Transcript
WEBVTT
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ever since I started having hot flashes, I'm a big fan of having that dessert before a meal.
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Well, or not, you know, like having it with lunch or something earlier in the day.
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So I don't like wake up with night sweats.
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yeah.
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So you're saying if you have a sugar too late in the night.
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Oh, it's, it's not just me.
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It is a very common cause of, of night sweats and of waking up in the middle of the night.
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So yeah, keep that sugar as an afternoon delight, as they say.
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there you go.
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Afternoon delight.
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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 do not apply any of this information
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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 Tina,
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Leia,
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I think we're about to be replaced.
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what do you mean?
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I saw this article in Cure Today about somebody who entered in some other medical information to AI to CHAT GBT, and CHAT GBT came up with their integrative treatment plan.
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Get out.
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No, I'm serious.
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I sent, I forwarded you the article.
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I don't think you've had a chance to look at it yet.
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Um, it asks, okay, so the person says, I asked chat GPT to build me a treatment plan for integrative and Western oncology based on me and my diagnoses.
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It built me a side by side chart showing me different options.
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Whoa.
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Was it any good?
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Did you get to see the chart?
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Yeah, no, it's right here.
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Like it's, it has the chart and it has the integrative oncology treatments, the Western medical treatments.
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And then this person has, two.
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Synchronous cancers and yeah, it doesn't show the full thing, but it has Western medical treatments as you know, one column.
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Does it tell, does it tell the person where they got the information from?
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I mean, is chat GPT just using the entire web or is it going to a reliable source?
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I don't know.
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I don't know.
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Uh, cause it doesn't show the full chart or there's no little asterisk or number next to anything.
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When I've looked things up in chat GPT, and I've asked for references, like I've asked for it to write something and I've asked for references.
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And then I go back and look at the references.
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They don't actually exist.
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Like it makes up references.
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And then I called ChatGPT out on it and it said, Oh no, we're just providing ideas.
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So yeah, well, you know, I've been using a lot of AI for research, right?
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All sorts of perplexity, illicit.
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I've got like a bunch of them.
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Gemini.
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by Google, is now telling you where it got the information.
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So that's impressive.
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It's actually giving you, like, we sourced this from, and it'll give you a citation.
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Oh, I see that when you do like, I hate when I do a Google search and then the AI comes up first, but it does.
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There's like a little link next to it.
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And if you click the link, sometimes their little summary is not exactly what the link says.
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And that's so dangerous.
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that's exactly what I was going to say about this whole treatment plan.
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I was like, well, how is someone who isn't a medical oncologist or a naturopathic oncologist or whatever, who's not familiar with the material, how is that going to be checked to make sure that it's accurate?
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So, for example, like, what did they say for this person to eat and what was their diagnosis?
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Yeah.
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So, okay, so they have a pancreatic NET, neuroendocrine tumor, and it has their Western medical treatments.
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And then for their integrative oncology treatments, it says ketogenic diet, herbal support with turmeric and ashwagandha, acupuncture for symptom relief.
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For their renal cell carcinoma, it says mind body practices, reishi mushroom and green tea extract.
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So it's pretty like.
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Okay.
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I'm just going to weigh in right away.
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Ketogenic diet It's a high fat diet, ketogenic, no matter how else you eat, you know, if you eat a vegan ketogenic or a meat heavy ketogenic, either way, it's going to be 70 percent or more of your calories from fat.
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And if your pancreas is involved in your diagnosis or your cancer or any other condition, your pancreas could be compromised.
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The function of the pancreas is to secrete which is the enzyme that breaks down fats.
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So, you'd have to be under the care of somebody, a nutritionist, dietitian, who is extremely familiar with what you would actually be able to tolerate without putting a burden on your pancreas, your gallbladder, your liver,
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and from what I recall, patients with neuroendocrine tumors tend to have diarrhea.
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depending, yes, what the neuroendocrine tumor is secreting.
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So the most common secretion is serotonin and serotonin will lead to diarrhea,
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And so doing a high fat diet in someone who is experiencing a lot of diarrhea just kind of seems like, eh, maybe not the best idea.
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right?
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So there's a lot of nuances that go into medicine and medical decision making that I don't know.
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I mean, eventually I'm sure AI could do it if it was fed the right source material, right?
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So AI is only as good as its source feeds.
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And so is it.
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Getting its sources from the NCCN guidelines for the medical oncology part, for the actual treatment part.
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If so, then that's a good source feed.
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So, chat GPT is probably just not right, the right AI to use.
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It's too broad in its source feeds.
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Um, but I do think AI is a phenomenal tool for us.
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I mean, I have been able to do research on topics with citations looking through just MEDLINE so fast and so much more information and just cut to the chase.
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You know, what might take me a week before I could do it in an afternoon easily.
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I I mean I use it for outlines, Like if I need to write a blog for a certain podcast, I'll use it to just kind of give me like a framework, and then I go in and edit it and make it sound like a human wrote it.
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And then if I have any sort of references, I make sure that they are actual references, and they're not like these fake ones.
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But I just think it's, I don't know.
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Okay, so let me go on.
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Yeah, I think that mind body practices meditation yoga.
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I mean, I think that's like pretty, it's great, but it's pretty vague.
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It's not really specific to renal cell carcinoma.
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It's kind of good for everybody.
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Um, so, uh, the person has liver metastasis.
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And so the recommendation is milk thistle for liver support.
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and plant based diet.
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So it's interesting because it's not taking all of these diagnoses and creating a plan.
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It's doing one for each one.
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So a plant based diet and a ketogenic diet may be,
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challenging to get everything you need to get in a day.
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Okay, so for pain and fatigue management, acupuncture for pain, essential oils, lavender and peppermint are recommended, and then reiki for fatigue.
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So it's kind of vague.
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That's its whole program for integrative medicine.
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This is what I'm getting so far.
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And it's like I said, not the whole thing's listed, uh, immune support.
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We see adaptogens and nutritional support, and it lists three vitamins.
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vitamins D, C, and E.
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There isn't any sort of link icon or anything after this.
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So I don't know where it's getting its information,
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Yeah.
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Yeah.
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I don't, I don't know.
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And I think this person was probably, I'm guessing, doing it more for fun.
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than anything else.
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But I'd like to think there aren't people out there getting actual medical advice from ChatGBT or AI.
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No.
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And again, I mean, I think chat GPT is too broad and too inclusive of all opinions out there that it's being fed.
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It could be fed nonsense, for all we know, but if you can source feed in an AI is just say only use the following websites and then use cancer.
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net as the ASCO patient facing, site or, you know, various, like what SIO, the Society of Integrative Oncology has some really nice papers on integrating safely.
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So I guess controlling the source feeds and then double checking the answers would be the only way to use it.
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With a human.
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Yeah, but, but not double checking yourself.
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Double checking with a human who knows what they're talking about.
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Yeah.
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Yeah.
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Which is basically what I do when I do research, right?
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Like, I look up papers, I'll do a bunch of papers, I'll write them all down, and then I'll go back to the actual citations.
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I won't, I will never read a line and assume the citation that they leave there is correct.
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I go back to the actual original paper and say, is that what that paper actually said?
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You'd be surprised how often it doesn't say what they just interpreted it as saying.
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I know, but not everybody's as thorough as you are, Tina.
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I
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No, but that's, I
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like that's, but that's, and that's a big problem is people will take it for face value.
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They'll be like, well, this is what was compiled.
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Um, I don't know, that's the, I just thought that was really, um, kind of interesting.
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Yeah.
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I think the use of AI to get us to the primary source is really useful.
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Instead of me finding a review paper, finding the papers within the review papers that I'm interested in going to those papers and then going all the way, you know, I'm, I'm always swimming upstream to the source of the material.
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that, that was my methodology, was finding, finding a review paper, and then going to the other papers within.
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I was like, oh, they did all the, they did all the legwork.
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I'm good with that.
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I'm, at this moment in time, on this date, in this year, I am fine doing that.
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I'm not comfortable with With AI, what I also thought was interesting is this person voluntarily uploaded their, um, their imaging results
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Hmm.
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Yeah,
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GPT for like them to translate it to human to human, you know, to more lay speak.
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to the mere mortals.
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Which I think is interesting, but at the same time, like, I don't know.
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Well I think that does bring up a whole other facet to this, and that is, I think we should be fairly protective of our, of our information, our own personal biological information, whether it's 23andMe.
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You know, everyone's uploading their genetics there or whole genome sequencing that's going on right now.
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Um, you know me, I've been a little bit leery of the whole thing for a long time.
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I used a pseudonym.
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I used a whole other name when I did 23andMe.
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Oh, yeah, see, and I thought like, eh, whatever.
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I mean, I did mine,
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Yeah, a little paranoia isn't a horrible thing, I suppose, when it comes to this stuff, because what was happening and what did happen back in time is people with BRCA.
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mutations or deletions that led to a higher risk of breast and ovarian cancer, they were being denied life insurance.
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So life insurance companies basically said, that's a blacklist.
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If that, if that is your, risk, if your risk of breast and ovarian cancer is that high, we're not going to give you a policy.
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And it was legal to do so.
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So I think that always stuck in my,
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But did that change?
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You said it was legal.
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Has that changed?
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I don't know, I haven't updated my knowledge on the topic.
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Oh, we should check with, um, ChatGPT and see what they say.
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No, because I, so I started teaching a course on medical documentation.
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And one of the things I just had my first class, and one of the things I pointed out is, there was an article that led me to this topic where you just don't upload patient information.
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Maybe somebody needs to know how to chart, how to write an assessment.
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Don't upload your patient information to AI to write your assessment for you.
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Oh, yeah.
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and do not put any sort of patient information on there.
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I mean, it's just, I don't know.
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I just, I'm not, I'm not trusting it entirely.
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Well, and there's a big difference between open source and closed sources of AI too.
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So chat GPT is an open source and they say so, like anything you upload to that is now publicly available.
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Anything you search for in Google is now being added
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Yeah.
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It's not true of all AIs.
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Some of them.
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I think Adobe has AI suite that, um, is.
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Reportedly private, I don't know.
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I don't, yeah, I, I just, you, you can ask, chat, GPT.
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Can you give me?
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an outline for a soap format for a soap note, and that's fine, but don't have it, fill it in with your patient information.
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And if you do want to look at the literature, I think my favorite tool currently is ELICIT.
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E L I C I T.
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It does a nice job of pulling up from the medical literature what you're looking for.
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So you can ask it questions and then it gives you summaries and data and you have columns that you can expand on and continue to ask.
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well, we should ask it to come up with an integrative treatment plan.
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Well, it's not generative like that.
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It's more of an assistant.
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Okay.
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Okay.
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Yeah.
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Once again, you know, we're going to soon be out of jobs because everyone's going to be, it's the next step from Dr.
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Google.
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Yeah, here's the thing.
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Yeah.
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It's going to be hard to teach the art of medicine to machines.
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Not impossible.
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And with enough data, they probably could figure it out.
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But there is a lot of decision making that goes on when you see any doctor, it doesn't matter who it is, that's not completely in black and white on some algorithm.
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It's some.
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Decision making based on experience and the individual in front of them, so I don't feel threatened by AI I think AI is a great tool, but I've had this conversation with a lot of people I feel like we're just all gonna be more productive and more creative and it's gonna free up our brains to do better things be more efficient
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I just think in the wrong hands of somebody who's like, I'm just going to ask it for an integrative treatment plan and then having someone follow it because it's not taking the whole human into account.
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It's just what you put into it.
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So if you're like, well, I'm a patient with, you know, kidney cancer, but I mean, it's not looking at your labs.
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It's not looking at, how you're doing overall, any other medications that you're taking.
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It's not looking at, any of that.
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Unless you put it in, but then are you going to know what to put in?
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Like, and then you're putting all your personal information in there and then what?
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yeah.
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That's why it's a, it's a learning curve going on right now.
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I think we're all learning.
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Well, what did you learn in the news, Tina?
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Um, I had a couple articles of interest to me.
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Um, you know, one that I was surprised about because I was like, I thought we put this whole topic to rest a while ago was, some acne creams are found to contain a known carcinogen.
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That was the headline.
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on October 8th.
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what they contain is benzene, which is a very well known carcinogen.
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There's no doubt that benzene is carcinogenic.
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Well, benzoyl peroxide is like what you think of for those acne creams that we used to use back in the day.
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well, they're still being used.
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Um, there was a new one approved in 2022 with, I don't remember it was a five or 10 percent benzoyl peroxide.
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And so benzoyl peroxide in and of itself is okay.
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It's when it gets used.
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Heated that it breaks down into benzene.
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And so what this study did that they just did a an article on the study went to stores and pulled these acne products off the shelf and One third of them had benzene levels that are higher than what the FDA deems safe
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So how hot does something have to be?
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Because you're, where do you store it?
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Like, are you storing it in your bathroom?
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Like, how hot and steamy does your bathroom get?
00:16:02.019 --> 00:16:03.279
That's what made this interesting to me.
00:16:03.289 --> 00:16:07.432
They pulled them off the shelf fresh and a third of them had too much benzene.
00:16:07.437 --> 00:16:10.876
But we don't know, like, what the truck was.
