Joel T Nowak from Cancer ABCs along with oncology nurse Fran Fanning (co-owner of Heavenly Hash) participated in a prostate cancer patient conference sponsored by Prostate Cancer International. The conference was held in Ft. Meyers Florida in March of 2019.
They offered a live presentation that described how hormone therapy worked, how it is achieved, its side effects as well as some "grassroots" methods used by men to control the side effects caused by ADT (hormone therapy). Fran's presentation included information and a discussion about the role of CBD and THC (marijuana) in cancer care.
Both Fran and Joel also answered many questions that were asked by the men and their support givers who were in attendance at the conference. Although most of the questions were about ADT, they also fielded other related questions about prostate cancer treatments as well as Cancer Thrivership.
Voice over introduction by Amber Bloom.
Joel T Nowak from Cancer ABCs along with oncology nurse Fran Fanning (co-owner of Heavenly Hash) participated in a prostate cancer patient conference sponsored by Prostate Cancer International. The conference was held in Ft. Meyers Florida in March of 2019.
They offered a live presentation that described how hormone therapy worked, how it is achieved, its side effects as well as some "grassroots" methods used by men to control the side effects caused by ADT (hormone therapy). Fran's presentation included information and a discussion about the role of CBD and THC (marijuana) in cancer care.
Both Fran and Joel also answered many questions that were asked by the men and their support givers who were in attendance at the conference. Although most of the questions were about ADT, they also fielded other related questions about prostate cancer treatments as well as Cancer Thrivership.
Voice over introduction by Amber Bloom.
Welcome to this cancer ABC's podcast. This podcast was recorded on March 2nd, 2019 in Fort Myers, Florida. It is alive, edited recording of a presentation given by Jolty know, ACC and Fran fanning on hormone therapy side effects for prostate cancer. The presentation was given as a part of a patient conference presented by prostate cancer international cancer. ABC's makes no representation about the legal use of either CBD or THC. The laws vary state by state, so check carefully with your own state and municipality before obtaining or using any of these substances. If you obtain or use any of the substances are products mentioned in this podcast, you do so at your own risk. The opinions expressed in the presentation are solely that of the presenters and not that of cancer. Abcs onto the podcast.
Speaker 2:Welcome everybody to our hope here is to answer your questions about hormone therapy. What I'm going to do is invite anybody if you have questions as we go along to raise your hand and depending upon the flow, Fran arrived, they recognize you at that point or not. We also have a couple of natural breaks, so we have the slides that we'll say any questions, but if something is burning and you're afraid you're going to forget, stop us. We're here. And what if to help you learn more about hormone therapy. My goal in my presentation is first to describe hormone therapy, how hormone therapy is practiced, and some of what I referred to as the grass roots methods that people have devised in order to help remediate or minimize as much as possible. The side effects, how do we do hormone therapy and why do we do hormone therapy? We're trying to aim for walk your body's production of testosterone and the other and budgets. And the second question, hormone on therapy is to block the ability of the cancer cell to utilize whatever hormones are still made by your body. We have basically two lines, hormone therapy, Gary's, what we've heard too, or I referred to as crime area. It's strokes, like we'll try one of the common ones. And then we also have drugs like by glutemide. Lou prime stops the production of testosterone from the testes, and that's about 90% of the hormones that a man's body will produce. We're still producing hormones, so we also use drugs that block the ability of the cancer cell to use it. Then on the surface of the cancer cell, you have these receptors and think of them as if their locks and keys. This is the simple way to it. The testosterone will flow by and fit into that key into the receptor, which then takes the testosterone in and allows it to get to the nucleus where it will help the cancer cell growth. We have the drugs that stop the production from the testes and then we have the drugs. Cassa decks, also known as buy Caluda might fit that key on the surface of the cell so that when testosterone that is being produced flows by. You can't get in because it's already you key in the lock, but we have different ways to actually do hormone therapy. The first way that it was ever done was to orchiectomy. We still use orchiectomy or he ectomy is not as common in the United States. It's used a lot of other places in the world. Basically it's the surgical removal of the testicles. If you don't have testicles, you can't produce testicular androgen. You can have prosthetic testicles installed. That restores the test is to a normal thing, so you're not necessarily facing looking so different. We also use what's called Lhrh agonists. The examples being Lupron, Elegua Bar, those are the ones that stopped the testicular androgens. There's a relatively new one called dagger, Dell X, also known as Firmagon. It has a different mode of action. It's a shot that's every 30 days. The Lupron and the yellow. You can get a one month, two month, three a month in a six month option. Firmagon obsessively every 30 days. You have to be obsessive about it. Estrogens, the first chemical way of creating castration. Estrogens have some advantages and some disadvantages. The biggest disadvantage in the United States is there. Not a lot of doctors use it and they don't know what they're doing with it. It's very difficult to get a good balance of estrogen, the best way to use it as do patches and if you do decide to go that route, you want to make sure that you're the doctor has some experience in helping you to balance out the levels because these patches from one brand to another not consistent and how much the body absorbs them had been originally some concern that giving estrogen to men because we use thing whole des they cause all sorts of birth defects and it also causes a lot of stomach issues and so forth, but if you use it to attach, you avoid that whole way of absorption. Best Way to do it if you're going to go that route. Haven't experienced doctor work with you and use patches. We also, as I mentioned, have the Anti Androgens. Those are the drugs that fit into the key holes. There's also now newer drugs or hormone therapy and most people don't realize this, but drugs like at standing enzalutamide and Abiraterone, I was, it got there actually hormone therapies also, but I think of them as being hormone therapies on steroids. What they do is not only block the testicular androgens but they also block the testosterone that is also being created by the adrenal glands and also by the cancer cells themselves and also probably by fat tissue in your body. It's a more complete blockade. These are the new drugs and are a lot more expensive and as you become castrate resistant, which we'll talk about, usually you move on from through prime, then add those drugs later on. Two common ways that androgen therapy or ADT or hormone therapy or delivered on different schedules. Sometimes they're delivering continuously from the moment you start it, you stay on it until you died. If she get hit by in New York City, but that's my goal in my, by the way, he wouldn't answer. I want to dine out of cancer and my died to get hit by a New York City to us. Some of us will take it forever. There is a move and I do this as called intervention. I go on and off the therapy. There is some controversy as to how effective it is in the sense of how long you survive. There's a lot of data that shows that men who do intermittent means you go on for a period of time, you'd get that PSA down, you hopefully see regression in your scans, you in reality improve the quality of your life and then when your PSA gets to a certain point or your scans done to a certain point in consultation with your doctor, people that got there is some issue as to whether or not you're sacrificing survival for that. The numbers are index. There's some great big studies that show that there's really no difference in survival and there's some studies that show there are very personal choice. Why do I do it? I'm prepared to give up a couple of years of my life to have a much better quality and I have had a better quality, but if you have aggressive disease, Gleason eight nine a lot of disease decision you need to make in very careful consultation with your doctor and get a second opinion on it. Second opinions on everything is vital. There is also some controversy as to whether hormone therapy on its intermittent. First Kenny was whether you become castrate resistant sooner, so there's some people that believe that if you stay on hormone therapy continuously, you may develop resistance more quickly. It was a good break time. Any questions or comments?
Speaker 3:Long Story Short, I had testicular cancer in my twenties I had the orchiectomy I had at the time what was normal radiation. They radiated me from my chest to just above my knee. I am now paying the price for that over radiation. Two years ago, two and a half years ago, I was diagnosed with prostate cancer, went to Moffitt. Dr Pals Sang, said that I am not a candidate for radiation therapy because I'm been over radiate. It sent me down here for a prostatectomy, perineal prostatectomy, and just recently my PSA has quadrupled in the last year or so. Two days ago I went to a medical oncologist and she was very loved London without survival rate. This is the only option. I responded every single time. Somebody said, well, you got this, do this, do this. I don't want to take her word that that is my only option. Corn on therapy would, should I do? Can I wait and see if there was something else six months down the line?
Speaker 2:I am a voracious proponent for second and third opinions and I would never make an important medical decision without being very comfortable with the decision. One way that I become comfortable with the decision besides doing research, I also would need to speak to a second and the third doctor, maybe even a fourth doctor. I will share a brief story. I have a pen to seal cancer, which is a rare cancer. There was only seven people in the United States that have ever treated it. When I was diagnosed, I saw five of the seven and I spoke to the other two on the phone and I think I made the right decision and that helped me make a decision and I ended up doing something that none of them really had suggested. I kind of merged stuff. I think I'm going to urge you to get at least a second opinion. Insurance companies will pay for second opinions. I've never had them. Even though I had five opinions and I got billed for, I never had a peep from my insurance company. That doesn't mean you're not going to, but they will definitely pay for second opinions and you should always take advantage of that. Yes. The hormone therapy, should you accept the word of the radiologists that you're dealing with the oncologist or should we seek a hormone related? Doctor Hormone therapy is usually, and the most experienced, our medical oncologists particularly who specialize in prostate cancer, he has, there are urologists who also will use it. What I think is important when you pick a doctor, a little bit off topic, but I think I'm gonna respond to it. What's important when you take your doctors, get a doctor who's very experienced, the more experienced your doctor is, the better the cancer control and the better the outcomes and the side effect profiles. It's been demonstrated time and, and again I think it was reflected in the opening session where are presented and talked about things getting better. Part of that he referred to with the technology, but when he didn't say it was also the experience of the person who's performing the procedure. I think Mike touched on that very briefly when he asked him, well, how many of these have you done? That's a really important question. How many of these procedures have you done? The data is clear. The more experience, the better the outcome, and you as a patient should always ask the doctor, how many of these procedures have you done? It's important. Never be afraid to ask your doctor a question. What's a doctor? The doctor was a really well educated contractor and that's the way I approached my doctor. I have a lot of respect for their experience and their education, but I'm the one who's going to go home with the result. If not, then they're going off to the next patient or whenever I'm going home with the results. So I have to be responsible as an oncology nurse and number 30 years. It is extremely important once all the saying. Um,
Speaker 4:and you need to be comfortable with what that doctor's telling you, that they will listen to you, that they will listen to your ideas that you bring to them. If not, they may not be the right position for you. And it's 100% oak pay to get that second, that third opinion, depending on their training, depending how long they've been practicing, depending on their beliefs, they may not coincide with yours. So important to do just that. Thank you. Yup.
Speaker 2:One footnote to, I'm very familiar with prednisone and I'm going to tell you that is a
Speaker 4:horrible, horrible, horrible drug and hormone, whatever you want to call it, work. Okay. How long of a period of time do you see in the statistics from the hormone deprivation therapy to the castration resistance?
Speaker 2:Excellent question. And the answer is nobody knows. First of all, it's very different. So if you read the literature, my understanding of the literature is that one will normally be on hormone therapy for approximately 18 months. I'm on 13 years. And so you know what,
Speaker 4:that's a bullshit statistic.
Speaker 2:So I think it's very individual. The vast majority of men that I deal with, and again I talked about the numbers go much longer than 18 months. There are some guys who I unfortunately never have a positive effect coming out of the starting gates. A lot of it depends upon two cancer. You have and Mike referred this morning of the fact that we know if there are 30 different cancers, I suspect there's a whole lot more. We just haven't been able to identify that. Yes it is two years considered a long time and so you went continuous. You are an intermittent or continuous continuous means you're on forever and then three more days after.
Speaker 4:I don't, did I answer your question though?
Speaker 5:If you want to do intermittent, no, go on and off in consultation. I need to really continue saying they didn't consultation with your doctor. You decide how long you want to stay on and how do you make that decision in consultation, how your PSA response, what was your Gleason score if you were at Gleason nine I personally am not a doctor. I personally don't sing intermittent therapies and terribly grand idea, so you've got to look at your Gleason score. For me, I had a Gleason seven I was a four plus three but I had a PSA of four when I was diagnosed, I did surgery. I went five years, no PSA, and then it came back my first on session I stayed on for about 14 months. My other sessions that cut it back to about nine months and then they go off and I get good long periods, but that's my cancer. Your cancer may be different. We don't have trigger points. There's no research that says you go back on when your TSA gets to here and you go off and get PSA is here. It's not that scientific.
Speaker 2:Some of the side effects that men have complained about, I only put some in red only because I'm going to briefly touch on those facts. Flashes the most common loss of muscle mass, cognitive effects, insulin resistance. I think the important takeaway on this is that bottom statement, not everyone side effects will be the same. Not everyone's side effects will be of the same intensity and because the list is up here, it doesn't mean you're going to get it. Don't get depressed by this listing. You're not destined to have is. There are some guys that have hormone therapy and they say he was the same and there were other guys that are lose on the floor. We're in the range in the middle. What I have found from my own experience that when you're on intermittence, the side effects are not the same. Each time I go on, I experienced different side effects and I experienced different intensities so I can't even predict it because it's up there. It doesn't mean you're going to have it.
Speaker 6:In fact,
Speaker 2:remediation that I had been told about by other patients at work or I played with it myself, a hot flashes, cooling pillows and mattresses, net cooling wraps. Some people think that wearing socks to bed helps at night. I don't know that it has for me personal fans. I walk around, I'm back on therapy and I walk around with this and you'll see me sitting here like this. By the way, just I don't usually endorse products and I'm not getting feedback, but this is the best handheld fan I've ever come to called old polar, o. P. O. L. A. R. It's rechargeable batteries. It's got three speeds and it's really strong. I get no money back from them. I got it online. I went to Amazon and I read all the reviews and that was the one that reviewed the best that I actually like it and Amazon doesn't give me a kickback either. Although if you go to cancer, ABC is is your charity and trust and I get 5.5% back. I do admit that these are other things that I had cotton handkerchief just I've got more cotton handkerchiefs shifts, I carry my, you'll go anywhere that makes sure it's cotton and polyester, polyester. It just does not work. That can try. CDC got a nice pretty one, right? They're layered clothing, deep breathing and some men will use estrogen patches. The big thing, Wassup muscle mass and physical strength. We will have muscle wasting. You have to do whatever you can to try to lose as little as you can. That's exercise and that's weightbearing exercise for muscle mass. Go to the gym. If you can find a trainer, find a trainer. Ideally, if you find a trainer who's dealt with people who have cancer, that's always the best. Can't always do that, but get a trainer. Don't go into the gym by yourself and get help and putting together a routine and also will help motivate you. Weight gain is another one. My first round of hormone therapy, I gained 45 pounds. I was fat. I started heavy, I've came fat, I did chemotherapy for another cancer. I lost most of that weight. Stayed stable for two years on back on hormone therapy and four months I'm up eight pounds. That's too much and it all comes right here in the middle and we know that fat in the middle is bad for the heart. Hormone therapy is not good for the heart. There are cardiovascular issue, so we really want to be careful. Watched how much we eat, exercise my family when I do fuse to walk and move. When they bought me a dog and they came, here's your door. We're not walking it. He's actually now my best friend. I want to talk briefly about emotional response being told, you have cancer is tough. We get depressed and then we take these drugs and these drugs including hormone therapy tend to add to depression. It is normal. It does not mean you're crazy or you're sick. What it means, perhaps find someone to talk to. I recommend if you're feeling depressed, go to a psychologist or a social worker and find a way to talk and also the consider. If you need to go to a psychiatrist for low dose antidepressant. I don't like the idea of an oncologist prescribing psych drugs. They're not experienced. Go to someone knows what they're doing. There's nothing raw. It's common. We all suffer it. We suffer depression because we live our life, but we set more depression because we have cancer. It's normal. That doesn't have any meaning. You're a person. You're a human being expected, not a big deal. It's really common. Cognitive effects, pride, the concentrate. You got to work through it as much as you can, but if you do feel this way, don't worry. It's not you. It's the drugs weight gain. We talked about it. Breast growth, very common. There are some ways if it really bothers you, oh you can before you start the hormone therapy, you can't have your breasts radiated. Personally, I don't like it because you're exposing yourself to radiation. Radiation can cause secondary cancers, but it is something that you can do. Also, I'm going to back just briefly met for, I mean on weight gain, a med form. It is a really good drug. There's some evidence that made form and actually will help treating the prostate cancer. It's a cheap drug. It will keep your blood glucose levels down and we'll help on weight gain. I'm on Metformin and insulin resistance. The metformin hopefully will help stave off the development of diabetes. Bone density. Again, exercise is so important. There are some drugs that you can take. Certainly we should all be taking calcium and vitamin D. You can take these other drugs. I wouldn't do them. I don't like the idea of people doing them until our hormone resistant and then you got to do it carefully because long exposure to these drugs quest, terrible fractures of the femur so you gotta be careful. Don't go lightly.
Speaker 6:And the cardiovascular events, it says agonist versus antagonist. The firm again is from a guy has less cardiovascular or I believe
Speaker 2:that it has less. Okay. But it has other side effects. You got an injection on the belly and make sure you don't get to get it on the belt line. Make sure the nurse or the doctor who's giving it to you has given many more because of the injection is not given correctly. It will hurt
Speaker 3:for a long time. We've been there, done that. Okay. Is it common to have the hormone therapy and then Rudy? That's an excellent question.
Speaker 2:There is a lot of good evidence that shows that hormone therapy given truck her prior to the use of radiation will enhance the radiation, will make the radiation more effective and good radiation delivery lead. You should involve at least a discussion with your doctor without preceding before I'm on therapy. There's a lot of good evidence about that because that's good practice. Should you pretreat with
Speaker 3:hormone therapy and continue on after radiation? Depends upon your situation. Could you comment on out less alcohol? That's kind of few less spicy foods.
Speaker 2:Yeah. Caffeine, alcohol, spicy foods tend to kick high flashes. I know that. I love spicy food. I find for instance, I had some spicy food about a week ago and I just waited like a pig. Alcohol also can do that and so can caffeine. Caffeine for me it doesn't, but alcohol and spicy food does. It's individual. If they basically kick hot flashes, you can see it. If that's what it does for you, then you want to find a way to avoid it or kind of down and if it doesn't. Joints.
Speaker 3:Question about other approaches. Uh, you mentioned that form and then I read about the possible contribution there, but something I read about within the last six months, it was a small, just a small article and I haven't heard it mentioned since by anybody is talking about the lock and key thing with testosterone and the Castleberry. What I read was a cancer gets to a point where it gets around supposedly as well. I'm just telling you what I gets around testosterone and moves to, it's either cholesterol or some derivative of it and it picks up where the loss of the testosterone left off. And I've read where I think there may be even a clinical trial, I think it was in Pennsylvania where they're using a stat that was prescribed for morbidly obese people that is supposed to target that. Do you know anything?
Speaker 2:My understanding and I would qualify the amount of any, any by any means an expert. My understanding is that cholesterol can break down and create androgens that can then feed the cancer. So it's actually not the cholesterol, but a byproduct of it is my understanding. And yes, there are men who do take status with the idea of controlling their prostate cancer. A lot of people think of status as being benign. They're not necessarily benign, so you need to discuss that with your doctor. So the answer is yeah, there may well be in effect, last question we
Speaker 3:want for for the boom when it looks that would mentioned there, you know we should have for some action, you know the recent risk for necrosis of the Joe. Yes. From then and I read that of the options to prevent the breakdown of the bone Boniva what do you think of? Well how are you,
Speaker 2:I don't know enough about the different drugs and there are some differences and I can't really speak to them but I think what's really important, you know and that's something you need to have a conversation with your doctor. But I think what's really important to start understand that these drugs are not benign. How'd you talked about the jar problems though in j and then also the femur fractures. I'm glad you raised that. Thank you.
Speaker 3:Now I'm going to ask ran if she would give her presentation.
Speaker 7:Okay,
Speaker 4:so we're just going to do a continuation on managing the side effects. To answer your question, there was actually a talk this afternoon about chemotherapy side effects and we do talk heavily. It's with a medical oncologist and myself as well about Lnj. So it will be in that.
Speaker 3:What did they do? I backwards. Sorry about that guy quoted us separately. You may be honest. I don't know. That's what I look at it and tastic I have my thumb drive. Sorry about that guys. So why we're friends working at any other questions or issues people want to raise. You haven't said anything. Right? Good. Then. Yeah. Now you're on. What about diet? No one has said anything about diets. Yeah, no. Well actually I said that you need to control what you eat. I think diet is a whole area that you really need to talk to. A nutritionist. I would recommend that. I think that you use anything. I, again, I'm far from an expert on diet. I don't eat very well. Uh, my wife will attest to that. I think there are a lot of people who really feel that becoming Vegan or vegetarian can definitely support anticancer action. Certainly lowering your fat, lowering carbohydrates will help on weight. Kind of frank, can you? Yes. You're better about diet. So watching
Speaker 4:your sugars is, is a big part of it, especially when you're talking about the side effects and as well as the Diet. You know, there's a lot of myths out there about cancer feeds off of sugars, things like that. More so it's managing and symptoms and the side effects and the things of that nature. Sugars are actually going to increase your immune system. It's going to stimulate gastritis. So if you have underlying conditions as well as helping manage your diarrhea, constipation, things of that nature, uh, muscle wasting. Again, very, very important because if you start to lose muscle in general, you're going to end up with problems being able to ambulate, walk, set, things like that. So it's really important that we're maintaining our muscle mass.
Speaker 3:Any other questions in the meantime? You having to ask for anything yet? Yeah, prospect, insert going. Uh, I think cancer in general, including prostate cancer comes from two different places is germline genetics. In other words, the genetics that you're born with, good evidence that there's a 10 to 20% of prostate cancers,
Speaker 5:probably germline. Other the words you have it in your family. And it gets passed on. I'm a great germline prostate cancer guy because my father had prostate cancer. His brother who is only sibling died of prostate cancer. His only son was treated. My grandfather had prostate cancer and breast cancer and my great grandfather, according to his death certificate, I had died of prostate prompts. So I'm a really, although I have an older brother by the way, his PSA is undetectable, so you does just because you have the germline doesn't, you know, or they have other members of your family. It doesn't mean your destiny with, and then I think the rest of the cancers probably come from exposures that we have in the environments. And I think we're seeing more prostate cancer today and more serious prostate cancer. Of course, we're exposing ourselves to so many terrible, terrible things in our environment, drive our cars and we breathed the air and the cities and farmers are working with pesticides in the fields. I mean, I think for veterans, we know that they can significantly damaged by their military experience. If you were in Vietnam, you probably had some sort of level of disclosure to agent orange. We see today the guys that fought in Afghanistan and Iraq because of the burning oil wells and they would walk through and breathe this stuff that probably is contributing to which depleted uranium in artillery shells. You had a shell of blue up here and then you walk by it, you're exposed to depleted uranium, so there environmental factors, so there's germline, what you're born with and then your other exposures with homophones or at least what might be a typical regimental continuous, continuous, continuous. That's my opinion. I personally, and again, I can only talk to you about what I would do. Okay. I'm not making a recommendation. If I were a Gleason nine if I had multiple nines, I would be continuous. That's an aggressive cancer. If I can knock my PSA down and knock my scans down, I personally would not be comfortable allowing it an opportunity to go back and grab hold again. So you wouldn't wait until the PSA starts rising again. I would say on a continuous like never go off it. That's a balance and that's something that you really need to speak to a couple of different doctors have af and you're going to have to cause a magic trick here. You're going to have to get your oncologist to talk to your cardiologist. If you can do that, please let me know how you did it and I want to share it with other people. Well, you know, one of the things that I look at is looking at which ways to go. It's probably the more comfortable they are. I don't know. I sorted other hand. Yes. So the recommendation on calcium and vitamin D two assistants, are there any specific levels that we shouldn't look for? Is this something I would talk a nutritionist and your
Speaker 3:oncologist. Very easy. Vitamin D three classes, a blood test. It's inexpensive. It's not a bad idea to do with the Monitor.
Speaker 8:Sure.
Speaker 3:I was diagnosed stage four if the chemo they'll face today. Sorry, Tega just failed that. Starting a new standing, I guess. What snacks? You're asking me a question. I'll just because you're feeling as though your size of birth or that you get from being in college. Just that says here's the standard of care order we do things I don't like seeing that. I'd like to see I oncologist who has a lot of experience who will look at you, look at your disease and be able to understand what the guidelines are, but figure out what's best for you. I think treating prostate cancer, seeing any cancer really needs to be a very individual thing and that's fine. You are comorbidities. What else? Issues you have if you have illness or nothing. Second Cancer, your cancer side and we're still to a great extent in the learning phase of about what prostate cancer is and and I'm going to be moderating a conversation later on with a doctor Ellie. Then Allen, that genomic approach. Mike referred this morning about there being 30 different prostate cancers and I said there's probably more and what he's referring to is we identified, I understand he's can't just be different based on the genomics, the underlying genes, the genes, your cancer. But are there other treatments after Chemo and challenging again yes and and so for instance some of the options I would look, how'd you sell, sequenced and find that if you have a one of the Braca mutations or an ATM because then you have potential of a PARP inhibitor. Me, none of which are approved but you can get them. Insurance companies are paying for them. I think that there are a couple of other drugs, Saturday three trials that are looking good. You have a flexible doctor. I would raise the issue of looking at some of the treatments that a little different than ours in the in that exact proof space that you get your insurance pay for it. So does he drive that recently a group called Apple glutemide also know lead up early I e r l e a d a apple glutemide is the generic name you disapprove or non metastatic castrate men. But I have a guy who's taking it who is burned through a number of treatments including at Sandy, Andy Sandy was some changes in the molecular structure. Just a couple of little groups. He has gotten the best PSA and scan response and tackling anything. His PSA is negligible. He went from 800 to almost nothing. So I think that's where the skill and the experience of your oncologist is so important. You want to go to a doctor, this is what they do. So they understand and know what the options are. That's what I recommend. But there are options also a good doctor will perhaps look at some other the cancer treatments and say, cause I do know one guy who took the chemo is reps and welcoming and this was back right, here's the go. So we didn't have a lot of these drugs when I came up. The options for follow up there at the and though she patched with chemotherapy. Right. And that was 1213 years ago. Now we have a place I hear people use the word with or I don't think so. We have a lot worse and we have a lot of drugs that are in development. So I think we have every reason to certainly feel optimistic.
Speaker 4:I apologize guys were having issues with being able to download it but you don't have the slides on here. So basically what we're going to talk about is managing some of the side effects especially. Yeah, especially the symptoms and the side effects from hormone therapy with CBD and understanding the difference between CBD and the use of CBD versus what everybody knows as marijuana. And there is a huge difference out there. You look on your handout, we solidify the differences between hemp based CBD or cannabis that has THC in it. What everybody knows as marijuana, it comes from two different plants. So basically how contains can avid oils or CVD now can have a dials are part of our endoccanabinoid system. What does that mean to you? It is something that is actually naturally found in our body as mammals. Yet them from a lot of the foods we eat, I'll use one of the most common that actually have[inaudible] and it's chocolate. Why do we feel good when we eat chocolate? Because the cow plant, we're chocolates come from actually have can the dials on it. Mango was another thing that actually has cadabra dials in it. So what's the difference between marijuana and half? Half was basically Rowan and used for textiles, for papers, for fibers. They grow very, very long. They almost look like a bamboo. They don't look like those little tight plants at a marijuana actually is. They're used for the oil and have them just benefit to the oils. They are non psychotropic said that means you're not going to get high off of using a pure CBD oil. Plants are extremely tall. As I said, they can grow up to 10 to 20 feet legal. So CBD, in order for it to be illegal and you're not meeting a marijuana card or a medical marijuana license on it must contain less than 0.3% of THC in it. Most of them have 0.3% which is basically zero. Then there's some other levels and there that have the THC, but that's going to require a medical marijuana card. Cannabis, again, we'll commonly known as marijuana. It's actually grown for the buds. It's highly concentrated. The high concentration of Thc, again is that six to 30%? It is illegal all than those states that it is found that it is, um, allowed or it has a medical indication. So they talk about the green cards and the state of Florida. It is legal for medicinal use. Buy A, you will get that psychotropic effect from the marijuana, so it's going to give you that a high. And then the plants, like I said, do you not really have an industrial application right now so they're not used for their fibers are not used for a strapping their oil. It's not a thought, a remediation or the use of CBD to help reduce some of those side effects from cancer treatments. There's multiple uses out there. They may be beneficial in helping to reduce some of those side effects. So Kane, if it actually, what CBD works on is in the inflammatory system in our body, so they bind to what we call canal receptors in our brains. A CBD basically works directly on the immune system so it can reduce inflammation. It can help decrease that nausea and vomiting that sometimes you can get from our medications, stimulate your appetite, not in a way that you're going to have it with Thc, but CBD can actually help to stimulate the appetite or is very strong on the GI system decreasing anxiety. Joel talked a lot about that. Depression. CBD is very helpful in that calming effect in decreasing anxiety and decreasing some effects of depression. Clashes just talked about the hot flashes because we're working on decreasing the inflammatory system, decreasing inflammation. You're now going to also work on decreasing hot flashes. So again, hormonal therapies are some of the things that we're putting on, but even with prostate cancer that may not be an option for you on may not be working enough. A lot of practitioners and a lot of patients that found that CBD oil is very, very helpful for that. Decreasing fatigue and boosting energy. Again, it could help to stimulate and decrease some of that overall fatigue that we feel and then it has antibacterial effects as well. Again, these are just some of the ways that it helped irritated skin. They actually find that for a lot of radiation burns that using it topically it can help. I'm down some of that redness and some of that dryness that they feel as well. Speaking to your physician, making sure that it's not going to interfere with your treatment and how it may fit into you is very, very important as well. CVD applications and forms and availability comes in a variety of forms. It can be topical, it can be an oil. There's a lot of pure oils that you can add to your foods, put underneath your tongue for nausea and vomiting and even see sickness. You can actually put it behind your ear as well. They can come in multiple foods. I actually co represent them oncology nurse, but I also work with another oncology nurse. We have actually created a company called heavily Hash creamery. We actually have CBD infused ice cream and it comes in two different ways. One just to help get the benefits of CBD, but we talked about the[inaudible] and the muscle wasting. We have a high protein ice cream formulation to help those patients because who doesn't like ice cream? I actually have a patient that benefits from it and actually put some drops of it and one of our air diffusers finds that the kids who are very, very calming effect. We have had patients that utilize CVD. They're able to come off with some of their pain, so again, it's important to talk to your physician, find out if it's right for you or talk to your clinician about it.
Speaker 6:That is kind of the quick,
Speaker 4:that's what I have. Do you guys have any questions? If the CBD is not marijuana, you don't need a pursuit, you know you do not need a prescription for have me CBD, which is legal in the state of Florida legal and all of the states. If it has the marijuana, the THC levels, then you require a Florida green card, but just CBD itself is 100% legal and you do not need a prescription for it. Are there different kinds of oil for different things? There's different, there's different milligrams stripes is usually what there are. There's so many companies out there so everybody will have a different oil. Really what you want to make sure is that the oil is a pure half based CBD oil. I'm looking at the amount that's in it and what it's going to be useful. Again, there's multiple different reasons and use the sport and again, the milligrams rice, so it would be good for hot flash. What would you again, usually anything that we're going to be taking internal and it's going to help me because it's helping you systematically. So again, something like an animal or an oil that you can even add to your coffees, it's usually going to help.
Speaker 6:I just wanted to add to that.
Speaker 4:There's a lot you see CVD everywhere. Please know. Ask him about the testing behind shit. Yes. Don't take something that you don't know where it's pretty strong. Right. You want the seat to get increased in United States as they should have the testing parts behind it. Right on, right on the wall.
Speaker 6:Yeah. Oh Man. That's kind of a trick question.
Speaker 4:Finding out that it's been produced in the United States, it's going to be, it's not FDA governed so much, so what you're going to have is it's falls under what they call generally regarded as safe work. Ras, FDA approval, especially one of the
Speaker 6:animal.
Speaker 4:Ron in a paper lead it. I also take CBD and I have virtually no hot flashes. There you go. I love hearing testimonies. It is an absolute wonderful anxiety. Hot flashes. That definitely helps. What way is it anti inflammatories? How have they shown you could set rates? Yes. So, um, if you go into the scientific studies and there are lots of them out there, CBD hemp derived CBD second avenue oil from pure hemp, actual reason at works on the cannabinoid receptor to THC works on cannabinoid receptors, one in our body and cannabinoid receptor to actually work on the immune system. So that's how it works into the anti inflammatory properties and how it was working in the immune system, how it works on our hormone levels by decreasing our hormone levels. It actually, and again we're talking about hemp derived CBD, it actually can work to lower blood sugars as well. And there was lots of statistical data, um, in scientific data out there on how it works and where it's working, what inflammatory markers or they have. Yes. And again, I don't have those in front of me, but I can give you plenty of websites that you can go and you can see it. There's testing being done at some of the largest academic institutions all over the world in Europe. They're far more advanced than we are when it comes to this and the uses that they have been doing to show its properties is just, again, everybody is different. It depends on your body size as pawns in your body weight and where you're coming from. Most people, 20 to 40 milligrams is enough, but again, it depends on what you're utilizing it for. Natural Lane, we always tell people start low and slow and kind of gradually go up depending on other medications you're on or your symptoms that you have, but 2040 and 60 milligrams tend to be that common. Yeah.
Speaker 6:Yeah. Any other questions? That's it. Great. Thank you.