Dealing with your Diagnosis and not Despairing! - Part-4

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Good day and welcome to Medicine Health with Dr.

Paul Anderson. That's me, I'm Dr. Paul, and I'm coming to you still from Seattle, Washington. And this is actually the 4th part in a series we're doing called Dealing with Your Diagnosis and Not Despairing. And it follows the chapters in my latest book called Cancer: The Journey from Diagnosis to Empowerment. But as we've talked about in the previous 3 sections, there's a lot of crossover between a cancer diagnosis and the mental-emotional strain that that puts on you and your loved ones and caregivers. And also non-cancer long-term chronic illness diagnoses that may, may not have the same sort of— may or may not have the same sort of maybe danger associated as cancer, or they might. But they certainly have a lot of the same characteristics as far as what you have to deal with. And so the purpose of this particular book is, number one, it's, it's a very quick read. It's available on any format that you can find books on. So all of the ebook things like, you know, Kindle, all of the audiobooks, you know, such as Audible and all the other, you know, players that there are for Audible books. And then there are paper books if you want to have something you can hold and read as well. But the purpose of the book is really to help both a patient and then anyone who is either caring for or cares about them, or maybe both. So patient and their circle of loved ones and caregivers to be able to deal with the change in your life that happens when you're diagnosed with something that literally changes your life from that step. forward. So that certainly applies in cancer. You go from being someone who doesn't have cancer to someone who has a cancer diagnosis, and there's a lot of, you know, heavy weight that goes along with that. And it could also be something like you're diagnosed with something that may have a significant amount of disability, change in quality of life, maybe shorten your life, such as some of the more aggressive autoimmune conditions. And some of the other chronic illnesses that involve a lot of chronic pain, etc. So it's not just about cancer, but really it's that realm of life-changing diagnoses we're talking about in this series. Now today, what I wanted to do is talk about the—it relates back to chapter seven in the book. I want to talk about. The external cancer journey or the physical cancer journey.

Now, the—

when I was writing up the, you know, chapter titles and doing the outline originally, the reason— because I've had people ask that, they said, why do you call it the external journey? And it's because the book is focused on, you know, it's the journey from diagnosis to empowerment. So it's not just acceptance of your condition, it's being empowered with it. That's a very mental, emotional, or mental, emotional, and spiritual activity. And so whatever way you look at that, your mind and your body get involved. Now, there also, parallel to you being diagnosed with cancer, is a physical journey that goes on. And the reason I said the external journey in the title is It's really metaphorically external to the mind-body experience that you're having. Now, of course, your body's involved in the mind-body experience, but this chapter was really more about just a quick chapter to take you through certainly a continuation of the story of the 2 types of patients and their kind of backstories, but also really to take you through What is it about cancer that has such, you know, wide-ranging effects on people? What ways does it make us as a human sick physically? And what kind of things can happen as you go through? And then in the second part of the chapter, I talk about some very basic but core kind of bedrock foundational ideas around understanding the things that you have control over and that you can do. And also some foundational concepts around just, you know, how does cancer work? Like, what does the timeline look like? And what do we call these different checkpoints throughout the process that you might be going through? So all that's in there. And the point of the chapter really is to help you be knowledgeable, and knowledge becomes power. And the more knowledge that you have, the more you can make distinctions. We'll talk about that in a moment, between what you do have control over and what you don't have control over. But also, the more knowledge you have about a process, The less it can surprise you, the less it can trigger excessive fear and anxiety because you understand what's going on. And while your experience may be different than other people, at least you understand what you're dealing with. So I want to just start out with, we talked about why use the word external, so you could just say physical if you want to.

But I want to talk about how this idea that your body is going through this big change and you've been diagnosed with something that you've always heard only bad things about, something like cancer, and what does that interaction have when your body is also now in an immunologic fight? How does that affect them, you know, your mental-emotional state? And your mind-body connection. So going back to things we've talked about in the previous 3, one of the core concepts in moving from this, just, I've just been diagnosed and it's like I was hit by a truck. And, you know, I'm in disbelief and I'm disillusioned and confused and all of that in the very beginning, moving towards not just acceptance but empowerment. Part of that process is certainly the steps of, realizing you're gonna have some denial and you're gonna have some maybe anger come up and some anxiety and some other things that go along that make you human. That'd be unusual if you didn't have those things. But the other side of the coin is a big portion of being able to navigate that trip towards being accepting and empowering so you can be on top of your condition as opposed to it being on top of you. is an assessment of what you do and do not have control over. So while everything is part of you that has to do with your cancer diagnosis, and you have to certainly be involved in things and you have to be aware of things, some or all control of, and then there are groups of things that you probably have minimal control over. Okay, for example, if you are, you know, depending on the type of cancer and its stage and grade and when you get diagnosed and your age and your health, there may be options presented to you that are, you know, we could do this surgery or radiation or chemotherapy or some combination of all of those. Or as it happens in many cases, they may say, you know, with the stage and grade of cancer that you have, we actually have very poor outcomes with the standard treatments we have. And certainly if you wanna take the odds of, you know, 4 or 5% chance of having a good outcome, you can take those. But I've heard a lot of, you know, oncologists tell people, you know, if it was me, At 4% odds and, you know, pretty much 100% odds of side effects. If it was me as the oncologist, I would say, you know, I wouldn't do it myself, but it's your decision. You know, you got a lot of things like that that then you get involved with, but once you get past that, okay, and you've decided to do or not do whatever you're going to include in your treatment program, Then you have to leave that in the hands of the professionals who are providing you with that treatment. Now, certainly you still have control in that situation because it is your body and you get to make decisions as you go along. And there are times I've seen where people, you know, just didn't really mesh with their particular provider. And that happens. It's happened with me. It happens with every healthcare provider. And they transfer to, you know, a different provider. And that's someone they mesh with, and then they move forward. Sometimes the doctor will get involved and come back to you and say, based on your response to your first round of treatment, or after we did surgery and we see a bigger picture through pathology and through, you know, whatever other factors we have. I know we told you we're going to do these things, but we're actually going to change and modify your treatment program. So you're certainly involved in those things, but you normally, under almost no circumstance, are going to choose how much radiation you get if you have a radiation oncology program. You're not going to choose, you might choose your surgeon, you might not, you might choose your surgeon, but you're not gonna choose the procedures that they do and all that, except in certain very rare instances. You're certainly not going to be involved in how they dose your chemotherapy in most cases. Now, the times that you are, they may come to you and say, we actually have 2 ways that we can do this. We recommend starting with this and fall back on the other. Uh, But the data is roughly equal for them. And, you know, here's, here's the positives and negatives, the risks and benefits, and we'll let you help, you know, contribute. But for the most part, if you put those things in the box of stuff you can't control, cannot control, you have a little bit of input into those things, but that's where it ends. So part of moving towards being empowered is realizing that there's a lot of the physical part of the cancer journey that you have moderate amounts to low amounts of control over, and parts of the physical portion of the journey you have a lot of control over. Now, what else could be in the category of things that you don't have as much control over except the way that you maybe respond or set boundaries? Well, things we talked about in part 3 that are other influences, friends and family. family. And as I mentioned back then, friends and family can either be medicine or poison for you, literally. And if you're having people who are really bringing a lot of good healing messages and energy around you, and they're doing things, you know, to help out, and, and it really, you know, it resonates with the way that you're feeling, what you need, or they're responsive to what you need. Great, you know, things are going to go really well there. If, on the other hand, you have, you know, sort of a toxic or poisonous input, you can't control that person and what they think, but you can control their access to you and you can set boundaries. So it's an example where, you know, what, what goes on with and around you, you have a pretty good amount of control. Over, but you have to realize you can't control the other person. And this gets into other things we talked about with caregivers and friends and family where they're, you know, they care about you and they're as surprised and upset about your cancer diagnosis as you are. And they may not be taking it very well. And your responsibility as the patient is to understand that You can't go through that journey for them and that they are going through the same journey you are. But what you can do is say, you know, and until I get it, I, you know, I'm going through the same process myself. I'm kind of angry, I'm upset. But, you know, dear loved one, caregiver, you know, until you get to the point where you're a little more settled with this, I need to, you know, I can't. I can't have this sort of input around me. And most people do get there. You know, it's a matter of just, just working through things, which is why I wrote the book for both the loved one and caregiver as well as the patient. So while you do have control over limits and boundaries and things, you can't control how somebody else is going to react. That's completely out of, out of the realm of, of our control. So why this big, you know, thought about the boxes of what I can and can't control and how much— if I can't control it, I usually have a little control. Is it a tiny bit or is it like 50%? The reason for doing that assessment— and last time we talked about assessing where you're at, like, am I in the anger phase? Am I still, you know, a little bit on the, you know, denial end of the spectrum, or am I moved on? Um, The other part of the assessment that fits in here is, what do I really have control over? What do I need to keep an eye on, but maybe professionals are going to be controlling the technical aspects of, such as a surgery or, you know, dosing of medicines and things of that nature? And then it allows you to be aware of everything that's going on, the whole box that is you, but also be focusing on the things that you personally can do something about. So you don't want to ignore the stuff that, you know, you don't want to just go on autopilot and have people doing surgery that, you know, you haven't checked out and you don't know. And, you know, you don't want to go on autopilot and not tell, you know, the oncology team if the, you know, you had a very bad reaction to the first round of chemo or something of that nature. But you also, you know, can't be in there telling them how they're doing, you know, how to do their dosing and their job too. Well, by identifying what you do and don't have control over, you then come to a place where you have more availability of peace, literally within yourself, because you can see how to apportion your time and your efforts. So what are things that you do have control over? Well, you have control over the thoughts that you have. Remember, we can't control other people. You do have control over, to a large degree, over what you allow in. Now, if it's another human and they live in the same house as you, you might have limited control over that because of proximity, but you do have control over the things that you listen to, the programs you watch, the books you read, you know, your own input can be quite large around there. And also, you know, the other people that you talk to, they can be very positive and uplifting and supportive, or they can be very negative and, and, you know, not so much of a help. You have, you know, unless you're a child, generally you have complete control over what you eat and what you don't eat. Whether you get movement in and exercise or whether you don't, and things of that nature, you know, what's going on with you. Now, if you're a person who's decided to do integrative oncology therapies, or what happened a lot, I know, in our, in our practice, but also in the cancer research I was involved in, is we'd be referred patients. where the oncology staff would say, you know, you're too old for me to dose chemo. And so, because I could give you chemo, but you'd probably die from it. So we would prefer that we not do that to you, even though you have an aggressive cancer. Here's this study of integrative oncology. Maybe they have something that's not as toxic. It might help you, you know, with your quality of life. And we did a lot of that sort of work. People, you know, With different medical conditions, people at certain ages, the oncology staff will often say, you know, if you were 20 years younger, we'd do this with you, but we really can't because of your, you know, your age or your medical status. So you might be, you know, involved in other things that are going on. You have a lot of control over those things. Again, there has to be some professional level of involvement, but generally those are much more, you know, patient-sought. sort of treatments. Now, a common question that comes up is we're talking about the physical or the externalized, you know, physical body experience of cancer. So what does cancer do to the body? Why is it, you know, I mean, we all know cancer is not a good thing, and we all probably know someone who's had and unfortunately maybe passed away from cancer. But because it's not something that, unless you've taken the time to dig in and look at it, it's not the kind of thing that a lot of people spend a lot of time dwelling on. A lot of people are, you know, don't understand, like, how do you go from this diagnosis of this, you know, bad thing that nobody wants to some people going into remission and living a long time, some people kind of having a roller coaster experience of they get some gains with therapy and then they kind of crash and then they get some more gains and they crash and, you know, maybe, maybe get remission, maybe they don't. Some people have a real short course of treatment and they're in remission right away. And then some people, no matter what is done, they just progress forward. So you have kind of all these options with one disease. Well, just to break it down and not to take a ton of time, obviously this could be days and days of discussion, but one of the hallmarks of cancer is that it hijacks your cellular machinery and it becomes its own entity. So for the pathologists, to look, you know, microscopically at changes in cells, they have a system that goes from mild changes that are non-cancerous to a staging and grading system for cancerous cells and cancer itself. So the general rule in pathology is if you look at the cells and they've been irritated— chemicals do this a lot, certain infections do it, you know, other things do it— if the cell's been irritated, it may be in a precancerous state. And the distinction there with your cell biology is if it's a precancerous state, often if you take the irritant away, whatever it is, the infection, the chemicals, the smoking, Whatever, the cells can go back to being normal. But you cross a line when you get into the world of cancer, in which the pathologist can look and they see that the cells that the original cancer came from, let's say it was liver cells, have a few characteristics left, but not many. And the less characteristics of your original cells the cancer came from that you have, the worse the progression of the cancer is. The other thing about that is, is that while it's healthy to remove the inciting events after you get into the cancer system, and it pathologically is cancer, you can remove the inciting events for your health, but it won't turn it around like it will a precancerous lesion.

Right.

Now, a lot of people, just because it's much more common to hear this talked about, you can hear a lot of women will have a Pap exam, and they may look, and maybe there might be a biopsy, there might not, and they may see, you know, there's some premalignant cells, and they'll do a treatment for that. And there's many things that would be done, and then you go back for the follow-up, and they're back to normal cells. Whereas if you do the exam and then there's a biopsy and there's malignant cells of different grades, those are not going to get better without some sort of treatment to either kill them, remove them, et cetera. But if you think about this, well, that's great on the cell level, but why do people get so sick? And, you know, why do they lose weight? you know, have all these other things happen. Well, the cancer then, once it breaks over that threshold of being not like you anymore and being cancer, it's after its own purposes at that point. So if it's a solid tumor, it will build its own, you know, vascular network and take nutrients away from you, et cetera. If it's a blood cancer, it may settle in your lymphatic system, your bone marrow, all throughout your body. The hematologic or the blood type cancers have all their own characteristics, but they still are all about perpetuating their life form, not you. You're now the host. So one of the things that happens with cancers as they get larger is that the nutrients that are going in to feed you are diverted to the cancer to make it stronger. So this is why some treatments that are done will maybe restrict certain types of nutrients, categories of nutrients, you know, such as a lot of the metabolic cancer therapies and certain other restrictive treatments, just to try and help slow that aspect down. But the cancer really is building its own entity, and it cares about you in that you're the host and you're providing everything. But it just, it will get larger and larger and take away from you. So then people will say, well, why can't you just, you know, cut it out or radiate it, you know, or kill it, toxify it with chemo and have it go away? Well, sometimes that happens, especially in, you know, people you hear about with, you know, a stage 1, maybe a stage 2, you know, breast cancer, prostate cancer.

Yeah.

Treatments might be fully curative, you know, at lower stages. When you get to stage 3 and 4, where the cancer has moved and metastasized to other places, you can't go chasing down all of the cancer around, say, surgically. Now, they still might remove pieces of the cancer that they can get to, to debulk it, because there's another danger of large tumors, which is compressing important— things like your other organs, arteries, veins, you know, if it's in your brain, it'll compress your brain. So there are reasons to do surgery other than eradication totally. So there's that, that's what cancer does to the physical body. And then the pathway of cancer treatment is a whole other thing that's very taxing on the physical body. So, you know, through chapter 7, I kind of go through this and break it down and The upshot though, is if we're looking in this book at the journey from being diagnosed and sort of victimized by cancer to being empowered as a patient and being in charge of our own diagnosis, et cetera, what we want to really relate this physical or external experience to is how is that going to make you feel? Well, there's a number of levels at which this can hit you in the mental-emotional sphere. The first one is you, um, have a sudden loss of your previous life. So now you are a cancer patient. You didn't used to be a cancer patient. The next is you may be undergoing treatments that make you feel horrible, and you might be on medications for the side effects of the treatments, and they may make you feel even more horrible, albeit taking away the side effects of the treatment. You might have things that just fatigue you greatly. You might lose your hair. You may lose the ability to taste or smell or all of the above. You may have digestive problems that are really extreme. You can have all sorts of things go on with this. And so when you're trying to process the shock of the cancer diagnosis and all this, We, we talked about in the book how you have to honor your time, you have to honor the reality that on top of your full life that you had before, now you're a cancer patient, and that involves doctor visits and treatments and scans and all this stuff. Well, that takes a pretty big mental-emotional toll as well, because you're giving up a lot of other things there. But then on the physical side, when you start undergoing treatment, Or maybe you just have a very advanced cancer that affects you, you know, by, you know, taking nutrients away and all this stuff that cancer does. Physically, you just feel horrible. Well, think about the last time that you tried to, you know, do some self-discovery and, you know, work through some problems and, you know, become, you know, become a quote unquote better person by, you know, self-development and all that. You know, we've talked about in the previous things, maybe, you know, maybe you need to work on the denial part, or maybe you need to work on the anger part or whatever. Um, imagine trying to do that and go through all of that while you feel really horrible. When we feel really horrible, we don't tend to want to do the things to help us with the mental-emotional side because you kind of want to hibernate. So the physical part or the external part of the cancer journey definitely affects this idea of moving from your diagnosis to empowerment. And as I kind of relate that, those steps in diagnosis to empowerment to stepping stones, you know, or a pathway. And everyone, you know, some people's stepping stones are real easy to get from one to the next, and some get to one where they haven't done You know, it's just they're not good at handling, you know, the denial or not good at handling the anger, you know, or whatever. And they're there for a while, right? Well, the other things that go on that become impediments as you go along are toxic influences of other messages, humans, etc., around you. So if you're taking in a lot of negativity, And that's not to say that, you know, you need to ignore the fact that you have cancer. I mean, you have to be realistic about your diagnosis. But if, you know, if everything you listen to is a real downer, and, you know, you're consuming tons of, you know, the news, which is never uplifting or positive, you know, way beyond being informed, you're over-consuming that and you're not getting anything that sort of feeds you. in the mental-emotional sphere, that will compound when you start to feel badly. So stepping stones also have, you know, roadblocks that come up— people, messages, physical problems you go through with cancer, etc. So it is important to understand those things. Now, briefly, and in the book I break this down a lot more, You know, definitively, but to understand the cancer journey throughout the span of one's life, really. And if you don't ever have cancer in your life, you know, you're one of, one of the one out of 3, you know, who doesn't. You, you won't participate in 3 of these stages, but if you do have cancer, you'll participate in Multiple stages. So stage one, the first the first group of time is what we call primary prevention, and that means you don't know you have cancer, and you are doing things to prevent it happening because you know you know that statistically, you know a large portion of people in modern times do develop cancer throughout their lifespan. So you're doing things to help your epigenetics. you know, be less triggered and your metabolism be less triggered into developing cancer. So primary prevention means you don't have cancer that you know of and you're doing something to prevent it. This is where diet and lifestyle interventions become very, very important. The mind-body connection is actually very important in this stage, and a lot of things that you really have complete or Major control over. The next stage is— so part 2 is when you get from your diagnosis of cancer. So now you're no longer a non-cancer person, now you're a cancer patient. Diagnosis through active treatment. That's a very busy time. It's a very taxing time. And that is a phase where most people, of course, are meeting doctors they never thought they were going to need to meet. You know, oncology specialists and surgeons and things of that nature, maybe doing, you know, working with integrative practitioners, whatever you're doing, a lot going on there. But the second phase is really from your diagnosis through your active treatment. And this is often where a lot of these physical things come up that are part and parcel of the treatment. So you have a lot of treatment side effects and other things that make you just physically not feel very well. Then phase 3 is the recovery phase. And this is a common place where people will, you know, kind of rest and recuperate. A lot of people will go back to sort of doing a lot of integrative sort of therapies and a lot of diet and lifestyle things. And again, going back to more, more things you have control over, but recovery is you're recovering from surgery or you're recovering from radiation or chemo or all 3, and it's a lot to recover from. And sometimes what will happen is the goal of those things— surgery, chemo, and radiation— is, if they're appropriate for your case, is usually to debulk, so shrink down the tumors as much as possible. Now, if it is a A low-stage-grade tumor, there might just be one treatment, which might be surgery or might be a radiation treatment or something. And they may say, there's no evidence of disease in you, we believe we got it all. But if it's, you know, a stage 3 or 4, you know, high-grade cancer that's more aggressive and spread around, you may still be doing those things. to shrink everything down, but it's going to be on a more body-wide basis. Now, that's going to be helpful in many cases, because what we see with chemo and radiation especially is you usually get a big bump in effect right away if you can tolerate the chemo and radiation physically, meaning your tumors often do shrink with chemo and radiation. The problem is it's It's a limited mechanism. And so let's say you get to the place where your active treatment now can take a pause because the oncologist says, we usually do, you know, 4 rounds of this therapy and X amount of radiation, and you're done with that. Now we're gonna watch you and we're gonna rescan you or check your numbers or whatever combination of diagnosis that they do. We're gonna do all of that.

Yeah.

You know, in X number of weeks, and we've got a schedule for checking in on you. So we're going to call you, you know, in remission or on a treatment break, or maybe no evidence of disease in some cases, and we're going to recheck and see if you stay that way. Now, one of the problems that happens, and the reason why I think Phase 2, diagnosis through active treatment, super critical, But phase 3, often we don't put as much, you know, thought and effort into, which is recovery from treatment. That's the time to have your body in a situation where if you literally are on a break from chemo and radiation and no surgeries, everything else, is the time to heal your body up. And where I was saying, you know, especially with chemo and radiation, we get this big initial decrease in tumor size in a lot of cases. Et cetera, you can get some kind of false, you know, false long-term hope from that, in that often what happens then is in the post-chemo radiation phase, you can have your cancer stem cells get very active and kind of come back. And I mean, everyone knows about this, and there's different strategies. But a lot of what you need to do during that time is be as healthy as possible in the recovery phase 3. And things like your nutrient status, getting out and moving around, getting your muscles to work, having more muscle metabolism than fat metabolism, for example, eating very, you know, clean and working with people who know about recovery, you know, dietary interventions, reading good books about that, etc. All of those things can be very helpful in keeping the cancer stem cells quiet. Now, in the other— in our first cancer book we did, Outside the Box Cancer Therapies, I did a whole chapter on this and kind of the biology behind it. But really what it boils down to is being as— including as many healthy actions in your life as possible, whether it's movement, mind-body, diet, nutrients. other lifestyle things. That's the best way to keep the recovery, so you do recover, but also you keep your cancer stem cells quiet. Now, this is a good time in phase 3 to work with people who do integrative oncology work, and there's a lot of different practitioners who do that, because that is the phase where you have a lot of options and you have a lot of things that you can do do for your body to not just heal it up, but to keep your cancer stem cells quiet. Well, then there's a 4th phase, and not everyone goes through all of these because some people obviously don't live through, you know, phase 2, active diagnosis and treatment. Some people don't live through phase 3, but many people do nowadays. So you get to phase 4, which is Secondary prevention. Now, primary prevention was the first phase, and that was I don't have cancer, and I, and I'm preventing cancer I don't have, right? I'm doing diet and lifestyle and healthy living things to prevent cancer. Secondary prevention means, well, we've already had cancer once, but we would like to prevent it from coming back, hence secondary prevention. So those are the 4 phases that you go through physically with cancer if you, you know, if you have the type or the treatment, etc., that allows you to make it all the way into secondary prevention. Now, secondary prevention is sort of a broader scope, especially in the world of integrative oncology. It's a broader scope of things that you need to do than the recovery phase. Recovery phase You literally are focusing on recovering from your treatments, getting function back, healing your body, and then, as I was saying, do all of the healthy things to keep the cancer stem cells quiet. When you get to secondary prevention, you have usually healed up and you're past your cancer treatment trauma, you're past your initial cancer trauma. You have usually no evidence of disease or maybe a hard remission. And so you're in secondary prevention. Now, secondary prevention, which is something that it's always been a thing in cancer therapies, but doing integrative oncology, it's something that we really focused more and more on in the last, say, 10 to 15 years. Because if you go 20 or 25 years ago, people would look at integrative oncology as sort of a last-ditch effort when they were, you know, in the In the last stages of dying, and certainly things you can do for people at that stage. But nowadays people are more aware and they're more likely to be proactive. And so in secondary prevention, you have a time now where you literally need to kind of look under all of the rocks physically and see what your body is doing physically on a macro big scale. And what's not working correctly and get it, get it corrected and remediated. Why do you need to do that? Well, secondary prevention is a very aggressive version of the recovery phase because the cancer stem cells never go away. And our goal is to have them for the rest of our life be very quiet and not have a need to generate new cancers.

Okay.

Okay. Now, one of the downsides of chemotherapy and radiation is, and this is in all of the modern data, is it kills the main cells, the daughter cancer cells, but the cancer stem cells usually are not killed by chemo and radiation. And so they will go back into hiding as a survival mechanism. And then when everything is quiet, if the conditions are correct, they will create either the same cancer or sometimes a new cancer. You see this in people. So you think, well, in secondary prevention, then you're saying it's a bigger picture macro. What areas do you look in? Well, there's a number of things depending on your therapies during cancer, the type of cancer you have, all of that.

Yeah.

In secondary prevention, you need to work and look distinctly at laboratory measurements so you can see that all of your hormonal system is working, so that your thyroid is working and reproductive hormones and your blood sugar control and all of that. Now, why is that so important? Well, part of the homeostasis and balance of your body is All the hormonal system has to be playing together. And it's very common, even if you didn't have problems before, that the stress of the cancer itself and/or the stress of the treatments and everything else you went through will deplete one or more of your hormonal output centers. And so checking for that and not overtreating it, but just getting back to balance, very, very important. Other things that come up, because cancer also is an immunologic disease, your immune system gets very involved in it. And then the treatments can be either, you know, kind of pro-immune or anti-immune, but they can very often be dysregulating to your immune function. We often found people at the end in secondary prevention where they had picked up a lot of chronic infections. And if you don't look for those, you will never find them. So much like the hormonal things that you check for, you have to look. Now, a lot of people would say, well, I don't have any symptoms of chronic infections. Yeah, I don't, you know, I don't have very good energy, but I had chemo and, you know, everyone knows that makes you tired. Sure, you know, but the real point is If you're looking at keeping cancer stem cells very quiet, happy, and not wanting to make new cancer, a bunch of chronic infections smoldering below the surface are very pro-tumor stem cell because the chemistry that they put off is very pro-cancer return, their immune chemistry. And we often find people, just because you're on immune sidelining or immune You know, very heavy immunologic treatments, we often would find people with asymptomatic infections that, that were just good to get rid of. Certain chronic virus, some chronic bacteria that are real common, sometimes some chronic fungal things or digestive tract things depending on, you know, their whole story prior. But if you don't check, you don't find them. Those things need to go. They need to be out of your life.

Yeah.

Because you don't need any of these things. It's like a hole in the bucket at this point. Bucket will stay full with health. More holes you poke in it, the more your health will run out, right? Well, that's what these things are. Now, I mentioned, you know, infections and people often would, you know, have no symptoms because their immune system had been so beat down by the cancer treatment, which it did its job, but then your immune system has to be active before you get symptoms. And so eradicating these things that are there, very important. But again, if you don't look, you won't find them. Now, the other thing, which is sort of related, but it's a much more broad issue, is the process of cancer treatment can be extremely hard on your digestive tract. And that's because not all, but many of the cancer therapies target rapidly dividing cells. Well, that's why you lose your hair, because it's rapidly dividing cells. Well, your mucous membranes, especially your digestive tract, turn over a lot because you're, you know, you eat usually every day, and you're putting a lot of, you know, it's a lot of stress through the digestive system. So digestive system likes to regenerate all the time. Well, If you have a therapy that blocks rapidly regenerating cells, it's not really targeted to, you know, cancer versus not cancer. And so your digestive tract can take a hit. Well, that can create a plethora of problems that can, you know, be either a short or long-term repair. In secondary prevention, if that doesn't get repaired, what happens is your GI tract microbiome, the good bacteria and flora that are there, And really, to a larger extent, your digestive tract immune system gets very confused and doesn't work correctly. And that's another reason for immune confusion, chronic infections, chronic inflammation, but also your digestive tract is where you digest and absorb nutrients. And if a big part of recovery and keeping the stem cells quiet and all that is nutrients and antioxidants and stuff. If your digestive tract and your microbiome and your digestive immunity is beat up, you're not going to get as many good nutrients on the inside, and that's very important to see and to do something about. Now, there are many other things. There are physical medicine things. You may have restriction from radiation cause adhesions. You may have other problems in your joints secondary to, you know, certain chemo or radiation or other problems. You might have post-surgical issues. Most people need some physical medicine attention, and that can be with people, you know, there's a lot of ways to get physical medicine into your life. So we think of, you know, the most common is probably the physical therapists, and they work with a lot of these things. There are chiropractic physicians who work with these things, osteopathic physicians who focus on physical medicine, a lot of subcategories, also acupuncture and Asian medicine, and on and on and on. There's massage therapy. There's many, many people to work on the physical parts. And then there's a number of other things. But as you can see in the last phase, secondary prevention, you've got a lot of work to do, okay? So you, you've got a lot to clean up if you want to stay in remission or no evidence of disease. That's where we all want to stay. So as the physical process goes through, it's important for your own knowledge to just know that there are these 4 phases. So you've got primary prevention where you don't have cancer, don't know it, trying to prevent it. Phase 2, diagnosis of cancer through active treatment. Phase 3 is recovery from active treatment, and phase 4 is secondary prevention, and they all have a place. So also, if you're coming to this and you're trying to deal with your journey from the, you know, from the horror of a cancer diagnosis to being empowered, it also makes a difference, you know, where you are in that physical journey because you're going to feel physically different during those times. And, you know, maybe it was such a whirlwind when you got diagnosed, and then there's all these doctors and all these treatments and your mind was there. You may have totally not had any time to, you know, barely get through the denial phase that you're in. Remember last week, part 3, we talked about this a lot. There's different types of— there's just all-out denial where you just ignore your disease. But there's also this tacit denial where, you know, you have the disease, but you kind of go on with your life pretending you don't have the disease, which happens more commonly than other things. So, you know, where you're at in these 4 phases, there's a lot of difference in how much energy goes into different kinds of treatment, what your body's doing, but also just how much energy do you have to process all of this. Now, in the last few minutes, I want to talk about a couple of things, but one of them is highly in the— remember we said to kind of do an assessment of what do I have control over or not? And most things we have degrees of control. There's some things we have very little control over, some we have partial, and then there's some things we have almost or 100% or 100%. And the 3 pillars of— and there's previous podcasts on this if you want to go back and look, but there's 3 pillars that I saw when I looked back over 3 decades and looked at cancer patients. And, you know, which ones had better qualities of life, better reaction to treatment, better length of life, you know, all the things that we're going for with cancer, because cancer is so, just so tough universally. The 3 pillars that all other therapy sort of stands on are things that you largely have a lot of control over. And in the book, we use this mnemonic memory device of food, muscle, and brain. Well, food is what you put into your body for fuel. It's also how much you put into your body, what timing you're eating or not eating. And anything related to the feeding of your body. Now, the other thing we talk about a lot in the first book especially is you need to have clean sources of food going in because you— one of the best ways to toxify yourself certainly is through eating. Now, we eat once or more a day, and if your food is full of a lot of toxic material, that is not good for keeping the cancer stem cells quiet. So food, it's fuel, it's good nutrients, it's eliminating toxins as much as you can, and it's managing your macronutrients so that, you know, you have healthy dietary things. Muscle is real simple. All of the data that we have, and it makes complete sense metabolically, shows that the more our skeletal muscle, the muscle that moves our body around, the more active it is, the more metabolism we have from muscle, and the less metabolism we have from fat, the longer we live and the better our quality of life is. And this is even if you start out a little heavy or a lot heavy. So you don't have to become a marathon runner. You just need to get your muscles moving. core of your body. For some people, they're so fatigued that standing up a few times a day. Some people it's walking around their living room. Some people it's taking a walk every day, whatever it is, move. And the fat metabolism goes back to your, your diet, because if you're eating a high sugar load diet, all you're going to do is get a lot of fat and insulin metabolism. That's negative. So more muscle, less fat. And then brain is really what this whole book is about and why I wrote the book. Because your mind and what you let into it, the things that you partake in, as far as, you know, what you feed your mind with, as far as information, etc., all of that goes into the brain aspect. And so food, muscle, and brain becomes kind of the 3 pillars. And you generally have a, if not 100%, a super high degree of control over those 3 things.

Yeah.

things. But we are out of time for this week, and so this is installment 4. There will be at least an installment 5 and probably 6 going through, and we're basing it on the book Cancer: The Journey from Diagnosis to Empowerment. You can get that online in any form you want, anywhere you buy or get book products of any kind. There is a hub website It's new. And so for instance, you want to go and you want to find the books, but you also want to see the newsletters and all this stuff. It's dranow.com, Dr. A Now, dranow.com. And that has links to everything. If you're a healthcare professional, it's got links for you. If you're looking, as I said, for, you know, the webinars or the book website or the newsletters, It's all there, dranow.com. And that is, that is the website you should go to to find everything else out. Well, I'm out of time now. It's been my pleasure speaking with you, and I will see you all either live or in a recording on the radio next week. Thank you.