Provision patient has pre-treatment health makeover

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When Hal Livergood came to Provision for treatment of his prostate cancer last February, he discovered he was living just two miles from the only proton therapy center in the Southeast. He was impressed by the brand new facility—“like coming into a resort,” he says. His doctor and personal research told him protons were the best treatment option for his disease.

There was just one problem.

“Dr. Fagundes said, ‘You need to lose weight,’” Livergood says, of Provision Center for Proton Therapy’s medical director, Marcio Fagundes. Otherwise, treatment would not be an option.

At 455 pounds and faced with a life-threatening disease, he wasted no time.

He met with nutritionist Casey Coffey at Provision Health and Performance, adopted a clean, real, whole foods diet and began exercising two hours a day—cardio in his home pool spa plus a strengthening regime.

“I lost 50 pounds in just a few months,” Livergood says. By the time he was ready to start proton therapy, he had lost 90 pounds in all. His edema disappeared. He felt better.

“Between Casey and Dr. Fagundes, they’re saving my life in more ways than one,” he says.

Livergood’s case may have been extreme, but early research is showing that tackling lifestyle changes prior to treatment can help improve long-term outcomes for cancer patients.

A recent article in the Washington Post documented this “pre-habbing” phenomenon, citing a study in the journal Anesthesiology that showed patients diagnosed with colo-rectal cancer who adopted a program of exercise, nutritional counseling and relaxation four weeks prior to surgery experienced better recovery than those with eight weeks of rehabilitation following the procedure. Research findings for non-cancer-related operations indicate the same, although more study is needed to determine the broader impacts of pre-treatment lifestyle interventions.

Some research shows a positive impact of healthy lifestyle choices during cancer treatment. For example, exercise has been shown to help alleviate fatigue in breast cancer patients and relaxation exercises help improve mental health and sleep patterns for cancer patients. Other research shows improved immune response and response to cancer treatment with particularly dietary supplementation or interventions.

In spite of the lack of studies into the impact of diet on cancer treatment outcomes, Coffey says “sugar is the only fuel cancer can survive on,” so she advocates a diet in which her clients that reduces carbs and focuses on proteins and whole, unprocessed foods. She also works with patients to identify foods they enjoy and build a plan around making lifestyle change workable.

“I had lost thousands of pounds over my lifetime,” Livergood says, with diets ranging from liquid to fat free. But after learning about the chemical reactions of the food in the body, necessary balance between protein, carbohydrates and fat he’s made changes for the long-term. And he says he doesn’t even want the junk food he once ate on a regular basis.

“The goal is to control carbohydrate intake.  We need a balance in nutrients, protein, fat and carbohydrate,” Coffey says.

When patients understand the way food affects their health and make changes for the right reasons, “the desire is just not there,” she says. “”You also have that thought process, is it really worth it?”

“’If it’s killing me,’ I think, ‘I don’t want to eat it,’” Livergood adds.

Support at home has also been crucial, and Livergood’s wife, Nancy Lee, has been there every step of the way—losing 18 pounds in the process herself. Coffey took her to Trader Joe’s, patient consults frequently include a grocery shopping trip, showing her products that support their new lifestyle.

“It’s one thing to sit in a room with somebody,” Coffey says. “I say, ‘I want you to start shopping like you would normally shop. What does it look like when you’re trying to implement something? We are so programmed to our own pattern of shopping and eating, and it’s eye opening for patients and their families to start looking at food in a new way.”

Now that he’s in treatment for his prostate cancer, Livergood says he is suffering through a low residue diet, a low-fiber regimen required for prostate cancer treatment that requires patients to cut out legumes and whole grains and reduce dairy consumption. The treatment and related hormone therapy have also left him feeling fatigued and limited his exercise routine.

Once he’s done, however, he plans to tackle the weight loss anew.

“I’ve got another 120 pounds at least to lose,” he says. “I’ve got to stay on the program.”