The Future of Integrative Oncology, Dr. Andrew Weil

Good afternoon welcome to the Donald I Abrams lectureship in integrative oncology my name is Shelley Adler and I have the pleasure of serving as the director for the UCSF osher Center for Integrative Health and today I have the um the the great honor of um of introducing uh both Dr Abrams and uh today's distinguished speaker Dr W so to begin the Donald I Abrams lectureship and integrative oncology which is being Uh inaugurated today is an annual speaker series to share developments in integrative Cancer Care and research uh Dr Abrams is an integrative oncologist at the

UCSF osher Center and he is now Professor uh Emeritus in the Department of Medicine he is also much much more I will keep this short because the truth is that this inaugural lecture ship could have just been talking about Dr abrams's accomplishments but we do have a guest Speaker um so um let me just see he um among among many other things uh was a uh a really um a pivotal figure uh in hematology and oncology at Zuckerberg San Francisco General Hospital he's been president of the Society of Integrative oncology um served on many many

different um uh uh Committees of the American Society of clinical oncology he uh was one of the original clinician Investigators to recognize many of the early uh AIDS related conditions and he's also conducted numerous clinical trials investigating both biomedical and complimentary Therapies in patients with HIV uh he's looked at traditional Chinese medicine interventions medicinal mushrooms and medical cannabis um but Dr ab's uh influence is is far broader than this for all the folks who um have the pleasure of knowing him whether he's introducing People to people including me to the wonders of eclipse chasing uh

waxing poetic about his beloved doc hunts or or sharing what I'll call um helpful hints about the nutritional quality of uh Ure Center snacks um Donald is truly devoted to improving the well-being of of everybody around him in a word he is a true mench I guess that's two words um I really can't think of a more fitting way to honor this wonderful person than with the establishment of this annual lecture Ship so uh to start us off please join me in thanking Dr Abrams for all of his [Applause] contributions thank [Applause] you thank you

and to know just how embarrassed you should be uh Donald uh there are several hundred people on the webinar as well so um lots of lots of eyes on you um now it's my pleasure to introduce today's speaker uh Dr Andrew W who truly needs no introduction is a World-renowned leader and Pioneer in the field of Integrative Medicine um I I was uh talking uh uh with him before uh this presentation about the fact that he completed his internship here at Mount Zion Mount Zion hospital um he uh is the founder and director of the

Andrew wild Center for integrative medicine at the University of Arizona where he also holds the level Jones endowed share in integrative Rheumatology and uh is a clinical Professor of medicine and professor of Public Health I was also noting earlier that um many of our clinicians and certainly clinicians all around the world have benefited from uh the outstanding training they've received through the uh clinical Fellowship um at the University of Arizona Dr W has authored 15 books many of which are National and international bestsellers of particular uh relevance to uh today um uh he also uh

co-edit With Dr Abrams the Oxford University uh press textbook on uh integrative oncology Dr W has been a friend of the osher centers for many many years uh he spoke at a symposium uh that was actually part of the initial celebration of the of the UCSF oer Center in 1998 so um let me note quickly that after Dr W's presentation we'll have about 15 minutes for discussion and for now please pleas join me in welcoming Dr [Applause] W thank you good afternoon Donald it is a pleasure to honor you with this lectur ship uh I

first met Donald Abrams in 2002 at the tellure IDE Mushroom Festival a unique and wonderful event and shortly afterwards he enrolled in the fellowship at the University of Arizona and is one of our first graduates one of our first oncology graduates the demand for integrative oncology in our country is enormous and The supply of practitioners trained to provide it is very small uh and that's something that I think we all need to work on about 10 years ago I was in Beijing and I was taken on a tour of guangan men Hospital a very large

Hospital in the center of Beijing which is entirely devoted to integrated medicine and when you walk into this place uh you'd think you were in one of our major hospitals in New York or San Francisco very modern facility the Largest Department there is oncology and I was presented a number of patients every PA every cancer patients there gets uh chemotherapy surgery radiation as indicated but in addition uh gets very sophisticated nutritional therapy acupuncture Mass M and especially very sophisticated Botanical therapy uh which is designed to reduce the toxicity and increase the efficacy of the conventional

treatments to improve quality of life and reduce risk Of recurrence it made me very sad that so few patients in our country are able to access that kind of care and of the patients who were presented to me some were remarkable one was a woman in her I think she was nearly who had metastatic lung cancer and she had actually refused all conventional treatment and was only using the you know their the other treatments she looked great I mean better than anyone that I've seen you know in our country with that kind of Condition so

I have sent a few of our uh oncology fellows over there to do rotations to see what they could learn and also I urged the people at that hospital to publish some of their best cases um and make them available so that people here could read about them since I think that whole world is unknown I have to say it it infuriates me when I see institutions like Memorial Sloan ketering taking out full page ads in the New Yorker advertising that they're Providing integrative uh care when I look at what they do it's all the

safe stuff you know they're providing nutritional counseling massage yoga uh stress reduction they wouldn't go near Chinese herb you know if if it was on a 10-ft pole you know people are scared of of herbal products in general uh and Chinese herbs in particular my undergraduate training was in botney and so I have a long career interest in medicinal plants and let me Just digress a bit and tell you some of my experience with them when I was actively seeing patients uh I estimate that for every prescription I wrote for a pH itical drug I

gave out 40 recommendations for Botanicals and in the time that I did that I did not see a single adverse reaction to any of the Botanical remedies that I recommended do you know the extent of drug toxicity in our country from Pharmaceuticals I think most people have no idea it's estimated That just in the hospitalized population in this country there are between two and 400,000 deaths a year directly attributable to medication and this is not not mistakes this is the right drug in the right dosage for the right indication and the right patient and hundreds

of thousands of people die and that's just in the hospitalized population and that's not not looking at less than death events you can count on the fingers of One hand deaths from herbal products and almost always they are the result of some mistake that somehow a toxic plant has been mislabeled and sold as a useful plant there was a a much publicized case here in San Francisco some years ago of a woman who drank a a Chinese herbal tea and died and the tea had in it raw aconite uh aconite or monks hood is one

of the most poisonous plants but it there's a traditional use in Chinese medicine of aconite Roots which are Prepared in a way to make them non-toxic so somehow this herbal tea had raw aconite in it and there was one fatal result this was front page news all over the country uh and editorials and medical journals saying this is what happens when people you know ignore the advice of Physicians and Pharmacists and go on their own to health food stores and buy these kinds of products I mean that is just so hypocritical know there's no Comparison

uh some some uh I just consistently hear from uh conventional doctors and pharmacologists and pharmacists that natural products are dangerous because they're we don't understand them they're complex you know we rather work with single compounds um the long ago I think this probably in the 1970s when I was first learning about traditional Chinese medicine it struck me that mushrooms were so prominent in the formularies of Chinese Medicine and they had been completely ignored in Western medicine you know we're inclined to think of mushrooms as being worthless or toxic and they've never been looked at as

sources of medicines and that's strange seems strange to me because first of all uh mushrooms have very unusual chemistry they have molecules that aren't found elsewhere in nature so that would be a promising place to look for you know new agents secondly a lot of mushrooms are Toxic to one degree or another and there's really no difference between a drug and a poison except dose you know many many drugs become toxic and high enough dose and some poisons become useful medications and low enough dose so if you want to find new medication one place to

look is an area of nature where there's a lot of toxicity and then on top of that the greatest success of of pharmacotherapeutics in the past hundred years has been the discovery of Antibiotics from very closely related organisms uh so for all those reasons you would think people would have looked to mushrooms as sources of new medicines but they haven't and in in traditional Chinese medicine uh mushrooms are used for all sorts of things but one of their main indications is what are now called adaptogens that is non-toxic products that make the body more resilient

and more resistant to stress of all kinds And a lot of them were indicated for cancer and other chronic conditions so that fascinated me and I then uh I began traveling to Japan and to China I met with researchers who were studying these mushrooms I learned a lot of interesting stuff one was that you know the little inoi mushroom the skinny white ones that are available in our Market they're mostly grown in one area of Japan in the Gano prefecture and a researcher there found that within a 50 mile radius of The city of Nagano

which is the center of this cultivation of this mushroom there were significantly lower cancer rates than in the rest of Japan and he attributed this to high consumption of these mushrooms on a daily basis by Growers and their families and this led to the isolation of a compound you know that that had protective effects against many kinds of cancer so this I began trying to teach people about this and uh make people aware of the importance of Medicinal mushrooms and I'm happy to say that after a very long time there has been a great uptick

in research you know not there has been a lot of it going on in Asia but there has finally begun to be research in this country as well uh I think the great advantage of these medicinal mushrooms the ones that are used for cancer treatment they are completely non-toxic uh no adverse effects and they work by in apparently in ways that we Have nothing comparable for in Western medicine you know they modulate immune function now Donald and I have a little disagreement uh Donald is worried that if we use these in certain kinds of cancers

and lympo proliferative Cancers they may be contraindicated because they upregulate immunity I don't think they actually upregulate immunity I don't think they increase the potential for allergy or inflammation I think they they modulate immune function in a way That I think is perfectly safe so I I think these are okay in all kinds of cancer but we don't have research on this and I you know encourage us to try to get a definitive answer to that I think these are quite safe and a general piece of advice is that we should all be eating more

mushrooms uh you know it's also interesting that in in Chinese traditional Chinese medicine there's really no distinction between medicines and Foods uh there are many ingredients In Chinese cuisine that are there for their perceived medicinal effects as much for their flavors or Texture uh for instance woodier mushrooms which are the crunchy ones that really have no taste uh have a significant anti-coagulant effect um and can be used some people are able to use this in place of our conventional blood thinning drugs and this is a traditional use in in Chinese medicine and they have been

considered you know that they've been useful for The health of the blood uh red yeast rice which is a natural source of statins uh as I think many of you are aware is a natural product that works for many people as well as pharmaceutical statins with a far lower chance of adverse effects I think the reason for that is and this goes I could talk endlessly about this is the difference between complex natural products and isolated compounds I think you know that that Statins I think are generally quite safe and effective for the way that

they're used but for some people they cause muscle pain they they distort liver function and I think when you give the red rice yeast you're less likely to see that because you're presenting the body with seven different monoc colons which are these molecules and so it's like a suite of of molecules that are like each other but slightly different and I think that sort of con prevents The body from mounting a counteractive response to getting a single molecule and that's a general pattern I see with using complex natural products versus isolated compounds but that's another

fungal product that you know traditionally has been used uh in Chinese cuisine both to add a red pigment to Foods uh as well as to help combat obesity for example now I could talk it before before I talk about other aspects of Integrative oncology or actually no this is a central aspect of it you know Integrative Medicine in general one of our aims is to try to shift the whole Enterprise of our collapsing Health Care System away from disease management toward health promotion and prevention and I think you know we have to ask ourselves a

very hard question as a society why don't we do a better job at health promotion and prevention and I'm afraid that has a very simple answer They don't pay and until we can figure out how to make prevention and health promotion pay we're not going to get anywhere and the the other fact is that the diseases that we're trying to manage are mostly lifestyle related diseases that could be prevented if people early enough made better choices about how to eat how to be active how to handle stress and so forth and again we have to

ask ourselves why can't we do a better better job at that the the other just Sad reality is that as dysfunctional as our Health Care system is and I think it's getting more dysfunctional by the day uh it is generating rivers of money that are flowing into very few pockets it's the pockets of the big pharmaceutical companies the manufacturers of medical devices the for-profit Health Care Systems uh and you know other institutions and these vested interests want nothing to change they also have total control of our Elected representatives doesn't not matter whether you're Democrat Republican

liberal conservative you can't get elected to office in this country unless you have made deals with those vested interests and I don't see any way that that's going to change unless there is a Grassroots social political movement uh in which we begin electing different kinds of Representatives who are not beholden to those vested interests and I don't see That happening yet I don't know what it'll take for people to get angry enough you know to begin working against this current system and doctors are as much a victim of it as patients are um you know

when I went into medicine uh it looked like a very attractive profession and one of the reasons was that it promised you autonomy You Could Be Your Own Boss and that's going completely out the window you know you were now told how many Patients you have to see an hour and you're told What treatments you can you can prescribe and which you can't and this is all part of this you know system that we are all that so many of us are victims up when I look at at um cancer the efforts we put toward

prevention I think are slight compared to the efforts we put toward treatment and since treatment of cancer is difficult especially many kinds of cancer I think it's especially important to focus on Prevention we know a lot about preventable causes of cancer and what are we doing about them you know uh Donald just sent me an article about the percentage what was the estimate Donald the percentage of cancer that 50% is preventable you know a leading cause is smoking which continues to be and our attitudes towards smoking I mean I find this very interesting you know

in the early part of the 20th century when there began to be an epidemic of lung Cancer for many years the medical profession said the cause was air pollution and ignored what was right in front of their faces you know of people you know doing this habit when I was in medical school in the ear in the late 1960s first of all all the pulmonologists at the University of ARA smoked and and uh secondly I was taught nothing about smoking as an addiction no it was a habit and therefore it wasn't worthy of Attention the

way that heroin addiction was I started lecturing to first and second year medical students in the 1970s 1980s and I proposed giving a one-hour lecture on Tobacco addiction and strategies for managing it took three years to get permission to give that lecture because nobody would give up an hour you know here is the single greatest cause of preventable serious medical disease and it wasn't taken seriously and when I look around today I Think we've changed the demographics of smoking but I'm not so sure we've done much about the total number of people who are caught

up in that addiction and I am also Disturbed at the amount of smoking I see in movies and in TV series you know it seems to be greater than ever and that is an a tremendous inducement for young people to begin that that habit by the way the one statistic that I that is just astounding Is that a young person who smokes more than one cigarette has only a 15 one 15% chance of remaining a non-smoker you know that drug taken by that delivery method is right up there with cracked cocaine it's more addictive than

heroin and that's a consequence both of the pharmacological power of nicotine and the manner of delivering it to the brain um and so I think we have a lot of progress to go there you know another I think second On the scale of preventable causes was obesity and excess weight and that is a very complicated one and I'll just want to give you some thoughts about that the Obesity epidemic in this country which is dramatic know a few years ago a book came out that tried to argue that the Obesity epidemic was an artifact of

the way we're measuring people you know that's nonsense all you have to do is look at movies from the 1940s and 1950s documentaries with the huge crowd Scenes you don't see a single fat person you know we have changed phenotypically dramatically and what's causing that I don't think it's just a matter of people overeating and underere exercising something else is going on there and I think it has to do with the way we've changed food you know Michael pollen wrote that our great-grandparents would not even recognize as food what most people eat today and it's

it's not obvious stuff you know there was a a Book that I recommend to you uh called the Dorito effect that came out several years ago by a medical journalist and it began by saying that if you talk to people in their 80s 90s who about what food was like when they were growing up that people say that it tasted much better that chicken tasted better vegetables tasted better fruits tasted better so we have in in our agricultural practices we've selected for varieties that are that resist shipping that are Shelf stable at the expense of

flavor and in response to that a multi-billion dollar industry has grown up in flavorings which is dominated by I think six companies around the world three in the US one in in the UK one in Japan they manufacture thousands of chemicals some of these are natural some are synthetic some are semisynthetic they are in all of our food sometimes dozens in any one product and they're concealed under the Label flavorings they are the FDA doesn't regulate them they are not required to be put on the label we have no idea what these things do to

us individually or in combination and I suspect that that's one of the things that's driving you know the the changes that we're seeing and we know very little about that uh one category of food additives that I've been focused on recently is uh gums and products like guar gum xanthan gum molto xtran which Are used as emulsifiers or thickeners in many many food products they all these are all called generally recognized is safe by the FDA but there is reason to think that they cause inflammation throughout the body particularly in the gut and you know

one of the kinds of cancers that we're seeing increasing is colorectal cancer especially in young people and I think anything that promotes inflammation in the gut you know to me is suspect for uh being Potentially carcinogenic so that's just one category of these things that are out there but this is my my guess is that there's something about the way we have changed food that is driving this obesity epidemic and by the way those of you clinicians I think that our attitudes toward obesity in this culture have really warped medical judgment uh I don't think

it is necessarily unhealthy to be to have excess weight and I there are many people out there who cannot Lose weight no matter what they do and I think the best advice you can give them is to stay fit it is much better to be fit and fat than to be thin and unfit no question about that so I think think that that is you know a very practical piece of advice but I also feel very strongly that the more we distort food from the way nature produces it the more likely we are to reduce

its nutritive qualities and increase its dangerous qualities and I think that that's Something that really has happened here so you know I am delighted that there is a society for integrative oncology that there is a textbook of Integrative oncology that there is a demand for integrative oncology I think we have a long way to go um and I also feel that you know I liked I I gave a a lecture at the University of Arizona a few years ago called what were we thinking uh looking back at really awful medical mistakes that we've made and

uh you know Just like well I'll tell you one when I was growing up shoe stores had floros Scopes in them to check the fit of shoes so uh you you know this big console and as a kid you know you you had a new pair of shoes and the shoe salesman took you over put your feet under looked in there was a glowing green screen in which you saw the bones of your feet and the shoes and they'd show your parents and as a kid the game was to distract everybody so you could stay

under it as long as Possible I mean unbelievable Flor Scopes and shoe stores you know what were we thinking uh go back a little further I found um at Harvard Medical School there was was an old an attic that had a museum of medical Curiosities and one of them was a belt uh to be worn around the waist for two hours a day with two pouches that fit over the kidneys that were filled with radium ore and this was designed to deliver healthful radiation to your Kidneys you know but I could there are so many

things like this here's one that many people don't remember that nobody should be allowed to forget the well first of all when I was growing up it was impossible to make it to adolescence with your tonsils and adenoids you know they were considered useless organs vestigial organs and somehow that gave doctors permission to take them out you know at the drop of the Hat you know we now know these are Important parts of the immune system that are there to guard against infection coming in by the oral route same thing with the appendix there are

many many people who went into the hospital for abdominal surgery things like hysterectomies or gallbladder removals who did not find out until they got their hospital bill that their appendix had also been taken out as a preventive measure because it could cause trouble and had no function and It's also filled with lymphoid tissue and it's there to guard against infection coming in by at that end of the GI track but worse than all this was what we did to the thymus gland you know when I was in medical school I was taught that the thymus

had no function uh it was a vestigial organ it's really interesting you know here we don't understand the function of an organ so we say this that it's functionless uh the the thymus is very Active in childhood and Adolescence when it's training lymphocytes to recognize antigens for the rest of your life and somewhere in adolescence it begins to shrink that was called the involution of the thymus and somehow that was taken to mean that it had no function I don't follow that logic but that's what doctors said so in the 1950s doctors at leading medical

centers invented a disease that every child had called thic hypertrophy meaning the Thymus is too large which was treatable by bombarding it with x-rays you know the thymus has quickly dividing cells so it's very susceptible to radiation and you shoot X-rays at it and it shrinks up right away so kids were parents were persuaded to bring their kids in for weekly treatments I don't remember for how how long and I found out about this because a college roommate of mine who was then a clerking for a Supreme Court Judge got a letter out of the

blue from Michael reee Hospital leading Hospital in Chicago saying you know according to our records you know in so and so such a date you were uh given a a course of x-rays to deliver to your thymus and we're now finding that people who had this treatment have a higher incidence of thyroid cancer and they urged him to come in for a checkup how would you feel if you suddenly got you know such a letter but what what I don't know what even to say about this I mean what Hutzpah to say you don't understand

what this organ does so let's you know let's do something horrible to it to make it shrink and I think there's also an interesting contrast with Chinese medical philosophy that the Chinese did not understand the internal anatomy they didn't do autopsies but they had a very uh clear under they didn't you know they didn't understand what the immune system was in terms of organs but they understood that the body had a defensive Sphere of function and they searched the natural world to find things that would enhance or protect that function and that's where these mushrooms

fall into they are in this category of of natural products that enhance the body's defensiveness and I think that is a great contrast to the way we treated these organs that we didn't understand uh I have to say when I look at these kinds of medical blunders and I could go on on about them it makes me think you Know what are we doing now that 20 years from now 50 years from now will look back on with that same sense of you know astonishment and horror that we do with these things that I've mentioned

and I have a feeling that chemotherapy and radiation are going to be in that category you know these these treatments are very crude know they the rationale for them is that they kill dividing cells and the assumption is that cancer cells are dividing faster than normal Cells that is true for some kinds of cancers and those are the ones that we can treat successfully but for many kinds of cancers the cell division rate is not as high as that of normal tissues especially T the skin the lining of the GI tract and most importantly the

immune system so you can afford to have your hair fall out and you know GI upsets but you don't want damage to your immune system which might be your long-term hope you know for a permanent remission Or cure so to my mind I think these treatments will be replaced and you know I think they'll be replaced by targeted Gene therapies by you know variet other things on the horizon and that one day I I hope sooner rather than later we'll look back on these with the same sort of feeling we have about looking at at

floros Scopes and shoe stores so uh let me repeat that the the demand for integrative oncology is enormous and That model that I saw at that hospital in Beijing was very encouraging and I think that kind of care could be provided easily here by people were trained in how to use it and it's not a matter of rejecting conventional therapy and this is true of Integrative Medicine in general you know we're not trying to replace conventional medicine we're trying to make it better uh you we're trying to add to it and in these in our

Center and our fellowship and other Educational trainings we're trying to remedy all the deficiencies uh in subject matter that should be taught to Physicians but aren't starting with nutrition for example in my four years at Harvard Medical School the total instruction that I got in nutrition was 30 minutes which were grudgingly allowed to a dietician at One hospital I worked at in Boston to tell us about special diets we could order for patients I don't think That's changed a whole lot since I've been out of medical school you know when nutrition is taught now it's

taught as biochemistry and it's forgotten as soon as the biochemistry exams are over um and one consequence of that is that doctors are really unable to act as a a counteractive Lobby to Industry pressures for example the USDA um dietary pyramid was revised a few years ago and the dairy industry got the serving recommended serving of dairy Increased from 3 to 4 a day not one member of the medical profession testified in Congress against that um the last I checked 48% of us hospitals have fast food restaurants on their premises I mean what what example

are we setting for our patients and here's another cautionary tale I will tell you which points up what I said at the beginning about how the vested interests out there you know are blocking any kind of change I got a letter a few years ago From a first year student at the University of Pennsylvania who had started a campaign to get a McDonald's out of the University Hospital uh he got a petition going among his fellow students they got publicity in the Philadelphia papers and he was called in by the dean of students who told

him that if he persisted in this he would jeopardize his medical degree that's the problem you know the the university the hospital had signed a deal with the Devil you know it was money and this was a threat to it and this is the kind of thing I mean whenever you look for how we change things you run up against you know these powerful kinds of vested interests and I'll just say again that the only way I see this changing is if there is a Grassroots social political movement in this country uh and we begin

voting in different kinds of Representatives so let me leave you with that message and I Would like to continue by answering any questions you have thank you thank you so much um I will um uh ask folks to raise their hands if they have questions we'll uh do some from the audience first here and then also if there are questions uh for people online will do that as well oh Dr W great to have you here um the there is seems to be this Rising promotion of car uh hardcore carnivore diets of no Vegetables no

grains just meat and people are saying oh this is therapeutic and I'm like you're crazy yeah they're not only saying that they're saying I I hear them say that vegetables are toxic uh that they have lectins in them and oxalates also I've heard them say that cultivating vegetables is more damaging to the planet than cultivating meat I mean what nonsense uh I think it is it is very clear I don't tell people not to eat meat but I think cutting down on the Percentage of meat in the diet is a ver very healthy strategy I

I think these carnivore diets are ridiculous did you ever how many of you have followed the liver King before he had a fall from grace this is a guy who's like incredible musclebound guy who only ate meat and a lot of raw organ meat um he got busted it turned out that he was using a lot of steroids too but the pictures of are just amazing anyway that's pretty dumb and then there's the You know there's so much dietary nonsense out there uh you know the the the the advice my dietary advice can be put

in one sentence which is to stop eating refined processed and manufactured food I mean that is the the single most important thing you can tell people to do uh that's what's doing Us in you know that's what fills our supermarkets today um you know I look at the the extreme keto and paleo people they tell people not to eat beans you Know beans are very good food they have a lot of fiber they have protein they have slow digesting carbohydrate they have minerals and most of all they are cheap you know one one of the

arguments that I hear a lot is well integrative medicine is only for the afluent if you want to eat healthy you have to shop at Whole Foods not so and beans are a perfect example of you know one of the healthiest foods and and here is a whole group of people selling people that Don't eat them that they're not healthy for you so the the dietary nonsense out there is just crazy similar to that question what about fasting what's your feeling well I don't I I'm not an expert on that you know I think uh

there's first of all there's different kinds of fasting one is just short-term fa first to me fasting means nothing but water and short-term fasting is like up to a day and I think that can be a very valuable strategy if you're coming down With a a cold or some infectious illness to stop eating that's what animals do it frees up energy that the immune system can use that makes sense to me then there's long-term fasting which can up to several months and there is very interesting research I mean this is not easy to do and

probably needs to be done under supervision but there is very good research showing that long-term fasting can cause dramatic complete remission of rheumatoid arthritis of asthma of all Sort of colitis the problem is that when people go back to eating food often these conditions come back but you can find ways of transitioning people to a vegan diet you know and then maybe adding other things to it and maintaining the Improvement then there's intermittent fasting which has gotten so much publicity lately and I think I I'm not an expert on that I see research go back

and forth there's all different schedules that people follow which makes It hard to you know understand um I've tried it doesn't work for me I get ravenously hungry if I don't you know eat in the morning um but you know for some people it seems to work it may improve insulin sensitivity I don't think we know enough about it yet I you know I was going to say if folks want to maybe say your name also and and role for example hi my name is Christa I'm a Pre-doctoral trim fellow at the oer center um

I just wanted to ask when you visited China and Asia and learned from oncologists there did you catch any Vibe on what they think of how we operate in America with oncology um like what they think of our system what are their perspectives well you know I think that confounding for them is the expense of our system since they just don't have those resources um so they can't provide that kind of um expensive care that Depends on expensive technology um so I think that cancer patients you know outside of that hospital I mentioned you know

a lot of them don't get the the quality of care that people would get here um beyond that I I don't know what to say I think there are you know the incidence of cancer there is high and certain I think there's differences in the kinds of cancer that are more common there than here there's still an awful lot of smoking in China uh there's you Know a lot of the uh foods that are eaten there are no longer as healthy as they probably were traditionally um so I I can't say more than that I

didn't get a chance to see enough of it hi my name is Lena I'm a naturopathic doctor and I'm a postdoctor fell at the oer center um I just have a question about your thoughts on some of the more invasive natural treatments in oncology like high do vitamin C aramin curcumin mistleto that Whole realm in IV format injection format and where you stand on that let's I'd like to hear what Donald has to say about that you know I I I uh first of all I I am uneasy when people are injecting themselves with things

you know I often say I think we're born without direct access to our veins for good reason I was just I was just staying at a hotel in a fancy hotel in New York and the uh the they had a butler for you know individuals and she Came into my room and she telling me about their services and she said you know we offer IV therapy I mean a hotel offering IV Therapy you know as for the you know Donald would you say something about IV Emin or or circumin I agree with you I wouldn't

go there even intervenous high dose vitamin C I've never seen it really be great benefit what about [Laughter] Coffee there was an alternative cancer therapy called The Gerson Therapy uh which for a time had you know a following it was finally I think driven out of the US to a clinic in Tijuana and it had some uh you know there was some useful nutritional advice part of that it was focused on detoxifying and one of the things that was recommended was coffee enemis which were supposed to uh stimulate the liver to excrete toxins and one

of the arguments was that coffee By that root was not stimulating which is nonsense there there's it's much better absorbed you know that way because there's more blood vessels there so my uh I mean I thought this was long dead and gone but my daughter who runs my social media I stay off of social media entirely but she you know posts all the stuff on there and uh periodically asks me questions to answer and tells me some about the responses which mostly I don't want to know about But she said that one that provoked the

most angry Deluge of comments was I trashed coffee animes I said you know there's no reason to do them I'm unbelievable numbers of people got angry with me for saying that so I don't get it um you know another one that I worry about is ozone therapy you know ozone is a very powerful oxidant and if you buy the whole antioxidant you know Theory uh why would you want to put strong oxidant in your system and especially you know People that are doing this intravenously that seems potentially dangerous to me re and Rec right with

coffee let me ask a question from the webinar that's going back to oral route if that's okay with folks um uh here's a question are recently the New York Times rep reports uh that any amount of alcohol is toxic do you agree that we should now avoid any alcoholic you know it is interesting to look at this historically and see how the pendulum has swung back and forth About alcohol over the past 50 years you know we're told that it's beneficial that it increases heart health red wine is good for you drink a glass of

red wine every day then it's you know not good for you now we're in this phase where any amount of alcohol is not good for you I I I don't take an extreme position here I think the main advice advice that I give people about alcohol is that if you're going to drink it don't drink it every day you know the You want to emphasize moderation with it and there are probably some people uh who should be especially cautious about it Donald what about women with uh some forms of breast cancer uh would you advise

them to avoid alcohol relation risk the American Institute for cancer research changed the guidelines now about alcohol they used to say if consumed at all limit to two a day for Men and one a day for women difficult somebody doesn't drink that seems a lot and I you know I would add to that don't drink every day canc it's best not to drink alcohol again 6% of all cancer is help right related to alcohol so you know the benefits of Al alcohol is a relaxing and for many people in our culture it is their primary

way to relax and the benefits of relaxation and stress reduction May override any negative Effects of it you know it may have a beneficial effect on the cardiovascular system directly on the other side it is definitely toxic to the liver and it's definitely toxic to the nervous system so I think those things have to be balanced out I don't know what the answer is I would [Laughter] go thank you H yes Science Magazine um a report that the NIH had discontinued Research into the possible benefits of alcohol because the researchers alici it is so hard

to know what you know in this kind of mudel what's what's right and what's not and I just come back to if you're going to drink moderation um I'm okay great and then we're gonna go back to the mic just so people can hear medical mushroom what I find Because I recommend them to most of my cancer patients is that as soon as a patient's liver functions Elevate the oncologist demands that they stop their medical mushrooms and I say hello that right and you know the that we have a wonderful uh Botanical for protection of

liver function which is milk thistle uh and that should be any anybody receiving a a potentially liver toxic drug should be on milk thistle and that's one you know that you hear this reflexive oh It's dangerous to take any Botanical product another one like that is a stralis a Chinese herb that's been used for Cent IES to ward off colds and flu completely non-toxic and has a protective effect on bone marrow and I think can be taken with you know by cancer patients who are receiving any kinds of chemotherapy agent or radiotherapy that may damage

bone marrow and these are things that should be used routinely as part of Integrative Oncology um I can't see who has the mic okay thank you hi um my name is Ava jao I'm working on a breast uh cancer education um at the Center and um so I wanted to bring the topic back to diet and nutrition uh specifically I was struggling between picking the Falafel outside versus the Chicken uh skewers and I wanted to get your opinion on what are your thoughts on meat in general because in traditional Chinese medicine um meat is incorporated

as a having Medicinal nutrition however I've been reading uh recently you know how not to die think by Michael Gregor and he Advocates a vegetarian diet so I'm curious what your thoughts are well I'm a pescatarian so I haven't eaten meat in a long time but I do eat fish uh I think one of the best changes that Americans can make in their diet is to eat less meat you know I won't say no meat but to eat less and to replace and some of the animal protein in general uh with plant Protein I'm a

big fan of soy and soy protein and that's another one where you know the it's interesting to see the division of opinion there there has been so much antiy propaganda in in the press and on the internet I think some of that is neophobia and xenophobia you know soy was a foreign food that was suddenly introduced to this culture not that long ago so I think some of the reactions to that uh some of it I think is coming from the meet and dairy Industries you Know some years ago I saw an enormous tanker truck

going through the streets of Manhattan that labeled silk so if it's gotten to that point surely the dairy industry has taken notice you know and some of this stuff is coming out you know I've read articles saying that milk causes homosexuality uh causes breast to develop in young boys and so forth I mean nonsense and the other but the other uh the the other kinds of Arguments come I think from people who don't understand the nature of complex Botanicals soy has four isoflavones in it these are estrogen likee compounds if you isolate these and put

them in test tubes with cultures of of breast cancer cells two of them stimulate growth and two of them inhibit growth so the fact that there are elements there that stimulate the growth of breast cancer cells leads some people to say that soy is cancer promoting and should be Avoided but that does not take account what does the body do when it's given a mixture of things that have opposite effects that have a pushpull effect I think the body decides what to use and that probably has to do with which receptors are available for binding

the epidemiological evidence is overwhelming that soy is protective that it protects against prostate cancer in men and breast cancer in women and I think the earlier in life that it's introduced uh The greater the protective effect um and so that's I hope that answers your question I think Less meat and some vegetable you know some vegetable protein in place of it hi my name is Fatima beran I'm a pediatrician here at the osher center and a previous alumni of your integrative medicine program um I have a two-tier question number one I agree with you I

think there needs to be a Grassroots program that is started so That we can all join together and I think also it should come from someone of your stature to allow us to because if it starts for someone like me to start it there may not be as much of a pool to bring it forward so if if that is of interest to you yes um that's that's the first point and then the second part I think one these things like what were we thinking right as a pediatrician I focus a lot on preventive medicine

and I think Processed foods is a big thing for children and I worry a lot based on the access different types of children have to different types of foods when even things that are offered through Wick or food stamps programs or or whatever they are based on what state are a lot of it is processed and so what advice would you give a pediatri you know whenever you try to attack things like this you run up against the same issues um the people eat what's cheap and what's Available we have made the unhealthiest food cheapest

and most available one way we've done that is through Federal subsidies of commodity TR crops that have made products like high fructose corn syrup and refined soybean oil so cheap that they're ubiquitous in processed food we don't subsidize fruits and vegetables you know you try to change this and you run up against those vested interests again but that's the kind of thing that has to change the Density of fast food restaurants is much higher in poor neighborhoods than it is in other neighborhoods uh the the way we advertise processed and refined Foods is very appealing

to kids you know you look at kids going down the aisles of a supermarket you know and looking at all the brightly colored cereals and things like that and we just have a long way to go but I think that that that's an essential problem is how do we how do we change the nature of food and and make Healthy food more available to to people well let me know when you want to start that gra I will I'm I'm ready I'm ready and we we have a few comments actually on um online about any

advice on getting started uh advocating for political change so maybe we'll begin yeah you know I every graduating class of fellows I tell them you know my hope is that you will can help catalyze this movement you know by starting to talk to your patients About It by talk to your Colleagues there are several groups around the country that are working this direction and one of the things I'm trying to do is to coordinate these and get some kind of communication so um keep in touch with our Center at the University of Arizona this is

like high on my agenda of things we have to do thank you and I think this will likely be our last question for now hi there my name is Sarah Patterson I'm a rumatologist and a researcher here at The oer center um I really appreciated the comment about the importance of being like that it's preferable to be fat and fit over thin and unfit and you know I think as a physician I've noticed that there's so much emphasis in clinical practice on the number on the scale and what the BMI is in our EHR it

always says what the BMI is you know in the top right hand corner um how do you think we can operationalize in clinical practice and For the transition to more of an emphasis on body composition and being fit like how do we Define that for folks and um kind of move that that that Focus toward being strong yes well it's like I mean you want to assess what a person's level of physical activity is and you know make recommendations to them I think the Mind Body component is very important helping people feel better about body

image is very important you know teaching people to eat healthier Food of course but you know there are an awful lot of people out there that no matter what they do they can't take weight off so you want to tell them that you know okay then you want to put a lot of effort into keeping yourself as healthy as possible by the nature of your physical activity by the things that you do you know your mental States and all of that we have we have a ways to go perhaps by the next time see you

here We'll have solved these um I want to thank you so much Dr W um and again thank you Donald for all of your work um and uh hope to see you very soon good