Pathologist Dr. Monisha Bhanote explains how diet, stress, sleep, and movement send signals to your 37 trillion cells that can prevent or reverse disease. She notes 90-95% of cancers aren't genetic, and walks through how reflux can progress to Barrett's esophagus and cancer if left unchecked. Lifestyle changes can alter your cells and lab values before disease takes hold.
Questions this video answers
90–95% are not genetics
Approximately 37+ trillion cells
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Three of my expertise is in what we call pathology. And most people, when they think of pathology, they think of, like, you know, a TV show that has, like, a morgue and it's like, all dead people. But that is far from the reality of what is going on. So I'm trained in anatomic pathology, clinical pathology, and cytopathology, with additional fellowships in breast cancer, bone and soft tissue cancers, and cytopathology pathology. But so this has shaped my expertise in the sense that I've been looking at human cells in individuals who are alive for decades now. And what that means is anybody who has gone to get a biopsy, whether that, you know, they went for a mammogram and something was found on their mammogram, and they had a breast core needle biopsy or somebody who went in for their standard screening colonoscopy and they found something. Basically, anything taken out of the human body ends up in a pathologist's lab. So we can give you the final diagnosis. And so pathologists are really seen as doctors. Doctors, because we're the ones with the answers. Like, we're literally looking at the cells and how the cells are creating disease over time and the different transformations that happen on this microscopic level. And. And so what happened is, is I'm sitting there doing this for years and years and, you know, over decades, and I'm like, wait a minute. I'm seeing common things here. I'm seeing these cells. But a lot of what's going on is preventable and reversible. But people don't think of their body in that way. They just think, oh, I got this. My. My parents had this. My family member. You know, it's. It's. It's genetics. Okay. I hear that also often. It's genetics. And I'm like, well, that's not really true, because as pathologists, we test genetics. So especially when it comes to cancers. 90 to 95% of cancers are not genetics. Wow. Wow.
I pause for a second because that. That is massive. 90 to 95% are not genetics. So what are they?
What is. Is our lifestyle. So what happens is, over time, based off of. Off of our lifestyle, whether that's, you know, the way we eat, the way we manage stress, which, you know, we'll definitely talk about that. The way we move our bodies, the way we, you know, sleep and have recovery, all of this is going to influence the way your cel function. And now imagine you have 37 trillion cells in the human body or more, and you are sending signals to them. With every action you do. So every next sip of water or coffee or alcohol sends a signal to your cells. Every, you know, let me sit on the couch and eat some donuts and not move my body versus going out for a walk. So cells sends a signal to your cells. So this signal goes on and on and on, and it communicates, you know, 24 hours a day. And for years, we're either, you know, helping our body go in the right direction or, you know, we're like, we have no idea that everything we're doing is influencing it because, you know, we're just focused on, let me just lose the weight or let me just, you know, look like this. Instead of understanding that our cellular makeup is going to influence how your. Your mood is, how your ability to respond to stress is, how your ability to prevent chronic diseases is. And so that's what was so fascinating about this, because I'm looking and I'm looking at these cells under the microscope, and I'm like, wow, this person's story. I can see their story. And then I go look at their chart, and I'm like, oh, yeah, so they've had this going on in their lifetime. But what if they knew that they could address this so they didn't need to come back to the doctors in six months and get another biopsy and keep doing this? And that's where I really started looking into how can we approach this from a preventative aspect instead of the end result that I'm seeing on the slide. Right. And so then I further trained in integrative medicine at the Andrew Wheel center for Integrative Medicine, and then also in culinary medicine and using food as medicine. And that's when I really started seeing a difference in. When I work with my patients that, oh, when we change these things, their cells change, their lab values change, you know, and their way to handle life changes. Wow. What.
What do you mean by their cells change? Like, you can see that visually?
Yes. So let me give you an example of something that is very common. Reflux disease. Okay, so I'll give you an example of reflux disease. And it's very common. So common that proton pump inhibitors is one of the most prescribed medications. Okay, so what is happening in the body with this entity is that there is, with your esophagus, it reaches the kind of GE junction and then goes to the stomach. At that junction, we call it the gastroesophageal junction, there is a sphincter. And that sphincter is supposed to close up. So the acid does not go up. Now, it. Most patients do know, they are told, don't. Don't have coffee, don't have chocolate, don't have these acidic foods, because this is what's making it, right? But. And then they're given a medication like, oh, here. This medication will fix and suppress these acids. So what do people do? They're like, oh, it's fine. I'm taking the coffee and I'm still doing this. But on a cellular level, what's happening is that acid is changing the tissue. Normally at that area, we have squamous epithelium, which is part of what's on your esophagus is a specific type of squamous epithelium. And in the stomach, we have gastric epithelium. Gastric epithelium does different things. Squamous is really kind of more. It doesn't release, like, biochemicals or anything like that. But what happens with the reflux is because that acid goes up, the cells try to find a way to survive. And they're like, okay, well, yeah, I'm getting this medication, but that doesn't mean I can survive here in this kind of terrain, the body's terrain. So they change. They're like. They're the masters of changing. And they change into something we call intest metaplasia, or goblet cells. And I can see this under the microscope. So this is when people who are getting endoscopies first, their endoscopy might. And their biopsy might show that squamous epithelium with an infiltration of eosinophils, which are a specific type of inflammatory cell that goes to fight off all this, like, trauma that's happening. But over time, it says, you know what? We can't do this anymore. Let's just change who we are. And it changes into these intestinal metapl. Well, that leads to a path of the cells in that area can, over time, if we don't reverse this. And once you have intestinal metaplasia, that's essentially called Barrett's esophagus. And now you are in a designation where you're going to be getting an endoscopy every six months to make sure it doesn't develop into dysplasia, which is precancerous, because that is a natural progression. But meanwhile, what's happening is you're still on your proton pump inhibitor. You're still living your life, ordering your pizzas, having your fast food, and lying down on the couch after you have a meal, right and this progresses over time. It's not like an overnight progression. Right. But this progresses over time that you go from dysplasia to low grade dysplasia to high grade dysplasia, which you get sampled. And then if it's high grade, um, you know, sometimes they'll. They'll take a bigger part of your esophagus out to eventually progressing into what we call a adenocarcinoma or a cancer of that area. So what happens then? All right, we go in and we get surgery, and we get this part taken out and nowhere along that pathway. Because I've sat in many conference rooms and tumor board rooms and conversations around these patients with my. The GI doctors and the surgeons and all this. Is the patient really educated enough on, oh, my God, okay, this is what's going on in my body. This is like, you know, an actual thing that's happening that you can't see because most people just can only see what's out on their outer surface. Right. And that's where, you know, I feel like my platform. Well, institute. We really aim to educate people, you know, whether that's, you know, on our YouTube channel or in my clinic or however, because we want people to understand how their body works. And I joke that I'm like, oh, I put you through med school on your body in, like, six months. Because when you understand how it works, you can also pay attention to the signals that affect the like, oh, that might not be normal, or this is normal, or these kinds of signals. So. Because otherwise, we have no idea.
