially or largely triggered by a deficiency of endorphins (including cancer and autoimmune diseases), or are accelerated by a deficiency of endorphins (such as HIV/AIDS), restoration of the body’s normal production of endorphins is the major therapeutic action of LDN.

I have been taking LDN for just over 3 months now and my NK cell activity has increased further than it has under any of the prior protocols (detailed in Appendix A) that I had tried. I believe everyone is different and different things work for different folks so it is worth listing all of these protocols as any one might prove helpful to a particular person. Also LDN is a pharmaceutical and requires a prescription. Note that LDN is less expensive by far than many of the other options in Appendix A and it also is potentially beneficial for a host of other diseases (as are the other options but LDN has the most research performed on outcomes). See Appendix D for a list of other diseases for which Bernard Bihari, MD, as well as other physicians and researchers, recommend LDN.

Traditional Chinese Medicine (“TCM”): Some TCM practitioners believe that cancer of the skin is a result of too much heat inside the body. They believe that the cancer that develops on the skin is a result of the body attempting to disperse internal heat. This makes sense in my case as I have been told many times that I am overheated internally. This diagnosis opens up multiple channels for treatment.

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Cooling Foods: One can seek out foods that are energetically cooling, assuming there are not other reasons why they should be avoided. Some foods that are energetically cooling and clear heat include: asparagus, carrot, celery, cucumber, eggplant, wheat gluten/seitan, kelp, lettuce, lotus root and wheat (list derived from Academy of Healing Nutrition Food Energetics Chart).

Cooling Supplements:

Ron Teeguarden’s Cellular Detox Support: This is a superb detoxification formulation and has excellent skin clearing effects. It disperses wind-heat, improves physical condition, detoxifies the liver and cools blood.

Ron Teeguarden’s Virugo Max: This is an extremely effective combination known to clear heat that supports the defensive Qi of our immune system. Virugo Max is a raw, plant-based, balanced formula that helps to quickly restore respiratory balance and health. Highly active ingredients such as Isatis root, Turmeric tuber and Anemarrhena rhizome are extracted using Dragon Herbs’ exclusive FITT cold water technology for maximum efficacy, multiple immune functions and optimal benefit.

Cooling Treatments: Acupuncturists can clear heat by placing needles at junctures to release heat.

Exercise and Physical Relaxation Work:

Exercise: I gradually built up an exercise program after gaining my sobriety. I began by daily walking increasing the distance and speed until I was walking 5 miles per day in under an hour. I then began to study a couple of different forms of internal martial arts, Iyengar yoga and Pilates. Today I am mostly focused on Gyrotonics two to three times per week and walking on the days I do not have Gyrotonics.

Physical Relaxation Work: Since 2011 I have been receiving acupuncture at least once every other week. I have been in physical therapy at least once per week (sometimes 2-3 times per week) for the last five years. For the last two years I have been treated every two weeks by a Maui osteopath and every four weeks by a New York osteopath. Note that all of my providers perform craniosacral therapy. While these providers may have had specific issues they were focusing on each session, an overall theme of all of these modalities over the long term has been to calm down my central nervous system. The thought has been that by calming down the central nervous system and releasing the trauma held at the cellular level through hands-on compassionate bodywork, the immune system can regain traction and start to function more normally as well as the rest of the systems within my body. My core team of practitioners are:

Marshall Wood, Acupuncturist movelikedragon2002@yahoo.com (917) 609-5592

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Elliot Fishbein, PT, OCS, CFMT, (212) 463-8338, (917) 846-7210 FAAOMPT

Melanie Seeley, PT (808) 463-4663 Dr. Eve Berman mothershands@ymail.com

(808) 573-1677 John H. Juhl, D.O. www.drjuhl.com

(212) 344-5361, (845) 358-4000

Psychiatric and Psychological Counseling: I have been under the care of a psychiatrist since 2009. Since 2009 I have also periodically been in group therapy and seen psychologists and therapists. I have done extensive work with Eye Movement Desensitization and Reprocessing (“EMDR”) and with Somatic Experiencing (“SE”), both techniques proven effective for the treatment of trauma. EMDR is very effective in lessening the intensity and duration of thoughts relating to past traumas. SE is based on the understanding that symptoms of trauma are the result of a dysregulation of the autonomic nervous system (ANS) whose inherent capacity to self-regulate is undermined by trauma. SE bases its approach on mammals’ ability to automatically regulate survival responses from the primitive, non-verbal brain, mediated by the ANS. In the wild, animals spontaneously “discharge” this excess energy once safe. Involuntary movements such as shaking, trembling and deep spontaneous breaths reset the ANS and restore equilibrium. SE restores this capacity to self-regulate by facilitating the release of energy and natural survival reactions stored during a traumatic event. According to founder Peter Levine, “Trauma lives in the body, not the event.” (Conceptual basis of SE sourced from Wikipedia).

The cumulative effect of all of my therapy work has been a marked reduction in looping, negative, critical thinking and in the duration and intensity of such thinking. It has also led to a reduction in PTSD reactivity and flashbacks and in the duration and intensity of the reactivity and flashbacks.

My psychiatrist (since 2009) and current therapist are:

• Stephen Joseph Lee, M.D. (212) 366-0499 • Charles Eisenberg (212) 576-4104

Relationships:

Partners: I ended a relationship with a partner who was violent prior to my leaving work and seeking treatment. He was an addict when I met him but I did not realize this until after the fact. I remained in the relationship long after the abuse started, never thinking I would have been “one of those people.” My trauma history started long before this abuse and today I understand much more about why victims remain with their abusers.

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I allowed another unhealthy relationship to begin within a couple years of the demise of this one. It was not violent but it was extremely unhealthy. My mind was very unhealthy and that was what it attracted: like attracts like. It was not until after I gained my sobriety that I gained the strength to set boundaries and to stand up for myself and finally remove this unhealthy presence from my home. The process took years. It was very painful. I am single today. I would rather be lonely and single than be lonely in the midst of a relationship.

Family: My relationship with many family members is strained. Addiction and mental illness abounds in my family but I am the identified mental patient. I am the one who sought treatment so they love to hold that over me. As a result of my treatment, however, I am the one who holds increasingly healthy attitudes. As I have become healthier and have developed healthy boundaries, I increasingly do not want to be around their unhealthy behaviors.

What others think of me is none of my business. I do not care what they say regarding my addiction or my seeking help. My chemical addiction has been the single largest blessing I have received in my life and from that blessing the blessings continue to flow. I lived a life out of balance since I was a single digit child and in many ways our society rewards individuals for unbalanced achievement. My chemical addiction brought to my attention a life lived out of balance and has given me the will power and the inner strength to fight all of my battles to get to where I am today. I am alive. I am a far better man today because of my addiction. My addiction has brought compassion, loving kindness, sympathetic joy and equanimity into my life. It has brought me grace and dignity. I will be forever grateful for my chemical addiction.

Friends: I used to want to liked by everyone. I craved acceptance. This comes from feeling that your father never accepted you as a child—that you were born innately bad, defective. As a result I was a perfectionist and an overachiever, a recipe for misery and suffering. No matter what your goals are, as soon as they are achieved you feel let down the minute they are achieved and the next hurdle must be set so that the next round of over-achieving numbness can set in. It is a great way to get a lot of initials after one’s name and to achieve a certain amount of academic and corporate success but it is not a prescription for a happy life.

I am very particular as to who I allow into my circle of friends these days. I love my alone time. I do not need anyone’s approval. I know who I am for the first time in my life. I have achieved a certain degree of serenity. I have much more self work to do but I have realized life is about the journey anyway, not the goal. I used to live my life thinking that when I just get ___, life will ___. Life is no longer on hold. People who are in my life know all about me. If they cannot accept all of me they cannot be in my life. They do not deserve to be in my life. My time here is too short to waste.

Pets: I grew up with pets but had rarely had a pet as an adult. My work hours were so intense that I felt it was unfair to any animal to bring them into a household where they would have so little potential contact. After I made the decision not to return to work I decided to get a cat. I adopted a cat that was very sick with pneumonia from

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the ASPCA who was on antibiotics for the first two months after I brought him home. He was so weak he could not even jump up into my bed. He and I have been through many rough times together and he is such an incredible comfort. I now have a female cat that helps to keep him company, another adoptee from the ASPCA. Pets can truly help to lower stress levels.

Work: After my first stint at Rehab I thought I was done and I came home and thought I had to return to work. I relapsed. It took me months to return to Rehab. I would repeat this formula over and over again for close to two years. I do not think I was able to remain sober until my psychiatrist convinced me that I did not have to return to work, that it was not an environment in which I could ever maintain my sobriety and that I could remain out on long-term disability. It was after I accepted that that I was able to maintain my sobriety. The thought of returning to the toxic work environment was too much—my subconscious kept sabotaging my return to health.

When I left work in 2008 I felt very unsupported at work, I felt the work life balance that I used to enjoy had totally disappeared with my move into my new department and that my personal life had vanished. To be fair, in hindsight I’m not sure how much my perceptions of the situation were colored by my undiagnosed PTSD leading to addiction. In the end, the handcuffs at work were golden and I would never have had the courage to walk away from the incredible dollars even though the environment was literally killing me. It took a chemical addiction and near complete mental breakdown and break with reality for me to seek help. In hindsight it’s clear that as long as I contemplated returning to that environment I could not return to wellness. It was when I decided not to return to work that I finally gained sobriety.

Vipassana (from www.dhamma.org): Vipassana is a way of self-transformation through self-observation. It focuses on the deep interconnection between mind and body, which can be experienced directly by disciplined attention to the physical sensations that form the life of the body, and that continuously interconnect and condition the life of the mind. It is this observation-based, self-exploratory journey to the common root of mind and body that dissolves mental impurity, resulting in a balanced mind full of love and compassion.

The scientific laws that operate one’s thoughts, feelings, judgments and sensations become clear. Through direct experience, the nature of how one grows or regresses, how one produces suffering or frees oneself from suffering is understood. Life becomes characterized by increased awareness, non-delusion, self-control and peace.

Vipassana, which means to see things as they really are, is one of India’s most ancient techniques of meditation. It was rediscovered by Gotama Buddha more than 2500 years ago and was taught by him as a universal remedy for universal ills, i.e., an Art Of Living. This non-sectarian technique aims for the total eradication of mental impurities and the resultant highest happiness of full liberation.

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I have tried various meditation techniques over the years but while many made me feel better, I always felt that something was lacking. When I attended my first Vipassana retreat in Shelburne Falls, Massachusetts, it quickly became apparent that I had found something truly different. The training is rigorous. The minimum initial commitment is ten days. Ten days of silence. No phones, no books, no computers, no music, no eye contact. 12 hours of meditation per day. I have been back every year since. This year I am planning 4-6 retreats. I hope to complete my first 20-day sit. This practice has given me so much. I have gained such awareness. With PTSD I sometimes have no control over my reactions. Vipassana has given me the ability to not react in those situations when I am in control. When I am not in control Vipassana gives me the grace to accept that PTSD still takes away control at times and I must accept that gracefully. Today I am less angry. I have less aversion. I crave less. I am freer to offer forgiveness, both to others and myself. I carry around less resentment. I am freer. I have a long way to go but I have traveled a long way since I started. I look forward to continuing on this path.

Conclusion: The paper’s author in this case knows the patient very well. Studying the patient has been my full-time job for the last eight years. Obviously we will not regularly have the opportunity for the depth of insight that I have gained by observing myself so closely in an effort to find my path back to wellness. I have included much information that some may find distracting, but I believe it is all relevant and I included deeply personal information because I believe the past informs the illness and the post sober actions informs the recovery. I have deliberately not gone into much detail related to my trauma because it spans over four decades and would fill pages and amount to voyeurism. It is not necessary to tell the entire story. I gave small indications of pieces of trauma but that is all that they are, very small pieces of the puzzle. No more is necessary.

What is important from my perspective is the vast array of considerations that can play into wellness beyond mere diet. Not everyone may feel comfortable bridging these areas but they are there to consider as you develop relationships with clients. These are natural areas of conversation for me. I have conversations regarding these topics daily. I always start with the three legs of the stool: mental, spiritual and physical. Are all three being addressed? Humans require fulfillment in all three areas for wellness (note that spiritual can be defined in any number of ways). How are relationships? This is a really broad category. What about physical activity? What about bodywork? What are they doing to lessen stress? What are they doing for brain health? Many factors impact the immune system. Obviously, if the immune system is not working correctly certain diseases, including cancer, will be harder to control. Much of what I have covered may have no relevance for many folks with basal cell carcinoma or squamous cell skin carcinoma. But in certain cases some of the issues I raise might be worth considering.

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Appendix A Prevention of Basal Cell Carcinoma

(From Mayo Clinic Staff)

You may reduce your risk of basal cell carcinoma if you:

Avoid the midday sun. Avoid the sun when its rays are the strongest. For most places, this is between about 10 a.m. and 4 p.m. Because the sun’s rays are strongest during this period, try to schedule outdoor activities for other times of the day, even in winter. You absorb UV radiation year-round, and clouds offer little protection from damaging rays. Use sunscreen year-round. Choose a sunscreen that blocks both UVA and UVB types of radiation from the sun and has an SPF of at least 15. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or perspiring. The American Academy of Dermatology recommends using a broad-spectrum sunscreen with an SPF of 30 or more. Even the best sunscreen might be less effective than the SPF number on the bottle would lead you to believe if it isn’t applied thoroughly or thickly enough, or if it’s perspired away or washed off while swimming. Wear protective clothing. Wear protective clothing. Sunscreens don’t provide complete protection from UV rays, so wear tightly woven clothing that covers your arms and legs, and a broad-brimmed hat, which provides more protection than a baseball cap or visor does. Some companies also sell photoprotective clothing. And don’t forget sunglasses. Look for a pair that provides full protection from both UVA and UVB rays. Avoid tanning beds. Tanning beds emit UV radiation, which can increase the risk of skin cancer. Become familiar with your skin so that you’ll notice changes. Examine your skin so that you become familiar with what your skin normally looks like. This way, you may be more likely to notice any skin changes. With the help of mirrors, check your face, neck, ears and scalp. Examine your chest and trunk, and the tops and undersides of your arms and hands. Examine both the front and back of your legs, and your feet, including the soles and the spaces between your toes. Also check your genital area, and between your buttocks. If you notice anything unusual, point it out to your doctor at your next appointment.

Ask your doctor about screening. If you’ve already had skin cancer, you have an increased risk of a second cancer. Talk with your dermatologist about how often you should be screened for a recurrence and whether you should do periodic skin checks on your own.

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Appendix B Causes, Risk Factors and Complications of Squamous

Cell Skin Carcinoma (from Mayo Clinic Staff)

Causes: Where skin cancer develops: Squamous cell carcinoma of the skin occurs when the flat, thin squamous cells in the outer layer of your skin develop errors in their DNA. Ordinarily, new cells push older cells toward your skin’s surface, and the older cells die and are sloughed off. DNA errors disrupt this orderly pattern, causing cells to grow out of control, with squamous cell carcinoma of the skin as the result. Ultraviolet light and other potential causes: Much of the damage to DNA in skin cells results from ultraviolet (UV) radiation found in sunlight and in commercial tanning lamps and tanning beds. But sun exposure doesn’t explain skin cancers that develop on skin not ordinarily exposed to sunlight. This indicates that other factors may contribute to your risk of skin cancer, such as being exposed to toxic substances or having a condition that weakens your immune system. Risk factors: Factors that may increase your risk of squamous cell carcinoma of the skin include:

Fair skin. Anyone, regardless of skin color, can get squamous cell carcinoma of the skin. However, having less pigment (melanin) in your skin provides less protection from damaging UV radiation. If you have blond or red hair and light-colored eyes and you freckle or sunburn easily, you’re much more likely to develop skin cancer than is a person with darker skin. Excessive sun exposure. Being exposed to UV light from the sun increases your risk of squamous cell carcinoma of the skin. Spending lots of time in the sun — particularly if you don’t cover your skin with clothing or sun block — increases your risk of squamous cell carcinoma of the skin even more. Use of tanning beds. People who use indoor tanning beds have an increased risk of squamous cell carcinoma of the skin. A history of sunburns. Having had one or more blistering sunburns as a child or teenager increases your risk of developing squamous cell carcinoma of the skin as an adult. Sunburns in adulthood also are a risk factor. A personal history of precancerous skin lesions. Having a precancerous skin lesion, such as actinic keratosis or Bowen’s disease, increases your risk of squamous cell carcinoma of the skin. A personal history of skin cancer. If you’ve had squamous cell carcinoma of the skin once, you’re much more likely to develop it again.

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Appendix B (Continued) Weakened immune system. People with weakened immune systems have an increased risk of skin cancer. This includes people who have leukemia or lymphoma and those who take medications that suppress the immune system, such as those who have undergone organ transplants. Rare genetic disorder. People with xeroderma pigmentosum, which causes an extreme sensitivity to sunlight, have a greatly increased risk of developing skin cancer.

Complications: Untreated squamous cell carcinoma of the skin can destroy nearby healthy tissue, spread to the lymph nodes or other organs, and may be fatal, although this is uncommon. The risk of aggressive squamous cell carcinoma of the skin may be increased in cases where the cancer:

• Is particularly large or deep; • Involves the mucous membranes, such as the lips; and • Occurs in a person with a weakened immune system, such as someone who takes

anti-rejection medications after an organ transplant or someone who has chronic leukemia.

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Appendix C Natural Killer Cell Activity Stimulators

I. Active Hexose Correlated Compound (“AHCC”)

A lentinan extract from Shitake grown on rice bran—contains

a 1,4 glucans

ß 1,4 glucans, basidiomycetes mycelia

­ NK cell activity

­ macrophages

­ IL-12

1) AHCC Source Naturals 750 mg #60 capsules

2) AHCC ImmPower 500 mg #30 capsules

II. b 1,3 glucans 5-20 kDa ® CR3 receptors ³ 500 kDa crosslinks CR3’s

b 1,6 glucans

from a variety of sources including Maitake, Bakers Yeast

­ NK cell activity binds neutrophil CR# receptors to prime

3) Maitake D fraction PRO 4X 60 ml 6 drops 3x/day (800) 747-7418

4) Wellmune WGP Immune Support 500 mg #60 capsules

III. Fermented product made from Saccharomyces Cerevisiae, originally as an

animal food fortifiesr, found to reduce sickness in the workers in production

factory where it was made.

­ NK cell activity ¯ IFN g

­ IgA

5) EpiCor 500mg #90 capsules 1-3/day www.vrp.com

6) Ortho Molecular WholeMune #30 capsules Ortho Molecular Products

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Appendix C (Continued)

IV. Immune Stimulators: made from the cell wall of Klebsiella pneumonia

bacteria. ¯ chronic bacteria

7) Biostim 1mg #32 IAS (866) 800-4677 www.antiaging-systems.com

V. Coriolus versicolor mushroom mycelia extracts from Basidiomycetes contain

PSP PolySaccharide Peptide ­ apoptosis, ­ IgG, IgM

PSK PolySaccharide Krestin ­ TNFµ, ­ IL-8

8) InForce PSP/PSK 450mg #60

9) InForce Platinum 450mg #60

10) Krestin

VI. Andrographis panniculata extract made by HPLifeScience (877) 903-9657

­ PPAR receptor ® ¯NF-kappa b

¯IL-2, IFN g ® ¯ COX2

11) Paractin #90 www.herbalpowers.com

VII. Colostrum—first milk of the recently pregnant cow contains antibodies for

calf.

12) Biomune OSF Plus

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Appendix D Bernard Bihari, MD, and Other Physicians and Researchers, Have

Described Beneficial Effects of LDN on a Variety of Diseases, Including:

Cancers: • Bladder Cancer • Breast Cancer • Carcinoid • Colon & Rectal Caner • Glioblastoma • Liver Cancer • Lung Cancer (Non-Small Cell) • Lymphocytic Leukemia (chronic) • Lymphoma (Hodgkin’s and Non-Hodgkin’s) • Malignant Melanoma • Multiple Myeloma • Neuroblastoma • Ovarian Cancer • Pancreatic Cancer • Prostate Cancer (untreated) • Renal Cell Carcinoma • Throat Cancer • Uterine Cancer

Other Diseases:

• Common Colds (URI’s) • Emphysema (COPD) • HIV/AIDS • Depression (Major; and Bipolar)

Autoimmune: Neurodegenerative:

• ALS (Lou Gehrig’s Disease) • Alzheimer’s Disease • Autism Spectrum Disorders • Hereditary Spastic Paraparesis • Multiple Sclerosis (MS) • Parkinson’s Disease • Post-Traumatic Stress Disorder (PTSD) • Primary Lateral Sclerosis (PLS) • Progressive Supranuclear Palsy • Transverse Myelitis

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Appendix D (Continued) Other Autoimmune Diseases:

• Ankylosing Spondylitis • Behcet’s Disease • Celiac Disease • Chronic Fatigue Syndrome • CREST Syndrome • Crohn’s Disease • Dermatomyositis • Dystonia • Endometriosis • Fibromyalgia • Hashimoto’s Thyroiditis • Irritable Bowel Syndrome (IBS) • Myasthenia Gravis (MG) • Nephrotic Syndrome • Pemphigoid • Primary Biliary Cirrhosis • Psoriasis • Rheumatoid Arthritis • Sarcoidosis • Scleroderma • Sjogren’s Syndrome • Stiff Person Syndrome (SPS) • Systemic Lupus (SLE) • Ulcerative Colitis • Wegener’s Granulomatosis

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Appendix E Vipassana (from www.dhamma.org)

Vipassana Meditation: Vipassana, which means to see things as they really are, is one of India’s most ancient techniques of meditation. It was rediscovered by Gotama Buddha more than 2500 years ago and was taught by him as a universal remedy for universal ills, i.e., an Art Of Living. This non-sectarian technique aims for the total eradication of mental impurities and the resultant highest happiness of full liberation. Vipassana is a way of self-transformation through self-observation. It focuses on the deep interconnection between mind and body, which can be experienced directly by disciplined attention to the physical sensations that form the life of the body, and that continuously interconnect and condition the life of the mind. It is this observation-based, self-exploratory journey to the common root of mind and body that dissolves mental impurity, resulting in a balanced mind full of love and compassion. The scientific laws that operate one’s thoughts, feelings, judgements and sensations become clear. Through direct experience, the nature of how one grows or regresses, how one produces suffering or frees oneself from suffering is understood. Life becomes characterized by increased awareness, non-delusion, self-control and peace. The Tradition: Since the time of Buddha, Vipassana has been handed down, to the present day, by an unbroken chain of teachers. Although Indian by descent, the current teacher in this chain, Mr. S.N. Goenka, was born and raised in Burma (Myanmar). While living there he had the good fortune to learn Vipassana from his teacher, Sayagyi U Ba Khin who was at the time a high Government official. After receiving training from his teacher for fourteen years, Mr. Goenka settled in India and began teaching Vipassana in 1969. Since then he has taught tens of thousands of people of all races and all religions in both the East and West. In 1982 he began to appoint assistant teachers to help him meet the growing demand for Vipassana courses. The Courses: The technique is taught at ten-day residential courses during which participants follow a prescribed Code of Discipline, learn the basics of the method, and practice sufficiently to experience its beneficial results. The course requires hard, serious work. There are three steps to the training. The first step is, for the period of the course, to abstain from killing, stealing, sexual activity, speaking falsely, and intoxicants. This simple code of moral conduct serves to calm the mind, which otherwise would be too agitated to perform the task of self-observation. The next step is to develop some mastery over the mind by learning to fix one’s attention on the natural reality of the ever changing flow of breath as it enters and leaves the nostrils. By the fourth day the mind is calmer and more focused, better able to undertake the practice of Vipassana itself: observing sensations throughout the body, understanding their nature, and developing equanimity by learning not to react to them. Finally, on the last full day participants learn the meditation of loving kindness or goodwill towards all, in which the purity developed during the course is shared with all beings.

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The entire practice is actually a mental training. Just as we use physical exercises to improve our bodily health, Vipassana can be used to develop a healthy mind. Because it has been found to be genuinely helpful, great emphasis is put on preserving the technique in its original, authentic form. It is not taught commercially, but instead is offered freely. No person involved in its teaching receives any material remuneration. There are no charges for the courses - not even to cover the cost of food and accommodation. All expenses are met by donations from people who, having completed a course and experienced the benefits of Vipassana, wish to give others the opportunity to benefit from it also. Of course, the results come gradually through continued practice. It is unrealistic to expect all problems to be solved in ten days. Within that time, however, the essentials of Vipassana can be learned so that it can be applied in daily life. The more the technique is practiced, the greater the freedom from misery, and the closer the approach to the ultimate goal of full liberation. Even ten days can provide results that are vivid and obviously beneficial in everyday life. All sincere people are welcome to join a Vipassana course to see for themselves how the technique works and to measure the benefits. All those who try it will find Vipassana to be an invaluable tool with which to achieve and share real happiness with others.