Remembering Michio Kushi
On Dec. 28, 2014, Michio Kushi—the man who introduced the macrobiotic diet to the Western world—passed away. He was 88. I first met Michio 30 years ago and was struck by the power of macrobiotic diets for health. Based on principles of Chinese medicine and interpreted through Japanese cuisine, this largely plant-based school of thought has helped many people regain their health. For those unfamiliar with macrobiotic diets, I would like to reprint the experience of Anthony J. Sattilaro, M.D., from my book Foods That Fight Pain. I first met Tony in 1986. The events I will describe here began several years before.
Tony was a successful physician who had started out as an anesthesiologist and had become president of Methodist Hospital in Philadelphia. One day, during a routine chest X-ray at the hospital, the radiologist found a large density in the left side of Tony’s chest. This was puzzling, because he had no symptoms, apart from a chronic backache. Given all the projects he had taken on in his work, he had not given much thought to his health. But this looked potentially serious, and a careful workup had to be done.
The radiologist scheduled a bone scan, which was done the same day. Before the exam was even finished, it was clear that the results were far from normal. The suspicious area on the X-ray turned out to be a large knot of cancer cells in one of Tony’s ribs. More clusters of cancer cells were lodged in his skull, sternum, and spine and were slowly growing.
This was not exactly what Tony had had in mind for that day, and he was scared. In a few hours, he had gone from being a busy doctor preoccupied with his work to being a patient with advanced cancer.
His doctors wanted to track down where the cancer had started in order to plan the best treatment. They scheduled him for biopsies to look for cancer cells. The prostate biopsy told the tale.
Prostate cancer is common in older men. When it begins later in life, it often grows slowly—so slowly, in fact, that doctors sometimes recommend no treatment at all. But Tony was just 46. At that young age, prostate cancer is extremely aggressive. In his case, it had already spread so widely that there was essentially nothing to be done. Surgical removal was impossible. His oncologist told Tony honestly that he would have to get his affairs in order.
Not long afterward, the pain of cancer cells growing inside his bones took hold. As it worsened, he began to need narcotic painkillers to get through the day. They caused problems of their own, particularly nausea, which, at times, was severe. Between the cancer pain and the side effects of his medications, he struggled to continue his work at the hospital for as long as he could.
Tony Sattilaro had no illusions about the disease, however. He had seen his share of cancer, as any doctor has. Moreover, his own father was dying of lung cancer at the time. Not long after Tony received his own diagnosis, he had to bury his father and try to support his mother as best he could.
After the burial, he drove to the New Jersey Turnpike to return to Philadelphia. Two hitchhikers—men in their midtwenties—were looking for a ride. And while they looked a bit scruffy, he picked them up, welcoming the chance to have someone to talk to. He told them of his father’s death, and that he himself was now under the same sentence. As it happened, these two young men had just gotten out of macrobiotic cooking school. Very taken with the power of food, they told him that cancer did not have to be fatal. He could change his diet and make it go away.
This he found thoroughly irritating. Here were two kids, half his age, with no medical background at all and no apparent recognition that he was a trained physician who knew all too well what he was up against. They treated his condition almost casually. But he did not stop them. He let them go on about yin and yang and how foods could affect the energy balance of the body, all of which struck him as complete nonsense. When he dropped them off, they asked for his address in order to send him more information. A few days later, a package arrived, sixty-seven cents postage due. Inside was a book about diet and cancer. It was not much more convincing than the young men had been, except that it included a statement written by a physician—a woman with breast cancer, for whom a macrobiotic diet had made an enormous difference. It had apparently driven her cancer into remission. That rang a bell, because breast cancer is a hormone-related cancer, as is prostate cancer, and here was a physician endorsing a nutritional approach. Still skeptical, but interested in learning more, he found himself on the doorstep of Philadelphia’s macrobiotic teaching center.
The word macrobiotic means “long life,” and the macrobiotic diet is based on grains, vegetables, and beans, which are balanced in certain ways using principles derived from Chinese medicine. Modern macrobiotic diets draw heavily on the traditional Asian foods, with generous amounts of rice and vegetables, and strictly avoid dairy products, meats, and sugary and refined foods.
Tony could find no double-blind studies to show what the diet could do, but he was driven by a mixture of curiosity and desperation. He shared meals at the center, and the staff gave him food to take home. The tastes were a departure from what he was used to, but soon something happened that made it all take on a very different flavor: His pain started to diminish.
He could feel changes day by day. He needed less and less pain medication, and in three weeks his pain was gone. He had no idea whether the diet got the credit for this change, but he was not about to stop it. Each day, he carried his chopsticks into the doctors’ dining room and, much to the amusement of his colleagues, followed an Asian peasant’s diet—with no Western indulgences whatsoever. His energy returned, and without any need for painkillers, he was able to concentrate on his work again.
A year later, he still felt well, and he decided to ask his treating physician if they could take a look to see what was going on. He wanted to repeat the bone scan that had shown the spread of his cancer. They scheduled the test, and when the results came in, his doctors were shocked. No trace of the cancer was left—not in his spine, not in his skull, or anywhere else. Presumably it was not gone, but it was too small to be seen on the scan. His health continued to improve, and he decided to leave Methodist Hospital to devote himself to exploring the relationship between foods and health, and to writing and lectures. He wrote a book about his experiences that became a best-seller.
When I met Tony, he was living in Florida, studying, writing, and exercising every day. He showed me the scan that had been used to diagnose his cancer and the follow-up scan that documented its disappearance. He had received endless letters from people with cancer seeking advice, to whom he responded saying that he honestly was not sure whether diet had made the difference for him. Certainly, he had had a remarkable recovery, but he could simply not say whether what had worked for him could do the same for others.
Then he told me something that made me nervous. He had decided to stop the diet. Having been free of cancer for close to ten years, he wanted to test himself to see whether the cancer really was gone. He gradually added fish and then chicken back to his routine.
I could not see why he would want to do this. A cancer that has been effectively suppressed is not the same as a cancer that is totally gone. And whether he believed that the diet brought his improvement or not, why rock the boat? His macrobiotic counselors had told him that getting cancer to go away once is enough of a challenge. Letting it return and trying to tame it again is something they did not want to try.
Not long after this, Tony’s cancer returned, and the pain that had disappeared for years enveloped him again. He had to resume his narcotic painkillers, and this time there was no going back. During my last conversation with him, his speech was slurred, and he was groggy and unable to concentrate.
After he died, the questions he had posed still remained. Did the diet change make his cancer disappear? Had abandoning the diet caused it to return? There is no way to answer these questions definitively, but a surprisingly large body of evidence shows that foods do indeed influence the hormones that drive cancer and also play a role in determining whether cancer will start and progress.
This does not mean that people with cancer should ignore other treatments. Surgery, radiation, chemotherapy, and hormonal treatments all have important roles. But it does mean that, in addition to the other treatments a cancer patient is receiving, it is important to take advantage of the power that foods do have.