Transcript
WEBVTT
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What are we talking about today?
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Why am I talking about this stuff?
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What?
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What's your point, Leia?
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I'm Dr Tina Kaczor and as Leah likes to say I'm the science-y one
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and I'm Dr Leah Sherman and on the cancer inside
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And we're two naturopathic doctors who practice integrative cancer care
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But we're not your doctors
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This is for education entertainment and informational purposes only
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do not apply any of this information without first speaking to your doctor
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The views and opinions expressed on this podcast by the hosts and their guests are solely their own
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Welcome to the cancer pod Hello, Tina.
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Hi.
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So I'm starting to get into spooky season.
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we're gonna talk about some things that might be considered scary to us.
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All right, so we're doing an episode of what people shouldn't do during treatment, and that is scary in a
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It's scary.
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It's kind of spooky.
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Knowing all that we know over 20, well, in my case, 20 plus years doing naturopathic oncology.
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In your case,
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I don't know, 10 something.
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I don't know.
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I don't pay attention
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like 15,
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it 15?
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No, I don't know.
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I don't know.
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I, you know, I saw a post where somebody commented that 2013 was 10 years ago and they were like, yeah, it only seems like it was six or seven years ago.
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And that's kind of where my brain is like, I don't have any sense of time, but um,
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Mine just conveniently.
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And you know, I graduated in 2000, so mine is kind of like self calculated every
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Yeah, you're a good round number.
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I am, I'm not, and the math is not my forte, so I
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That's right.
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That's right.
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I forget you're a verse.
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I'm a ver a math averse.
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You should see me with patience.
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If I have to calculate something, I'm like, so sorry.
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But, um, yeah.
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So this is our, uh, It's not our, never have I ever,'cause I'm sure way back in the day, there may be things that we were like, oh yeah, that's not a bad thing to do.
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But, you know, information changes, treatments change.
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We get smarter,
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Well, we get wiser.
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we practice, you know, with practice comes some, you know, improvements.
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So that is what medicine is.
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And with practice, I think, know, we become more conservative.
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Yeah, it's true.
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And, and it is, it is a funny word, practice because I think of it as literally that when people practice medicine and, that what that means is your clinicians practitioner of any kind is through time and observation, getting better at what they do.
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And so, don't discount experience.
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It's great to have young.
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People as practitioners'cause they know the latest and the greatest and the cutting edge.
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And, and then it's kind of nice to have someone who's been out a decade, two decades, maybe three decades, to uh, kind of bring in the things that aren't in print and you can't find on Dr.
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Google.
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nothing replaces experience anyways, that's in a grand gestalt of things.
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And so you, you definitely, I mean, I think we both do.
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We look at the risk benefit of everything that we do.
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And so there might be two people with the same treatment and we're not necessarily doing exactly the same things, based on their goals with treatment, their personal medical history, and all of that.
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yeah.
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And today's episode is really about some things that you and think are risky.
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Too risky during treatment relative to the possible benefit, and qualifying this with during treatment.
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Because during treatment, you're trying to get a certain response from your treatment, whatever percentage that is.
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If it's, you know, 70% of people respond, or 90% of people respond to a given treatment.
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Great.
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What we don't want to do is lower that percentage, so we don't wanna take something that works 90% of the time and risk making that 85 or 70 or less.
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So the risk during treatment really is in getting in the way'cause in the studies, whether it's chemo or radiation, or even immunotherapy, the studies are done without any adjunctive integrative.
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Natural agents or anything like that.
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So we know those numbers.
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What we don't wanna do is ever even theoretically get in the way of success
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Okay, so let's start off.
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So what's the first thing that you would avoid with treatment
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across the board.
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across the
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Well, I would.
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Say avoid anything that boosts glutathione or taking glutathione itself.
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'cause there's supplements with glutathione in them.
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There's supplements that support glutathione and glutathione.
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Not to be confused with glutamine, which is an amino acid.
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Glutathione is.
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A means in our cells to rid them of some of the assault that's going on normally great out in the world today.
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I'm not getting treatment.
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I'm out in the world.
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I smell some smoke from the forest fires, glutathione within my cells helps my cells be healthy and detox, anything that claims to boost or increase your glutathione should be avoided during treatment.
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And I do have a hierarchy when it comes to this point.
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If you're taking radiation, absolute radiation works by.
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Creating oxidative damage and glutathione is a powerful antioxidant within your cells.
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So radiation don't take anything that supports glutathione during radiation.
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That's an acetylcysteine, that's lipoic acid, It's juicing.
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It's even taking your Vitamix or your juicer and throwing in greens and berries and nectarines or mangoes or whatever you put in your juicer and making a mishmash of.
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Highly colorful vegetables and drinking that during radiation.
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It's a big no-no, I think it could defeat the actual treatment.
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Glutathione is a very powerful antioxidant that is made within our cells.
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We create glutathione, and so whether it's a supplement or you're juicing, you are increasing your own production of glutathione, which could.
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Take away some of that oxidative damage that you need.
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It's the point.
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I mean, that's the, that's the point of, of radiation is to create oxid and, and some chemotherapies is to create that oxidative damage.
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so that's why I say radiation is first a hundred percent of the time, don't do anything to support glutathione.
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Chemotherapy depends a little bit on which chemotherapy drug, and if you don't know one from another, which ones are working through oxidation and which ones are not, then I would say don't do it while the chemotherapy is actively killing cancer cells.
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And then with immunotherapies it's a little different.
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And immunotherapies, there might be some room for this, but I would take it on a case by case.
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'cause immunotherapies, there's a lot of different types out there.
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And that would be a case by case basis, but
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People don't always just get immunotherapy.
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Sometimes they do, but sometimes they're getting immunotherapy while also getting other systemic therapies, whether it's an oral pill or it's, you know, chemotherapy infusions or something.
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and that's what gets really confusing these days, is that it's not just straightforward.
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Treatments.
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It's, you know, it's a lot more nuanced.
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Yeah.
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So interestingly, I had a patient ask, they've been using this patch that's like one of those anti-aging patches, and I'd never heard of it before.
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I didn't even know these things existed, um, to be honest.
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And they were gonna be starting treatment with radiation and.
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I said, well, let me look into this patch'cause I'm not familiar with it and I could find a lot of information online.
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But the promotional material for this product talked about it supports glutathione as part of this anti-aging process.
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And so they were using it for anti-aging, for, aches and pains and All of these other symptoms they were having that was unrelated to their cancer.
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And I didn't know if the patch did what it claimed to do, but it it claimed to support glutathione.
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And so that was a, no, that was a, that was an easy no.
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Mm-hmm.
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During treatment, yeah, whether the patch works or not in that fashion, it's
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It It did.
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Yeah.
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It didn't matter even if it was, you know, just, you know, a bunch of hooey.
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And the other thing that the patch purportedly did was to support stem cell growth.
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Another anti-aging kind of thing out
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Yeah.
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Yeah.
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So that would be like a number two type of a thing of not wanting to do when you have active cancer and going through cancer treatment is to support stem cell growth.
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Right, because you don't know if we can differentiate between normal stem cells and cancer stem cells,
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Yeah.
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So that was a another way for me to be like, This other point that it's making.
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not worth the risk.
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yeah, it's not worth the risk.
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And so this is something that we do as part of our job.
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It's not just kind of like, oh yeah, no, that's a great product.
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Or you know, like I spent a lot of time looking into this product and contacted the patient and they were really appreciative of the information, like the, and the time that I spent.
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So yeah, the stem cell thing.
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Was really interesting because there are more products than just patches that purport to do that.
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Yeah, I think a lot of the things within the anti-aging community can be dangerous during treatment and even after treatment sometimes, Because of the characteristics of aging and the characteristics of cancer overlapping.
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So if you look in the hallmarks of cancer and the hallmarks of aging, you can see that there are similarities and we have to be careful that we don't help immortalize cancer cells along with our own.
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While, while trying to become immortal ourselves.
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Yes, I don't, I'm not a huge fan of the anti-aging idea.
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I think we should just, Embrace aging and have more respect for the whole process, and maybe look to our elders instead of thinking that it's a bad thing.
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I mean, it's quite the, it's quite the gift actually.
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Well, I'm a, I'm a fan of, trying to age gracefully without doing anything that's,
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Yeah.
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Because going through treatment, you really do feel a lot older, and I know I am older.
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My diagnosis was almost 10 years ago, so I definitely am older, but I always felt younger and now I'm feeling my age.
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And so yes, I understand the desire for anti-aging, but there are things that can be done that cushion.
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Cushion.
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The aging.
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It's not anti it's, it's just you're wrapping yourself in Bubble wrap.
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It's not anti-aging.
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Okay.
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Okay.
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It's, it's softer aging.
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you go.
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Aging gracefully.
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I like that.
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Because it's really important how you feel in your body.
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I mean, that's really it.
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You wanna live a long time with a lot of capability and enjoy life.
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I mean, no matter what, that's really the goal.
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It's not anti-aging so much as it is aging gracefully.
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Yeah.
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And, you know, we talked about anti-aging when I was, um, when I was a resident back at the naturopathic school.
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And there are things that weren't available at the time, but we were using things like fish oil and, you know, exercise or whatever.
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It was like there were a lot of.
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There were a lot of things that, treatments that we were doing that just seemed less spooky, less scary than what they, that is out there now.
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Just supporting health rather than trying to, uh,
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Turn back time.
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It's really getting scary here.
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Um, okay, so, so number three.
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Is never would I ever take a probiotic during immunotherapy.
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And when immunotherapy first came out, we did give probiotics, certain strains of probiotics because you know, some studies had shown that it could be beneficial.
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So I remember There was an oncologist that worked at the cancer center who wanted their patients who were getting certain treatments to definitely take a certain strain combination of probiotics.
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Then dun, dun, dun.
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Yeah, I think what happened is that fell into the unproven, right?
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So it was unproven at that time that probiotics would get in the way of an immunotherapy.
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Then there was actually evidence of people taking a probiotic and having worse outcomes and.
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Worse outcomes with certain checkpoint inhibitors in particular.
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These are those PD one inhibitors, checkpoint inhibitors.
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Maybe people have seen commercials for Keytruda or Opdivo.
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Um, but those, that's the drugs that we're talking about, they started to have some evidence that it was a bad idea.
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So now you went from an unproven and somebody makes an assumption when something's unproven.
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Those oncologists, believe it or not, were going without, they're, they're going rogue with no evidence to say that that was a good idea.
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They assumed it was a good idea.
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Turns out evidence was to the contrary.
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So now taking probiotics has been disproven for the most part until we figure out exactly which strains might work.
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And the reason for this is diversity within the gut.
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Diversity, meaning there's thousands and thousands of different types of bacteria.
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There's a plethora of diversity in the gut that leads to the best outcomes.
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So much so that.
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that it's very clear in the research that if they take an antibiotic which lowers the diversity in the gut, within three months of beginning one of these checkpoint inhibitor drugs, they have worse outcomes.
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And so I would actually have some patients who, out of necessity, took an antibiotic and now they're looking at immunotherapy.
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You know, being scheduled to do a checkpoint inhibitor.
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And I was like, when did you take your antibiotic?
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Was it a month ago?
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You know, like, can we stall a little bit more?
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And let's do everything to, to up the diversity in your gut before you even begin.
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We found this out the hard way, right?
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We just find this out through clinical trials and now we know.
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What creates diversity in our gut is a lot of different prebiotics.
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So, so you think about, Prebiotics are basically plant foods with various fibers that we can't digest.
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So it's everything from the starch in potatoes and legumes to um, beta glucans in some of the grains out there.
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so you really want to just eat a lot of very diverse plant foods, and that will feed the bacteria in the gut and that.
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Will then result in better diversity.
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So now you're giving a little bit of this, a little bit of that, a little bit of this, a little bit of that.
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you're supporting different strains and different types of bacteria, and that's your best bet.
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Again, the best results from a immunotherapy.
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So yeah.
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Antibiotic is the worst thing you can do.
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I mean, you do have to do it once in a while because antibiotics also save lives by preventing systemic infections.
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But if you can avoid it, great.
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Don't take a probiotic.
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'cause what that does is it limits the diversity because one strain or even 12 strains, it doesn't matter, they limit the diversity.
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'cause you're now promoting just those strains.
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And I think people also will take a probiotic.
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Because immunotherapies often cause diarrhea and bowel issues.
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And so sometimes that's a go-to for a patient or even a provider.
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A provider can prescribe an antibiotic and be like, oh, take a probiotic with it.
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Not thinking of the treatment that they're on.
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They're just like, okay, every time I prescribe a an antibiotic, I'm also gonna recommend a probiotic.
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and that's to prevent.
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Diarrhea that the antibiotic might cause.
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And so it's just it's hard.
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It's hard because it is one of those go-to supplements that people have,
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and people think as harmless.
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I mean, even practitioners assume that it's harmless.
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The very earliest study, if some, if someone is really wants to dig into this, go back to the original studies on the PD one inhibitors.
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The checkpoint inhibitors in.
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The journal science in 2015, the first couple studies were coming out and it really showed how essential what and is inhabiting the gut has to do with how these drugs work.
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Like you have to have the right, and they're called commensal bacteria.
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We call'em probiotics or beneficial bacteria, but those.
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Little buggers that we had a whole episode on with probiotics in the past are absolutely essential to the drug working colitis, which is inflammation of the colon actually was associated with better outcomes from these checkpoint inhibitors.
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So when people had colitis, they had better outcomes.
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This was in metastatic melanoma specifically quite a few years ago.
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This is 2017 or 18.
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So we knew that sometimes in controlling the side effect, especially if it was with the.
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The organisms in the gut we were screwing around with.
