Everything You Need To Know About Colon Cancer Early Detection, Preventive Remedies, Cutting-Edge Medical Treatments & More With Dr. Ahvie Herskowitz.

My name is Ben Greenfield, and on this episode of the Ben Greenfield Life podcast, we know that people in the developed world have higher rates of cancer than in the underdeveloped world, and that may be an issue of simply reporting. We just don't know. Something is causing this, but the trends have already been present in the past, so the younger population is involved more, more so.

Fitness, nutrition, biohacking, longevity, life optimization, nutrition, spirituality, and a whole lot more. Welcome to the Ben Greenfield Life Show. Are you ready to hack your life? Let's do this. Alright, folks. Everything you need to know about colon cancer and cancer in general, early detection methods, preventive remedies, cutting-edge medical treatments, and a whole lot more with a 3-peat guest now, Dr. Avi Herskovitz of Anatara Medicine in San Francisco. Pretty cutting-edge facility that does all sorts of molecular immunological and genomic treatments for inflammation, for cell injury, autoimmunity, heart failure, myocarditis, cancer, you name it. They have a ton of experience. They work with some of the Bay Area's top biohackers, celebrity actors, a longevity enthusiast, and Avi Herskovitch is just a wealth of information, just an OG of functional medicine. So I hope you enjoyed today's show. Show notes are going to be at bengreenfieldlife.com/cancer-episode. All right, here we go, recorded straight from Avi's clinic, and there's going to be quite a bit of extra video content that you can tune into also at bengreenfieldlife.com/cancer-episode. Well, Avi, it is good to see you. It's good to be back in San Francisco. We have, uh, we've, we've podcasted now, well, twice, even though our last podcast was so big and long and hairy and audacious we split it into a two-parter. And by the way, for those of you listening in, I'll link to all of the podcasts I've done with Avi if you go to bengreenfieldlife.com/cancer-episode- bengreenfieldlife.com/cancer episode. And indeed, like, we've talked about all sorts of stuff in the past, like constitutional assessments, which is how you first met me, eating a giant pork chop that was not conducive to my constitutional assessment. And then you fed me through the fire hose about that, and I learned a ton. Uh, we've talked about advanced blood and biomarker testing and nerve blocks and joint treatments and stem cells. But, this whole idea of cancer is something that you and I haven't taken much of a deep dive into besides briefly talking about these biopsies, these liquid biopsies, which I think we'll talk about a little today. But, I've been very interested in cancer for a couple of reasons, and I'll have a chance to fill you in here. But, one reason is that seems to me like I've been reading a lot of articles, a lot of news reports that people are getting cancer with increasing frequency, often at younger ages. I doubt that it's just we have better detection methods and people are just catching things earlier, but why is it that cancer seems to be on the rise across the board?

Oh, well, I think you're— I agree that there's data sifting in now because now we can look at data from 2022. Okay. You know, a year behind, of course. There's no data yet for 2023, um, with a trend that predated COVID of getting certain types of cancers in younger populations. So cancer used to be, aside from leukemias and certain other cancers, was a disease of the aged. With spectacular rises after the age of 75 and incidence rates. But now, the group that seems to be targeted disproportionately is the 40 to 49 years.

40 to 49. So, when you say young, we're not talking 18-year-olds getting cancer, but people 40 to 49, remarkably younger than this 75+ we've seen in the past.

Right. I mean, it starts rising after 60 traditionally, but now 30 to 40 and— or 30 to 49 is being hit harder. That's what the oncologists that you can talk to for anecdotal information about, that they're seeing very large rises. And the more provocative thing is that these are late-stage cancers.

Meaning that they have been developing for a long period of time.

Or an accelerated— oh, an acceleration of that faster. Okay, an acceleration of that phase. So, just a quick anecdote, and anecdotes are just not worth their weight in gold, obviously, but they do heighten your awareness when you have serial studies in the same person, which we're seeing now for the first time. People with negative PET CT scans or negative MRIs but good solid imaging for a tumor in one location, let's say colon, looking at the liver in May and looking at the liver 6 weeks later in late June showing multiple metastases in the liver.

With like a PET scan?

Yes.

Okay.

I mean, PET CT. So, you're seeing it in one study, it's negative, and the other study is positive, but only 6 weeks has gone by. And, you know that it was there before, but it was too small to see. Right. But, to go to have a 6-week, a mass that's 6 weeks that you're looking at for 6 weeks, only after 6 weeks where you can see it at probably 2 or 3 millimeters, now at 10 millimeters is spectacularly aggressive. I mean, this is mutating. This is a very accelerated thing.

Even in young people? Yes.

We're seeing that.

Yes.

We've seen it in all age groups of folks that coming in with later stage disease. So, something is causing this, but the trends have already been present. In the past. So, the younger population has involved more, more so breast, lung, colon, the three most. So, lung is the most common cancer in the United States, then colon is second, but happening in younger people.

And, just to address the elephant in the room, this is not because people at younger and younger ages are out getting PET scans and MRIs because Tony Robbins is championing the benefits of a full-body MRI and all the biohacking and anti-aging enthusiasts got to go off and get their advanced CT angiographies and everything. It's not a matter of us testing younger people. You think there's actually something going on causing cancer at a younger age.

Right. Well, it's very unlikely that that's the reason. And during the pandemic, the first year of the pandemics in 2020, 2021, there was a decrease in cancer incidence. And that was because we weren't identifying people in a timely fashion.

People just weren't going to hospitals.

They weren't going to the hospital, they weren't getting screening tests. So, we lost a lot of the folks with earlier cancers at that point. And then, in 2022, it's now back to pre-pandemic levels. So, that's one message. At the same time, There are entities now that'll do whole body MRIs specifically to find that lesion that's early somewhere in your body, some 200+ cancers that they can identify. And we've seen a case like that, but one case out of hundreds of cases you need to follow in that particular fashion is very inefficient to take these screening tests willy-nilly. And we'll talk about that Even when you're, you're concerned about cancer and you look at these tests, uh, we'll go over the different findings with the test, but it's unlikely.

Okay.

So the, the elephant in the, in the room is also what is the impact of COVID and what is the impact of vaccination on this trend that already was accelerated?

Yeah. Well, how do you even know? Because, because you have the COVID pandemic, but it sounds like the trend was already accelerated. We've vaccinations, which have been around for a long time. We have some new ones, but then there is, of course, stress and emotional processing, which I know has a very large correlation. I just got done with a book called Anti-Cancer Living, which is all about how human connectivity, or the absence of it, and loneliness is one of the biggest contributing factors to onset of cancer or even poor cancer survival. We've got, you know, you go back and read books that kind of get an eyebrow raised at them like the Electric Rainbow that talks about increased incidences of chronic diseases with response to excess exposure to Wi-Fi and electromagnetic radiation and radio frequencies and cell towers. We have ultra-processed food and toxins in the, in the food supply. I just interviewed a guy last week who talked about pesticide companies creating small short-chain peptides that replicate cone snail venom cobra venom and scorpion venom and that these venoms may cause a steep rise in the incidence of cancer. Is it like a cluster of a bunch of things, you think, or—

Yeah. Well—

Is that a crazy idea?

My hypothesis when I first opened up this clinic, Anatara Medicine, in San Francisco about a dozen years or so ago was that our area under the curve of these individual risks is now taking a transformational shift and putting us into much higher risks than we had before. It's an area under the curve. So it's multiple factors always, as you know, all the different factors you just cited and many, many more with both specific cancers as well as others. What we do know, let's just take it from the top. Okay. What do we know? We know that people in the developed world have higher rates of cancer than in the underdeveloped world. And that may be an issue of simply reporting. We just don't know. Now, in the countries that do report well, and there are Latin American countries that do that and African countries that do that, it tends to be still higher in the developed world.

Undeveloped countries that report well still have lower incidence of cancer than developed countries.

Yes, they have specific— they have regional cancers, you know, but overall as a general trend, there's one thing about the way we live versus the way they live that it has to be taken into account. So of course there's many different factors and we'll talk about each of them. And then in the United States, and then when you say, well, what's going on in the United States? Well, the United States, Ranks in the top 10-15% of all nations with cancer rates, but not as much as Germany and not as much as Czechoslovakia is like not the number one, and number two is Australia for some reason that, you know, so are people in Czechoslovakia drinking more alcohol? Are the Australians drinking more alcohol? Are they exposed to some specific regional toxins that we're not aware of? They're not less, they're not more sedentary than we are. You know, certain things are clear. They're eating the same food as we are, maybe even a better food supply than we are. So there are multiple factors going on. But why has lung cancer, for example, still the number one cancer worldwide, even in places that don't have high smoking rates anymore?

So we've reduced Smoking rates and actually alcohol rates in France and Italy are going down, but although air pollution is still a pretty hefty issue and a growing issue as well.

So you're left with the area under the curve that something else has supplanted what was exposed by smoking, and now you remove the smoking from the equation and you still have it because the rates of air pollution over— and the rates of inflammatory states in the lung that we're constantly inflammatory, yeah, interacting with the pollution.

And when you say smoking has decreased, at the same time we've seen a concomitant increase in vaping of nicotine and cannabis. And from what I understand, that's— that at this point is dwarfing the rate of decrease of cigarette smoking. That's correct.

So that way, polyethylene glycol all day That's true, and that's a disaster in the making because again, the exposure to environmental toxins and food toxins and oncogenes and viruses and so on. So when you say, "I want to see what the area under the curve is," well, I have to know that on an individual basis. We're not talking about epidemiology now. We're talking about natural history. Natural history of cancers we know are affected by the inflammasome, this inflammatory cascade that's generally much more pro-inflammatory today than it was 20, 30, 40, 50 years ago. We understand that to be a fact.

The inflammasome.

So this is the pro-inflammatory signaling. So this is— so when I first became immunologically trained, We had 3, 4 cytokines that we knew about, TNF-alpha, IL-1, IL-2.

Those are inflammatory molecules.

These are cytokines that talk, communicate. So generally speaking, you'd say certain ones are modulatory, like interferons are modulatory, and certain ones are pro-inflammatory. The one that's probably the most commonly known are TNF-alpha and the IL-1 and IL-2 receptors. But you need them to exist. I mean, they're not bad, they're just constantly activated. So when you study this today versus— and now we have, we know that the cascade is about 300 of these communicating molecules.

These inflammatory molecules.

These signaling molecules that some tend towards— most of them tend towards inflammation. Inflammation and repair overlap. So many of them are useful in repair. Many tend you to autoimmunity, many tend you to allergic phenomenon, but they're all in a cascade. No supercomputer today can figure out any— if you measure all 300 in a person, no one's going to be able to figure out the puzzle at this particular point in time. But we know that the overall inflammatory state is now pretty secured in the population. You know that if you go out drinking, um, and eating junk food, the next morning you're inflammatory, period. Yeah, you can measure it with the basic, basic, basic stuff like C-reactive protein. Yeah, because it's an acute phase reactant, it'll go up, you know.

But qualitative measurements like how long you lay in bed watching Netflix when you wake up because that's right, everything just feels too hard.

Right. And it has total body effects. We know that if you're sensitive to it, the reason you feel crummy is because a lot of that is because of these inflammatory signaling molecules give you a touch of the flu, even though you don't have fever, you don't have a virus. Yeah, just this. It feels the same way. Your fatigue feels the same way. It's just not as extreme as it is when you're—

And so what you're saying is that you have, because I know you do and we talked about this in our last podcast, a much more comprehensive series of inflammatory marker measurements than you might get on the average blood test. You're saying that an increase in those inflammatory markers is something that has risen in correlation to this rise in cancer? Yes. And that could be due to some of the other things we talked about— toxins, electromagnetic soup, ultra-processed foods and ingredients. Animal venoms, poor emotions and lifestyle and stress, et cetera. Any of those things could cause rise.

Right. But the reason I bring it up today because we're talking about cancer is I think that that aspect of things is not discussed in depth as it should be because it's— everyone, "Oh, I know that I'm eating ultra-processed foods and the chemicals, they're bad for me. I understand that, but it's okay that I'm My doctor said my C-reactive protein is 5 or 4, the upper limit is 3, but we want everybody to have it less than 1 or less than 0.1. I mean, it should be 0.

Yeah.

Period.

And that— unless you just got done with a workout.

Yes, but by the next morning, right, you should be back to baseline. So when you're running around with the inflammasome activated in a pro-inflammatory way, that's what inflammasome means. It's this pro-inflammatory Inflammatory cascade is good and bad. You need, you need both. You need, you need it to survive. You can't, you can't exist only on antioxidants.

Yeah, but why, why is it? Because, because like, obviously if you exercise, right, you know me, like, I'm— that's my jam. Like, my business is exercise science and fitness to a great extent. You create inflammation, um, you know, arguably even if you do a hefty sauna session or something like that, you could create hyperthermia-based inflammation. Um, but you don't see people who exercise frequently or lift weights, it seems, at least getting cancer at as high a rate as someone who develops inflammation from, say, a toxic lifestyle, ultra-processed food. So there must be a certain flavor of inflammation or a certain environment in which the inflammation takes place that would cause the rise in cancer.

Yeah, that's correct. So inflammation and repair go hand in hand. I mean, there's a tremendous overlap. So when you microscopically injure a muscle by overuse, it, it requires the same cytokines that also would produce in a chronic state, an inflammatory state that is not reparative.

Yeah.

So it goes overboard. It's, it's not modulated back. Right. And why is, why is that? Well, well, some of the major modulatory pathways are completely off now. What are, what are they? Vitamin D pathway is one of the major immunomodulatory pathways. I mean, it's a, it's a hormone, it's not a vitamin. So that hormone is responsible to modulate your immune system back to the center. It does so not just by acting as an anti-inflammatory. It is not. It's a it, it goes through sets of hundreds of pathways including anti-inflammatory pathways, but it also modulates with the renin-angiotensin system that has— that is the target of COVID That's why I bring it up. It's a target of setting the system out of its modulatory pathway. Yeah. So, so for example, you could argue that the cancer rates have really been pretty flat despite, you know, treatments and despite everything, the death rates are pretty flat overall for the last 30 years. Well, we have better treatments, better surgeries, better chemotherapies, more targeted immunotherapies. We have those, but it hasn't really made a huge dent. I mean, certain ones on a total— totally. The total number hasn't changed and the total number is anticipated in the modeling today, is anticipated based on these other factors that modelers put in, like what's the effect of being more inflammatory than we used to be? What's the effect of being more stressed than we used to be? What's the effect of a more miserable biome that we currently treat ourselves with? What is that effect? It's going to rise by 60% to 70% by 2040. So, whatever the numbers are, they're going to go up according to logic and according to the models. Yeah.

So, it sounds to me like we might not know the exact reason even though there's a cluster of clues as to why it's increasing. But, I think that what I'm interested in is how people like me in our young virile ages can actually know This morning I got up at the Holiday Inn. Last night the front desk called up and said my pee cups were here, and I went downstairs and I gave my first morning void, and I brought that in, which I think has something to do along with this needle in my arm with the type of ways that you can detect whether or not a young person or an old person would be getting cancer even before you might see a PET scan or an MRI. This is interesting to me because I haven't even told you this, uh, 6 weeks ago my dad showed up at my house with gut pain. And he has a history, you know, he's Ashkenazi Jewish, which I think has a little history of gut issues as well. I even have a princess gut myself. And, um, and so I said, oh, our daddy, you know, this, you know, everything you're talking about, it sounds like diverticulitis, some inflammation. And, you know, I, uh, I cleaned up his, his diet for that day, and I brought him down to my friend who's a naturopath. We gave vitamin C IV and some ozone. And as I was driving him home, his pain was just getting worse and worse. And I said, Dad, something's not right here. I'm going to take you into the ER. So I pulled a UE on the road, took him to the ER. Long story short is, via a series of scans, um, you know, CT scan, chest X-ray, etc., uh, the nurse came into the room and said, well, Mr. Greenfield, you know, we thought this was diverticulitis or some type of inflammatory pocket in your colon, but it it's instead like a pretty massive growth. As a matter of fact, when we met with the physician for a follow-up a few days later after more scanning, they said that it was likely that the size of the growth, this tumor that was blocking nearly his entire digestive tract, had been growing for nearly 10 years. And I don't know if that is the case, but regardless, uh, went in for emergency surgery because it had progressed to a pretty concerning point. Almost died in the hospital 3 times with sepsis and surgical complications, and It was a very emotional time. Just 6 days ago, he was discharged from the hospital and he's now at home, but I've been calling up my brothers and saying, "Well, look, 3 cousins on our mom's side have died of colon cancer. My grandfather died of colon cancer. Now, we know my dad who was adopted, we didn't know his genetic history, obviously has some issues and there's likely issues on his side. We got to get colonoscopies, guys, and we got to start to do some detection and also begin to educate ourselves on the treatment." I've been on this, on this journey to learn more and more about why it happens and how we can detect it. And so that, that kind of leads into my next question for you. You know, you got me, you got my, my two brothers, and we're sitting here quaking in our boots. Maybe we have something that even a PET scan or an MRI wouldn't be able to pick up. What do you do? What's your screening method?

Well, let's just again take it from the top. Um, There are some factors that we know about. So, you've heard that genetics mediates some percentage of risk, whether it's cardiovascular or Alzheimer's risks, so on. So, somewhere in the low range, 5-10%, something like that. But for colon cancer, there is a specific genomic alteration called Lynch syndrome. These are the genes that deal with repairing your DNA at night. Mismatch genes. So, these are the genes that repair at night. So, when the copy is not exactly the same as the original, they repair that. So, there's a group of maybe about 10 genes. So, the Lynch syndrome people have an increased risk for colon cancer specifically, all the gut cancers, but mainly colon cancer. And, that's where you have to be very aggressive in terms of colonoscopies much more often. And, I'll explain why colonoscopy is the better way to go for them, but also probably for the entire population. Although, we would all like it to be easier than that, and I'll review all that too. But, so So, that's one thing. So, let's just assume that only occupies a small portion of people. It's probably not your dad because your dad is getting colon cancer at an age that is standard.

Yeah, 70.

A standard colon cancer.

And there's the 3 cousins on my mom's side who are more like 40.

So, that's the risk. The risk is there. On that side of the family. But, so, it's been there for a long time. It's enough to obstruct. And, that's not an uncommon scenario because unless you go to the doctor and/or buy a Guaiax stool test and say that I'm leaking a tiny bit of blood microscopically.

A Guaiax stool test?

No, it's called G-U-A-I-X. A-I-A-C, guaiac. It's just a stool— it's a stool test for blood. Oh, okay. Um, and microscopic amount of blood. This is not when you, you're seeing blood, right, in the toilet. This is when you can't see it, right? Uh, typically someone like your dad may, may actually have an anemia from that microscopic loss of blood over the years, which he didn't notice, because ultimately it obstructed him, right?

Yeah.

Um, and, um, and then by that point he may be unfortunate enough to have metastatic disease and local disease or local lymph node involvement or metastatic disease. But, the point is, what do you do when you're 40 and 50 to figure this stuff out in advance?

Especially if you don't just want to get a series of colonoscopies every year.

No, no, I understand.

For example.

Yeah, of course. But right now, even the trend to younger age groups getting colon cancer, just on a national level to understand that there used to be when they first came out that colonoscopies were only paid for by insurance if you were— even if you were Asian, it was 50. And now it's lowered to 45. And they're not going to go lower than that because it's going to be prohibitive, a little expensive for them.

But, um, but that's not enough tubes to go around to shove up people's butts, right?

I mean, so ultimately, even if you're asymptomatic, 45, you can get your, your first one, then not another one for 10 years, okay? Unless you find a polyp. You could say, listen, I'm willing to take a Cologuard test, you know, which is a Cologuard test. Cologuard, C-O-L-O-G-U-A-R-D, which is a test Also, a test that's based on DNA, mutated DNAs that are found in the colon secreted by colon cancer.

I've seen this once. Is it like a blood test that you send in that has a certain percentage rate of being able to pick up colon cancer specifically?

So, that has a pretty good positive predictive value. It means if it's positive, it's good. That means you already have it, right?

Okay.

So it's not preventative at all. It just is maybe, maybe you'll catch it earlier.

And this is something anybody's doctor could order for them, a Cologuard test?

That's correct.

Okay.

I think you can order it. You may be able to order it soon on your own. It's not going to be covered by insurance.

At-home test kit type of things?

Something like that, yes. But you have to be— you have to fulfill very strict criteria. They won't run it if you're below 45. 45. They just don't want it.

You can't ask. Even if you have high genetic risk.

No, no, they want— and they don't want— they don't want you if you have high genetic risk for some reason. I don't quite understand all the different— it's odd— things. So you have to be asymptomatic and you have to be above 45 and not have a family history. And so why they stay away from there, I don't know. Perhaps it's something to do with, I, I can't afford to have a true— a false negative test. In the population. And that population really needs to go to colonoscopy. The major advantage of colonoscopy, even though you have to be prepared and prepped and then put under anesthesia, of course, is the fact that you're going to find in a higher number of people, not cancer, but you're going to find the precancerous lesions that the blood test can never—

Are those called the polyps?

The polyps.

Okay. —How big are those, by the way? I think polyps, I think about a bunch of mushroom spores when I'm walking through the forest or something like that. —Right.

So, you'll pick it up on a colonoscopy if it's about half a centimeter. —Half a centimeter.

Okay.

All right. It doesn't have to look like a bulbous mushroom that you see in a cartoon. But, in any case, at that point, it's precancerous. It's it's an adenoma. It doesn't have dysplasia and it doesn't have an abnormal cell type in it, but it also sometimes can actually have a carcinoma in situ right there. And you just, you clip it off and you're done. But then, you owe yourself another colonoscopy in 5 years.

In 5 years. And so, that's what I'm wondering. Obviously, with what you were talking about earlier with this rate of cancer growth, I mean, you cited a figure of 6 weeks. You could do a colonoscopy, get a polyp removed or not. If you don't find one, wait 5 years, and by 5 years have a pretty massive growth. It sounds like the Cologuard test could be one option as a blood-based screening. Is that the best one out there?

Probably for colon, yes. There's the Galleri— G-A-L-L-E-R-I— test, Galleri test, uh, that, um, there's also a blood-based DNA test that can measure about 120 different cancers at one time. Again, very strong positive predictive value. That means that if you have a positive result, 99 times out of 100, you, you have cancer.

Is that the one you were telling me about that you send off to Europe?

No, that's different. So I'll get to that. Okay. Uh, but it's poor for early stage. So, stage 1, they only, they only can identify 40%. Okay. Stage 2, 60%. Stage 3, 80%. And 95% of stage 4 cancer. So, your father would have a positive Galleri test, but he obviously knows he has cancer. Yeah. And if he knew about it 6 weeks earlier, it wouldn't have made much of a difference? Probably not. But if he, if he was wanting to predict 5 years ago when he had perhaps had a very early stage disease, it wouldn't be a great test to use. So, we send the test off. There are multiple German-based tests looking—

And, by the way, is this a blood test that you send off?

A blood test, yeah. Okay. This you need a doctor for. There's a few German entities. The one we send moved laboratories over to Greece. We call it the Greek test, the RGCC test. It actually means something.

It's the name of their lab. RGCC. Is the name of the lab in Greece that you send these tests off to.

But using the German technology that he brought over. So, this is a brilliant German immunology oncologist who put forward the methodology to look at multiple cancer stem cell receptors on circulating blood. Okay. And finding it in small numbers.

Is this what you would call a liquid cancer biopsy? Yeah. So, this is the liquid biopsy.

So, there's a liquid biopsy revolution happening in the United States, which we'll talk about. But, this one is the technologies in Europe currently that are approved there but not here at this point will show you results when you have a circulating marker that's abnormal, but you can't find the tumor in that location. It's not visible yet. Yeah, yeah. So, so, so you're catching it truly in an early—

even before what you could potentially find in a colonoscopy? Oh yeah. Wow. Yeah. Okay.

So, so once that polyp turns cancerous and it's more than a millimeter or 2 millimeters in size it will leak into the bloodstream. And then in the bloodstream, it has a life of its own because the cancer stem cells are immortal and they're immortalized so that they exist there and they grow a certain amount. But even in low numbers, they can be picked up. And then you have to track it down. Sometimes each of the different tests— the one that we use can pick up prostate-specific, breast-specific, squamous cell-specific cancer.

Oh, so you don't send off the test and say, "Hey, we want to test this for colon cancer." No. We'll just test it for all of them.

So, there's one panel. You get hematologic because lymphomas and lymphomas are up and leukemias are up and myeloma is up. And then, they run it all. They run it on everyone, but they have a different panel for the epithelial. Epithelial-like cancer, for the solid tumors. Okay.

And if someone's listening in, how do they even find a doctor who would run a test like that? Do you just do it like a Google search for this RGCC test?

Well, you, you go to their particular website.

I mean, and they'll— the RGCC website.

Yeah, because they'll— I mean, obviously we do them, uh, a lot, and we do them a lot for other doctors because, uh, in, in the Bay Area.

But someone still has to come into clinic?

They have to because it's a, it's a, it's a real blood draw. So you have to take 30, 50, 40, 50 cc's.

Is that what they did on me this morning, this, this blood draw?

Uh, no, that was, that was filling in everything that I'm going to talk about from now on with regards to, to really having a cancer prevention stack of data. Okay. Okay. Um, but we've already sent your test over there as it was negative. Right, didn't we send the RGCC test?

I don't know, I lose track of all the things you do to me. Yeah, okay, I think we did. Okay, so what are these other tests that you do then, like the ones that you, that you drew from my blood today?

Well, um, I, I, uh, figured that if I let the, the clinic grow organically when we first opened, that we would learn more than if we restricted it. Coming from immunology and cardiology background, I mean, this never, never came close to becoming a cardiovascular risk reduction type of a place because it was open to everyone. And the folks and the inflammatory state sort of was king here for the first 10 years.

So what's that mean, open to everyone?

I mean, we didn't select patients, patients who who came through the door, came through the door. And then we noticed that we had to find our solution, best care solutions for cancer care patients. And they were in two different groups, one that was doing traditional chemo and one that had an affinity towards just doing it in an alternative integrative way, right?

So apricot kernels and high heat saunas and all that stuff. Right, right.

So, but, but, but there was— but there's an over— so that— so we had this, this extraordinary data set from cancer care patients and understood what was associated with that. And I'll, and I'll talk to that in a minute. But then we also were interested, because of my own age, I was interested in— tremendously interested in longevity. And its interaction with the immune system. So when you look at cancer prevention, it's wise to look at what the drivers of longevity are because it's the same thing. It's sort of— it's an accelerated form, area under the curve pushing you into mutational forms. But when you look at it, we sort of also forget some of the most basic stuff. So, for example, the single most important piece of information that we'll get from your urine, the early morning urine that you and your wife brought in, was your urine pH.

Your urine pH? Yeah. You can get that from just like a pee test strip, right?

No, you can get that for $4 from, from any Walgreens. But that's a single— one of the most important tests you can use every day for cancer screening. Really? Yeah, I'll tell you why. So, um, because you know from your own studies that having a more alkaline urine means that at night you, you, you repaired more DNA, you repaired— you produce more pro— more reparative proteins. You know you'll recover faster if you're acidic. So a lot— most of the people walking the street have a urine pH of 5 or 5.5. They're quite acidic. Which is very acidic, yeah. So, that's a pro-cancer environment, period, end of sentence. The tumor microenvironment is acidic. It's also hypoxic. But, that's the information—

Based off Warburg's hypothesis. That's right. Cancer growing in hypoxic, anaerobic, lactic acid-accumulated environment.

That's correct. So, and most doctors don't think about That's the most important thing to change, and one of the most important. And that's the one that's also been associated with longer life. If you look at the few things that have been documented in the literature that are associated with longevity, early morning pH between 6.5 and 7.5 rather than lower or higher, mainly lower, is associated with longer life.

Well, so we all just need to get one of those Kangen alkaline water generators, right?

Maybe that would work. I, I don't know if it would work because it, it, um, the question is what gives you the effect. And the effect is mainly from food and, and, and from shifting your metabolic system into a better state.

Poor kidney function, mineral depletion. There's a lot, there's a lot there.

So acid alkaline balances. Yeah. And some of us get it back by just simply taking a different approach to nutrition. But then, what are the drivers? What drives longevity that we know about, been proven, is vitamin D, hemoglobin A1c for your blood sugar metabolism. We know that from Warburg's days that tumor cells love glycogen and glucose. So, having that under control, So pH, hemoglobin A1c, vitamin D, glucose—

these are all things that you would test. These are very basic tests.

They're very, very basic. Yeah, but look at them as a stack. You have to include whatever you're— whatever you're measuring. Most of us have normal renal function and liver function. Okay, but you have to add C-reactive protein. Has been shown to— you live longer. And the— that's pretty much about it. That's been—

that's not documented or fancy series of tests.

No. That's not sexy. No, but I think it's lacking. It's lacking because we've identified a much deeper dataset that is much— Oh, so you go beyond just what you just told me. Yeah, because the only immunological marker there is, are you inflammatory or not? And it's one of the more basic ones. I mean, it's just basic. Everyone does a C-reactive protein. That has their normal, I don't know, cardiac risk factors done. So you need to go more. So for example, what is the area under the curve of all the toxicity end up doing? What is it doing in everybody? Well, it's affecting everyone's biome, and that's a— well, and we have to get into that. But it also affects our innate natural immune system. The summation of all the pollution, all the chemicals, and so on affects it. So, what that means is our surveillance system looking for foreignness, looking for foreign proteins, looking for mutations which are foreign is suppressed. Okay. Then, you add the absolute epidemic of toxic mold, which is also a suppressant. And then, the epidemic of having most people today having a very large viral load over when they were kids.

I've also heard in addition to mold and viruses, parasites can also be a contributing factor.

Yeah, except one interesting thing, having worked in global health for a long time and traveled all over the world, that again, when you look at the association between countries with heavy parasite loads They have a lot of stuff, but they don't have autoimmunity and they don't have cancer.

They also eat a lot of hot peppers.

Yeah, and they eat what they eat.

Yeah, those Thai ghost peppers, no cancer can survive that. That's true.

So when you add something that measures some measure, so it's not the fanciest 100 cytokine panel that we can organize here, but You measure something called natural killer cells. So, these are the CD8 NK natural killer cells, which are labeled CD57. These are what we call here in the office, "Oh, just do a CD57 count." And everyone knows what we mean. So, that has a huge range of 60 to 360. So, the range is really high. It's very, very broad. But if you're less than 100, if that's the number that you have and you're less than that, then you have some work to do. And that's to me one of the most fundamental reasons I like thymosin alpha-1 as a peptide because it can move that number up. Now, you have a very high number.

It can move the killer cell.

The killer cell. So one thing I find that's a cute story is someone comes in and is proud to tell me that, you know, everyone is sick in my family, I never get sick. I'm just the one who's so strong and never gets sick. And I tell him, sit him down, I'm saying, that's not good news. It's not good news. It's not good news. No, it means your innate system is asleep. I mean, get sick once in a while.

But could it also mean you have good vitamin D status and toxin clearance? Yeah.

But then, you don't get sick very often. But the last time I got sick was 12 years ago doesn't make sense to me because you're in everyone else's environment. So, you're right, most people are getting sick too often. Yeah. And their innate system—

I was going to say you're making me nervous because I rarely get sick.

Well, I'm saying, but your number is really high. My number of— You have CD56. CD57 natural killer cells is really high. And we'll see what your wife says today. And that's, to me, when we apply AI to our dataset, we'll find— I think that there's a strong likelihood that we'll find that CD57 counts will be associated with longevity. Okay. And you also said thymosin alpha-1 peptide is a peptide that can increase that? Yeah. So, this is the thymus, the thymus communicator. The thymus is governing our immune systems until we're adolescents, 12, 13, 14 years of age, and then disappears. So, it's a peptide. And we always have our— we're right here next to the major street with all the—

San Francisco, baby. San Francisco.

But we're in a big city. Yeah. So, that can move the number up. The way you train your thymus gland is when your mom breastfeeds you with colostrum. Oh. So, that's— I love colostrum. But, that's real colostrum. That's why my levels are so high because I do colostrum almost every day. But, I don't believe that that's the case, but that's because the colostrum that we eat is— that we take in as a supplement. May or may not, I don't know. We have to see. But that's where it comes from. So, thymosin can act on it. But you say, "Well, I want to know what my number is." And about 90 to 95% of the cancer patients have very low CD57 counts, have very low natural killer cell counts. And the ones that get cured all have them raised up. Okay. Over time. So they clean up, clean up, and then—

so this is one reason people go and do like NK killer cell treatments in Mexico and things like that. Sort of.

It seems like that's logical. I don't know, I don't know that anyone's proven that that makes a big difference, but that makes sense. Yeah. But that's where— what suppresses it? Mold, oral infections, the deep oral infections from root canals. The deep sinus infections that are occult, and heavy metals, all of it, you know. And then you have the, the biome consistently being a source of, of inflammation.

So yeah, so you mean like gastric inflammation?

Well, gas— yeah, the whole GI system is— we have explosion of SIBO, we have an explosion of dysbiosis. So dysbiosis that's untreated. So you say, it's okay, I only pass gas once or twice a day, and I, I have my bowel movements every, every 2 days. That's completely unacceptable. Every 2 days, a long time. Completely unacceptable.

I can't hit even once a day in the morning without, uh, without having a giant dump, giant toilet-filling dump.

The masters in the developing world that take care of themselves 100% naturally and do it. They're pooping every time they eat, after every meal. But I think twice a day is quite normal. But again, sometimes we're even suppressing our desire to go to the bathroom because we're too busy.

Yeah. I'm a two-a-dayer, 7:00 AM and 4:00 PM, like clockwork, baby. Well, that's—

well, that means your elimination pathway, your major— the major one that you're using for toxins. I mean, urinary function is normal in almost— and so much, so much of the population, but pooping is not, you know. And so you have to regulate that. And so then you have to say, well, what's my— what's my detox area under the curve? What do I need to get out of my system? Well, you have to measure it. I can't, I can't guess what it is. And looking at blood, blood tests for heavy metals and all the toxins is not appropriate because these are in the deep tissues. You have to provoke them out. So blood test that shows you, you're low in lead and mercury is worthless. Yeah, just— what now? If it's positive, it's already elevated. You don't need to— you just need to know the provoked level to see where my baseline is, how long. Then you could predict how long you're going to need to chelate it out. And, the mold takes— and, to change the subject back to mold again, it takes time. And, the mold is not easy. It doesn't happen overnight. You got to take the binders for which you were started on probably for 12 to 18 months to get it out.

Ben Greenfield: Yeah. There's a couple of good books, one by Nasha Winters and one by Leigh Erin Connelly, both books about cancer screening. Much of what you're saying. I've seen some of these same tests in those books. So I'll certainly— in the show notes at bengreenfieldlife.com/cancer episode, so I'll link to those titles if you guys want to take a look at a comprehensive review of some of these labs in case you weren't writing down notes like I am right now. But I, I guess, you know, it's important beyond testing, I think, to talk a little bit about what you, particularly in your practice, would do? Let's say you find a young person who you've found tests positive with one of these cancer screenings, or at least shows a lot of the signs, or even, you know, shows a significant growth on a PET scan or an MRI or a colonoscopy. You know, I mentioned slightly in jest but slightly not, you know, apricot kernels and ivermectin and monoclonal antibodies and drinking your own pee and, you know, going off to Mexico for the killer T-cells or off to Paracelsus in Germany for the hyperthermia and You know, and so there's just so many remedies out there that it seems like you can't swing a cat by the tail without hitting one. And then with my dad, with what's going on, everybody's like coming out of the woodwork, your dad needs to do this, your dad needs to do that. I respect you and, and your opinions on these matters. You're very well connected in the medical community. So what's your general approach as far as the things that really seem to move the dial for cancer treatments?

So as you know, on the big picture side, the earlier the better. The earlier the better. So early detection, even with nothing about what we're talking about, when you get into the system earlier, you know, at stage 1 versus stage 3 and 4, it's a big survival difference. So that teaches you. So when you get super early with these liquid biopsies, then we have never had a person that's been treated here in the 12 years that has had a liquid biopsy that showed circulating tumor cells that has advanced.

Really? Because of the treatments that you're doing?

Because of the laboratory screens And then fixing what you're— if you're depleted in something fundamental, then you have to replace it. You have to understand that for some reason you need more magnesium than the person next door. Sometimes, you know, you have something going on with the vitamin D receptor, you need more vitamin D, and you need to reduce your carb load. Yeah, that makes sense.

But so many people talk about you got to like cut and burn and get it out of the system.

The cancer. Well, I'm saying, but here you don't even— you can't even find the cancer because it's very, very, very early. So you have that 5 years in order to— yeah, to— yeah. So, so no one's ever progressed, and the great majority of them go to, to back to zero. Wow. Um, and, and one lesson we learned about that was we used to ask patients to do the test every month It's an expensive test. Do which test? Do this RGCC test every month. The RGCC. So, they start off with, let's say, the number was 3 and then to 2, then to 1, then to 0, 0, 0, 0, 0, 0, 3. What happened? Oh, my husband got ill. I went off my routine, tremendous stress.

And, when you say they went off their routine, they specifically were going off of the replenishment routine for whatever vitamin D or magnesium or anything anything else you have.

And then, and then you go back on the routine, back to zero. So you have to be aware that, you know, cure, cure is, is, is— it may take another 5 years if it was left untreated in some way by you, unadjusted. But, but it could come back. So, so, but that's one group, and that's the best possible group because it doesn't change your life forever other than making you healthier than you've ever been. Now, if you're stage 1, um, that's where we start saying all of this shouldn't be done— or stage 1 or 2— all this shouldn't be done orally. I mean, you have to replace what you're depleted in, you have to detox, you have to get rid of your, you know, the infections in the root canals, you have to get the mold out over time.

It's not an emergency. All things you'd probably want to do even if you didn't have cancer.

Well, that's the point. If you want to live longer, it's the same gig. But if you want to end up to be stronger than you've ever been and be alive and know that you're actually cured, you have to go to intravenous chelation. You have to go to IVs to replace, replenish, and get there faster because you don't have an endless amount of time to wait.

Yeah. If you've found cancer in its later stages, you use those more aggressive approaches.

Approaches. And even with stage 3 or 4, but obviously with stage 4, you have a very limited time because— and it seems to be that the cancers are getting a bit more on the aggressive side. So, you have less time. And then, we have our approach which takes in the German biological medicine approach that subsumes it into our—

yeah, which I'm kind of familiar with. I don't know if I told you this, I took a whole group of people like 3 years ago, more than that, on a medical tourism trip to the Swiss Clinic in, uh, in Switzerland, of all places. Uh, and it was up in the Alps. They did a lot of these German European biological treatments. I spent 4 hours in a hyperthermia chamber just to see what it was like. You know, lots of IVs, lots of chelation, lots of ozone. And so, these are the type of protocols that you'd have to go to Europe to do?

No, no, you can do them here. Really? What we don't have— what we don't— in this particular clinic, in our clinic, we use a surrogate of hyperthermia. When you look at the mechanism of action of hyperthermia, it induces heat shock proteins and that runs a cascade that ultimately ends up to have more oxygen in cells and tumor cells don't have antioxidants. So we have— we use the, the laser frequencies to get the same, to get the same.

Oh, so you'll generate heat shock proteins with lasers?

With lasers, yeah. So we use that. But other— and can we use obviously all the same IVs? All of our— most of our IVs are, are—

you don't have to go to Europe. No, you don't.

You don't. No more. Uh, and, and the, the trouble with going to Europe is very simple, and that is You can't stay there forever.

You want to be able to do it— Ask my wife, she'd probably like to. Closer to home.

But, at the same time, your wife's going to go there just to do their version of rejuvenation. Yeah. So, that's fine. But, you can do chelation here, of course. My organization that I'm president of called ACAM, we brought chelation to the United States 50 years ago.

With chelation basically being a detoxification? Protocol. Any particular strategy for that, for the chelation?

Well, when you're chelating orally, you, you can only do it for, uh, let's say we start off with 3 days on the chelate— on chelating agents, and then 11 days off.

And you're consuming a chelating agent orally that's binding toxins, and then you're also binding your minerals via urine and stool and sweat. That's right.

But they're also binding your nutrients.

You can't run, okay, all the time.

Yeah, but intravenously you do it once a week.

Okay.

In Germany, you— in a cancer protocol, even here, you'd probably end up doing it twice a week. Yeah. Um, and, and, but we have a more immunological-based system here, trying to get your own immune system to work on your behalf 24/7, than the Germans do. So we're more focused because of my background in that area.

Yeah.

Okay, so we're more advanced in that particular area, I guess. Yeah. Um, and, uh, and hyperthermia is, is also uses the same type of mechanisms. And there are the world's best hyperthermia units, uh, probably in Germany. But again, you have to stay there. And yeah, this is not a single treatment. You can, you can go through 20 hyperthermia.

For people who don't know, it's way more than just a sauna. Like, it's this pod and just your head sticking out and you got a rectal probe in to gauge your temperature and you're getting extremely hot. Yeah, inducing a full body fever basically, right? Like 105, 106, something like that.

And then, and then some of the centers, uh, take you so high, which is a reasonable thing if you can tolerate it. Yeah, under general anesthesia. Yeah. So, but I do want to mention something. There's another marker that I think is going to end up going on to the longevity list. Really? Which is a very bad marker to have when you have cancer, and that is ferritin. Really? So ferritin is an iron store marker. Yeah, iron storage protein. But you know about oxidation and you know about lipid peroxides and you've heard that term before, but basically our oxidative stress state that we're in produces rust from the iron. Now, iron is everywhere—hemoglobin, cell repair mechanisms, all the phosphorylated enzymes that are working on all the systems that we know are anti-cancer also contain iron as part of their molecules. But when you're oxidizing it, it produces a food for, for tumors. So, the ferritin starts going up.

Is that why red meat can be a predisposing factor for cancer?

I think that red meat is probably— has been shown in the literature to be predisposing for cancer at a relative risk of, let's say, 1.2:1, 1.3:1. Smoking is higher, alcohol ingestion is higher. Yeah.

Red meat countries, yes. But, do they break that out between processed crappy red meat— No, no, no. McDonald's versus like a— I've wondered that before because I think I still limit my red meat consumption. I probably have it 1 or 2 times a week and I'm careful with pork chops now based on your advice. But I've been doing a lot more fish and poultry to a limited extent just since my father's cancer battle.

But in nowhere in the literature does it suggest that eating less than a pound of meat a week is ever been increased in terms of cancer risk.

Okay. Less than a pound.

I mean, that's eating meat from our wholesalers. That's eating the meat you get at Safeway and Costco. Right.

So, your average processed, grain-fed, high omega-6 meat. That's right.

So, that has its own toxicity. So, So, I don't preclude my patients to eat meat. At the same time, the ferritin number, unless it's normal, you're not going to be cured. You're not going to get cured. Something is still quite off. You need more antioxidants. You need more— a better metabolic system overall.

Ben Greenfield: Are you familiar at all with the Root Cause Protocol by Billy Robbins, which basically is a copper and mineral-based protocol, and part of it is designed to limit the amount of oxidation that takes place in iron and ferritin accumulation. It's called the Root Cause RCP, Root Cause Protocol. You can find it free online.

Yes. Well, I think those, those are really good ideas, um, to incorporate both for longevity and for cancer prevention. But it also has to go on to, I think, the thing you've been talking about more recently, and that's the talk about being emotionally stressed. Yeah. And when particularly—

by the lack of connectivity. Yeah.

Right. So, all those things that we also know have some connectivity with longevity, but at the same time, To today, do you want to talk about what you're doing today? Absolutely, sure.

We can talk about anything. Yeah, yeah.

So, so we're in fight or flight. Yeah. So you're measuring it on, on your people, your coaching with heart rate variability. Yeah, yeah, yeah. So, and most of us are— most successful people are running in a sympathetic state. And, that's part of why you're successful. But, to modulate your parasympathetics up and to be the equivalent of what some of the masters feel are 1,000 hours of meditation in 90 seconds.

And, I want to come to my defense real quick. A lot of people think I'm driven, hard-charging, high-achieving sympathetic. My HRV is extremely high. High, sorry. Yeah. Am not very stressed despite being a driven guy. Um, most of my stress factors, from brainwave production to HRV to heart rate to body temperature, I tend to have very high readiness scores. But I also do a lot. I do like vagal nerve stimulators and meditation and yoga and cold plunges. And I'm every single day paying a lot of attention to nervous system balance. And I believe you.

I mean, I know you well enough to know that that's what you're saying is true. You could also sense it in somebody, um, when, when they're just out of, out of sorts. Yeah. But the stellate ganglion block that you're going to get today will, um, will modulate it even further, and, um, we'll, we'll see what the subtle effects are. So we know one of the reasons, at minimum, that you, you're going to benefit from it is we know that people, particularly the Navy SEALs, have been studied the most. They get stronger, their recovery times decrease, um, they're after doing a stellate ganglion nerve block. So they— and they— and you know, they're massively disciplined people as you are, and they're exercising, they're doing a lot every day and pushing themselves to the limits every day. And, and, and they, they have documented the metabolic effects and the efficiency effects on the musculoskeletal side, and VO2 max goes up, and so on. So you get all those benefits. And some of the world-class athletes that Dr. Tierney talks about a lot, they know to come in for their next stellate block when they've been leading the world in their fields for a long time. And then as they get closer to— as someone comes closer to them, then they know it's time to get their next stellate block, and they get pushed further. So, uh, so they're back to being 100 meters ahead.

It's like block doping. Yeah. And that, that's just an injection that, that triggers the vagus nerve to, to rebalance, right?

But it's, uh, it's unsafe when it's done, uh, in, in the wrong hands. Yeah.

So I do have to I actually have found a great deal of success with what would be considered the baby version of that, which are just these vagal nerve stimulators. I have one called a, uh, a Pulsetto that I use. There's another good one called the TrueVega. But yeah, those are, those are fantastic at-home devices for, for some of this nervous system modulation via the vagus nerve.

So just for your audience to understand that, um, I've chosen a stack of testing that does biomic tests, lymphocyte reactivity assays to 180 or 200 foods to see what you're reacting to, heavy metals, immunological studies. They're expensive. And I think everyone is shocked and surprised by saying when insurance doesn't come in, it may cost $5,000, $6,000, $7,000 just for the studies. Wow. To finish, to do a job. And of course, the older you are, um, I'm concerned just a little bit more, but I don't leave anything unturned, right? Um, so for you, the first time we saw you, we didn't run every test known, right? But that's quite expensive, and we don't— that, that's what it costs. Yeah, to do the right thing. And then serially, over time, what we'll do is we'll identify a landscape for you and say, this is the hierarchy of the things you should worry about. These are things you should measure 2, 3 times a year. And this is what you're depleted in, this is what you need, you know, for now. And then you probably repeat some of those tests, a fraction of those tests, once or twice a year after that. And that's an investment that you do again once when you're younger, big investment, and then you do it, you repeat it again 5 years later.

Yeah. And so on. Yeah. Well, what I like about this is it's a lot of, of pretty simple tests from the get-go that you're recommending, some basic protocols like your gut biome, mold, parasites, viruses, you know, C-reactive protein, hemoglobin A1c, urine pH, vitamin D, glucose. You know, I've got some very helpful notes here. And then, you know, like we were talking about earlier, it's kind of a multimodal approach, especially if you're concerned about being young, your risk of cancer, and a lot of these preventive strategies. I do recommend for anybody listening that book I just finished that I mentioned, uh, Anti-Cancer Living, which is also the book that talks quite a bit about connectivity. That's fantastic. Uh, like I mentioned, Nasha Winters is another resource that I've delved into quite heavily. She's good. Um, for you, uh, I'll, I'll of course link to your, your website in the show notes at bengreenfieldlife.com/cancer-episode. But generally, someone could just go to Anatar Medicine. You have like a new patient form or something like that if people are interested.

Yes. And, um, and ask for, uh, you know, the— that you're interested in the cancer prevention type of stack of things, the cancer prevention stack, the CPS.

All right, cool. Avi, as usual, you're a wealth of knowledge. I always learn a ton when we sit down and make the mics hot. So, okay, thanks once again for coming to the rescue for everybody who's been asking me all these questions about cancer screening and cancer treatment. You're welcome. Appreciate you, man. You're welcome. Ben. All right, folks, I'm Ben Greenfield along with Avi Herskovitch from Anatara Medicine, signing out from bengreenfieldlife.com/cancer-episode. Have an amazing week. Want free access to comprehensive show notes, my weekly roundup, cutting-edge research and articles, my top recommendations for everything that you need to hack your life, and much more, visit bengreenfieldlife.com. In compliance with the FTC guidelines, please assume the following about links and posts on this site. Most of the links going to products are often affiliate links, of which I receive a small commission from sales of certain items, but the price is the same for you. And sometimes I even I get to share a unique and somewhat significant discount with you. In some cases, I might also be an investor in a company I mention. I'm the founder, for example, of Kion LLC, the makers of Kion-branded supplements and products, which I talk about quite a bit. Regardless of the relationship, if I post or talk about an affiliate link to a product, it is indeed something I personally use, support, and with full authenticity and transparency recommend in good conscience. I personally vet each and every product that I talk about. My first priority is providing valuable information and resources to you that help you positively optimize your mind, body, and spirit, and I'll only ever link to products or resources, affiliate or otherwise, that fit within this purpose. So, there's your fancy legal disclaimer.