Don't panic. There's been a small mistake in your life

Biomedical medicine, often referred to as "allopathic" or "conventional" medicine, is based on the concept that as long as there is not organ damage or noticeable loss of function, you are not sick. So, you basically wait until someone is sick, then you treat them.

This is a passive form of medicine and part of the answer to this approach was to develop screening tests. This is a great idea. It's what we do in endobiogenic medicine all the time with the biology of functions lab tests. But, the way this has been done is to take one single factor that is considered to be "the" cause or "the" indicator of some disease--like a cancer--and measure that in everyone, or those determined to be at risk.

Unfortunately, by trying to be progressive, by trying to be preventative, this approach has suffered from the same reductionist tendencies that were problematic in the first place. For example, the idea that a microbe alone is the cause of an illness rather than the result of an imbalanced internal terrain.

In terms of prostate cancer, for example, Prostate specific antigen (PSA) was determined to be the cause that was specific and sensitive for prostate cancer. What my mentor and co-developer of the endobiogenic system, Dr. Jean Claude Lapraz has said for over 10 years is that PSA is not enough to be an indicator of prostate cancer, especially when it is only mildly or moderately elevated. It is only an indicator of prostate congestion and a disturbance in factors related to prostate growth. Now, why that prostate is enlarged is a different matter all together.

Dr. Otis Brawley, chief medical officer of the The American Cancer Society, had the bravery to admit, 

 “We don’t want people to panic,” said Dr. Otis Brawley, chief medical officer of the cancer society. “But I’m admitting that American medicine has over-promised when it comes to screening. The advantages to screening have been exaggerated.”

The article in the New York Times in which he is quoted goes on to say that screening for prostate and breast cancer has not prevented the more severe types of cancer which cause death, but has only increased diagnosed mild, local cancers, some of which are benign and will go away on their own. Unfortunately, with increased diagnosis of possibly benign cancers has come an increase in not so benign medical interventions, such as CT scan (read radiation exposure) biopsies.

Let me reiterate again the importance of having an integrative understanding of the myriad factors that can influence the development of a cancer. When a patient has a "fascinoma"--a fascinating finding to a physician with questionable clinical significance--from an imaging study, an executive health check up, body scan, etc.--it induces fear in them, but it does not clarify what it is, where it came from, why it is there and whether or not it is benign, potentially harmful or currently harmful.

The amazing thing about the biology of functions, the biological testing service of the endobiogenic method, is that it can answer all these questions in most cases of cancer. By evaluating all the factors that can cause a cancer to develop, and by taking a careful history and physical to understand the intervening factors, we can develop a very sophisticated understanding of how to understand an elevated PSA level, a suspicious lump in the breast, or a person's risk of cancer developing again.

A man I knew came to me because his doctors at the VA hospital found a fascinoma--a suspicious lump on a lung and his adrenal glands on a CT scan, quite by accident. They were very concerned that it may be a cancer given his long history of smoking. He categorically refused a biopsy. He came to me and we performed a biology of functions, which showed that it was not cancerous, but simply an overgrowth of a certain type of tissue due to a different non-cancerous pathology, which we treated with medical plants.

A woman was living with breast cancer for 14 years which she only treated with a lumpectomy and localized radiation one time, but never chemotherapy. She came to me in this state and we performed a biology of functions, which showed the cancer, but also indicated that it was like a crouching tiger ready to spring into a state of metastasis and spread beyond the local area that somehow her body had contained it in for all those years. We started a medical plan treatment plan which unfortunately she did not continue and she was diagnosed 3 months later with metastasis to the local lymph nodes and lungs.

In both cases, the biology of functions was clear and accurate to the cause and direction of a concerning situation. In the first case, we were able to avoid unnecessary intervention. In the second case, it has a grave result due to a lack of concerted action.

I am not saying that people should not receive blood screening for cancer. Quite the contrary. What I am saying is that screening needs to be based on understanding the factors (plural) that are involved in the risk for cancer in general, as well as particular cancers. 

The biology of functions gives you a full cancer evaluation panel routinely, and for people who are cancer survivors, who have a strong family history of cancer, or who are generally very concerned about cancer, we measure important cancer antigens such as PSA, CEA, CA 15-3, CA 19-9 and CA 125 which can tell us about early disturbances in certain orgain systems, such as the prostate, ovaries, breasts, etc. but in general which hormonal system is playing the biggest role in general internal imbalance and where to put the emphasis of our treatment and preventative care.

Cancer: Silver Bullets and Silver Linings

My cancer patients often send me links to cures they've found online, or articles they have read on pubmed, the free database of scientific publications. "Do you think this is good for me?" they ask. The answer is easy. It's always the same: "It all depends."

In some patients, a lack of oxidation and free radicals contributes to their cancer, in others, just the opposite. In some patients, a very active thyroid axis--drives the metabolic rate of a cancer. In others, hypothyroidism, signaled by a high TSH level, occurs a few weeks to a few months right before the diagnosis of cancer and plays a role, instead. It's important to understand the various factors that participate in the growth of a cancer.

There are three main factors. First and foremost is genetics. Some people have particular genetic coding that suppress natural anti-cancer activity in the body such as programmed cell death (apoptosis), or over-expresses pro-growth factors such as certain cytokines, or hormones such as estrogen or growth hormone. But every gene is expressed in a certain environment, internal or external, which influences if it is expressed and to what degree it is expressed. So, even when we speak of genetics, we must remmber that there are environmental influences that play a role.

As far as the internal environment, even if a person is not born with genetic factors that are "pro-cancerous" there are certain factors that influence the growth of cells. Broadly speaking we can talk about hormonal (endocrine), nervous system and immune-mediated factors.

Among the hormonal factors, perhaps estrogen plays the most important role because estrogen makes everything grow, not just cancer cells, and not just in women. Some women who use birth control pills, or bio-identical hormones later in life will put themselves at risk for uterine, cervical and breast cancers, especially if progesterone is not used to balance out the estrogen activity. If you like Russian roulette, then this is the way to go for you.

If you don't like the idea of being a statistic, then you should look for natural alternatives to balancing hormones or meeting lifestyle issues regarding birth control. The endobiogenic system I use in my clinic if very well suited to managing hormonal imbalances in women using medicinal plants rather than hormones.

Women who never give birth or breast feed are also at higher risk. Some women chose for religious or personal reasons not to, or cannot for biological reasons give birth or nurse. If you are in this group, consider being evaluated more closely using the endobiogenic approach as well.

High androgens, growth hormone, insulin, Thyroid stimulating hormone (TSH) play important roles, but so does insufficient TSH. Many of these hormones can be stimulated by various nervous system, emotional and immune factors too. They are all inter-related, which is why you can have perfectly balanced estrogen activity and still be at risk for cancer. Slight imbalances in many hormones also put you at risk for cancerous cell growth.

Nervous system activity can get roled up with emotions. Emotions--expressed or suppressed--play a role in cancer too, although I am not saying that sad people or angry people or ungrateful people get cancer and that it's their fault. Plenty of nice people get cancer and plenty of mean people do not. Emotions cause a cascade of hormonal, nervous and immunological reactions in the body which in the right person can support unfettered growth of cells which can eventually become a cancer. It's just physiology, it's not a moral judgment.

Immune imbalances refer to cytokines and other mediators of inflammation, cell growth and blood vessel proliferation. Chronic infections with viruses and fungi are implicated here, but diet plays a role as does insulin and the thyroid system.

Congested or over-worked organs, such as the pancreas, liver, lymphatics, etc. can also play a role in cancer development or spread. So, regular drainage and detoxification of organs with fasts, diets, medicinal plants, homeopathic agents, aromatherapy, etc. are recommended.

The external environment also plays a role--probably and larger and larger role due to the growing toxin burden--in cancer development. Xenoestrogen from plastics and poultry raised on soy, radiation, heavy metals and other factors play a role. We should include chronic low grade infections here, too, like Epstein Bar Virus and Fungus.

Diet, of course can play a role too by influencing all of the above. Our food sources are filled with xenoestrogens, steroids, pesticides and antibiotics. We eat too many pro-inflammatory foods depleted of nutrients, low in omega-3's, stimulating high insulin responses which in turn stimulates more inflammation...

As you can see, there are many factors that can play a role in cancer risk. Some play a smaller role, some larger, but when added up, many small imbalances can create an environment that allows our cells to grow unfettered, which is what cancer is...which is why when my patients ask my about how to prevent cancer. They say, should I become a vegetarian? Participate in triathalons? Meditate? Do yoga? Avoid dairy? Stop hormone therapy...I say, "It depends."

In my practice I have taken care of vegetarians who should should be sainted for their benevolence but they get cancer, and I have grumpy alcoholics who don't get cancer. I have people who do yoga every day with high pre-cancerous activity and lazy slobs who don't have that risk.

There is no single prevention or cure for cancer, no silver bullet. The silver lining, though, is that by getting an individualized evaluation you can focus on what will help you reduce your risk of cancer. One person, one cancer treatment plan.

War on Cancer? Give peace a chance

Forty years ago, Richard Nixon declared a war on cancer, and thus started the great money sink of cancer research, so says a recent New York Times article. The article lists all sorts of reasons--the doctors who stand to lose money from good cancer research, government bumbling, corporate collusion--the stuff I usually mention. But that's not really what my concern is here. Six paragraphs from the end of the article, the author says

In most studies researchers have not accounted for genetic differences in tumors.

Therein, as Hamlet said, lies the rub. [the full soliloquy is at the end of this post] Ironically, Hamlet was fretting about the misery of long life, not a shortened life expectancy from cancer or other ailments.

Cancer research has yielded a lot of interesting results, such as elucidating the mechanisms of cancer growth, activity, metabolism, etc. Cancer research, and the organization of cancer trial working groups--particularly in pediatric oncology has led to impressive reduction of mortality of certain pediatric cancers. For example, ALL (Acute lymphocytic leukemia) used to have a 90% mortality and now it is down to 10% except in certain high risk groups. Sadly, though, there has been no overall reduction in cancer death in the US. In fact, even as the death from certain cancers have been reduced, other cancers, once rare, have become quite common.

Where cancer research has been lacking, and I say this with all due humility about very, very smart and dedicated researchers, has been in creating a global, dynamic and integrated understanding of cancer vis-a-vis the entire physiology and psychology of the individual. I am not referring to looking "estrogen" receptors or genetic markers. These are trees in the forest but not the forest itself. Genes need to act in a certain environment and having a gene in no way dooms you to have cancer. Conversely, not having the gene does not get you off the hook. I have a patient who has had recurrent breast cancer. She had a genetic survey done which said she had a lower than average risk of ever getting breast cancer.

I would add that there are two related errors that most cancer research has suffered from. First, it has become so reductionist, so mired in the fine details of mechanism, of the "how", that it cannot ask "why did this cancer come about?" And by "why?" I mean both physiologically, emotionally and spiritually.

Second, cancer studies in petri dishes (in vitro) and animals (in vivo) are so contrived and so far removed from the complex, decades-long dysfunction experienced before a cancer comes about that it is difficult to translate this research to an individual person with all the epic events of their life--birth, fear, hope, love, loss, illness, environmental pollution...

Experimental cancer treatments--even those using "natural" treatments use dosing far beyond what could be used in treatment that ceases to be practical. Many of the new treatments being trialed by drug companies hold out the promise of extending life by a few weeks but at huge costs. The article in the Times explores this very thoroughly, so I won't do so here.

If we wish to have a new approach to cancer, we must begin with the most Socratic of exercises: defining terms before any discussion occurs. So, what is cancer? The great killer? The barbarian at the gate? The feared stalker? He who cannot be named? We don't even know how to discuss it. In polite conversation, we lower our voice when we speak about someone who has cancer, then continue at our normal tone. Even in medical circles, we would refer to cancer as "CA" in front of patients or on medical exam forms.

So, what is cancer? Quite simply, cancer is the dysregulated growth of our own cells. That's it. That's fundamentally the struggle of life: regulation, dysregulation, a return to regulation and balance. If we don't go back to balance and regulation, we die.

A tacit assumption of cancer immunology has been that tumors express non-self or "foreign" antigens. The recent identification of a handful of potentially immunogenic cancer antigens shows that they are not truly foreign. Although the boundary between self and non-self is not well-defined, this first look at cancer antigens fits more with a self/altered self paradigm than with the non-self paradigm for antigens recognized in infectious disease

I wish I said that, but it was Dr. Alan Houghton, Chairman of Immunology, Chief of Clinical Immunology, Memorial Sloan-Kettering Cancer Center and Head of Melanoma Disease Management, Cornell University in a 1994 article.

So, in many ways, we return to the play Hamlet, for cancer is like the character of Hamlet: the perpetual angst of adolescence asking "Who am I?" and unable to give a proper answer.

Cancer is not foreign to us. It is us. It is at some level, a confusion about who we are, why we are and where we are in time and space.

How pointless then, how nihilistic to declare war on ourselves. Isn't that how we got ourselves into this mess? So much hatred, anger, and destruction of our race, our country, our environment and now ourselves? Rather than a war on cancer, how about a space race to the furthest depths of our soul?

Addendum: Hamlet's Soliloquy

To be, or not to be: that is the question:
Whether 'tis nobler in the mind to suffer
The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles,
And by opposing end them? To die: to sleep;
No more; and by a sleep to say we end
The heart-ache and the thousand natural shocks
That flesh is heir to, 'tis a consummation
Devoutly to be wish'd. To die, to sleep;
To sleep: perchance to dream: ay, there's the rub;
For in that sleep of death what dreams may come
When we have shuffled off this mortal coil,
Must give us pause: there's the respect
That makes calamity of so long life
--Hamlet, in "Hamlet" by William Shakespeare

Probiotics: A tale of lemings and foxes

Probiotics have been quite the hot topic for a number of years now. For a hundred years, health conscious Americans have been aware of the beneficial effects of friendly bacteria, and for thousands of years, so have most traditional cultures, who have at least one fermented food that is considered to be pluripotent in its health-inducing effects.

Probiotics are healthy microorganisms--mainly bacteria and a few fungi--that live in our bowel. They have many important roles, the most capital of which is establishing a healthy immune system. This is much more far reaching than avoiding a cold now and again. Immune imbalances play a role in many disorders from autism to arthritis, from Crohn's disease to cancer. Probiotics also help digest our food and generate B vitamins. They also help prevent aggressive organisms from invading our gut, or worse, our blood stream.

Sounds like everyone should be taking probiotics, right? Normally, I would tell you to eat fermented foods, like yogurt, kefir and kombucha, which are rich sources of probiotics. And, I am telling you to do that. They are an important way of establishing and maintaining a lifelong healthy ecosystem within the bowel. However, if you have an immune imbalance, it will take more than eating these great foods to reverse the disorder. That is where probiotic supplements come in.

Unfortunately, the multinational food companies have co opted the revolution and corporatized it. I have been told by a reliable source in the industry that what is sold as kefir (Turkicized Arabic for "makes you happy") does not resemble the real McCoy any more than Trix flavored yogurt (I'm not making this up) resembles what Nana made in Crete.

Dannon has patented strains of probiotics and even renamed subspecies to include their company or product name to make you think that they poses some rare and exclusive line of proprietary strains of bacteria. So people rushed like lemmings to consume anything from cookies to chocolate that say "probiotics" on the label (Dannon has been fined $35,000,000 for making unsubstantiated claims on its products). I don't know if anyone has tested this, but knowing what we do about how difficult it is to get probiotics to adhere to the bowel when taken in powdered form, and made the right way, most of the enhanced foods are virtually useless for improving bowel function.

There are three reasons by people do not get good results with probiotics. First, they don't use high enough doses. According to the clinical trials, effective doses range in the billions, not millions. Second, they don't use the right strains. Most people don't realize that we have hundreds of different bacteria living in our bowel, and it varies by our age, the seasons, and individual metabolic needs and phases of life, such as pregnancy and menopause. Some of these organisms help us digest carbohydrates, others proteins, others make vitamins or do many of these tasks, so, choosing the right strain depends on understanding where the deficiency lies.

Don't even get me started on the foxes guarding the hen house. The New York Times had an interesting article about probiotics and how many of the experts on the panel had ties to major companies promoting probiotics. I will say though that the author of the article had a good point in that clinical studies to date have tested about 50 different strains of bacteria and fungi and have shown specific strains to be helpful for specific disorders and it may not be correct to generalize these effects to all strains or other disorders not studies. The point is that you can't just take "probiotics" for health any more than you would eat "food" for health. The food you eat depends on the health goals you have in mind.

The third reason people may not get good results with probiotics is that they don't use them long enough, or, don't transition from probiotics to fermented foods as a daily part of their diet once the symptoms have gone away.

In my clinic, using probiotics is part of a larger assessment of the terrain of the digestive system and the health of the other organs that effect or are effected by the bowels, such as the pancreas, the gall bladder, the immune system, etc. There are quick ways to asses dysbiosis--imbalanced microbial ecology in the gut--and specific lab tests, too. We look at the immune system, the endocrine system, inflammation, and many other factors that interplay in a subtle dance between the gut and the rest of the body.

Don't fall pray to foxes promising you a healthy gut with diet-antioxidant-probiotic-decaffeinated-rain forest-chocolate cola. It took time to enter a state of imbalance and good treatments give the body time to return to balance through measured and prudent treatments.

October is cancer prevention month, so for the rest of this month, I'll be blogging about cancer.