Dhru Purohit Show - The Biggest Drivers of Cancer and How to Minimize Your Risk Today with Dr. Jason Fung

Starting point is 00:00:00 Hi everyone, Drew Prode here. Today's mini episode, we're talking all things cancer. Specifically, we have New York Times bestselling author Dr. Jason Fung talking to us about a revolutionary new understanding of this medical mystery we call cancer. And he breaks this down in his book, The Cancer Code, and we're going to get a lot of the top gems in today's mini episodes. Specifically, we're going to go into like, what actually is cancer? I know that's a basic question, but we have to ask the most basic questions if we're going to and think differently about this approach. What is the seed and soil analogy of cancer and how does it change our current model and approach to dealing and even treating cancer? Jason also goes into the interview and talks about the biggest drivers of cancer today based on the latest research and what feeds cancer cells. There's something that's in our diet, especially here in America, that we know through the latest science and research that's out there, that it feeds and accelerates the growth of

Starting point is 00:01:03 cancer sales. And lastly, we're going to talk about what you can do today to minimize your risk of cancer. Cancer is one of the most scariest diseases that's out there. You know, so many people worry about it. So many people have it in their family or have had past friends or family members who have had it. If you've suffered from that or if you're curious about the topic, today's mini episode is absolutely for you. I hope you can walk away today with a better understanding of cancer from Dr. Jason Fung. I want to pull a quote from your book to start off the conversation, which is you say, and you start off in the book, you say the most pressing question in cancer research is the most

Starting point is 00:01:40 elusive question, what is cancer? So can we start off there? Because it's still a question that we're asking today, which is what exactly is cancer? Yeah, and that's sort of the most important thing is to understand a disease, you really have to understand what it is, like what causes it, what the disease is. And really, of the common diseases, cancer stands virtually alone because we had no idea what this disease actually is. So you look at other diseases like COVID or, you know, infections. So we've identified viruses. We've identified bacteria. We've, you know, figured out fungi, and so these are external invaders for heart disease and stuff. These are, you know, blockages in our blood vessels which starve the heart or the brain of blood,

Starting point is 00:02:33 so you get heart attacks or strokes. So we sort of understand what the disease is, how it develops, and that kind of thing. But for cancer, this is sort of a very, very strange disease. So it's unlike any other disease we've ever faced. It's not a vascular disease, like heart disease. it's not an external invasion like bacteria or viruses. You know, it's not a, you know, stones and stuff. There's all these other diseases, but what is this strange disease?

Starting point is 00:03:06 And it's not that it's one of these sort of rare diseases. It's unfortunately extremely common. So the lifetime risk of cancer is somewhere around 1 in 10, and it's going to, you know, affect everybody's life in that if you don't get it, you will know people who will get it. Almost everybody does. But we don't know what this is. And this is the whole sort of discussion in the book is what is this disease?

Starting point is 00:03:32 Because it's a disease where you have a normal cell, which is part of your own body, because it's derived from your own body. And for some reason, this normal cell breaks off and becomes cancerous to the point where it can kill you. And it kills, of course, many, many people. It's the second biggest killer of people. So our concept of what this disease actually is has been changing. So, you know, it's changed throughout history. But really, even in the last sort of 10 years, there's been this massive change in the way that we look at this disease.

Starting point is 00:04:13 And this is what I call the paradigm of cancer. That is, you know, I'm not arguing about, oh, this is how to treat cancer. We've done lots of studies on, you know, use this drug and this drug and these drugs in combination with surgery and chemotherapy and radiation. You put them in this sort of regimen and you can treat cancer. And I'm not disputing any of that. But in the end, it doesn't help you answer the question of what is it. So if you want to understand what it is, then you have to start sort of from the beginning, go through it and say, what is this disease? And that's where we've really made a lot of progress within the last sort of 15.

Starting point is 00:04:51 20 years. And most people haven't even really appreciated that. And that's what I wanted to bring forward is that sort of recent research and bring it to the people so they at least understand what this disease is that that is affecting so many people. This episode is brought to you by Inside Tracker. You know, I'm turning 40 this year and I can honestly say I've never felt better. So many people have this fear about getting older because they think it has to come with chronic disease and a deteriorating mental and physical health. If that were the case, I'd be worried about getting older too, but it doesn't have to be that way. It's possible to get older and stay young at the same time, but sometimes we need a little bit of help knowing exactly how to do it.

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Starting point is 00:07:02 Just pay for shipping and handling. Just head over to Drewsalt.com. That's D-H-R-U-S-A-L-T dot com, Drewsalt.com, to try out the world famous Ava Jane Kitchens, Colima C-Sysalt. for free today, just cover shipping. That's drew salt.com. I think this is a perfect opportunity to jump into, you've sort of set the stage for this kind of central point that comes into. Okay, so now that we understand this in part of paradigm three,

Starting point is 00:07:34 you use this sort of seed and soil, you know, analogy. And I'd love to set that up just to make sure that we get to that while I have you here. Yeah, so that's exactly right. So if we understand now, this is an evolution. process, which goes back towards our origins, then you have to say, what drives evolution? And it's not just genetic. So if you think about evolution, Darwinian evolution, which is the survival of the fittest, for example. So what he had observed was that in the Galapagos Islands, it had these birds. And if they had these short beaks, which were really ideal for eating nuts,

Starting point is 00:08:13 and there are birds that these had these long beaks that were really good for eating fruit. And in the areas where there's a lot of nuts, you found a lot of these short beaked animals and where the areas you had a lot of fruit. You had a lot of these long beaked animals. And what he said was that's not a coincidence. What happens is that the environment selects the genes that are most successful.

Starting point is 00:08:34 So if you have a lot of nuts, you select for the genes that's a selective pressure which favors the survival of those genes that produce the short thick beak and the areas that have a lot of fruit have exert a selective pressure on the genes that give you the long, narrow beats, right? That makes sense. It's just sort of basic evolution. And cancer does sort of the same thing. So if it's an evolutionary process towards this sort of original being caused by chronic damage to the cell, then it's not the genetics, which is the important part, but it's the environment. right? And that is the seed of cancer is there. But if you don't provide that environment that,

Starting point is 00:09:21 you know, selects for this sort of survivalist, cancerous sort of, you know, story, then you're not going to get cancer. So what you have to do then is to say, this is not just a genetic disease, because for years we've been sort of thinking about it as a genetic disease. So we think, well, it's just sort of pre-programmed into us. But it's not. because the rates of cancer depend on your environment more than it does on your genes. That is, if you look at, say, breast cancer, breast cancer, if you go from Japan, a Japanese woman in Japan, when you move that person to San Francisco, their rate of breast cancer like doubles or triples within a couple generations. It's not the environment. It's the environment.

Starting point is 00:10:11 But that's fantastic because then if you can figure out what point. part of the environment is what's selecting for the damage. So, you know, in some cases, we know it's smoking, it's tobacco, it's viruses, right? In many cases, we don't know breast cancer, colon cancer, what's damage, prostate cancer? We don't know. If we can figure out what part of the environment is driving this evolutionary process, then that's how we're going to reduce the risk of cancer. And so the question is, what is it in our environment? So they've studied this question for a long time. So back in 1981, they did a study where they're going to estimate the risks. So we do something called a population attribution factor, which is what percentage, a certain risk

Starting point is 00:11:03 factor will contribute to cancer. So tobacco smoke is the biggest, 35%. So tobacco is responsible roughly for 35% of cancer overall. But number two was the diet at around 30%. Right. So really like very, very close to tobacco and dwarfing almost everything else. So all the stuff like the pesticides and the chemicals and stuff, that's like one or two percent, radiation, one or two percent. But cancer was caused in large part due to one tobacco, which we know about,

Starting point is 00:11:39 And two, the diet. The question is... Which never really got that. Like, people didn't get that, you know? Like, they didn't get that. And so they were looking for what part of the diet. That was what the tricky part was. So if it's diet, then what part of the diet is causing cancer, right?

Starting point is 00:12:01 So they looked at fiber wasn't the case. They looked at dietary fat. It wasn't the case. They looked at vitamin deficiencies. We've done so many studies like vitamin A, vitamin B, folic acid, vitamin C, vitamin D, vitamin E, you know, omega-3 fatty acid, selenium. We've tested all of those in multi-million dollars trials, and it wasn't deficiency of vitamins that was causing cancer. And the answer came somewhere around 2000, what part of the diet was the most important?

Starting point is 00:12:33 And we didn't know this really until about 2003. And it turns out that it was obesity, was the biggest, biggest driver of cancer. And probably more specifically is that it was the hyperinsulinemia. That is too much insulin, which is very typical of obesity, is probably what's driving cancer in those cases. The reason I say we didn't know is because, so I went to medical school in the mid-1990.

Starting point is 00:13:03 and we never talked about this stuff. But in 2003, a very large study came out, which showed that obesity actually raises the risk of all kinds of cancer. So now the WHO classifies 13 different types of cancer as obesity-related, including breast cancer and colorectal cancer, which are after lung cancer, sort of the most common cancers. So really, really important causes. And this is what's important is now, you know,

Starting point is 00:13:31 what we're doing is we have to go, pass again. So this paradigm, which gets us to evolution, which gets us to the seed and the soil, which is this sort of evolutionary ecological, ecology being the study of how the environment interacts with an individual, how you can change that environment in order to prevent cancer. And that's sort of what's sort of exciting about this is that now hopefully we can start to understand and then make some changes that are going to minimize our risk of developing these types of cancers and, you know, hopefully preventing them in the future. Yeah. And I mean, and even question basic premises. You know, I was on the Mayo Clinic website.

Starting point is 00:14:13 I've been in preparation of this interview, you know, there's like a myths and there's like a myths in fact section on cancer and diet. And like one of the questions inside there was sugar, you know, somebody saying, you know, does consuming less sugar have any impact on cancer? right? And it was like there's no research, there's no evidence at all that consuming less sugar has anything to do with cancer. And again, Mayo Clinic, well established place. They're doing the best they can based on the research and the evidence that's out there right now. And part of the thing that you're bringing in is that highlighting, especially with your previous books, that we're really talking about, you know, insulin resistance and what that relates to diabetes, especially

Starting point is 00:14:55 type two diabetes, is, well, if we know that obesity, through this big study that you were talking about plays a major factor. And then what is it as part of that also contributes obesity and how do cancer cells get their energy? Then of course we're going to want to pay attention to the level of sugars as one example that we're having inside of our diet because that's going to cause a whole chain of effects that ultimately supports the growth of cancer. Yeah, exactly.

Starting point is 00:15:27 And so one of the, so Dr. Lou Cantley, who's a very prominent researcher, cancer researcher, you know, he was one of the ones who sort of uncovered the link between sort of what sugar does, which is, you know, it contributes to this high insulin state. And insulin, other than being a metabolic hormone, is actually a very, very potent growth factor. So it tells cells to grow. And if you're going to tell cells to grow, then you're going to tip the scales towards, you know, increasing growth of cancer cells, for example. So, you know, here's a guy who's sort of like one of the most prominent cancer researchers, and he's like, sugar scares me. You know, that's what he says in one of his articles he's written.

Starting point is 00:16:16 It's like, okay, well, that's all I need to know, right? Totally. And also, too, on the basic premise of, like, what is chemo? therapy, right? Yeah. Could you explain like that link on that? Like how do they get these well-intentioned poisons into cancer cells? Can you explain that to like our audience through, you know, like exactly like what goes into chemotherapy that takes advantage of exactly that that we're talking about? Yeah. So yeah, exactly. So when you look at the cancer cells, you can do something called a pet test, which is a positron emission test. And it basically looks at how avidly cells take up glucose.

Starting point is 00:16:59 So when you do these tests, things that light up are eating a lot of glucose, and those are what are identified as cancer. So they're taking in, you know, like five or ten times the amount of glucose, which is a type of sugar compared to normal cells. So it's like, okay, when you look on these sophisticated sort of scans, you can see the cancer cells basically devouring sugar like there's no tomorrow and it's like, well, you know, if I had cancer, I certainly wouldn't be trying to eat too much of the stuff because you know that the one place in the body that loves it 10 times more than the next guy

Starting point is 00:17:39 is the thing, right? And then you have certain chemotherapies which take advantage of this. They try and get in, you know, by because they're, you know, they mimic the sugar and that's how they do it on the positron emission tomography testing, for example. They mimic the sugar so that the cancer takes it up and then it lights it up. And then people are trying to use that to sort of target the cancers as well. But interesting, you know, it's an interesting story of how this sort of this new paradigm explains so much more about the phenomenon of cancer and how, you know, what implications it has for screening and this sort of evolution of and this is sort of the promise of this cancer paradigm 3.0 is that if you now understand that what is happening now is that the cell is evolving away from normal cells evolving into a foreign species because and people always think oh that's so weird right but that's the way the body actually looks at the cancer cells so when our immune system looks at a cell

Starting point is 00:18:44 It has a way to tell between self and non-self. That is, the immune system is a very powerful weapon. You don't want to use it on its own cells. That's like friendly fire, right? Automidium type behavior. Exactly. And it's very, very bad if that happens. So your body has these ways to distinguish between your own cells and everybody else.

Starting point is 00:19:09 So bacteria, viruses, it will try and kill it. And when it sees a cancer, it will try and kill it. That's just the way. That's what happened. So it has evolved this cell. So say you take a lung cell, this lung cell, which was originally your own cell, has evolved into basically a new species that is foreign. That's why Frankenstein in your own body. Exactly. And that's the reason that instead of trying to the third paradigm, which is like, okay, now we have these cells that were originally part of us, but they've basically broken away and they've become their own sort of, you know, invader. Now you say, well, instead of trying to just get indiscriminate killing,

Starting point is 00:19:52 which was paradigm one, or genetic targeting, which was paradigm two, now what we're going to do is enhance the immune system to identify it. So basically, you have these sleeper cells, like, you know, you have terrorists, sleeper cells of terrorists in your city, and now what you're trying to do is uncover them so that you can get your police and your SWAT teams in there to kill these sort of domestic terrorists. That's what we're doing with immunotherapy. So these new drugs, these checkin inhibitors are basically uncovering. So there are certain ways that these cancer cells hide and they're basically trying to uncover them. Right. And this is the new paradigm. What we're going to do is trying to uncover these sleeper cells,

Starting point is 00:20:36 these hidden sleeper cells so that they can be identified, targeted, we can direct the immune system. So something like those new drugs you're talking about the, you know, those checkpoint inhibitors, then you get CAR-T, where you're actually going to take the cancer and then engineer sort of a swap team that is going to identify and kill them, right? That's a new therapy based on this immunotherapy, but it's based more specifically on this new paradigm of looking at a cancer,

Starting point is 00:21:06 as a new foreign species. And it's very, very interesting because, you know, it's, it's, the promise is, is sort of immense. Like, we're not there yet. And, you know, I hope that there's a lot more to come. But it's a totally new way of targeting cancer and treating it based on a whole new paradigm. And that's what gives me hope for the future that there's more going to be able to be applied. Because you can apply these lessons of evolution. biology and say, well, you know, what can I do to change the environment, for example, because

Starting point is 00:21:43 that's evolution. That's biology. So things like losing weight and, you know, intermittent fasting, which is another way to lose weight, you know, trying to reverse your type two diabetes, type two diabetics, of course, get much higher rates of cancer because it's also hyperinsuliniaic. So getting reversing the type two diabetes, that's going to likely reduce your risk, you know, other things like chemo preventative agents. So there's not a lot. They've been studying stuff to try and prevent cancer, but there's not a lot. So the only things that might work, that pharman gets a lot of

Starting point is 00:22:18 research, which is a diabetes drug may be useful. And then green tea, probably a very small effect, but there's some data from, you know, from Japan where they do drink a lot of green tea, that some of the compounds in that are maybe, may be effective. So, hey, maybe that's a great, you know, great thing to do. Drinking green tea is probably good anyway. And really the two central themes that I got out of your book after really going to that history is one, the future is hopeful in a way that is really understanding

Starting point is 00:22:51 more of that central question, coming back to how we start off the podcast, which is what the heck is cancer? So we're better shaped for what we're developing in terms of treatments and drugs in the future because we're more, we have a we have the most robust answer that's actually getting to the source and the root of what is cancer and the second component is exactly kind of what you were just talking about which is

Starting point is 00:23:15 what are the things that you can do today to both enhance you know whether it's some of the work of like walter longo or other people that are out there that are showing that fasting could support right targeted fasting especially before chemotherapy can support and enhance the the potency of these drugs, if somebody actively has cancer, cutting off the source of the supply of food, which is significantly reducing the amount of glucose so that we're not in this place of hyperinsulinemia. And if you don't have cancer right now and this is something that you're paying attention to in the future, what would be your biggest recommendations? You know, somebody who's healthy, who's listening to this podcast right now, and they're like, wow,

Starting point is 00:24:03 this is all super fascinating. I've never understood this before, but now I get it. It's almost like you just gave us a masterclass on cancer. What are the one or two things to do today besides not smoking that will help us be the most resilient to potentially avoid this disease in the future or greatly minimize our risk? Yeah. And so you get back to those sort of attributable risk, which is number one is tobacco smoke. So, of course, that's probably the single most important thing, and still is, is to not smoke. And then two is the diet, so avoiding hyperinsulinemia, which is that sort of what I talk about more in the obesity code and the type two diabetes code is that insulin is this hormone, which tends to make us gain weight and also causes insulin resistance. And too much insulin is a bad, is a very potent growth factor.

Starting point is 00:25:01 so that's going to so if you're, you know, you want to avoid things that are going to raise insulin, which is eating a very diet that is very high in refined carbohydrates, for example,

Starting point is 00:25:15 sugar is probably something you should best take, you know, in small amounts. And then this other idea is that you really should be having a regular period of fasting every day. That's really sort of basic. It's the word breakfast.

Starting point is 00:25:31 breakfast. It's the meal that breaks your fast because really you're supposed to be eating at say dinner time, which is say six o'clock and eating at breakfast time, which is maybe eight o'clock. So you're getting somewhere between 12 and 14 hours of fasting every single day. That's what's supposed to happen. That's buried in the word breakfast, right? Break fast. That is what's supposed to happen every day. That's not what happens to most of us in 2020. Because if you look at sort of societal norms and stuff, instead of having three meals and then no snacks, we sort of grazed throughout the day believing that it's actually healthy for us. I don't think it is because every time you are eating, you're stimulating your insulin, which is giving growth signals to the

Starting point is 00:26:18 cells, including the cancer cells, which love insulin. You know, you look at a breast cancer cell, for example, it has like five or six times a number of insulin receptors compared to a normal breast cell. they love this stuff. They love incant. They love glucose. So therefore, you want to lower it. So eating sort of whole unprocessed foods is important. That's probably the most important thing.

Starting point is 00:26:41 Not eating all the time is the second, probably the second most important thing. And, you know, maintaining a normal weight as best as you can. I mean, that's not always the easiest thing to do. But if you are overweight, then try to lose that weight. If you are type 2 diabetic, try to reverse that type 2 diabetes. And that's the two, you know, the tobacco and the diet are so overwhelmingly more important than everything else. Like you could also, you know, look at the viruses, for example, you can get the, you know, try to avoid the hepatitis B and hepatitis C, which cause cancer and human papillomavirus. But those are sort of givens.

Starting point is 00:27:21 But the diet and the tobacco are sort of in a class of their own. everything else is like 2% and they're at like 30, 35%. And, you know, I think I just want to say from somebody from the outsider's been an observer of your work and consuming it and just super appreciative, the cigarette is piece is easy, you know, tough to break, but actually there's really a lot of really interesting stuff that's coming out of Johns Hopkins and other places of using psychedelics to help break cigarette succession, you know, maybe those things will incorporate and we'll figure out new ways to help people. I think it's about 15% of adult population smokes here in the United States. So

Starting point is 00:28:01 it's gone down massively and cancer rates have gone down for that. The diet, sometimes people listening here, if they're not familiar with your work, can think, okay, you should talk about eating healthy. But really you're talking about getting out of this central paradigm, to use the word, where we're eating sugar in all its other forms. So people who are listening are like, I don't really have a lot of sugar in my diet, you know, maybe a little bit in my coffee, some birthday cake here and there, one of my parties. But, You know, how often are you eating those meals of refined starches that are a regular part of our daily life, the big bowls of rice or ultra-processed foods or breads or other things like that,

Starting point is 00:28:43 that fine, you know, have those things every so often as, you know, parts of your diet. But when they become the norm, now you understand why so much of America is in that pre-diabetic state where they think they might be eating healthy because they're just a little bit overweight, but actually their diet is constantly spiking their blood sugar, which leads to all these problems with insulin that you're talking about. So you're not just talking about eating healthy, let's be a little bit more mindful, you're talking about really actually leaning in and getting your blood sugar under control. Yeah, exactly. And, you know, one of the ways, I mean, a lot of people talk about diets and there's all these different opinions on

Starting point is 00:29:26 diets, but what people hadn't focused on really at all, I think, until a few years ago, was this meal timing that is, is eating all the time really the same as eating, you know, a few times? And I think the answer is no, because the point is that you need to let your body sort of digest, let your insulin levels fall so that you don't get all these problems with the insulin resistance and so on because insulin is not intrinsically bad, but it is a hormone that goes up when you eat. So if you eat constantly, is that a bad thing? And that's not been talked about a lot. And that's what I've really focused on is that I think it's actually highly detrimental to be eating constantly. It's just not the way that you're supposed to be doing it.

Starting point is 00:30:18 And we've never done it. Which was a little bit of the trend of some of the advice, especially in like the 90s and 2000s, eat six meals a day, you know, raised throughout the day. And really, you know, we're backing away from that largely through the work that people like yourself are doing and just educating, well, let's actually look. Is this actually helpful or could it be harmful? And it's looking like it's not supportive of our overall health goals inside the body. Yeah. I mean, I think the whole idea was sort of silly that you should eat, eat, eat to lose weight. And it's like, well, how's that going to work exactly? If you're eating all the time, how are you expecting to lose weight? And you know, of course, that if you eat a little bit and then stop, that doesn't suppress your appetite. It increases it. That's what an appetizer is. It's a small portion of food to make you more hungry, not less hungry, more hungry, right?

Starting point is 00:31:16 So if you're going to eat small portions of food, you're going to stimulate your appetite, then you're going to stop. Right? It's like when you start urinating, you just want to finish, right? When you start eating, you just want to finish. If you were to go pee and you just stop and start and stop and start, it's like, why would you want to do that? Like, that's the dumbest thing ever, right? So it's like you're going to make yourself hungry by taking a little appetizing portion

Starting point is 00:31:43 of food. And then you're going to stop, right? It's like, oh, well, that's not really useful. And then you're going to do it again and again and again, six times a day. Well, why would you want to do that? That's ridiculous because it's never been done before. Because prior to like 1977, nobody did that. So why would you even think that it's a good thing to do?

Starting point is 00:32:05 Like, why would you even come up with that? And the answer is that there was no real scientific evidence that actually helpful. It was just sort of made up. People just thought it might be good and they just said it. And that's it. Sure. Well, you know, there's that old saying that I don't know who discovered water, but it probably wasn't a fish.

Starting point is 00:32:23 Sometimes we're so in the cultural norms of the way that things have been done that it actually takes a lot of courage, especially for somebody in your position, to step back and say, wait, does any of this make sense? Let's start with the basics and let's question the premise and then go from there.

Starting point is 00:32:43 If not, we're in this rat race where today still in the U.S., unfortunately, number one reason for bankruptcy is medical bills. Cancer rates are continuing to go up. Quality of life is not increasing. Out of 90% of our insurance dollars that we pay in, young people, old people, everybody,

Starting point is 00:33:03 out of all the insurance dollars that we pay in, 90% of it is used in the last six to eight months of somebody's life to try to keep them alive through these expensive treatments. A lot of them well-intentioned, a lot of them well-intentioned that are there. Some may be coming from business perspectives, but it's not a winning race.

Starting point is 00:33:22 We have to step back and we have to question the basic idea. And that's exactly Dr. Fung, what you do inside this book. And I want to thank you for really putting together some strong material. I hope progressive medical schools out there start to make it required reading. Because, you know, as we all know on this podcast, is that it can take 12, 17, 20 years for what's the latest literature to end up becoming part of the practice that's out there. So kudos to you for writing an incredible book. book.

Dhru Purohit Show - The Biggest Drivers of Cancer and How to Minimize Your Risk Today with Dr. Jason Fung

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