Health Longevity Secrets

Keto for Cancer?

• Robert Lufkin MD • Episode 231

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What if the real action in cancer isn’t in the genome, but upstream in the mitochondria and the metabolic “terrain” that shapes every signal your cells send and receive? We sit down with Dr Nasha Winters to rethink cancer as an ecologic disease and explore how shifting the terrain can change outcomes without rejecting standard care.

We dig into why ketones are more than fuel. Nasha explains how a therapeutic ketotic state—reached through fasting, carb restriction, or exogenous support—can lower inflammatory cytokines, dial down insulin and IGF-1, reduce angiogenic drive, and directly influence the vagus nerve to move the body into a healing state. You’ll hear practical ways to pair ketosis with radiation, hyperbaric oxygen, and hyperthermia to both enhance efficacy and protect healthy tissue, plus real markers to track progress, from GKI and CRP to LDH and organic acids.

Skeptical about “alternative” claims? So is Nasha—until the data line up. We talk pharmacogenomics, validated drug-sensitivity testing, and the smart use of repurposed meds like metformin, low-dose naltrexone, and mebendazole when the biology says they fit. We also connect longevity and cancer prevention through mitochondrial health: strategic fasting, urolithin A, melatonin, vitamin D, circadian repair, and toxin reduction all play a role in building metabolic flexibility. To close, Nasha unveils her vision for a residential, integrative hospital and research institute on a regenerative farm, where tumor experts and terrain experts co-manage under one roof—data first, dogma last.

If this conversation expanded your map of what’s possible in oncology and longevity, follow the show, share it with someone who needs options, and leave a review with the biggest insight you’re taking into your own care.

https://drnasha.com/

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SPEAKER_00:

Hey Natha, welcome to the program.

SPEAKER_01:

What an absolute honor. I've been following you and your work for so long. I'm just very excited about being here with a conversation with you today.

SPEAKER_00:

Well, well, likewise. The feeling is mutual. I mean, I'm I'm really amazed we haven't we haven't met before this. I've I really enjoyed your book. Uh it came out a few years ago. It's still very relevant. I recommend it to everyone. Uh and you know the the work, the work you're doing. Yeah, I just gotta fix the zoom here. But um the the work you're doing is exciting. I can't wait to dive into metabolic oncology and everything, everything around that. But be and and before we do that though, maybe just take a moment and tell us a little bit about your journey and how you came to be so passionate about this this fascinating area.

SPEAKER_01:

Oh, thanks, Doc. Well, I mean, I think a lot of folks don't get into the oncology space unless they've had a personal story. And so mine is no different from that. Um, at the ripe age of 19, shortly thereafter to be 20, I was diagnosed with terminal ovarian cancer. And unfortunately, it had been missed because my other collection of metabolic diseases, polycystic ovarian syndrome, endometriosis, um, cystic acne, even IBS, um, anxiety disorder, all of these patterns I had had going on for many years. So they just thought it was more of the same when my symptoms started to get worse. I was in college, I was in pre-med, it was very stressful, I was working multiple jobs, I was working grave shifts. So they just thought it was the new stress environment causing worsening of my symptoms until I landed in the emergency room and I had a different doctor with a different perspective who dug a little deeper and unfortunately found out that I was uh on my way out of this world to the point where there was nothing they could do from standard of care. I had a 100% bowel blockage. Um I had metastasis throughout my entire abdomen, into my liver. I had fluid buildup on my abdomen, in my lungs, around my heart. I had a grapefruit size um tumor on my right ovary, and I had um lymph nodes throughout my whole pelvic cavity just loaded with cancer. And um, it had clearly been brewing for a while, but it had been masked by a lot of other conditions that I'd been carrying my entire life at that time. So that expectation was not that I was gonna fight it or live it or battle it or survive it. I just simply wanted to understand it. I'd always been a pretty curious person. And that's what's led me on this almost, I mean, at the time of this conversation, I'm just thigh shy of 34 years out from that dreadful day or group of days. Um, and I'm still learning. Um, here we are today, all these years later, still learning the why of my process and still weren't learning the why of other people's process.

SPEAKER_00:

Yeah, it's so fascinating how many, how many of us, myself included, in this space, were were sort of compelled, drawn into it like you were, out of personal reasons that that made us begin to question the the narrative that's still that's still out there, you know.

SPEAKER_01:

Yeah, we could be three plus decades later, we'd be a little further. In some ways we are, but in many other ways we are not. Yeah.

SPEAKER_00:

Yeah, yeah, totally, totally. Well, I'm I'm so excited to get into this. I mean, your your work, one of the themes of your work is that that cancer is uh is an ecologic disease of the terrain. Can you just like you know, you know, in a few words, summarize kind of the terrain theory and what people can take home from that?

SPEAKER_01:

I mean, my gosh, I mean, we've been treating cancer as a genetic disease uh basically since 1914. There was a little moment in there from the 1920s where Dr. Otto Warburg came in and broke up that construct a bit. And that lingered for a good 25, 30 years until we found the DNA helix, and we kind of jumped back into the somatic mutation camp. But ultimately, we treat this like it's a genetic accident, like it's a genetic mismatch, that there's nothing that we can do about it, that it's simply bad luck, and we are disempowered sitting ducks. That is how we've been presenting cancer for decades now. That's how our research is focused, that's how our treatments are focused, that's where our funding goes. And so what we've learned, and in fact, I believe you could correct me on this. I believe in um 20 November 2024, nature came out with an article suggesting that the somatic mutation theory is finally laid to rest. Now, how does that translate into day by day? Maybe we won't see that still for a while as standard of care, but at least now the the sort of consensus is in that that perhaps the genetic doesn't start there. Perhaps there's an upstream effect. And that upstream effect found by people like Dr. Wada Otto Warburg later down the line, many years later, people like Dr. Mina Bissell, later even further, people like Dr. Tom Seafried and Angela Poff and Dom Dagostino and others started to realize perhaps the genome was under the protection of something higher up. And that is this metabolic mitochondrial, you know, process, which is basically this energy exchange process that's doing a lot more than just creating energy. It's the surveillance, it's the intake of stimuli, it's the translation of that information, and it's the signaling of that information to the surrounding organelles, cytoplasm, cells, tissues, organs in this, you know, big meat suit that we carry around. And yet we keep treating it like it starts at the genetic level, but it in fact starts upstream. And so that's probably the simplest way to describe that this is really more at the root, a mitochondrial metabolic disorder. And, you know, Dr. Rob, you more than anybody know that people still hear the word metabolic and they immediately think, oh, my metabolism is fast or slow, you know. It's so much more than that. The metabolic aspect is literally how the ecosystem inside of us interfaces with everything on the ecosystem outside of us and the signaling that it has, the communication it has with the entirety of the ecosystem. It's under um the the gut, it's under this powerful communication process. So there's also a lot of opportunities for communication to go terribly awry. And in the last, you know, several hundred years or so, we've put in a lot more information into our bodies, a lot more data, a lot more stimuli, a lot more exposures of things that we've never been exposed to before. And our body is overwhelmed, and specifically our mitochondria are overwhelmed. And as such, they can kind of chug along and do their job appropriately until they can't. And that's what we're finding is likely the underpinning of many of the chronic illnesses that plague us today from, of course, cancer, just my area of expertise. But it could be diabetes, it could be mental illness, it could be um obesity, it could be autism, it could be any of these collections of conditions that are now understood to be more mitochondrial and metabolic in nature rather than genetic in nature.

SPEAKER_00:

Yeah, it's amazing the the revolution in our understanding in all these areas and especially the the focus on, as you say, metabolism and especially the mitochondria. And you know, and today there are at least three companies now that are working on mitochondrial transplantation, you know, as a you know, as a treatment for so many things. And and and it just, you know, the mitochondria when I went to medical school were kind of batteries, you know, that was it. And they certainly do that, but it they do they apparently do a lot more. One of one of the hallmarks of uh metabolic therapy that you that you talk about, and we others have talked about on this program is uh a ketogenic uh state uh achieved through nutrition, in other words, what is it about ketosis that is uh metabolically healthy or advantageous in general and for cancer in particular?

SPEAKER_01:

First of all, I'm so grateful that you called it a ketogenic or keto, you know, ketone state versus a ketogenic diet. Ketogenic diet is one way to achieve ketosis, to achieve this natural physiologic state. So just really appreciate that you clarify that from the get-go because um, my goodness, there's a lot of misinformation. There's probably more misinformation about ketosis than there is good information about it, and partially because it's relatively new in our discussion, despite the fact that it's been a therapeutic intervention since, you know, for over a hundred years, but you know, neither here nor there. Um, but ultimately, ketone bodies are signaling eight molecules. Really simple. So when I talked about the role of the mitochondria, are they taking in information, they're translating that information, and they're sending out signals to the rest of the body as to what to do with that information, one of their most powerful lever levers, you know, the things that they can leverage the most are ketone bodies when they're present. And so I often like to explain to people that even as babies, when we're first born, we're in a state of ketosis. And as we're waiting for our mother's milk to come in, we go into an even deeper state. That's a that's a survival mechanism. It's like, let's burn an alternative fuel source until we can get access to some fast carbs, right? Through the galactose of the mother's milk. And yet our desire from that moment is we kind of get our sweet tooth right from the get-go. And it's really difficult for us to want to go to anything but that after we have our first hit, if you will. And yet, it for many, many millennia, we were more seasonal of our access to easy carbs. And that has changed in modern times. It's now available to us 24-7 and in forms that our ecology have never seen in previous, you know, generations. And so now it's like we're extremely overfed and more and more undernourished, and it's more difficult to achieve that natural state of ketosis when we are in a state of lack in our energy resources in our body, because none of us ever kind of dip into that accidentally anymore. Um, and so, you know, I've been in practice long enough to know that anytime you suggest that someone caloric restricts or fasts or alters their diet in any way, it is a hot button, controversial discussion. It really triggers people from all sides of this. And yet what I've learned is that ketone bodies, whether they are achieved in just a natural state of fasting, um, are achieved in carb restriction in general or just carb minimization, or if they're achieved through an actually high fat, low carb diet, or even exogenous ketones, they are really powerful signaling agents to potentiate any other therapies and to have vast, like massive impact on change in the physiology, um, in and in the microbiome and in the way we think and feel. And so I think they're this really under underrated um signaling agent that we could leverage much more readily in the medical field to make a lot more dense than many of the pharmaceuticals we have disposed at our disposal.

SPEAKER_00:

And so clearly the the ketogenic diet then will make us sorry. Ketosis. No, being in ketosis, however we get there, will make us um healthier. Their advantages are microbiome, our metabolism, our mitochondria. But there there's evidence also that it actually can um improve outcomes in cancer, right? There are some early studies now that we're beginning to see that, correct?

SPEAKER_01:

Correct. And and even, I mean, my goodness, let's go all the way back. 1909, Dr. Mureshi um, you know, learned that just fasting was debulking tumors, so shrinking tumors. And we didn't know this then, but we can look back now and maybe assume that yes, there were, you were starving some of the fuel sources for that cancer, but you were also eliciting ketone bodies, which pull other levers. It it lowers inflammation. So it has direct impact on particular cytokines, um, which are very, I mean, inflammation is a big cancer proliferator and a big uh proliferator of metastasis. So you want to lower that inflammation as much as possible. And here's a very valuable um, you know, molecule that does that. It also regulates the insulin pathways, which my gosh, studies show between 70 and 90 percent of all cancers are under direct go mode in the face of insulin and insulin growth factor. And so if you can turn down that volume, you really give yourself um, you know, some runway to get ahead of the curve of growth factors. Uh, it it definitely lowers things like vasoendothelial growth factor, which is a marker of angiogenesis. So we don't have a lot of tools in our toolbox and standard of care to address the vasculature that goes to feed tumors. And when we're in a fasted state and have ketone bodies, we redirect that blood flow elsewhere. We redirect those resources elsewhere. Those are just examples. But one of my favorite examples is even the direct impact of ketone body and their signaling um potential on the vagus nerve. And there's so much, in fact, I just spoke at a medical conference on this very specific topic to uh 1,700 clinicians from around the globe on the research behind this, of which there is a ton. Um, so it has a direct impact on what's happening in the microbiome, what's happening in neurotransmitter communication, it's downregulating the excitatory components in the brain, it's upregulating the feel-good components of the body, it's helping change behavior, it's helping change belief system, um, it's helping put the body into a state of rest versus um run, so that the body can actually receive treatment and receive healing. And so it has such implications that I think that people underestimate. I think they think the ketones themselves are just starving the cancer, but it's doing so much more.

SPEAKER_00:

So if if the the evidence or preliminary evidence all the way back to 1904, and then certainly after your book came out, it literally in the last few years, there just been growing evidence of the benefits of uh ketone being in a state of ketosis as an uh augmentation for for cancer therapy. I guess the question then becomes what's the pushback? In other words, what do you think the issue is? Why isn't everybody uh doing this for, you know, while their cancer is so common, why aren't all cancer patients uh managed somehow metabolically in addition to their other things? I mean, it it's not it's not an either-or thing, correct? I mean, these are not exclusive, it doesn't diminish uh chemotherapy or surgery or radiation or standard treatment regimens, right? Right.

SPEAKER_01:

Well, in fact, the studies are really clear, and I've seen this clinically with thousands and thousands of patients, it actually potentiates those therapies and protects from the side effects. So it's definitely not exclusive. It's not like just do the ketogenic diet. In fact, I would never recommend that. Like it's it's a it's a tool to leverage other therapies, make other therapies work better. So from the conventional, like chemotherapy and radiation, to even the more unconventional, like hyperbaric oxygen and high dose IV vitamin C, for instance, like those are some ways that no, they doesn't, it's not mutually exclusive to the alternative space. To your question about why is this not more accepted or more mainstream, I have similar questions, but there's a few things. Um, number one, clinicians have what is it? I think the studies currently are uh less than 25% of medical schools have even an elective course offered in nutrition. And when you have a medical student who's going through med school, those elective courses are not something you jump to typically unless you just have a very personal interest. So, and even that elective course is very, very limited. There's really no room in our training for this. You have to go off campus, if you will, to learn this type of medicine. Number two, I mean I failed to mention in the signaling aspect of ketone bodies, when we look at the hallmarks of cancer, you know, they went from six to 10 to now upwards of 14 and 16. Hannahan and his team just kind of keep building on it. And we keep looking for drugs to target those hallmarks. And the irony is that it hasn't changed our outcomes, one iota, because no one's asking, well, why are those hallmarks expressing? But either way, when you look at a tool that absolutely targets each and every one of those hallmarks simultaneously, ketone bodies do just that. And so I believe that there's also a bit of pushback and maybe fear from pharma that there is something that is virtually free, you know, that you can access through diet and lifestyle that is far more potent to address those hallmarks than any of the pharmaceuticals on the market. So I believe there's industry pushback from that. And I've got good good reasons for that. Uh, my husband worked for Merck Pharmaceutical. He was a K RAS uh tra uh RAS mutation expert. There was no interest in this. And guess what? One of the best target, one of the best treatments for targeting KRAS mutation is therapeutic ketones. And so it's like these are the places where the KRAS mutation pharma pharmaceutical drugs are failing miserably. And so they don't really want you to know that there's a better therapy, just like when we were treating little kids in the 1920s for epilepsy until the drug Depacote came out in the 40s, the diet, the therapeutic ketogenic diet worked beautifully. But once the pharmaceuticals made it to the market, they never worked as well as the diet, but they quickly replaced the diet. And so we that theme is playing out here. And part of that is because there's also a belief system from doctors. They lay their own beliefs on the patients. I will hear doctors say again and again, that's just too hard for them to do. That's too demanding. It's too difficult for the patient to do this. And I just want to like slap them upside the head and be like, let them make that decision. Don't make that decision for them. Don't impose your own sugar addiction behaviors on your patients, right? Because that's what they're doing. They are limiting the belief system and therefore limiting the opportunity that these patients have to become um like sovereign, empowered individuals in having a hand in their own outcomes. And so I think that's the other one. So I think industry is frightened. I think people want the quick fix pill, and I think that people also limit the belief systems around it.

SPEAKER_00:

Yeah, I mean, so it yeah, the a very benign thing would be just ignorance and people aren't aware of it, and then more darker, pernicious influences from the pharmaceutical and other industries that uh after all, medical education is largely paid for by pharmaceutical companies. So it really colors what you know all of us get in our in our training. But I guess you know, you have to wonder that it's it's not just something that's that's nice to add to treatment if you take like the glioblastoma papers and some of the other early work that's coming out where people actually improve their outcomes and even survival on a keto uh keto approach, a ketogenic approach versus the people who didn't get it. And these are you know um well-controlled trials. You can make the argument that it's you know, that it's actually life-saving for these people.

SPEAKER_01:

As a clinician who's got the boots on the ground with a patient and the clinician serving those patients, you know, I hear people always say, well, that's just anecdotal, that's anecdotal. But my gosh, Doc, when you see thousands, if not tens of thousands, when does it move from anecdotal to fact? Because we, it's it's easily measurable. This isn't subjective, right? We have amazing tools like continuous glucose monitors and you know, blood stick like the keto mojo and others like that in the market to check for glucose and ketones in the blood and GKIs, the glucose ketone index. We have imaging, we have other labs, we're looking at the other metabolic fingerprints like lactose dehydrogenase and Lactate pyruvate ratios, we're looking at organic acids profiles, we're looking at um, you know, just even changes in uric acid and inflammatory markers. We have data upon data upon data, as well as patients' subjective experience of this, which the side effects are many, meaning calm, different mental clarity, resolution of other comorbidities, resolution of lifelong mental health um issues, those go along for the ride while we're also leveraging um cancer treatments, you know? And so I think it's just so ironic. And to your point, I think several years ago, I think 2018, Steve Reed brought out a paper with a lot of colleagues about that ketogenic diet should be standard of care with standard of care. And, you know, I've got a really dear friend who's come through my training, Dr. Chris Smith from Barrows, you know, head of neurosurgery, well known for his work in glioblastoma. He's has reported it dozens and dozens of neuroconferences. Um, and even in his own backyard, despite the fact that his outcomes are better than his colleagues, by bringing in this tool, no one wants to hear it. No one wants to hear it. Like, you know, we we've lost famous people and senators and whatnot who literally in the same state where this is happening did not end up in Dr. Chris's camp, which is a bummer because could there have been different outcomes? We can't ever say for sure, but I can tell you clinically, I see the difference when someone brings it on who hadn't been on it. I see the difference when people jump off of it when they've been on it for a little while. Um, and I know that you can definitely change the experience and the outcome measurably when you are adding this tool into the rest of your treatment protocol.

SPEAKER_00:

Yeah, we we touched on exogenous ketones already. I mean, Dom D'Augustina was just on the program here. Um what which patients do you use them for? Or what do you in general? What how do you what's the application for you in in oncology?

SPEAKER_01:

So a lot of folks, you know, I was a little nervous early on when the keto, um the ketone bodies started, you know, exogenous ketones start hitting the market because I was really afraid that people would default to like the easy button. That's our human nature. Like we're seeing a whole whole thing of that with GLP ones and the whole bit here, which by the way, ketone bodies are GLP ones. So just saying, you know, they have that same impact, just saying. Um, but I was worried that it would just be kind of abused that people like I can still go and eat my crappy diet and my ultra-processed foods and still, you know, have my buckets of sugar and just take these. Well, you can, and yes, you get some benefit, but it doesn't have the same impact than if you're making them endogenously. But I certainly use them to enhance and also to help smooth the ride. And so what I mean by that specifically is somebody who's not um a fat burner, someone who's not a dual engine, you know, a hybrid there, um, who's really new, especially if they've been very metabolically dysfunctional for a very long time, it can be a bumpy ride moving into that dual, you know, that hybrid engine or into that fat burning state. And so it can cause a lot of people can hit that discomfort and and bail, right? And instead of breaking through to the other side, a lot of them will hit bump up against that and fall back. So I have found that exogenous ketones can really enhance and help them achieve that state faster to get into more of an adaptive state, a fat burning state. And it could smooth the ride of their discomfort and especially help with what's known as like the keto flu. So I love it for that for folks who are really struggling. I don't often offer that up front, but I because I don't want everyone to lean on it. I want them to feel that they've empowered it themselves, but I definitely know it's a very powerful tool when it's needed, you know, when they can't break through it on their own. And that's not a failure of them. We're all wired differently, that some people have some single nucleotide polymorphisms that may make it more challenging to become a fat burner. Some people may be on certain pharmaceuticals that may make it more challenging. So the exogenous ketones can really help override that, which is exciting. Where I also love to use exogenous ketones is to potentiate other therapies. So for me specifically, um hyperbaric oxygen therapy, radiation therapy, um, as well. So what I do is I have a person in a therapy either at a state of ketosis, so they've got some measurable ketones on their blood, blood monitors, um at least a 1.5 and above is my preference for before you go into radiation or hyperbaric oxygen or even hyperthermia. And then if they're not quite achieving that on their own, then 20, 30 minutes prior to that intervention, we have them take a bump of ketones. You know, 10 milligrams is typical of what we often offer for that. So we really strongly lower the glucose, strongly lower the insulin, and strongly up the ketones and get them more into a therapeutic state closer to three, four, five. And man, it potentiates the other therapies. It protects the healthy cells even more, and they recover even faster. And so those are some ways that I've used exogenous ketones in practice.

SPEAKER_00:

Yeah, and so and speaking of other adjuncts, um, just maybe like off-label stack triage. I mean, I've got a list here, metformin, statins, doxycycline, mabendazole, LDN, rapamycin. Which have you found to be valuable or all of them?

SPEAKER_01:

You know what? Time and place for each. Um, we've learned like I love to look at pharmacogenomics. So a lot of people, everyone got super excited about metformin, but about 30% of the population have these SNPs, these single nucleotide polymorphism hiccups that make them number one, not use that drug well and even have terrible side effects with it. Metformin across the board will damage methylation and will damage um microbiome. So I don't want people to like lean on that as their way to lower insulin growth factor. Um, but it definitely has a time and a place, and I use it kind of like a scalpel instead of like a sledgehammer into the system around this. If someone has a lot of history of autoimmunity or TH1-dominant patterns in their immune system, low-dose naltrexone is one of my favorite tools to bring on board. It has direct um impact on inducing apoptosis in many cell lines, but it also has a really powerful effect of modulating and enhancing the immune system. And it's also a really powerful tool to help bring on board either before or during someone is using a checkpoint inhibitor so they don't overshoot the desired effect. It really can dampen the excessive autoimmune process that happens in a lot of people taking the modern cancer immune therapies today. And then some of the other drugs like mebendazole and fenben, again, time and a place. I like to, I really like it if I can see in their labs that their monocytes, eosinophils, and basophils are all elevated. That often indicates a parasitic or growth, a dysbiotic overgrowth. And I find that those patients with that sort of fingerprint in their labs do really well for a short course on the finbins or the mebendazols, even the ivermectins. Um, but we have come to the point, gosh, in the last few months, even, but over the last few years, we can actually test people's blood to see what off labels. Um, and there's let me just let me just preempt by saying there are tests that have said that they've been doing that for a very long time. And I will also carefully say that not all of these tests are created equal. My advice to the consumer would be to look for one that is FDA approved, third-party validated. Okay, so don't get caught up in the influencer side of things because there's certain tests that say to do the that say that they're doing this that I don't trust that they are. So I'll leave that unnamed. But there are tests that do offer um third party, you know, third party validated FDA approved testing, not yet covered by insurance. So They're they're pricey. We're talking four to six thousand dollars out of pocket. But when people are spending, you know,$3,000 a month on high dose IBC and all these off-label drugs and maybe some hyperbaric oxygen, wouldn't you like to know if those are doing anything for you first? You know, so to spend that up front, you are saving yourself literally tens of thousands of dollars down the down the line. And you're also seeing what are actionable targets for you in that moment. So we can actually look at various off-label drugs. We can look at various natural therapeutics, we can look at various um uh sort of repurposed standard of care, you know, chemotherapies. So we can even use standard of care chemotherapy in a unique way. We use it in a metronomic way that's acting more like an immune modulator than an oxidative, you know, bomb in the body. So there's so many cool ways we can harness standard of care therapies better, but they need to be done so based on the individual and what their body's asking for and not based on NCCN guidelines, which is the dictatorship of how we practice, which does not hold any reality of what's actually happening in a patient, which is really unfortunate because a lot of companies are doing these types of testing, even insurance-covered ones like Foundation One, Keras, et cetera. But then they get that data and they still don't use it in practice. So they're still like, oh, you're still gonna get what NCCN guidelines tells you to get, despite the NCCN guidelines not fitting what that patient's body is actually saying on the test, is would be a good target for them. Um, so I'm seeing this again and again. Like I'll give an example yesterday. I had a consultation with a doctor who's working with a patient who's about ready to go with Dr. Patrick Sun Chang's protocol, you know. Really, I like I am one of his biggest cheerleaders out there doing raise the roof for him since 2014 when I first heard him on 60 Minutes talking about that we should stop calling it breast cancer or prostate cancer and start talking about pathways, you know, instead of tumor sites. That I was so excited about that. The man was really speaking more about terrain than tumor. And then he's really ahead of the curve and understanding that the immune system really does need to be harnessed for this, but he also is still protocol-based and everyone's getting the same approach. And what was really unfortunate is there was this patient who was about to spend almost a million dollars, you know, because this is an out-of-pocket treatment right now, um, and doesn't even have the PD1 or the PDL1 target. And yet everyone's like, well, we're just gonna give it to you anyway. Well, the guy also has Hashimoto's autoimmune thyroiditis and Shogun syndrome. This is going to wreak holy havoc. He will wish for death with this. This is what happens in over 80% of patients who take these medications. And just because it's innovative and amazing doesn't mean it's for you. And it doesn't mean that you can't do that therapy, but you've got some work to do to be able to receive it in a different way. And so, my my job with helping this clinician help this patient is to get because this patient's very, very much determined to do this treatment. So we have about three weeks to get them ready and hold our breath and you know, hope for the best. Um, because uh when it works well, it's a miracle. But when it doesn't, uh it's can be a death sentence. And you have to be very careful. It's very little wiggle room between those two places. And I think we can do so much better for our patients. Um and you only hear about the good stories, you don't hear about the bad. And so um I think that we can be more nuanced and more sophisticated with this approach that actually serves our patients better rather than our own agendas.

SPEAKER_00:

Well, well, given the given all the challenges that we've talked about in the guidelines you've mentioned, um, when you talk to conventional sort of mainstream oncologists who are skeptical, are there any particular data points you use to win them over? Or what what are your arguments?

SPEAKER_01:

Well, oftentimes, I mean, honestly, what I just kind of outlined for you here usually makes them go, wait, what? When they're we're talking the same language. And so I learned that data is the equalizer. And so if I can say, well, let's look at their, let's look at their mutations, let's look at their molecular profile, let's look at their single nucleotide polymorphisms, their pharmacogenomas, let's look at their labs, their neutrophil to lymphocyte ratio, their markers of inflammation. I mean, a C reactive protein is prognostic for whether this patient's even going to respond to this therapy. And so when I start to feed them back their own data and show them the studies that go with that data, my my job is to say, you're the tumor expert, I'm the terrain expert. Let me help you and the patient get their terrain as ready as possible and as primed and resilient as possible to fully utilize your therapeutic to the best outcomes. And when they hear that and they realize we're on the same side, and I can literally make their job better and their patients' outcomes better by coming in with this terrain approach, it's a win-win for everybody. And then usually those are the doctors that end up taking my training program. They can they get through like some funny stories as early on when I would have patients hire me to do a consultation when I was still seeing patients, and they would hire the oncologist and the oncologist would get on the phone and be like, I don't even know why I'm here, but they paid for my hour and your hour. So let's just get this over with. 100% of the time, I probably did this 200 times. 100% of the time, never once did this not work out this way. They were like, This is amazing. Can I do this for other patients? When do I have a follow-up and can I do this for myself? And so that's what happened because they realized like it there is so much misinformation out there. I understand why there's the alternative medicine camp and the conventional medicine camp. And I am maybe it's because I'm a Libra, I don't know. But I really believe that there is the best of both worlds that can be brought together for the good of the patient outcome.

SPEAKER_00:

The um cancer and aging share share many, you know, many hallmarks, and aging is, you know, one of the for many cancers, the single greatest risk factor or you know, among them. Yeah. Yeah. So it what longevity levers do you use, if any, to meaningfully reduce cancer risk? Is that a part of a part of the program? You know, even rejuvenation? Because the progress, there's so much progress being made in this space now.

SPEAKER_01:

Well, first I love that question. And I do want to say, you know, we used to think of cancer as the disease of the elderly. When I was in medical school, the average age of a cancer patient was 68 years old. Um, I believe it's been, I think it was 2015, that average age was is now 48 years old. I'm imagining it's younger now because of just what I see in myself in the thousands of, you know, over a thousand clinicians across 46 countries that are feedbacking the same finding. But here's the thing it's not because these people, it's like, oh, the young are now at risk. No, no. What I want people to understand is our age is dependent on the health and wealth of our mitochondria. Our mitochondria are our longevity. They are our chronology, you know, they are our biography and our biology. They are the expression of our health. And so what's happening today is I mentioned our mitochondria are under more duress than ever before. And what that translates to simply is that our mitochondria are aging faster than we are chronologically. So that's what's happening is you're seeing younger and younger people, but they have older and older mitochondria. Does that make sense? And so when you talk about the longevity world, you know, a lot of people think of longevity like a little bit of something here, here, and a little tut tuk here. That's not longevity medicine. Longevity medicine is looking into the ways that we can actually extend those telomeres, that we can actually improve the health and wealth of our mitochondria and our mitochondrial function. And there are so many cool hacks around this. And probably the best, fastest, cheapest, most free is fasting. And so I really love the whole longevity research world around the utility of fasting. You know, intermittent fasting in particular, um, waves of fasting, longer fasting here and there is like a bigger punch. I mean, even Dr. Tom Siegfried and even Dr. Walter Longo said that, you know, every one of us would do ourselves a huge favor of prevention of all-cause mortality if we did a five to 10-day water fast twice a year. Like just the amount that drops there. So I think that's one big hack. Another big hack is things like urolethen A. I'm really excited about some of the those markers or C60, you know, the um buckyball things that are very big mitochondrial resuscitation nutrients that are very, very powerful there. And of course, taking care of your environment. Everything you're putting in on and around you really nurtures and fosters healthier mitochondria, getting back into rhythm, knowing, you know, getting back into rhythm of your circadian rhythm. Sleep is a very powerful, powerful anti-aging, you know, remedy. Um, melatonin, um, something that, you know, uh people like Dr. Ryder, Russell Ryder, big, big researcher in this area, you know, has done a ton of research that we all naturally lose our melatonin levels over our lifetime as we age, but we're losing them early. Again, it seems to go hand in hand with the age of the mitochondria. And so we used to worry that giving melatonin in high doses would replace our own body's production, but that's not the case. And Dr. Ryder has shown that over and over again. That's a really powerful sort of defense hack that I think that we can utilize as well. So those are some of like the ones, and then optimizing vitamin D. Um, that's one that we've all been so taught to fear the sun. And we also use detergents on our skin. It takes three days to process, you know, the vitamin D into our skin and absorb that. And if you don't have single nucleotide polymorphisms and you don't use detergent on your skin, you might be fine. But the majority of us are actually walking around with very low vitamin D levels unbeknownst to us, which is like between melatonin and vitamin D3, they can be very big protectors of the genome through mitochondrial mechanisms. And so there's a lot there. And I think that um, you know, fasting, I think is still probably my favorite longevity hack that there is.

SPEAKER_00:

We're we're almost out of time here. I want to be respectful. Just a quick question. When you mentioned mitochondria, do you measure mitochondrial function or age directly, or is it more inferred through overall metabolic health?

SPEAKER_01:

Well, I love, I've been doing the inference for some time, but we are starting to get more and more testing that allows us. The organic acids gives us some information. We can gather a bit. There's some new ones about ready to come out of the market this year, which I'm very excited about. Um, some of the longevity testing that's out there gives us some, but I'm not quite sure how reliable they are yet. So I'm still the jury's out. Um, but this is something that we're actually doing in our nonprofit lab, metabolic trained student health lab, is we're starting to actually test this. We want those answers ourselves. So we're looking at cell line studies, we're looking at cell respiration studies using a technology called the seahorse, which is kind of like a modern day Warburg test, um, as well as metabolomics testing, because we really can start to get a better sense of how old or how robust or how what kind of quality or quantity do we have in our mitochondria and what therapeutic interventions um make a difference? And so that's what we hope to answer from our laboratory environment.

SPEAKER_00:

In the last couple of minutes, I'd love to hear about your project. You we talked offline a little bit about so many exciting things you're working on. Uh, maybe you could just share some of those things.

SPEAKER_01:

I'll keep it brief, Doc. So here we go. Um 30 plus years ago, I started dreaming about needing a place where everything is under one roof. Um, to save my own life, I had to literally travel all over the world. And with someone who had no resources, I literally traded for house cleaning and parts of the world just to get labs done or, you know, just did things like I worked in such unique ways to find resources to take care of myself. I knew that someday we needed to have the best of all worlds under one roof. There's a lot of places that say they have alternative or integrative medicine centers at big academic institutions, but I will tell you right now, it's those places are only putting lipstick on pigs. Okay, so that's really all it's doing. It's not actually integrated medicine. Yes, things like yoga and meditation are important and very good medicine, but do we need to be spending millions of dollars of research to say that? No, we do not. When I'm talking integrative medicine, I'm talking off-label drugs. I'm talking using leveraging various tools that are vetted, curated tools from the alternative space that fit the patient individually. But I also need good testing, good imaging. I also need good more direct intervention. Sometimes surgery is required, sometimes radiation is required, sometimes off-labels are required, chemotherapy, et cetera. That needs to all be done under one roof because when we silo off all these practitioners, we fail the patient. Those patients can easily fall through the crack. We also need to make these therapies accessible by all because the people to get access to this type of care have to have resources. And so that's one of the long-term plans. So I've had this vision of a residential hospital and research institute that's taking form in Southeast Arizona on an organic regenerative farm. Because you honestly, you look at some of the most toxic buildings on this planet, toxic building syndrome, hospitals are at the top of that. Um, they're on campuses that are completely sprayed down with just, frankly, shit tons of glyphosate and pesticides. The food, they average$1.49 a day to feed patients in a hospital setting. Um, that's not okay. These are not places where people will go to get well. I'm building a different model of different system. We're building in the data platform for that. We're building in the education for that, we're building in a new model of research for that. And so honestly, I'm taking on a Goliath. I'm not just, I spent the first 20 years of my career trying to fix a broken system. That almost killed me multiple times over. So now I'm just going to build a new one. And I have a lot of people helping me do things like this around the world, maybe in seemingly unrelated fields, but we're all rowing in the same direction.

SPEAKER_00:

Wow, that's so exciting. And they can find you on your on your website and through social media. I follow you, all your great, all your great things, and you and your podcast also. Uh so but thanks so much, Nasha, for spending time with me today. This is this has been a lot of fun, and I'm look looking forward to great things in the future, hearing more.

SPEAKER_01:

Can't wait. So, so honored to be here with you, Doc. And I can't wait to have you on metabolic matters. So we'll we'll go there soon.