The Real Problem With Standard Cancer Care

If you or someone you love has cancer, you probably feel safer when you hear the words board certified oncologist. And you should. I have friends that are board certified oncologists. This is a doctor who's gone through intense training. But let me ask you a hard question. It's controversial. This could change your entire treatment plan. Is your doctor actually treating your unique biology and getting to the root cause of your cancer and targeting the care? Or are they mostly following committee guidelines written for the average patient in a clinical trial? The truth is even, even the most dedicated doctors can be trapped in the system of the one size fits all approach called the National Comprehensive Cancer Network guidelines. This system is usually built on the model of the double blind placebo clinical trial, the gold standard. A great model for testing drugs, but not such a great model for testing the unique biology of every cancer patient's unique targets. Doctors go to school, they do their residency, their fellowship, and they have about a half a million dollars, let's say in debt on average. And now they're part of a group hospital, big hospital. They're part of a medical practice that does oncology. They're not going to rock the boat. They're going to do their job, they're going to do their best. They're going to work within the confines of their organization and the limitations of their organization and follow the billable insurance guidelines. In this episode, I'm going to show you the real difference between standard board certified oncology and precision oncology. I've been asked this many times by people and reporters and I can tell you this. The gap is a big difference between the two. I'm Dr. Dino Prado. For the last 25 years, my team and I have helped thousands of patients who've often and failed treatment at the top cancer hospitals across the country. I've also trained doctors, many from different backgrounds, including board certified oncologists, to practice precision oncology. It's totally different. Here's one of the critical things I've learned about training doctors, no matter the background, an MD or a DO or a naturopath or a board certified oncologist. Even after doing all the work to become board certified, most doctors still will need 2,000 hours and a full year of free training to really practice precision oncology. To understand the mechanisms of action, the multi omics, the pathways of oncology and how to design care. This type of care that focuses on all the targets and brings in the root causes is not taught in standard oncology. It's really additional. So today I want to walk you through this, what's a board certified oncologist actually? And the good and the bad, how are the NCCNN guidelines built? The treatments that are used in all the major cancer hospitals, the National Comprehensive Cancer Network guidelines, and why? I think a lot of times they fall short, especially in late stage and complex disease. So what's precision oncology and how different is it, how advanced? It's testing with DNA, rna, immune spatial biology and profiling, looking at a thousand plus data points. And when you have that model, you can go on label, off label with repurposed drugs. You can use plant based phytotherapeutics that are custom delivered. You can use cellular biologics, cancer cell vaccines. You can deliver the care in a targeted manner. This is the power of precision oncology. Nothing I'm saying here is personal medical advice is to open up and challenge your thinking. But this episode will help you to ask smarter questions and to get a better understanding of what's going on with your cancer treatment. So let's here's the good news. A board certified medical oncologist has done a lot of intense training, medical school, internal medicine, residency, oncology, fellowship board exams. And they've learned the standard of care. And really after that it's their time and years in practice that give them the experience of becoming better doctors just like anybody else. Basically five years after and seeing a number of patients, doctors get on board of understanding how to manage the patients. Hopefully they learn how to use chemotherapy, immunotherapy, targeted drugs, radiation. And the system is built mainly on big pharma pipelines. So what do I mean by this? Yes, you're going to get chemotherapy. That's standard of care prescribed for your type of cancer. You will only get an immunotherapy if there is one approved for your type of cancer. You will only get a treatment if it is the regimen model. You will only get the radiation that is available at that hospital or in that institution because that's what they're going to recommend in their facility. That's what I mean by the cancer industrial complex. You're stuck to that. How do you manage the harsh side effects and complications? So you pre treat with some medications, you block side effects by giving these combinations. That really becomes the work of oncology. This training is very important and in many cases, particularly in early stage disease, it can be life saving because usually surgery does most of the work and chemotherapy might help a little bit. But it's deeply rooted in these NCCNN guidelines. I just talked about and it's tied to the double blind clinical trial model, Not n of 1 Precision oncology. Precision care is the future of cancer treatment, often leading in my clinical experience to better outcomes because we have more targets. I remember oftentimes we're seeing patients that already failed standard of care. They've tried it and then they need precision. And I think the sooner you implement precision the better. And here's the key problem. The training is built in standard oncology or in board certified oncology on these protocols they are built on the standard of care models and not around deep biology, not around targets. Those are starting to come in. They're making some recommendations for DNA genetics, but not the level of testing that I'm talking about. Spatial biology, RNA transcriptomics, DNA ngs. It's coming but it's not here yet. And once you have that, then you need to know how to combine the care for that individual patient. Patient do root cause analysis of what's causing the cancer. Is it infection? Chemical toxins, heavy metals? How does that affect the immune system? And how do we help the patient get back to health? After all, so much of modern cancer treatment is rooted in warfare instead of root causes. Chemotherapy came from the mustard gas that we used in world war battles. Radiation therapy grew out of the same physics that gave us nuclear weapons. And we're kind of stuck there. In our thinking we've inherited a medical approach shaped not from deep learning and data that's unique to each person and personalized for healing, but for a short term survival. And basically a one size fits all. That's my clinical opinion. Most board certified oncologists in the United States follow the NCCN guidelines and they basically have to if they're linked to any of the top organizations. These guidelines are developed by expert panels based on published evidence. So that's good. And it's updated regularly on paper. That sounds great. They give your doctor a clear map, a way to show insurance companies what they're doing and get it billed and covered. That's great. That's a standard of care. But there are some big limitations you rarely hear about. And the number one limitation is the guidelines lines are written for groups, not for you. These are big populations. They're built around the one size fits all average patient population health. The second problem is evidence level is highly mixed. Some recommendations are strong, but others can be based on weaker evidence. Yet still they drive expensive toxic treatments that are not individualized for your markers and your specific data. Number three, almost everything is drug centric. It's all based on big Pharma, very little on detoxification and getting the immune system involved. Unless it's an immunotherapy therapy drug or nutrition, there's very little custom drug build or metabolomics. So when your oncologist is just following the NCCNN guidelines, understand what that means, they're applying a committee group protocol to your individual biology. And that's been my argument. Now there's times it makes sense, but not across everybody with all stages and types of cancer. That's why we see so many people unfortunately die with cancer, in my opinion, because they're not getting the individual care their unique biology deserves. With only a small amount of people getting personalized care. If you look at it today as maybe 20% of all people, even getting a BAS DNA next generation sequence testing, that definitely needs to improve. And even the problem with that is if you do have a marker, it's hard to find an approved drug for that because there's very few approved drugs. So this is where the majority of patients are getting the treatment or lack of treatment. And the reason for this slow progression in oncology is really simple. It's until big pharma develops a drug for every one of those markers, you will start to see it being tested. I've seen this over and over again in 25 years. Instead, we can custom build those medications on label, off label, repurposed drugs, phytotherapeutics and immune modulatory agents to meet meet the patient's custom targets. So let's talk about medical training for a moment. Most people assume my doctor, he must have tons of hours in training in nutrition or metabolomics or in understanding molecular tumor boards and how to use RNA transcriptomics and our DNA ngs and how to fight the cancer. The answer is that's not true. But study after study has shown us that most medical schools do not give even enough education in nutrition. The National Academy of Sciences recommends at least 25 hours and the survey shows about 70% of US medical schools even fail those basic 25 hours to hit the minimum. These doctors have to go to functional medicine to learn this kind of nutrition and integrative care and longevity. So what do doctors get? Tons of pharmacology. It's all big Pharma derived. The big pharma is in bed with the universities and in the hospitals and they fund the organizations. It goes back to the Flexner report with the Rockefellers. Yes, there's benefit in it, but now it overdrives the system and that's the problem, you give regimen a if you have this disease, hospital driven technologies get promoted because we can bill for this surgery or this radiation equipment, these devices get install and this is how we bill for them. That's the current model and there's something wrong with that. And here's something most patients never hear. If a hospital owns that equipment, that's pretty much what you're going to get. They have robotic surgery, that's what you're going to get. You get the highest billable units, you're not going to get the best technology in the world or the best fit for your biology. You don't typically see that. So you got to look at that strong financial incentive unfortunately, because it is a driver. So your care is shaped by guidelines, pharma guidelines, insurance rules and hospital equipment. And what they want to build, what it's not deeply centered on is you. Your full metabolic picture, your genetic analysis at a very high level, your root cause analysis, your immune system being customly built for you. And that brings us to precision oncology. In the standard board certified oncology, a typical workup might be 20 or 30 markers. I've said this over and over again, you might have biopsy, tumor markers and imaging. And from there you begin care. In precision oncology we aim for well over a thousand data points and actually that's growing. And then we use deep learning to give custom treatments that are microdosed and targeted for each patient. We custom build the treatment with root cause targeting and immune centric care. And you'll always hear me talk about immune centric care because at the end of the day, your immune system is the key to getting rid of cancer. That's why we have so much effort being put into immunotherapy breakthrough drugs because the key is immunity. So let me break that down in simple terms. Number one, DNA testing. The blueprint here is next generation sequencing. Many studies show us that next generation sequencing reveals actionable mutational targets. The problem problem is we don't have a lot of drugs for all those targets. But if we go on label, off label, repurposed phytotherapeutic and like I always talk about, the immunotherapy drugs we can get there for a lot of patients this can help because we can use the data to custom build the medication. Think of it as like you're pulling all the wiring diagrams for your tumor and now understanding what to do. The next one is RNA transcriptomics. What are the genes doing right now? What are the escape panels for this cancer? The Roads in which they're going to try to reroute. DNA tells us to blueprint the rna, tells us which genes are actually turned on, on and driving the cancer. And we want to shut those down. Think of transcriptomics as a live microphone inside the cancer cell, listening to what it's shouting. And through heat maps we can see what the cancer likes to grow and spread. With number three, immune spatial biology and immune profiling. What are the neighborhoods that are blocking your immune system from killing the cancer? A lot of times your cancer tumors are cold. They're hiding from the immune system. So once we can turn the immune system on and bring the immune system to the tumor and the body can recognize it, we can get rid of the cancer and we can predict who who will not respond to certain immunotherapies and who needs custom drug builds to help their immune system. This is the key. These same advanced tools of this type of testing are used by pharmaceutical companies to build blockbuster drugs. But what if we use them to actually find the right targets for one individual person and then custom build the treatment for them. That's called multi omics mapping. We build a layer of technology and mechanisms of planning that are custom for each person. So let's say you have a stage three cancer and somebody wants to use regimen A or B. We don't jump to that. We do the deep mapping. And the deep mapping tells us actually here is the custom best regimen for that patient. What's going to help them best survive, respond outcomes, immunity, quality of life, what caused the cancer? See that's the key. Then we can open up a much bigger toolbox. Repurposed drug on off label phytotherapeutics using the immune system cancer cell vaccines, deploying them direct to tumor, overcoming resistance, delivering it with nanoparticle for better absorption, microdosing. And we want to train the immune system to recognize and attack these tumors. That's the go of most cancer treatment because if we can do that, we can shut the cancer down. So instead of just pushing a one size fits all standard path, this is the promise of precision oncology. So let me put this together with a simple story. We'll call her Sarah. She's age 52 and she has a standard of care path. So Sarah started standard chemotherapy regimen based on the national comprehensive cancer network guidelines. This is board certified oncology standard of care. Now she has a second path, precision oncology. Sarah now has thousands of markers built around her precision mapping. We can find the mutations, the RNA exit paths, what are the switches turning on the cancer, the heat maps and take those cold tumors that are hiding and make them hot. So the immune system goes there and does the work. So now her plan includes on label, off label repurposed drugs, all custom built including cellular biologics to get her immune system on board. For many patients this is a huge difference, particularly people who have failed care and are refractory or late stage cancer. This type of targeting is very helpful, but the sooner you implement it, in my clinical experience, the better. This is why When a new doctor comes to train with us, it takes about 2,000 hours in one year to become minimally proficient in precision oncology. To truly learn how to interpret all these complex maps and communications of multi omics, you have to think of it as a terms of mechanisms and targets and how one thing can cancel something and another thing can enhance something. What one drug does, the other one can take away or an add on can make it better. And when you have the right algorithms, the goal is for one plus one to equal 11 and how to properly integrate care with nutrition, root cause analysis, reestablishing the immune system and we have have the ability to do this with today's technology. This is the key of a precision doctor. So let me give you some questions you want to ask your doctor so this is worthwhile for you and your loved ones. Don't argue with your doctors, just ask some questions. It'll help you better understand where they're coming from and what type of care you're getting. Number one, what guidelines are you using for my cancer? Ask them if they're using the NCCNN guidelines as evidence based support for the care. Number two, have we done any DNA testing at a basic next generation sequence level to find mutations that could help slow down my cancer? Now rem, most of these DNA drugs, they don't actually kill cancer, they slow it down. So you're going to need immunotherapy on board. Okay. Number three, have we looked at RNA Transcriptomics? Are we looking at 1,000 plus markers to see what are the heat maps that's feeding my cancer with RNA transcriptomics? Number four, is anyone evaluating my immune system in tumor microenvironment? Can they turn on my immune system from cold to hot so that my immune system can do the job of killing the cancer? And can they tell you if your tumor is hot or cold? Do they have any way to test for that? Are there repurposed drugs, phytotherapeutics, combinations, diet and lifestyle being used with my pathways to enhance my cancer treatment. How does my nutrition and metabolomics fit into this cancer treatment plan? If you had my exact multi omics, would you do this exact same treatment or would you do anything different? If the answer to at least one or more of these questions is no, we don't do this, I can't tell you. I'm not sure. I think you should look for a different doctor. That's my personal opinion. So let me finish this episode by saying we have great doctors out there. They're doing good work, but we need to take it to the next level because the data is here, guidelines are good, protocols are good, but when we can custom design, when we have precision markers, we can find the best combinations and we don't need to guess, we can get out of guesswork and we can get into quality of life. That's the promise of precision oncology. So you and your cancer is not a protocol. It's made up of a series of markers that can be mapped out. That's what precision oncology allows us to do and to do it in a way to help improve quality and length of life. My hope is that this helped you get some more information, get you informed, understand more of N of 1 custom targeting and precision oncology versus just board certified oncologist doing NCCNN guidelines. There's definitely a place for both. But what we want to focus on is the latest technology to help our patients live with the best quality of life. And that's the goal. I hope this episode was helpful and may the Lord bless you on your journey to healing. Sam.