Joint pain is common, but that doesn't mean you have to suffer! There are so many natural remedies to control and relieve the discomfort. Whether you are preventing joint pain during treatment or you have ongoing arthritis-type pain, Tina & Leah talk about ways to find relief. We even tackle the tough-to-treat joint pain from aromatase inhibitors (yes, there are things you can do!). Sometimes, the answer is already in your kitchen!
Links to prior episodes we mention:
Turmeric
Brain Fog
Sammy Peterson, RD, CSO
Rebecca Katz- nutrition, recipes, etc.- her website and her cookbooks.
Aromatase Inhibitors and Vitamin D in your blood.
Exercise to reduce the joint pain from aromatase inhibitors.
Community acupuncture can keep your cost for acupuncture way down.
Our website:
https://www.thecancerpod.com
Have an idea or question? Email us: thecancerpod@gmail.com
Join our growing community, we are @TheCancerPod on:
THANK YOU for listening!
Joint pain is common, but that doesn't mean you have to suffer! There are so many natural remedies to control and relieve the discomfort. Whether you are preventing joint pain during treatment or you have ongoing arthritis-type pain, Tina & Leah talk about ways to find relief. We even tackle the tough-to-treat joint pain from aromatase inhibitors (yes, there are things you can do!). Sometimes, the answer is already in your kitchen!
Links to prior episodes we mention:
Turmeric
Brain Fog
Sammy Peterson, RD, CSO
Rebecca Katz- nutrition, recipes, etc.- her website and her cookbooks.
Aromatase Inhibitors and Vitamin D in your blood.
Exercise to reduce the joint pain from aromatase inhibitors.
Community acupuncture can keep your cost for acupuncture way down.
Our website:
https://www.thecancerpod.com
Have an idea or question? Email us: thecancerpod@gmail.com
Join our growing community, we are @TheCancerPod on:
THANK YOU for listening!
I saw this funny thing. Oh my gosh, what was it? It was like talking about how I can't remember what it was, but it was equivalent to like the length of a some sort of a whale or something, and I wish I could remember the joke. But it was like saying, like such and such is the same distance as like the length of a whale, or three whales, and they're like you know how come the US just can't use like regular, so bad at telling jokes. But it was funny. I swear I'll take your word for it.
Speaker 2:I swear we can take this out. I'm Dr Tina Kaser and, as Lea likes to say, I'm the science one, and I'm Dr Lea Sherman and I'm the Cancer Insider, and we're two naturopathic doctors who practice integrative cancer care, but we're not your doctors. This is for education, entertainment and informational purposes only. Do not apply any of this information without first speaking to your doctor. The views and opinions expressed on this podcast by the hosts and their guests are solely their own. Welcome to the cancer pod. Hello Tina, hello Lea, so formal this morning.
Speaker 1:I know, I know. Well, you know it's a new year. I guess it will be. We're releasing this in the new year.
Speaker 2:Yes, Welcome to 2024. Happy New Year everybody.
Speaker 1:So today we're going to be talking about something that I've actually received several requests from people if we could discuss it, and we're kind of making it more broad. I've gotten a few messages from people wanting us to discuss the joint pain related to aromatase inhibitor use, and that's not the only cancer treatment that can cause joint pain, and so that's going to be. Our subject today is just joint pain related to cancer treatment, and we're probably focused a little bit more on the aromatase inhibitors because it is so common and I would even say that some of the things we talk about today will be generic, just for joint pain in general.
Speaker 2:So oh, yeah, like arthritis? Oh, definitely, yeah, so I don't think it's going to be. I mean, we're going to put it in the context of cancer treatments and it'll also help people understand what's going on with generalized joint pain as well. So talk about general. I've had requests from specifically family members saying why don't you talk about joint pain?
Speaker 1:And they don't have cancer. They haven't been.
Speaker 2:They're just like. I really like the show that you're doing?
Speaker 1:Tina, Can you talk about joint pain? Can you help me out?
Speaker 2:Yeah, and you know it's so universal. I mean, if you live long enough, generally you're going to have some discomfort in joints.
Speaker 1:So I didn't receive an aromatase inhibitor. I received a chemotherapy which can kind of cause that achy joint pain, and I also was on tamoxifen and what I noticed was it seemed like areas that maybe I had probably a risk of getting arthritis, like one day down the road I probably was going to have arthritis in my lower back or my hips. I found those were the areas that really hurt. So definitely there is a correlation and I found that also when I got my first COVID vaccination and I got achy and all that kind of flu-like symptoms. But the joint pain was really more noticeable in those the hips and the lower back where I probably am at risk of having arthritis anyways, and I think I do now.
Speaker 2:So yeah, and you know that that speaks to just generalized inflammation, because we all manifest an inflammatory reaction differently. Some people get sinusitis and their sinus passages will fill up with mucus, and some people will have joint pain, and so whenever anything in the background whether it's a vaccine, chemotherapy or an ongoing drug like these aromatase inhibitors that are used whatever increases that background inflammatory state, will manifest in where your vulnerabilities already lie. So I think that's a I don't know from a clinical perspective, from my perspective, when I'm talking to a patient, I mean that's important information for me, going forward for preventative purposes and to address any pain that's happening right now. So I suppose that's what makes it a generalized topic, right, because joint pain happens and preventing it and getting yourself as resilient as possible as you head into treatment, as you come out of treatment we'll talk about what can be done and, yeah, we have talked about inflammation a lot like.
Speaker 1:That's pretty much like a common thread and a lot of the things we talk about.
Speaker 2:Yes, because in some systemic inflammatory effect is inevitable if you're getting chemotherapy or radiation.
Speaker 1:Okay, so let's talk about risk factors for just joint pain in general with treatment, and then also there are some that are specific for aromatase inhibitor pain.
Speaker 2:Yeah, and you know we've keep saying aromatase inhibitor as if people listening know what we're talking about. Well, the people who are on it will know, but I think we should explain to everyone else what it means. And aromatase inhibitor is exactly what it sounds like. It inhibits an enzyme called aromatase and that aromatase is responsible for the production of estrogen in the body. So when people are on this drug, it essentially brings the estrogen levels very close to zero nil, so there's no estrogen being produced in the body when people are on that drug, which that alone tells us something. Right, because these aromatase inhibitors pretty much always give some level of joint pain. Not always. I've had a few patients take them and have no side effects at all, including no joint pain, but I would say the majority of people who start the drug have joint pain.
Speaker 1:And examples of aromatase inhibitors are things like anastrasol, letrasol.
Speaker 2:Yep, anastrasol, letrasol, X-mestane. They're steroidal and nonsteroidal forms.
Speaker 1:And I have found studies that show that tamoxifen also can cause joint pain, even though there are some providers out there who will say that it does not, but there are studies that talk about it.
Speaker 2:So there you go. That's not too surprising. Tamoxifen. Unlike those aromatase inhibitors, tamoxifen is a estrogen receptor modulator, and so you always have to keep in mind that tamoxifen is often given when there is a lot of estrogen circulating already. So it's often given not always, but often given to pre-menopausal women who have plenty of estrogen circulating, and estrogen acts a lot like a lubricant on the joints, and so the loss of estrogen creates more friction within the joints. And so if you go on tamoxifen after being, say, you're 35 years old and you have plenty of estrogen circulating, you go on tamoxifen. It's actually kind of like less estrogen in the joint spaces than you had, because estrogen itself, and estradiol especially, is so estrogenic and tamoxifen is considered a weak estrogen or a neutral estrogen on the joints.
Speaker 1:There is a greater risk, though, of having the joint pain in patients who've received aromatase inhibitors and tamoxifen, if they've also received chemotherapy. So that's one of the risk factors. So for patients who have received radiation and tamoxifen or surgery and tamoxifen, they may have not really that risk than if you have received chemotherapy. So in general, you have a greater risk factor of joint pain with cancer treatment, if you are diabetic, if you have a history of alcohol abuse, a history of arthritis or a history of neuromuscular disease like myocenic ravis or muscular dystrophy or something. It could either be genetic or auto immune. I mean, there are a variety of neuromuscular disease, but anyways.
Speaker 1:So having a preexisting condition that would favor one having joint pain will put you at greater risk of having joint pain. That makes a lot of sense. And then the risk factors for aromatase inhibitor pain in general is younger age, having had received chemotherapy with, in particular, those taxings, which is pachylo taxol and taxiteer, and then the use of granulocyte colony stimulating factors like nupigin and nulasta, prior history of joint pain Laughing because it's like, oh, you're going to get joint pain if you have a history of joint pain. So a prior history of arthralgias, which is joint pain, arthritis or even fibromyalgia, which I see a lot.
Speaker 2:Yeah, that all seems to make sense. None of that's too surprising, I don't think yeah, yeah, well to us.
Speaker 1:But I mean, for somebody thinking like, oh, I'm diabetic, is that why I'm getting the joint pain, you know, it's not really what comes, I think, front of mind for a lot of people.
Speaker 2:Yeah, and I think of those taxing drugs as well, and true funny chemotherapy. There's collateral damage, right, and there's some damage to systems, whether it's your nerves, your joints. And when you have diabetes, healing is slower, you know, especially, I should say, if you have uncontrolled diabetes, because if your glucose levels are controlled well, your hemoglobin a1c or glyco hemoglobin, that's the same thing that gives you an idea of the last three months where your glucose has been, then If that's fairly well controlled, then it shouldn't be as much of a factor. I think it's when your glucose goes high, which often happens during these treatments, because they give a steroid and so Glucose shoots up. It's harder for people with established diabetes to, you know, get that glucose under control post treatment even.
Speaker 1:It's pretty important that you mention it to your doctor. There are some things that you want to rule out osteoarthritis, rheumatoid arthritis or even, you know, bone disease. So you know, mentioning it, talking about what aggravates it, what makes it feel better of anything, can really help guide what you know your treatment can be mm-hmm.
Speaker 2:Yeah, and brings up something that is a. It's a tough topic and that is new joint pain, especially low back pain and hip pain. I don't care if it's 510 or 20 years after a diagnosis of any cancer. It needs to be at least taken seriously. And if you do things for joint pain whether that is you know what do you call it Advil and it doesn't work if it doesn't respond to treatments for garden variety arthritis, then make sure you get it worked up. I mean, the worst case scenario is that there is a recurrence of the cancer and that needs to be found sooner than later. It's kind of an ugly reality that I know everyone who has had a diagnosis lives with. But I just want to put that out there Because I know in my practice there's been a delay of diagnosis, money times when Cancer has metastasized to the bone because it was dismissed. Yeah, it was just written off because cancer happened, you know, 10 years ago, 15 years ago, and so nobody was looking for it anymore.
Speaker 1:So that's one of the things that my oncologist did work me up for, because I was having this sort of I guess it was just more like an increase in back pain, lower back pain, just and and hip pain. It was really really bad and it was several years after I'd completed treatment and I got an x-ray and then I ended up getting an MRI and it was just your run of the mill kind of arthritis, joint pain and I what we'll talk more about. You know treatments and whatnot. But yeah, I was referred to physical therapy but that was scary. I mean, it was truly scary when it's interrupting your sleep and everything else I've had patients see a physical therapist for like a year or two before it was found.
Speaker 2:I know one. We're really thought to work it up and and sometimes you as a, the patient there is a fear of recurrence. That is normal, right, that is completely understandable, and sometimes I think, because that happens so often, it's almost like crying wolf to your own consciousness. You're like no, I couldn't possibly be so. You kind of, even yourself, ten years down the road, might be like I shouldn't. If nobody else Is worried about it, I'm not gonna worry about it. So I'm not talking people into just checking it out, but I think it's. It's important because these days we have so many treatments that Bone metastasis is something that's very treatable now that it didn't used to be. You know, when I started 20 plus years ago, it was less treatable.
Speaker 1:All right. So let's take a break and when we come back We'll talk about what is typically recommended Conventionally for joint pain, as well as what we would recommend as naturopathic doctors. All right let's do that.
Speaker 2:So, lea, yes, tina, what's top of mind conventionally, because I think you are more attuned to what's happening on a regular basis in the Conventional world, coming from the hospital Environment.
Speaker 1:I mean, it depends on what the treatment is as to what they're going to recommend, but it can be anything from ibuprofen, tylenol, sometimes alternating the two. I've seen tramadol recommended those cox, two inhibitors like celibrex that's another one that is.
Speaker 1:Mm-hmm often recommended and that doesn't really have as much of a effect on the, the GI system, the way that, like ibuprofen can I have seen prednisone used, I have used, or I you know, with my patients, especially with the, the taxing related pain, gabapentin can be used as well. And then you know there are other recommendations that I don't know. You know what the evidence is behind it, but I've also had people who were referred to massage. I mean it starts to get more into like more than naturopathic type things. Like you know, get a massage. My oncologist actually recommended that I take Boswellia, which I thought was really cute.
Speaker 2:That's awesome.
Speaker 1:Referrals to physical therapy, that kind of thing. And then it starts to you know, there's like that, like meld between like words, like the integrative.
Speaker 2:Yeah, it's interesting that your oncologist brought up Boswellia, which is a plant, because oftentimes I have found oncology. You know, when they're conventionally trained they're okay with the body work, mind body medicine, they might even be okay with acupuncture, but they stop, just shy of any supplements or plants because that's not their realm. So they're okay with things that they know are nonchemical or non-pharmaceutical.
Speaker 1:So my oncologist is at a cancer center where there are naturopathic physicians employed there, and so I'm assuming that she learned about Boswellia. I think she used it herself, even though she's not a cancer survivor, but she was using it herself for her own joint pain, and I'm sure she heard other patients were using it, and so that's probably where the recommendation came from.
Speaker 2:That is so funny because I have found most conventional doctors who are open to our medicine. They'll use their own experience and make a recommendation based on that Right. So they used something. It worked. They're like, oh, you should try this because it worked for them. Which is fascinating because it just shows you that there is a way to do it. It shows you that there is another level of evidence they will listen to. It's their own personal evidence.
Speaker 1:Yeah. So what's funny is, my initial reaction was well, I need to check and see if that's going to interact with my tomoxifen. That's funny, yeah, okay. So let's keep going with this whole integrative naturopathic approach to joint pain.
Speaker 2:All right. Well, you mentioned Boswellia, so I'm just going to riff off of that and just talk about some other plants that are useful Turmeric, turmeric root or curcumin, if you're taking in a supplement, is strongly anti-inflammatory and can help with joint pain. And then ginger comes to mind. Ginger is high on the list. If you take enough of it, it can be helpful. It's an anti-inflammatory In plants, whether it's Boswellia, turmeric, ginger plants. For those of us who recommend plants for people, they never have one effect. So if you're looking for an anti-inflammatory for your joints and you line up those three different plants and you say, okay, which one should I take, or should I take more than one, you look at other things that are going on and other things those plants do. So ginger is really helpful for the GI tract, really helpful to promote digestion. It's very warming. It's a very warming plant, so it supports the fires of digestion, as we say.
Speaker 1:Yeah, it can stimulate appetite. It can help if you have that feeling where the food's just kind of sitting there. You know that happens a lot with treatments where your food just doesn't seem to be moving along. Yeah, ginger helps it to move along. Yeah, it's kind of a nice addition, as long as it doesn't interact with anything.
Speaker 2:We'll have a whole episode on ginger coming up in the near future, so we'll go into details. Turmeric is something I might think of if I want someone to have digestive support. Further down the line, like this is someone who could use more bile acid production and they're not absorbing their fats so well. Bazwellia I might think of for someone who is also having brain fog and issues with executive function, which is high level processing in the brain. So translation chemo brain Could be. Yeah, it could be chemo brain. It could be plain old aging.
Speaker 1:We have a whole episode about turmeric and we have a whole episode about cognitive issues as well, so go back through our catalog if you have not listened to those yet.
Speaker 2:Yeah. So we've talked about these things in depth, so I want to put those things out there. But before you take any plants and everybody should be doing this you have to have to have to have a foundation of an anti-inflammatory diet. Because think of it this way Inflammation is like an accelerator pedal. There's an inflammatory process in the body. What pushes the accelerator? Chemotherapy pushes the accelerator. These aromatics inhibitors push the accelerator, meaning it creates inflammation in your body. So what puts the brakes on those plants I just mentioned can put the brakes on An anti-inflammatory diet is basically taking your foot off the accelerator.
Speaker 2:So I say this because there's no use putting your foot on the accelerator and the brake at the same time. This is not logical. What you want to do is take your foot off the accelerator first. You can't stop the treatment, you can't just put your drugs aside and cross your fingers. So your diet is generally, if you're not paying any attention, you're just eating a standard American diet, or whatever we want to call it these days, a Western diet, which is high in meat, high in processed foods, high in sugar, high in animal fats. That diet is very inflammatory. And so removing inflammatory foods and eating an anti-inflammatory diet and there's a lot of ways of going about that. We've talked about some, but we probably should do a special episode just on that topic. If you can remove inflammatory foods, you take your foot off the accelerator a little bit so that everything else you do, that all works better because you're not adding to the inflammatory state of the body. So I would put anti-inflammatory diet is like a must do. Nothing else will work if you don't do that.
Speaker 1:And it is difficult for some as they go through treatment, because with taste changes, with nausea I mean sometimes the only foods that taste good to them or that they can tolerate are foods that might not be considered part of an anti-inflammatory diet. So that's where you can find someone to work with, whether it is an oncology trained, registered dietitian or somebody who has experience working. You know a naturopathic doctor who has experience working with cancer patients. You know that's really vital.
Speaker 2:Yeah, and if you can't do that, because I just think of how many people are just out there and they just don't have access to that. Rebecca Katz K-A-T-Z does a nice job online of giving away a lot of information on how to deal with taste changes throughout treatment, how to cook for someone who is going through treatment. So if you're a loved one and you want to make some meals and bring them over, how to make healthy meals so you're not undermining their inflammatory state unwittingly with your casserole nothing wrong with a good casserole. You just have to make sure that you, you know, put some ingredients in that aren't inflammatory. She also wrote a couple cookbooks. One is called One Bite at a Time. That's her older cookbook, and then the newer edition is called the Cancer Fighting Kitchen. I would recommend both of those.
Speaker 1:And that's like for a newer edition. I mean, that was around 10 years ago when I was, when I was going through treatment, but again and this is, I think, from my experience working in the Midwest, where people's food preferences in general may not be vegetables and you know a variety of fruits, it's just not their experience. And so to be just given a resource and say, oh here, you know, start cooking with this, you know, or have someone cook this for you, that's not always an option, and so that's why, if you can find a dietitian who can really work more specifically, I don't know. I just keep thinking of like, when I ask you people you know, like, do you eat vegetables? And you know it's green beans and corn.
Speaker 2:Yeah, yeah, If you did one thing the person you're cooking for is like, all I want is, you know, meatloaf and mashed potatoes and that's it. Add to it. You know, I think berries are kind of an entry, Absolutely yeah. So adding some kind of berries can can actually negate some of the inflammatory effect of the animal fats. So there's been studies showing that when colorful berries are added, doesn't matter if it's blueberries, blackberries. You don't have to get exotic, you don't have to go to South America and get a side berries or Costco you don't have to go to Costco and get this.
Speaker 2:I saw you berries, but I'm saying well, yeah, go to you. Know what I'm saying? I would say eight out of 10 people have no access to a dietitian who is well versed in this. Eight out of 10 I would put in America. I think the folks that you and I talked to who are RDS and are dialed in to nutrition as we know it, are not the majority. I think that's in the minority.
Speaker 1:No, no, but that's a whole. Yeah, that's a whole.
Speaker 2:another episode, okay, but oh, speaking of back episodes, they can listen to the Sammy Peterson episode. Oh, there you go. She is an RDS that is dialed in oncology trained.
Speaker 1:Yeah, so, and again, I know we have mentioned this in the past, but taking turmeric, you know, or curcumin as a capsule, taking a lot of herbs or supplements, just check with your provider if it's safe to take while you're in treatment.
Speaker 2:While you're in treatment, yeah, yeah, especially the pharmacist. I would ask the pharmacist. If you have access to a pharmacist, ask someone, yeah, after treatment. It's tough because I will tell you my issue with this, and the reason I'm hesitating a little bit, is because that's going to be don't do anything. In general, I think in community clinics, if there's no one trained in integrative oncology and there's no pharmacist dedicated to it, they're just going to say don't do anything. And that may or may not be true, but I'm just saying that's going to be the default because, of course, if they don't know about it, they're going to say don't do it.
Speaker 1:So one of the number one things that I do recommend, if it is joint pain related to treatment, is well, I ask the patient well, what makes it better? Does movement make it better or worse? And nine out of 10 times, movement makes it better. And so having someone referred to physical therapy and recommending exercise so important with joint pain, whether it's arthritis pain, whether it's aromatase inhibitor pain I have found that and this is also through personal experience, but I've found that, just because of fatigue and other factors from going through treatment, you get weaker. If you have weaker glutes, that can lead to lower back pain. So if you're sitting a lot, if you're laying down, if you're propped up in bed and you're not quite sitting up or laying down, you know. So there are physical things like if you strengthen your muscles that support your lower back, then that can reduce the pain as well.
Speaker 2:Yeah, there was a study on aromatase inhibitor induced joint pain and they showed that while joint pain didn't improve, it didn't become worse. And so you're basically going to tread water for some of these, at least as far as the studies show. The people who didn't exercise the control group, their joint pain got worse and worse and worse and worse over the course of 12 months of that study. So even if you think, oh gosh, I still have my joint pain, it's not getting any better, it's also if it's not getting any worse, that is some level of success when you're on a drug that continually causes joint pain.
Speaker 1:Otherwise, and from my patients that actually took up exercise when they kind of made that correlation like, oh, you're feeling better when you move. I actually had patients who felt that it resolved altogether. But there were also patients that were working with dietitians and doing other things. You mentioned acupuncture. I think acupuncture if acupuncture works for you, it's great. It works so well for joint pain and you can do that while you're going through treatment and beyond. There are specific joints that if you have pain, I think it's like knee pain, though, where it will get covered by insurance depending on where you live. So that's kind of a but that's specific to your joints.
Speaker 2:But anyways, because I know acupuncture isn't available to everybody either, Right, right, and there are a couple of supplements I would say pretty much everyone should be taking to make sure they're not deficient Omega-3 fatty acids, so that's fish oil or algae oil that's important to keep the joints healthy.
Speaker 2:And if you can't test your vitamin D level in your blood which a lot of doctors will test that now and make sure your vitamin D levels are normal, you want them in their normal range at least, ideally between 40 and 60 nanograms per milliliter. So if you can't do blood work, you can always take a small amount of vitamin D. It's safe to take a thousand or 2,000 IU per day, so that's not going to harm anyone and they're not going to get mega-dosed that way. So that's a nice kind of low safe level to make sure that you don't hit the deficiency zone, especially in the wintertime, because we don't get as much sunshine and that's where we should get vitamin D. An ideal source of vitamin D is sunshine on your skin at least 15 minutes a day. But if you live in a northerly latitude or somewhere where the sun doesn't pop out very often, then just take a small amount of vitamin D, because vitamin D was shown to help with some of the joint pains induced by chemotherapy treatment, and not to harp on the aromatics inhibitors.
Speaker 1:But there was one specific aromatics inhibitors, lettresol yeah, and the level, I think, was actually over 60, around 65 or something.
Speaker 2:People who had blood levels over 60 nanograms, which is very different, because we have a bunch of listeners down under in Canada and they don't use nanograms and so you'd have to do the translations into micromoles if you're looking at a lab in metric countries. So it's different numbers if you're in Canada, down under, or the UK or Europe or pretty much anywhere but the United States.
Speaker 1:Yeah, the US is where we're rogue. Something else that might be just kind of a little more simple and easier to obtain would be applying heat to the area. So, whether it is using a product like an icy, hot kind of methylated product or using a heating pad, warm Epsom salt baths. I saw a recommendation for I thought it was kind of a cute way of saying it a whirlpool. I think it's like a hot tub.
Speaker 2:A whirlpool yeah.
Speaker 1:But I never think of them as a whirlpool. Is that like a regional?
Speaker 2:thing. It could be because that's the brand. Maybe it was like jacuzzi, like we call it a jacuzzi.
Speaker 1:Oh no, but it wasn't, it was in a medical thing, so it was.
Speaker 2:Oh yeah, because jacuzzi is also a brand, even though we call the whole thing a jacuzzi.
Speaker 1:Yeah, so some sort of a warm container of fluid that moves rapidly. But the Epsom salt is one of the things that I do recommend, as long as it's safe to get in and out of a tub and if that person has a tub has access to a tub. But just anything that is kind of like that mint menthol-y warming kind of ointment is nice too.
Speaker 2:Yeah, and I think sometimes it goes unnoticed, especially during treatment. But the other thing that can make joint pain worse is anemia. So if your anemia is pretty severe, that can cause generalized joint pain in the whole body. So just want to throw that out there as just another during treatment time reason that you can feel achier than usual. You know what I didn't say?
Speaker 2:With all my anti-inflammatory diet I also, as a general rule, I test for food sensitivities, and inherent to any anti-inflammatory diet is avoiding certain foods, and that's the big ones that would be things that really kick up inflammation of people more often are usually gluten-containing foods like wheat and anything made of wheat, flammatory, which is whey and casein and all that derived of the cow stuff, cheeses, that of the cow. What about the sheep or the goat? Often it's less inflammatory, okay, often. So you can do substitute your cheeses for some sheep cheese or goat cheese and you don't have to go off it very long to find out. I mean, you really need to go off it for at least I would say, two, maybe three weeks. Again, this might not be something you do during treatment, because during treatment you have other priorities just getting through it. But after treatment if you still have an inflammatory state and you have joint pain, they might be worth going off a bunch of foods.
Speaker 2:I said dairy wheat, corn is high on that list and soy is high on that list. And then there's weird ones out there, right? Some people react to nightshades like tomatoes and peppers, and some people react to garlic and some people react to name it I mean they could put out beans Some people react to that. So if people went off the major allergens and still had inflammation, I would often do a blood test that would test for antibodies in the blood to the foods, called IgG antibodies, and so this is very different than the skin prick test that people get. Skin prick test test for IgE, as in Edward, I did IgG, as in George, as in ghost, as in ghost. So I'm just putting that out there because there's a lot of ways of doing an anti-inflammatory diet. That was. My preference is to test if people didn't get a result from just taking out a big dog or two, like dairy and wheat.
Speaker 1:And, like you mentioned, during treatment may not be the time, because you don't want to cut out swaths of food that might cause weight loss.
Speaker 2:And, honestly, there's too many confounders during treatment. I mean, you're having, basically during chemotherapy, by definition, a chemical compound going into your bloodstream. So I don't think that's a clear slate to even test this on. If you go into chemo knowing your food sensitivities or food reactions, you can avoid them and you will get through chemo more easily because it'd be less inflamed in general. But you can't really test during treatment because there's too much going on. There's too many confounders. There's steroids, there's co medications, there's the ups and downs of chemo. Yeah, it's not going to happen.
Speaker 1:So I had this thought about our microbiome and the role that the gut microbiome plays in terms of joint pain. I'm sure there's a connection there. Always, when it comes down to it, it's inflammation and microbiome. Thank you, good night. Okay, we're out of here. Yeah, but it is true, there's a lot more information coming out about the role of microbiome during treatment, so I think we're going to start seeing more and more information about the role of a healthy gut microbiome and cancer treatment.
Speaker 2:Yeah, and I think, I think well, there is a lot emerging on that and the healthiest gut microbiome will be when you are eating the healthiest diet Right. Those little bacteria depend on fibers going through and and colors from nature going through. So the nice thing is, no matter how you slice this, it all comes back down to eating a plant-based diet. It doesn't mean you can't have meat, it just means there needs to be plants alongside it.
Speaker 1:And getting that rainbow of colors in and getting as much variety as possible 30 different plants a week, 30 plants per week, and that includes herbs and spices because of, as we have discussed in a previous episode in our nutmeg episode we talked about how nutmeg and other spices can favorably affect the gut microbiome. So those count as your plants, and so the more flavor you add to your food, whether it's fresh or dried herbs and spices, you're feeding those healthy gut bugs.
Speaker 2:Totally agree. The only thing we didn't touch on as far as naturopathic stuff is essential oils.
Speaker 1:Oh, we also didn't talk about glucosamine. Oh, we skipped right over the obvious. Yeah, which is, I think, is the first thing that people tend to try on their own Mm-hmm, yeah, yeah, so glucosamine works for some people and it doesn't for others.
Speaker 2:And often it comes together with either chondroitin, or chondroitin and MSM methyl sulfonyl methane. I would recommend a combo. You know not. Don't just do glucosamine. You may as well. If you're taking a capsule or a pill already, you may as well get the others in there as well. There's no harm, and it may hedge your bets, because if it's not the glucosamine that helps, msm may help. I think what it's doing is it's treating the underlying osteoarthritis more than anything. Osteoarthritis is garden variety, wear and tear, erosion of the joint, and that happens with age, it happens with use, repetitive use. It happens if the joint doesn't articulate properly.
Speaker 1:Right, it doesn't sit in the joint Like the bone, and the joint don't quite sit the way that they should.
Speaker 2:So that will cause more wear and tear, that'll it'll erode the joint space. So glucosamine is something that I do recommend and I have had to help people. It's kind of a when they stop taking it they notice it. That's how I know it's helping Right More than oh, I took it and I feel like a million bucks. It's not a pain reliever, it's helping build up the joint space. So it takes time and usually people notice it when they stop more than when they start. So the other thing is essential oils and you know some essential oils are known to be anti-inflammatory, topical, topical Topically. So frankincense comes to mind.
Speaker 1:Right, that's the big one that I think of, and then anything that kind of has that sort of camphor menthol-y, yeah, yeah, menthol, because that actually works on pain receptors.
Speaker 2:Good old, what is it? Tiger balm has lots of camphor and menthol in it. But yeah, the frankincense is derived from Boswellia, so it's all the same plant, so it has similar components. Other than that, topically, now we have also over the counter. We have that topical what's that stuff called a Volterin.
Speaker 1:Oh, that's right. That used to be prescription, yeah. And that you have to be careful with Use the least amount that you can. Don't slather it all over the way that you might with like a you know, a menthol-ated ointment, because it is a topical NSAID and you can get gastrointestinal distress from applying it topically. All right. So I think we covered a lot that can apply to both the joint pain with cancer treatment as well as just generalized. You exist and have joint pain. You've lived your life. Joint pain, life acquired, how's that? So let's kind of summarize what we talked about. We talked about the foundation of an anti-inflammatory diet, adding movement.
Speaker 2:And if it hurts to move, then swimming is probably one of the entry points of getting movement in your joints and building muscle. Good resistive exercise, you know, because sometimes it's weight-bearing joints that hurt, whether it's your hips or your knees, and sometimes swimming is a nice way to relieve the joints and weights.
Speaker 1:working with someone you know, working with a physical therapist Again, I'm a provider who found this evidence on my own to be beneficial. So you know exercise is so important for people going through treatment and beyond. So lift weights, safely supervised all of that we talked about acupuncture, because we love acupuncture. We talked about some supplements that can help and, as always, check with your doctor before starting anything new.
Speaker 2:Can I kind of say something about acupuncture. If someone is considering it, I always put acupuncture under the why not label, like if you have joint pain, you have some nerve pain, you have anxiety, you have whatever your symptoms are, then you think to yourself maybe I should try acupuncture. Don't ask yourself why try it. Ask yourself why not try it. So maybe insurance doesn't cover it and you can't afford it. That's a legit reason. But there's not a lot of why nots? I mean there's not. A lot of times acupuncture is contraindicated and so if your insurance covers it especially, then there's a big why not try it? And oftentimes it's worth a few dollars to go three to five times and see if it's helping with something.
Speaker 1:You need to go several times. Sometimes it does feel better after one treatment, but for many people they need to go at least four times, you know regularly. The other thing that you can look into is community acupuncture, which is where multiple people get treated in the same room. You don't disrobe or anything. The points that are chosen are ones that are easily accessible and that tends to be less expensive. That's a good idea and it's something that might be offered in your town and you might not be aware of it. And, like you're saying, the nice thing with acupuncture is if somebody practices traditional Chinese medicine acupuncture, they're not treating oh, I'm just treating the back pain. There are some providers that receive really quick courses on acupuncture. You know, a six-week course or weekend courses or something where they're putting points specific for an ailment. But if you're going to somebody who practices either traditional or classical Chinese medicine, they're looking at you as a whole. So yeah, like you're saying, like sleep anxiety.
Speaker 2:And you know they're looking at you as a whole. When they tell you to stick your tongue out, then they take your pulse for a really long time.
Speaker 1:Yes, and they lift up their fingers and they're like checking things and you're like what are you doing? Yeah, that's how you know. So, yeah, doing pulse or tongue diagnosis really will key you in on you seeing the right person.
Speaker 2:So I think the big take home is, you know, keep moving.
Speaker 1:Keep on truckin', keep on going. So if you liked this episode, or if you know someone who you think would benefit from some of the information, pass it on. Leave us a rating, write a review. Those reviews are really I don't know. They're really helpful.
Speaker 2:They're helpful to have other people find this information, yeah, and we have a lot more coming out. We have a lot of plans, but we're always open to suggestions. So if there's topics you want to hear about, drop us a line. There's a microphone on our webpage, you can leave an audio message or you can just email us thecancerpodgmailcom and hit the follow button so you can look back at our back episodes. So there's plenty of back episodes that we hope are resources for people out there in need and we talk about during treatment and after treatment, and then we have a little fun looking at some movies. So, yeah, hit the follow button and I hope there's more entertainment in our bank of episodes at this point, or ones that maybe are appropriate to help a friend who's going through treatment. You can forward the episode to see if it helps them.
Speaker 1:Yeah, that's a really great gift to give someone who has been diagnosed. A lot of people are like oh, let me know if I can do something for you. Don't ask, Just say, hey, there's this podcast and I think it can help.
Speaker 2:So that's kind of a nice thing to do, yeah, yeah, and we're mindful. I will say In general, we're mindful of our recipients. We tried to land with empathy and kindness in our pretty frank discussions on the topic. So, on that note, I'm Dr Leia Sherman and I'm Dr Tina Gaiser, and this is the Cancer Pod.
Speaker 1: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 Leia Sherman, and by Dr Tina Gaiser. Music is by Kevin McLeod. See you next time.