In April 2010 I became gravely ill with prostate cancer, which had spread to my backbone and ribs. Radiation therapy and steroids shrank the tumours and hormone therapy reduced my testosterone so that, for a while, the cancer couldn’t feed on it.
By April 2011, I was continuing to improve, but more slowly; and my PSA – a measure of cancer activity – was starting to climb. The hormone therapy was losing its efficacy, which, I had been informed early on, it always does. So I was referred to a medical oncologist at Princess Margaret Hospital, whose expertise involved treating the cancer with drugs to prolong my life and ease the pain. No cure was available, I was assured. It was only a matter of time.
Even before our first meeting with the oncologist, my wife Shelly and I had decided that we had to seek out alternatives. A couple of years previous, a friend of ours, who had seemed tired and unhealthy, started to look positively radiant. She told us she had been seeing an Ayurvedic doctor and was following his recommendations for diet and exercise. She had given us his number, so we called him.
Dr. Surendra Tripathi was in his early 80s. He had taken the full six year course in Ayurvedic medicine in India, and then received his MD from the University of Minnesota in 1970, specializing in sports medicine. He had been a physician for the Olympics in 1972 and 1976. Now he sees patients from his small clinic at Gerrard and Main in Toronto’s east end.
We had several consultative appointments with him, as we felt each other out. He wanted to make sure that we understood his philosophy and that we were prepared to follow through on his treatment, which was comprehensive, to say the least. It required a considerable commitment.
Ayurvedic doctors treat everyone differently because people are so different – in their body types, in their nutritional needs, in their emotional makeup. If twenty people with the same condition walked into Dr. Tripathi’s office, no two would be treated alike. When one thinks about it, it is absurd to assume that everyone will benefit equally from the same food, exercise, or medicine.
In Ayurvedic practice the patient is a full participant in the healing process. This doesn’t mean simply following a diet and doing exercises regularly. It means engaging the mind and will, in believing that we are all equipped mentally as well as physically to heal ourselves. “You are the master,” is Dr. Tripathi’s constant reminder.
From June through October 2011 we went to the clinic twice a week, usually for about three hours, half the time for talking, half for treatment. From the beginning Shelly came with me and was part of the whole process. She had been caring for me and helping to heal me, and her determination to be included in the treatment was taken for granted right away, both by her and by Dr. Tripathi. She made it clear that our visits were as important to her as to me – her state of mind, her own health, and her ability to help me. Dr. Tripathi made this explicit when he talked with us.
The talking part included discussions of my condition, philosophies of healing, gardening, handling pain, stories and parables – in the end, almost everything. More often than not, Dr. Tripathi’s wonderful assistant, Andrea, would make spiced tea, and the four of us would enjoy it together. We would usually be served fruit or biscuits. Sometimes the doctor would cook up a special snack, from scratch, in the small kitchen and serve it to us with tea.
The treatment involved placing small hot pillows on my back and legs, followed by a vigorous massage with a fragrant mixture of oils. It sounds like a spa, I know, but it often hurt a fair bit. Dr. Tripathi was powerful. He’s about five and half feet tall, but we got the feeling he could have picked me up with one hand.
During the same period I took three separate herbal medicines, including a powder which I mixed each morning with my finger in a tablespoon of honey — “to put your own energy into it,” he told me.
My diet included a good deal of rice, dal (split lentils), and cooked vegetables, occasionally chicken or fish. Raw vegetables were dropped. No one over 60, he said, can digest raw vegetables properly. There was also fresh fruit, but no citrus, which is too acidic for someone with cancer. Moderate amounts of coffee, tea, and sweets were encouraged. In addition to potatoes, beets, and carrots, I was told to eat lots of bitter vegetables: spinach, bitter melon, chard, kale, and rapini.
Some of the exercises I had been doing he said were OK, others he advised against. He focused on ones that improved the strength and flexibility of my back and abdomen. The most joyful addition, for me, was the bicycle. Even though I was still walking with a cane in June 2011, he told me to ride a bicycle as much as I could. He loaned me a stationary bike, but he encouraged me to ride out on the street. I was thrilled and started riding around the block right away, although I could barely get my leg over the seat. My legs had been largely paralyzed the year previous. Now, on the bike, I could feel energy coursing through them. Little by little I rode farther and faster.
In April, when we first started seeing him, Dr. Tripathi had told us he was going to India on business at the end of May. But he didn’t. He stayed in Toronto, we believe, to treat me. There are not a lot of doctors like him.
By September I was feeling and looking much better. I’d gained twenty pounds. After some intense discussions, I decided to go off the hormone drug, even though my PSA was still rising. The oncologist, to give her credit, was willing to give it a try. “I don’t diagnose just with numbers from a blood test,” she told us. There are too many other factors in assessing a patient’s condition.
In October, I was feeling better than ever. My PSA jumped as my body started making more testosterone. In June my PSA had been 33, by October it was 580.
Meanwhile, Dr. Tripathi told me that I was doing fine, that the PSA count was not a concern, and that he was going to take his long-delayed trip to India. The diet and exercise would continue, but the treatments and herbal medicines were ended.
When he came back, starting in December 2011, we saw him every couple of weeks. While my bowels had started working on their own three weeks after the radiation in April 2010, a urologist I had been seeing since that November had had no useful advice to help me urinate again. I had been using a catheter three or four times a day to empty my bladder. Dr. Tripathi thought that this was ridiculous, and he told me to get to work. “You deserve to urinate without any outside gadgets,” he told me and suggested all sorts of techniques to get things started. By early 2012 I was going mostly on my own and using the catheter only once a day, before I went to bed. By May the amount of urine left over was less than half a litre.
But I had been losing weight (over 20 pounds in four months) and my PSA skyrocketed in spring 2012, 4500 in April and 6100 in May. The oncologist asked me to have another CT scan, which showed some spreading of the cancer, and she strongly recommended another round of hormone therapy to bring down my testosterone. On May 30 I received the shot.
June was a nightmare. Almost immediately there was significant and constant pain under my left shoulder blade and I could barely lift my left arm. Urination was weak and irregular. The pain at night was so severe that I couldn’t sleep at all, so I started taking pain killers. I had to drop more than half my exercises because they hurt too much. I continued riding the bike but even that was painful.
Our family doctor found information on the drug that said symptoms could get worse for two weeks after getting the shot. But this went on and on, and towards the end of June it was just intolerable. We went back to Dr. Tripathi and asked if he could help.
He did. The diet became very simple. He asked me to eat half a pound of cherries (which were just coming into season) twice a day. Also lots of bread to help me gain weight. He insisted I get off the pain killers and gave me some herbs and exercises to get my bowels and urine going again. He also gave me some exquisitely painful massages and inspiring pep talks. By the end of July I was feeling better.
While the conventional medical treatment had undoubtedly saved my life, it had little to offer me in terms of a long term cure. Dr. Tripathi always has something to offer and he tells me constantly I can choose how long I want to live. He is demanding but unrelentingly optimistic. There are many difficult choices ahead for me, but so far Ayurvedic medicine seems to have a lot more to offer than medications from the oncology experts.