Latest / Intellectual Medicine / Fear, Food & Prevention: The Truth About Cancer, Screening, and Immune Power

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Fear, Food & Prevention: The Truth About Cancer, Screening, and Immune Power · Intellectual Medicine

• 0:00
  Cancer is happening everyday. Don't worry about it.
• 0:03
  Your immune system is killing it.
• 0:05
  Take care of your immune system, avoid carcinogens, and you're
• 0:10
  going to have a great shot at having that rectangular lifespan
• 0:14
  that I always lobby for you guys to have right?
• 0:17
  Vital living, feeling great, powerful, strong and healthy.
• 0:23
  Do not let them crush you. Do not let them tell you that
• 0:28
  you must fade, either to treat a disease or as a consequence of
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  aging. That's nonsense.
• 0:37
  Fear. Fear is a great motivator.
• 0:40
  Medicine knows this. Marketing companies know this.
• 0:45
  Not necessarily a bad thing. I mean, if fear of a bad outcome
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  makes us put on our seat belt, OK, that's rational.
• 0:55
  How about fear of a disease state?
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  Few things scare men and women people more than cancer.
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  We have a fear because, God, it's an awful disease and we
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  should have a justifiable, balanced concern.
• 1:12
  Thus the screening. Now we're going to talk about
• 1:15
  screening for esophageal and colon cancer.
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  But before I launch into that, notice how the focus shifts in
• 1:24
  conventional medicine toward procedures that are reimbursable
• 1:29
  for screening purposes. Where is the zeal?
• 1:33
  Where is the time and focus on primary prevention?
• 1:39
  Cancer folks is largely environmental, especially
• 1:43
  gastrointestinal. Yes, there are some rare genetic
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  conditions, familial polyposis among them, that predispose
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  toward cancer, but it's a surface that comes in contact
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  with the environment, much like skin.
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  Most skin cancers are environmental.
• 2:01
  Same for gastrointestinal. And think about what we do or
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  what has been done to us with our food, with our obesity, with
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  the inflammatory dynamics, with the drugs.
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  So in America, right, If what, what's, what's a warning sign
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  that something's not right in your gut?
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  It's uncomfortable, it burns, there's pain.
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  Well guess what? Now we have a drug that can take
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  the pain away so you can eat crappy and not feel a
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  consequence. That's just flat awful Now
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  primary prevention as an osteopathic primary care
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  physician, somebody focusing on anti aging health.
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  It starts at the cellular level. As we speak, you and I were both
• 2:53
  making cancer cells. Our immune system is killing
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  them before they amount to anything.
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  This is what goes on every day and our immune system only works
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  as well as we nurture it. The basics, right?
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  Sleep, it's got to be restorative.
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  Length is somewhat less important as long as you re
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  energize. I'd say 5 to 7 hours.
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  Good window. Obesity.
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  Well, there's a lot of conversation about healthy
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  foods, unhealthy foods. Guess what?
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  Foods are not healthy nor unhealthy.
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  Human beings were healthy or unhealthy food.
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  It's like a force of nature. It's just there.
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  Is it healthy or unhealthy? It depends on who you are and
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  how much you're eating. Are blueberries A superfood?
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  No, that's just stupid. They're a Berry.
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  If you eat a little bit may not be bad, may be helpful, but if
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  you eat a lot, you're creating a problem.
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  What's the most dangerous and toxic food you can eat?
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  The answer too much. So therein lies a carcinogen.
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  Whenever you eat, whenever we eat, we create a free radical
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  surge. It's necessary to digest the
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  food. The more you eat, the bigger the
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  surge. It's a free radical storm every
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  time you eat food. Thus, a larger meal instigates a
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  greater amplification. In medicine, there's something
• 4:16
  known as the holiday heart syndrome.
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  You know, after a big weekend, there's an uptick in heart
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  attacks on a Monday and it's felt because of this
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  inflammatory storm creates endothelial inflammation.
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  The same chronic inflammation state can be an instigator of
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  cancer, especially gastrointestinal, because it's a
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  surface that comes in contact with the environment.
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  One of the most powerful correlants of gastrointestinal
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  cancer, esophageal, pancreas, colon, yes, breast and prostate
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  is adiposity. Excess fat increases cancer
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  risk. If you're a non-smoker, it's
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  probably your biggest risk factor if you're overweight.
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  So without having to think too hard about specific foods, their
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  toxicity or lack thereof, you can start by volume
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  modification. There are other things that are
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  in preventative realm. I'm an advocate of vitamin D
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  getting the blood level between 50 and 100.
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  Search research supports that correlates with some cancer
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  prevention. Avoid known carcinogens as best
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  you can. Nitrites.
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  I don't eat cold cuts anymore. I found this out and it disturbs
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  me so I'm going to share it with you.
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  I was paying extra money for organic nitrite free cold cuts
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  and I thought this is awesome I'm making this high protein
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  food and I'm sparing the carcinogens.
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  Guess what? The government lets the food
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  people label their product nitrite free if the nitrates are
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  from a natural source. That's stupid.
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  Whether natural or chemically created, nitrates are
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  carcinogenic. Period.
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  Now maybe you could tolerate some, you know that that char
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  grilled steak that you like in the summertime, yes, it's a
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  carcinogen, but small amounts you could probably handle that.
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  The thing about these carcinogens is a cumulative
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  effect. So it's difficult because we're
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  bathed in them. My advice is to not stress but
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  take rational steps to mitigate them, right.
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  Get rid of your non stick pans that's covered in a carcinogen.
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  Avoid as best you can toxic heavy metals.
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  I like filtering your drinking water at the source.
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  You can't trust what's coming out of your spigot.
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  And guess what? You can't trust what you buy in
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  a bottle either. Don't even get me going on
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  microplastics, people. You should be drinking out of
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  glass and stainless and yeah, stainless steel, but only no
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  plastics. All right, so prevention, that's
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  critical. Cellular prevention, if your
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  stomach isn't behaving correctly, you're having
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  bloating, heartburn, and other symptoms, Get to the course, get
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  to the cause of that. Let's fix it.
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  You know, in America, we don't have a standard of screening for
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  esophageal cancer. It's not that common of a
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  cancer. In Japan, they have more
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  vigorous screening. They have a much higher rate of
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  cancer. It's felt due to the sake, you
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  know, that hot, hot drink that they have alcohol consumption.
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  Clearly a risk factor, but how about your esophageal cancer?
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  When should you be concerned? Persistent heartburn,
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  absolutely. If you're living on a proton
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  pump inhibitor, Prevacid, Prilosec, other agents, that's a
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  problem. You should not need a drug to
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  soothe your your gastrointestinal system.
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  And the more you use the drug, the more you're masking the
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  symptom, the primary symptom of esophageal cancer.
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  One of them can be heartburn. Well, if you have heartburn all
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  the time, you've lost the ability to have that
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  discriminate. So often times, at some point in
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  the face of persistent heartburn, a recommendation will
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  be made for an EGDA scoping procedure to look inside and see
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  what's what. Well, what are the risks and
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  what are the benefits of that approach going into the stomach?
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  Anytime you do a procedure like that, anesthesia is involved.
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  Aspiration can occur. So pneumonia is a potential side
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  effect. This is not a benign procedure
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  and it ought not to be done in a cavalier manner.
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  When it is performed, they're looking for precancerous
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  changes, sometimes called Barrett's esophagitis.
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  It's when the normal cells line in the esophagus morph from a
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  squamous to a columnar form. That's something that has a
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  visual appearance and on occasion biopsies are done to
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  help confirm it. Now, Barrett's esophagitis does
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  correlate with an increased risk of esophageal cancer.
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  And before you jump on the bandwagon of getting scoped
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  every year, we have to consider risks and benefits.
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  This is always a factor. There is no screening procedure
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  that is perfect, that captures everything, or that is risk
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  free. The bias in medicine is to be
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  very proactive regarding screening procedures, partly
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  because they believe in the ability they have to prevent
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  death from cancer. OK, that's a true statement.
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  But there's also this cocktail of incentive.
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  They get paid. You get paid a lot for a scoping
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  procedure. You don't get paid much to
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  think, and if you're part of the investment group that opened up
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  this this endoscopy suite, it cost millions of dollars.
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  It's a legitimate endeavour. Doctors have a right to make a
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  profit from their intellectual work, from their procedural
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  work. But there's a little bit of a
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  challenge when that investment compels sort of a slanting of
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  zeal for advice. So what do I'm talking about in
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  EGD? What's the risk profile?
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  There's a potential risk of perforation, there's a risk of
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  infection, aspiration. If you have a Barrich
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  esophagitis, if it's mild, it can be rated based on its level
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  is at about a .1 to .5% per year incidence of it morphing into
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  cancer. So the risk of Barrich
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  esophagitis turning into cancer is small.
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  It's not negligible, but it's small.
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  So how about the procedure itself?
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  Now here's the problem. Serious complications from an
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  EGD requiring hospitalization occur in about 0.1% of the
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  cases, almost equivalent to the risk of cancer happening.
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  So you take somebody who is healthy, subject them to a
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  procedure and the annual incidence of hospital visits
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  after an EGD, 66 to 102,000 visits per year.
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  I'm not telling you to never do it, just to be thoughtful about
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  how it's done, how often it's done.
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  And by all means, get yourself out of the sort of washing
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  machine cycle of taking the drug to block the symptom, right?
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  Chronic proton pump inhibitors. So the treatment for Barrett's
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  esophagitis is to put people on a proton pump inhibitor like
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  forever. And I'm telling you, I see them
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  in my practice. They come in and they say I have
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  barouchy esophagitis. Do you get heartburn?
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  No, but I have barouchy esophagitis.
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  Going on a chronic proton pump inhibitor has very weak evidence
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  of protection against the esophageal cancer.
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  It is somewhat speculative. That is, the acid reflux is a
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  friction point can increase cancer risk.
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  OK, but there are better ways to address that.
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  A proton pump inhibitor itself correlates with an increased
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  risk, possible increased risk of stomach cancer, increased risk
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  in some studies of dementia of type 2 diabetes.
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  These are the details of drug therapy that are hard to find.
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  There is no incentive people for big pharma to do a research
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  study to determine if their drug is hurting you.
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  So it tends to go underreported. There's no huge incentive for
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  the doctors to report their own complications.
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  Look, they're honest and good people, but it's human nature.
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  They'd rather not have it amplified.
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  Those studies are hard to find. So we we have to make our own
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  decisions based upon our own sense of comfort and our
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  knowledge. So what do I advocate?
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  I do not advocate routine scoping procedures in a low risk
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  environment. If you had Barrachie esophagitis
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  Once Upon a time and you are now symptom free and you're off the
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  proton pump inhibitor, that's all good.
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  Your likelihood of having cancer if you're a non-smoker really
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  tiny in the absence of a symptom.
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  So you don't need to stay on the proton pump inhibitors, in my
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  opinion. Based upon that scenario, what
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  else can be done? Well, how about just raising up
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  your headboard? You know, if you take a 2 by 6
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  and put it under your headboard, you're going to get a slant and
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  use gravity to keep all that acid in your stomach.
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  No, pillows don't work. They tend to kind of kink your
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  back more than angle it. Now, in a perfect world, you get
• 13:54
  that adjustable mattress thing. You know, the bed frame.
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  Yeah, that cost over $1000. Trust me, I bought 1.
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  I loved it. My wife hated it so we sent it
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  back. Then I got the split bed 1, you
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  know, so that we get each adjusted individually.
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  I hated it. It's a Grand Canyon right there
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  in between us. Was terrible so we sent it back.
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  Save your money. Just put a 2 by 6 out of the
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  headboard. That'll work.
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  Avoid obvious toxic, irritating things to put in your stomach.
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  Now if you can identify cause and effect.
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  Whenever I eat milk, I feel terrible.
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  Well, your body's telling you something.
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  Alcohol consumption moderation is the key.
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  Tobacco to direct risk factor. Now, if you're going to get the
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  scoping done, there's a safer way to do it.
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  It's with a nasal scope. I like this approach better than
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  going through the mouth because you do not need to be sedated.
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  It can be done in the doctor's office.
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  The scope is thinner and smaller.
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  And here's another good thing. Doctor cannot biopsy through
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  that scope. That'll prevent him from being
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  tempted to take pieces of you when it may not be necessary.
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  So primary prevention, if you're going to get a scope, consider
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  and ask for the nasal scope instead.
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  All right, well, I want to hot light up colon cancer screening.
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  This is an exciting field because of the dramatic changes
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  in the past few years. When I was 50, I had my
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  colonoscopy. Awful, just awful.
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  I lost 2 days of my life I'll never get back to prep and the
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  procedure. Drugged up for the procedure.
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  I puked in the parking lot on my way out.
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  I was a zombie. Terrible.
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  Now at the time it was the only game in town.
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  But now they do have other studies, other means of of
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  screening. One of them is a fecal
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  immunochemical test. The fecal test, the FIT FIT test
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  can determine whether or not there's blood in the stool.
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  That can be a herald sign of possible cancer.
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  And that test is inexpensive, doesn't require you to prep, and
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  it can be done every year pretty good.
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  There's also the Cologuard test combining blood search with DNA,
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  looking for fragments of DNA from polyps and from cancer.
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  It is very effective at finding colon cancer or signs thereof.
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  A wonderful screening test. It's inexpensive, there's no
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  prep, there's no pain. 0 risk of complication.
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  Colonoscopies. Once Upon a time it was the only
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  game in town. However, the rate of
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  complications is relevant. You're looking at 27,000 yard
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  visits per year from complications, especially if
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  you're past 70. A risk of things like heart
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  attack and stroke from the stress involved piercing the
• 16:56
  colon by virtue of taking a biopsy, which is commonly done.
• 17:01
  Doctors like to take biopsies. It gives them reassurance.
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  It also bumps up the reimbursement a little bit.
• 17:07
  I know I used to do sigmoidoscopies in my office.
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  I always did a biopsy. My office manager told me to do
• 17:14
  that. We got paid more SAT admissions,
• 17:19
  but doctors are humans, they get affected by these things, right?
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  Protective from medical, legal and and also reimbursed.
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  So what's a person to do? You got to direct your own care.
• 17:32
  What's the argument in favor of a colonoscopy?
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  Well, you know, you can look at the tissue directly.
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  Here's a problem very operator dependent.
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  If it's done too quickly, the value and the results diminish.
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  There are folds in that colon and if you're very careful, you
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  go up and you look around it with your scope.
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  That takes more time. Those colonoscopy centers are
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  volume driven. The number of scopes equals
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  reimbursement. You don't get paid extra because
• 18:01
  you were slower in doing your scope, even though it's a better
• 18:05
  study. The other variable is the prep.
• 18:07
  If there's a veneer of stool left behind, you can't see that.
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  Well, all of these things, the operator variability, the risk
• 18:16
  factor, all of these things have led me to conclude that for the
• 18:20
  average patient, as a screening tool, by all means, I love the
• 18:24
  cola guard. It's what I do for my patients,
• 18:26
  what I do for myself. If that pops positive, yeah,
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  then you can justify a colonoscopy.
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  Look, nobody ever became septic from a cola guard.
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  There was never a ruptured viscous from a cola guard.
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  You don't have to worry about us.
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  You look, that scope was in somebody else's butt earlier
• 18:44
  that day, and you're depending on whoever's in the back make
• 18:48
  sure they sterilize a thing properly.
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  I'm really down on colonoscopies because as a screening tool, way
• 18:55
  too much risk, not enough benefit.
• 18:58
  The notion that they're superior because you can see things is
• 19:02
  really a false premise. The seeing things is highly
• 19:07
  dependent on the operator and on the prep.
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  The ability to do biopsies is more counterproductive than
• 19:14
  helpful, and the the complication rate is not to be
• 19:18
  sneezed at. Now, if you're advised to get a
• 19:23
  colonoscopy, simply ask, can I do a colon guard instead,
• 19:26
  Doctor? They should endorse that.
• 19:28
  There's no reason not to. Sometimes, however, the pressure
• 19:33
  is on. Look, if you just spent $10
• 19:36
  million in your endoscopy suite, you're not too happy about a
• 19:40
  sudden shift rendering the colonoscopy obsolete as a
• 19:45
  screening tool. But I think it should be.
• 19:49
  I think it should be obsolete as a screening tool for backup
• 19:53
  diagnostic purposes. It's a wonderful adjunct if
• 19:57
  you've had a prior history of colon cancer.
• 20:00
  Or precancerous polyps. It's reasonable to do 2 basic
• 20:05
  kinds of polyps. The precancerous are
• 20:09
  adenopolyps. Adenomas are precancerous.
• 20:14
  The other type hyperplastic they're just little bumps.
• 20:17
  They mean nothing does not change risk.
• 20:20
  So if you've ever been told you have colon polyps, you have to
• 20:23
  know what kind they were is in an adenoma or hyperplastic.
• 20:27
  It'll make a difference regarding you know how things
• 20:29
  are managed. So in summary, if you're going
• 20:33
  to get an EGD nasal laryngoscope, if you're going to
• 20:37
  screen for colon cancer, I'm all on board with a cola guard.
• 20:41
  It's less expensive, it's safer, and it's high quality.
• 20:44
  Does it capture as much as a colonoscopy?
• 20:47
  I don't think we'll ever really know that answer.
• 20:50
  Theoretically A colonoscopy may be able to capture more.
• 20:53
  However, the independent, the individual variables are really
• 20:58
  significant. Another thing I like about the
• 21:01
  Cologuard, it can be done more often every three years based on
• 21:05
  insurance reimbursement. And for those of you that are, I
• 21:08
  don't know, hyper screeners, you can pay for it.
• 21:12
  I think it's about 500 bucks, not crazy money from many
• 21:15
  people. For those in whom it's
• 21:17
  prohibitive, let the insurance pick up the tab.
• 21:20
  So folks, remember, cancer is happening everyday.
• 21:24
  Don't worry about it. Your immune system's killing it.
• 21:27
  Take care of your immune system, avoid carcinogens, and you're
• 21:32
  going to have a great shot at having that rectangular lifespan
• 21:36
  that I always lobby for you guys to have, right?
• 21:39
  Vital living, feeling great, powerful, strong, and healthy.
• 21:45
  Do not let them crush you. Do not let them tell you that
• 21:51
  you must fade, either to treat a disease or as a consequence of
• 21:55
  aging. That's nonsense.
• 21:57
  I want you to die in great health at an advanced age,
• 22:03
  without much forewarning, with just a quick exit after a
• 22:06
  beautiful life. So screen, yes, but screen
• 22:11
  cautiously and do not lean on screening.
• 22:14
  If you have a screening test that's good, that's good for
• 22:17
  that day, you should be living the anti cancer lifestyle.
• 22:22
  All right, it's all I got for today folks.
• 22:23
  Thanks as always for following and I look forward to our next
• 22:26
  chat.