Cancer's Four Phases

Good day and welcome to Medicine and Health with Dr. Paul Anderson. That's me, I'm Dr. Paul. And today we're gonna have a program that I got a number of questions about, and so I thought, well, this would be a really nice thing to do on the podcast and kind of put it all together into one place. And that is, uh, in In well, in my recent book and in a couple of lectures I've given, etc., there's a concept that I call the four phases of the cancer journey, and a lot of people have, I guess, resonated with it or thought, well, that's I'd really like more information about that or or whatever. And so the questions kind of revolve around well, okay, I kind of get the idea there. But number one, you know, this isn't sort of a typical way to think about it. It seems logical, but it's not a typical way to think about it. And also, why would I think about the cancer journey in these different sort of sections? Why does that make any sense, or why would that be useful? And like I say, most of the questions revolve around those sort of concepts. So I think it's really, really good. That those were brought up. So a couple of things. I'll go through and kind of do top-down. I'll tell you the 4 steps, and then we'll kind of break down each one and look into it and talk about them a little bit more. But something that I want to be really clear about is that, like every other construct that we come up with as humans, this is not something that necessarily applies to absolutely everybody. In their journey with cancer. Now, there's some things that are in common with everybody, but there are sometimes where things don't kind of go in this order, and we'll talk about that. So just at the top, I want to say, you know, this is a way to think about the process of being diagnosed with cancer through your journey with cancer. It's a way to kind of prioritize and think about, you know, what's, you know, what's good to put our efforts into here and what should we maybe think about Putting off till later. But it's just that. It's just a way to think about it. But since it went into the last book, Cancer: The Journey from Diagnosis to Empowerment, I've gotten a lot more people, of course, reading the book and then also asking me about this particular 4-part process. So I thought, well, this is not a bad thing to break down and go into a little bit more deeply. Now, and by the way, if you want to look at that book or our newsletters or any of that, the new website is dranow.com. So dranow.com. And on there is a link not only to this podcast, but newsletters, the books, and a whole bunch of other media things and information. So you just go to dranow.com and And check that out if you want to. So the 4 phases, just kind of saying them all in a row, is first one is primary prevention. Then there is your diagnosis through your active treatment. Then there is the recovery from active treatment. And then there's what we call secondary prevention. So as you can see, you have prevention kind of bookending you on both sides. Those 4 steps come from basically just knowing about the journey that people go through with cancer, but observing it for all these years and seeing that those are pretty reliable steps. Now, as I said in the intro, they might not always happen for everybody all the time. For example, you might have prevented a problem or maybe were in primary prevention and got a really early diagnosis and kind of nipped it in the bud, and you never really went into a whole big bunch of depth of other treatments, and there wasn't a lot of recovery and all that. Even if you do that, you're still in secondary prevention. We'll talk about what that means coming up. Also, there are some people who get diagnosed, but they don't have active treatment. For example, there are some people who are diagnosed and they may have a a watch and wait, uh, you know, monitoring period, etc. Uh, for some people, they may be diagnosed and, you know, they might, uh, unfortunately have a very aggressive cancer and maybe get treatment or not get treatment, and they may, you know, they may pass away during that first time. But for anybody who kind of goes through the whole process, um, this is fairly predictable. So I mentioned in the, in the outset that, you know, if, if we don't have one of those situations where it's not really the same for you, but you're going through this, what would the purpose of this be? Well, the purpose is partly just to make sense of what's going on, which is always good if it's happening to you or a loved one. And the other purpose really is once you make sense of what's going on, to be able to Prioritize your, you know, thinking about things, your resources, whether it's time, energy, money, whatever else. You're prioritizing what you're focusing on during that time. And the other thing is knowing what, you know, what not to focus on or what to maybe know that you're going to focus on a little bit later. So for example, if you're in primary prevention, primary prevention means you don't have cancer that you know of. Now, I put this in the journey because everybody who gets cancer didn't have cancer that they knew of unless they were born with it, which does happen, but thankfully, you know, not as common as other cancers. So when you're thinking about primary prevention, there's really only 2 categories of people in primary prevention: those who are, you know, in the preventive stage who don't have cancer and are not going to get it, and those who are in the preventive stage who have cancer growing, but they don't know it. You can look up online and it's different for different types of cancers, so you can't really generalize. But a large majority of people who have a cancer that they discover in diagnosis have had that cancer growing for, in many cases, years and years, sometimes decades before they notice it. And that's because cancer starts growing at the cellular level, and there's often, you know, it's not like it's large, it's not like it's taking away your energy resources and all this stuff, so you may not have a lot of symptoms until later. There are some cancers that are kind of famous for progressing for a long time and not being discovered until you have very high-grade symptoms. For example, ovarian cancer, pancreatic cancer, things like that. So primary prevention is part of the journey because everybody who has cancer didn't think that they did for the time prior to diagnosis. Now, primary prevention includes all of the things that you might think of, like healthy living and getting things checked regularly and getting enough nutrients and enough sunlight. Air and water and all that stuff. In some cases, it may also include specific preventive things, but most of them are things that are in the realm of diet and lifestyle. When I talk about prioritizing time and effort and resources, this would be a time then where in primary prevention, you're not going to be treating cancer because you don't know you have it or you don't have it. It'd be inappropriate to treat the cancer that you don't know is there and hasn't been diagnosed. So in primary prevention, our goals really are to make our body the least appropriate target for cancer to show up. Now, there's going to be some other examples and exceptions and things to what I'm about to say. But again, if we think about sort of the middle of the bell curve, A large, large percentage of cancers have a component that is diet, lifestyle, and other sort of those general things related. That doesn't mean that you can live sort of a perfect toxin-free, perfect diet kind of life and you're guaranteed not to get cancer. As a matter of fact, that still happens. But you can lower the percentage chance that that will happen. Now, I always like to say, you know, the exceptions are the things that we, you know, really can stick with you. And so we never want to make somebody, you know, feel like, well, we're saying if you would have just been a better person or lived a cleaner life or whatever, you would, you know, not— you would not have got cancer. That's in most cases not true. What you need to think about is there are some people, and I've had people, I've interviewed some in the book who shared their stories where, you know, they did everything quote unquote right. You know, their diets were as clean as possible. There was, you know, all of these factors that we say, you know, feed into developing cancer were pretty much handled, and they were maybe younger and they still developed. cancer. So that does happen. There's also children who develop cancer. I've had children who are born with their cancer. I've had children who, um, you know, were diagnosed at, uh, you know, under, under 3 months of age, etc. And, you know, they certainly didn't do anything, you know, to create this cancer. So you do have to be careful with that. But if you look statistically at cancer, a lot of cancers, there is sort of a creation period. And so one of the things I wanted to talk about was just generally, um, what is it we are preventing? So in order to understand what you're preventing, it's probably good to understand what is it that triggers cancer in general. Now, cancer can be of a number of different types, and it can manifest in many, many different ways. For example, you hear about somebody having, say, breast cancer, colon cancer, lung cancer, prostate cancer, etc. It can manifest as starting in an organ. That's why we give it a name like that. It can be a hematologic or a blood and lymph system cancer, like a leukemia or lymphoma or something of that nature. Or it can be one of the skin-type cancers, like a melanoma or squamous cell carcinoma, etc., and a number of other things. Cancer is not just one thing, but if we get underneath it and we look at what is triggering cancerous growth, cancer is a shift in the cell metabolism of your cells where the cell starts to drift away from its primary station in life, if you will. And so when they talk about cancer under the microscope, they'll use terms like differentiation. And that means, is the cancer cell kind of like the original parent cell? Is it kind of medium? Is it really not like it? Or is it nothing like it? Those are sort of the grades of the differentiation of cancer. And the reason for that is, if it starts out, say, in your liver cells and you have, say, hepatocellular carcinoma, the pathologist will look at it and say, how much does the cancer cell look like the original liver cell does? And that's a way to tell how far along it is, how aggressive it is, etc. So you have a process whereby you start with normal cells And somehow they drift away from being normal cells, and now a cancerous cell, so a neoplastic cell, is all about itself and propagating its new, its new self that is not part of, say, your original liver cells or breast cells or whatever. So cancer is a sort of movement away from the parent tissue itself. So one part about primary prevention is to know that many cancer cells arise. There are estimates that every day we have some cancer cells arise, and the immune system and/or the cells remove those cells. So there's a process by which the immune system can see the cell. It's not like the self, the original And the immune system will actually clean the cells out because they're not like the original cells. There's also a process by which the cell starts to, starts to grow and mature, and the cell itself realizes that it's not like itself and it actually disintegrates through a process. So that's another thing. So there's a whole bunch of things that can be involved. Well, those are feeding into primary prevention. So you think about what feeds those 2 things. One is keeping your immune system as spunky and operational as possible, and then the other is, which is just kind of an extension of that, if your natural cells, when they're going through cytokinesis and they're dividing, if your natural cells have all of the right things that they need as far as nutrients, balance of antioxidants, all this other stuff that we talk about that's healthy, they're more likely to, if they start growing as an abnormal cell, as I say, sort of disintegrate and go away. So these are very, very basic things, but this is what protects us from getting cancer most of the time: our immune function and our overall nutrient and antioxidant status. But Let's say that, you know, the cells progress on and they get less like their parent cells. They become cancer cells. Well, in that case, then they're going to differentiate into 2 different groups. One group is going to be the cells that we might see develop into a tumor. Okay, those are called the daughter cells. So those are the reproductive cells of the original cancer. Then there's going to be a group that can create more cancer but can also kind of hide, and those are called the cancer stem cells or the tumor stem cells. So you've got stem cells, and we hear a lot about stem cells now because we use them in treatment and research and stuff, but a stem cell is basically a multiple potential cell that can turn into lots of other stuff. So now we have sort of a couple of targets there, one of them being The tumor proper and the other being the stem cells. So they're going to play a role as we go on down the timeline. So primary prevention has to do with keeping the general areas clean and clear. So as I said, diet and lifestyle. So things like exercise and movement. The more you are focusing your body in moving muscle and tending to your muscle, the less you will focus and move your body towards the tending to enhancing the, say, insulin and the high blood sugar side of things. Because more muscle metabolism equals less cancer, more insulin blood sugar metabolism means more cancer. This is why a lot of diet and lifestyle things become involved there in primary prevention. The other thing is being careful about what's going into you. That means if you hopefully are drinking water and You know, hydrating, etc. You're getting the cleanest, clearest version of you know fluids in you. You're eating foods that are not full of chemicals and toxins and things of that nature, etc. So this basic basic things that go into primary prevention. Now there will also be things that are either related to nutrition or nutrient or other diet and lifestyle things. So that could be like having reasonable and appropriate levels of vitamin D, D like dogs. So you hear a lot about vitamin D and cancer prevention. And so that is another thing you want to have that checked periodically and you want to make sure you have adequate levels. Then there's things that may be preventive and this is something we may see over time. You tend to see these in studies that are like association studies. So people that have a lot of this, will have less cancer. There might be a mechanism in between, we know there might not be, but it's an association. A positive association are things like a lot of the spices and things like that that are added into our diet. A lot of them can be inflammatory modulators and other things like turmeric and a lot of the other flavorful spices are that way. They also do other things. Then there's negative associations, meaning the more things you have in your lifestyle, diet, etc., that are toxic, the more it's associated with potentially more cancer. Certain metals and chemicals are, you know, well known to be associated with cancer, but probably most toxins are not good for you at the very, very least. So all of these things are things that can be thought about primary prevention. Now, the other thing to think about in primary prevention is chronic things, so chronic infections, mold exposure, all of these sort of chronic health issues. It doesn't mean that you wave a magic wand and those things go away, but the more you do to clean that up and improve, you know, your health from those things, the better you are as far as primary prevention of cancer. Now the next one is diagnosis through active treatment. Well, diagnosis through active treatment is just what it says. It's now you know you have cancer. So you were diagnosed maybe by some imaging and some pathology that was done and physical exam, whatever. And they say, yes, you have an X type of cancer and it's at a certain stage, maybe grade, and here's what we want to do about it. The reason this is a different focus time is, number one, now you have cancer. You've got this diagnosis that you really weren't looking for. You know, I've never really met somebody who wanted cancer, and that's kind of normal not to, so I think that's wise. You know, here you've got a cancer diagnosis. Point of the last book, Cancer: The Journey from Diagnosis to Empowerment, was all about what do you do once you get that diagnosis mentally and emotionally. But the reason I have this as a separate time, diagnosis through active treatment, is your goals during that time really are to get whatever treatment you and your team decide is necessary. And to survive it. Okay, now there are things that are little subtleties as far as enhancing the treatment, protecting your normal cells. All of that's very, very important, but really your main efforts are really going to go into getting diagnosed, working with your treatment team on what to do, and then doing it. And so during this time, there may be things that would be really important to focus on either in primary prevention or in the next step, but you just don't really have a lot of time to do it there. You got to really focus on core things. Now, if you have some sort of curative procedures, say they can go in with one surgery and remove, you know, an in situ cancer, And that's all they're going to do, you have a lot less intensity during this time. Not saying surgery is intense, but by comparison, you have a lot less intensity to somebody who is going to have, you know, major surgery, radiation, and chemotherapy all during this treatment time. So the person who's going in just having maybe a radiation procedure or a surgery They've got a shorter window for diagnosis to active treatment, and they can do a lot more things. If you get diagnosed and it's this sort of whirlwind and they, you know, grade and stage your cancer, and then the next thing you know, you're going in and they're going to do a debulking surgery first, meaning they're going to go in. and they're going to surgically remove large parts of the tumor, and then maybe they're going to do some radiation, maybe not, and then they're going to give you chemotherapy. In that case, you have a bigger chunk of not only time but effort going into diagnosis, proactive treatment. If you're on the one end of the spectrum where maybe there's no or very little treatment, this is a short period of time. And you're going to have a lot of index of things you can do. If you're having, you know, one of every treatment, so you're having, you know, radiation, chemo, and surgery all at the same, you know, same time period, you're gonna have a longer time doing stuff and you're gonna have less margin for doing a bunch of other things. So, for example, with people getting more intense therapies, your goals then go to Dealing with the side effects of the therapy, protecting your normal cells and your normal tissues, and doing anything that you can to augment the therapy you're getting. Now, in a lot of cases in the world of integrative medicine, this is a time where integrative medicine really can shine because even if you're doing surgery, chemo, and radiation, if you look at it like a pie, your surgery, chemo, and radiation are really only a fraction, 15 to 25%, of the whole pie because they're not interested— those therapies are focused on the cancer. They're not interested just by default. That's not a choice. It's just the way those treatments are in your normal tissues and your normal cells. And that's an important thing to keep in mind. So what you want to do to augment those therapies and protect yourself And all of that is you're focusing on, you know, yes, the side effects of the treatment because we want to be able to continue to eat and do all these things, but also you are focusing on taking care of the normal cells that you have inside you. Now, what would be one big reason that you would want to take really good care of the normal cells that are left that are not cancerous? It goes back to our previous discussion about the genesis of cancer. And the fact that there's the daughter cells that become the bigger tumor if it's a solid tumor, and then the cancer stem cells. Well, the cancer stem cells are going to be what would recruit your normal cells to become cancerous. So we want your normal cells to be as healthy as possible. so that they do not have the drive to be recruited by cancer stem cells. And this is a process that happens all of the time. And if you think about the process you go through having, say, a stressful event like surgery, chemotherapy, radiation, that doesn't leave your normal cells usually in a really great place. It's not super positive for your normal cells. So they get weakened, they get more oxidized, they have more oxidative stress and all of these things. And so what you have to be cautious with is you don't leave them like that. Okay, so if you need the surgery, then you need to get the surgery, but you need to do something to protect the rest of you. Now, again, thinking about priorities, if you, you and your care team have decided that a particular set of therapies is important, Those are the things you're going to focus your time and effort on, and you're going to do basic things to help with side effects and also protecting your normal cells, and you do as much as you can. Now, that can be things like sometimes during certain types of chemotherapy, we'll have people take things orally in a soft form, so it helps to keep their mucosa, the lining of the digestive tract, healthier so they don't get quite so many digestive symptoms. You can get this condition called mucositis where the mucous membranes will swell up and become ulcerated and things. So we can give things, you know, and some— this is not medical advice, just examples— we have people mix, you know, certain types of soothing or demulcent herbs like slippery elm And maybe a powdered thing like turmeric and the amino acid glutamine, and they will take it and eat it in a, you know, yogurt or something soft and smooth. And it helps just to kind of coat the digestive tract, keep it healthy and all of that. Sometimes during certain treatments, people will take certain natural therapies. Maybe they might do, you know, mushrooms or immune mushrooms or certain nutrients or certain herbs to support the normal tissues. But you can only do what you can do during that time. But thankfully, that diagnosis through active treatment is just the middle step. Well, then you get over to the next step. So what would the next step be? You've got number 1 step, primary prevention. Number 2 step, diagnosis through active treatment. Well, number 3 step is actually recovery from active treatment. So as I said at the beginning, if you have a greater amount of trouble or you're going to be on therapy for a long, long time, you know, that step 2 might be really elongated. And some people will pass away during that time, so, you know, they're not going to go through all these steps. But for the average person moving through, they may reach a point where they're done with their treatment. And either because the treatment itself was considered to be curative, or it got them stable, and they went into a stage of either no evidence of disease or remission, etc. Well, at that point, and all of your healthcare team decides, okay, there's no more surgery for you, no more chemo, no radiation, whatever, or we're going to take a break for six months and watch it, or three months. Then fine. Well, then you are in the recovery from active treatment phase. At this point, everything gets turned on its head. So during diagnosis and active treatment, all of your goals are focused on the treatment you're doing for the cancer. When you get to recovery from active treatment, your focus is all on literally recovering from the treatment that you've had. Now, that means that there's a lot more time and effort and resources that are going to be going into what you do to recover. But why are we so keen on recovering from active treatment? The reason that we're so keen on recovering from active treatment is we now know— and we wrote about this in our first book, Outside-the-Box Cancer Therapies, you can read about it in there— but there's a lot of research that shows that things like chemotherapy and radiation are really good in the beginning to shrink down the tumor and all this stuff. But they make those stem cells, those cancer stem cells, more emboldened so that the cancer has more of a likelihood of recurring at some point down the road. So literally, if you have had chemotherapy or radiation, it increases the percentage of cancer you get later, statistically. Now, again, how do we avoid that? Because we'd like to get the good parts of our treatment, but not this rebound cancer thing? Well, it all goes back to what I said about the cancer stem cells, and that is that we want to keep the cancer stem cells quiet and we wanna keep our cells, our healthy cells healthy so that they can't be recruited by the cancer stem cells. Now, it turns out that keeping the stem cells quiet and keeping the normal cells as healthy as possible are basically achieved through the same means. Okay. So what that means is that if I take care of the normal cells and get their nutritional levels maximized, improve the oxidative reductive— so the antioxidant-oxidant balance And all of that sort of thing, I am making the normal cells and normal tissues stronger, more immune competent, and so they're less likely to be recruited. Now, the other side of the coin then is that if I do all of that stuff— so I'm improving the oxidative reductive balance, I'm improving the cellular nutrition, I'm getting the junk cleaned out. that also lowers the excitability of the cancer stem cells. Because it's pretty much impossible to avoid the, you know, having cancer stem cells and having them become, you know, agitated. But what you can do is make the environment, the milieu that the tumor is in, You, you make that environment as anti-cancer as possible. Now, what is a thought with respect to making the environment, you know, inhospitable for cancer? Well, there's a few things that need to be looked at in this recovery. time period. So the big things are ongoing diet and lifestyle things that would be good for every phase, but especially primary prevention, are still important. So we want to be moving our skeletal muscle. Okay, want to be getting our body moved around so that our core muscles are working. We want to have more muscle activity, less fat activity. Okay, and people will kind of get discouraged and say, well, gee, you know, I'm overweight, I don't do a lot of working out, I'm not a marathon runner or whatever. That's fine. You don't have to be. If you get up, if you can get up, okay, if you get up and you move your body around, your legs have some of the biggest muscle in your body, and your legs and your core muscles through your spine and the core of your body are the most important for staying healthy. So even in people who have a lot of surgery, chemo, and they're really knocked out energy-wise, we'll have them start by just stand up a few extra times. Or if they're bedbound, we'll do some arm exercise movement, et cetera. It's just about getting the skeletal muscle moving. You don't have to get a 6-pack. You don't have to become anything. You just need to, you know, need to move your body. Now, over time, if you can lose some fat, that's better because fat metabolism, insulin metabolism are both pro-tumor. So this is fat versus muscle, and you can look at— there's research that shows that the more muscle activity you have and less fat activity you have, less likelihood of cancer recurrence, etc. So those are some real basic things you can do to make the environment inhospitable for cancer. Now, the other thing to consider is we talked about the sort of interventional things, if you will, of cell nutrition and then the antioxidant-oxidant balance, the redox balance. Those are very important and they're very kind of core level. You do that through diet and some supplementation, etc. But then there's also what else would be in the neighborhood of the normal cells and the cancer stem cells that would make you more hospitable to the cancer stem cells becoming active? Well, anything that upsets the inflammatory balance, the redox balance, for one thing. So that's things like toxins. So whether it's metals, Or chemicals, etc., that are going in. Those are not going to be helpful. They're going to be pro-cancer. That could also be chronic infections and other things that didn't get cleaned up. Anything that stimulates the inflammatory process on a kind of a chronic basis. So toxicity is a really big one there. Chronic infections are another big one. And then, as we talked about on a lot of the other podcasts, Your digestive system is not only where you eat and digest and absorb food, so that's a very important thing. We want to get that healed up after cancer treatment, but also it has a large part of your nervous system and your immune system attached to it. So your digestive system is something that, unless it's giving you troubles, you're getting symptoms, we do stuff about symptoms. A lot of people's digestive systems get so beat up that they don't notice. They don't notice how bad off it is in there. Well, in that respect then, while we're healing things and while we're moving our muscles around and decreasing, you know, having our diet be not high insulin producing and all of this, we want to be thinking about what are we doing to heal up the digestive tract. So this is sometimes where we might use a little more aggressive group of either herbal things or nutrient things to kind of refeed the GI tract and get it Healing. A nice thing about the GI tract is it turns over and it heals. You know, it's— if you let it heal, it can heal pretty well. But the other part about that with your GI tract is then that helps to shore up that part of your immune system, which is very important. So we have things like nutrition, antioxidant balance, body movement, so augmenting muscle minimizing insulin and fat activity. We've got tending to detox, chronic infections, all of those things. These are all just ways to kind of come around the body in a 360 way and say, let's put the good stuff in that we need to do and let's take the bad stuff and minimize it. Now, some people will say, well, does that mean I have to do like a really large-scale detox program? Or, you know, do I need to do chelation or all these other things? Well, in the part right after diagnosis and active treatment where you're doing recovery, the focus of your energy there needs to literally be recovering. So if you had, again, a fairly limited amount of treatment, you're going to recover faster. Your treatment phase is going to be shorter, and your recovery is going to be shorter. But if you had surgery, chemo, and radiation, and a whole bunch of stuff going on, Your recovery may be a while. So we want to focus on the core things and build our way out. And the reason that I put it that way is normally when we get through recovery, if we've rebuilt the body in an appropriate way, it's ready to do more effort in the 4th phase, which is what we call secondary prevention. Now, secondary prevention is like primary prevention, only now you know you had cancer, okay? So you're trying to prevent it from coming back a second time. So it's kind of very similar sorts of things that you're going to be focusing on, but now that you've recovered from active treatment, all of your energy and focus goes into broadening out what we talked about in recovery which is keep the milieu, the chemistry and all that around leftover tumor cells and tumor cancer stem cells as calm as possible. And so that you can keep the cancer stem cells quiet, you keep your normal cells healing better and better and resistant to the growth of a new cancer or the restarting of a cancer by those stem cells. So this is all the same reasons we talked about. So it's things like cell nutrition and redox and all that good stuff. But now when you get to secondary prevention and you're past the recovery phase, your focus needs to broaden out into a lot of different areas. So what are those areas? Well, those areas are things we already talked about— cell nutrition, redox, immune support, All of that. But this is also where we start to be a little bit more focused on removing toxic things. Now, the first step of removing toxic things from your life is always identify how you're being exposed right now and don't do that anymore. Remove that. So for some people, that is the quality of, say, the water that they're getting A lot of municipal water is, is not very good for you, and you can look these things up. You have your water tested and all that, but that may be as simple as, you know, using filters and things for your water. Also your food, because we eat every day usually, unless you're fasting for a long time. Your food is a great gateway into your body beyond water and what you drink. Your food is the big gateway in for toxic material. So if you have, for example, a lot of non-organic things entering your body, whether they're fruits, vegetables, meats, fats, etc., you're going to have a gateway into your body of a lot of toxins that are kind of come with food. So if you're not drinking it through the water and the fluids you drink, the toxins, you might be eating it. This is why, uh, in the other, other podcasts we talk a lot about, um, focusing on the least toxic foods you can get. Now there's a concept that is worth mentioning here, and that is that there is no non-toxic anything in the world right now. Right. We have toxified the world to a degree that there is no going back to no toxins, okay? But we can reduce them as much as possible. So for example, there's the Environmental Working Group, for example, on the internet. Just look them up, Environmental Working Group. They have this concept of foods called the Dirty Dozen plus a couple, and then the Clean 15. So If you're trying to allocate your financial resources and you're going and saying, I don't know if I can afford to buy everything organic and all this stuff, you can look at the Dirty Dozen list and say, okay, if I'm going to spend money on something that is— I'm going to put it into being organic, I want it to be one of these, you know, Dirty Dozen foods if you eat them. If it's on the Clean 15 side and, you know, you can't really afford to allocate everything to be organic, you have less trouble, less toxins in the foods in the Clean 15 group. You could— Environmental Working Group, you can find them in a millisecond online, so you can, you can do the work after that. If you're going to be eating animal foods, so flesh foods, you want to keep in mind that animals, whether it's a fish or fowl or Larger animal, they bioconcentrate toxins that they are eating and breathing in and drinking. So if you have an animal, whether it's a smaller one like a fish or a chicken or a bigger one like, you know, a cow or something, you have to think about that animal has taken in a lot of food. It has processed it through its digestive system, turned it into nutrients, to build its muscle, which is what you're eating usually. Well, if along for the ride with the food to that animal was a lot of, you know, chemicals like PCBs and mercury and other stuff like that, you're going to just be eating things that retoxify you. So when it comes to animal flesh foods, what I generally recommend is If you, if you, you know, your, your macros— I've got a video on macros if you want to look that up on YouTube— but your macros, so the big how much fat, protein, carbohydrate, you're going to work out with your healthcare team. Most of the time in modern days, we consider a low glycemic diet to be a starting point, so you don't have a lot of insulin triggering and all of that. But so we'll leave the how much macro you're getting and what foods that comes from to you and your healthcare team. But if there is a part that is flesh foods like animals, whether that's going to be some fish or whether you're going to eat, you know, like omnivore, kind of all animals, you want the animals as clean as possible. Now again, they're like us. There is no clean universe to live in anymore for animals or people. But what you need to think about Is whatever money and resources you put into procuring that food, you should spend it on the highest quality, and you're going to probably have less animal intake, you know, depending on your diet type anyway. And the reason for that is it's it's not just as simple as like vegetables or fruit where you can kind of see where it was grown and how they. propagated and all that. Remember that the animal, it's going to bioconcentrate from the feed it's eating, from the air it's breathing, and the water it's drinking and all that. So animals are much more complex when it comes to bringing toxins into your body. Why all this talk about toxicity? Because before you go out and put a lot of effort into doing a detox and doing detox stuff, which is certainly a good idea, you want to stop the flow coming into you as much as you can. So whether that's you and what you drink and breathe in and all of that stuff and, and eat, or the animals and the plants that you're eating, you want it to be as clean as you can get it. Can't ever be totally clean. Why? Because toxins are one of the things that disrupts that balance that pushes your normal cells towards recruiting to cancer and the stem cells towards being able to recruit. Less toxins, less of that. Next thing that's really important that we find with a lot of people when we're working with them after cancer and secondary prevention is the cancer process itself is very stressful and it can throw your hormones off. So we generally would do baseline testing of not only their reproductive hormones, so whether it's estrogen, testosterone, progesterone, etc., but also their adrenally oriented hormones like DHEA and cortisol. Thyroid, certainly. And people say, well, before I had cancer, I never had any problem with those. Well, you had cancer and you had treatment, or you did whatever. You have a different body than you did to start with. So it's just really good. Why are hormones so important? Because they are orchestrating everything in the background. So if your hormones are all whacked out after cancer, you are not doing your body biochemically any favors by having your hormones all out of balance. Now, yes, sometimes after cancer, you have to minimize certain hormones. So you might be on an estrogen blocker or an androgen blocker, or you might, if you had thyroid cancer, you might be on some thyroid hormone to suppress your thyroid activity or whatever. So yes, there are outliers there, but the rest of the hormones can be looked at and balanced up. So you got toxicity, you got hormones. Chronic infections. I have a lot of people in the post-cancer world phase where they basically started out, they weren't that unhealthy. They didn't realize they had some chronic infections before they had cancer. Then after cancer and after the immune manipulation by the cancer treatments, these chronic infections flourished. Well, we're all exposed to the things that can cause chronic infections, whether it's, say, Epstein-Barr or its cousins like CMV and other viruses or chronic bacteria, whatever. We're all exposed to them. Most of us don't keep them in an active state. But when you go through immune suppression, you can wind up with these either reanimating, kind of coming back out to play, or you can actually be exposed to a chronic infectious agent like, say, Mycoplasma or something, and instead of kind of fighting it off, you may It may flourish in your body. Now, a lot of the post-cancer patients would be frustrated and say, why are you checking me for infections when I don't feel sick? I don't feel like I have an infection. Well, it's kind of like the hormone thing. Before you were, you know, dealing with cancer, maybe you could go by how you felt, etc. Now you've been through cancer, which throws off your immunity. You've probably been through cancer treatment, which throws off your immunity. And so you may have infections going on that you don't feel. You just feel generally not good. And that's an important thing. So we would usually check people for the majority of the chronic infectious things, certainly the chronic recurrent viruses, some of the bacteria, maybe some digestive tract things, parasites, etc. Very, very important. Well, why is that important? Well, that's important Because the more chronic infectious stuff that you have going on, the more trouble you have with respect to the inflammatory balance in your body. Your immune system is diverted. The immunome and the inflammasome, the inflammatory part, are out of balance. They're not orchestrated well, and it's taking away resources from your cellular nutrition, the antioxidants and all that stuff. So the chronic infections become important. So you have these big things like toxins and your hormone system, your digestive system healing, your chronic infections, moving your body and all that. When secondary prevention, your whole focus is on those things. Those are discrete focus for you. And so you have a lot to do, but you have time to do it. And so if people are— and I mentioned this in the recovery from active treatment section— people say, well, that Like do chelation or detox or something. Maybe not in recovery. But when we get to secondary prevention, we usually do some testing. So number one is remove it from your intake so you're not getting new stuff in that's toxic. But then we might do some testing to see, you know, what's your metal burden like? Do you have a lot of chemicals that are in your urine when we test or something? And then we may recommend certain types of detoxing for you to do as you go along. So in the secondary prevention, you've got time generally, and you want to use that time to heal up your system, heal your GI tract, recover your cell nutrition, but take away these negative association things like toxins, abnormal or imbalanced hormones, digestive inflammation and digestive tract damage, chronic infections. and on and on and on. If you can do that, then you wind up having more propensity towards long secondary prevention, long remission, long no evidence of disease, whatever it is that you're doing. And some people, because in modern times we try and look at even active cancers as a chronic disease rather than, say, a death sentence, There are some people who live long, long, long periods with cancer that doesn't go into remission. Okay, we've had many patients who, especially elderly patients, who would live, you know, 5, 10, 15 years with a cancer that never really went into remission, but it wasn't doing, you know, it wasn't doing a whole lot. It was there, but the body sort of had a relationship with it that kind of kept it static. It was still an active cancer, but it was able to be worked around, so to speak. Whether you can get to a total remission or no evidence of disease, or whether you have an active cancer that you just slow down, all of the above are good. As long as you're still here, you've got time to work on that stuff. We're getting down to where we're going to have to sign off here very soon. I just want to remind you that number 1, these 4 phases, work for most people, but there's always exceptions to the rule. So this is not like hard and fast, everybody does it. But it's— number 1 is primary prevention. That's you don't know you have cancer yet, you're trying to prevent it. Number 2 is diagnosis through active treatment. Number 3 is recovery from active treatment. Number 4 is secondary prevention. Each one you have different goals and focus and amount of time to deal with things. We want to focus our efforts on what's in front of us, what's primarily important, and then leave the rest to the other stages. We'll talk more about this in other settings too, but that's a basic overview. Again, you can read about this in the book, Cancer: The Journey from Diagnosis to Empowerment. We also talk more deeply about treatments in Outside-the-Box Cancer Therapies. If you want information on the books or other podcasts or the newsletter or whatever, Just go to the One Hub website, which is dranow.com. dranow.com. Also on there as a related thing to our podcast here, I've got some shorter YouTube videos. Go to the YouTube channel. Please subscribe if you like the information. There's a whole bunch of shorter videos that are like 10 minutes about health topics that go a little bit quicker. And these podcasts do. Well, I'm Dr. Paul Anderson with Medicine and Health with Dr. Paul Anderson, and it's been my pleasure speaking with you. And I am going to get ready to sign off here, but I want to thank everybody, um, for, uh, always tuning in, for the questions we get. And again, through dranow.com, D-R-A-N-O-W dot com, you can go and, uh, you can also send in questions. things of that nature too. All right, well, thank you everyone. I'll see you next week on the radio.