Recovering From Cancer Treatment & Preventing Recurrence (Full Interview Part 1/2)

So the whole goal of this is to get things calmed down, heal the body, and then set your body up for success in a long-term secondary prevention or remission. What I thought I would do is focus today on the aspects of recovery from active treatment and then secondary prevention, which is keeping your cancer as far away from you as possible, or at least as quiet as possible. I'm going to use a few slides here just to kind of keep on track and kind of have a way to set up our discussion. Because when you're looking at things like cancer, there are so many ways that it can manifest inside of humans and so many ways that treatment can go either good or bad or somewhere in the middle. It's in my mind, and this is something I really didn't come to until I've been practicing a long time, but looking backward, it really, really is important, I think, to have a top-down view so that then you can become specific for each person. Getting into that then, the cancer journey, and I am bringing this up as a journey, looking at cancer and what do we do with cancer and how do we, you know, deal with it. One of the things that can become very confusing both for doctors and patients is what do I do specifically when I'm at a particular place? So if we look at cancer and dealing with cancer as one thing, it can become very overwhelming. And we can wind up with all sorts of you know confusion that goes on. So now these are the four phases of the journey as I see them, and this is kind of how they break down in people going through cancer. There's primary prevention, which is you don't know you have cancer yet and you're trying to keep it away. We all know that we all develop cancer cells every day, and thankfully the immune system does something with them. Then there's diagnosis through active. Now, we're not really going to talk about that today, but that's a very critical time because it's a very busy time. You have the diagnosis and all that that means to you, you know, mentally and emotionally, but also physically, financially, your time, everything. Really a lot of upheaval there. There's a lot of good things that can be done there, but sometimes that time period is a bit complicated because you might be very busy with— You know, maybe surgery, biopsies, et cetera. What we want to focus on today really is recovering from all of that and how important that is, and then secondary prevention, also very, very good. So this particular way of looking at it, if we have phase 3, which is recovery from active therapy, why do I have these funny blue arrows on here? Well, if we want to be realistic, sometimes when we're in the cancer journey, we get diagnosed and We'll have patients maybe who are diagnosed at a very high stage grade with an aggressive cancer, and they may not survive to go on to one of the other therapy areas, and so we just want to be realistic about that. Now, obviously, we want to do everything we can so that doesn't happen, but that's a real thing, and sometimes people get on the other side of active therapy and also may not survive the secondary prevention, but what I really want to focus on today obviously is— All of the people who do get to the other side. So the goals that we all have, I think, when we're in recovery from active therapy, I just want to say that this could be a couple of different ways that it plays out. One of them would be we're completely done with all other therapy. The other might be that our standard oncology plan includes some sort of maintenance that we're doing. Either way, we kind of look at this as its own phase, and it's a very important phase to heal the body, but also set the body up for success in secondary prevention. One of the things that much of standard cancer therapy does, and that's not to say that standard therapies are always bad or all of that, it's just to say this is the reality of standard therapies, is very stressful on the body. So whether you have had surgery, had radiation, chemotherapy, immunotherapies, maybe a mixture of all of those or pieces of that, your immune function can become either very suppressed, even damaged by some of those processes, or in the case of some immunotherapies, your immune system can become altered. And so you could think of that as damage, or you could think of it as kind of twisting the immune system so it has a stronger relationship with the cancer cells, which is the point of a lot of immunotherapy. From our point of view, we're thinking about healing and recovery here. So let's say you've had surgery. It's a big— focus to try and heal up after the surgery, just from the point of view of her physical function. But then when you've had therapies that might be either directly attacking tumor cells or altering the immune system, we want to do everything we can to get you back to a good and functional immune system. And sometimes that's quite a tall order there. And then something that we'll be talking a lot about in all of this section is marginalizing cancer stem cells. So I'm going to get more into specifics about cancer stem cells, but the bottom line is, is that the tumor that you see and the tumor that they're trying to treat are normally what we would call daughter cells. These are the cells that come from the stem cells, and that's the big, you know, burden of tumor. And so that reacts one way, especially to therapies and surgery, et cetera. Cancer stem cells are much, much smarter than the daughter cells that make up the tumor that you can see. And the cancer stem cells that Turns out are what, kind of our predicate to how your cancer journey's going to go. So in the healing and recovery phase, we really wanna put effort into healing you up and also making sure that your immune system comes back online so that you can think of it this way, the cancer stem cells become as quiet as possible and the immune system is as basically florid and full functional and keeping things in check. That's really the goal there. You know, from a psychological and a time point of view, you know, people are obviously very happy that their active cancer therapy is over or they're in maintenance, whatever. Usually it's pretty traumatic to go through. And so they often though have signs and symptoms that they don't like, and that's often what brings them to integrative medicine to try and help. That's really a good thing because signs and symptoms that you find unpleasant are usually related to these areas that we were just talking about, which means a need for recovery, a need to get the immune system back online, a need to heal up from therapies or at least maximize your healing, etc. There's lots and lots of things that you can quote unquote treat or intervene with, etc. Here, a lot of people have fatigue, a lot of people have pain, a lot of people have restrictions, things especially, you know, chemotherapy can create actual chemical changes, but certainly radiation therapy and surgery, you have physical restrictions, etc. So there's lots of things to focus on. Now, one of the things to keep in mind in regard to this is that while we want to certainly, you know, enjoy the fact that maybe we're done with Done with chemo, or whatever it is that we were doing, or maybe we're just on a little bit of maintenance of something, and we want to have that time to kind of rebound because of this big stressful experience of being diagnosed and treated, and you kind of just feel like, okay, I'm done with that, I'm just— I need to kick back. Well, kicking back is part of it, so we want to, you know, we want to honor that, but the other thing is, is that if we can be real active intervening right in this time period after active therapy, We can get the cells and the parts of the cells that get damaged, like the mitochondria that give us energy, etc. We can start to move them back online to where they will be more functional and less dysfunctional, which gives us better function and better immune function. So our goal here is to use this sort of break that we have, as you will, where we're getting very little or no standard on. oncology treatment, to do everything we can both at home with what we do and then with your integrative oncology providers to help bring in all of this healing. Very, very important in that particular time period. So the big focus areas that we have, obviously healing, very multifactorial. Core areas which, you know, people like us might give you advice about, but Really areas that you need to incorporate into your lifestyle and your life. When I look back over all of this time dealing with patients and looking at people recovering from cancer and other very bad diseases, the core things of what we put in our body for fuel, diet, and all that has to do with that, the core ideas of keeping my body moving, etc., exercise and all that, and then How my mind and my body are talking to each other, what I'm letting in my mind. So the brain aspect, those are really the foundation upon which every other thing works. So while you may be getting some assistance to a greater or lesser degree from a healthcare practitioner, and they might be doing particular therapies with you or interventional things, nutrients or botanicals, etc., or any number of other things, these things that you can focus on yourself, maybe with some extra help from other people, or maybe you already know, being what you put into your body for fuel and how clean it is and how good it is for you, etc., and how you keep your body moving and keep your muscles engaged, etc., and then your brain, your mind-body, your thought life, your filtering of what comes in, etc. Very, very important as base for everything else that we do. Now, calming the epigenome, we're going to talk about this a little bit more, but just the terms are interesting around genetics. So genetics are essentially a fairly straightforward thing, not simple, but straightforward. It's like a code. Epigenetics are what come around, or you can think of on top of the genetic code. The genetic, with some exceptions of modern technology, don't usually change. Epigenetics are things that happen to us that are alterable, things that can be changed. So what we want to focus on is the epigenetics becoming as health-producing as possible. Now, a wonderful thing about this is that all of these things that we're talking about, as far as focus, are very doable because they all relate back to these things that we can do to intervene to make ourselves healthier. And then we can be more specific about it, but the healthier we are and the healthier the factors that create health are around us, the more our epigenome becomes health-producing instead of health-inhibiting. Supporting anti-cancer therapies. So maybe you're all done with standard of care things, whether it's surgery, chemo, radiation, immunotherapies, but you might still be doing natural botanical therapies Or acupuncture and oriental medicine or physical type medicine or photodynamic therapies or a million other things. We want to make sure that those have as much chance as they can to be supportive. Maybe in this time period you're off of all the big standard therapies, but they have you on a maintenance. Also, if you're going to be on a maintenance therapy, it should do as much good for you and as little bad for you as possible. And so our goal here is to To recover from phase 2, which is all that active therapy around your diagnosis, and then move you to where we really want to be, which is phase 4, which is secondary prevention. And secondary prevention is, okay, we— it's not like primary prevention, we don't know we have cancer yet and we're just trying to have it not happen. Secondary prevention, we all know that cancer was there, but what we want to do is have very durable remission, a complete either remission or no evidence of disease or one of those type of categories, or if the cancer is still there and active, we want it to be as minor of an influence on you as possible. So the whole goal of this is to get things calmed down, heal the body, and then set your body up for success in a long-term secondary prevention or remission. So, secondary prevention, you know, if I go back 25+ years, generally speaking, the only people that would come to doctors like myself would be people where the standard system had completely written them off and they would say, well, there's no more we can do, or, there's nothing we can do for your cancer, and the patient would often say, well, could I explore alternatives, and they would say, well, we have nothing for for you, so you can do whatever you want. And so in, in those days, that was pretty much the cancer patient we would see. And I remember the first time I, I had a patient come in that wanted primary prevention or secondary prevention, it was almost a shock because it was just not very common that people thought of. Well, now, thankfully, because I believe people are more educated, they're more empowered, et cetera, we have more people coming in wanting primary or secondary prevention. And so, in secondary prevention, you've been through the journey, you are either in a remission or there's no evidence of disease, or you have what they call stable disease or smoldering disease, something like that. So, this is the time where, generally speaking, there is not a whole bunch of active therapy going on. You often have been sort of released to your own devices. by the standard oncology world, and it's time for you to put as much effort as you can into being healthy and maintaining, as I say, a durable remission, no evidence of disease, etc., etc., all of which are— so again, remember, secondary prevention comes after everything else, so again, we already know what's happened. There are things that can affect secondary prevention, some of which would be how much therapy did you have? When you were getting active treatment? How did that go for you? Did you have a lot of bad side effects? Did you have a lot of damage from maybe radiation or surgery or other things? Did you have, you know, great response to biologic therapies or real bad response to biologic therapies? What was going on there? So that all is part of what we on the healthcare side have to kind of take in and decide, okay, You know, do we have you know a pretty good system to work on prevention with, or do we actually have to sort of back up and go into phase three and do some healing therapies before we move forward? So these are eight big areas that are, in my experience, very worthy of looking at because they're kind of big determinants of our health areas that can either make us healthier or less. Healthy. The cell function, I'll just kind of go through real quickly and describe these, but cell function is deceivingly a small phrase that has to do with everything. So how are the mitochondria? Do they survive all the therapy? Is the nucleus working, the part that helps you with, you know, reproducing your cell and making proteins and things? How's the cell membrane? Cell membrane is a very dynamic area and it has a lot to do with the communication with with your immune system, et cetera. All of that can take a while to kind of get back online afterwards. But also this is where things like your genetics and your epigenetics come in to a large degree. This is the target of your nutrition. It's the target of detox, kind of the target of everything. Then there's toxins. Now you can immediately think, well, I had chemotherapy and that was fairly toxic, or I had radiation or something. Certainly those are there. But the other thing is that when you have the experience of going through the cancer journey, a lot of times there's no nontoxic part of the world, unfortunately, and so we're all exposed to toxins. But our threshold for being able to deal with toxins gets smaller the more stress we're under, and cancer and cancer treatment, huge stress. So whether or not you picked up new toxins during your treatment, you can be more sensitive to what's around you, and we see this a lot with folks. So looking at that from the biofilms and resistance factors, these often we think of in people with chronic infections, but also biofilms are a part of nature. There we have normal ones in our body, and there's normal ones out in the ocean and other parts of nature, but then there are pathological ones, and they become the core of a lot of resistance to kind of chronic infections, chronic inflammatory triggers. So I found that when I'm looking at patients who aren't getting, you know, through the process and they're stuck, these 8 areas are also places we have to look and say, is this a bigger factor than we thought? So resistance factors to you getting better are very important. And then immunology is, of course, another deceivingly small term. So that could be chronic infections, that part of immunology. It could be immune deficiencies or immune imbalances. It could It can also mean autoimmunity, and maybe you had autoimmunity before, or maybe you acquired it because of treatment or some other thing. All of that though is taking away resources from your immune system working properly. So whether you have chronic infectious things or autoimmunity or an acquired or a permanent immunodeficiency, that does not set you up for a lot of success in the post-cancer treatment world because Your immune system working is so hypercritical. So again, this is an area that, you know, we need to look at. Your endocrine system, hormonal system. Now, I try not to make, you know, 100% declarative statements, but I've really never run into a secondary prevention patient who had normally balanced hormonal system. And part of that can be therapies, but also part of it is just the stress of the And because our hormonal system, much like our immune system, you know, talks to everything, our hormonal system talks to everything. And while you can't always get things back to the way they were maybe 30 years ago in your hormone system, when it is appropriate, it's very good to get things balanced up again. Because again, if you think of, you know, your immune system, which keeps you from getting cancer, keeps cancer from getting worse, very sensitive, but it, you know, it's got a 1,000 inputs or more. It's like a big web. Well, the endocrine system is part of what talks to it to tell it, you know, how to upregulate or downregulate or modulate. So very important there. Psychosocial factors, huge. And I think we all know that, but sometimes those are the, maybe the last thing we think of dealing with, although they're huge in healing. Digestive and GI things. Very few people have wonderfully functional GI tracts after cancer therapy. They're very, very damaged. And another thing to constantly be working on. And then there's, you know, your physical and structural things, and again, that can be just good physical medicine, moving your body, can be seeing particular therapy therapists for therapies, it can be a whole bunch of things depending on what's happened to you, and the whole idea here with these determinants of health is trying to get you as healthy as possible so the cancer stem cells, which are there and will always be in your body, will calm down and stay very quiet.