Who's in Your Pod? Lise Alschuler, ND, FABNO, The Naturopathic Professor

Interview with Dr. Lise Alschuler

[00:00:00] LEAH: Hey, Tina,

[00:00:00] Tina: Hey Leah.

[00:00:02] LEAH: probably say this about every interview, but this was a really good interview

[00:00:06] Tina: Well, we say that at every interview because we invite people we want to talk to, so then we're all pleased that we just talked to them.

[00:00:11] LEAH: Yeah, so in this episode We talked to Lisa Altshuler,

[00:00:18] Tina: Dr. Lise Altshuler.

[00:00:20] LEAH: Dr. Lisa Altshuler, who is a Naturopathic physician We'll go into her bio in a bit. But yeah, we talked about her top three things What I don't remember what they we called them Desert Island

[00:00:35] Tina: I think you might have said that. I think you did

[00:00:37] LEAH: I say desert island for everything.

I don't know. Like if you were on a desert island, what are the three things you, you would, you know, take with you? It's that kind of concept. What are like the three most important things when somebody has cancer,

[00:00:51] Tina: She and I also work for a journal together, so we know each other very well, and she herself had Breast cancer, a while ago now, thankfully.

[00:00:58] LEAH: which we don't talk about. She doesn't, she doesn't talk about it in the episode.

[00:01:02] Tina: She doesn't talk about it in the episode. She has certainly written about it and she is very public about it. Um, but does not talk about her story as the centerpiece because she is a professor at University of Arizona. So she sticks more to the medical aspects and she does a lot of lecturing to our colleagues.

Um, probably more so than the public even, but I think this discussion was fun because we had her boil it down to the three things that she believes most important. In the prevention of cancer and the prevention of its recurrence. And, uh, you know, she's thought about it for 20 years. And so, boiling it down and distilling it to the, to bare bones must do's, you know, she was the perfect person for the job, really.

[00:01:40] LEAH: And because she is a professor at university of Arizona, it's all evidence based.

[00:01:46] Tina: Yes! Yeah, you know, I just ran into somebody at a gathering, and it was, Someone who used to be, I don't know, like a IT person or something, something in the Bay area having to do with technology. And when she heard what I do in a grade of oncology, naturopathic oncology, the first thing out of her mouth was.

Well, I'm very data driven. When I had cancer, I didn't do anything like that. Now this is a social setting, so I didn't, you know, on the spot school her or anything. I just thought to myself, how interesting. She automatically thought there was no data behind it. That's basically what she was saying. I didn't go that direction because there's no data.

There's so much information and there's so many studies and there's so much data that if you're data driven, then you would have done integrative oncology. So anyways, back to your comment about Lease. Yes, all evidence based.

[00:02:35] LEAH: Well, I think the most surprising thing was what her number one. Recommendation is like, I think that's going to be really, um, I think a lot of people are going to be surprised by that.

[00:02:46] Tina: think so too.

[00:02:47] LEAH: So you should stick around and listen to this episode because you're going to learn a lot.

[00:02:53] Tina: I'm Dr Tina Kaczor and as Leah likes to say I'm the science-y one

[00:02:57] LEAH: and I'm Dr Leah Sherman and on the cancer inside

[00:03:00] Tina: And we're two naturopathic doctors who practice integrative cancer care

[00:03:05] LEAH: But we're not your doctors

[00:03:07] Tina: This is for education entertainment and informational purposes only

[00:03:11] LEAH: do not apply any of this information without first speaking to your doctor

[00:03:15] Tina: The views and opinions expressed on this podcast by the hosts and their guests are solely their own

[00:03:22] LEAH: Welcome to the cancer pod

Okay. So we have, we were doing an interview today and our interview is one of these people that I consider one of the rock stars of naturopathic oncology. Um, just somebody that we're always excited to listen to when she does, you know, speaks at conferences, um, the two of you together at a conference.

is, truly memorable every year.

[00:04:04] Tina: You're just saying that because we do, we do some kind of entertainment for five or ten minutes before it even starts.

[00:04:09] LEAH: Yeah, no, it's, yeah. Because you make us laugh. Um, anyways, okay, so, today we're talking to Dr. Lise Altshuler, who is a professor of clinical medicine at the University of Arizona, where she's the assistant program director of the Fellowship in Integrative Medicine. at the Andrew Weil Center for Integrative Medicine.

A highly accomplished naturopathic physician, she is a graduate of Bastyr University, where she also completed a general medicine residency. She holds board certification in naturopathic oncology and is licensed in the state of Arizona. She's co author of Definitive Guide to Cancer, now in its third edition, and Definitive Guide to Thriving After Cancer.

Dr. Allshuler also co hosts 5 to Thrive Live, a podcast about living more healthfully in the face of cancer. Is that about it? Did I miss anything, Lise?

[00:05:00] Lise: I have two dogs. I live in Tucson, Arizona. I love the desert. I'm a, I'm a golfer. Not as good as I'd like to be, but you know I do myself proud. True,

[00:05:13] Tina: know any golfers who are, uh, you know, really happy about their own game. They all think they could do

better next

[00:05:19] Lise: Yes, very true.

[00:05:21] LEAH: And you're getting, you have like nine months of beautiful Arizona winter in which to play golf

[00:05:27] Lise: Yeah, we play in the summer too, actually. It's quite hot, but it's nice because there's hardly anybody out there. And,

[00:05:33] LEAH: because it's so hot.

[00:05:34] Lise: yeah, because it's so hot.

Exactly.

[00:05:37] LEAH: So what are we talking about today, Tina?

[00:05:39] Tina: Well, since we have Lise, who has been doing this for, gosh, over, Like, I don't know, you've been practicing over two decades, and I know you know a lot, so we're going to try to do a distillation.

[00:05:49] Lise: Almost three. Almost three, believe it or not.

[00:05:52] Tina: Get out of here.

[00:05:54] Lise: I know, I know. I don't look that old, but it's

[00:05:56] Tina: I was going to say, did you start practicing when you were 15?

[00:05:59] Lise: Yeah.

[00:05:59] LEAH: Yeah.

[00:06:01] Tina: So distilling down the must do's to reduce the risk of developing cancer or having cancer recur. So in the huge landscape, because, you know, there's so many things people can do, should do. Um, what do you think, if there was... Three things. That's what we're going to talk about today. We'll go into one by one, and we'll kind of have a little chats about those things.

But, um, what's the number three thing? I'm going to go backwards and have number one last. What's the third most important thing?

[00:06:32] Lise: Okay, I just want to preface this by saying that there's a lot... To do with cancer that people cannot do anything about. So I just want to say for instance I think that the environment in which we live is Toxic and is cancer causing for the most part

[00:06:54] Tina: Mm hmm.

[00:06:55] Lise: in utero All the way through. And, you know, it's hard to do something about that, so I'm not going to talk about that as one of my top three, but I do just want to say that in a way that maybe I should, because we can do something about it.

We can be activists, we can be mindful about our environment and our homes, we can, you know, vote along the lines of, you know, whatever we need to, to help our environment become cleaner. It's very indirect and it will probably affect the next generation more than us But I do just want to say that I think the environmental Toxin story or reality is something we should pay attention to

[00:07:33] Tina: Yeah. Yeah.

That's the thing. I, we're seeing this huge uptick in colorectal cancers, as you know, in people in their twenties and thirties now. And I do wonder if that has to do not just with their parents, but their grandparents, because that's how that works in rodents, right? We call it skipping a generation, but biologically it all makes sense that it doesn't get handed down to the progeny, but the second.

And the third generation after the exposure, which is, you know, really interesting because we had some nasty stuff like DDT in the environment and it was everywhere, 60 years ago.

[00:08:04] Lise: Yeah, so Yeah, I think it's a really important thing. I think it's becoming increasingly important to you know, not just toxins per se but I think that because of the imbalance In which we live, there are more infectious organisms and more dysbiosis, not only in our gut, but in our tissues, which can dysregulate gene expression and lead to cancer.

So, I think it's a really important thing. Maybe, maybe, since we're talking about it, maybe I'll make it number three. What the heck. You know, I mean, I think that, um, It's overwhelming for people a little bit, like, oh my gosh, the environment, what am I going to do about it? And, you know, to some extent, there is definitely a list of things that we could kind of check off in our own homes.

Like, is the water that we're drinking clean? Do we have, you know, air filters or purifiers? Are we conscious about the chemicals that we're using, especially the ones that get hot, so in Our dishwasher and then our laundry machines and things like that. So I think there are those lists. I think those are impactful for sure, absolutely.

Um, I think really what's going to be most impactful is when we as a society really take responsibility for how we're living on this planet and to collectively start to make some changes. And we are, you know, there's definitely some changes that are happening, but, I feel there's a certain urgency now to this.

And I think it's really important that really every opportunity we have to, um, as I said, to, you know, choose to do something that's maybe greener versus not as green, to just really think along the lines of environmental health. I think that over the long term, that's going to probably make one of the biggest impacts on cancer prevention.

[00:09:51] Tina: I agree. I'm very hopeful because the youngest generation seems to understand that better than, our age at that, at, what's that, years ago, 35 years

[00:09:59] Lise: Yeah. Right. Right.

[00:10:02] LEAH: And I think that's important too, because people think that, you know, there's... nothing that they can do. And maybe it feels that way on the big grand scheme of things, but like you're saying, like in your own home, you can reduce the risk of exposures on the individual level, in addition to being an advocate on a more, you know, global level.

[00:10:25] Lise: Mm hmm.

[00:10:26] Tina: Let me ask you this, Lee. So, once someone has had a diagnosis of... Any cancer. Do you think it's just as important for that crowd as for the crowd trying to reduce the risk of initial diagnosis? Because sometimes that's that attitude of like, well, I've already had cancer, but what's the difference?

[00:10:41] Lise: I mean, yes and no. You know, I think we don't really understand fully how long it takes for these environmental toxicants to, um, change our biology and to manifest in cancers. You know, from the data I've seen, I think it's years and years and years of accumulated exposure. So, if somebody's already had cancer, obviously their concern is recurrence, which is, for most cancers, going to happen within.

Not always, but let's just grossly generalize and say within five years, Right, ? So would environmental toxicant avoidance make a difference in terms of recurrence in those five years? I don't know the answer to that. I mean, I don't think it's been studied. I think what I would say is that it would make a difference in terms of how people feel and the health of their detoxification system.

The level of inflammation in their body, and we know that there's links between inflammation, chronic inflammation and carcinogenesis. We know that there's links between, uh, impaired detoxification and carcinogenesis. So I could theorize that it would make a difference in terms of reducing the risk of recurrence, but this is out on a no data limb.

[00:11:50] Tina: Right, ?Yeah, and we have entire episode about detoxification and elimination and how people can support that. So we'll just refer people back to that episode if they're interested in looking at how to clear out their own systems and their own body burdens of chemicals that are inevitable.

[00:12:07] Lise: Yeah. Two? Were you up to two? Okay, so, I think I'm gonna, I'm gonna do a nice little segue, right? So, um, cause I'm gonna merge, I'm gonna combine what was my three and two into two. As a segue from my new three. So, we've talked about environmental toxins, and you just mentioned detox. So, I think one of the ways we can support detoxification is through exercise and our diet.

So, I'm gonna just make a point that I think number two would be exercise and diet. Merge together.

[00:12:40] Tina: Okay? Mm-hmm.

[00:12:41] Lise: not just because of their role in detoxifying and lowering inflammation, but, you know, I think a lot of people think about diet first, which makes sense, because we eat a lot. We eat many times a day, we think about what we're eating, we spend time preparing food, we eat socially, so it's like on our minds a lot.

Um, at best, the data seems to indicate that, you know, if you had a pristine, perfect diet every day of your life, you would probably reduce your risk of... Initial cancer or cancer recurrence, depending on the type of cancer, around 30 40%. So, that's a relative risk reduction. So that's great, that means 100 people ate perfect diets, 30 40 of those people may not get cancer because of the way they're eating, which is a lot of people, so that makes a big impact.

But, it's not zero, right? it's not a 100 percent risk reduction. So, diet is not enough. One of the things I hear in my patients is sometimes they think about their diet to the exclusion of other things. So I think it's really important to put diet into context. Um, I also think that people can get very extreme with their diets.

And, you know, extreme diets are not generally sustainable, and they're also really not evidence based in terms of long term risk reduction. Speaking about specifically cancer risk reduction. Really, the only evidence based things we can say is that if we eat a diet that's plant based or plant forward that doesn't mean vegetarian, but that means that we're eating mostly plant food, or at least we're having some plant food every meal, that we're eating a diet that's replete in, protein, but more specifically, amino acids.

So we're getting all of the amino acids we need to support, especially our immunity and our digestive tract, lowering inflammation. that's pretty important. And we do that by diversifying our protein sources, right? So it's not just meat. And I think meat can be inflammatory if we eat too much of it, but it's nuts, it's seeds, it's some high protein grains.

And, you know, things like that. And we can say from an evidence based perspective that eating less is important. And actually I've come to believe that's probably the most important component of diet is just eating less. Every time we eat, we're introducing this enormous oxidative insult to the body.

Like it's a huge oxidative stress on the body to digest food, and so the less often we do it, and the less that we're eating, the less oxidative stress. Just that alone is going to be impactful, and it's also true that when we have an excess of calories, it really disrupts our metabolism, and the ability for us to regulate glucose, and insulin, and leptin, and all these things. Hormones and chemicals, which we know are involved in cell proliferation, in tissue cleanup, and regulation. So I think, you know, the most important thing that people can really think about is portion control. I mean, ultimately, it just comes down to portion control Uh, which is hard, because we use food for lots of things besides just meeting our needs of hunger.

Um, but I would say that if, if people want to really use diet as a weapon, In terms of cancer prevention, it would be eat a plant based diet that's somewhat calorie restricted. Not starving yourself, but even there's some data that even if you reduce your caloric intake by as little as 10%, You will make a difference in terms of your risk of cancer recurrence, and I think, you know, the more the better, to an extent, you know, depending on how much you're eating now, but would say that if I have to narrow diet down to a couple things, it would be that.

[00:16:27] Tina: Okay, so majority plants and less calories in general.

[00:16:32] Lise: Yeah, yeah, and then, you know, within that, just think about protein and making sure you're getting a good diverse set of proteins, and then, of course, oils, right? So we want good anti inflammatory oils, particularly olive oil. Um, not seeds. I mean that, that right there will take you so far. Now, along those lines, obviously if you're filling up on processed foods, it's going to be hard to calorically restrict because those are typically high calorie foods that don't really give a lot of nutrition.

So just by focusing on plant based, calorie restricted, good quality proteins and maybe some good quality oils, you will have to reduce processed foods and packaged foods, which are not good for us either. You

[00:17:13] LEAH: So, regarding protein, would you say that there's any formula to calculate how much the average person should have in terms of protein? Because there's a lot of conflicting information where some of the more plant based crowd says that we don't need as much protein as, you know, traditionally believed.

What are your thoughts on that?

[00:17:35] Lise: know, I think some people don't need very much protein, however, I do think that, um, You know, cancer affects mostly people that?

are older. So the majority of cancers, and this is changing to some extent, as Tina mentioned, with colorectal cancer in younger individuals, but most people who have cancer are over the age of 50, As we get up into those age ranges, the protein needs increase because we're at high risk for muscle failure.

Mass loss and with any degree of sarcopenia or muscle wasting we again disrupt our metabolism our ability to manage blood sugar insulin inflammation So, I think for the population at risk, protein is really important. And most people probably need about a gram at least of protein per kilogram or per 2.

2 pounds of body weight a day. So, you know, depending on your weight, that's gonna generally be between, say, 50 and 90 grams of protein a day. And the key though is that that protein, especially as we get older, needs to be divided into at least three. Equal measures so that you're having protein with your breakfast, protein with your lunch, and protein with your dinner.

And it's that spreading out of the protein intake that has the biggest positive impact on our metabolism. this is something I counsel patients about a lot. A lot of us eat a very carb rich breakfast. So we don't really get a lot of protein. We've already overnight fasted.

So our protein stores are already low. Then we put a bunch of carbs in. We don't have any protein. We may have some protein with lunch, then we eat most of our protein with dinner. And it just really needs to be spread out. And frankly, a lot of people as they age, especially I've noticed women, tend to eat insufficient quantities of protein.

[00:19:24] Tina: So this is a little tangential, but do you also recommend that people go 12 hours fasting overnight, like a daily time period where people don't eat anything or nothing caloric, I should say?

[00:19:35] Lise: Yeah. so I usually recommend 13 hours if they can do it. you know, I think the magic really happens after that 12th hour where... you know, we're operating on the law of averages, right? But for most people after that 12th hour of overnight fasting, that's when autophagy or cell repair starts to kick in,

The immune system starts to get kind of pushed into gear. So I think that 13 hours is kind of, um, critical. And then up to 16 hours is good. Beyond that, I think it actually starts to create more stress on the system than benefit. So I think that there's sort of a diminishing returns after 16 hours of overnight fasting.

And, depending on who you're talking about, it can be... Uh, even more detrimental like a menopausal woman because of the hormonal state that she's in Really shouldn't be fasting in my opinion for 16 hours overnight. She should be way back at 13 max And that that's where there's going to be benefit but not increased inflammation, for example Um, but I do think that overnight fasting is important because it allows the body A rest from that oxidative stress so it allows your body on a cellular level to restore your antioxidant capacity or status and all these other processes which are really important in terms of cell cleanup to start to take place.

[00:20:52] Tina: Yeah. That cell cleanup or autophagy is... Probably one of the most amazing discoveries in the last 20 years. it's basically, uh, to put it in lay language, it's your body's ability to cull out the weaker cells. And so whether that's in your brain or in other tissue in your body, autophagy is one means of removing unhealthy cells.

 we'll put a link to it. in our show notes, just because it's fascinating.

[00:21:20] LEAH: Exercise. The other part was exercise.

[00:21:23] Lise: Yeah, so here I am, like, exercise. So, I used to say that exercise was the most important strategy, but, uh, now I have a different one. We haven't gotten to it yet, but I think exercise is absolutely critical. Um, so, you know, we're meant to move, of course, but when we exercise on a regular basis, we... Um, it has really what's called a hermetic effect on the body.

So, exercise.

itself, let's play this, exercise itself is a stressful event on the body, just like eating. It generates a huge amount of oxidative stress, it causes muscle destruction. It's, pretty hard on the body, but when we do it in sort of these limited ways, in which we exercise like 30, 45 minutes an hour, the body responds to the damage.

So it ends up up regulating our antioxidant defenses. It ends up up regulating our anti inflammatory defenses. And exercise muscles secrete their own slew of chemicals, myokines, which have very important anti inflammatory, immune regulating effects, anti cancer effects. So, exercise... I just can't stress enough how important it is, just on a physiological level.

Never mind the psychological benefits of exercise. When people move, they tend to have better mood. um, it's one of the best anti depression strategies. if you exercise out in nature, you're getting the benefits of being out in nature, which is very healing to the body. plus you're just more fit and able and capable.

In your day to day life, again, if we're talking about people at highest risk of cancer, we're talking about people that are more advanced in their age, and mobility and fitness is really critical to leading a high quality life. so exercise is important. However, it's not just getting, I mean, Getting out for a moderate stroll is great, and if you're able to do more than that, to push yourself so that exercise is still fun, still enjoyable, but more difficult, then that's where you want to be, as Tina, and I've, you know, borrowed this from Tina many years ago, but you always want to be at the edge of your fitness.

I think that's so critical, so that you're always working to develop more and more physical ability. So you're, you're literally creating that oxidative stress and that muscle strain and, and even injury so that you engage the body's healing response, which is what that hormesis is about. It's like these small little stressors.

that end up creating the anti stress response that, that's more dominant.

[00:23:50] Tina: Yeah. And do you recommend people do any particular type of exercise? Cause one of the other debates out there is resistive exercise.

no aerobic exercise, no, you know, how much and what type. So other than, you know, pushing yourself a little bit all the time and going to your own limits and pushing that.

What type is ideal?

[00:24:08] Lise: Yeah, so, I mean, the data indicates that both resistance exercise and aerobic exercise confer benefit in terms of cancer prevention. Pretty much on par with one another. Um, having said that, there are certain populations which benefit a little bit more from one type. And I think what most people miss is resistance exercise.

So, you know, I've talked to my patients about, yeah, getting up, they're getting your cardiovascular system pumped up through aerobic exercise because that obviously has circulatory benefits, not just blood circulation, but lymphatic circulation, which is really important going back to what we talked about earlier as part of our detoxification capabilities.

 but the resistance exercise is where we get that. muscle kind of tearing and then the healing response that occurs. So I think resistance exercise is really important. We know, for example, that men with advanced prostate cancer or who are at high risk for occurrence need to do pretty intense exercise and they definitely need to do resistance exercise.

 it's been shown to be beneficial in women with a history of breast cancer. So, you know, I talk to my patients about like, you know, make your gun. Is it, you know, when you touch it, is it hard? Like, if it's not hard, it's all mushy. There's work to do, right? So we just have to really, keep ourselves as fit as possible with resistance and aerobics.

So both. Both ends.

[00:25:30] Tina: I like that. Show me your guns.

[00:25:33] LEAH: It depends on what state you're in

[00:25:35] Lise: True, yeah.

[00:25:38] LEAH: So should we take a break? And then we come back and we talk about the number one must do to reduce your risk.

[00:25:44] Tina: Let's do that.

 All right, so I will admit, I thought exercise was going to be your number one.

Not even I know what you're about to say because normally when we talk out there on the circuit, Exercise is like, that's it, that's your take home point. So insert drum roll.  What is number one?

[00:26:12] Lise: So number one is Psychospiritual wellness. So it's more than stress management. Stress management obviously is a part of that, but true full on Psychospiritual wellness, I think is the most important tool we have for optimizing our health which includes preventing cancer. And, you know, this is really on so many levels.

So, just from a data perspective, for example, if we think about breast cancer, there was a landmark study that came out several years ago that showed that women who were socially isolated were at an increased risk of breast cancer recurrence. I think it was like 60 percent increased risk of breast cancer recurrence and death from breast cancer.

Just, they took out a lot of confounding variables and narrowed it right down to being socially isolated. So... let's think about social isolation. What is that? Social isolation is a feeling of disconnect, a feeling of being adrift, a feeling of being alone. And that is obviously going to have feelings of depression associated with it.

It's going to have feelings of anxiety potentially associated with it. And it's, it's a sense of not being part of a greater whole. And not being connected into a greater sense of purpose and meaning. There's some really interesting work that Tina and I have presented actually together on eudynamic wellness, which is this idea of having a sense of meaning and purpose in life, and that people who have higher eudynamic wellness Have a lower risk, for example, of ovarian cancer.

And, you know, we now know from data that when people are under high amounts of stress or depression, their gene expression patterns change. It's almost like the genes say, oh, you're not interested in life, you're not interested in living. Okay, we'll do a weekend. You know, shorten your lifespan. And, you know, that's like literally the strength of the messaging that we're sending ourselves on the cellular level.

So, I think it's really critical that people develop a way to feel connected to their community, to rediscover their sense of purpose and meaning, and to achieve a daily pattern of wellness activities that support that. So... This is where I talk to patients about everything from breathing exercises, just as a way to get centered and more present in our bodies, to mindfulness exercises, whether it's meditation, listening to music, doing art, contemplative reading, whatever it takes to just sort of take our nervous system out of the fight flight mode and into the relaxed, calm.

And then to think about, you know, okay, am I, am I lonely? Am I alone? Like, how can I connect with others? What's, what's important to me? Is it important for me to have animal beings in my life? Is it important for me to be in partnership or to be in a quality partnership? Is it important to me to be in a group where I can engage in meaningful work?

Do I enjoy my work? Do I socialize with my colleagues? I mean, these are all things that give us the opportunity to think about how we can kind of plug in to our community. We are meant to be social beings, and I think that without that sense of, Connectedness, doesn't mean we have to be out partying every night, that's not really what I'm talking about, although that might be true for some people, it's really just about feeling like we have some pendrils in the community, and so yes, I feel like this sort of isolation, spiritual angst, emotional confusion, or turmoil, these things will unravel our physiology, They will derail any other healthful habits that we're trying to establish, so that this is an area that has to be addressed first and foremost.

[00:30:24] Tina: I can appreciate why you've come to that in, in many of the reviews I've done for adjunctive cancer care in, in my kind of fog of information, I always come down to the nervous system as the root and in what you're saying is your mind and your thoughts and your spiritual side informs the rest of your nervous system.

That then goes on to have a physical effect,

[00:30:50] Lise: Mm-hmm. ? Yes. Mm-hmm.

[00:30:52] Tina: This is a little bit up the alley of, um, Bruce Lipton, who wrote the biology of belief a long time ago, talked about how it's a cell to cell communication issue. And what we need to do is change how the cells communicate with one another. And he talked about how beliefs ultimately inform your cells.

And it was very woo woo. Um, to be honest, it was. marketed as kind of with a little prism looking thing, like new age, but he's actually a PhD. And there was a lot of science in. the entire theory. He's still out there, you know, talking and he has a good following, but the biology of belief is ultimately a lot of science behind what you're talking about.

And, studies now are catching up to that whole idea, even though it was very new agey 20 years ago.

[00:31:37] Lise: Well, yeah, and I think another pioneer in this is Candace Peart, who wrote Molecules of Emotion, and she was really one of the first individuals that identified how our emotional state literally changed the cytokines that our cells produce. And we know cytokines are some of the most powerful messengers to our cells and change our cell behavior pretty dramatically.

So if we're in a consistent emotional state and we're Producing a certain cytokine profile, we're going to have a certain predicted cell behavior as a result, which I think can lead us towards a path, lead us on a path towards disease or towards health. you know, and I just, again, I just want to emphasize that this is, this is not overnight work.

This is something that people, you know, really have to commit and to, to engage in on a regular basis. And it takes time. It's just. It's a slow process, but incredibly important, incredibly impactful. And the nice thing about all this is that in addition to changing our physiology, changing our biochemistry, putting us more solidly on a cancer prevention path, we feel happier or more joyful in the process.

So we actually start to experience life more fully and with more gratitude and more joy, which, you know, who doesn't want that?

[00:32:59] Tina: You know, it reminds me also, cause you said nutrition and exercise, and then we are coming to this number one being. The psycho spiritual side. And in some of those studies that were done for exercise for prostate cancer and seeing better outcomes, specifically soccer was used in some of these studies.

And they found that soccer was unique or team sports are unique because there's also camaraderie and there's basically community building around it. And so it's interesting because they credited the exercise, but there was no way to really differentiate the exercise from the community building aspect of exercise.

[00:33:33] Lise: is true with yoga, like they've shown that yoga is beneficial in terms of reducing fatigue, let's say, after a cancer diagnosis, or even having some impact on risk reduction, and that if people enroll in a yoga class, it's more beneficial. And most of the time when you read those studies, the authors say well that's because people are more adherent.

There's accountability. But I think, like you, they're not really taking into account the social aspect and the connected aspect of being in a class as opposed to doing it on your own. Which for some people is fine, and you want to do it on your own in between. But what about that, you know, social connection?

[00:34:08] Tina: Mm hmm. Mm hmm. And if I remember right, there was a study that looked at exercise for breast cancer and colorectal cancer reduction, and they specifically saw in the data when people went to a gym, left their house to go do it, they had better results in

the subsets. And this, that was the one that looked from 1955 through is when it came out.

It's the one you and I have

[00:34:28] Lise: Right. Yep. Yep.

[00:34:30] Tina: So yeah, it's interesting because I don't think it's being tracked. You're right, but we can't tease that out of the information and I'm wondering how often that's been a confounder in our exercise studies that we don't really track. Maybe it's community as much as exercise.

[00:34:43] Lise: Right. Yeah. And, you know, I think, I mean, there's other Almost every other intervention that we've talked about, even with diet, you know, there's been studies that have shown that people who enroll in a diet class where they're taught how to cook generally have better outcomes, like their physiology changes, and they're more adherent.

So again, is that because... They're being held accountable, or is that because they're enjoying themselves as part of the community in that cooking class? Like, I just think we just, um, It's sort of staring us in the face a little bit. And I think that as researchers and as people who analyze research, we're also kind of missing it, in a way.

[00:35:25] Tina: It's not being tracked.

[00:35:26] LEAH: I got nothing to say, because Tina, you and I, you and I are going to download some of this stuff that's going on in my head once we're done with this. You know what's going on in my head right now.

[00:35:37] Tina: Okay.

[00:35:38] Lise: Well, I will say one other thing then, since you guys are speechless, um, I think that this sense of psychospiritual wellness is also one of the most important roles that those of us, three of us, as healthcare providers, provide. So, you know, we have our minds and our brains that give people information, and we kind of download the research and give them specific tactics, which is valuable.

But if we do that, In the absence of creating a connection with our patients that's based on unconditional love, that's based on respect, that's based on gratitude and joy for them being in the world, I think we're again missing an opportunity to really be fully in our role and our opportunity to be healers and also to gift these individuals with a connection, especially at a time when they're most vulnerable and most in need of it.

So. I would say that too.

[00:36:36] Tina: Yeah, that, you know, I, I've seen patients in clinic one on one in my clinic in Eugene. And then when I sold the clinic And went remote, I will say the healing relationship through a screen is not the equivalent of sitting in an office and sharing a space. It's just, I, it's good. You can still guide and help people, but it is, there's something that's, just not the same as far as the healing relationship.

You have to have contact with people. And I'm a little concerned with this remote medicine that we're going towards for everything. I think it's fine when you're being a technician, you know, and you're just saying, this is what, you know, Mrs. Smith, this is what your x ray says. And this is what we're going to do is very different than the healing relationship that's involved in the intimacy of a one on one conversation with the door closed and being in the same room where it feels different.

It feels like you're having a healing encounter.

[00:37:31] Lise: Yeah, I think that's, that's, I would, I would disagree with you a little bit just based on my experience. I think that, um, it is true that in, there's something about being in somebody's physical presence, a hundred percent, that's just different and important and, Really kind of sacred actually and I think that I find that when I'm doing video consults One of the things that I've noticed very clearly is that the people that I'm talking with are Much more comfortable because they're in their space.

They're not in my space and so that they're sort of more relaxed and Because they're more relaxed, they're almost more present, and when they're more present, more of themselves comes forward, and so there's more to connect with, actually. So I've actually found some really powerful connections remotely, too.

[00:38:19] Tina: Hmm, that's good to hear.

[00:38:21] LEAH: And that's, I think that's one of the things I really like about working. in a hospital or in a cancer center is kind of, you know, making the rounds through infusion and seeing a patient and just kind of sitting and just, you know, shooting the breeze, checking in on them, you know, more on that social level.

I will have social appointments. If I have a slow day, I will just go socialize with my patients, you know,

help them. help them. eat up some of that time while they're, they're getting their chemo or their infusion. And yeah, I think that those are some of my favorite appointments to be honest, is just, you know, checking in on them and seeing how things are going, um, which I don't, you can't really do that.

If you're doing telehealth, you can't just bring up your patient and be like, Hey, what's up on FaceTime. But it is something that I do enjoy the most, you

[00:39:10] Lise: Yeah. Great.

[00:39:11] LEAH: Oh, at least do you have anything that you want to promote? Is there anything that's going on that, um, You want to talk about,

[00:39:19] Lise: Um... I don't have an event per se, um, I have my own podcast, which is Five to Thrive Live, and that's also like yours available on all the podcast outlets, so people are welcome to listen in on that if they can't get enough, and, Uh, other than that, you know, my, my books are not new, but I think they're still relevant.

So I still have the books out there. If you just Google definitive guide to cancer, both will show up. Definitive guide to cancer and then also definitive guide to thriving after cancer. That's all I got.

[00:39:51] LEAH: It's a lot.

[00:39:52] Tina: That's all I got. You have a huge amount. If anyone googles, uh, Lise and spells her last name correctly, you'll see. It's a little tricky.

Um, but Yeah, Yeah, but you'll see a ton of information and all of it very useful and valid and you know One of the things that we all appreciate one of the reasons that whenever you lecture the room is jam packed Generally speaking all the chairs are full and it's either standing room or people are sitting along the sides is um You keep it very practical and actionable information for us clinicians.

Like here's the point. This is why Now go, go forth and help people, which I think we all appreciate. We want the take home point and we want to understand it in a way that we can help our, our own patients when we go back to our offices, um, if we're seeing patients. So, yeah, so it's really appreciated and we can't thank you enough for a lifetime of doing that.

Cause I know that the one thing you've always done is top of mind is to keep the idea of helping. The patient at the very forefront of everything you do, whether you're teaching at the college or you're in a lecture hall or writing a book. So it's all a similar vein. So it's appreciated.

[00:40:59] Lise: Well, thank you for saying that. I appreciate that. And I appreciate the work you two are doing with this podcast. I think getting this kind of information, not just this episode, of course, but all your episodes is so helpful and important for people, you know, just to really give them a resource of valid, trustworthy, Information that maybe they can't readily find in their sort of typical course of care.

[00:41:23] Tina: Yeah. Yeah. that's the goal. All right. Well, thank you, Lise. And, um, Leia, any other last comments?

[00:41:29] LEAH: No, I, this has been, this has been, no, this has been awesome. This truly has been, um, a pleasure hearing you speak on our show. Like I just said, it's really hard for me because I do really, I really do look up to everything That you do and, um, to have you on our show is really special. So, I'm like fangirling here.

[00:41:50] Lise: Well, my pleasure and um, Yeah, we'll have to have you guys on my show.

[00:41:55] LEAH: Oh, that'd be fun.

[00:41:56] Lise: What comes around goes around, right?

[00:41:58] Tina: Well, I will be on your show. We're recording live early December.

[00:42:02] Lise: That's right. You are going to be on our show. All right, Leia, you're up next.

[00:42:08] LEAH: Great.

 That was so good.

And a surprise! Like, number three and number one, both surprises.

[00:42:21] Tina: I know. See, that was good. That was unscripted.

[00:42:25] LEAH: Unlike us, who usually, who usually are scripted.

[00:42:30] Tina: No, we're never scripted per se, but, uh,

[00:42:33] LEAH: No, that was awesome, because we did not know what she was going to say, And yeah, forgive my fangirl moment, but it was kind of cool getting a little Altshuler. I don't know. And that's what you said is so true. You know, I think a lot. of people when they, when they present to the naturopathic community, um, They're, they tell you some things, but then it's like, everything's like proprietary, like they only, they give you tees, they want you to buy their book, they want you to do, you know, buy their formula, whatever, and Lise just tells you, you know, she wants people to, like you said, make people feel better, you know, like, it's great.

[00:43:09] Tina: yeah. And I didn't say this while she was on, but, um, she's probably the reason that I ever even got up on a stage to lecture myself. She pushed me up in 2007. She insisted. that I lectured to our fellow colleagues at the American Association of Naturopathic Physicians. And I was reticent. I was like, I don't know more.

These are my seniors out there. They're, they've been practicing 20 years. I've been practicing seven. I shouldn't be talking. And so it was on cancer care, which I had been doing exclusively for, you know, seven years at that point. But still, I didn't feel like I was qualified. Um, but I did it and I kind of got over that hump and.

Yeah. So from then on, I got enough positive feedback to get enough reinforcement to continue doing that. So it was really Lise that kind of cracked that open and said, ah, shut up and get up there.

[00:43:57] LEAH: I think, um,

[00:43:58] Tina: Pretty much. Not in those words. Yeah.

[00:44:05] LEAH: we should probably do some shows, some shows. We should probably do some podcasts on, um, on the number one, on the kind of psychoneuro, you know, psychoneuroimmunology aspect.

[00:44:21] Tina: I already have some, uh, hookups for that, people who are doing that exclusively.

[00:44:26] LEAH: Sweet.

[00:44:27] Tina: You can stay tuned because those were people I've already talked to about being on the podcast and have agreed to do it. So. Yeah.

[00:44:33] LEAH: Awesome.

[00:44:34] Tina: Not even you know, because I haven't told you.

[00:44:36] LEAH: No, this is new to me.

[00:44:38] Tina: Uh huh.

[00:44:38] LEAH: This whole, this whole day is full of surprises. So, if you like this episode, which I sure as heck did, um, let us know, leave a review, um, leave a rating, hit that follow or subscribe button and go listen to Lisa's podcast as well.

[00:44:58] Tina: That was called 5 to Thrive. 5 to Thrive Live.

[00:45:01] LEAH: yeah, I mean, so this is just a taste of the information that she, she, you know, provides on her show. And I don't, I don't know. I'm all, I'm all like, I'm so clipped.

Um, yeah,

[00:45:16] Tina: Oh, and of course you can, as always, you can use Buy Me a Coffee to do a minor donation. It's in the token of buying us a cup of coffee and that helps keep us going. And this community of which she speaks is our ultimate goal is create a membership and create more. Interaction with our audience and allowing our audience to interact with each other as well.

So stay tuned for that. There will be a link soon, if it's not already in these notes, because I don't know when this is going to be released somewhere in October. so yeah,

community is, is actually one of the inspirations for doing the podcast in the first place, way back in the day,

[00:45:52] LEAH: yeah, that's right. That's right.

[00:45:53] Tina: two years ago now.

 now we've got a fire lit under us to do it.

[00:45:57] LEAH: Now we're just, we're just kind of getting a rhythm going, huh?

[00:46:00] Tina: Well, now it's even, if we think of it as medicinal, it makes, it definitely bumps it up in our priorities, our list of priorities.

[00:46:06] LEAH: And on that note, I'm Dr. Leia Sherman,

[00:46:09] Tina: and I'm Dr. Tina Kazer,

[00:46:11] LEAH: and this is the Cancer Pod.

[00:46:12] Tina: until next time.

Thanks for listening to the cancer pod. Remember to subscribe, review and rate us wherever you get your podcasts. Follow us on social media for updates, and as always, this is not medical advice. These are our opinions. Talk to your doctor before changing anything related to your treatment plan. The cancer pod is hosted by me, Dr.

Lea Sherman. And by Dr. Tina Caer music is by Kevin McLeod. See you next time.