Integrative Cancer Care with Dr. Paul Anderson: Rational Wellness Podcast 257
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Dr. Paul Anderson discusses An Integrative Approach to Cancer at the April 28, 2022 Functional Medicine Discussion Group Meeting with Dr. Ben Weitz.
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Podcast Highlights
12:55 While in early cancer care, conventional care has a reasonably high rate of success and the protocols are fairly standardized, in stage four cancer care there’s just as much experimentation and unknown in standard of care oncology as there is in Integrative cancer care.
14:00 We need to share with patients that while we don’t know how their case will go, we know a lot more and have a lot more tools to help patients with cancer, but being realistic is a difficult balancing act. When patients ask if he can cure their cancer, Dr. Anderson will typically answer that curing cancer is above his pay grade, but that we can help to improve your quality of life and when that is done, we often see cancer markers improve as well as cancer outcomes. For patients with stage 4 cancers who kind of know how things are playing out, they want to have as much energy and they want to be on as little medication as possible. For patients with curable cancers, they may have other outcomes that are important for them.
19:03 The patients who did the best with an Integrative Oncology approach have addressed the three main foundational pillars, which are the following:
1. Food. Your diet should be low glycemic and it should be as clean as possible. We also know that doing at least a 13 hour intermittent fast daily is associated with longer life and better survival in cancer patients.
2. Muscle. For all chronic diseases, but especially in cancer, that I think we all realize now that whether it’s cancer or not, but especially in cancer, the more muscle metabolism you work yourself through and the less fat metabolism you work yourself through, the better your survival and the better your quality of life. And so this doesn’t mean the person has to be a power lifter. It just means they need to move their body.
3. Brain. How you think about cancer and how empowered you are as a cancer patient will affect your outcome.
The cool, high speed, high expense therapies like IVs, hyperbaric and hyperthermia will work better in the setting of these foundational things being attended to.
35:22 While chemotherapy and radiation will decrease the size of tumors in many cases, we know that in the long run, they are associated with the more likely return of more aggressive cancer. That might be months later, it might be years later, but we know that happens. We need to be supportive to those therapies but also supportive to their normal tissue so that we don’t get recruitment of cancer cells by emboldening the cancer stem cells with the chemo and the radiation. While cancer patients are undergoing active treatment, we often focus on reducing side effects, like mucositis, and enabling the patient to tolerate the therapies. Whatever we can do to improve their quality of life will be helpful on the back end. What is done from an integrative perspective, unless you’re doing something really strange, you’re actually not going to interfere with anybody’s chemotherapy or radiation for the most part. For every 100 units of concern that a radiation oncologist has or a medical oncologist has with you interfering with their very powerful therapies, there’s probably two or three units of actual concern that need to be had. Now, that doesn’t mean they’re going to buy that, but you need to have that conversation with your patient.
38:54 Antioxidants. The concern that most radiation oncologists and medical oncologists have is usually around antioxidants, since one of the mechanisms by which radiation and chemo kill cancer cells is using free radicals, there is concern that antioxidants will uncouple these therapies. Often patients are told not to take any nutritional supplements because of this concern, even those that are not antioxidants, like glutamine and fish oil. You might be best off having a conversation with your patient early on that there is a difference in world view between the oncologist and you, the Integrative practitioner, and that while the oncologist is going to be sure of what they believe, but that this information about antioxidants has a low level of scientific validity. Unfortunately, all doctors are not on the same page. Dr. Anderson will often tell the patient that it is they who have the cancer, not the oncologist. Radiation oncologists tend to be particularly hostile to the use of any nutritional compounds. Medical oncologists are on a huge spectrum and some are so extreme that they don’t want you to eat salads or any foods that have antioxidants, which makes no sense at all, while others do not have a problem with nutritional supplements.
42:19 During chemotherapy, Dr. Anderson tends to focus on using supplements that help reduce some of the side effects, like mucositis with L-glutamine and probiotics, as long as they have a good white blood cell count and demulcent herbs. During radiation, Dr. Anderson tends to use nutrients that help to potentiate the radiation, like milk thistle, curcumin, and boswellia. Most of these nutrients would be taken daily several times per day. The dosage for milk thistle is 400-600 mg 2-3 times per day. Milk thistle is a really good is a radiosensitizer and a healing agent and it also keeps the vitamin C glutathione cycle really humming along. He also like to use IV vitamin C on the Mondays of the week when they get radiation at a starting dosage of 25 grams and going to 50-75 grams.
44:32 Is Glutamine contraindicated in cancer? Unless the person is on a high sugar diet, glutamine is a non-issue in cancer. Glutamine only becomes a fuel for cancer if they are on a high sugar diet. And the same for glutathione. What we know is that tumors can pump out glutamine and glutathione into the extracellular space, but this has nothing to do with the glutamine and glutathione that we might supplement these patients with. We should use glutamine during treatment, esp. if the patients have mucositis, 3 or 4 grams 3 or 4 times per day, but once their treatment is done and they start to heal, we back off on that dosage and discontinue. The concern that some doctors feel warrants not using supplemental glutamine is that research shows that glutamine can feed tumors is based on glutamine feeding tumors that is produced by the tumors and not from ingested glutamine.
49:12 Fasting before, during, and/or after chemo or radiation. Even major cancer centers are recommending some sort of fasting or intermittent fasting around active treatment to reduce the side effects of treatment and also to enhance the effectiveness of the treatment. But you have to ask people what they are able to do. Some people can fast easily and like it, while other people might say that all that they can do is a 13 hour fast daily, which is still very helpful. A good tool is Dr. Valter Longo’s Fasting Mimicking Diet, called Prolon. It feels like they’re eating but it’s more like a fast. As far as diet, Dr. Anderson recommends either keto or low carb or modified Mediterranean. Low glycemic. Moderate in protein, since protein can be converted into glucose. Lots of low glycemic vegetables. Lots of herbs. Small amounts of low glycemic starches or none. Very small amounts of colorful fruit. At least a 13 hour fast daily from dinner till eating the next day, while drinking a lot of water. Doing a short term water fast for one to three days is very helpful, such as one day prior to treatment, the day of treatment, and one day after. Or just fasting one day prior to treatment is still good. Dr. Anderson has a bunch of free articles and also paid courses on many of these issues, such as about vitamin C and other antioxidants and chemo and radiation on his ConsultDrAnderson.com website. He also has some articles and courses on IV vitamin C and on how to detox after chemo.
55:03 During recovery from cancer treatment is a good time to reverse some of those things that chemo and radiation do, which is to make the cancer stem cells more bold. During chemo and radiation the cancer stem cells go and hide and wait and are largely unaffected. You want to make your normal cells more cancer resistant to keep the cancer stem cells from coming back. You want to focus on healing from the treatments. Do they have radiation burns? Do they have leftover mucositis? Do they have mucositis induced diarrhea that won’t stop? Is their microbiome all messed up? By cleaning up and helping to fix the quality of life issues, you also are actually getting at healing the normal tissues. And the more you do that, the more you make them resist cancer stem cells. It’s also important to bring back mitochondrial function, which will help to restore their energy. Dr. Anderson has developed a radiation recovery formula via IV that includes nutrients and glutathione he developed for radiation burn patients, but this is after they’re done with radiation.
1:02:54 Will natural treatments or supplements interfere with some of the newer targeted therapies being used for cancer patients? Some of the targeted therapies are synergized by natural substances, such as curcumin and melatonin and it is unlikely that natural supplements will interfere with these therapies. For melatonin for cancer, Dr. Anderson usually recommends 20 to 60 mg up to 300 mg per day. Dr. Shallenberger has a good presentation on high dose melatonin: High Dose Melatonin Therapy. Melatonin is particularly effective with breast and prostate cancer.
1:09:00 There are three main theories of oncogenesis: 1. Genomic Theory, 2. Metabolic Theory, and 3. Cancer Stem Cell/Trophoblastic theory. Each of these theories have a place and there is not one theory that wins.
Dr. Paul Anderson is a Naturopathic Doctor, Medical Director & Founder of Anderson Medical Specialty Associates (AMSA). He is a recognized authority in the field of integrative cancer research and the treatment of chronic diseases, genomic conditions, and auto-immune and infectious disorders. Dr. Anderson has written three books, Outside the Box Cancer Therapies: Alternative Therapies That Treat and Prevent Cancer, which he wrote with Mark Stengler, Cancer, The Journey From Diagnosis to Empowerment, and the recently released Cancer, The Journey from Diagnosis to Empowerment. Dr. Anderson also offers 80 different courses on a wide variety of aspects of a Naturopathic practice, including on biofilms at ConsultDrAnderson.com. Dr. Anderson also has a hub website, DrANow.com.
Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.
Podcast Transcript
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness podcast for weekly updates. And to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.
Welcome everybody to the Functional Medicine discussion group meeting tonight on an integrative approach to cancer care. I’m Dr. Ben Weitz, and I’m very happy to be joined by Dr. Paul Anderson, naturopathic physician and expert on an integrative approach to patients with cancer. I’ll make some introductory remarks before introducing our sponsors for this evening, which are Integrative Therapeutics and Vibrant America. And then I’ll introduce our speaker. I encourage each of you to participate and ask questions by typing in your question in the chat box. And then I’ll either call on you or simply ask Dr. Anderson your question when it’s appropriate. So thank you for joining the Functional Medicine discussion group meeting, and I hope you’ll consider attending some of our future events. On May 26th we’ll be speaking about functional maternity with Dr. Sarah Thompson. And June 23rd, we’re going to have Dr. Ali Rezaie, who’s one of Dr. Pimentel’s partners, and he’s going to give us an update on some of the new, exciting research on SIBO and IBS.
And he and Dr. Pimentel have just published a book. If you’re not aware, we have a closed Facebook page, The Functional Medicine Discussion Group of Santa Monica that you should join, so we can continue the conversation. I’m recording this event and I’ll include it in my weekly Rational Wellness podcast, which you can subscribe to on Apple podcast, Spotify or YouTube. And if you listen to a Rational Wellness podcast, please give me a ratings and review on Apple podcasts. And so now I’d like to introduce Steve Snyder of Integrative Therapeutics, to tell us a little bit about some integrated products. Steve?
Steve Snyder: Hello everyone. Just real quick. We actually have … this is a good topic for us. We have a line of products that were developed by Dr. Lise Alschuler, who’s a naturopathic oncologist and also happens to be a cancer survivor. And her idea on this was, there’s more and more people that are actually surviving cancer treatment these days. And they come out of this treatment and they’re trying to find the best thing for them, and their primary care doctor typically doesn’t have any clue. So they end up going to Whole Foods Market and some high school kid tells them to take this multivitamin. And so her idea was to scour the research, come up with formulations for common issues that face, what she calls Thrivers, and that were sort of dual purposed to address the issue that they’re facing, as well as to have some chemo protective properties. The product line is called ProThrivers’s Wellness. There’s four products. There’s a multivitamin, that’s unique in what it doesn’t contain. So no beta-carotene, no copper, no boron, things that maybe generally the research suggests are not good for cancer survivors to be taking.
There is a product called the flavonoid complex, that is CoQ10, glutathione, resveratrol, green tea, theracurmin, and the alpha-glycosyl isoquercitrin altogether, kind of in a synergistic combination of antioxidant, anti-inflammatory ingredients, that people are probably taking multiple tablets to get to. And then there’s a couple targeted products. There’s a ProThriver’s sleep that uses a high dose melatonin, that’s typically kind of an antioxidant dose for cancer patients, that’s designed to help with people that come out of cancer treatment with insomnia. And then there’s a ProThriver’s brain formula that deals with chemo brain. And that has the Lion’s Main Mushroom, acetyl-L-carnitine, some citicholine. It also has theracurmin. So those are really interesting products. If you’re treating patients that are survivors, these are really something you want to look at. We don’t typically recommend them other than the multi for people that are in treatment, but once they’re out, these are great options. And then the other one that comes up all the time is theracurmin. And almost every talk we have, theracurmin comes up, because the research is ridiculous. But there’s research on theracurmin in prostate cancer, biliary cancer, esophageal cancer, liver cancer. So it’s a really, really important product for people that are dealing with this stuff. So anybody have any questions, you guys know how to find me, but that’s just wanted to make sure everybody knew about those.
Dr. Weitz: Okay, great. Thanks, Steve. And Integrative Therapeutics is one of the few brands that we carry at our office. Now we have Margo Haswell of Vibrant America. Margo, are you there?
Margo Haswell: I am. Yeah. Thank you Dr. Weitz.
Dr. Weitz: Thank you.
Margo Haswell: Thanks for everyone for joining. So my name’s Margo, I’m the rep in Los Angeles for Vibrant America. We’re a full service lab offering functional medicine tests. Pretty much everything under the sun, under one roof. We’re CLIA certified. So our focus initially was on early diagnosis of chronic disease like Celiac, Lyme. We had some other tests as well. We’ve published several studies, validating our tests with the Mayo Clinic, Hopkins and Columbia University.
Recently, we’ve shifted our focus towards longevity. So specifically around reducing inflammation and oxidative stress. So we offer tests that look at toxic burden. We just came out with a new nutrigenomics profile. We offer testing for chronic inflammation, things like that. We do offer a $400 coupon, so you can try it out. You could do a clinical consult if you want, to basically try the test out on yourself and see what you think. So if you’re interested, I’m going to go ahead and put my email and my phone number in the chat. And I’ll go ahead and put our website as well, so if you want to open an account, we just need an NPI number. All right. Thank you.
Dr. Weitz: Thank you, Margo. And I vouch for Vibrant. We use their testing all the time. Everybody’s talking about, how do you coordinate all these different tests into some platform. You just have to get all your tests from Vibrant and they pretty much have everything. You can get all the full panels that you would get looking at cardiometabolic factors. They’ve got a great micronutrient test, that’s better than the old Spectracell test was. They’ve got the full Lyme testing. They’ve got the toxin testing, the mycotoxins. They got this great trio of toxin test, the toxic burden test through urine and it tests heavy metals, mycotoxins and environmental toxins. It’s really a killer test.
So our speaker for this evening is Dr. Paul Anderson, who’s a naturopathic physician, medical director and founder of Anderson Medical Specialty Associates. He’s a recognized authority in the field of integrative cancer research and the treatment of chronic diseases, genomic conditions, and autoimmune and infectious disorders. Dr. Anderson offers a large number of courses on his website, Dr.Anderson.com. So there are many aspects of naturopathic, functional medicine practice, including integrative cancer care. He’s an author of a number of books, including Out of the Box Cancer Therapies and his latest book is Cancer, the Journey from Diagnosis to Empowerment. Dr. Anderson, you have the floor.
Dr. Anderson: All right, well thank you. Thank you everyone for joining this evening. I know how these evening things are. So what we’re going to do, I’m going to switch the screen over. I’ve got some slides just to kind of keep me on track, just so you know kind of the direction we’re going, and then we’ll have some Q and A time obviously too. I really thought, because you talk about integrative cancer care and you could spend days, and days, and days speaking about it and we don’t have that. So one of the things that I’ve done, especially now in the third decade of working with people with cancer, is in addition to my work doing research, cancer research with National Institute of Health Funding, I started to look backwards at just generally my cancer patients and what were the characteristics of the people who were more likely to survive, over the characteristics of their treatment pathways, et cetera? And then that sort of led to a, what I think of as a nice overlay, a rational way to look at people in the cancer journey when you’re interacting with them. And so I want to come at the topic from that point of view, because I think gives a nice framework. And it also sort of informs what are the basics? And a lot of times we get people, as you all I’m sure have had, who everything is expensive everywhere, right? Everything that has to do with cancer and integrative cancer care can be very expensive. And so I also looked at well, what were the things that really don’t cost people any more time or money to incorporate into their life, that are a base that we can work our way out from? And so I just want to talk about that as we go through. And then look at, there’s really four phases of interacting with a cancer patient, and that also can kind of help narrow down your approach and get focus for your patients. So I am going to go to share screen here. Now, also, Dr. Weitz, and I talked beforehand. Certainly just put your questions into the chat. If he has something that he thinks really fits right in, he’ll interrupt me. Otherwise, we’ll have time at the end as well. And so I’m good anyway you want to do it. So let’s get this moved over. All right.
So we can move past there. So with cancer, there’s always a few elephants in the room, and these are not surprising to anybody, but I think it’s good. Maybe it’s not the happiest thing, but it’s good to start out when we’re thinking about anywhere in oncology, standard oncology, integrative oncology, et cetera, to just remember that we have a lot of wins. We have a lot of people who, as was mentioned earlier, are thrivers. They make it all the way through. But we also have people who do progress and they do pass away. And one of the hard things I know early in my career, was not that I didn’t realize that, but just kind of coming to grips with the fact that the more cancer patients you deal with, the more people in the different parts of the spectrum you’re going to be working with.
And so in the standard of care world, they’re very clear with their statistics normally, even though they may not always share them appropriately. But it’s also good, I think to know, and this is coming from someone who’s both worked alongside and right with, and also in distinction to the standard of care oncology world, that they’re really, especially when you get to stage four cancer patients, there’s just as much experimentation and unknown in standard of care oncology, as there is in what we do. It’s just, they usually don’t call it that when it happens. Now, I do also want to just say, that while I have had patients of all over the spectrum in cancer, and as time went on, I certainly gained a lot of broad spectrum cancer care because of a number of things, probably time and practice, being associated with research and just being a referral center, my patients tended to be later stage aggressive cancer patients.
So I did not tend to get the people who had the more simple type cases. Occasionally, but not much. So one of the things that, I think that we have to come face to face with, is the fact that we actually now, especially if I look now versus say 20 or 30 years ago, we have a lot more tools than we used to have, a lot better understanding of how to use the tools. And I think that it’s incumbent upon us to share that with the patients, and in a positive way to let them know that we don’t know how this is going to work for you individually. But collectively over time, we certainly know a lot more and are a lot better, we’re better informed about how to deal with people with cancer.
And so, one of the things that I have seen, is being realistic is a balancing act. Not so realistic that some of my colleagues will say, “Well, you just don’t have enough evidence for what you’re doing, so you shouldn’t be doing any of it. Or you’re just taking people’s money.” I’m sure we’ve all heard that. Actually the bottom one is a quote from a relatively famous oncologist. He said, “I’m morally opposed to your oncology practice.” So I’ve heard all of these things. So I think we shouldn’t be really on that end of the spectrum, but also we need to understand that there’s a lot of realism that comes in with people who have cancer.
And I think what most of us come to, if you’ve seen more than zero or one cancer patient, is really with anybody, any patient, but especially cancer patients. When you get past the question that many people have, which is, can you cure my cancer? And I would always tell people, “That’s above my pay grade. I’ve seen cancer cured, but I cannot do that personally.” When you get beyond that, really what they’re looking for is the best quality of life, like we all are. And I think if you’re going to have that as a heart-to-heart with a patient and say, “Look, we’re going to do everything we can.” And a lot of times in striving for quality of life, you actually improve a lot of other cancer markers and a lot of other cancer outcomes.
It helps the patient get on the same page with you. And these are just some things I’ve learned the hard way over years. Good upfront discussion, find out what their real outcomes are that they want. Because you have people, it’s like, they kind of know how things are playing out, but they want to have as much energy and they want to be on as little medicine, and all this stuff as possible. And you get other people, at other places along the spectrum and they may have a very “curable cancer,” and they have many other outcomes that they’re looking for.
Dr. Weitz: Hey Paul, could I just interrupt you for a second?
Dr. Anderson: Yeah.
Dr. Weitz: On this topic of discussion and being realistic with patients as to what their prognosis is. Do you find that a lot of times patients are not really being given the proper information about what their prognosis is? And so I just had a patient this week and has a stage four cancer, that’s not very treatable. And they gave him a round of chemo and he thinks that he’s … they told him, “We don’t see any sign of cancer.” So he’s thinking, “Hey, this is great.” And I think it’s important for patients to be optimistic, but unfortunately it seems like a lot of times they’re not being told exactly what the truth is about what their treatment is. They’re getting palliative care and they think they’re actually getting curative care.
Dr. Anderson: Yeah. I think that kind of goes along with that theme, there is … it’s extremely common that what you just described happens, and part of it is the oncologist not being completely clear. Part of it is denial on the side of the patient. And you can usually sort that out, if you have a discussion with them about the difference between, you got a stage four aggressive cancer and they’re doing chemotherapy, there is no curative intent there. And they may be missing that. I’ve also seen a fair number of patients with, again, aggressive stage four cancers who were on second, third, fourth, fifth line therapies, which are experimental at that point. And they still believe that there’s some curative intent. So there’s a lot of clarifying that needs to go on. And I think one of the most powerful things is, in your first visit or two, really just having the space in your conversation to have that discussion. Yeah. Because people are confused and sometimes it’s, they’re hearing what they want to hear. But other times also, they’re not hearing a good message or a clear message.
Dr. Weitz: Right.
Dr. Anderson: Certainly. This next section is real short and you’ll get the point real soon. But I just wanted to keep this in this presentation, because this really speaks to the basic things that I have seen over, and over, and over, over the years. That if these basics are covered, and this is something common to all of us who do integrative therapies, we often forget how important the basics are. And these are things that are part of our life, whether we’re doing other things or not. And my real take home point from this, and I’ll kind of go through these slides fairly quickly, because they’re going to be obvious to you. My real take home point is, when I look backwards over those three decades, and I look at the patients where the treatments that we did really kind of stuck and made a big impact, they were attending to these core areas of foundational areas. And they’re that important. When I teach this to medical students, I use the pneumonic food, muscle and brain. And literally, if people are attending to these things, they shore up their physical foundation, so that whatever other treatments you’re doing go in and stick. And if they’re not, well, it doesn’t work out so well.
So it’s kind of like we use the analogy of a house and it has to have a foundation. That’s exactly what this is. And the idea is, so food is of course what you’re eating and your fuel, but it’s also how clean is the food and the drink that you’re eating? Are you taking in more toxins than you need to? Obviously there’s no non-toxic way to eat, but there’s lower toxic ways certainly. It also has to do with the timing of eating. We know now that at least a 13 hour intermittent fast daily is associated with longer life and better survival in cancer patients. And then also your relationship to food and the way it affects your metabolism. So what way your diet is structured, beyond just the fuel, et cetera. Muscle is the fact that I think we all realize now that whether it’s cancer or not, but especially in cancer, the more muscle metabolism you work yourself through and the less fat metabolism you work yourself through, the better your survival and the better your quality of life. And that’s true with other diseases, but with cancer, it’s very apparent. And that’s largely, I think because muscle metabolism signals the rest of the body that you are in the cytokine mode and your chemokines are such that they’re more resistant to cancer growth. Fat metabolism, which is largely but not completely insulin dominated is associated with proinflammatory cytokines and things that would tend to enhance growth. And so this doesn’t mean the person has to be a power lifter. It just means they need to move their body. They need to combine their diet, that has a low glycemic index, with their skeletal muscle moving to the degree it can. Real sick people, that might be standing up a few more times every day. People who are in recovery, it might be actually working out, getting the skeletal muscle working.
And then brain is the topic of my recent book, which is the Mind-Body Connection, how you’re thinking about cancer and really how empowered you are as a cancer patient. And so what I really see here, is if you look then above at step two and step three, you’ve got kind of foundational cancer supplementation and that’ll work better if you’re working on the dietary, and the food, and the fuel part, and the cleanliness. You’re working on getting your muscles to move a little bit. And then you’re working on the mind body connection.
And then all the, what I call the cool, high speed, high expense therapies, a lot of the things, like our clinics were set up to do IV, and hyperbaric, and hyperthermia, and all these cool things. They really do work longer at better in the setting of the other things being prepared and attended to. So I think you kind of get the idea. This is not new to people who are doing integrative care. But I was personally a little surprised when I look back at about 20 to 25 years of practice, and I started to see this pattern where the people, you have stage four cancer patients all doing the same other therapies. But the people that really hung in there and had the quality and length of life, were people who were doing these basics on top of the other things.
Now, the bulk of what I want to present is, again, something I kind found retrospectively looking back. I think we all do this intuitively, but I think it’s good to kind of call out the fact that the cancer journey can be divided into four discrete steps or areas. And the reason that’s important, is that your clinical focus and priorities, and really the patients, probably are different in each of these phases, because some of them, you have real high stakes things going on and you really need to laser focus on particular things. Others, you have a lot of background things going on and you have a lot of options as what to do. But those phases basically are primary prevention, where they don’t know they have cancer yet, which is we’d love to get everybody here. And we all make cancer cells every day. We’d like to keep those from doing anything. So, that’s primary prevention. Then you get diagnosed. So diagnosis through active therapy is phase two. And this is usually where people are suddenly hit in the face with the diagnosis of cancer. They’re often, for good or bad rushed into cancer therapies. And they’re real confused and they’re overwhelmed. Now there’s an arrow that leaves here, because some people die during diagnosis and active therapy. We obviously don’t get everybody through all four phases.
Then there’s a very important part for long-term survival, which is recovery from active therapy. So this is when you get to the place where they say, “We’ve given you all the treatment we can. We did surgery, chemo, radiation, whatever, we’ve done all we can. So go and live a good life.” Well, this is a place where, every phase you can interact with people, but this is a place where we can really shine, because we can help people not only physically and mentally recover, but also strengthen their system to oppose cancer return or cancer aggression.
Post cancer return or cancer aggression. And, of course, there’s an arrow leaving there because some people don’t make it through that. And then there’s what was spoken of earlier as the thriver state. And we call that secondary prevention. That’s when you get to the point where you’re in either no evidence of disease or remission or stable disease, something where you’re not really having new therapies, you’ve recovered from the old therapies. And what you want to do is stay as healthy and anti-cancer as possible. So this is, like I said, just a way to think about your cancer journey and say, my patients coming in, where are they in this spectrum? And then that leads you to what things do I need to focus on, because I get this question all the time at conferences when I’m speaking and people say…
We might be talking about active cancer therapy where we’re doing some high level interventions and maybe they’re getting chemo and we’re trying to support the chemo and not have die from it and all that. And people say, “Well, why don’t you do these other things?” All of which are good. Well, the reason is that we only have so much time and resource to put into somebody in that phase. Whereas in the next phase, we have different goals, different objectives. And I’ll share these slides. You guys can have them and read them. They’re fairly straightforward.
Now, there are exceptions to this model, and those are usually when we get a patient who has a super aggressive stage four cancer, and we may only have one crack at doing something with them. In that case, we may throw a lot more at them. We may get very aggressive very quickly. And that’s fine too. It’s just that’s a unique circumstance. So primary prevention essentially is trying to keep your epigenome from turning your genome against you. And so primary prevention is doing everything you can to be anti-cancer before your cancer goes anywhere. So that is at the beginning on the left side of that scale there. And obviously prevention’s the best medicine. And your goal is to try and keep all your epigenetic signals in the mode of turning on your resistive genes and turning off your suppressive genes. More on that later.
This is something my staff named after me, because I kept preaching it to them for years. And so these are eight areas that we look at in primary and then secondary prevention just to try and clean the system up as much as possible. And I will not spend tons of time on them, because they’re fairly self-evident, although they’re labeled in an overly simple way. Self function means everything from your organelles working to the pH, to the input of good and output of toxins. And all that stuff includes your nutrigenomics and all of that.
Toxins, whether chemical or mold or metal, etc, always a problem, but certainly more of a problem as an epigenetic trigger when we have chronic illness in cancer. Biofilm and resistance factors, which include certainly biofilms as name, but also immune suppressive drugs, which a lot of our patients are on during their cancer journey and other things of that nature. The patient’s immunology becomes very important in primary and secondary prevention because what you’re concerned about there is, number one, you’re not engendering auto immunity, but also you have enough immune reserve so that when the immune system is called upon to fight with cancer, it can do that.
And so the big hindrances there beyond biofilm and resistance factors are chronic infections that are undiagnosed, auto immunity that is undiagnosed and those things that get in the way. The endocrine system is universally important through the whole process. The psychosocial obviously is huge. And then the whole digestive GI tract, which usually gets wrecked through treatment and it is going to need constant care. But because you have not only your GI neurology that goes on, but also your microbiome in your GI immune system, those are so critically important when it comes to cancer outcomes that the repair and maintenance of the GI tract becomes a constant project. And then physical and structural things.
So these are some explanatory slides about all that. But in primary prevention, I think it’s important obviously to think about your family history. Obviously you can be the first person in your family to have cancer. Not all cancers are certainly related, but if you have a family history of a lot of cancer, that does change. There’s something there in your epigenome that maybe is a little too friendly with cancer. And that means maybe we need to be a little bit more aggressive with cleaning the system up, etc. Looking at your determinants of health via those eight areas and really everything matters. But in primary prevention diet and GI tract health are easy to come first, because you can access the diet and there’s no cancer treatments or anything going on here.
Movement or exercise, and as we talked about the mental emotional space, people with chronic stress, people with certain types of neuro emotional disorders, etc, do have more cancer. And so getting after that and helping people find their way to empowerment becomes very, very important. Toxins, chronic infections and endocrine, these are all things in primary prevention you can clean up. You got time. So these are all great things to look at.
Then you move to initial diagnosis and therapy. And this is where you have usually… The sky’s the limit, but usually you’re trying to really focus what you are doing on the integrative side of things. So this is once the cancer is known and the patient’s going to do something about it. Now, that might be total standard of care and you’re going to do something to help out. They may, as Dr. Weitz was mentioning earlier, and one thing we see a lot is I will counsel people, especially if they have a stage four cancer, and I know that the standard of care is not very efficacious. If they haven’t already, I will ask them, ask your oncologist, number one, what the five year survival with the standard treatment is. And number two, if they personally would do this for themselves or a family member.
And in modern times, meaning not 20 years ago, but recently, I’ve seen more and more oncologists being a little bit more honest, not all of them, but more. And often they’ll say, “You know what? There’s less than 5% chance of a five year survival, and I’ve got 100% chance of giving you side effects. So I wouldn’t take those odds as an oncologist, you need to do whatever you want to,” because they don’t want to be put in the position of talking down on their care and limiting people with care. But if you’ve got cancers like that, it’s really good to know that because if you have somebody with an early prostate and early breast cancer and the survival at five years with treatment is 80 to 95%, you take those odds and we can do a zillion things to keep you healthy and help you in secondary prevention.
If you got aggressive cancer, that’s got under 50%, but certainly like under 20% survival rate with standard of care, as a patient, you have to decide, is it worth the side effects I’m going to get? And we have a lot of people who decide I’m not going to take a 5% positive risk. So that’s the idea there. We do need to remember during this phase that people are freaked out. They’re overwhelmed. Nobody wants to get a cancer diagnosis that I’ve ever met. And these people are overwhelmed in that situation. So we do have to walk them into their care carefully, add things as you go, like I said, unless you have a really aggressive cancer where you may only have one shot at it.
And one of the things that Mark and I wrote about in the first book outside the box cancer therapies, and to my knowledge, we’re the first book about cancer to put this into a book as opposed to being in scattered research. And that is that we are now pretty much 100% certain that while chemotherapy and radiation will decrease the size of tumors in many cases, we know that in the long run, they are associated with more return of more aggressive cancer. That might be months later, it might be years later, but we know that happens. And that’s for reasons I’m going to talk about later. But since we know that, what we have to do, if our patient, let’s say is getting radiation or chemotherapy surgery or some combination there, we have to be supportive in a way that is not only supportive to those therapies, but also supportive to their normal tissue so that we don’t get recruitment of cancer cells by emboldening the cancer stem cells with the chemo and the radiation.
So big thing is just being realistic with the patient what time do they have available? How much time do you and they have to work during this very intense time? They might be doing five days of radiation a week or a bunch of chemo or some combination there. They might need surgery and you may have little windows where you can interact with them. So you have to be strategic. How much energy do they have available? How healthy are they to put into doing things? You really have to prioritize here. Are there financial constraints? Everybody has them. It’s the rare person where money is no object, but it’s just something that needs to come up in my opinion, early. How are they tolerating the therapies? Should that be a big focus? So a lot of times, during active therapy, especially if they’re getting a chemotherapy, especially old line chemotherapy regimens, we’re focusing on mucositis and the standard side effects of that, because that’s a giant quality of life thing. Well, it turns out that whatever you do, as I said for quality of life is also helpful on the back end. And it’s good to remind people of that. They might think, well, all I’ve got time, money and energy for is for you to try and lower my side effects. Well, that’s still a pretty tall order. That’s a pretty good thing to do.
Now, interactions between what you’re doing on the integrated front and surgery radiation and chemotherapy, for the most part, unless you’re doing something really strange, you’re actually not going to interfere with anybody’s chemotherapy or radiation for the most part, etc. For every 100 units of concern, for instance, that a radiation oncologist has or a medical oncologist has with you interfering with their very powerful therapies, there’s probably two or three units of actual concern that need to be had. Now, that doesn’t mean they’re going to buy that, but you need to have that conversation with your patient.
Dr. Weitz: That discussion in my experience is always around antioxidants. Antioxidants are going to uncouple radiation, they’re going to uncouple chemo. And I’ve had oncologists say anything you give them, they shouldn’t take because it’s an antioxidant. I just recommended glutamine for a patient and the oncologist said, “No, that’s an antioxidant, you can’t take that.”
Dr. Anderson: And I think what this really comes down to, there are times where you have to be judicious, of course. But what I have found more important is if you have the chance and you can have eyeball-eyeball conversation with your patient and explain this difference in worldview and explain to them how and why the oncologist is going to be so sure of whatever they believe, and also how much of a low level of scientific validity that has. It’s just a belief system for the most part. And what I always tell patients is, look, it’s not the oncologist that has cancer, it’s you, it’s your body, you get to decide what you want to do with it. I happen to be the expert with this end of oncology care. And they happen to be the expert with that end. And if you’re comfortable with it, why don’t we let them? I don’t tell them how to dose chemo, I don’t give them the schedule to do radiation therapy, and they really don’t have a lot of business in my end of the world. Most patients, if you explain it like that will come to some place where they understand what’s going on. And I always just tell them, look, you’re never going to convince a radiation oncologist that anything is safe. Medical oncologists are on a huge spectrum. And most of them don’t even want you to eat salad. They don’t want any antioxidants in your food. They would like you to have a dead diet actually. It makes no sense. There’s really no science behind it. So if you’ll let me do my thing, I’ll keep you out of trouble here. We will let them dose what they’re doing. And I find it’s a lot of… It’s like front end communication, because my experience has been, if you don’t tell them that, and then they come back and they think that you’ve been lying to them because the oncologist freaked out and said, you can’t take any of that stuff, you lose a lot of credibility. So you got to really do it on the front end. And they won’t understand because I think we aren’t all doctors on the same page. You just have to tell them no. And there’s a lot of reasons.
Dr. Weitz: Can you clarify since there is a lot of controversy about this? What is your position on patients taking antioxidant supplements while undergoing radiation or chemo?
Dr. Anderson: Well, the first thing is you can call probably 80% of the supplements that people take antioxidants in one way or another. And a lot of times they are. So that’s one of the things that bothers the oncology community. During chemotherapy, I focus on basic nutrients. I focus on opposing mucositis with things like glutamine like you did. And as long as they have a good white cell count probiotics and demulcent herbs and things like that, if they’re just on chemotherapy, it depends on the chemotherapy. Like if your basic nutrients they’re going to have some antioxidants in them, that is not going to block anybody’s chemotherapy. Also, we do vitamin C IVs and other stuff like that. That’s not blocking any chemotherapy either. I don’t have people on oral mega doses of a lot of other things, because again, there’s only so much they can get in during chemo. During radiation, it’s a little bit different. I tend to do radio potentiating, things like milk thistle is very good, curcumin can be good, boswellia can be good, a lot of botanicals are very good in that setting. If they can do (IV) vitamin C the beginning of every radiation week, they have far less trouble later on. And I’m going to give you some resources for that.
Dr. Weitz: Some of those things you just mentioned, would they take them on the same day as they get their radiation, before the radiation, afterwards? Does it matter?
Dr. Anderson: If they’re doing radiation, let’s say we’re doing milk thistle and their basic nutrients and whatever, they would do the oral things every day. Yeah. And if it’s no radiation, but there’s chemo, if that’s an appropriate strategy, a lot of times we use curcumin and boswellia right along with chemo, there’s just data on that. And glutamine, even though you had that experience with the oncologist, that’s an everyday thing, because we’re just trying to keep their blood levels trucking along so that they can have the protection and the support together.
Dr. Weitz: Somebody just did ask a question about what about glutamine being contraindicated in cancer?
Dr. Anderson: Yeah. You can go on my website. If you look up glutamine, I think one of the first two or three hits will be glutamine and cancer. This is a rather long discussion. And I actually have a CE webinar about controversies in oncology, which goes into glutathione, glutamine, all these other things that we’re talking about. And it’s a pretty deep well. But the upshot of it is unless a person is on a high sugar diet, glutamine is actually a non-issue in cancer. It is thought to be contraindicated, but there’s no data for that. There’s no human data. It’s theoretical. Now, if they’re on a high sugar diet, glutamine would become a fuel. And they shouldn’t be on a high sugar diet anyway, but here’s where the problems with glutathione and glutamine come in with cancer is probably well-meaning. And a lot of them are in the integrative medicine world. People don’t understand the tumor biology behind why glutamine and glutathione in the research appear to be associated with resistance. And that is that the tumor cells can make glutathione and they can pump out glutamine into the extra cellular space. That has nothing to do with the glutamine and glutathione that the patient is given if given rationally. And so they make the step that if the tumor cell does that for protection, then you giving those things must protect the cancer. And that’s actually not true. That’s not how it works. A glutathione producing tumor or a glutamine influxing tumor will laugh at your glutathione or your glutamine. It’s not going to be enough to give it a big deal. Now, with glutamine, we do make sure that they’re on appropriate low glycemic diet at the very least. But the other thing is we use it during chemo and during mucositis, and then we back off on the dose. So if someone has mucositis, you might be giving them three, four grams three or four times a day, and once they start to heal you back off on that because they don’t need that much long term. So it’s a thought thing. And that is a very quick rendition of a real deep well there. Yeah.
Dr. Weitz: If you don’t mind, there’s one more minute. I spoke to one of the leading proponents of the metabolic theory of cancer. And he advocates a ketogenic diet. And he also recommends… His concept is that cancer can basically get its energy either from sugar or from glutamine. So he recommends a ketogenic high fat, low sugar diet. And then recommends taking a drug that blocks glutamine and pulsing it.
Dr. Anderson: Yeah. And there are times where that is like the blockade of glutathione or blockade of glutamine is appropriate. Most of the time, again, that’s a misappropriation of the tumor biology because the glutamine that is feeding the tumor is coming from those tumor cells is not coming from elsewhere. And so what they’re really talking about there with the blockade is if you’re going to do a metabolic therapy, you need to have them on a keto or a low carb diet to starve the tumor in that direction. And then what we do is we put them on things that force the tumor out of anoxic metabolism so that the glutaminolysis and the forcing of the glutamine out doesn’t happen. So that’s what he is talking about blocking the glutamine and all that, but really you’re doing that through their diet primarily.
And then things like we talked about earlier, the fermented wheat germ extract help in that area. There’s other metabolic shifting things that are very useful in that area as well. But also if you’re using glutamine therapeutically, it’s fine. You just use it appropriately, like I said, high dose when you need it, and then you take it away when they don’t eat it. So it’s not that cut and dried.
Dr. Weitz: Have you ever recommended fasting around radiation and-
Dr. Anderson: We’re getting to that. Yeah.
Dr. Weitz: Okay. Good.
Dr. Anderson: As a matter of fact here. So now I usually tell people I don’t put these University of California, San Francisco, Osher Center slides in because I think they’re so wonderful. I think they’re great people. But these are all things I’ve been telling people to do for a long time. And now we have a major cancer center telling people these are okay to do. And so I just find it’s nice to back up what we’ve been saying for a long time with the credibility of someone who’s on the inside, I suppose. So I’ll share these slides. You can read it. This is a little short thing they do about fasting, but here’s the thing. And fasting is like diet change. You have to ask people what they can do. Some people can fast really easily and like it, other people they might say, I can do daily 13 hour fast, which is still very helpful, but I can’t probably do much more than that. Or they can do a 24 hour fast right before their chemo or their radiation and then fluids on the day of treatment and then go back to eating. Still helpful. Okay. And they go through here looking at different studies and saying, well, you could do up to a five day fast. Well, there’s less people to do a five day fast.
One of the things, and I’ve not used it a ton with people, but I think it’s a great tool is the fasting mimicking diets, and you can make your own up too, but Prolon is the famous one that Valter Longo helped develop. So you got people eating almost nothing, but it feels like they’re still eating and yet they’re actually fasting. If you can get people to fast, be right up to the time of treatment, and then the day of these don’t feel that great anyway and then go back to eating, not only does it lower side effects, but it tends to make things work better and more tolerated.
And so the red is eating whatever you want and the blue is fasting. And essentially these are side effects of this. In this case, this was chemo, but you could say similar for radiation. And so you can just see graphically that the blue is a lot lower than the red if the person is doing some fasting around treatment. Now, these are again from the UCSF folks. Pretty close to things that I tell people on the base. Anti-inflammatory diet. I would say colorful fruit in tiny amounts because you don’t really want a whole lot of fructose in a cancer patient, vegetables, you can get a low glycemic vegetables and other stuff, that’s fine, lots of herbs. Low to moderate carbon intake with low glycemic starches or none. We do a lot of keto, low carb and modified Mediterranean. All of them are in that direction. They’re very low glycemic. Protein, they make a good point. If you’re doing these things, you have to be careful with protein because one of the things that are going to happen with protein is when you cut the carbohydrates down, which you should, you can get glucogenic amines out of your protein. And if you have too much protein, you wind up with your blood sugar going back up. And this is a case where you really, in my opinion, if you’re really doing therapeutic diets beyond the good basics, you really want either you or somebody working with a patient like a coach so that they can eat this, not that, all of that.
Again, they reinforce the 13 hour fast every day. And basically I just tell patients when you’re done eating dinner, you can drink water all you want, but you don’t eat until 13 hours later the next day. Drink tons of water. I’ve done this for a long time, almost all of the side effects of 13 hour fasts are dehydration. So if they just keep drinking water, they’re fine. And then here they have short term water fast one to three days, very useful. And then prior to treatment, even one day prior to treatment is still good.
Oops, sorry. Wrong way. Now, as far as these are some free writeups that I’ve done about interfering with standard of care. So the first one is all about vitamin C and chemo and radiation. Next one’s about antioxidants and next one’s about leukemia specifically. And then the final one really gets to one of our next topics, which is detoxing after treatment. And so this is a area that some people also get kind of mixed up.
These are some very deep, if you do like vitamin C therapies, especially IV, there’s some kind of deep classes. So all the stuff here are writeups, these are free. Classes cost a little bit. And then you can just search the website there. So there’s that controversy oncology class. There’s off purpose or off label drugs. And then there’s one that’s on advanced cancer. Now recovery here, this is a time, I’ll just kind of tell the story and we get right past it here, but recovery from active therapy is actually a golden time for you to reverse those things I was saying that chemo and radiation do, which is make the cancer stem cells more bold. So really to simplify the way we want to think about this, and there’s a whole chapter in outside the box about this, or at least we talk about it in there.
You have the daughter cells, the cancer that we see, it’s usually bigger. Then you have the cancer stem cells. They are biologically opposite. So when you’re treating the cancer with chemotherapy or radiation, or you could say surgery too, but especially chemo, radiation, the daughter cells are heavily attacked by the chemo radiation. That’s why they shrink. The stem cells go and hide and they wait. They are unaffected by chemotherapy and radiation for the most part. And there is paper after paper after paper published that says this and everybody at the end of their paper says, “Well, this is true, but we don’t want to make a big deal out of this with the public because then they’re going to be afraid of chemotherapy and radiation.” And they’re hoping some day to come up with some magic fix for this. Well, the magic fix is actually taking care of the patient with the stuff we do.
The cancer stem cells retreat during therapy. When you’re in active recovery and in secondary prevention, you want to start to take care of the normal cells in a way where they become more cancer resistant. Because if you don’t, and you do what most people do, like you were saying, Ben, about your patient who they think, “Oh, the cancer got smaller and they’re really doing palliative therapy.” You can have the cancer get smaller and a patient thinks, “Oh, I’m cancer free,” which of course they’re not. And then they go about their life and they don’t do anything to clean up the system, the cancer stem cells will come back with a vengeance. They take advantage of that. So when you’re recovering from active therapy, there may be specific things such as surgical recovery where we’re given a more regenerative nutrients and things to help them rebuild, et cetera. Or it might be what is most common recovery after chemotherapy and radiation. And maybe this is the first time you see the patient.
So what we have to do there is first focus on the quality of life things. Do they have radiation burns? Do they have leftover mucositis? Do they have mucositis induced diarrhea that won’t stop? Is there microbiome all messed up? By cleaning up and helping to fix the quality of life issues, you also are actually getting at healing and getting on the road to healing the normal tissues. And the more you do that, the more you make them resist these cancer stem cells. Because everybody’s got cancer cells every day. We probably have some cancer stem cells and everyone who’s survived cancer still has their stem cells. What we want, because there’s no way to make them go away-
Dr. Weitz: Are there natural methods that help to target cancer stem cells?
Dr. Anderson: Yeah. So yeah, I will elaborate. What you want is to keep them asleep, okay? There is no way to kill cancer stem cells for all intents and purposes. You want them to be so happy that they have nothing to do and you want your normal tissue and whatever’s left of the person after treatment to be so healthy that there’s no impetus for the stem cells to recruit in the stroma and the tumor micro environment, your normal tissue back to being cancer. So we’ll get into that a little bit here. So just psychologically, you have to remember this is a time where people are pretty happy usually because they’re finally done with chemo or radiation or whatever they were doing. And so we need to support that, but we also need to support the idea that they need to work on things to clean up the quality of life stuff, which will decrease cancer stem cell activity. And then we want to do things to heal their normal tissue, which also decreases cancer stem cell activity as well. there may be specific things like surgical healing. There may be global things like I’m just fatigued afterwards, et cetera. You treat what you see and then you work your way down towards the epigenome. The other nice thing about recovery from active therapy is this is usually a time where the oncology team says “Go and live your life. We’re not going to do any more chemo,” or “You’re done with surgery or radiation.” And that often, if you’ve had a contentious relationship with the oncologist, that sort of takes the handcuffs off during that time as well. During this time, a lot of our goal beyond side effects, which is a huge goal, is getting their mitochondrial function back. That helps to get their energy back, their recovery, getting their membranes working again. Detoxing usually can get started here and then repairing whatever else got messed up. Just during radiation, like I said earlier, orally, I use a lot of milk thistle during radiation and sometimes curcumin, but more milk thistle because as a radio sensitizer and a cell protectant, it’s hard to beat.
Dr. Weitz: What’s a good dosage of milk thistle in this case?
Dr. Anderson: If you get a like, and I’m doing this from memory so my apologies to Integrative Therapeutics, but they have a really good milk thistle product and it doesn’t have to be just milk thistle, but I’m usually going during radiation for about four to 600 milligrams two to three times a day. And that kind of keeps the silibinin levels level in the body. And so that’s a really good one because a lot of people don’t have access to IV vitamin C or something. But if you are going to do it, what I like during radiation is actually high dose vitamin C, at least on the Monday when they start their radiation-
Dr. Weitz: And what is high dose?
Dr. Anderson: Well, if they have a normal G6PD level, we start them at 25 grams and usually go to 50, 75. Can go higher. But during radiation, usually 50 to 75 is plenty for the average person. After radiation, there’s a radiation recovery formula which is nutrients and glutathione and all kinds of other stuff that we develop for radiation burn patients but this is after they’re done with radiation. And so that one is useful in that setting. So obviously in recovery, you’re focusing on healing, kind of get them back into their dietary changes, muscle, brain, all those things. And like I say, you’re looking at calming the epigenome down so that you don’t get this recurrence with the cancer stem cells. Now-
Dr. Weitz: We’ve been talking about whether or not some natural treatments might interfere with traditional chemo or radiation. What do we know about potential interactions between natural therapies and some of the newer targeted therapies, the immunotherapies and some of the other targeted therapies?
Dr. Anderson: Yeah. And again, that’s a three hour discussion at least, but-
Dr. Weitz: Oh, I know, I know.
Dr. Anderson: The upshot of it is, because now that we have more of those therapies, I teach about this a fair amount. Most of them are synergized by some of the things we use commonly, such as curcumin and melatonin. Those have some data with some of the targeted therapies. Vitamin C is very safe with them. There’s very few things that actually are going to block or inhibited most of the targeted therapies. Now-
Dr. Weitz: You just mentioned melatonin. What dosage do you like for melatonin?
Dr. Anderson: It very much depends. It’s interesting is 25 years ago, we commonly gave people a hundred or more milligrams when they had cancer and then we sort of, for whatever reason, went to 20 to 60 and now we’re giving people one to 300 milligrams of melatonin.
Dr. Weitz: Oh, okay.
Dr. Anderson: So it’s during either active treatment or especially in recovery, I think the higher doses make sense as a, again, that’s another real long discussion, but it’s also totally appropriate to do the medium high doses of 20, 40, 60 milligrams, which are still pretty darn high because they’re having a very therapeutic effect at those doses. It’s very different from say a low dose. If you’re doing therapeutic melatonin, actually free you can get the presentation. If you just search Dr. Shallenberger’s name and melatonin, he’s got a PowerPoint online all about high dose melatonin. And to my viewing, that’s probably the best resource for high dose melatonin. But regularly it’s very common for most people nowadays to do 20 to 60, even if they’re not doing the super high doses. But most of the targeted therapies, what I will normally do is if it’s something I know that are mainstream, so like curcumin or vitamin C or some of the other stuff, fine.
If I’ve got an idea to use something real specific and we get this brand new PD-1 drug or something like that. What I will generally do is do a search and I’ll do the drug class like PD-1 or NITNF or whatever it is and then I’ll put in the name of say the herb or the mushroom or whatever or the vitamin and I’ll just put in those two search terms and see if anything comes up. Occasionally you’ll find there’s research where they’ve actually tested them together and they’re okay and that’s even better. Once in a while, you’ll run into a study where maybe it looks a little shaky, but most of those studies that natural products are having a problem with biologics are like in vitro studies that may or may not at all match humans. So there’s that.
Dr. Weitz: Okay.
Dr. Anderson: Now these next slides, I’m just going to tell you why they’re in here and then you guys can read them if you want to. There’s two concepts that are of paramount importance to keep you in remission or to do secondary prevention. One is keeping the tumor microenvironment calm. Like I say, you want your healthy cells to be as healthy as possible. You want the tumor cells that have died to stay dead. And then the other is the cancer stem cell milieu, which is right next door, and you want the stem cells to stay quiet and asleep. That’s what keeps you in remission. Now you’re fighting uphill because chemotherapy and radiation have made the stem cells stronger and more spunky. But what you can do, especially in this recovery or secondary prevention stage is the more things you do to clean up their environment of their body, so you’re starting to look at things like detoxification, look at their nutrigenomics and optimize those, get their gut healed up and working again, get their microbiome working again, not forgetting in your toxicity assessments. We think of metals, but chemicals and microtoxins are huge immune side liners.
And then kind of the opposite of the concerns early in cancer care, you really do want people to have really good antioxidant potential, which means that they have all of the compartments covered. You got vitamin E and omegas and phosphatidylcholine for the fatty areas. You got glutathione for cytosol and the plasma. You got vitamin C in the water soluble areas. They all back each other up. And of course, vitamin C is the weak link because we don’t make any in our body, but they all need some help. And then from there you can build other things on top.
One of the reasons I keep bringing up milk thistle is because we don’t talk about it as much as like curcumin, but milk thistle beyond being a radiosensitizer and a healing agent, it also keeps the vitamin C glutathione cycle really humming along, which is what you want. So these are theories of oncogenesis. They all actually have a place. So there’s not one theory that wins, they all have a place. But the bottom line is what they have in common between them, whether it’s metabolic or the stem cell theory, which we used to call the trophoblast theory, they’re the same thing, or the genomic theory, which is a small number of cancers, but they’re real. The crossover in keeping those things from coming back is your epigenome. And all that is is working on cleaning yourself up. Your hormones are balanced.
You don’t have any residual infections or other immune junk going on. You’re detoxing. You get rid of the junk from your system that’s all nasty proepigenetic triggering stuff. As I said, you’re healing the gut. You are doing all of those things with the whole body. This book is a lot about the how, like the targets and treatments during cancer, stuff like that. This book, as Dr. Weitz mentioned, this is a new one. This is more about the mental part and how to, you know, almost agnostic of how you’re treating your cancer. Your mind body connection is so important to healing up. So you can read through these. These are basically about tumor microenvironment and cancer stem cells. And these are some of the metabolic and biochemical reasons that the microenvironment gets either pro-cancer or anti-cancer return.
Dr. Weitz: Can I ask a question about that?
Dr. Anderson: Yeah.
Dr. Weitz: In terms of the metabolic theory of cancer, which is that cancer stem cells are primarily glycolytic and therefore a low carb diet’s going to be best, do you think that there’s certain kinds of cancer that are different? Like for example, prostate cancer seems to work somewhat differently and respond to different dietary factors like choline seems to be potentially a problem for prostate cancer whereas it’s not for other forms of cancer.
Dr. Anderson: Yes. Short answer is yes. Like I said, all of our therapeutic diets, we have an array of therapeutic diets. And the only thing that they have in common is that they all have a very low glycemic impact on the body. So there is no type of cancer that benefits from sugar. There are some types of cancer that are less impressed by low sugar diets, but you still remember sugar drives insulin metabolism and insulin metabolism is pro-inflammatory, it switches all of your eicosanoid fat metabolism towards inflammation. So even if the sugar is not really the part of it, keeping your insulin from bouncing around is a huge thing. And like you say, especially advanced prostate cancer, sort of its own little animal. And that’s because it has a lot of connection to toxicity and infections that other cancers do, but not as like prostate cancer literally concentrates those problems like we’ve been talking about. So yeah, and it’s why many of the people I know who used to only recommend say ketogenic diets now really look more at the person’s metabolic flexibility. So like I say, none of the diets that we offer are high glycemic. None of them trigger a lot of insulin release. But there’s different ways to get into that depending on the person’s metabolic flexibility. And because that’s individual, we usually have people, if they really want to track what their diet is doing to their metabolism, we have them have a ketone and glucose meter and they check periodically through the day and they enter it into a chronometer program online and we track it. Because number one, most people who think they’re doing ketogenic diets aren’t. Really they aren’t because no one’s checking. And so people say, “Well, keto didn’t work” and they actually never were keto.
But then there are a lot of people where they can’t do a traditional ketogenic diet anyway. So yeah, diets are, you have to have the big picture, kind of your north star which is not a lot of insulin stimulation, a lot of good flavonoids, a lot of clean stuff in it. And then from there you build the macros to whatever. This is an odd representation of a human, but you have your cancer there in the middle, you have the tumor stroma which is the communication area between the cancer and the stem cells and normal tissue. And then they have most of your patient, which is actually non-cancerous tissue. The more quiet you can keep that middle ground by returning, you heal them up. As I said, everything you do for quality of life is in favor of anti-cancer. So even if that’s all you do, it’s huge. Their diet, their movement, all that stuff is in favor of anti-cancer. And then you’ve got to get the rest of their cells and their tissues to have good antioxidant balance, to have low amounts of insulin going into trigger. And then that keeps your normal tissue from being pulled to the dark side and recruited by the cancer stem cells.
And there’s stuff in here you can read about all that, but that’s kind of the bottom line. I just put this in because it turns out that vitamin C, even at fairly low doses, pushes your epigenetics all in the direction that are anti-cancer. So beyond being helpful as an antioxidant or in high dose being a prooxidant, it has a lot of epigenetic strengthening that it does to your system. And so, especially in the healing and secondary prevention stages, vitamin C is cheap, it’s water soluble and we don’t have people on tons of it, but they’re taking one or two grams a day just to kind of keep the tank filled and that can be incredibly beneficial to their epigenome and also just their normal cells.
Dr. Weitz: Can I ask you about the alkaline acid? Are you going to mention that concept?
Dr. Anderson: I don’t bring that up in here because mostly if you’re doing… Well, two things. One is if you’re doing a dietary intervention that doesn’t have a lot of insulin signaling, your movable pH balance is going to be fairly stable, which is what you want. Now, and there’s no slides on this, although many people talk about it, there’s actually a lot of decent research now that shows that especially with aggressive cancers, if you add in alkalinizing supplements. So there’s some clinics that have people take extra sodium bicarbonate orally, but what we find is if you use like the alkalizing minerals, there are those mineral products that are the-
Dr. Weitz: Potassium citrate.
Dr. Anderson: … yeah, the alkaline salts of potassium and mag and that. That way, they’re going to need the minerals anyway. And it turns out that that actually orally can, again, kind of keep the pH. And people always say, “Well, your pH is so tightly controlled. Does it make that much difference?” What we’re seeing now is, like I say, this is a moveable thing through the day, and you’re not looking at giant changes because you’d be dead. You’re looking at small changes and keeping the cell pH as alkaline as possible through the day over time. And that’s actually in kind of standard research now.
Dr. Weitz: I asked one of the other leading integrative cancer experts about this and she said that there’s really no benefit, that what’s observed is that cancer cells give off an acid, and so this idea that cancer thrives in an acidic environment is not really true.
Dr. Anderson: Yeah. I think it’s an oversimplification to say that, but if the folks listening want to look at a really well-informed person who lectures on this, and I think some of his presentations you can get online free. There’s a doctor in Portland, Oregon, named David Allderdice, A-L-L-D-E-R-D-I-C-E, Dave Allderdice, and he’s done presentations on acid/alkaline in cancer that are very much based in the current science. So what the person you’re talking about there was saying is this oversimplification of well, there’s acid and cancer thrives there. That actually does work. It just doesn’t work the way that people have talked about it for a long time. So again, it’s a little hard of a concept to explain really quickly, but it’s not exactly that simple, but there is benefit in having alkaline forms, especially in minerals, going into your patient on a regular basis, kind of like vitamin C. It’s a base thing. Yeah. So you can read through that stuff. But I just want to end really quickly, secondary prevention, as was said at the beginning, we’re getting more people who survive and they’re in no evidence of disease or remission, or they have stable disease and their oncologists tell them, “Okay, go live a good life. Don’t get cancer again,” or something.
And now they’ll come to us and they’ll say, “Well, what do I do for secondary prevention?” And nobody likes the answer until you explain it to them and that’s that you have to investigate all of those areas, so all of those eight areas, whether it’s cell function, infectious and autoimmune and resistance factors, GI toxins, on and on and on, and people say, “Why is it so important in secondary prevention?” Well, there’s a couple things. One is you could go into cancer treatment with no endocrine problems and come out with a ton of endocrine problems. If you don’t fix as many of those as you can fix, the person will not maintain their health. You can come out of cancer treatment very toxic. Most people go in very toxic and they don’t know it, but you can be super toxic when you come out. If you do not open up the bodies [inaudible 01:20:58] and get the toxins moving out, you will never keep that person in remission.
I have never tested a cancer survivor who didn’t have at least one, if not five infections, stealth infections, that they didn’t have any symptoms of. And the reason for that is either the cancer and/or the cancer treatment squelches their immune system so much that they’re growing all of these infections and they don’t know it. So you have to look at all. And like I said, the GI tract is this constant project you’re working on. So you’re always trying to repair that.
And then you got physical and structural and psycho-emotional, et cetera. So [inaudible 01:21:44] prevention literally is looking at everything and you don’t have to do it all at once, but you pick what’s the worst things you find. Do we want to work on endocrine first? Then do we want to go to toxic stuff? And then do we want to work on the leftover infectious things or should we really tackle the infectious things first and work our way down? Somehow you got to look at that as a constitutional holistic approach to the patient.
And that’s really these areas. Now, people say, well, which ones are usually messed up in people after cancer? The answer is they all can be. I’ve found all of them in people, but the most common are toxins, endocrine stuff, infections and gut problems. And obviously there’s going to be physical and structural as part and parcel. There’s going to be psychological issues that come up, there’s going to be other stuff. But those are the big areas that I find with people trying not to have cancer come back.
Dr. Weitz: Do you ask your patients to get a stool test at some point during the process?
Dr. Anderson: And a lot of this depends on if you’ve had them from the beginning, when they first got diagnosed and you’ve really been working on their gut, maybe you’ve really done a lot of work there, but a lot of times we get people later in the stage. And I really think that because the gut is so important and cancer treatment ruins the gut so much, some kind of a test to look at the gut integrity, the leftover infections. I like the ones where you’ve got a number of different laboratory type views in. So that would be maybe some PCR and some culture and some microscopy of say the stool testing, also though there’s usually the membrane. The GI membrane is pretty inflamed. So you’re trying to heal that up. And obviously if they have sensitivities or allergies, that feeds into that, so I see definitely-
Dr. Weitz: Which stool testing you like best?
Dr. Anderson: Well, I’ve used a number, but not everybody. Okay. So the two I’ve used the most, and I forget their specific names from each company, but Doctors Data has one that has that combo of some PCR and culture and microscopy. And then also Genova has a similar one, but there’s others too. You just want something that kind of gives you as broad of a look into what’s going on with the microbiome as you can. Yeah. So this is kind of the, like I said, the focus is they need to know, look, you don’t have to jump on this all at once. This is a long term thing. We want to keep you alive for a long time. So let’s work on cleaning your body. Most people can wrap their head around cleaning their body up. And so if you check them and there’s not a lot of infectious stuff, move on. Usually you get to toxins and there’s a fair amount of toxic stuff. And so you get them doing the basics, like saunaing and some glutathione. And then if there’s metals, you use specific things there. If there’s chemicals and mycotoxins, you do more binders. And then the endocrine things, they can be pretty bad, depending on the type of cancer somebody’s had.
You give a lot of really slow thyroid and adrenal function [support] usually, just because they’re so worn out from the cancering process. And in almost everybody, you don’t want to overdo these things with the hormones, but you can bring the adrenals and the thyroid back up to good levels and that’s not going to hurt anybody’s cancer. In fact, it’s going to make them a little more resistant. If they have a hormonal type breast cancer or prostate, and it’s very hormonally active, then you have to be a little careful with the reproductive hormones. That depends a lot on what they’ve got going on, but there are a number of things like as you clean up their system, a lot of their side effects from hormonal therapies, et cetera will just improve anyway.
And this is something I try and share with patients. And that is that the white crescents here are actually how much intervention the standard system has. And the gray is how much potentially we can do for them. So in primary prevention, there’s almost nothing in the standard system for primary prevention. There’s a few things. Diagnosis and active treatment, yeah there’s little bit more because maybe they’re getting surgery or chemo radiation, something like that, but there’s still a lot. They’re not doing a ton with a person’s diet and their gut, not doing a ton with side effects, not doing a ton with even enhancing the other therapies. Recovery, again, not much that they’re going to do, and secondary prevention there’s almost nothing from the standard point of view.
All right. So whether we have time or not, I’m open for questions. I’ll send you these slides.
Dr. Weitz: That’d be great. Yeah. You mentioned using glutamine for some of the side effects for the mucositis. Maybe a couple of other clinical pearls for helping with some of the side effects from chemo and/or radiation.
Dr. Anderson: Yeah. I think that certainly glutamine is one of the things we think about a lot. Also let’s say maybe you just don’t feel comfortable using glutamine. There are other things that I use in place of glutamine for the mucositis, et cetera, one which you can get from a number of supplement companies is called zinc carnosine. And so it looks like a zinc supplement, but it’s actually the carnosine that does the gut healing and it’s actually a bit anti-cancer, et cetera. So that’s a good replacement for glutamine. The other though are some of the gut repair powders that you might use that may have a little glutamine, but they’ll have like some demulcent herbs in them like slippery elm and marshmallow, things of that nature. Those aren’t going to do anything to the cancer and they’re going to be very healing to the gut.
As long as the person’s white cell count is not suppressed, so they’ve got at least 2,000 total white cells, I also give them human microflora type probiotics. During chemotherapy, I don’t use non-human strains. So I don’t use spore based and I don’t use other non-human strains. I might use them elsewhere, but during chemotherapy, I only want their gut to see what would normally be in a human. So the HMF types, human microflora strains. So as long as they have some white blood cell count, I have them do it, eat it in a little bit of yogurt or some applesauce or something. So a demulcent like let’s say slippery elm or marshmallow, or one of those powders that’s got it all in one thing and then throw the human microflora things in there.
The other thing that’s very helpful, if you can get the person earlier on, is like I said, probably in 98 out of 100 cases, you can have go-tos such as curcumin and milk thistle, and they will generally be very supportive to the chemo, but also supportive to keeping your normal tissue as healthy as possible through the process. Now, like I said, if you’ve got one of these new targeted therapies or something like that, what I do still to this day is I’ll look the targeted therapy up, the category like PD1 inhibitor or something. And then I’ll look up, I’ll say any data on curcumin and that, or the other. And usually you don’t find anything bad and then I’ll feel good going forward. If you can get people early on and you’re doing melatonin, whether it’s a moderate dose or the 20 to 60, or even the super high dose, that pretty much doesn’t have anything it crosses over negatively with and so it’s easy go-to.
Dr. Weitz: And do you have them take all the melatonin in the evening or do you split it up?
Dr. Anderson: It depends a bit. I usually have them ramp their doses up to if they’re doing high dose because it can disrupt their sleep. And there are some people who are not sensitive in that way, so they could take their melatonin at dinner and after dinner and at bedtime and they’re not falling asleep on the couch. Other people are very sensitive and they have to take it closer to bedtime. I have them start and I usually give them a 10 milligram [inaudible 01:31:46] for a week, take this within an hour bedtime. Let’s see how you sleep. Let’s see how you do. If that goes well, we go right to 20 and then 40, and then 60. If they’re doing the super high doses, like an aggressive cancer, then we may split it up more.
Dr. Weitz: Dawn, do you have a question? Do you want to unmute yourself?
Dr. DeSylvia: Hi, thank you.
Dr. Anderson: Hi.
Dr. DeSylvia: Hi. So I have two quick questions. What’s your experience with SOT therapy? Do you use it and have you found it helpful in patients?
Dr. Anderson: I have to answer this carefully so I don’t get sued.
Dr. DeSylvia: Okay. Yeah. It’s maybe similar to my experience.
Dr. Anderson: SOT, so this is not sacred occipital technique. This is specific oligonucleotide therapy. So I’m not talking about occipital. So that therapy, if you look at it from the top down and the science around it, it has a big upside in future, I believe. The problem is at least what we have available right now in North America, it’s been only available through one company that I have personally and in groups I’m in with people who do a lot of this, not had good success with, but also not had good, reliable resulting from. And so because of that, I’ve not seen it really show out in a lot of people’s cases. [inaudible 01:33:40] people who do, but yeah, I don’t.
Dr. DeSylvia: Yeah, I appreciate that. And that’s been my experience, but again, it sounds so good on paper. So hopefully someone here-
Dr. Anderson: Patients really want it, and what I was telling them is it’s like it’s not ready for prime time and I wish it was. As soon as you start seeing more, if this happens, because the theory and the science behind it is actually fairly solid, as soon as you start seeing more people enter the SOT world from the laboratory point of view, I think that’s when I would maybe return back and look at it again. And I’ve experienced, so I consult for some hospitals outside of this country, and we have associations with real live big universities and their immunology departments and everything. And we’re working on cancer vaccines and dendritic cell treatments and all this stuff. And what I know from working with the actual immunologists is all these things have a huge potential upside in the future, but anyone doing them now is doing them at like 10% of what they really could do, because we just don’t understand the tech. The technology is actually quite complex in these things. Yeah.
Dr. DeSylvia: Yeah. And thank you. And along those lines then, I have a lot of patients that ask for my advice of where to go. And I know you’re not seeing patients, but do you see a difference in Hope For Cancer or Integrative Cancer Centers of America? Or someplace else? Is there some center that you feel stands above the other ones or somebody who’s doing something that …
Dr. Anderson: I know some of those places and not others. I’ve had patients have good results with Hope For Cancer. There is a much lesser known smaller integrative center in Baja. And if you look them up, they would be under Nube Health, N-U-B-E. I believe it’s a Spanish word.
Dr. DeSylvia: Oh, great.
Dr. Anderson: Nube Health. And they do a lot of really interesting … They have a lot of doctors who consult and they do a lot of very interesting integrative treatments, including photodynamic therapies and IV and all kinds of stuff. I think of them, they’re a lot smaller than a lot of these other big places that you know the names of, but I’ve shared and consulted with them on patients that were in quite bad shape and they’ve kept them alive, which is usually, I mean, if anyone can do that, that’s a pretty good thing.
Dr. DeSylvia: Yeah. Yeah.
Dr. Anderson: So Nube Health, they’re also known as Baja Medgate, M-E-D-G-A-T-E. They’re worth looking at, and what I often tell patients is, I mean, if they’ve got time, I’ll say, look, give me the list of who you’re considering. I’ll tell you my top three or whatever. Visit two of them and see who you resonate with because they all do good stuff, but some do some stuff better than others. And quite frankly, some of them are way more expensive than others and that may take them out of the running too. Yeah.
Dr. DeSylvia: Thank you. That’s helpful.
Dr. Weitz: If I may, I’d like to ask you one more question. There’s a lot of medicinal mushrooms and it seems like for a while this mushroom was the most popular, it was AHCC, it was maitake D fraction. What do you think is the most powerful mushroom supplement for cancer patients?
Dr. Anderson: Yeah, I was going to bring that up earlier. Thank you. Well, the way I look at mushroom supplementation is it kind of depends where they’re at in the process. So I was not involved with it as much when we were doing the NIH research, but another part of our group was doing a lot of work with Cory Ellis, with turkey tail, which we hear a lot about. And there were a lot of tough cancers that they were actually having some good results with. And then they used it a lot in breast cancer and your common breast, colon, prostate, et cetera. So a lot of times what I would do with people would be during the active treatment phase, I would do specific mushroom things, such as turkey tail specific intervention or AHCC is another one you brought up. I use that a lot.
And then if we got past the active cancer and we were more in the prevention stage, often what I would do, and this is more based on looking at it from more of a botanical medicine point of view, I would often transition them off of the specific, where there was AHCC or turkey tail, something like that, or even maitake. I didn’t use that as much, but that would be one. And I would go to more of a blend, a mixture. And this is certainly not the only company, but it’s the one that comes to the top of my brain. Fungi Perfecti has one called my community, which is one we would transition people to when they were more stable. And it’s just a mixture of medicinal mushrooms, because each of them, the reason you might use AHCC or maitake D or turkey tail or whatever at higher doses early on is they’re having a pharmacologic effect driving metabolism in one direction, which is great, but you don’t need that forever. So if the person gets over the hump and they’re in prevention, I like to broaden the mushrooms out and mostly that works pretty well.
Dr. Weitz: Awesome. Thank you so much, Dr Anderson. This was great.
Dr. Anderson: Thank you all. I’ll email you these slides. So you guys have them. So Dr. Weitz, I’ll just send them to you and you can do what you need to do.
Dr. Weitz: Great. Okay.
Dr. Anderson: And yeah, so at the bottom of all of my slides is my website and there’s hundreds of things you can search on there. They’re free. There are some courses, but do your search on there. There’s a ton. I have all my monographs that I wrote for cancer treatment and interactions and stuff like that, that we did for the research project that are free on there too.
Dr. Weitz: Great. Thank you. And thank you everybody and see you next month.
Dr. Anderson: Bye guys.
Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness podcast. And if you enjoyed this podcast, please go to Apple podcast and give us a five star ratings and review. That way more people will be able to find this Rational Wellness podcast when they’re searching for health podcasts. And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition clinic. So if you’re interested, please call my office (310) 395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you and see you next week.
