The Dr. Hyman Show - How Food Can Drive And Slow Cancer Growth

Episode Date: May 29, 2023

This episode is brought to you by Athletic Greens, Wonderfeel, and Rupa Health. Over the years, it has become a widely held belief that cancer is predominantly genetic or simply the consequence of bad luck. An empowering evolution in cancer research, however, suggests we have far more control over our risk than previously thought. For instance, the right diet is imperative to reduce insulin spikes that act as a cancer growth factor. In today’s episode, I talk with Dr. Jason Fung, Dhru Purohit, and Dr. Elizabeth Boham about things we can do every day to prevent cancer and support the body during and after cancer treatment. Dr. Jason Fung is a physician, author, and researcher. His groundbreaking science-based books about diabetes and obesity, The Diabetes Code, The Obesity Code, and The Complete Guide to Fasting, have sold over one million copies and challenged the conventional wisdom that diabetics should be treated with insulin. Dr. Fung is also the cofounder of The Fasting Method, a program to help people lose weight and reverse type 2 diabetes naturally with fasting. His latest book is The Cancer Code: A Revolutionary New Understanding of a Medical Mystery. Dhru Purohit is a podcast host, serial entrepreneur, and investor in the health and wellness industry. His podcast, The Dhru Purohit Podcast, is a top-50 global health podcast with over 30 million unique downloads. His interviews focus on the inner workings of the brain and the body and feature the brightest minds in wellness, medicine, and mindset. Dr. Elizabeth Boham is a physician and nutritionist who practices Functional Medicine at The UltraWellness Center in Lenox, MA. Through her practice and lecturing she has helped thousands of people achieve their goals of optimum health and wellness. She witnesses the power of nutrition every day in her practice and is committed to training other physicians to utilize nutrition in healing. This episode is brought to you by Athletic Greens, Wonderfeel, and Rupa Health.  AG1 contains 75 high-quality vitamins, minerals, whole-food sourced superfoods, probiotics, and adaptogens to support your entire body. Right now, Athletic Greens is offering 10 FREE travel packs with your first purchase by visiting athleticgreens.com/hyman. Wonderfeel Youngr™ NMN works by increasing your levels of NAD, a critical molecule our bodies produce that we literally need to survive. Feel the wonder of innovation at getwonderfeel.com. Rupa Health is a place where Functional Medicine practitioners can access more than 2,000 specialty lab tests from over 35 labs like DUTCH, Vibrant America, Genova, and Great Plains. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com. Full-length episodes of these interviews can be found here: Dr. Jason Fung Dhru Purohit Dr. Elizabeth Boham

Coming up on this episode of The Doctor's Pharmacy. The most important thing we need to focus on is not the genetics of the problem, it's the soil problem. Hey everyone, it's Dr. Mark. Now the basis of any healing protocol should be whole real food, but with all the GMO foods and long transportation, storage times and monoculture farming methods, depletion of our soils. Food's not as nutritionally dense as it once was, even good stuff. And that's why I recommend supplementing a whole foods diet with a high quality multivitamin as a basis for any health

oriented program. And the product I personally use comes from Athletic Greens. Their AG1 supplement has 75 different nutrients that work together to fill out the gaps in our diet. I take AG1 every day and I've noticed that I consistently feel better and have more energy throughout the day. Plus, it works with any diet, keto, paleo, vegan, dairy-free, even gluten-free. AG1 is a simple, easy way to optimize your health. Right now, Athletic Greens is giving away 10 free travel packs with your first purchase. All you have to do is visit athleticgreens.com forward slash hymen. Again, that's athleticgreens.com forward slash hymen. I want to take a minute to tell you about NAD. You might not have heard of it, but NAD is a critical molecule our bodies produce that we literally need to survive. Unfortunately, our NAD levels decline as we age, starting about our 30s,

which contributes to the onset of age-related diseases, including cardiovascular, neurologic, and metabolic issues. This is obviously a big problem. But my friends at Wonderfeel have come up with a solution. It's called Younger NMN. Younger NMN counteracts the natural decline of NAD, allowing your body to restore youthful levels of this vital molecule and helping you embrace a vibrant life for years to come.

I've been taking Younger NMN for three months now, and I'm already feeling more energetic and focused. NMN has been shown to enhance energy levels, improve brain, heart, and joint health, and even help you sleep better at night. It's really a game changer when it comes to longevity. I love Younger NMN from Wonderfeel, and I know you will too. They've done their research and patented the size behind their Younger formula, so get ready to feel the wonder of innovation at getwonderfeel.com. It's more than wonderful, it's Wonderfeel. And now let's get back to this week's episode of The Doctor's Pharmacy. Hi, this is Lauren Feehan, one of the producers

of The Doctor's Pharmacy podcast. The school of thought around cancer used to be focused only on the genetic component, but we now know that our environment, the air we breathe, the food we eat, and even our relationships have an enormous cellular impact on our ability to prevent and treat cancer. In today's episode, we feature three conversations from the doctor's pharmacy on how cancer cells grow out of control and what we can do to reduce that risk. Dr. Hyman speaks with Dr. Jason Fung about how a diet that is high in sugar and starch can drive cancer growth, with Drew Proitt about daily tips to reduce your risk of cancer, and with Dr. Elizabeth Boehm on the functional medicine approach to cancer treatment.

Let's dive in. For so long, we've thought about this as a disease of genetic mutations. We concentrate on genes and not on other things that are going to increase your risk of cancer. So the environment, which is predominantly diet and nutrition, plays a huge, massive role in the development of cancer and something which very rarely we talk about. So I reviewed the study. So in 1981, the U.S. Congress said, okay, we need a study. Let's figure out what causes cancer. So they got the best people is updated in 2015. And they said, Okay, let's calculate the population population attribution

fraction, which is basically how much of cancer is due to say, tobacco smoke. So about 35% of cancer is is caused by tobacco smoke. Well, diet is actually at 30%. So it's like, it's almost as high as tobacco smoke. And yeah, way above everything else, like the pesticides and the chemicals, all the stuff we worry about, you know, wood dust and asbestos, those all do cause cancer. But on a population basis, it's almost all tobacco smoke. And we know, of course, to stop smoking, but also diet is huge. Yeah. You know, Jason, I remember in 1985, I think I was on my rotation in oncology as a medical student. And I said to the cancer doc, the oncologist, I said, because I was always interested in nutrition.

And actually, I remember in college, I took a nutrition course and I had a little manual of scientific studies that was on nutrition and cancer back in 1980 right so i was sort of paying attention already back then and i said to the attending physician i said so tell me what do you think is the percent of cancers that are caused by or made worse by diet and i thought he would say oh 10 he said 70 and i was like whoa and i think when you you know when you think about functional medicine and the approach you're taking it's a very different model of thinking about cancer so yes if you have a tumor or something you might need to get it cut out you might need radiation or you might need some chemo at some point but the question that never really gets asked is one why did the cancer develop in the first place and how do I change those conditions?

And two, how do I actually create a healthy immune system and a healthy soil and to actually make sure that the cancer can't grow? And as a functional medicine doctor, I often say we're very much like regenerative farmers where we focus on soil health as opposed to industrial farmers, which use a lot of chemicals, pesticides, basically antibiotics and glyphosate and herbicides to make the plant healthy. And I remember being at this conference on nutrition. I don't know why they invited me. It was all the big food companies, the big ag companies. And I was invited to give a talk, which I did, and I didn't hold back

anything. And I'm sitting next to this guy at dinner. I'm like, so what do you do? He says, well, I'm in plant medicine. I'm like, plant medicine? I said, what is that? He said, well, we make pesticides. So I think, okay, got it. So you know this whole idea that you're bringing forth is so important so talk about this analogy of the seed and the soil and cancer and why we're ignoring soil conditions in the body and the environmental issues and diet and also lifestyle and stress and environmental chemicals all those factors so the the idea of the seed in the soil actually goes way back. I mean, it was written about sort of like 60, 70 years ago. But then, of course, everybody forgot about it. Because the point is that, you know, genetics, you know, this whole

focus we had on finding mutations in genetics really talks about the seed, right? It doesn't talk about the environment that you're in. And if you have a seed, of course, it has the ability to grow, but it needs the right conditions, the proper soil to grow. And what we always seem to not talk about is how certain populations that live a sort of traditional lifestyle almost never get cancer, like other than the ones that we know that are say, virally caused. But if you go back, so Dennis Burkett was this sort of legendary Irish surgeon. And he went to Africa, and you know, he discovered Burkett's lymphoma and stuff. And it's very interesting story. But, you know, he looked at these Africans were eating a traditional diet, living a traditional lifestyle.

And he said, boy, these people just don't get cancer. And the whites, of course, were getting colorectal cancer at the same rate as they were in the UK, for example. Yeah. And so they called these things diseases of civilization. So obesity, type two diabetes, and cancer would come as people change their lifestyle. But you see this actually all over the world. So the Inuit in the far north, they some people used to call them Eskimos. So again, eating a traditional diet very high and say, you know, animal, you know, whale meat and seal blubber and stuff. That's a traditional diet, they never get those cancers that we get. I mean, they get some viral cancers, but they don't get like colorectal cancer, breast cancer. In fact, the University

in Ontario, Canada, used to send an expedition to the Arctic Circle sort of every year to find out why these people were immune. But of course, they weren't actually immune, because as soon as in the 60s, 70s and 80s, they changed their lifestyle to Western sort of lifestyles with the sort of bread and sugar and all that sort of processed foods that we ate, then you started to see all the cancers. So clearly it wasn't a genetic problem because the gene pool of these Africans or these Inuit were not changing, but it was the soil. And it comes back, of course, to diet and lifestyle, which is the most important thing because that's the main thing that's changing

as these people come over. That is what is the biggest determinant of cancer you know these these these anyway go from being considered immune to cancer yeah to high rates of cancer of course they're eating sugar all the time right there's tons of smoking all this other stuff um and you see this everywhere so you see this say in japan where you can look at a japanese woman in japan compared to a japanese woman in san francisco and Japanese woman in San Francisco. And of course, the person in San Francisco has about double or triple the rate of breast cancer compared to the Japanese woman in Japan. So it's like, so this is clear evidence that the most important thing we need to focus on is not the genetics of the problem. It's the soil problem, right?

The seed is the problem. Yeah, I love, my favorite story is the Polish women who are from Poland eat 30 pounds of sauerkraut a year. And they have almost no breast cancer. And it affects their microbiome because it's a pre-probiotic food. Plus cabbage has all sorts of phytochemicals that fight cancer. And when they move to the United States, they get cancer at the same rates as

American women because they stop eating all the sauerkraut. Yeah, absolutely. And these are the things that are really important, because if you can figure it out, of course, then you have the ability to do the opposite, you could take a woman in San Francisco, and, you know, cut her risk of breast cancer by a factor of two or three, imagine how amazing that would be. I mean, with genetics and all this stuff, we're talking about, like, you know, you're making progress in inches compared to diet and lifestyle, where you're talking about huge leaps and jumps, like, you're not talking about like 10% higher risk, you know, in medicine, how we go oh

it's statistically significant there's a 10 lower risk it's like you know these people just never get cancer right it's like it's crazy the magnitude of improvement you can get or on the other hand it's like 10 is 200 or 300 right exactly totally different yeah it's a totally different order of magnitude and yet we focus all of our sort of resources on saying oh let's figure out you know this genetic condition which might affect like one percent of these cancer patients and trying to it's like okay let's let's not do that let's try and figure out the other stuff like what is it is it sugar is it pro is it you know fermented foods is it processed foods like what is that because that's so important but unfortunately it gets so little um sort of research money and you know

you start talking people people want the other stuff right so people are listening and wondering okay this whole soil thing makes sense, right? You want to create a hostile environment for cancer to grow. How do we build that hostile environment instead of a fertile one that most of us have for cancer? Yeah, that's a great question. And so I talk about in the book about like what is it that makes cells grow? And what's really important is sort of growth factors or a body contains natural growth factors that increase the rate of growth.

And one of the big things of the last sort of 1520 years has been the realization that our body contains nutrient sensors, which are hormones that go up when you eat, but they also are precisely the same hormones that our body uses as growth factors. So the most important one is insulin. So insulin, of course, is a well known, you know, metabolic hormone. So you eat and insulin goes up, you know, assuming you're eating carbohydrates and protein, sort of a mixed meal, you eat insulin goes up. But more importantly, what and protein, sort of a mixed meal, you eat insulin goes up. But more importantly, what it is, it's a nutrient sensor tells your body that food is available. And the reason that's important is because your body only wants to grow when nutrients

are available, right? So you don't want to you're saying you don't want more cells to continue to grow if there's no food available. That's not a good survival strategy. So the body links them. In fact, if you look back in evolutionary times, insulin was not a metabolic hormone, it was actually a growth factor. So when as we evolve, we actually use the same molecule that we use as a growth factor for nutrient signaling as well. So we know that insulin is a very potent growth factor. There's this thing called insulin like growth factor or IGF one. And Walter Longo actually described this this group of Ecuadorian dwarves, the laran dwarves who actually have almost no IGF one. So they're very short. Turns out they're also immune to cancer, because if you don't have

that growth signaling, then the cells can't grow and the cells that are going to be the most affected are those cancer cells. So what you have to do, of course, is say that, okay, if we have too much insulin, then that's going to be a signal to our body that we need to grow. So what can you do to sort of reduce that insulin signaling in the body by reducing nutrient availability, which is two things. One is getting rid of the hyper processed foods, which tends to really amplify the insulin response of sugar, for example, is especially bad because it causes all this insulin resistance, which causes hyperinsulinemia. A lot of the refined foods are very bad because they sort of take away all the other natural components and you're left with this big spike of insulin. Like if you eat cookies, for example, well, you know, it's just going to your insulin is just going to spike up. And the other thing,

of course, if you eat very, very frequently, you're going to keep insulin high all the time. So intermittent fasting is another strategy that you could use to reduce insulin. So it's what you eat and when you eat. Yeah, exactly. So it's what you eat and when you eat. Because if you eat a high carbohydrate diet, which people did, like people in China, for example, used to eat a ton of white rice, but almost zero sugar, and they were okay. So it's not necessarily just the carbohydrates. Well, I lived in China for a while. You're Chinese. I mean, I traveled around. I remember 1984. I mean, they had no accoutrements of modern living. I mean, they had to cut a board. They would use a saw to create boards. To grind the flour, they would literally walk in circles for hours with the grain in between two giant stones. They would work in the fields for 14 hours a day with hard labor. And yeah, you can eat a lot of rice if you do that. Yeah, that's true. And it's also like, it was very, it was like rice and vegetables,

like every day it was just rice and vegetables, rice and vegetables. Well, the land of milk and vegetables well the the the land of milk and honey the chinese phrase for it is the land of fish and rice so it's really what they think yeah so so so you're talking about what is the problem which is the incredibly high amount of starch and sugar we consume and you've talked about this in the diabetes code, the obesity code. This is a central driver of almost all chronic Western diseases, heart disease, cancer, diabetes, Alzheimer's, high blood pressure are caused by this phenomena of insulin resistance or too much insulin, which is driven from our diet, basically a highly refined processed carbohydrate diet, and also this constant eating pattern, this thing called snacking, which I think is a modern

invention. We have a snack food industry, but I mean, I don't snack. If you eat properly, you're never hungry. I mean, you don't have these spikes and insulin going up makes you hungry. But what's fascinating is that what you're saying is that insulin actually fuels the cancer growth and sugar fuels the cancer growth. Hi everyone, it's Dr. Mark. As a functional medicine doctor looking at hormones, organic acids, nutrient levels, inflammatory factors, gut bacteria, and so many other internal variables, it helps me find the most effective path to health and healing for my patients. But such extensive testing can be very complicated and time-consuming for both the practitioner, somebody like me, and our patients.

But lab ordering became very quick and painless since I started using Rupa Health. I can order, track, and get results from over 35 different lab companies within a few clicks in one lab portal. And this means one invoice for all labs paid online up front. Plus, patients get practitioner pricing and receive full patient support through easier personalized collection instructions, automated follow super bills and answers to testing questions and so much more. And best of all, it's free for practitioners. So sign up free today. You can find out more information by going to rupahealth.com. That's r-u-p-a-health.com. All of these diseases are actually diseases

of too much insulin. So if you look at obesity, for example, if you were to measure the levels of insulin, people who are more overweight tend to have higher insulin. Same with type 2 diabetes. Hyperinsulinemia and insulin resistance are really sort of two sides of the same coin. So one causes the other. Hyperinsulinemia can cause resistance are really sort of two sides of the same coin. So one causes the other sort of hyperinsulinemia can cause insulin resistance, insulin resistance and cause hyperinsulinemia. So they're really the same thing. And again, the same thing applies to sort of cancer. And this is the pattern that was noticed so many years ago that there are these diseases of sort of too much insulin, which is that that sort of they all go together the heart disease, and you don't see that in people eating traditional diets, because they're not eating all the time. So I remember there was a study of this NHANES

study, which is a big sort of American survey of lots of things, but they included dietary habits. So in 1977, they found that most people ate three times a day, so breakfast, lunch and dinner. And by 2004, it was almost up to six times a day, right? So it's like, wow, that's crazy. And it was never this sort of deliberate, hey, there's good scientific evidence that we should eat six times a day, it just sort of crept in there. And I think part of it was, of course, the snack food companies wanted to promote it. And, you know, people thought it was a good idea. So then it was sort of, it became almost gospel. Oh, you have to eat six times a day, right? And I remember thinking about it a while ago and thinking, where did that

suddenly sneak in? Did we have a big randomized controlled trial that I missed somehow? Because I don't think so. It was just this gradual change in attitudes. And you saw it because I start to think back to my upbringing in the 70s, right? So, I grew up in the 70s. And, you know, if you wanted a sort of after school snack, your mom said, no, you're going to ruin your dinner, right? And if you wanted a bedtime snack, your mom would say, no, you should have ate more at dinner. And it's like, that's just the way it was. And of course, people would have this sort of natural fasting period from after dinner, which was say six o'clock, because people ate a bit earlier back then to like, say eight o'clock. So 14 hours of fasting every single day without even we call that breakfast yeah exactly breaking the fast breaking

the fast that is the word that we use and it's like somehow we went from that where people didn't have the obesity problems type 2 diabetes problems because they have this natural fasting period built in that has always been there it's's even built into the English language. And then it's like, oh, you got to eat all the time. And it's like, oh, you can't ever skip your breakfast, you got to snack all the time, right? You see it in schools, for example, oh, they go to school, they get a mid morning snack, then they have lunch, and then they have their after school snack, and then they have the dinner, then, you know, you're playing soccer, and they think that they need to have a snack in between the halves of soccer you know i played

well jason you've written a lot about you've written a lot about fasting and and the effects of either time restricted eating which is you know 12 14 16 hour fast every day or taking a 24 36 hour fast a week or even longer fast for diabetes. And I'd love you to sort of share why around cancer this is so important. And on my podcast soon, we're going to have Dr. Patrick Hannaway, who is my colleague and friend, was the medical director at Cleveland Clinic, who had cancer and used fasting as an approach to his cancer treatment. He still got radiation, but he also did it in a way that actually reduced all the side effects to almost none, has kept him healthy now for well over a year, and his cancer was not a great one, and let him go through the process with really no issues, which was really

staggering, and really went on a ketogenic diet in order to do that, which is both using fasting and ketogenic diets to drop insulin levels to almost undetectable. So can you talk about this whole idea of fasting, cancer, ketogenic diets, why it's so important, and how it connects to this whole idea of insulin resistance and insulin, high insulin levels? Yeah, so both fasting and ketogenic diets have the same sort of goal at the end, which is trying to lower insulin. Because the difference between a ketogenic diet, say, and a low-carb diet is that, you know, you're sort of low-carb, ultra-low-carb for the keto, but sort of moderate protein. Because protein can also stimulate insulin.

Whereas some of the older low-carb diets were, like, very high in protein. You take protein shakes or whatever it is. Like Atkins, right? Yeah, like Atkins. Not a good idea. very high in protein, you take protein shakes or whatever. And that's generally not, yeah, like Atkins. And so high protein is not always the best idea because you can get high insulin, but you also get this high mTOR, which is sometimes not so good for cancer as well. But the idea is to really drop your insulin levels. And if these are diseases of too much insulin, then that's going to be a very useful adjunctive treatment. So fasting is, is actually fascinating, because there's all these different things we're discovering. So one of the things is sort of autophagy. So as you fast, of course,

your nutrient sensors go down, so mTOR insulin go down, and then you activate this process called autophagy, where you actually start to break down some of your subcellular organelles and stuff. So basically, your body's just trying to clean house. It's like Pac-Man coming around and cleaning up all the garbage. Yeah, exactly. People think it's a bad thing. Maybe people don't know who Pac-Man was, but that was the original video game that we all played back in the 70s.

Pretty simple. Very exciting though. Yeah. I don't pretty simple. I'm very excited now. I don't even know what Pac-Man is anymore. You can still find them sometimes. But yeah, the idea is that people think that this sort of breakdown process is really bad for you, but it's actually really good for you. And in fact, it's sort of one of the keys

to rejuvenating the body that is you want to break down all your old stuff, and then sort of rebuild the stuff that you need. So the whole idea of fasting is you're trying to put the body into this sort of regenerative maintenance mode. Because what we've recognized over the last little bit is that your body sort of has sort of, you know, you can go into growth mode, or you can go into sort of the cell maintenance repair mode. And it really depends on your nutrients availability, when nutrients are available, you want to grow, when nutrients are not available, you don't want to grow and you want to go into this sort of maintenance repair

mode. And everybody thinks growth is good, but growth is not always good, especially as an adult. So I always say think think about a car. Like if you have a sports car and you rev that engine and you're running it fast all the time, you're going to go fast, which is great. But it's going to burn out much faster. So you can't just keep revving that engine, keep redlining it. You've got to sometimes bring it to the shop, put it in the garage, let it rest and all this stuff. A pit stop. Yeah, exactly.

A little pit stop. So that's the point of the human body too. You can either go for growth or you can go for longevity or cellular maintenance repair. But you got to have a bit of both. It's a balance there. It's not all growth. And this is where you say, oh, eat, eat, eat, eat, eat. Well, you're going to put your body, your nutrient sensor is going to go up.

Your growth factors are going to go up. you're going to put yourself in growth mode. But you don't want to do that, especially for a disease such as cancer, which is a disease where cells are growing too much, you're basically feeding into that growth. And that's going to be very, very bad for you. So what you do instead is you do the fasting and you put your cells into this sort of maintenance repair mode. And it actually allows you to undergo the both the chemotherapy and probably the radiation therapy better. Because ray chemotherapy, we have a couple studies on fasting and chemotherapy, where what you do is you fast sort of just before and during and just after your chemotherapy. And what they've noticed is that those people

tend to get a lot less side effects from treatment. Because what you've done, of course, is taken the cells of your normal body, and you sort of put them into a more quiescent state, they're not trying to grow, they're actually trying to slow down and chemotherapy, the general way it works is it kills the fastest growing cells, which are usually the cancer cells, but also kills like the hair follicles, because they're fast growing cells, it kills the lining of the GI tract, so you get nausea in your hair falls out. So if you can put those cells into sort of a quiescent sort of repair mode, it's not going to sustain as

much damage from the chemotherapy. And instead, the cancer cells which can't stop their growth, they're always trying to grow, they can't do that. So therefore, they're going to sustain full damage from the chemotherapy while your body is relatively protected. And that's one of the things that might be very interesting to use as an adjunct to sort of standard treatment. I would never advise not to take the standard treatment because of course you know there's a lot of interesting work by dr mukherjee and others looking at ketogenic diets and cancer and i've heard him present on this it's just fascinating he wrote

the emperor of all maladies it's about cancer i'm sure he read that and he said that uh to me he said mark you know we figured out the solution to cancer. I'm like, what is it? It's this big discovery. He's like, and the cause. I'm like, what is it? He's like, it's sugar. I'm like, yeah, you know, I guess that's not really news, but maybe it's good you know that now. And then he said, we've been studying ketogenic diets and seeing incredible results with pancreatic cancer, melanoma, stage four cancers that weren't responding to anything else. They're animal models. They literally were curing cancers with ketogenic responding to anything else. They're animal models. They literally were curing cancers with ketogenic diets. And now they're doing human trials. Can you talk a little bit about some of that research and how it might be applied to people who are struggling with cancer? Yeah. So this was the sort of big discovery of Dr. Luke Cantley, who's discovered sort of this whole pathway, the PI3K pathway that links sort of

insulin and growth and cancer. So the important thing is that insulin, it acts as that growth factor, and therefore acts as a sort of pro growth, and therefore a sort of pro-cancer agent. Sugar, of course, plays a big role in the hyperinsulinemia. And it's interesting because Dr. Lucantli in several of his, you know, articles or whatever, he goes, sugar scares me, right? Here's this guy who studies cancer for a living. And he's like, yeah, sugar just scares me. And that's the same sort of thing that Siddhartha Mukherjee is talking about too, right? And that's the same sort of thing that Siddhartha Mukherjee is talking about, too, right? And that's the whole point is that with ketogenic diets with fasting, and of course, fasting, you have to cycle it because you can't obviously fast, you can't

fast forever, right? As opposed to ketogenic diet, which is sort of very low carbohydrate, you could sustain that for years and years, you can't fast forever, you need some some some food at some point. But the idea is the same, what you're trying to do is really reduce those insulin levels. There's, of course, studying this, in terms of drugs are trying to develop these blockers to the whole pathway of PI3K, and so on. I think they've, they've developed a couple companies for that. But, you know, just like anything else, it's like, why would you want to do it with a drug when you can do it with your diet? You know what's so striking, Jason, is that, you know, often when people go get cancer treatment,

their doctors make sure you keep your weight up, eat ice cream, eat milkshakes, have cake, you know, and I'm like, why are you telling them that for? I mean, that is death. And yet it's, I mean, I actually had a radiation oncologist as a patient who worked at MD Anderson. And he was very aware of these studies and these issues. And he tried to tell his patients to do the right thing. He said, all the nutritionists, and this is like the number one cancer hospital in the world, are telling their patients to eat a lot of starch and carbohydrates and sugar to keep their weight up.

And it's just such an unfortunate situation that is going on right now. I try to design my days in my life to actually help prevent all chronic disease, whether it's heart disease, dementia, Alzheimer's, cancer. And it's not like you have to do different things for everything. It's like similar therapies will actually help all of these. So I double down on diet every day. I really make sure I have high quality nutrient dense food full of phytochemicals that are anti-cancer, full of good omega-3 fats, low in starch and sugar. And it actually has a lot of nutrients and things that I can help my body actually handle a cancer. So diet is huge. Exercise, I do that regularly to help get enough sleep. Stress reduction, also very important because your thoughts and feelings do affect your cancer risk too. That's for sure. And then I make sure my nutrient status is optimized

with vitamin D and the B vitamins by taking the right supplements. This is sort of my daily maintenance approach. And then I do other things that I think can be very helpful. I like to do ozone quite a bit because I find it very helpful for me. I think it can, it can be an early treatment for, for, um, you know, just kind of boosting your immune system, helping increase your antioxidant enzymes, reducing inflammation, increases stem cells. So it just helps the body to build a stronger terrain and be able to fight whatever's going on. Um, and who knows, you know, there needs to be more research on it. I think there's some controversy about it but i think there's some really interesting options there there's different people using hyperthermia for cancer raising the body temperature and getting treatment that way

there are other therapies you know that are more aggressive dietary approaches but i think it'd be you know building a comprehensive team that focus on lifestyle and that also try some other modalities that could be helpful and to look at the ways in which you know um whatever cancer let's say i would have what it responds to best or least or so there's some personalization involved but i think there's a lot of options now around cancer and cancer therapy that are pretty exciting high dose ib vitamin c there's people looking at compounds that are derived exciting. High-dose IV vitamin C. There's people looking at compounds that derive from marijuana plants. There are people looking at various kinds of immunotherapy and vaccines, as well as things like ozone, hyperthermia, and other things. So there's a

lot of research that needs to get done for some of these things, but it's really promising in my mind that we'll be able to sort of lick this. So Mark, is there a case study that comes to mind of someone who you were part of their cancer team? You don't work with a lot of cancer patients directly, but you might work with a team who would be helping them from a functional medicine standpoint. Is there a case study that comes to mind on the topic of cancer? Yeah. I mean, years ago I had a patient with prostate cancer and you know, it was fairly aggressive and he needed a bunch of therapies, but we were able to really keep it under control through aggressive dietary approach, a bunch of different supplements that helped,

fixing his gut, getting rid of heavy metals. So we kind of cleaned up his whole terrain and he did remarkably well and lasted well over 20 years, which is a long time with cancer. So I felt like, you know, he probably would have been dead a long time ago if we hadn't have used this functional medicine approach and created an integrated model where he, well don't know when we see regular care,

but he received sort of the adjunctive care that helps support the body in its own healing and repair process. Well, about, uh, I'll have an anecdote that I'd like to toss in, which is, uh, my mom was diagnosed with breast cancer and this was about, uh, ago and uh after her diagnosis we put her team together she had a traditional oncologist through her normal insurance and hospital system she was at a great hospital uh christianic care in delaware and as part of that we uh understood the importance of making sure we had a functional medicine doctor in the mix. So we had a cancer survivor herself, Dr. Liz Boehm, who was one of your colleagues and the medical director of the Ultra Wellness Center, was her main doctor. And so with her oncologist and Dr. Boehm, who's a nutritionist, a medical

doctor, and a cancer survivor. And then there was one other person, sometimes individuals will use sort of like a cancer CEO. There's a gentleman named Ralph Moss. He's a PhD cancer researcher who was previously at Sloan Kettering. And he has a website called cancerdecisions.com or.org. We'll link it in the show notes. And he walks through every major cancer and talks about all the centers around the world that have had good results in treating that cancer. Some places like you've visited in the past as well, like San Aviv in Mexico and some clinics out of Germany. So he met with my mom as well and he does consultations. They're a little pricey around like $700, $800, but well worth it. And with the combination of those three individuals, my mom's traditional oncologist, Dr. Liz Bohm, Dr. Ralph Moss, they worked together to put together a protocol for my mom,

which included putting her on a ketogenic diet, getting her off of all the foods that were consistently spiking her blood sugar and making her insulin resistance, which were all the Indian vegetarian foods, unfortunately, that she had been grown up eating her entire life. Yeah, yeah. Doing a complete oil change, getting her off of all the inflammatory oils, getting her to have high quality proteins and things like omega-3s in her diet and a bunch of other changes. And knock on wood, we were able to catch it early. And eight, 10 years later, she's doing fantastic. And about two years into her treatment, she was officially diagnosed in remission. Obviously,

every cancer is different. Every patient is different. But that's another anecdote that I just wanted to talk into mix, add into the mix about what it looks like when you have a team approach to tackle something like cancer. It's so important. I think you mentioned something I forgot to talk about earlier, which is in terms of dietary interventions. There's a lot of research now going into ketogenic diet research and cancer. And in animal models, it's, you know, stage four pancreatic cancer, stage four melanoma are literally being cured with ketogenic diets.

And Siddhartha Mukherjee, who wrote The Emperor of All Maladies, who's one of the top cancer experts in the world, and won the Pulitzer Prize for that book on cancer, is doing a lot of clinical research now with humans and ketogenic diets. Also groups like Walter Longo and his work around fasting mimicking diets or calorie restriction, which also can put people in a more of a ketogenic state, was very effective in helping chemotherapy be more effective, radiation be more effective. So it's not an either or, but it can be an adjunctive treatment. My friend Patrick Hannaway, who is the medical director with me at Cleveland Clinic, ended up getting throat cancer and he ended up being on a ketogenic diet

and almost had no side effects from treatment, is doing great a few years later. And his risk was 50-50 on that cancer. So really impressive to see the work that's being used around ketogenic diets and cancer. I want to think about this in a totally different way. We've got to look at how all the different systems in the body impact if you're going to develop cancer or not. We've got to pay attention to the terrain in the body, the soil, the things that are feeding the cancer cell. And, you know, so each person, it's different. For me, I had to really focus on supporting my microbiome and detoxification and stress. But for somebody else, it might be really working on reversing insulin resistance, right,

or diet. And so there's so many, it's really important to have a real personalized approach here. And it makes a huge difference. Yeah, it does. And I think what I want people to understand is that we strongly support the use of traditional cancer treatments, whether it's chemo, radiation, or surgery. But it's not enough because it's treating the cancer, not the patient, and the soil in which the cancer grew. And so functional medicine is an approach that really treats the soil

so the cancer can grow back or that you won't get it in the first place. And I think that's a really unique approach. It's not either or, right? It's not like, oh, just have green juice and your cancer is going to go away. Forget that. You know, you need to deal with it.

But using supportive treatments, it works better. We have a colleague and a friend who recently had throat cancer. And, you know, it's 50. We have a colleague and a friend who recently had throat cancer and you know, it's 50-50 on that, but he did a ketogenic diet when he was going through treatment. Now there's a lot of science on this and one of the top cancer specialists, Siddhartha Mukherjee, who's wrote The Emperor of All Maladies, is doing a lot of research on ketogenic diets and cancer. And he came up to me once. He says, Mark, we made an amazing discovery about cancer.

I'm like, what is that? I said, is it sugar? He's like, how did you know? I'm like, yeah, well, it beats the cancer. And he said, we're finding that using chemotherapy along with ketogenic diets or even the fasting mimicking diets, different approaches, intermittent fasting can actually help the chemo radiation work better and have higher cure rates. And then, and so-

Because it puts those cancer cells, they're stressed in those situations, so they can't survive as well. And so the chemotherapy kills those cancer cells in those, when you're, when they're on, when somebody's on a ketogenic diet or a fasting mimicking diet, those cancer cells are more at risk. And so they die off. Because they only eat sugar. They can't, they can't live on fat.

Right. So we have like a, we're hybrid. Yes. So we can run on, you know, gas or electric, right? Right. Well, same thing with your body. You can run on carbs or on fat. Yep.

And when you run on just fat, it changes your metabolism and the cancer cells only run on sugar. Yep. So they don't, they starve. So this is just one example of the kinds of things we do in functional medicine to help our patients do better through treatment and actually prevent it after and to actually not get it in the first place. So people feel sort of helpless about this, but there's so much we know about what causes cancer, the things we can measure and test for,

the things that you sort of discovered on your own. And I think it's sort of shocking for people to understand that traditional medicine just doesn't even talk about this, right? Right, they're so focused on the cancer at the acute time, which is important, but we've also gotta really work on, let's prevent, we prevent it from coming back. Let's prevent it from coming in the first place. And the dietary advice is terrible

you get in cancer centers. I have a friend who was a top radiation oncologist at MD Anderson, which is like the top cancer center in the world. And he was like, our nutritionists, I'm just struggling because they say, if you have breast cancer, don't eat tofu, but you can load up on ice cream. Right, which is so backwards. Eat the tofu, forget the ice cream. They don't say stop drinking wine or don't eat

ice cream or sugar, which is driving the cancer cells. Right, right. Creating a terrain in the body, which is feeding cancer, right? So absolutely, we're looking for all those things that may create a terrain that will feed cancer, whether it's high insulin, high blood sugar, high insulin levels in the body, high inflammatory markers, so high inflammation in the body, which will drive cancer. Yeah, cancer is inflammatory. People don't realize that. Absolutely, right?

So we look for that. We test for markers that measure inflammation. And then we'll try to figure out why is there inflammation and what can we do to lower it. For some people, it might be the insulin resistance that's driving the inflammation. For somebody else, it may be the gut and imbal know, the insulin resistance that's driving the inflammation. For somebody else, it may be the gut and, you know, imbalances in the microbiome that's driving the inflammation. So we really want to look deeper. Or toxins.

Absolutely. So when you go to a traditional oncologist, they're just looking at the pathology. They're not looking at the biology, right? And they don't actually look at the terrain which is your nutritional status your stress level your your level of toxins right yeah your toxins yeah your microbiome your genetics around i mean they look at some genetics but it's not the kinds of things we look at which are more functional things and i don't know not the brachygene which is right but you know it's interesting you know the brachyg you know, back in the 40s, they sort of had records around this. And then, you know, the risk of cancer was like 30% if you

had the BRCA gene. Now it's like 70%. Why is that? Same gene, because the environment's different. Your diet's different, toxic load is more, stress is more, all these other variables are affecting the gene expression. So even if you have the genes, you're not necessarily predestined to get something. Right. So we call the BRCA gene like a high impact gene, right? It increases risk substantially of breast cancer, but so many women don't have the BRCA gene and still go on to get breast cancer. So we also look at these low impact genes, genes that we can really influence with the environment, genes that aren't going to cause a huge increase in risk of cancer, but if you've got multiple different ones together, they can influence your risk.

And what's most important with those low impact genes is we can really influence how they express themselves with our environment. So we can influence the expression of some of our genes by eating a diet that's really rich in our cruciferous vegetables and sulforaphane. The broccoli family. Yeah, the broccoli family. So, and we can maybe influence how these genes work by different supplements or different changes in diet. So like I had a woman who came to see me, she was 42 and she had an estrogen receptor positive breast cancer. So, and she went through surgery and then they did tamoxifen and she came to see me because she wanted to prevent this from coming back, right? So she's like, I really want to figure out why this happened and want to prevent

it from coming back. And so we did multiple different, you know, evaluations on her. And one of the things that showed up was when we did some genetic testing again those low impact genes we found a variation in the COMT gene and the COMT is a gene that encodes for this enzyme catechol all methyl transferase which is mouthful but that has to do with what yeah it has to do with methy? Yeah, it has to do with methylation, right? But it's been found that methylation just means the transfer of these methyl groups, which come from a lot of our folate, our B vitamins, like folate, which is in all of our foliage, our green leafy veggies, you know? There's a carbon and hydrogen that has to be shared between different

chemicals in the body. And if it's not working, you get all kinds of problems, whether you get cancer, you get dementia, you get heart disease, you get depression. So these have to be working. Yes. And so if this enzyme doesn't work as well because of your genetic predisposition, then your estrogen in your body doesn't get broken down and gotten rid of as well. It can become more cancer producing. It can change in a way that's less healthy for the body. And so we know that we can influence

that gene when we give a diet that's rich in folate, all those green leafy veggies. We can sometimes influence that gene with, we often give like methylated B vitamins. I think this is- Special forms of B vitamins. When you go to your grocery store, you get folic acid or B12. It may not be the right form to actually activate these things or to bypass these enzymes that aren't working so well in the body. Yeah. I mean, we have a concern about folic acid, which is the synthetic form of folate. So folate can be what we get in our food, right? Our foliage, our green leafy veggies, lots of other foods too. There's a synthetic form called folic acid, which actually has been associated with maybe an

increased risk of cancer. There's some concern about this synthetic form. And that's found in a lot of not, you know, not the highest quality, not the vitamins we use, right? So that's found in a lot of not you know not the highest quality not the vitamins we use right so it's found in some b vitamins and multivitamins that we're not going to choose to use because because for some people they can't utilize it in their body what you really want to look for is a methylated form of folate so this type of folate that's activated um that's found in a lot of our food. Like when we're eating folate-rich foods, it's going to be high in this methylfolate. But if you're taking your supplements, if you're taking a multi or a B complex,

you want to look to make sure it's a methylated form of folate. Because the body, for certain people, that's more necessary than others, but the body has an easier time utilizing it yeah and that helps with this whole estrogen metabolism process back up on that you know so people think there's something called estrogen there isn't there are estrogens yes and they're all a little different and some are more prevalent in you know early life some in reproductive years I'm in menopause and they all have to be metabolized by the body. And it's sort of like going down a pinball machine. You don't know where it's going to go.

And some people don't have good detoxifying mechanisms for all this estrogen, and then they get sort of estrogen toxicity. And I think one of the things that's really striking about what you're saying, particularly in terms of breast cancer, is that this woman had estrogen receptor positive breast cancer. And what that means is that this is an estrogen sensitive breast cancer. It feeds on estrogen. And so the beautiful thing about functional medicine is that we can, one, test for all these metabolites and figure out how to change the pinball thing so it's going down the right pathway to be anti-cancer versus pro-cancer. And we use lifestyle diets, supplements, all kinds of things to do that. But what's really important to understand is that a lot of us are out of balance and we have imbalances in our hormones and we make too much estrogen and maybe not a progesterone. And that

leads to symptoms of estrogen overload. And I remember, you know, medical school wasn't a very nice way to talk about patients, but we remembered, how do we remember the profile of someone with uterine cancer? Fat, 40, and fertile, right? Which is essentially saying high estrogen. And if you're overweight, you make higher estrogen. Obesity is linked to cancer. It's linked to breast cancer. You know, insulin resistance and prediabetes is linked to breast cancer and many other cancers. We have this enzyme aromatase in our fat cells.

And aromatase takes other hormones and turns it into estrogen. And this happens in men and women, right? So when you have more fat cells, you have more aromatase. And so you have more estrogen. And so that then is why, or maybe one of the reasons why that, that, uh, obesity, having more fat cells is linked to estrogen related cancers, which would be breast, uterine, prostate is, is definitely related to this higher estrogen level in the body, for example. So, so, you know, one of the things everybody can do is make sure their body fat percentage is lower.

Yeah. Yeah. Right? Because that helps with lowering estrogen levels. And we actually have a whole strategy for when assessing this in functional medicine, which is not what your traditional doctor will do if you go to breast cancer treatment. And we have a whole strategy for how to balance out your hormones, right? Yes. So things like diet, exercise, stress reduction, working on your microbiome, the right nutrients, getting rid of toxins that screw up your hormones, all these things fixing your liver.

Right. These can all really help. Fiber. Yeah, we really want to pay attention to those xenoestrogens, right? Those are those toxins from the environment that act like estrogen in the body. Yeah. So those are environmental toxins, things we know about like BPA, plastics, parabens, pesticides.

They- So you put your sunblock on, you get all these parabens, maybe you're causing cancer. Right, right. And they, because they can bind to, they're xenoestrogens, they're chemicals from the environment,

but they can bind to the estrogen receptor in the body. So they're like hormone mimickers. Yeah. And they're effective in powerful, extremely low doses. So I'm not that exposed to pesticides or like any damage parabens or whatever. They work in a microscopic dose to have a macroscopic effect. Yep. And they're synergistic. So people say, oh, this one chemical, maybe it's not so bad in animal studies, but we're exposed to hundreds and maybe thousands of these chemicals all at the same time.

And our different abilities to detoxify them affect our risk. And particularly in cancer, we know that these chemicals are associated with cancer. So how, when someone comes in with, let's say, breast cancer, what are the kinds of tests we'll do? What are the recommendations you'd make? And you have a whole incredible DVD I encourage everybody to get. Tell us about the DVD. So it's called Breast Wellness, and it's tools to prevent and heal from breast cancer.

And it looks at the functional medicine approach to breast health. And where can they get that? They can get it at my website, drboham.com. They can also download a free e-book there. I think it's also on Amazon and Vimeo. It's everywhere, right? There you go. There you go.

Actually, it's on our UltraWellnessCenter.com too, yeah. So, what do we do? So, you're looking at that comprehensive approach and treating that individual patient, right? And we're focusing on, is there toxins that we need to lower? You were mentioning that aspect of toxic load, which I think is really important, you know, because we know that sometimes it's not just one toxin, but it's a little bit of a lot of different toxins. So we can look at things, we can measure things like, is there high oxidative stress, right? That's like free radicals, right? Yeah, right. Which would indicate

an imbalance between the antioxidant levels in the body and the free radical production. So sometimes when somebody has oxidative stress, that just means that they've either produced too much free radicals because of toxins or infections or they don't have enough antioxidants. Because they're not eating enough of the phytonutrients that are the plant foods that are rich in antioxidants. And when we see that oxidative stress, which we can measure, we really work to lower it with a phytonutrient-rich diet. Sometimes we then have to look to see, well, why is it high in the first place? That's asking that question, is there some infection? Is there some toxin? Because you've got to figure out why so that you can help with insulin resistance, pre-diabetes, weight, that belly fat, gut issues. You know, you talk about how you measure the poop of patients with breast cancer. Why is that relevant? Right. Because there's, I know, right? Like how is the

poop connected to, well, there's a microbiome in the breast. Yes, right. And they're finding that the microbiome in the breast is different in women who have breast cancer. So there's so much more we're going to learn here. But in the gut, we know that if there's an imbalance in the microbiome, there can be an imbalance in this enzyme called beta-glucuronidase. It can increase, which can then lead the body to absorb back more of the estrogen and then put you in this situation

where you're more estrogen dominant or overloaded. So basically there's like overgrowth of these bugs that shouldn't be there that produce this enzyme that then when the estrogen is detoxified by the liver and dumped in there in the bile, which is how your body gets rid of excess estrogen, it sort of unpacks it a little bit and then you end up reabsorbing it. And so you get this increased reabsorption of estrogen, high levels of estrogen in breast cancer.

So we're looking at that level. We can measure that. And we can measure just the imbalances in the microbiome, which are impacting that level as well as multiple other things in the body. Yeah. I mean, given the view of functional medicine, which looks at root causes and systems, you know, the fact that antibiotics cause breast cancer is not a surprise. No. And I had, as a kid, I was on multiple rounds of antibiotics for urinary tract infections again and again and again. And then that just was probably the thing that along with some of my genetic predispositions and, and, and some toxins, you know, really allowed, allowed my body did not work in an optimal way. I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in. Hey everybody, it's Dr. Hyman.

Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you do is go to drhyman.com forward slash PICS to sign up.

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