Gynecological Cancers: Genetics, Hormones, & HPV with Dr. Natalie Godbee

Interview with Natalie Godbee DO

[00:00:00] Dr Godbee: but that vaccine has significantly decreased the, incidents of HPV related cancers. So that's the head and neck cancers, cervical, vaginal, vulvar, anal. All of those are mostly caused by HPV.

And so we still highly recommend getting HPV vaccine because it's gonna protect from those high risk strands of HPV that can increase the risk of cancer,

[00:00:26] Leah Sherman, ND: Hey Tina.

[00:00:27] Tina Kaczor, ND, FABNO: Hello, Leah. So I gotta tell you, I

Yeah, I personally finished listening to the episode.

you did this. And I love it, and I couldn't listening, so kudos.

[00:00:42] Leah Sherman, ND: kudos. Oh, thank you. Yeah, no, it was really nice, um, reconnecting with her. We used to work together and so yeah, she's such a huge fan of integrative medicine that, like, that made it like really easy,

[00:00:56] Tina Kaczor, ND, FABNO: Yeah, it's so great when we

great

allies on that are in conventional medicine that we can work

work with, and then

really,

really ultimately patient best possible care.

So I, I

So I, I just loved it. And,

know,

you know,

I'm just gonna

I'm just gonna tell people what they're about to hear.

is all

It's all about gynecological cancers. Ovarian, 

Endometrial, which is also known as uterus

Ute Cancer and Cervical Cancer. And what I like is that you actually,

every

every one of them

about.

talked about

Symptoms

symptoms people have early on. Mm-hmm.

tell them to go to their doctor

Doctor or their gynecologist and

to reduce the

how to reduce the risk of each of them.

So

So I just thought it was really

a lot of

a lot of information for, in a very short time.

[00:01:38] Leah Sherman, ND: Yeah, it's, it was kind of like the, my idea for it was just kind of doing like a gynecologic cancer 1 0 1. I think it's something that a lot of people don't think about. Um, you know, and we also talk about the HPV vaccine, which is. You know, very important to her, um, as it is to a lot of providers, because there is so much, misinformation going on around it.

Yep. Yep.

yeah.

[00:02:02] Tina Kaczor, ND, FABNO: And you

Can you,

talked about hormones and what high

high estrogen does.

its implications in

[00:02:08] Leah Sherman, ND: Mm-hmm.

[00:02:09] Tina Kaczor, ND, FABNO: so

So yeah, I feel like you touched on

for, in a very

in a very short amount of time. So,

um, I

um, I really appreciate that and it reminded me why and how you and I should probably continue to do exactly this, which is.

Talk to

Talk to true experts. I mean, we're talking to a gynecological oncologist who

this is

this is

she

all she does.

[00:02:29] Leah Sherman, ND: Mm-hmm.

[00:02:29] Tina Kaczor, ND, FABNO: when you

So when you go to someone

and that's

and that's all they do,

they're

they're going to be a, what I would call a true expert,

just

not just somebody who's

influencer

online.

I don't know,

Right. Just AI topic or something. I dunno.

I just had a

I just had a

appreciation for

for the

depth

death of knowledge.

In order to

In order to distill knowledge and distill information down, you need to know it really well,

why

is why this was a good interview because she's able to distill it down to simple

home,

home,

 messages for,

for, for the listeners, and probably do that when you know the topics

and

inside and out.

[00:03:03] Leah Sherman, ND: Yeah. Yeah. And she's such a great resource too. and what I found really surprising. Was I, when we talked, we started talking about the HPV vaccine. I had in my mind what all the controversy was because of what I've heard from, you know, other providers. and what I thought would be a major controversy with the population of patients that she sees.

Um, it was something completely different and that really blew me away. I was really kind of surprised by her response. So, um,

[00:03:34] Tina Kaczor, ND, FABNO: Yes.

[00:03:34] Leah Sherman, ND: was, yeah, because you and I don't have

[00:03:35] Tina Kaczor, ND, FABNO: so we don't, we're not in the, the, the conversations with other

conversation with other moms talking about what's going on with.

nine or 10-year-old.

old

yeah, we're not privy

not privy to

common

common.

are around it.

[00:03:46] Leah Sherman, ND: Right? And I also didn't realize like the age range for getting the vaccine was a lot different than when it first came out. And what, um, you know, we were told would be the age range. but before I introduce Dr. Godby, I want to, read a review. We got a review on Apple

 can I just say right now?

[00:04:05] Tina Kaczor, ND, FABNO: right now.

Those were really helpful. So anyone

So anyone who's listening on this,

Apple

Apple or even Spotify, giving

shout

shout out with

words

words on there.

Stars are great, but words are great too. They, they give us some more attention, they give us more traction.

search engine.

[00:04:20] Leah Sherman, ND: Yeah. So leave us a review, a rating, comment. If you're watching this on YouTube. the, the more interaction, the more people get to listen to us and find us. so this is from Greener LA and the title is, how did I Not Know About This Podcast?

And they wrote, I love this podcast. Doctors Kaczor and Sherman do such an excellent job explaining, need to know information in a way that everyone can understand, and it is fun. Thanks for continuing to share such important information for all.

[00:04:55] Tina Kaczor, ND, FABNO: Yeah.

Yeah. Yeah. AndYeah. And a little selfish piece of asking people to write is, you know, that really is energy for us, knowing that it's landing out there and helping people.

Uh, it's why we do it. Yeah. So any feedback people can give us really does,

give you know, give us energy and

and fuel to carry on, because here we are, you know, in this September,

September will be our our fifth year. That's crazy.

It is

[00:05:23] Leah Sherman, ND: I think it's

But yeah, this was just kind of like, we talk about this anyways, let's just record it. And so yeah, here we are five years later. It's kind of cool. Yeah.

[00:05:31] Tina Kaczor, ND, FABNO: Yeah. It's

Awesome.

Okay, so Dr. Natalie Godby, graduated from Howard University in Washington DC and she received her Bachelor's of Science in mathematics.

She went on to get her doctor of medicine from the Philadelphia College of Osteopathic Medicine in Swee, Georgia. she did. Her residency in obstetrics and gynecology at Henry Ford McComb Hospital in Clinton Township, Michigan. And her fellowship was at WellSpan York Hospital in Pennsylvania, and that was her fellowship in gynecologic oncology.

And she currently works at City of Hope in Atlanta, Georgia. So stick around for our conversation.

[00:06:15] Tina: I'm Dr Tina Kaczor and as Leah likes to say I'm the science-y one

[00:06:19] Leah: and I'm Dr Leah Sherman and on the cancer inside

[00:06:22] Tina: And we're two naturopathic doctors who practice integrative cancer care 

[00:06:26] Leah: But we're not your doctors

[00:06:29] Tina: This is for education entertainment and informational purposes only

[00:06:33] Leah: do not apply any of this information without first speaking to your doctor

[00:06:37] Tina: The views and opinions expressed on this podcast by the hosts and their guests are solely their own 

[00:06:43] Leah: Welcome to the cancer pod 

[00:06:52] Leah Sherman, ND: Welcome to the Cancer Pod, Dr. Godbee.

[00:06:54] Dr Godbee: Thank you. Thank you for having me. I'm excited to be here.

[00:06:58] Leah Sherman, ND: we had a little chat beforehand. Godbee and I used to work together

[00:07:03] Dr Godbee: Yeah.

[00:07:03] Leah Sherman, ND: um, then CTCA, now City of Hope in Phoenix.

[00:07:07] Dr Godbee: Phoenix. Yes. Yes. And it was such an honor to work with you. I miss you so much.

[00:07:12] Leah Sherman, ND: my gosh, I miss you so much. We had fun. It was a really good place to

[00:07:17] Dr Godbee: Yes. And I honestly learned a lot from you. I don't know if I've ever told you that, but I did. I learned a lot from You.

[00:07:23] Leah Sherman, ND: Oh, thank

[00:07:23] Dr Godbee: Did.

[00:07:24] Leah Sherman, ND: Yeah, because, so at, for those who are not aware, CT CTCA as well as City of Hope, has integrative services, and so they have naturopathic doctors, acupuncturists, and do you have massage therapists?

[00:07:40] Dr Godbee: Not anymore. We used to, um, chiropractor service. Mm-hmm. Mm-hmm. And then of course you, did you say nutritionist?

[00:07:49] Leah Sherman, ND: Oh, I,

[00:07:50] Dr Godbee: Nutritionist,

[00:07:51] Leah Sherman, ND: forgot the dieticians

[00:07:53] Dr Godbee: yeah.

[00:07:54] Leah Sherman, ND: We had, um, Samantha Peterson. Was she still there when you were there? She was on

[00:08:00] Dr Godbee: Yes. She was uhhuh.

[00:08:01] Leah Sherman, ND: yeah, we had her on,

[00:08:03] Dr Godbee: Oh, awesome. Yay.

[00:08:06] Leah Sherman, ND: I forgot the D. Oh, okay. I'm gonna hear for that, about that.

[00:08:10] Dr Godbee: Those are good times though. Very.

[00:08:13] Leah Sherman, ND: it was great. It was a lot of fun. know, I never asked you like, what, what brought you to gynecologic oncology?

[00:08:21] Dr Godbee: Yeah. You know, I've always wanted to do women's health. Once I decided to go to medical school, I said women's health, I have to be there. I have to be in it, you know? Um, there are a lot of women out there who need an advocate, and I wanna learn. About the female body, what we can do and how to advocate for, um, females.

So that took me down the OB GYN route. And then when I was in residency, that's where I learned more about GYN Oncology. And so, I got to experience the surgeries and awesome attending who, uh, taught me. GY onc, and from there I was like, I'm sold. This is where I'm supposed to be. This is where my heart is to do oncology and support women's services.

So that's how I became a GYN Oncologist.

[00:09:11] Leah Sherman, ND: And so for the people out there who aren't familiar with gynecologic oncology, um, can you just kinda give a brief little,

[00:09:19] Dr Godbee: Yeah.

[00:09:20] Leah Sherman, ND: of what it involves?

[00:09:21] Dr Godbee: Yes. So, it is a subspecialty of OB GYN. So we all do OB GYN training initially in residency. And then we go on to do a fellowship in, uh, GYN oncology. And so we focus on cancers in females ovarian cancer, fallopian two primary peritoneal uterine, cervical vaginal vulvar cancers, and we do the surgical interventions and the chemotherapy for them.

[00:09:49] Leah Sherman, ND: So. You're kind, you're kind of a combination of medical and um, oncologist,

[00:09:55] Dr Godbee: Yes. You know, we often call ourselves unicorns because a lot of times from the hospitals where I've been, they didn't really know what department to put us in. Are we with the medical oncologist? Are we with the surgical oncologist? 'cause we do both, so, but yes, yes, we're a combination of the two.

[00:10:14] Leah Sherman, ND: you mentioned that gynecologic oncology kind of combines a lot of different aspects because it is. women's reproductive health. Um, and so there are a lot of organs involved. And so, I wanted us to talk about the, just kind of like the three primary ones, ovarian, endometrial, or uterine.

And then, cervical cancer as well. And we'll kind of talk about them, and the risk factors, as well as like reducing the risk.

[00:10:42] Dr Godbee: Yeah, absolutely. Let's talk about that.

[00:10:44] Leah Sherman, ND: Okay. So with ovarian cancer, um. I mean, basically being born with ovaries, I would think would be a risk.

[00:10:54] Dr Godbee: Yeah. Yeah. And so, you know, honestly, just like most cancers, ovarian is sporadic, right? So it's, only about 12 15% that are genetic. the rest are kind of sporadic. Just, uh, um. Um, mishap and we know that it starts within the fallopian tube. And so oftentimes you will hear us interchange fallopian tube cancer and ovarian cancer.

Even though they're coming from two technically different organs, they're treated very similarly because they'll behave similarly. And because the the ovarian cancer comes from the fallopian tube 

[00:11:31] Leah Sherman, ND: So for reducing. One's risk if someone was getting a hysterectomy or if someone had a family history of ovarian cancer or fallopian tube cancer, then.

[00:11:43] Dr Godbee: Yeah. So that's why we remove it, right? So, um, if you know you've been to your gynecologist and You want your tubes tied, or if you're having a hysterectomy, they may offer to go ahead and take out the entire fallopian tube to lower that risk of ovarian cancer. Um, when you have a genetic mutation that increases that risk like a BRCA mutation, and there are a few other ones.

BRCA is the one that most people are aware of, um, that increases your risk of ovarian cancer and fallopian tube cancers. So in order to decrease that risk, we remove the tubes and the ovaries after you complete childbearing.

[00:12:22] Leah Sherman, ND: is there a connection with endometriosis and ovarian

[00:12:27] Dr Godbee: Yes, yes, yes, yes, yes. So, um, that came to light a few years ago. So endometriosis is that endometrial lining inside of the uterus that implants. Outside of the uterus, and a lot of females have it, um, most times they'll present with like, painful menstrual cycles. but we found that that can increase the risk of certain types of ovarian cancers.

And there are a lot of different types of ovarian cancer. If we mainly talk about the epithelial ovarian, because those are the most common. Um, but their germ cells and sex cord stromal cells as well. But it's gonna increase that risk of the, epithelial type cancers.

[00:13:09] Leah Sherman, ND: So that's something that if someone suspects or does have endometriosis, then they should get more of a follow up.

[00:13:17] Dr Godbee: Absolutely. And at least what I always tell patients is to pay attention to your symptoms. Right. it's gonna be very important because. Ovarian cancer is one of those that we call like a silent killer because 75% of the patients are gonna be diagnosed at a later stage because the symptoms not only are delayed, but once you start having symptoms, they often get misdiagnosed for something else.

Um, maybe like a GI upset or that watch and wait and see what happens as opposed to working up. So some of those symptoms would be like bloating. Nausea, vomiting, changes in stool, changes in urinary habits, pelvic pain, pressure, those things might be a clue that something's going on, and you should definitely advocate for yourself to have it worked up.

I

[00:14:09] Leah Sherman, ND: I don't know if you remember my mom had ovarian cancer.

[00:14:12] Dr Godbee: do remember, yes,

[00:14:14] Leah Sherman, ND: And she was diagnosed by her gastroenterologist.

[00:14:17] Dr Godbee: Yeah, so, and that's quite often patients get referred to GI

[00:14:22] Leah Sherman, ND: Mm-hmm.

[00:14:23] Dr Godbee: because of the nausea, vomiting, and GI changes, bloating and everything. They say, oh, this must be a GI issue

[00:14:29] Leah Sherman, ND: Right.

[00:14:30] Dr Godbee: It's all just those ovaries. Yeah,

[00:14:33] Leah Sherman, ND: Yeah, that's, we are, we're a lot more complicated,

[00:14:37] Dr Godbee: Yes, we are.

[00:14:37] Leah Sherman, ND: like, you know, anatomy wise. So, um,

[00:14:40] Dr Godbee: Yeah.

[00:14:41] Leah Sherman, ND: so then with endometrial or uterine cancer, um, genetics again.

[00:14:48] Dr Godbee: Yes, that can play a role. Those BRCA mutations can increase the risk of the, um, high grade uterine cancers. and then we have Lynch syndrome. That puts you at risk for endometrial cancers as well. So because of that, now when the patient gets diagnosed with endometrial cancer, we test them all for Lynch syndrome because that's also related to colon cancer too.

And we wanna make sure that the patients get the appropriate, screening done. And it also plays a role in the treatment as well. But, um, yeah, so with endometrial. That one is usually diagnosed at an early stage because of the symptoms, and most times it will present with abnormal bleeding discharge. the patients may have a change in their menstrual cycles.

 where they're bleeding a little bit more, um, or postmenopausal where you've completely stopped menstruating and then all of a sudden you see spotting or you have this menstrual cycle that's abnormal. I just want everyone to know that because I've seen patients come in saying, I had some spotting a couple years ago when they told me that I was just going through menopause.

But you stopped bleeding five years ago, so that's not going through Rupa. This is abnormal. So definitely pay attention to the spotting, the discharge, and the bleeding 'cause that could be a clue that something's going on inside of the uterus.

[00:16:13] Leah Sherman, ND: Are there things that, women can do to reduce their risk of uterine cancer?

[00:16:19] Dr Godbee: Yes. So, again, if you have those genetic mutations, you know, sometimes you can get the ultrasounds to follow the lining. Um, again, follow those symptoms too so that a biopsy can be done. and then, you know, recently it came out about hair products, increasing the risk of some uterine cancers as well.

Uh, so of course you want to try to decrease the amount of chemicals being put into the hair, because it can increase that risk of uterine cancer.

[00:16:55] Leah Sherman, ND: one thing that. We were often referred to as well as patients were referred to the dieticians was to, at least when I worked in Indiana, um, was to talk about exercise, physical activity as well as, um, it's so controversial because there, you know, there's that whole thing where women go to the doctor and they have a concern and they're told, well, you have to lose weight, you know,

[00:17:20] Dr Godbee: Mm-hmm.

[00:17:21] Leah Sherman, ND: but with. With uterine cancer, that's actually a concern,

[00:17:26] Dr Godbee: Absolutely.

[00:17:27] Leah Sherman, ND: excess adipose tissue.

[00:17:29] Dr Godbee: Yes, yes. That is, um, a big risk factor, right? So, um, I will say that majority of the endometrial cancer patients that I see are overweight, and we know that that adipose tissue, the fatty tissue, can convert to estrogen. And estrogen is what's feeding this uterus and making that lining grow, grow, grow into a cancer.

So we wanna decrease that exposure to estrogen. Um, and you can do that by weight loss. and then now that I mentioned the estrogen part, when we talk about hormone replacement therapy, if you still have your uterus, you wanna make sure that you're getting estrogen and the progesterone to it, because that progesterone is what's gonna protect the uterine lining.

[00:18:19] Leah Sherman, ND: So speaking of hormones, um, what are the risk factors for. Anyone who has taken tamoxifen, you know, for breast cancer, that's one of the, the side effects that you read about. So, would that also be just looking for spotting, if you know,

[00:18:36] Dr Godbee: it.

[00:18:37] Leah Sherman, ND: from my experience, there's no monitoring.

Nobody's, you know, checking your uterine lining.

[00:18:41] Dr Godbee: Yeah. Yeah. So that's very true. So Tamoxifen, like you said, that's a common drug that we use for breast cancer. it is a selective estrogen receptor modulator, right? The sms. And so in the uterus. It uploads those estrogen receptors and now the estrogen is feeding that uterus and it increases the risk of uterine cancer.

And so we don't necessarily monitor patients on a regular basis who are on Tamoxifen because we know their lining's gonna be thick. We, um. We'll do biopsies and ultrasounds if they start to become symptomatic. So if they're having pelvic pain, cramping, bleeding, spotting, then we start the workup process because otherwise it kind of leads to some unnecessary biopsies and unnecessary ultrasounds.

'cause we know the line's gonna be thick, right? So, if you are on Tamoxifen and have pelvic symptoms, then yes, you definitely should see a gynecologist.

[00:19:42] Leah Sherman, ND: Before we continue with the episode, I'd love to tell you about our community memberships. We've created three membership tiers. Each level has its own perks. Members get exclusive access to live YouTube meetups, and you'll be able to download practical cheat sheets, packed with real world tips for managing treatment, side effects and navigating survivorship, Whether you're newly diagnosed currently in treatment, living in survivorship, or supporting someone you love as a caregiver, we're building something really meaningful. Visit the cancer pod.com and click join us to explore your options.

And you can gift a membership too, which makes a really thoughtful gesture for someone who could use the extra support. Okay, now back to our episode. okay, so let's talk about cervical cancer.

[00:20:27] Dr Godbee: Okay.

cervical cancer. I think a lot of people know about it just 'cause it's been in the news. Um, but, let's talk about some of the, the risk factors and things people can do to reduce their risk Right. So cervical cancer is mainly caused by HPV human papillomavirus. And the biggest thing, to reduce that risk, of course, is the HPV vaccine. the controversy around that vaccine is, will it. Increase the likelihood of my child becoming sexually active because HPV is a sexually transmitted virus.

Um, and the answer to that question is no. Kids do not become more sexually active after they get the vaccine. but that vaccine has significantly decreased the, uh, incidents of HPV related cancers. So that's the head and neck cancers, um, cervical, vaginal, vulvar, anal. All of those are mostly caused by HPV.

And so we still highly recommend getting HPV vaccine because it's gonna protect from those high risk strands of HPV that can increase the risk of cancer,

[00:21:42] Leah Sherman, ND: The recommendation for the vaccine is

[00:21:45] Dr Godbee: males and females.

[00:21:47] Leah Sherman, ND: It's for

[00:21:47] Dr Godbee: Mm-hmm. Yes.

[00:21:48] Leah Sherman, ND: who is not yet sexually active.

[00:21:51] Dr Godbee: Even afterwards too, right? Because of the multiple strands that it can, um, provide protection from. so the average age is usually around 11 or 12 when they're still seeing their pediatrician. They're getting other vaccines as well. They should get the HPV vaccine at that point.

Um, but if for some reason they miss it, then we can still catch them up later on because in certain situations we can give it all the way up to, uh, 45 years old.

[00:22:18] Leah Sherman, ND: I didn't realize that, so it could be given that that late. Okay.

[00:22:21] Dr Godbee: Yes, yes. And up that late, it is, a conversation to have with your physician or your provider to see your risk factors for it. initially it was for nine through 26, but they move that age up. Um, for patients who may be at more risk.

[00:22:37] Leah Sherman, ND: And from what I remember, I haven't, know, I, I, I'm still kind of remembering my gynecology, but, um, a lot of the times. HPV can clear,

[00:22:49] Dr Godbee: Mm-hmm. In our younger population it can. And so, um, that kind of goes along with the test for right. Uh, your pap smear that we're getting. Back in the day when we first started doing paps, we were doing them like at the onset of sexual intercourse. So that would include teenagers. Um, they would get the, their pap smear done, but we've learned that it clears in younger populations.

So we moved that testing up to 21 before we start doing pap smears. Even still, you know, in your early twenties per guidelines, you know, you only need the cytology part of the pap smear. Um, after you are over 30, then we start doing the co testing with HPV and testing cytology or the,

[00:23:39] Leah Sherman, ND: okay. Yeah, those are all new guidelines since I was in school,

[00:23:42] Dr Godbee: yeah. Yeah.

[00:23:44] Leah Sherman, ND: I haven't had to keep up with that. So, um, but there is, there's like so much to, um. Because, you know, the female reproductive system is so complex. There's just so much

[00:23:54] Dr Godbee: Mm-hmm. and we're learning so much more too, right? As, as we get into the, um, microbiology part of it, just learning how these cells are working and everything, it teaches us more, and then we can kind of change the guidelines up a little bit.

[00:24:11] Leah Sherman, ND: and then with all the genetics.

[00:24:13] Dr Godbee: Exactly. Exactly. Yeah.

[00:24:16] Leah Sherman, ND: So, and there are other concerns with the vaccine. Um, I wanted to reemphasize that it's not just cervical cancer,

[00:24:26] Dr Godbee: All.

[00:24:26] Leah Sherman, ND: other cancers, like you said, like various head and neck cancers and, um, vulvar vaginal and penile cancer

[00:24:33] Dr Godbee: Yes. Yes, absolutely.

[00:24:36] Leah Sherman, ND: don't want people to think that they, you know, for whatever reason, like they, they feel they're safe.

[00:24:45] Dr Godbee: Right.

[00:24:45] Leah Sherman, ND: Not to, not to scare people to say that everyone is at risk, but you know, people, you know, people are at risk and there is a lot of, there's a lot of misinformation

[00:24:53] Dr Godbee: Mm-hmm.

[00:24:54] Leah Sherman, ND: and there is cause for, you know, there's legitimate cause for concern when it comes to any vaccine,

[00:24:59] Dr Godbee: Right.

[00:25:00] Leah Sherman, ND: a lot of misinformation.

[00:25:02] Dr Godbee: A lot of misinformation. Um, but you also have to look at how long it's been out, right? Um, geez, it's almost at 20 years now that the HPV vaccine has been out. So we have a lot of data on it and the safety of it, you know, as with most injections and vaccines. You might get a little pain where you get the shot, but other than that, it's overall a safe vaccine to receive.

And you have to remember, like this is gonna decrease your risk of getting a cancer. Cancer is a completely different beast that you don't wanna deal with. If you can lower the risk, eliminate the risk, you wanna do it because that, I've seen some bad cases of cervical cancer.

[00:25:51] Leah Sherman, ND: Oh yeah,

[00:25:52] Dr Godbee: Yeah. Yeah. And the treatments that they have to go through.

[00:25:56] Leah Sherman, ND: some of the things that I, because I was, I was brushing up on my, on my cervical cancer knowledge.

[00:26:01] Dr Godbee: Yeah.

[00:26:02] Leah Sherman, ND: smoking can increase the risk, right?

[00:26:06] Dr Godbee: Smoking increases the risk. Um, any immunosuppression does as well.

[00:26:12] Leah Sherman, ND: Like HIV.

[00:26:13] Dr Godbee: Yes, yes. prior STIs increase.

[00:26:18] Leah Sherman, ND: right? Isn't,

[00:26:19] Dr Godbee: Mm-hmm.

[00:26:20] Leah Sherman, ND: See,

[00:26:20] Dr Godbee: Increase,

[00:26:20] Leah Sherman, ND: I feel like I'm being quizzed.

[00:26:22] Dr Godbee: yes.

[00:26:22] Leah Sherman, ND: great. And then I saw on one site, I think it was Mayo, it says, access to healthcare is risk factor, which I guess would be a risk factor for of these cancers.

[00:26:35] Dr Godbee: Right, because they're not able to get their proper screening done,

[00:26:41] Leah Sherman, ND: Right.

[00:26:41] Dr Godbee: right? So if you're not getting your screening, then of course that risk is gonna go up. Um, 'cause you're, you don't know what's going on in your body. Yeah. So yeah, that goes along with that new testing that's out.

 so let's talk about the home testing

Okay.

[00:27:00] Leah Sherman, ND: cervical cancer,

[00:27:01] Dr Godbee: Yes.

[00:27:01] Leah Sherman, ND: typically a patient would go to their gynecologist and they would get a pap.

[00:27:08] Dr Godbee: Yeah. So, just this year the, uh, in-home cervical cancer test came out and, it uses a wand. That patients can, do at home, insert it and collect the specimen, send it off, and they have access to a healthcare provider who can review the results with them and then make further recommendations for 'em.

So I think it's really good. Like you said, one of the risk is being in a rural area, not having access to healthcare. For those patients, you know, you can order this in the mail, do your home test, get it shipped back off, without having to go out and seek, another provider. Um, so I think it's, it is a good space to be in.

It's a good opportunity. but there are some, caveats to it, right? Um, it does not replace your annual exam. You still need to see a physician. Um, and some people go to their primary care providers too for uh, pap smears, like their family doctor, internal medicine doctor, 'cause they can do them as well.

But you know, at those visits you're able to talk to someone about symptoms. Other things that may be going on. They're able to do a full physical exam, listen to your heart and lungs, do breast exam, get a visualization of the, female anatomy, do pelvic exams, which will, um, test the uterus and the ovaries.

And so that wand, it's not really doing that, right. It's only collecting sales for HPV, not the cytology part either. So, um, you know, 5% of the cervical cancers are not caused by HPV, so you might be missing a few of them, uh, with just the in-home test. So, you know, even if you decide to do your in-home test, I still recommend getting the full physical exam done, um, because you don't wanna miss something else.

[00:29:16] Leah Sherman, ND: And I would think that. A concern would be if someone were to get positive results, is there follow up to make sure that they are seeing another doc, you know, a doctor actually to, to help them, you know, manage whatever's going on.

[00:29:32] Dr Godbee: Right. So I know that that testing, company, they have, medical providers who can review the test results with you. But you're right. What if it comes back positive, then what? Are you referred to someone locally? Are you kinda out there on your own to just, uh, find that provider? Hopefully they have like a follow up system where they can ask the patients, you know, Hey, did you follow up yet?

Or they just checking in, you know? Um, but yeah, that is another valid point that you would still need to, at that point, go in to see, a provider.

[00:30:14] Leah Sherman, ND: Okay.

[00:30:14] Dr Godbee: And that test is not really for everyone. Right? Um, so the pregnant patients who need pap smears, um, those who are immunosuppressed, those who have a history of abnormal pap smears orcervical procedures, those patients, um, wouldn't necessarily qualify for that test.

So you would still have to go in,

[00:30:37] Leah Sherman, ND: Okay.

[00:30:38] Dr Godbee: And so in general for the gynecologic cancers, the treatments are, can be depending on the cancer, depending on the type of, The particular cancer, uh, the chemotherapy surgery, and also radiation.

Right, right. Yeah. And like you said, it depends on the type of cancer, the stage of the cancer, how we make our decision about, uh, which route we choose for a patient.

[00:31:02] Leah Sherman, ND: Okay.

[00:31:03] Dr Godbee: so this is the cancer pod and we do talk about integrative medicine and you have firsthand experience working with these integrative providers that we mentioned earlier. Um, so how do you. See the integrative services working with what you do, like what benefits have you seen for your patients?

You know, I love it. Right? so where I trained, we actually did not have the integrative services. So, like I said, when I started working with you out in um, Arizona. That was my first time and I so appreciate it because it really and truly does help the patients, right? And I've seen it benefit the patients, not only for those who are undergoing like chemotherapy and radiation, but also our surgical patients.

Right. and so, they help with the healing process of surgery, and then also the symptoms that patients will experience being on treatments and even the, um, the, uh, symptoms related to the cancer itself. So I greatly appreciate you guys, and I value what you do. Um, I'm, I'm so happy to be at a center that has that integrative oncology.

[00:32:21] Leah Sherman, ND: I really wish that it was available at, at more cancer centers

[00:32:25] Dr Godbee: Mm-hmm. Mm-hmm.

[00:32:26] Leah Sherman, ND: know that we see the benefit and it's like everything that some patients wa you know, wanna see you and, you know, they derive a lot of benefit and some patients are like, Nope, I don't wanna see you right now. You know, it's, kind of back and forth, but, um. I mean, we've worked with patients to manage their hot flashes.

[00:32:45] Dr Godbee: Yes. Yes. 'cause we put them in menopause.

[00:32:48] Leah Sherman, ND: yeah. And you know, the side effects from the, you know, like you said, the radiation, whether it's the bowel changes or, um, you know, like that comes with getting radiation, you know,

[00:32:59] Dr Godbee: Mm-hmm. Mm-hmm.

[00:33:00] Leah Sherman, ND: and all of that.

Yeah. And it is, it is a, for. Being a naturopathic doctor, it is really complex, um, because patients are getting multiple treatments

[00:33:13] Dr Godbee: Yes.

[00:33:14] Leah Sherman, ND: and so following with them as they go through each stage, you know, it was like really important.

[00:33:21] Dr Godbee: Mm-hmm. And the other, symptom that you guys help out with is the fatigue. Because just about every treatment that I give will cause fatigue. And I always say, Hey, let's put you in with naturopath consult.

[00:33:41] Leah Sherman, ND: Do y'all have an exercise program there? Is there an exercise program for the patients?

[00:33:47] Dr Godbee: You know what we don't? Um. We do have like our physical therapy team and um, but I don't think that we do. That's not a bad idea.

[00:33:59] Leah Sherman, ND: because I helped implement that at, um, at Goshen when I was working in Indiana.

[00:34:04] Dr Godbee: Yeah,

[00:34:06] Leah Sherman, ND: And

[00:34:06] Dr Godbee: help a lot.

[00:34:07] Leah Sherman, ND: it totally,

[00:34:08] Dr Godbee: Yeah.

[00:34:09] Leah Sherman, ND: our gyno there would refer a lot of her patients not only for like, you know, weight maintenance,

[00:34:15] Dr Godbee: Mm-hmm.

[00:34:16] Leah Sherman, ND: but for the fatigue and other symptoms too. 

 so yeah, so I think that's really great that, um, you have firsthand experience. Working with

[00:34:25] Dr Godbee: Yeah, and you know, honestly, some patients come in specifically to see you guys a.

[00:34:35] Leah Sherman, ND: And I know 'cause we're the ones that get asked like, so how, well, how would you treat cancer? And I was like, I would go to Dr. Kopi. Yeah, for sure. That happened. That happened in Indiana too. Yeah. That's, that's very common where patients go specifically because 

 they have all of the, you know, integrative providers there,

[00:34:55] Dr Godbee: Right, right. 

[00:34:56] Leah Sherman, ND: So, um, if there is anything that you would say somebody who's just been diagnosed with a gynecologic cancer, like is there a piece of advice that you would give?

[00:35:12] Dr Godbee: yes, so I know that a lot of patients come in wondering. How long have I had it? How did I get it? Why me? Right? And I frequently tell them a lot of that is unknown. It's unknown. We can't change the past. What we must do now is deal with what we know and look into the future. And treat what we have in front of us and remain positive.

I truly believe that patients who have a positive outlook, um, even though they may know the outcomes, but the positive outlook plays such an important role in getting through the treatments. Finding that support system. you know, we have, um, a team who connects patients with similar cancers so that they can have support, but it's also important to have those family members and friends who can support you too.

And I know not a lot of people like to, discuss their medical issues and health, but you need the support. You absolutely need the support to help you get through.

[00:36:40] Leah Sherman, ND: Yeah. Yeah. I think as well as with breast cancer, but with, from what my experience working with, with your patients, um, and you know, all of the gyno patients, it's a really hard cancer to kind of wrap your, all of them are hard cancers to wrap your head

[00:37:02] Dr Godbee: Mm-hmm.

[00:37:03] Leah Sherman, ND: you know, it's part of your sexual identity. It's part of,

being female or

[00:37:07] Dr Godbee: Yeah. Mm-hmm.

[00:37:09] Leah Sherman, ND: with the GYN cancers it, you know, it absolutely is part of, you know, one's identity. And I think that's, that's what I saw a lot

[00:37:20] Dr Godbee: Mm-hmm.

[00:37:21] Leah Sherman, ND: with. Especially working at CTCA with your patients, um, was like the mind body aspect is something that really needs to be supported.

[00:37:35] Dr Godbee: Absolutely. Absolutely. And that's too where that integrative medicine comes into play. 'cause we didn't mention about the, um, counselors

[00:37:45] Leah Sherman, ND: Right.

[00:37:46] Dr Godbee: are available. Right. Which can help with that. Um, psychiatry as well. Because it, it's tough. No one wants to hear the word cancer.

[00:37:56] Leah Sherman, ND: Right.

[00:37:56] Dr Godbee: No one wants to hear that word. And it's like as soon as you hear it, everything just kind of sinks.

Right? And so you definitely need that support to help uplift you as much as possible, right?

[00:38:12] Leah Sherman, ND: Yeah,

[00:38:12] Dr Godbee: Yeah.

[00:38:13] Leah Sherman, ND: And I know I'm gonna hear from my friends who are, uh, mind body counselors and they're gonna be like, how'd you forget us? So.

[00:38:24] Dr Godbee: We don't when in the.

[00:38:27] Leah Sherman, ND: That's right. We're like, please, please, you. You do need that support. And people are reluctant. But I really do think, and I, I know that it, it did benefit a lot of the, the gyno patients because it, it is, they all the, all of these cancers have so many different levels to it, you

[00:38:45] Dr Godbee: Mm-hmm.

[00:38:46] Leah Sherman, ND: is sexuality, it is reproduction.

[00:38:49] Dr Godbee: Mm-hmm.

[00:38:50] Leah Sherman, ND: Um.

[00:38:51] Dr Godbee: And like you said, the symptoms that come along with it, right? Because we're putting patients, most of these patients into menopause,

[00:38:57] Leah Sherman, ND: mm-hmm.

[00:38:58] Dr Godbee: if they've already gone through menopause, some of the medication that we use causes menopausal symptoms. And so. We all know that, you know, women going through menopause, it's a different time period in our lives.

[00:39:11] Leah Sherman, ND: Exactly.

[00:39:13] Dr Godbee: Yeah. So it, it can be tough for patients.

[00:39:16] Leah Sherman, ND: Yeah.

[00:39:17] Dr Godbee: Mm-hmm.

[00:39:18] Leah Sherman, ND: Yeah. I really appreciate you taking the time to come and talk with us here

[00:39:24] Dr Godbee: I'm so,

[00:39:26] Leah Sherman, ND: taking the time to talk to me.

[00:39:27] Dr Godbee: yes.

[00:39:28] Leah Sherman, ND: Um, yeah, it's really nice catching up with you.

[00:39:31] Dr Godbee: It is. Same here. I'm so honored to be here. Like I love this podcast. I, I love everything that you guys are doing and I wish you much success with it as well. Very inspirational.

[00:39:45] Leah Sherman, ND: Oh, thank you. Thank you so much. 

​

[00:39:50] Tina Kaczor, ND, FABNO: Well, that was an excellent interview, Leah. Thank you so much for taking the time to do that with Dr. Godby.

[00:39:55] Leah Sherman, ND: Dock. I have been. Wanting to interview her. so I'm glad that I was finally able to connect. and yeah, it, you know, it was a really nice review for me too, because I wanted to be on top of my game.

[00:40:09] Tina Kaczor, ND, FABNO: Right.

[00:40:09] Leah Sherman, ND: it's been a while since I've worked with her and so it, yeah, the whole experience is just, she's the kindest person

[00:40:16] Tina Kaczor, ND, FABNO: Well, and

[00:40:17] Leah Sherman, ND: such a great doctor.

[00:40:18] Tina Kaczor, ND, FABNO: yes, clearly she is an excellent clinician. It's just she's so present 

[00:40:23] Leah Sherman, ND: I think it's idea if people have listened to this episode to follow her on Instagram because she does continue to give out more

[00:40:32] Tina Kaczor, ND, FABNO: Oh,

[00:40:33] Leah Sherman, ND: Just the other day, she had a post about melanoma of the vulva

[00:40:37] Tina Kaczor, ND, FABNO: Mm-hmm.

[00:40:38] Leah Sherman, ND: It is not necessarily related to sun exposure. I did not know that, and it's really rare, but I know someone who has that or

[00:40:46] Tina Kaczor, ND, FABNO: Mm-hmm.

[00:40:47] Leah Sherman, ND: So, um, does continue to give out tidbits. Her Instagram, her social media is, you know, she mixes her personal life and her professional life, but she's got good info out there.

So her Instagram is, it's me underscore. Dr. Dot nsg, so we'll put that in the show notes. so people can follow her and continue to get this really good information.

[00:41:14] Tina Kaczor, ND, FABNO: Yeah. Yeah, I think that's really good and it does change over time. So that's the other piece of that is, you know, what was, what's true today wasn't true three, five or 10 years ago. So it's much better to follow somebody who is an expert than it is to try to figure it out yourself online. And

[00:41:30] Leah Sherman, ND: and

[00:41:30] Tina Kaczor, ND, FABNO: you can limit the

[00:41:31] Leah Sherman, ND: the

[00:41:31] Tina Kaczor, ND, FABNO: dates on Google, but still doesn't, does do the same as, uh, listening to an expert.

[00:41:36] Leah Sherman, ND: well, just just from like the information that you got when you were in school, the information I got years later and then practicing and what's out there now, like guidelines change.

So that was the other thing. So yeah, definitely follow Dr. Godby. Let us know what you thought of this episode. Again, leave a comment. If you're watching this on YouTube, leave a comment in a review if you are listening to this on

[00:42:03] Tina Kaczor, ND, FABNO: That'd be great.

[00:42:04] Leah Sherman, ND: or iHeartRadio or wherever you're listening. and then follow us on social media.

We are the cancer pod all over the place. TikTok, Instagram, Facebook threads. I don't know.

[00:42:18] Tina Kaczor, ND, FABNO: Yeah, and if you'd like and if you'd like to check out our website, because on our website we have some recipes, we've got some blog content, we've got links to a bookshop and some merchandise, and so, and you can find a whole lot on our website as well.

[00:42:31] Leah Sherman, ND: Oh yeah, buy a t-shirt. Represent, get a beanie.

[00:42:36] Tina Kaczor, ND, FABNO: I need to get a beanie.

[00:42:38] Leah Sherman, ND: I

[00:42:39] Tina Kaczor, ND, FABNO: I don't have one yet,

[00:42:40] Leah Sherman, ND: I don't either get on that note, I'm Dr. Leah Sherman,

[00:42:45] Tina Kaczor, ND, FABNO: and I'm Dr. Tina Kaser.

[00:42:46] Leah Sherman, ND: and this is the Cancer Pod.

[00:42:49] Tina Kaczor, ND, FABNO: Until next time,