33: The Metabolic Approach to Cancer | Dr. Nasha Winters, ND, FABNO

When it comes to treating cancer, conventional medicine is good at cutting it, burning it, and poisoning it, but many oncologists fail to address the root cause. Join me as I speak with Dr. Nasha Winters, ND, FABNO, about the importance of a terrain-based approach when it comes to treating cancer. Dr. Winters shares the ten key elements of a patient’s “terrain” that are crucial to preventing and managing cancer. We discuss the importance of listening deeply to the cells of the body (with labs, molecular profiling, epigenetic testing, and more), metabolically supporting the body’s terrain (with a therapeutic diet, oxidative therapies, and stress reduction), and recognizing that the body has an inherent ability to heal. 

What you'll learn from this episode: 

• Why addressing the body’s internal terrain is not only critical in prevention but also in the treatment of cancer
• How to address metabolic dysfunction 
• Limitations of conventional cancer treatment
• Lifestyle strategies integral for not only prevention but also better treatment outcomes
• The importance of emotional healing in the cancer journey
• & So much more!

Resources:

• Dr. Nasha Winters | Website | Instagram | Facebook
• The Metabolic Approach to Cancer
• Terrain Advocate Program
• Costs of Cancer Care
• Chronic stress-induced immune dysregulation in cancer
• An Integrative Approach to Breast Cancer - WellnStrong Guide
• Indole-3-carbinol as a negative regulator of estrogen
• Diet, insulin-like growth factor-1 and cancer risk
• Radical Remission
• Remission Nutrition with Jen Nolan

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Transcript

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Dr. Nasha Winters: Howdy do. It's about time. 

Jacqueline: I was just going to say, this is so exciting for me. I was chatting with my mom earlier this morning. She's like, when is your interview with Dr. Winters? I was like, it's coming up 

Dr. Nasha Winters: soon. Oh, sweet. Thank you so much. I love it. I'm excited to be here. Thank you. 

Jacqueline:  Well, first of all, I know we've been in touch for  the past, like two or three years.

And again, I've never had a chance to see you.  So I know it's,  it's not in person, but Hey,  it's the best we can do for now, but maybeone day we can actually meet in person. 

Dr. Nasha Winters: I love it. I hope so.  Do you have any big events on the horizon this next year? 

Jacqueline: I'm currently in planning mode.

Dr. Nasha Winters: Are you getting to the point where this might get to become your full time gig? 

Jacqueline: God willing. That's yes. . Iit's a matter of time. I feel like I'll never be fully really , but I just need to take the next step, we never are ready, right? That's the nature of life, but at some point,. I'm excited.

 I started this podcast back in [00:01:00] May, so it's still relatively new. I've have about 30 episodes under my belt. 

Dr. Nasha Winters:  Yes, that's so good.  I think you're doing a fantastic job. 

Jacqueline: I appreciate you. Thank you. Hopefully you've had a chance to look at my background on well and strong, but basically the reason I started well and strong is because my mom was diagnosed with stage four breast cancer back in 2018. And she was really the catalyst. I just started doing a lot of research on complimentary therapies and sharing what I was learning and it's expanded little by little, but again, God is good.

I mean, she's been doing a lot of high dose IVC therapy and she's starting to explore some off label drugs. 

Dr. Nasha Winters: Yeah, she was diagnosed with stage four, right?  

Jacqueline: So she had stage two in 2008 and then 10 

Dr. Nasha Winters: years later. Exactly. That's what I thought I remember from your story. So she had that unfortunate leapfrog, but still to be stage four in 2018 and still be here rocking it today.

Jacqueline: I know. Yeah. So [ she has some bone mets?????,  a few liver lesions. She recently started on Verzenio but again,  she's in good spirits. She's very strong in her faith.  

Dr. Nasha Winters: she has you being the detective and bringing in all the puzzle pieces in support of her, but also in support of you and so many of the rest of us out there.

So what a passion and purposeful project you have going on. 

Jacqueline: Yeah. Well,  similar to your story, although you experienced it firsthand, but again, we, we turn our pain into  our mission, right. And helping others. So. Those are the best 

Dr. Nasha Winters: stories. Oh, thank you so much. Thank you for sharing that. Because I definitely knew a little bit of it, but it's just great to hear it from you directly.

And I think that'll be helpful in our conversations today…..to make it very personal. Exactly. Personable for anybody and everybody feeling called to have a listen.  I do 

Jacqueline: I like to try to do that….. especially with you. I feel like I have an affinity with you. Yay! Good! We go back now. 

But I do like to share that. Well, Dr. Nasha, [00:03:00] I, I did pull out your book, The Metabolic Approach to Cancer, the other day. ……….

Dr. Nasha Winters: 

Jacqueline: I was preparing for what I wanted to discuss with you. And I will say, this is probably one of the most marked-up books that I have. There are  annotations on almost every page. It's certainly one that I constantly “go too” So it was truly difficult to narrow down what I wanted to focus on with you.

Dr. Nasha Winters: Well, I love you, but you put out a pile of really great thoughts and questions, but I like you just trust that this conversation will go wherever it just needs to go. 

Jacqueline: That's exactly what I was going to say. I mean, in the spirit of true podcasting, I'm excited to see what rabbit holes we go down based on the few questions I did manage to pull together.

Dr. Nasha Winters: Perfect. Thank you. Really good. 

Jacqueline: Wonderful. So before we dive in, Dr. Nasha. You have such an incredible story as to how you really found yourself in this space of integrative oncology. And I would love if you could just share a bit more about that with our listeners. 

Dr. Nasha Winters: Absolutely. So, [00:04:00] you know, I alluded to this in just the first seconds we were talking here in that I don't think anybody wakes up one day and says, gosh, I think I'm going to go work in the field of oncology.

That just seems like a really light and fluffy career choice. Like, that's not how it works.  We are called to it, whether it is from a very personal lived experience or one like yours, a very personal lived close experience with someone near and dear to you. And so we, we show up or we're being shown what we need in our lives and, and what we're supposed to do.

With those trials and tribulations. And so for me, that's what my diagnosis was at the age of 19 is when I was having issues, , but it would take them until about 2 weeks after my 20th birthday to get the official. diagnosis despite me landing in the hospital a few years before my 20th birthday.

That was just in 1991. That was the nature of it. We just were in a small town in Colorado and  the [00:05:00] technologies and the testing and the ability to turn things around in a quick way  just weren't there. And even what we've learned in the last 32 plus years, because we're now over 32 years out, still, yeah.

Oh, thank you. I love it. I love it. It's like I say that out loud. It just, it's just amazing, but just a number, just a number, more experience, more wisdom. I'm wise now. That's how we look at it, but it's just incredible what we didn't know then. And in some ways we haven't learned a heck of a lot more, at least in the standard of care world, although we've been able to qualify that type of cancer.

I was diagnosed with back then ovarian cancer. We kind of categorized it as a single cancer.  Well, we now understand it to be about 26 different cancer types with a lot of different personalities. And yet, we still, even though we know it has a lot of different sort of personalities, we still basically treat it the same way.

Everybody gets carbotaxol or some variation on that theme. So where we've learned a lot more, the way we [00:06:00] approach it, hasn't changed that much. And that's one of the things I hope we get to talk a little bit about today. But for me, my journey started, I, I don't even know how to describe to somebody that there's sort of like the pre cancer life and the post cancer life.

And my pre cancer life was, was pretty riddled with a lot oftrauma on many levels from physical, emotional and sexual abuse to extreme poverty to a lot of just circumstances that were not conducive to thriving in that poverty environment. A lot of going back and forth with parents were divorced and being kind of moved around in different family homes that would create their own dynamic of sorts.

And so it was just a really weird time. And I will tell you back in the early 1980s,  divorce rates weren't where they are today. So it was like a dirty secret. I remember in third grade when my parents were fighting, I remember the terror of like, what if they ever got  divorced?And when they did finally separate and eventually divorced when I was 11, I was so ashamed of that, like it was just such a, nobody knew anybody with divorced parents. Like today it's weird if you have parents that are together, like it's switched. Like the flip is switched there, but  it's interesting just to think about those dynamics.

So when I think about the, why I ended up with that diagnosis, there were a lot of contributing factors, and yet now, 32 years fast forward, I wouldn't change any of them. Those experiences because they forged me into who I am today. Those experiences. changed me, made me resilient, made me a survivor, made me keenly observant, insanely intuitive, which are my superpowers when it comes to helping other people on their journey.

Sometimes it's not great for me. It's why it's good to get outside help for your own care.But it's really something that I am [00:08:00] incredibly blessed to have experienced. Now, your listeners who might be still going through these types of things, and we all do at different times in our lives, it's not like we suddenly get on the rainbow unicorn and fly off into the sunset forever.

 Life happens, but,  even in the difficult situations that I met with in my life, I know that there are, my grandma used to say there's a lesson or a blessing in the lesson, right?

Jacqueline: I love that.

Dr. Nasha Isn't that so cute? And I just love it. It's a very Kansas thing too, because that's where I grew up. And so I just loved that, that it reframes the way you meet adversity.

And I think that's something that really early on in my diagnosis. I really understood that and I believe it is part of why I'm still here today is I did not want to associate myself as a victim to my circumstances. I became empowered and I took advantage of the information. That cancer brought into my life to give me new tools and new ways of being and living on this planet.

Jacqueline: I love that. [00:09:00] That was beautiful. And quite honestly, Dr. Nasha that's one of the reasons why I admire you so much among t everyone else in the field is your story and  your message. And even in my own experience, too,  there's been times where I look back at points in my life and in that moment, you question, you question everything.

Right? I would question God. Why is this happening? I don't understand. And I think the beauty is that he is working through our mess and he has a bigger plan and a purpose  Dr. Nasha, we could talk for hours. I already have a sense of where this conversation is going, but I, one thing that I've really started to implement in my daily life is keeping track of where God came through for me. So whenever I'm in any type of Difficulty or hard circumstance. I look back in the past and I say, okay, well this happened But look at what came out of this  and to see how He works So  I truly love that and again, I mean had you not experienced all that you would not be where you are right now touching millions of lives.'s 

Dr. Nasha Winters: really [00:10:00] love that.

I love that you share it that way because it is, it's, you know, we, we have all of the information in, on, and around us and, and, and we have all of the tools at our, at our fingertips. We are held, we are loved, we are supported. We just often forget that. And so to move into a practice that allows you to reconnect with that in whatever way you connect with your faith or your higher power, your spirit, your god, because a lot of people,  meet that in a different way, but it's a very important way to help you have a unique, I guess, outlook, a unique experience  and make meaning.

I think a lot of people explain that to be a human is to also make meaning of your existence. And I feel like those are the moments that give us meaning.in our lives. 

Jacqueline: Absolutely. I love that. So, Dr. Nasha you coined this term, the terrain based approach, which I have heard in almost every single cancer conversation I've had since this podcast’s inception.

And [00:11:00] many of the people I've spoken with, Dr. Lucas, Jen Nolan, they have all been trained in your approach, which essentially entails therapeutic nutritional changes, lifestyle interventions to essentially change what you call the terrain of the body, right? And decrease factors that lead to cancer growth.

So with that, could you first explain to listeners what you mean by the body's terrain? And then perhaps maybe give us the SparkNotes version of what some of those interventions are.  I think we can group them into like epigenetic, metabolic, and environment. Although I'm not quite sure if you have an internal hierarchy of how you like to rank them because they're all so ….

Dr. Nasha Winters: wonderful.

Yeah, yeah. Perfect. Well, first I want to start by saying that so many of the people you have interviewed here are dear friends, colleagues, mentors, you know, inspiration to me. And yes, they might have come through the methodology training, they in themselves embody. This concept just naturally of who they are and what [00:12:00] they're drawn to.

So we've like helped each other move into the space of terrain centric and they continue to perpetuate that message out there in a really beautiful way. So I just want to really give credit where credit's due there. That being said is watching what I've watched over three decades and learning what I've learned in reviewing, old literature, old readings in medicine. You know, we made a different choice in the late 1800s when we decided to focus on the germ theory, meaning something from outside of us comes in and is what causes the problems and therefore something outside of us is what is going to be the cure, the antidote, like the anti hypertensive, the anti diabetic, the anti inflammatory notice that terminology is very specific, right?

So it has this sort of war,  going to battle with mentality. Whereas the terrain theory that also arose around the same time, but we [00:13:00] just chose to go down germ theory.  The germ theory path was this idea that  our disease state starts from within, that imbalances within are what create vulnerability to the expression of disease and that it's accumulations of these as Hippocrates called it sends to our body.

So  getting out of right eating, getting out of right, sleeping, getting out of right….. Self care allows things to be vulnerable and then for other things to take root. So a very different mindset. And then instead of attacking it or doing the antidote to it, we instead Understand it, heed its message and work on nourishing and nurturing it back into homeostasis, back into balance.

And so a really simple concept is just for your folks thinking about the weed in their garden, right? So they might look at a pesky weed, like a lot of people will look at a dandelion, by the way, as a pesky weed. And yet this little guy is one of [00:14:00] the most powerful medicines, not just for the soil of our gardens and our yards and our farms and our ranches, but also for us.

It beautifully evolved with us in that if you see dandelions showing up somewhere, that is a clue that there's something wrong with that soil. And the irony is where those dandelions show up, they're showing you, they're highlighting where there's a problem, but simultaneously they're correcting that problem.

They have super deep root systems that pull nutrients up deep from the soil and bring it up to the surface. And then spread its nourishment and wisdom to the surrounding plants in the surrounding soil. That, to me, is what a tumor is doing inside of our body. It's saying,  there's some problems in here.

Let's look at how we can understand it, what clues it's giving us, and correct what allowed that weedto arise and express. And so therein lies a big [00:15:00] difference of how we think about it and how we approach it. And that we're not about just eradicating that weed, right? Or that tumor or that dandelion.

We're about understanding why it's here to begin with and how to make it so that the surrounding environment can keep it at bay and keep it in synergy and still glean what wisdom it's bringing to our body while letting the rest of the body come in and swoop in and do its job because eventually when you've corrected that soil, when you've given it all the right tools and removed all the obstacles to cure, then that weed resolves.

Or it goes dormant, or it gets smaller and more, you know,  you can barely perceive it any longer. 

Jacqueline: Yeah, I love that analogy. That's a beautiful illustration to visualize. And I'm actually going to steal it because I tend to use the one of mold growing in a basement when I try to explain the different approach between integrative medicine and a conventional approach, right?

With like [00:16:00] bleach versus a humidifier and identifying the environment and the terrain. Similar concept, but I like yours better. 

Dr. Nasha Winters: Well, you know, it's like your dish. You can imagine like digging it out with a spot, a spade. There's the surgery. You imagine spraying it with food, with poison. There's that you imagine burning it like a radiation.

Like that's what we do to fields of weeds. We do the same thing to our bodies in a cancerstate. And yet we make that soil even more vulnerable. And so whatever analogy you are drawn to using by all means do, because I think it helps illustrate. A good 50, 70 years in modern times taught us to believe that cancer can only be dealt with in one particular way.

And so you're allowing a conversation that helps people go, wait a minute, I've not quite thought of it this way. Maybe there's something else that can be done. 

Jacqueline: Yeah, absolutely. I love that. I've always been curious of your take on this. If you had to. Maybe prioritize three of the 10.

A

Dr. Nasha Winters: Well, and it's tough because what we do in the terrain 10, so just ripping, going down the list super quick, the epigenetics, so the genetic [00:17:00] predispositions, but we have the ability to overcome them, right? So just because great grandma, grandma, mom, and you have it,  doesn't mean you have to continue to have it and pass it on to your Children.

It's the buck can stop with you. So epigenetic means above the gene. Then we have the metabolic drop in the bucket, which is about what are you fueling your body with? Right? The third one is environmental toxicity. It's no matter if, if you're toxic, it's how bad is it? How does it interplay with your

Tterrain with your environment. And then we look at the microbiome that just a couple years ago, everyone pretended didn't exist. But now that we can monetize it, it's the rage of our discussions and our research. It's also very intimately connected to the other drop in the bucket, the immune system, which if you've lived on this.

planet. the last few years, the immune system is a high topic of conversation. Just given the virus that we're being exposed to, which I believe is also an expression of an imbalanced terrain in the world in  and around us. And then inflammation, poor circulation, hypoxia. The other one is hormone [00:18:00] modulations of hormonal issues, imbalances, stress and circadian rhythm, physiology, and then finally mental and emotional.

And so what we do is we assess our clients and our patients to understand what their priorities are by going through kind of a testing process, a questionnaire process. And then we highlight on the three top offenders in their particular pattern. So it will be individualized, but if I had to think about it 

the most common that I probably see in practice over and over that we want to probably take,  more charge of right up front. Especially when you're trying to prevent is to get a handle on your stress response, okay, and your emotional health. I kind of put those two together. They really go hand in hand.

So emotional resilience, stress resilience. Those are big. The other one that we have a lot of control over is what we put at the end of our fork. And so being mindful of eating real food, nutritiously dense food, Seasonal, local, as clean as possible food, as close to the source as possible food, [00:19:00] preferably not in a box or a bag or a can, you know, and things that you see that you know exactly where they came from.

They came out of a piece of the ocean. They came out of the sky. They came out of the ground. They came off a tree. Those types of things, that's our food. And then keeping it more normal glycemic. So we tend to eat way more carbohydrates today than ever before. And so being more carbohydrate, restricting is key.

And people think they don't eat sugar until you really do a diet dietary with them. And, and maybe you do blood testing and they're like. Oh, that's a surprise. So maybe get curious and really look at, evaluate honestly what your personal glucose levels, insulin levels, carbohydrate intake is, nd then the third big, big, big one is the environmental toxicity.

We have so much more control to deal with what we put in on and around us. And most people don't know I can walk into somebody's home and know immediately if I'm walking into a toxic waste dump.So It's like maybe  they dried their clothes sprayed on their couch to smell.

Thescented candle and beyond or whatever is more toxic. They're a known carcinogen and more toxic than cigarette smoke. The, Teflon that they're cooking our meal in that night, that is a persistent chemical that's virtually impossible to get out of your body and known carcinogen. The water that they're taking out of their fridge thinking that that fridge filter is enough.

The body care products are slathering on themselves before they greet you as their host at the dinner with them

Jacqueline: The VOC's in the air from their paint that they just painted their new room with. 

Dr. Nasha Winters: They're excited to share their new couch with you that is covered in flame retardant that is unbelievable while their little kiddos are rolling around on it, concentrating into those little tiny bodies even more.

And so when folks are always surprised when they're like, I was surprised I got cancer. I was healthy until I got cancer. When we go through that terrain 10 questionnaire, we [00:21:00] evaluate what's going in on and around their body. Suddenly it becomes very clear that there are a lot of things sneaking in. In their lives, in their diets, in their emotional state that they're unaware of and shining light on that is a very powerful tool because an empowered patient, an educated patient is a resilient patient and a lot harder to kill  patient.

Jacqueline: I couldn't agree more. And again, Dr. Winters, I mean, the mission of Well and Strong is to encourage readers to be advocates of their own health.  And I always say this. It's important to seek wisdom and counsel from our doctors so thatatthe end of the day,  You're in charge of your life, right? You need to educate yourself as much as you can.

 I love that tourney in 10. We should have an episode quite honestly dedicated to just each of those because there is so much to unpack. But for time's sake, I'd love to focus on perhaps the first two you mentioned. So, when you had mentioned the emotional aspect, right away my mind jumped to this quote.

And I had to pull it up as you were chatting that you wrote in your [00:22:00] book. And  basically uou said that stress is the most powerful carcinogen imaginable. It increases inflammation, spikes blood sugar, and disables the immune system. Metastasis is promoted when the body or mind is stressed and so is angiogenesis.

And this I actually included in my integrative guide to breast cancer as well because I just, it really resonated with me and I think it's so interesting too, right? The more people I speak with on the topic of emotional health, the more we realize how critical stress is in not only cancer development, but cancer progression.

And I was chatting with Dr. Veronique Desaulniers months back. 

Dr. Nasha: She's wonderful. Love Dr. B. She's so great. 

Jacqueline;: And we were just chatting and she said that interestingly, and I mean, I've witnessed this too. And my mom's case that typically, if you look at a cancer diagnosis, , and you look back at maybe two or three years before that, either initial diagnosis or recurrence, there will be some type of stressful event.

That [00:23:00] occurs in that patient's life, and you know, not to say like life is stressful, right? As long as we're in this world, we will all experience stress. But I think it's really important to your point to learn how to manage that stress effectively and find ways to release it so that it doesn't harbor and stagnate in your 

Dr. Nasha Winters: body.

Yes. Perfect. I love that you brought that up. In fact, later this afternoon, I have a consultation with a colleague over a patient of hers who's got a tricky stage four breast cancer diagnosis that originally was stage one in 2018 and quicklyexploded into stage four, this year and for her, she even, she even called it out for herself that it was an unsurmountable amount of stress and loss and tension and discourse that was.

Almost intolerable. And yet now she understands that until she [00:24:00] really works through that, which she is beautifully working through this and changing all the relationships in her life, all of her ways that she communicates her needs, all of the way she needs. gave away her power in different environments and swallowed down what needed to be said or done.

And she's already gone back into complete remission to back to back scans with no evidence of disease. And she did some standard of care in the process, but even the doctor said, we didn't expect to get you into NED. Yeah, right. Because once you kind of move into that zone, they're like, ah, we'll just keep you comfortable for as long as possible when it inevitably and takes, takes over.

She's turned this ship around in the harbor because she saw the writing on the wall right away and she was willing to go in there. And I will tell you, this is the hardest part of the patient journey. That's why even in our 10 drops of the bucket, you'll notice that stress and emotions are the last two week kind of talk about.

No one wants to deal with them. Right, right. And if I [00:25:00] started there in the book, people would be like, and we're done here. And they'd leave in chapter one or two. But by the time they get bought into some of the more tangibles that they can control that are easier, then they are like, okay, now the real, now the real job begins.

Now I can really go in. 

Jacqueline: that so funny though, Dr. Nasha, that people will consider doing a coffee enema over going to forgive someone who like offended them 10 years ago? 

Dr. Nasha Winters: Exactly. That's great. That gives me chills. And it's also kind of funny because when somebody recognizes that about themselves, when they are finally willing to look at it, they will laugh at their own, at their own years of trying to like dart and avoid it and all the things they would do instead of dealing with it, or all the things they would sacrifice or compromise instead of dealing with it.

And they're like, if I just ripped off the bandaid right away, would we be in the same situation we're in? And we can't answer that, but we have a sense that it might've been. played a little different role. Yeah, 

Jacqueline: no, I love that that's included in your 10. And even Chris work talks a lot about the power of forgiveness, right?

He's [00:26:00] like, you could be doing all the right things, eating all the right food, but if you have not forgiven those who hurt you, you can't heal. And I know Kelly Turner talks about that in radical remission, right? Yeah, incredible. I mean, for listeners, she basically was a PhD student who traveled the world observing cases of radical remission.

And she wrote this book on the 10 common themes, I guess, that she saw among patients who experienced remission, one of which was forgiveness. So, so much truth to that. 

Dr. Nasha Winters: Yeah, you know,, there's a point of, you don't forgive somebody for them. You forgive somebody for yourself. Exactly. And you don't have to ever see or be around that person ever again.

They might not even be on this planet anymore. And that doesn't mean you have to interact with them if they are or suddenly hang out with them again or trust them again. But the forgiveness is it's a two way street. I forgive myself for choosing to stay. Involved as long as I did or for, for, for letting [00:27:00] things go the direction they went, because we all have our role in these relationships as well.

If we're really, really young, maybe not as much,, but also then I forgive myself that I was too little to know how to do this. So how as an adult self, can I go back to a time of remembering how might I have cared for my little person self in those moments and been the,  person they needed.

Okay. During that time, we can go back and rescue ourselves from any trauma, no matter how old it is,  in our own ways that bring the healing and forgiveness within us that allows us to move forward without worrying about how it's going to impact the person that might have, you know, been the deliverer of that betrayal of that.

Jacqueline: Absolutely.  Toxicty of that trauma. I love that. And last point on this, again, whole other conversation, but I think one of the most powerful things too, that someone could do, and I've done this. On a personal note is to say thank you even just internally to your offender [00:28:00] or someone who hurt you because it enables you to again challenge yourself to forgive and really reach another level of humanness, right?

That we otherwise never thought we would be capable of. And have more empathy towards others, be able to relate to others better. So it's truly about perspective. 

Dr. Nasha Winters: It really is. You know, I'd love if you don't mind one little thing, you just made me think about a story I heard probably 20 years ago, and it was a  psychiatrist who worked in a prison environment and he was given like the worst of the worst of the worst cases, like people on death row, people who'd all committed very violent crimes, you know, pedophilia, like all of like the ones that we just sort of like want to lock them up.

No room for forgiveness, right? And he was like, there was all this massive violence, even within  the prison system. So violence to the the guards, violence among the, the inmates, this whole piece. And he decided to try something different. [00:29:00] And I'm really distilling this down, but basically he'd.

put open up a chart and he'd see the atrocities that these individuals had  done in their lives. And he would just place his hands on it, basically close his eyes, pray, meditate, however he was doing this and basically say, I'm sorry. I thank you. I forgive you. I love you. 

Jacqueline: I heard this before. This isn't a book.

Where is this from? 

Dr. Nasha Winters: No. I can't remember. It is. And he did this over and over. I got chills with the whole stack of like the worst of the worst offenders. Things changed. Nothing changed. No, there was no new medication or interaction with these guys. It was on a full on energetic field and they changed the level of violence and recidivism rate like people to actually start to.

They amend and heal themselves in a very different environment. So if you can do it in a place like that, imagine the power of doing that in all things of your life. 

Jacqueline: That's so powerful. So, [00:30:00] so powerful. 

Dr. Nasha Winters: We'll have to find this, we'll have to find this and share it with your reader, because it, your listeners.

Jacqueline: We will.  I'll include it in the links in the show notes. No, because when you were saying that, I was like, I remember reading this somewhere. Yeah. So powerful. Oh my goodness. Love. Love all of this. Well, Dr. Winter, so that was part one of the first two that I wanted to cover. Um, jumping to that metabolic piece, though, I know that you write a lot about the ketogenic diet in your book, but I will say I love that you aren't as dogmatic as some of the other people out there and that you really advocate for a metabolically flexible diet rather than consistently using the term ketogenic.

So, we of course know that a keto diet is certainly one way to achieve metabolic flexibility, as can fasting,  as fasting can be. And there's certainly been studies that have shown that either being in a fasted state or being in that state of therapeutic ketosis can increase the effectiveness of certain treatments and also mitigate damage to healthy cells.

So with all of that, Dr. Nasha, I do want [00:31:00] to address a few questions that I have based on some of the literature that I've read in addition to conversations I've had when it comes to keto. Does that sound good? 

Dr. Nasha Winters: Absolutely. And first I just wanna reiterate, you nailed it when you said, oh, when our book came out to be published,  that was at a time when the SEO was what drove, how they titled the book.

And if people actually read my book, they'll realize, yes, we talk a lot about therapeutic ketosis, but it's, we talk about a heck of a lot more than that. It's a small fragment of it, so Exactly. Put that on there too, at the time, in 2017 to sell a book, right. Because I then got pegged as the ketogenic diet girl, but I'm the metabolic flexibility queen.

And so I really appreciate that you brought that up. So absolutely reiterate that for your listeners, but please dive into your specific questions.  

Jacqueline: . Thank you for clarifying that. And again, I know that's something that I think has arisen people and it's like, no, she's metabolically flexible, metabolically flexible diet.

Well, my first question stems from a 2012 study, which I'm sure you've seen. That basically showed that tumors can actually use ketones for fuel. And [00:32:00] I mean, given that cancer cells are metabolically flexible and they're smart, if you starve them of glucose, I'm sure it could weaken or slow them down temporarily, but won't they eventually adapt by upregulating other pathways?

And I think you had even mentioned at some point, cancer cells are opportunistic in that they'll use whatever is most readily available to them. So given all of that. Is it possible to maintain a ketogenic diet or, you know, try to be in that therapeutic state long term, recognizing that cancer cells are opportunistic and adaptable?

Is that something, you know, perhaps we're like pulsing diets might be able to address like two months, two months keto, one month off or something to that effect? 

Dr. Nasha Winters: So what a great question. And it probably, I probably get a question or some study. In fact, one just came out this week that alludes to that.

But here's what I want you and your listeners to know is when you actually go in and you dig deep into these studies, they're not ketone bodies that are causing [00:33:00] the problem, right? So there actually is zero evidence that ketone bodies themselves can ever be a fuel for cancer cells. However, the means in which we try to achieve ketosis.

can be problematic. So what those studies were actually looking at were, were using fatty acids. And using fatty acids, you know, FAS and FAO, so fatty acid oxidation and fatty acid synthesis as a secondary metabolite of cancer cells. So let me back up a little bit further. When we look at all cancer types across the board, over 90 percent of them directly use glucose as a fuel source.

The other 10 percent are like, eh, give them or take it, you know, kick it or leave it, but they're really pretty rare, um, to not use glucose at some point. Out of all cancer types, 70 percent of all cancer types use a pathway called the PIK3CA [00:34:00] pathway, which is a metabolic pathway. insulin loving glucose hog pathway.

So again, reinforcing a little bit of how a carbohydrate restriction diet is really important across the board for every single patient with cancer, in my opinion, no matter what,  I'm. Pretty darn positive that there is not a person outside of, I want to, I'm going to have a little talk with Dr.

Joe Mercola, who put a post out that today saying glucose doesn't cause, can't, I'm like, wait a second, we have enough labs, enough information, enough 30 years of clinical experience to tell you it absolutely, it doesn't, cause cancer, but it will drive it for sure. So I'm like, he needs to reframe his language and I'll be harsh on that.

So Joe, we're coming, we're having a talk, but anyway, so that's just something important to know that no matter who you are, what type of cancer type, what stage you're in, please stay with carbohydrate restriction, period. The studies that, that are misrepresenting saying that ketones themselves cause cancer, that [00:35:00] actually is not what the literature is showing.

In fact, it's impossible. And all the big ketone researchers in the world, that aren't even outside of the cancer realm. They don't have any, they don't have anything to gain or lose by this information. We'll tell you it's literally not possible for cancer cells to use ketone bodies. What they can use are the types of fats that people might be using or that the cell line or the animal studies might be feeding that are problematic.

So what I want you to do like this, this study  that just came out this week It showed up saying, Oh, it shows here that ketogenic diet absolutely proliferates ovarian cancer cells. Now, I'm 32 years out from ovarian cancer. So, and I've helped tens of thousands of women with this disease to say that's not accurate.

And when you look at the diet, this is when I went back on this giant form with thousands of people saying, See, Chris was right or whatever. Like everyone jumps in. I'm like, when you break it down, I said, let me guess, I haven't even looked at the study yet, but let me guess what the fat, what the fat is.

The fat was soybean [00:36:00] oil, Crisco, corn oil, massive amounts to the level that you would have to. So the amount they were feeding the animals in this study, there's not a human possibility to take in that much of that fat in a human being. We could not eat that much. That is massively high in omega six. And what that what they showed in this rat in this particular mouse study was that this mouse study also had a part. 

Um, oh gosh, it's just a particular sniff, which is just leaving my brain right now, excuse me for that. But it's a particular sniff that a lot of people will say, Oh, you can't do ketosis with that. Well, that these animals have this problem because they don't utilize fats well, and they should be very particular about what fats they do use.

So they literally use the most fat toxic,  fats to feed an already genetically predisposed creature. to these wrongful fats that no one on the planet should ever be eating. And yet, unfortunately, it's the, if [00:37:00] you eat processed food, these are the types of fats you are eating. And so that's when you start to realize that we're really not number one, feeding them a good quality therapeutic ketogenic diet in any of these studies.

That's number one. Number two. A lot of them will say they're ketogenic diets like the two, 2012 one you're talking about. But when you look at it, it's, it's high fat, but also high carb. Mm-Hmm. , high fat and high carb is always a bad idea for everybody. Yep. Agree. Non combination. Right? And so and so, that's the place here that if you just go into fasted state or carbohydrate restriction or restricted like a, a vegan restricted carbohydrate diet, a vegetarian restricted carbohydrate diet, all of those make ketone bodies.

It's not a problem ever because it's not the ketone bodies that are the problem. And so it's really kind of sort of bastardizing the literature, the data using sensational headlines. But when people break it down, you just go, wow. And so when I revealed that, when they finally, someone who was on the [00:38:00] forum brought up the actual food.

I don't even call it that, that we're feeding this most recent study, everyone who was basically trying to throw me under the bus and the entire low carb industry under the bus, they went dead silent. They stopped yelling because they realized, and then we'll probably never say it, but it's like that moment you realize this is where we have to be critical thinkers.

We have to do a little bit deeper dive. Ketone bodies are massive signaling agents that enhance. All cancer responses in the right direction that enhanced all of our therapeutic input from standard of care to alternative care. It weakens the cancer cell, even if it doesn't need to be, because ketones do much more than just lower insulin.

They hit every one of the targets of the hallmarks of cancer. They absolutely redirect that PIK3CA pathway. They change your epigenetic expression. They're such, they're strongly anti inflammatory, strongly anti angiogenic. There's not [00:39:00] a drug on the planet that does as much as a ketone body does. So for instance, if somebody does have high homocysteine that is not responsive, to a, what we call a homocysteine challenge.

So taking a handful of B12, B2 folate, taking that in high doses for a few days, retesting their homocysteine. And if their homocysteine drops 50%, then we know that this is just a methylation problem and carry on. But if that homocysteine doesn't budge, then we would consider a methionine restricted diet, which includes, you still have to, this is what's happening in the, in the popular influencer world.

These patients then jump on what they perceive as a low methionine diet, which they perceive as a vegan diet. Right? 

Jacqueline: Some of the most methionine rich foods are within vegan diets. 

Dr. Nasha Winters: Most beans, most legumes, most seeds, and then they make the bigger mistake of jumping on to basically an all fruit diet. We could just go down a rabbit hole of what fructose does to cancer cells, right?

[00:40:00] In that kind of quantity. So when you do a low methionine, it's a pulsing diet. with carbohydrate restriction. It's a very restrictive diet for a period of time, and it can only be managed for a period of time. And so to your point, we as clinicians are trained to look at the pathways from tissue and blood biopsies, look at the patient's medical and personal history, look at the patient's labs, look at the patient's epigenetics or single nucleotide polymorphisms, look at their likes and dislikes and their day to day lifestyle, and then adjust their diet and their lifestyle accordingly.

But across the board, they will always stay low carb. Yeah. Across the board. And sometimes in certain cancers, we need to push a bit harder into a deeper state of therapeutic ketosis, which we can do that with fasting or further carbohydrate restriction or even exogenous ketones or even some pharmaceuticals.

But we can also do it with high fat, low carb, but you want to bet your bottom dollar you're going to use the right fats. for those patients. And you also will base those fats on what the [00:41:00] patient's epigenetics can tolerate. So I want folks to hear that it's not a catchall. Um, and that unless like for patients with GBM, for instance, they're probably going to need to stay on a therapeutic ketogenic diet for the rest of their lives.

But if you're, uh, you know, if you've got a stage one or two cancer, you're just using it to maybe potentiate your, your standard of care therapy. or your high dose IBC or your hyperbaric oxygen or your hyperthermia. If you're a stage three or four, um, you know, more aggressive cancer like lung, pancreatic or ovarian, you're going to be strongly carbohydrate restricted the rest of your long life.

The other cancer types, depending on the situation, the person. Um, and the stage may be able to pulse as you alluded to, and that's the place I still don't ever want them going back to as much carbohydrate as they were eating pre diagnosis. That's probably not a good idea for anybody, but ultimately, this is the way we get into this beautiful end of one.

So I love that. You gave me a little bit of aSoapbox to stand up and just give this wide range to know [00:42:00] that you can't just say yes or no, good or bad, black or white. It's incredibly nuanced and please work with a metabolic oncology expert. There is no metabolic oncology training out there. We're the only ones who offer it.

There's a lot of practitioners who piecemeal together and try and learn on their own, but it's so complicated and there's so many layers and there's so many research coming out. You want to make sure you're working with someone who's gone through the extensive training and is maintaining that training because the literature literally changes every week.

And so we are staying current with the tide of information that's coming our way.

Jacqueline: I love that. I couldn't agree more with all of that, Dr. Winters, and I mean, being adaptable, again, with the new research that's coming out is key. It's truly, truly key, because people who are so, again, dogmatic and staunch that their approach is this way or the highway and aren't open to, you know, evolving new evidence.

Dr. Nasha Winters: And there's a time and a like glutamine restriction, [00:43:00] methionine restriction, cysteine restriction, arginine restriction, but we can do those in these pulses. We can do these with certain medications, herbs, nutrients, supplements, off label drugs, even pharmaceuticals. This is what's so cool that still across the board, you want it carbohydrate restricted, and then you can be incredibly exact and precise and individualized the rest of the 

time.

Jacqueline: Yeah, that lends to my next question. So on a personal note, my mom has been trying to get into the state of therapeutic ketosis for the past four or five months. Right. And I think my area of concern with the ketogenic diet in her case, and I've witnessed this firsthand, is that in order for her to get into that therapeutic state, meaning her GKIs, to her below.

She really needed to dramatically reduce her intake of plant foods. And these vegetables, Dr. Nasha, weren't starchy by any means, but they still, but they still would knock her out of that state. And [00:44:00] given that she has an ER positive breast cancer, I mean, you even talk about this in your book, but I know that cruciferous vegetables and fiber, right?

They're so critical in helping the body detox from excess estrogen. So. That's not necessarily something I want her to have to reduce her intake of. So I really feel like we've been at a crossroads while, you know, I do want her to reap the benefits of being in that therapeutic state, but I don't want to compromise her intake of plants.

So we've kind of taken a step back and she's been incorporating fasting as you alluded to, as a means to improve her metabolic flexibility, especially on certain treatments like high dose IVC, but we're not necessarily. Myopically focused anymore on having that GKI of two or below and I 

Dr. Nasha Winters: think it that was so a couple things first of all there I you know But somebody trained and that would be looking at what the why you know, why is it tougher her to get into metabolic flexibility?

Well, it could be that some of the drugs she's taking for her process are Thwarting it so you have [00:45:00] to work with  what you got, right? So be gentle because she doesn't as far as I know because I don't know all of her history like some of those cancers I talked about She may not need to be in a therapeutic level of ketones.

Like she probably will do great with being in what we call a nutritional state of ketosis, somewhere between 0. 8 and two on her blood ketones, millimoles of her blood ketones and be still getting an optimal response. She may not be getting that GKI down to two or below, but as long as she's got the GKI under five, I'm a happy camper.

Okay. And so just to give you just your listeners, the average American's GKI, have you talked about this with everybody? Do you have a guess? Um, 

Jacqueline: over eight, 

Dr. Nasha Winters: 25 to 30. Yes. Indeedy. 

Jacqueline: That is crazy.

Dr. Nasha Winters: I know. Right. And that's where you're like, Whoa, when you realize how bad. So one of our colleagues out there, he talks about the three fives.

Get your 5, your insulin under [00:46:00] 5, and your, um, GKI under 5. And you are like bulletproof for everything metabolic. Cancer prevention, cancer treatment, Alzheimer's prevention, schizophrenia treatment, I mean all the things that are metabolic in nature, if we all pushed our clients in the world to get below 5 on all those three things I listed, we, I would be out of a job.

I would hopefully be out of a job. So for your mom, because she may have some things that are just pushing against it pharmaceutically, she might also have some snips, like perhaps she's got issues with her carnitine shuffle, scooching her fats. We need maybe help bust her fats across the cell membrane of her mitochondria to be more efficient.

In her Krebs cycle to make more ATP to see those little cart. Um, uh, ketones bump up. She may need to carbohydrate restrict strict a little bit further, but not necessarily bring up her fat, especially if it's not something she loves. And maybe she needs, if we've got some patients that just have, like, if they do have the PPAR [00:47:00] alpha, that's what it was.

I knew it would come if I didn't think about it. If she does have that or an ACAP mutation or an ACSL one mutation, then she might do better using exogenous ketones. To give her that little lift so she can eat more of those important, life giving, cruciferous giving veggies. Interesting. So she could augment with some exogenous to keep her humming.

But a little bit better. So those are just some examples in there might even be like, maybe that's why we look at her sleep pattern or her stress response, because I call it the three S's, sugar, stress, stress and sex. So insulin, cortisol, and hormonal imbalance, and just one to two nights of bad sleep will spike your insulin.

Yeah. So oftentimes that's a big one. So I'm wearing a. CGM, you might have her play with that and just start to experiment. So for me, when I go to sleep at night, I wake my husband up and he has a heart attack because my thing beeps in the middle of the night and I sleep through it because my blood sugar drops into the thirties at night.

Wow. Right. And I just started [00:48:00] using this just for fine. I'm like, Oh, that's interesting. And then, um, when I'm on a massage table, when I'm in a deeply relaxed state, my glucose drops below well under the fifties easily into the thirties and forties. And that's when I realized when I'm up, when I'm revving, like right now, let's just, I'll tell you like right now, cause I'm on, I'm excited.

I'm talking to you. My blood sugar is 99 right now and I haven't eaten. Yeah. 

Jacqueline: Dr. Nasha, that I was just going to ask you that my, again, I mean, I keep referring to my mom because she's been my primary source of learning. She is my muse. She, she consistently has elevated blood sugar levels.

And again, her diet is not one that's rich in sugar or carbohydrates. And i'm like mom even just stress and she's like i'm not stressed I'm, like it could be good stress that could raise your cortisol and boost your blood 

Dr. Nasha Winters: sugar Like i'm like revving with you. I'm like all excited. I'm on my passion purpose Woo at 99 and i'm in a fasted state at 11 49 a.

m. on a Friday morning, right? I'll break my fast [00:49:00] after this. And so that's a really good example. And I've been eating a therapeutic ketogenic diet or therapeutic ketosis or carbohydrate restriction for 30 years, you know, in some form or fashion, more ketosis in the last, you know, 10 or 12 years. But, but really for years, all of this and my vein of my blood sugar has nothing to do with what's at the end of my fork.

So interesting. 

Jacqueline: So maybe that's helpful. Yeah, yeah, no, it definitely is. Well, the consensus seems to be that diets are really bio individualized and that reaching that state of metabolic flexibility will really vary by patient. However, are there certain foods that you feel very strongly about that patients should include in their diets?

I know you have a whole section dedicated to this in your book. Again, it's highlighted in my version and my copy right here, but I'd love to touch on maybe a few of your favorites. 

Dr. Nasha Winters: Sure. Well, I know because 50 percent of the population has a non functioning TP53 gene, which is a tumor suppressor gene. So that means half [00:50:00] of us, which is also statistically significant because we're now expected to have half of us experience cancer in our lifetime.

That's a global statistic, not a naturopath statistic, right? So that's interesting. And once you have gone through standard of care, your TP53 is even more damaged. That's just the nature of the beast. So one of my favorite, favorite, favorite ways to support TP53 expression is broccoli sprouts and watercress.

And those are things you can, plus it's such a fun, especially if you have littles at home, like you can all make sprouts together, make them into chia pets, like make fun, like do it kind of fun. Start to put them in on and everything, sprinkle them on salads, bring him in soups. Just take out, go by and grab a handful and chomp on them.

Really, really powerful. It will help support your TP 53 in a very. very powerful way. That's one of my favorites. The one thing that in the next edition of the book, if Jess and I can ever find the time.

Jacqueline: There's another edition coming?. Oh my goodness. This is so exciting [00:51:00] 

Dr. Nasha Winters:  We hope so. We want to someday, but we both say it.

We're like, okay, we'll have to take up drinking. It's a lot of work. Oh my goodness. We probably have like an extra thousand pages of content to 2017. I'm sure. that's very relevant. There's only two things I regret that are in there today. One of them is about, hey, ketogenic diet is probably not a good idea for prostate cancer.

I would definitely qualify that. It's about the types of fats because ketone bodies are excellent for prostate cancer. It's just the means of which you achieve it is the, where we'd qualify that further. The second thing is our celebration of selenium via Brazil nuts. We need to pull that out of there because we've actually learned a lot that the form of selenium in Brazil nuts, the form of selenium and most supplements are actually highly toxic to the body and in some cancer types in particular prostate and some of the estrogen based cancers actually can be used as fuel

for the cancer cell because most of them are [00:52:00] selenomethionine based. So what we have learned is a form of selenium that we would place replace that within the book is called sodium selenite. S E L E N I T E. I would love for your listeners to go down a rabbit hole of research on that. That by itself Induces apoptosis and basically all cell line studies, animal studies.

It also is really powerful to, it is, you know, selenium when in the proper forms protect the DNA. So another way here, I would look at maybe taking a sodium selenite supplement. And then the other one you talked about food, but I really think for me, I think of sunshine as food. Um, because ultimately we'd prefer everyone to get their vitamin D from the sun.

That's the most powerful, but if it's cold where you live or dark where you live and you can't get your skin exposed or you're a little still scared of the sun for whatever reason and you can't get two thirds or more of your body exposed to the sun every day for your 10, 000 units you need every day to hum along, you'll need some [00:53:00] supplementation.

But ultimately, I really encourage everybody to get out there to do some good old vitamin D, from, from the sun, which is really powerful. And then that also kind of segues into high quality fats. Do not be afraid of the animal fats unless you've got some really strong snips, some really strong epigenetics that show that maybe you should limit your animal fats, which there are some people who need to.

But for the most part, that's where we got our vitamin D was from the backstrap of animals that grazed out under the sunshine. Right? That, that, or from our, our chickens that ate, they're, chickens are little carnivores, you guys. They're little like baby pterodactyls. They are not vegans and they should not be eating vegan feed.

They need to be eating bugs and dead things and sometimes each other and their egg, like all the things, it's kind of disgusting, but. You get massive amounts of really good quality vitamin D from a high quality egg. Um, you get mass amounts of really good quality vitamin D for some organic, raw, pastured butter.

Um, and, and A2 dairy, especially goat or sheep, if you can [00:54:00] tolerate that in small amounts, if you have genetics that allow for that, or really high quality lard or tallow. or backstrap of something that you've hunted, you know, for listening. So suddenly all my vegans, vegetarians are freaking out a little bit.

Myself included. I was a vegan for seven years, a vegetarian for 25 years, took a long time to get my mind around this, but my genetics and my labs and my ability to heal my body and get the resources my body needed to heal were, it was really thwarted, um, because I let my dogma. Get in the way of my data.

And so I, I have to be flexible in my thinking as well as in my cellular function as well. 

Jacqueline: Yeah. Again, Dr. Winters, this could be a whole other episode, but there is so much contention in the diet space right now. It's like, it's, it's really sad that like everyone has to be so extreme. Like I'm an omnivore.

I'm a fan of omnivory. I think it's the healthiest eating pattern. But. Um, and again, like there's benefits to everything in our diet, right? There's a time and place. Yeah, and exactly. And to that [00:55:00] point too, I would like to touch on the topic of red meat consumption, because I know this becomes highly bio individualized.

And we know that animal protein obviously contains a lot of essential amino acids that plant protein doesn't contain. But I also know that cancer patients, for example, with high ferritin levels, right? Again, my mom has very high ferritin levels. You know, should probably avoid red meat and other high iron foods.

Could you touch on why high ferritin tends to be high, or why ferritin tends to be high in cancer patients, and then perhaps some ways we can bring it down? I love this.

Dr. Nasha Winters: You know, a lot of people think, because they look at when they're going through chemo, or you get your first labs run to start chemo, a lot of the doctors nature paths included, functional and alternative included, will make a grave mistake of thinking that patients have low blood counts and we'll put them on an iron supplementation, which if you want to kill a patient quickly, that's what you do.

If you want to kill a patient quickly, you start transfusing them. You start putting them on, on blood transfusions. I can't even tell you the. Horrific number of [00:56:00] patients have lost to well meaning practitioners that were unfortunately not thoughtful in their approach. And so ferritin is a measure of iron storage.

And what's interesting is even if somebody has low hematocrit, low hemoglobin, low red blood cells, they may still, which in the cancer environment, more often than not, like if I had to give you a percentage, I would say more than 80 percent of patients dealing with cancer actually have high iron sequestration.

versus low, even when their blood counts look terribly low on the regular CBC. So when you add iron, which is an oxidizer, it's, it's like a blow torch on a gasoline tank. Okay. It will explode inflammation. Also, if there's a secondary infection. In the body, if there is a little bacteria in the body, it can put people in complete septicemia and kill them very quickly, which is the number one way that people die with when they're given iron transfusions is they end up dying of terrible secondary infections.

And [00:57:00] also, they end up dying from something known as secondary hemochromatosis, which is a massive, oxidative, acute inflammatory process. So what we want to do is somebody has high iron storage, but low blood counts. We can use things like IP6. Or lactoferrin to basically move that iron out of storage and put it into the red blood cells where it needs to be Without causing harm to the body like it doesn't add more It's just it's just like it's just shuttling around your endogenous levels of iron If you have somebody with a normal blood count with high ferritin you want to bleed them right?

That's where they go and donate a good whole pint of whole blood. Um, a therapeutic, a therapeutic phlebotomy. You'd be shocked at how difficult it is to get that done, to request that to be done, which is really unfortunate. And so if I have patients that I'm like, I literally have patients who've bled themselves.

We won't tell you how, but they've done it. Oh, my goodness. You know, [00:58:00] those are the ways you do it because we can get that as soon as we get that ferritin down. We also drop copper levels, which dry and drive angiogenesis. We drop, we drop iron levels, we drop calcium levels, we drop inflammatory marker levels that are really driving the cancering process at that time.

And so it can help the whole system cool right down. And so to your point, we don't want to add more insult to injury, like rush off and eat a bunch of bloody red meat Stakes during that time until we move your iron around appropriately. Right? Yeah. So you might stick with the whiter meats like fish and you know, poultry at that time.

Um, and then once you stabilize that iron storage, then you can go back to a high quality, please, organic regenerative, gas fed, fed, and finish. So you can get that, um, Omega-3 six ratio that you want. 'cause the CAFO raised animal protein is like a, anywhere from an 18 to a 30 to one of omega sixes, to omega threes, which is highly toxic.

No one should be eating that. Cancer or not, whereas a really [00:59:00] good quality organic grass fed finished, um, has a profile closer to what we genetically evolved from, which is a 3 to 1 ratio, actually like a 3. because it's hard to really get back to what we were eating. Yeah. Millennia ago. But you get much closer.

And so, but that's the piece of, I really appreciate you brought up the ferritin discussion because it's tricky. And so again, people need to test and assess. Yes, exactly. Never guess. And then know like, do I need to move stuff about in the building? Like calcium is a really good example. Everyone wants to take calcium levels or calcium supplements.

please never ever. Even if you don't have cancer, please don't. It will provoke a cancering process. Often the number one sign of cancer recurring or progressing is rising serum calcium levels. So the trick again is making sure it's in the right parts of the body, the right tissues of the body or out of the body altogether.

And that's what in the metabolic oncology space and the integrative oncology space, we know how to test for that, assess for that and address for that. 

Jacqueline: Yeah, I love that. And interestingly, too, I just [01:00:00] thought of this since we're talking about the topic of, of nutrition and plates. Last point I did want to talk about for nutrition.

I had a podcast episode with Jen Nolan, uh, who founded Remission Nutrition a few months ago, and she's actually been working with my mom. She's incredible, Jen. Love her. Um, but we got into this great, conversation of how plant based doesn't necessarily mean vegetarian, right? And people have this sad misconception that like, Oh, plant based, you're vegetarian.

It just means that most of one's plate consists of plants, which I think is a really great approach. I also know that plant diversity is really key in terms of ensuring we have strong microbiome health. And you touched on the immune system before and over 70 percent of our immune system is in our microbiome.

So wouldn't we want to try to optimize our plant intake to create a strong immune system? 

Dr. Nasha Winters: You're with it. And I am such a, I mean, honestly, I am a natural inclined. vegetarian. I just am. And I was a naturally inclined vegan. I never liked animal products. I didn't as a kid. My [01:01:00] mom, it tore, it tore, but it's actually probably what contributed to me getting sicker.

I was so malnourished. Right. And then what I did eat was so crappy, like I really put the wrong stuff in there. So I just added insult to injury. And by the time I figured that out, um, my body was like, we need more building blocks because you're not doing it. So I can remember like bringing in like my first high quality egg.

And I felt like the lights just got a little brighter. And then over a couple of years, it was still taking a couple of years where I would have a little piece of fish. And then a couple years later when I could suddenly the only way I was able to eat dairy again, I couldn't eat dairy for 15 years until I got rid of all grains because it's also when I learned I had celiac disease and a corn allergy and there's enough gluten and oats that that triggered me off too.

So I learned things. I was living laboratory learning for myself. So now I'm the person who will tell you I could, I would rather eat a piece of cheese and a piece of bread any day because I felt like I had this whole gift open up for me by shifting, by listening and being mindful and tweaking my diet.

in a way that I needed. But still to this day, I'm always inclined to do veg first, lots and lots of it. And I look at [01:02:00] my animal intake as a condiment versus the, you know, three quarters of the plate. And there are lots of bars out there doing carnivore and cancer. And I also caution that end because I see things with mTOR and IGF one and insulin levels, especially with certain snips that I've watched.

You know, patients just go off the hinges with progression, and a few will do really great on it, but we use the data to guide us. So there are some patients that can thrive on vegan when done properly. There are some patients who can thrive on carnivore when done properly, but they're a teeny percentage of the population, a very in of one.

Most people fit into that omnivore category, and so for instance, if you come from a place of faith where Okay, I, I can't eat other animals, but like in India, for instance, dairy is a very huge part of their diet, right? So we make sure we get the quality dairy in there or other parts of the world where they're comfortable having eggs.

That's not a problem. That's not taking the, you know, you can get the [01:03:00] nonfertile eggs. You're not taking the life of the animal. Like those are ways that you can kind of comprehend around your spiritual beliefs as well. So I just love that this conversation comes up to show that there are ways in which everything can be done really well or

really poorly and you can't just guess you really have to…

Jacqueline: Key areas that I really try to hone into my to my audience and again that being that one size does not fit all and I think in the age of social media and everyone voicing their opinions on what worked for them. I mean, someone might say a specific diet, you know, cause them to go into remission and that's wonderful for them, but that doesn't necessarily mean everyone else out there should should adopt it, right?

So. 

Dr. Nasha Winters: Nor does it mean that person should stay on that diet. Their body will tell them when they need something different and they are willing to listen. 

Jacqueline: Absolutely. Wonderful. Well, Dr. Nisha, again, I mean, nutrition, we could spend hours chatting with you. One thing I [01:04:00] also did, um, want to touch on with you is Integrative therapies or are integrative therapies and you've spoken about many different types of complementary therapies in your book with a heavy emphasis on mistletoe, high dose IBC, hyperbaric oxygen.

We know there are so many different modalities patients can explore right from the ones I just mentioned to. Coley's toxins, hyperthermia, off label drugs. So, with that, based on what you've seen in patients, what would you say are the top three most effective ones across the board? Again, recognizing that everyone's personalized and has different cancer, I'm just curious.

Dr. Nasha Winters: Well, I think you nailed some of them. I mean, a therapeutic diet is the foundation. Right. And then mistletoe is kind of my second because it just seems to be so supportive across the board for all things. And then, I mean, then it's really the sky's the limit based on the individual. So it could be an off label drug.

It could be photodynamic therapy. It could be a hyperthermia combined with radiation. It [01:05:00] could be a metronomic chemotherapy partnered with hyperbaric oxygen. It will depend very much on the individual. But for me, the 2 that kind of feel like they show up. Pretty much for every patient at some point of their journey is a therapeutic diet and missile toe.

Um, and then often and then optimizing of vitamin D levels we alluded to. I think that's a really big player and there's a lot of really amazing, uh, utility of even high dose melatonin. Yeah. And these are tend to be very accessible and. approaches as well. So pe IBC or photodynamic thera or travel to get these th to be in out of the count or in places that are ver are some simple things yo

I guess I think therapeutic diet fasting is the gold standard. Yeah, 

Jacqueline: no, truly. And I also know that you're, you're not against conventional treatment, right? You do state exactly. You do state there's a time and place for them. So [01:06:00] I'm just curious. Could you provide maybe some examples in which You know, maybe there's some cases where you recommend a patient do radiation or chemo.

So for example, like, would you be more inclined to use radiation on a bone tumor versus an organ? 

Dr. Nasha Winters: Well, I will tell you the place where it's most important to actually use radiation is if somebody has what they call a pathologic fracture in their bones, which a lot of cancers can do that. Over time, they can both the cancer itself can contribute to bone, you know, getting tumors into the bones or bone meds But also the treatments for cancer can weaken the bones, especially when they've used the preload of steroids So the bones become quite vulnerable and we get a fracture in places where it could be life threatening if it actually full on broke there is no other treatment but radiation for those fractures.

And so how we prepare a patient for it is we get them in a deep state of therapeutic ketosis because cancer cells are made, they basically ignore and defy radiation [01:07:00] when insulin is high. So we want to get that, we want to get them insulin sensitized, which will get the cancer sensitized to the radiation.

Then we want to use massive doses of melatonin to sensitize the cancer cells to the radiation and also protect the healthy cells. And then it's Followed by hyperbaric oxygen, which helps protect all the surrounding tissue. So that would be a really good example of how we can bring in the best of both worlds.

Very, very effectively. 

Jacqueline: I love that. And I'm also curious Specifically within the area of breast cancer. What are your thoughts on the use of aromatase inhibitors? So again, my mom was put on tamoxifen for 10 years following her first diagnosis and that was quote unquote the gold standard. I think it still is today.

I think they've tacked on like a cdk 46 to that, but clearly it's not bad. It's not bulletproof, right? Because her cancer recurred. So are there 

Dr. Nasha Winters: Her cancer recurred because no one looked under the hood and looked into her garden. So that's where I want folks to hear that too. [01:08:00] We kind of started our conversation, but, but it wasn't because she didn't do all the right things.

It's because they didn't find out the why of her cancer. And now she's on a different path of understanding that, but please continue. Yeah, 

Jacqueline: exactly. No, that's, that's spot on. And interestingly too, I mean, During her back in 2018 when this recurred it really I took a completely different look at everything She'd been doing up until that point in time.

I questioned Everything her oncologist had said, why was she on tamoxifen? You know, what else could we have done? And I came across all these other options of things that were shown to be just as, if not more effective than some of those, these aromatase inhibitors out there with fermented wheat germ being one of them.

Dr. Moss. published so many studies that basically found that it inhibited estrogen positive and estrogen negative breast cancer tumors better than tamoxifen. And it just, it's, it's just mind blowing. So what is your take on all these, again, conventional drugs specifically for ER positive cancers? 

Dr. Nasha Winters: Well, first of all, you want to test [01:09:00] again.

So for instance, a person who had their initial diagnosis and their initial biopsy, There is a high rate of changeover that after a period of time, anywhere from six months and beyond of whatever treatment you're on, you become resistant to that treatment and the cancer starts to morph. So people really should take a pause, whatever they're doing.

If something seems to be on the move again, you want to take a two week break and get a new blood or tissue biopsy. So you can get a fresh look at, Hey, we changed this animal to something else that might have different targets. So that's number one. Number two, we have, so like for Tamoxifen. So this is a really good question.

We actually can do a genetic test to see if the patient will respond, be a responder to Tamoxifen. So it's a CYP2D6 test, which is a single nucleotide polymorphism for one of the P450 enzyme pathways that shows whether a patient is able to metabolize and utilize this drug effectively. And for those who can't, which is about 70 percent of the population, Wow.

Okay. That actually can lead to a [01:10:00] secondary cancer of uterine cancer and more side effects and more symptoms. So we need to be more sensitive and specific. These women and men deserve better. So number one, we do 2d6 testing. Number two, we also want to evaluate for a proliferation score on their initial biopsy.

Like, is it under 20 percent Ki67? If it is, you might be questioning whether any additional treatment is necessary because that's a low pro, a low proliferating process that can likely be dealt with more through a terrain centric approach. Because what happens when you over treat those low proliferating scores, they come back with a vengeance.

Yeah. Okay. Because now you've made the terrain very sick. All right. And that's where you see metastatic disease. Like the woman that I'm doing a consult with later today, over treated in the beginning. The second thing is you brought up about aromatase inhibitors. Again, we can test for this, but here's something that's new in the literature in the last couple of years, brand new, like probably like the last year and a half.

If they have snips of ESR one and two, that's my mom. Yeah. [01:11:00] And if they have even a tumor assay of an ESR one or two, they're actually contraindicated for aromatase inhibitors. Really? Yep. Interesting. So that one, and one of the things, so the studies you can just go and read about this, they're just non responders to those therapies and it can also create, um, more of a mutation and proliferation.

And so then to your point of, they're saying, well, now we just kind of throw in a, you know, a, a CDK4, 6 inhibitor into the mix, guess what? You can test to see if the patient has a CDK4 6 target. If they don't, do not put them on those drugs because those drugs are insanely toxic. Every time I have a patient who gets put on those drugs that doesn't have that target, they end up with liver meth.

Right? I just have seen this so many times in my practice. I feel confident to say that, and that'll probably get me hate mail and maybe even threats from the FDA. But I'm telling you, you've got to be wise of what you're choosing to use. Do you have a target for that drug they're offering for you? And if you don't know, you ask them and you force them to test you [01:12:00] before they put you on anything.

And then if it is a targeted area that you can use, then you want to do all things you can to support the toxicity of those. Because even if you have the target, they're still toxic, right? So that's the piece that I'm hoping I'm, I'm just drilling into your listeners that please don't guess we have the technologies we have evolved so much in the, in the conventional medical environment that my job now is to make standard of care work better than it's ever worked before and help determine which patients are candidates for it.

or not, and to help prevent the almost 70 percent recurrence rate of anybody who's already had a cancer diagnosis and a cancer treatment that are expected to see it come back again. And so that's where I don't understand why these are that no one's like out in the streets, you know, raging against this, that this is what we have going on, especially knowing that 50 percent of us will meet this diagnosis in our lifetime.

We are not winning any wars here and is not a war to be waged. It is a process to be understood, [01:13:00] individualized, personalized, and precisely targeted and treated. 

Jacqueline: I couldn't agree more. And I think it's so sad that most oncologists, again, group their patients. Within groups. Right. Without even testing. I mean, personal note, my mom's oncologist too.

It's, this is what the literature has shown. This is, these are the steps. Right. You go through CDK four six. Yep. You know, El Esra. It's an algorithm. It's an algorithm and it's, it's just, it's really sad. So I'm, I'm just, I'm so thankful for you and all the incredible work that you're doing in this space. Um, and quick side note too, 'cause I've always been curious, I don't know if you touched, I don't think you touched on this in your book, but what are your thoughts on off-label drugs, particularly like Meen Isol?

Yeah, 

Dr. Nasha Winters: well, I've been, so I've been at this since the nineties, right? I have watched the off label drug craze coming up. It is still a tumor centric tumor cell specific tumor metabolic pathway specific process. It takes no account of the terrain. And it will worsen the terrain. [01:14:00] It's still a drug with inherent side effects.

So if you're going to use them, they need to be tested very specifically and thoughtfully to see if they are a fit for your process. So a drug like Mibendazole has a beautiful time and place. A drug like, you know, metformin or a drug like 

Jacqueline: doxycycline or LZN. 

Dr. Nasha Winters: But what's even cooler is we have more and more natural products coming out on the market that target the same pathways with less toxicity.

Interesting. So that's where the drugs teach us about the pathway. And we can create novel formulations and therapeutics and interventions to be of less toxicity to the terrain. 

Jacqueline: Yeah. Yeah. I love that. Cool. Dr. Nisha, this has been so incredibly helpful. I do want to be conscious of your time. Again, I could spend hours chatting with you.

You're, you're just so brilliant. You're a wealth of information. And I'm just. I'm beyond grateful for everything that you've done. Well, I am just so 

Dr. Nasha Winters: grateful that you are such a go getter, that you are such an advocate for your mother, [01:15:00] for yourself, for your community that follows you. I am super grateful for that because it takes of a tribe.

And I would love to see you maybe joining our advocacy program. You already are doing this naturally. I would love to see you being one of our network members to, um, to really spread this word globally. And if any of your listeners are listening and are drawn to that, we have our physician training. And our advocate training, we offer two cohorts a year of each.

We're now up to 200 clinicians and over 300 advocates in over 29 countries to date. And our goal is to just continue to expand that and make the ripple that's required to change the cancer conversation. 

Jacqueline: That's incredible. I think I also heard you mention you're working towards building some integrative centers in the United States

Dr. Nasha Winters: So. We've got our, our, um, our beta, our first location will be in Southeast Arizona with the land has been donated and we're now in our capital campaign to build the first ever residential integrative oncology and metabolic, uh, hospital and research [01:16:00] Institute on a 1, 200 acre. farm. And so it's something anybody has the desire to with time, with expertise with your wisdom, with your reach out to us.

T. 

Jacqueline: Wonderful. That's incredible. Absolutely incredible. And my last question for you, and this is the one I enjoy asking the most is what does being well and strong mean to you? 

Dr. Nasha Winters: I love that, you know, in the Webster's dictionary, they give a definition about health and they talk about it like, oh, health is an absence of disease.

And it kind of goes through, but there's this one part that seems to get left out of the equation. And it's about flourishing because health is not just an absence of disease. It's about having the vitality to do what you came here to do in the world. [01:17:00] It's about finding joy and light, even in the darkest times.

It's about having gratitude for those lessons, lessons, lessons, and the blessings, right? Or blessings and the lessons. And it's about connection to another and, and, and truly seeing the light in another individual and helping them see that light within themselves. For me, that is health and vitality. And, um, we're unfortunately falling very short of that and, and my hope and prayer is that folks will, if you don't, you know, I, I just saw a quote recently and I'm going to slaughter it, but basically says, if you look all around you and you only see darkness, you might be the only light.

And so my hope is that people start to realize it, step into it in whatever way you can, because it will reflect back to you. 

Jacqueline: That was absolutely beautiful. I got the chills. I've gotten chills so many points during this conversation. So that's when you know it was a good conversation. Well, [01:18:00] 

Dr. Nasha Winters: God kisses, right?

God winks. Yes. 

Jacqueline: I love that. I love that. Well, again, Dr. Nasha, thank you so much for your time. I'm beyond excited to share this with listeners and I hope to have you on again soon. 

Dr. Nasha Winters: I hope so too. And we'll definitely spread the word as well, Jacqueline. Thank you so much and all the best to you, your mother and all of your cherished listeners.

Jacqueline: Thank you.

 It's about time. I was just gonna say, this is so exciting for me. 

Jacqueline: I was chatting with my mom earlier this morning. She's like, when's your interview with Dr. Winters? I was like, it's coming up soon. 

Dr. Winters: Oh, sweet. Thank you so much. I love it. I'm excited to be here. Thank you. Well, first of all, I know we've been in touch what the past, like two or three years.

And again, I've never had a chance to see you. So I know it's, it's not, it's not in person, but Hey, it's, it's the best we can do for now, but maybe. Maybe one day we can actually meet in person. I love it. I hope so. I hope so. Do you have any big, um, events on the horizon this next year? 

Jacqueline: Great question. I'm currently in planning mode.

Um, [01:19:00] Ivelise  had extended an invitation to their Believe Big,  one that happened this past year. Um, but I, I wasn't able to attend. You're going to laugh, Dr. Nasha. I still have a full time job. I, I work for, I work for Fidelity Investments still. I started Well and Strong about three years ago. So it's just been a matter of learning to juggle and balance, but wow.

Dr. Nasha;  Are you getting to the point where this might get to become your full time gig? 

Jacquline:  God willing. That's yeah. And, and I'm just, and I'm just, again, it's a matter of time. I feel like I'll never fully really be ready, but I just need to take, we never are, right? That's the nature of life, but at some point, so I'm, I'm excited.

But I, I started, I started this podcast. Back in May. So it's still relatively new. I've had about 30 episodes under my belt, but it's, it's really been fun. Yes, that's so good. I thought, I think you're doing a fantastic job. I appreciate you. Thank you. And, and Dr. Winters too. I [01:20:00] don't know if you, hopefully you've had a chance to.

to look at my background on well and strong, but basically the reason I started well and strong is my mom was diagnosed with stage four breast cancer back in 2018. And she was really the catalyst. I just started doing a lot of research on complimentary therapies and sharing what I was learning and it's expanded little by little, but again, God is good.

I mean, she's been doing a lot of high dose IVC and she's starting to explore some off label drugs. So. Yeah, she diagnosed with stage four right in the beginning. No. So she had stage two in 2008 and then 10 years later. Exactly. That's what I thought I remember from your story. So she had that unfortunate leapfrog, but still to be stage four in 2018 and still here rocking it today.

I know. Yeah. So she has, she has some bone mets, um, a few liver lesions. She recently started on Rosinio, but again, she's, you know, she's in good spirits. She's very strong in her faith and that's. Yes. And she has you being the [01:21:00] detective and bringing in all the puzzle pieces in support of her, but also in support of you and so many of the rest of us out there.

So what a passion and purpose project you have going on. Yeah. Well, I mean, similar to your story, although you experienced it firsthand, but again, we, we turn our pain into, into our, our mission, right. And helping others. So. Those are the best stories. Oh, thank you so much.

Dr. Nasha:  Thank you for sharing that. Because I definitely knew a little bit of it, but it's just great to hear it from you directly.

And I think that'll be helpful in our conversations today. Like, to make it very personal. Exactly. Personable for anybody and everybody feeling called to have a listen. Exactly. I do like to try to do that. I mean, especially with you. I feel like I have an affinity with you. Yay! Good! We go back now. We go back, yeah.

But I do like to share that. Well, Dr. Nasha, I, I did pull out your book, The Metabolic Approach to Cancer, the other day, as I was preparing for what I wanted to discuss with you. And I will say, this is probably one of the most marked up books that [01:22:00] I have. There's annotations on almost every page. It's certainly one that I constantly So it was truly difficult to narrow down what I wanted to focus on with you.

Well, I love you, but you put out a pile of really great thoughts and questions, but I like you just trust that this conversation will go wherever it just needs to go. That's exactly what I was going to say. I mean, in the spirit of true podcasting, I'm excited to see what rabbit holes we go down based on the few questions I did manage to pull together.

Perfect. Thank you. Really good. Really good. Wonderful. So before we dive in, Dr. Nasha. You have such an incredible story as to how you really found yourself in this space of integrative oncology. And I would love if you could just share a bit more about that with our listeners. Absolutely. So, you know, I, you, we alluded to this in just the first seconds we were talking here in that I don't think anybody wakes up one day and says, gosh, I think I'm going to go work in the field of oncology.

That just seems like a really light and fluffy [01:23:00] career choice. Like, that's not how it works. Um, it, we are called to it, whether it is from a very personal lived experience or one like yours, a very personal lived close experience with someone near and dear to you. And so we, we show up or we're being shown what we need in our lives and, and what we're supposed to do.

With those trials and tribulations. And so for me, that's what my diagnosis was at the age of 19 is when it, um, uh, I was having issues my 19th year on this planet, but it would take them until about 2 weeks after my 20th birthday to get the official. diagnosis despite me landing in the hospital a few years before my 20th birthday.

That was just in 1991. That was the nature of it. We just was in a small town in Colorado and just the technologies and the testing and the ability to turn things around in a quick level just weren't there. And even what we've learned in the last 32 plus years, because we're now over 32 years out, still, yeah.

Oh, thank you. I [01:24:00] love it. I love it. It's like I say that out loud. It just, it's just amazing, but just a number, just a number, more experience, more wisdom. I'm wise now. That's how we look at it, but it's just incredible what we didn't know then. And in some ways we haven't learned a heck of a lot more, at least in the standard of care world, although we've been able to qualify that type of cancer.

I was diagnosed with back then ovarian cancer. We kind of categorized it as a single cancer. Okay. Well, we now understand it to be about 26 different cancer types with a lot of different personalities. And yet we still, even though we know it has a lot of different sort of personalities, we still basically treat it the same way.

Everybody gets carbotaxol or some variation on that theme. So where we've learned a lot more, the way we approach it. Hasn't changed that much. And that's one of the things I hope we get to talk a little bit about today. But for me, my journey started, I, I don't even know how to describe to somebody that there's sort of like the pre cancer [01:25:00] life and the post cancer life.

And my pre cancer life was, was pretty riddled with a lot of, of, um. Trauma on many levels from physical, emotional and sexual abuse to extreme poverty to a lot of just circumstances that were not conducive to thriving in that poverty environment. A lot of going back and forth with parents were divorced and being kind of moved around in different family homes that would create their own dynamic of sorts.

And so it was just a really weird time. And I will tell you back in 19, um, you know, the. Early 1980s, people weren't divorce rates weren't where they are today. So it was like a dirty secret. Um, I remember in third grade when my parents were fighting, I remember the terror of like, what if they ever got divorced?

And when they did finally separate and eventually divorced when I was 11, I was so ashamed. Of that, like it was just such a, nobody knew anybody with divorced parents. Like today it's weird if you have parents that are together, [01:26:00] like it's switched. Like the flip is switched there. Um, but it's, it's interesting just to think about those dynamics.

So when I think about the, why I ended up with that diagnosis, there were a lot. Of contributing factors, and yet now, 32 years fast forward, I wouldn't change any of them. Those experiences because they forged me into who I am today. Those experiences. changed me, made me resilient, made me a survivor, made me keenly observant, insanely intuitive, which are my superpowers when it comes to helping other people on their journey.

Sometimes it's not great for me. It's why it's good to get outside help for your own care. Um, but it's really something that I am incredibly blessed to have experienced. Now, your listeners who might be still going through these types of things, and we all do at different times in our lives, it's not like we suddenly get on the rainbow unicorn and fly off into the sunset forever.[01:27:00] 

Um, life happens, but. Even in the difficult situations that I met with in my life, I know that there are, my grandma used to say there's a lesson or a blessing in the lesson, right? I love that. Isn't that so cute? And I just love it. It's a very Kansas thing too, because that's where I grew up. And so I just loved that, that it reframes the way you meet adversity.

And I think that's something that really early on in my diagnosis. I really understood that and I believe it is part of why I'm still here today is I did not want to associate myself as a victim to my circumstances. I became empowered and I took advantage of the information. That cancer brought into my life to give me new tools and new ways of being and living on this planet.

I love that. That was beautiful. And quite honestly, Dr. Nasha that's one of the reasons why I admire you so much amidst everyone else in the field is your story and your mess became your message. And even in my own experience, too, I mean, There's been times where I [01:28:00] look back at points in my life and in that moment, you question, you question everything.

Right? I would question God. Why is this happening? I don't understand. And I think the beauty is that he is working through our mess and he has a bigger plan and a practice. Dr. Nisha, we could talk for hours. I already have a sense of where this conversation is going, but I, one thing that I've really started to implement in my daily life is.

Kind of keeping track of where God came through for me. So whenever I'm in any type of Difficulty or hard circumstance. I look back in the past and I say, okay, well this happened But look at what came out of this exactly right and to see how he works So I I truly love that and again, I mean had you not experienced all that you would not be where you are right now touching millions of lives So it's really love that.

I love that you share it that way because it is, it's, you know, we, we have all of the information in, on, and around us and, and, and we have all of the tools at our, at our fingertips. We are held, [01:29:00] we are loved, we are supported. We just often forget that. And so to move into a practice that allows you to reconnect with that in whatever way you connect with your faith or your higher power, your spirit, your God, because a lot of people, um, meet that in a, in a different way, but it's a very important way to help you have a unique, I guess, outlook, a unique experience and, and, and make meaning.

I think a lot of people explain that to be a human is to also make meaning of your existence. And I feel like those are the moments that give us meaning. in our lives. Absolutely. I love that. So, Dr. Nasha you coined this term, the terrain based approach, which I have heard in almost every single cancer conversation I've had since this podcast inception.

And many of the people I've spoken with, Dr. Lucas, Jen Nolan, they have all been trained in your approach, which essentially entails. Therapeutic nutritional changes, lifestyle interventions to essentially change [01:30:00] what you call the terrain of the body, right? And decrease factors that lead to cancer growth.

So with that, could you first explain to listeners what you mean by the body's terrain? And then perhaps maybe give us the SparkNotes version of what some of those interventions are. I mean, I think we can group them into like epigenetic, metabolic, and environment. Although I'm not quite sure if you have an internal hierarchy of how you like to rank them because they're all so wonderful.

Yeah, yeah. Perfect. Well, first I want to start by saying that so many of the people you have interviewed here are dear friends, colleagues, mentors, you know, inspiration to me. And yes, they might have come through the methodology training. They in themselves embody. This concept just naturally of who they are and what they're drawn to.

So we've like helped each other move into the space of terrain centric and they continue to perpetuate that message out there in a really beautiful way. So I just want to really give credit where credit's due there. That [01:31:00] being said is watching what I've watched over three decades and learning what I've learned in reviewing.

old, old literature, old readings in medicine. You know, we made a different choice in the late 1800s when we decided to focus on You know, on the, the, the germ theory, meaning something from outside of us comes in and is what causes the problems and therefore something outside of us is what is going to be the cure, the antidote, like the anti hypertensive, the anti diabetic, the anti inflammatory notice that terminology is very specific, right?

So it has this sort of war, uh, going to battle with mentality. Whereas the terrain theory that also arose around the same time, but we just chose to go down germ theory. Um, the germ theory path was this idea that are our disease state starts from within that imbalances within are what create vulnerability to the [01:32:00] expression of disease and that it's accumulations of these as Hippocrates called it sends to our body.

Um, you know, so getting out of right. Thought getting out of right eating, getting out of right, sleeping, getting out of right. Self care allows things to be vulnerable and then for other things to take root. So a very different mindset. And then instead of attacking it or doing the antidote to it, we instead Understand it, heed its message and work on nourishing and nurturing it back into homeostasis, back into balance.

And so a really simple concept is just for your folks thinking about the weed in their garden, right? So they might look at a pesky weed, like a lot of people will look at a dandelion, by the way, as a pesky weed. And yet this little guy is one of the most powerful medicines, not just for the soil of our gardens and our yards and our farms and our ranches, but also for us.

It beautifully co, um, evolved with us in that if you see dandelions showing up somewhere, [01:33:00] that is a clue that there's something wrong with that soil. And the irony is where those dandelions show up, they're showing you, they're highlighting where there's a problem, but simultaneously they're correcting that problem.

They have super deep root systems that pull nutrients up deep from the soil and bring it up to the surface. And then spread its nourishment and wisdom to the surrounding plants in the surrounding soil. That, to me, is what a tumor is doing inside of our body. It's saying, um, there's some problems in here.

Let's look at how we can understand it, what clues it's giving us, and correct what allowed that weed. To arise and express. And so therein lies a big difference of how we think about it and how we approach it. And that we're not about just eradicating that weed, right? Or that tumor or that dandelion.

We're about understanding why it's here to begin with and how to make it so that the [01:34:00] surrounding environment can keep it at bay and keep it. In synergy and still glean what wisdom it's bringing to our body while letting the rest of the body come in and swoop in and do its job because eventually when you've corrected that soil, when you've given it all the right tools and removed all the, um, obstacles to cure, then that weed resolves.

Or it goes dormant, or it gets smaller and more, you know, non, you can barely perceive it any longer. Yeah, I love that analogy. That's a beautiful illustration to visualize. And I'm actually going to steal it because I tend to use, I tend to use the one of mold growing in a basement when I try to explain the different approach between integrative medicine and a conventional approach, right?

With like bleach versus a humidifier and identifying the environment and the terrain. Similar concept, but I like yours better. Well, you know, it's like your dish. You can imagine like digging it out with a spot, a spade. There's the surgery. You imagine spraying it with food, with poison. [01:35:00] There's that you imagine burning it like a radiation.

Like that's what we do to fields of weeds. We do the same thing to our bodies in a cancering state. And yet we make that soil even more vulnerable. And so whatever analogy you are drawn to using by all means do, because I think it helps illustrate, cause we've been. A good 50, 70 years in modern times, uh, taught to believe that cancer can only be dealt with in one particular way.

And so you're allowing a conversation that helps people go, wait a minute, I've not quite thought of it this way. Maybe there's something else that can be done. Yeah, absolutely. I love that. Um, are there, and I've, I've always been curious of your take on this. If you had to. Maybe prioritize three of the 10.

Ah, good. Yeah. Yeah. Well, and it's tough because what we do in the terrain 10, so just ripping, going down the list super quick, the epigenetics, so the genetic predispositions, but we have the ability to overcome them, right? So just because great grandma, grandma, mom, and you have it. It doesn't mean you have to continue to have it and pass it on to your Children.

It's, it's the, the buck can stop with you. So epigenetic means above the gene. [01:36:00] Then we have the metabolic drop in the bucket, which is about what are you fueling your body with? Right? The third one is environmental toxicity. It's no matter if, if you're toxic, it's how bad is it? How does it interplay with your?

Terrain with your environment. And then we look at the microbiome that just a couple years ago, everyone pretended didn't exist. But now that we can monetize it, it's the rage of our discussions and our research. It's also very intimately connected to the other drop in the bucket, the immune system, which if you've lived on this.

planet. Um, the last few years, the immune system is a high topic of conversation. Just given the virus that we're being exposed to, which I believe is also an expression of an imbalanced terrain in the world in on and around us. And then inflammation, poor circulation, hypoxia. The other one is hormone modulations of hormonal issues, imbalances, stress and circadian rhythm, physiology, and then finally mental and emotional.

And so what we do is we assess our clients and our patients to understand what their [01:37:00] priorities are by going through kind of a testing process, a questionnaire process. And then we highlight on the three top offenders in their particular pattern. So it will be individualized, but if I had to think about.

The most common that I probably see in practice over and over that we want to probably take, uh, more charge of right up front. Especially when you're trying to prevent is to get a handle on your stress response, okay, and your emotional health. I kind of put those two together. They really go hand in hand.

So emotional resilience, stress resilience. Those are big. The other one that we have a lot of control over is what we put at the end of our fork. And so being mindful of eating real food, nutritiously dense food, Seasonal, local, as clean as possible food, as close to the source as possible food, preferably not in a box or a bag or a can, you know, and things that you see that you know exactly where they came from.

They came out of a piece of the ocean. They came out of the sky. They came out of the ground. They came off a tree. Those types of things, that's our food. And [01:38:00] then keeping it more normal glycemic. So, uh, we tend to eat way more carbohydrates today than ever before. And so being more carbohydrate, restricting is key.

And people think they don't eat sugar until you really do a diet dietary with them. And, and maybe you do blood testing and they're like. Oh, that's a surprise. So maybe get curious and really look at, evaluate honestly what your personal glucose levels, insulin levels, carbohydrate intake is. And then the third big, big, big one is the environmental toxicity.

We have so much more control to deal with what we put in on and around us. And most people don't know I can walk into somebody's home and know immediately if I'm walking into a toxic waste dump. know it. So maybe I'm sm is. It's like maybe I'm s they dried their clothes sprayed on their couch to smell.

The um, scented ca and beyond or whatever th is more toxic. They're a known carcinogen and [01:39:00] more toxic than cigarette smoke. The, the, um, Teflon that they're cooking our meal in that night, that is a persistent chemical that's virtually impossible to get out of your body and known carcinogen. The water that they're taking out of their fridge thinking that that fridge filter is enough.

The body care products are slathering on themselves before they greet you as their host at the dinner with them. The VOC's in the air from their paint that they just painted their new room with. They're excited to share their new couch with you that is covered in flame retardant that is unbelievable while their little kiddos are rolling around on it, concentrating into those little tiny bodies even more.

And so when folks are always surprised when they're like, I was surprised I got cancer. I was healthy until I got cancer. When we go through that terrain 10 questionnaire, we evaluate what's going in on and around their body. Suddenly it becomes very clear that there are a lot of things sneaking in. In their lives, in their diets, in their emotional state that they're unaware of and shining light on [01:40:00] that is a very powerful tool because an empowered patient, an educated patient is a resilient patient and a lot harder to kill a patient.

I couldn't agree more. And again, Dr. Winters, I mean, the mission of Well and Strong is to encourage readers to be advocates of their own health. Right. And I always say this. It's important to seek wisdom and counsel from our doctors that the end of the day. You're in charge of your life, right? You need to educate yourself as much as you can.

Um, but I, I love those, I love that Terrain 10. We should have an episode quite honestly dedicated to just each of those because there is so much to unpack. But for time's sake, I'd love to focus on perhaps the first two you mentioned. So, when you had mentioned the emotional aspect, right away my mind jumped to this quote.

And I had to pull it up as you were chatting that you, that you wrote in your book. And it basically You said that stress is the most powerful carcinogen imaginable. It increases inflammation, spikes blood sugar, and disables the immune system. Metastasis is promoted when the body or [01:41:00] mind is stressed and so is angiogenesis.

And this I actually included in my integrative guide to breast cancer as well because I just, it really resonated with me and I think it's so interesting too, right? The more people I speak with on the topic of emotional health, the more we realize how critical stress is in not only cancer development, but cancer progression.

And I was chatting with Dr. Veronique Desaulniers months back. She's wonderful. Love Dr. B. She's so great. And we were just chatting and she said that interestingly, and I mean, I've witnessed this too. And my mom's case that typically, if you look at a cancer diagnosis, right, and you look back at maybe two or three years before that, either initial diagnosis or recurrence, there will be some type of stressful event.

That occurs in that patient's life, and you know, not to say like life is stressful, right? As long as we're in this world, we will all experience stress. But I think it's really important to your [01:42:00] point to learn how to manage that stress effectively and find ways to release it so that it doesn't harbor and stagnate in your body.

Yes. Perfect. I love that you brought that up. In fact, later this afternoon, I have a consultation with a colleague over a patient of hers who's got a tricky stage four breast breast cancer diagnosis that originally was stage one in 2018 and quickly. Exploded into stage four, um, this year and for her, she even, she even called it out for herself that it was an unsurmountable amount of stress and loss and tension and discourse that was.

Almost intolerable. And yet now she understands that until she really works through that, which she is beautifully working through this and changing all the relationships in her life, all of her ways that she communicates her needs, all of the way she rapture gave [01:43:00] away her power in different environments and swallowed down what needed to be said or done.

And she's already gone back into complete remission to back to back scans with no evidence of disease. And she did some standard of care in the process, but even the doctor said, we didn't expect to get you into NED. Yeah, right. Because once you kind of move into that zone, they're like, ah, we'll just keep you comfortable for as long as possible when it inevitably and takes, takes over.

She's turned this ship around in the harbor because she saw the writing on the wall right away and she was willing to go in there. And I will tell you, this is the hardest part of the patient journey. That's why even in our 10 drops of the bucket, you'll notice that stress and emotions are the last two week kind of talk about.

No one wants to deal with them. Right, right. And if I started there in the book, people would be like, and we're done here. And they'd leave in chapter one or two. But by the time they get bought into some of the more tangibles that they can control that are easier, then they are like, okay, now the real, now the real job [01:44:00] begins.

Now I can really go in. Isn't that so funny though, Dr. Nisha, that people will consider doing a coffee enema over going to forgive someone who like offended them 10 years ago? Exactly. That's great. That gives me chills. And it's also kind of funny because when somebody recognizes that about themselves, when they are finally willing to look at it, they will laugh at their own, at their own years of trying to like dart and avoid it and all the things they would do instead of dealing with it, or all the things they would sacrifice or compromise instead of dealing with it.

And they're like, if I just ripped off the bandaid right away, would we be in the same situation we're in? And we can't answer that, but we have a sense that it might've been. played a little different role. Yeah, no, I love that that's included in your 10. And even Chris work talks a lot about the power of forgiveness, right?

He's like, you could be doing all the right things, eating all the right food, but if you have not forgiven those who hurt you, you can't heal. And I know Kelly Turner talks about that in radical remission, right? Yeah, incredible. I mean, for listeners, she [01:45:00] basically was a PhD student who traveled the world observing cases of radical remission.

And she wrote this book on the 10 common themes, I guess, that she saw among patients who experienced remission, one of which was forgiveness. So, so much truth to that. Yeah, you know, there's a, there's a point of, you don't forgive somebody for them. You forgive somebody for yourself. Exactly. And you don't have to ever see or be around that person ever again.

They might not even be on this planet anymore. And that doesn't mean you have to interact with them if they are or suddenly hang out with them again or trust them again. But the forgiveness is it's a two way street. I forgive myself for choosing to stay. Involved as long as I did or for, for, for letting things go the direction they went, because we all have our role in these relationships as well.

If we're really, really young, maybe not as much, but, but also then I forgive myself that I was too little to know [01:46:00] how to do this. So how as an adult self, can I go back to a time of remembering how might I have cared for my little person self in those moments and been the, the, the, the, the, the person they needed.

Okay. During that time, we can go back and rescue ourselves from any trauma, no matter how old it is, um, in our own ways that bring the healing and forgiveness within us that allows us to move forward without worrying about how it's going to impact the person that might have, you know, been the deliverer of that betrayal of that.

Absolutely. Toxicity of that trauma. I love that. And last point on this, again, whole other conversation, but I think one of the most powerful things too, that someone could do, and I've, I've done this. On a personal note is to say thank you even just internally to your offender or someone who hurt you because it enables you to again challenge yourself to forgive and really reach another level of humanness, right?

That we otherwise never thought we would be capable of. And have more empathy towards others, be [01:47:00] able to relate to others better. So it's truly about perspective. It really, really is. You know, I'd love if you don't mind one little thing, you just made me think about a story I heard probably 20 years ago, and it was a psycho, it was a psychiatrist who worked in a prison environment and he was given like the worst of the worst of the worst cases, like people on death row, people who'd all committed very violent crimes, you know, pedophilia, like all of like the ones that we just sort of like want to lock them up.

No room for forgiveness, right? And he was like, there was all this massive violence, even within the, like, within the prison system. So violence to the, to the, um, the guards, violence among the, the, the inmates, this whole piece. And he decided to try something different. And I'm really distilling this down, but basically he'd.

put open up a chart and he'd see the atrocities that this individual would done in their lives. And he would just place his hands on it, basically close his eyes, pray, meditate, [01:48:00] however he was doing this and basically say, I'm sorry. I thank you. I forgive you. I love you. I heard this before. This isn't a book.

Where is this from? No, I can't remember. It is. And he did this over and over. I got chills with the whole stack of like the worst of the worst offenders. Things changed. Nothing changed. No, there was no new medication or interaction with these guys. It was on a full on energetic field and they changed the level of violence and recidivism rate like people to actually start to.

They amend and heal themselves in a very different environment. So if you can do it in a place like that, imagine the power of doing that in all things of your life. That's so powerful. So, so powerful. We'll have to find this, we'll have to find this and share it with your reader, because it, your listeners.

Yeah. We will. I'll, I'll include it in the, in the links in the show notes. No, because when you were saying that, I was like, I remember reading this somewhere. Yeah. So powerful. Oh my goodness. Love. Love all of this. [01:49:00] Well, Dr. Winter, so that was part one of the first two that I wanted to cover. Um, jumping to that metabolic piece, though, I know that you write a lot about the ketogenic diet in your book, but I will say I love that you aren't as dogmatic as some of the other people out there and that you really advocate for a metabolically flexible diet rather than consistently using the term ketogenic.

So, we of course know that a keto diet is certainly one way to achieve metabolic flexibility. as can fasting, um, as fasting can be. And there's certainly been studies that have shown that either being in a fasted state or being in that state of therapeutic ketosis can increase the effectiveness of certain treatments and also mitigate damage to healthy cells.

So with all of that, Dr. Neshap, I do want to address a few questions that I have based on some of the literature that I've read in addition to conversations I've had when it comes to keto. Does that sound good? Absolutely. And first I just wanna reiterate, you nailed it when you said, oh, when our book came out to be [01:50:00] published, um, that was at a time when the SEO was what drove, how they titled the book.

And if people actually read my book, they'll realize, yes, we talk a lot about therapeutic ketosis, but it's, we talk about a heck of a lot more than that. It's a small fragment of it, so Exactly. Put that on there too, at the time, in 2017 to sell a book, right. Because I then got pegged as the ketogenic diet girl, but I'm the metabolic flexibility queen.

And so I really appreciate that you brought that up. So absolutely reiterate that for your listeners, but please dive into your specific questions. No, thank you. Thank you for clarifying that. And again, I know that's something that I think has arisen people and it's like, no, she's metabolically flexible, metabolically flexible diet.

Well, my first question stems from a 2012 study, which I'm sure you've seen. That basically showed that tumors can actually use ketones for fuel. And I mean, given that cancer cells are metabolically flexible and they're smart, if you starve them of glucose, I'm sure it could weaken or slow them down temporarily, but won't they eventually adapt by upregulating other [01:51:00] pathways?

And I think you had even mentioned at some point, cancer cells are opportunistic in that they'll use whatever is most readily available to them. So given all of that. Is it possible to maintain a ketogenic diet or, you know, try to be in that therapeutic state long term, recognizing that cancer cells are opportunistic and adaptable?

Is that something, you know, perhaps we're like pulsing diets might be able to address like two months, two months keto, one month off or something to that effect? So what a great question. And it probably, I probably get a question or some study. In fact, one just came out this week that alludes to that.

But here's what I want you and your listeners to know is when you actually go in and you dig deep into these studies, they're not ketone bodies that are causing the problem, right? So there actually is zero evidence that ketone bodies themselves can ever be a fuel for cancer cells. However, the means in which we try to achieve [01:52:00] ketosis.

can be problematic. So what those studies were actually looking at were, were using fatty acids. And using fatty acids, you know, FAS and FAO, so fatty acid oxidation and fatty acid synthesis as a secondary metabolite of cancer cells. So let me back up a little bit further. When we look at all cancer types across the board, over 90 percent of them directly use glucose as a fuel source.

The other 10 percent are like, eh, give them or take it, you know, kick it or leave it, but they're really pretty rare, um, to not use glucose at some point. Out of all cancer types, 70 percent of all cancer types use a pathway called the PIK3CA pathway, which is a metabolic pathway. insulin loving glucose hog pathway.

So again, reinforcing a little bit of how a carbohydrate restriction diet is really [01:53:00] important across the board for every single patient with cancer, in my opinion, no matter what, like it, it, I, I'm. Pretty darn positive that there is not a person outside of, I want to, I'm going to have a little talk with Dr.

Joe Mercola, who put a post out that today saying glucose doesn't cause, can't, I'm like, wait a second, we have enough labs, enough information, enough 30 years of clinical experience to tell you it absolutely, it doesn't, cause cancer, but it will drive it for sure. So I'm like, he needs to reframe his languaging and I'll be harsh on that.

So Joe, we're coming, we're having a talk, but anyway, so that's just something important to know that no matter who you are, what type of cancer type, what stage you're in, please stay with carbohydrate restriction, period. The studies that, that are misrepresenting saying that ketones themselves cause cancer, that actually is not what the literature is showing.

In fact, it's impossible. And all the big ketone researchers in the world, that aren't even outside of the cancer realm. They don't have any, they don't have anything to gain or lose by this information. We'll tell you it's [01:54:00] literally not possible for cancer cells to use ketone bodies. What they can use are the types of fats that people might be using or that the cell line or the animal studies might be feeding that are problematic.

So what I want you to do like this, this day that just came out this week It showed up saying, Oh, it shows here that ketogenic diet absolutely proliferates ovarian cancer cells. Now, I'm 32 years out from ovarian cancer. So, and I've helped tens of thousands of women with this disease to say that's not accurate.

And when you look at the diet, this is when I went back on this giant form with thousands of people saying, See, Chris was right or whatever. Like everyone jumps in. I'm like, when you break it down, I said, let me guess, I haven't even looked at the study yet, but let me guess what the fat, what the fat is.

The fat was soybean oil, Crisco, corn oil, massive amounts to the level that you would have to. So the amount they were feeding the animals in this study, there's not a human possibility to take in that much of that fat in a [01:55:00] human being. We could not eat that much. That is massively high in omega six. And what that what they showed in this rat in this particular mouse study was that this mouse study also had a part A park.

Why are not a part? Why? Um, oh, gosh, it's just a particular sniff, which is just leaving my brain right now. Excuse me for that, but it's a particular sniff that a lot of people will say, Oh, you can't do ketosis with that. Well, these animals have this problem because they don't utilize fats well and they should be very particular about what fats they do use.

So they literally use the most fat toxic, um, fats to feed an already genetically predisposed creature. Yeah. to these wrongful fats that no one on the planet should ever be eating. And yet, unfortunately, it's the, if you eat processed food, these are the types of fats you are eating. And so that's when you start to realize that we're really not number one, feeding them a good quality therapeutic ketogenic diet in any of these studies.

That's number one. Number two. A [01:56:00] lot of them will say they're ketogenic diets like the two, 2012 one you're talking about. But when you look at it, it's, it's high fat, but also high carb. Mm-Hmm. , high fat and high carb is always a bad idea for everybody. Yep. Agree. Non combination. Right? And so and so, that's the place here that if you just go into fasted state or carbohydrate restriction or restricted like a, a vegan restricted carbohydrate diet, a vegetarian restricted carbohydrate diet, all of those make ketone bodies.

It's not a problem ever because it's not the ketone bodies that are the problem. And so it's really kind of sort of bastardizing the literature, the data using sensational headlines. But when people break it down, you just go, wow. And so when I revealed that, when they finally, someone who was on the forum brought up the actual food.

I don't even call it that, that we're feeding this most recent study, everyone who was basically trying to throw me under the bus and the entire low carb industry under the bus, they went dead silent. [01:57:00] They stopped yelling because they realized, and then we'll probably never say it, but it's like that moment you realize this is where we have to be critical thinkers.

We have to do a little bit deeper dive. Ketone bodies are massive signaling agents that enhance. All cancer responses in the right direction that enhanced all of our therapeutic input from standard of care to alternative care. It weakens the cancer cell, even if it doesn't need to be, because ketones do much more than just lower insulin.

They hit every one of the targets of the hallmarks of cancer. They absolutely redirect that PIK3CA pathway. They change your epigenetic expression. They're such, they're strongly anti inflammatory, strongly anti angiogenic. There's not a drug on the planet that does as much as a ketone body does. So for instance, if somebody does have high homocysteine that is not responsive, to a, what we call a homocysteine challenge.

So taking a [01:58:00] handful of B12, B2 folate, taking that in high doses for a few days, retesting their homocysteine. And if their homocysteine drops 50%, then we know that this is just a methylation problem and carry on. But if that homocysteine doesn't budge, then we would consider a methionine restricted diet, which includes, you still have to, this is what's happening in the, in the popular influencer world.

These patients then jump on what they perceive as a low methionine diet, which they perceive as a vegan diet. Right? Some of the most methionine rich foods are within vegan diets. Most beans, most legumes, most seeds, and then they make the bigger mistake of jumping on to basically an all fruit diet. We could just go down a rabbit hole of what fructose does to cancer cells, right?

In that kind of quantity. So when you do a low methionine, it's a pulsing diet. with carbohydrate restriction. It's a very restrictive diet for a period of time, and it can only be managed for a period of time. And so to your point, [01:59:00] we as clinicians are trained to look at the pathways from tissue and blood biopsies, look at the patient's medical and personal history, look at the patient's labs, look at the patient's epigenetics or single nucleotide polymorphisms, look at their likes and dislikes and their day to day lifestyle, and then adjust their diet and their lifestyle accordingly.

But across the board, they will always stay low carb. Yeah. Across the board. And sometimes in certain cancers, we need to push a bit harder into a deeper state of therapeutic ketosis, which we can do that with fasting or further carbohydrate restriction or even exogenous ketones or even some pharmaceuticals.

But we can also do it with high fat, low carb, but you want to bet your bottom dollar you're going to use the right fats. for those patients. And you also will base those fats on what the patient's epigenetics can tolerate. So I want folks to hear that it's not a catchall. Um, and that unless like for patients with GBM, for instance, they're probably going to need to stay on a therapeutic ketogenic diet for the rest of their lives.[02:00:00] 

But if you're, uh, you know, if you've got a stage one or two cancer, you're just using it to maybe potentiate your, your standard of care therapy. or your high dose IBC or your hyperbaric oxygen or your hyperthermia. If you're a stage three or four, um, you know, more aggressive cancer like lung, pancreatic or ovarian, you're going to be strongly carbohydrate restricted the rest of your long life.

The other cancer types, depending on the situation, the person. Um, and the stage may be able to pulse as you alluded to, and that's the place I still don't ever want them going back to as much carbohydrate as they were eating pre diagnosis. That's probably not a good idea for anybody, but ultimately, this is the way we get into this beautiful end of one.

So I love that. You gave me a little bit of a. Soapbox to stand up and just give this wide range to know that you can't just say yes or no, good or bad, black or white. It's incredibly nuanced and please work with a metabolic oncology expert. There is no metabolic oncology training out there. We're the only ones who offer it.[02:01:00] 

There's a lot of practitioners who piecemeal together and try and learn on their own, but it's so complicated and there's so many layers and there's so many research coming out. You want to make sure you're working with someone who's gone through the extensive training and is maintaining that training because the literature literally changes every week.

And so we are staying current with the tide of information that's coming our way. I love that. I couldn't agree more with all of that, Dr. Winters, and I mean, being adaptable, again, with the new research that's coming out is key. It's truly, truly key, because people who are so, again, dogmatic and staunch that their approach is this way or the highway and aren't open to, you know, evolving new evidence.

Those are the ones, in my opinion, you have to

And there's a time and a like glutamine restriction, methionine restriction, cysteine restriction, arginine restriction, but we can do those in these pulses. We can do these with certain medications, herbs, nutrients, supplements, off label drugs, even pharmaceuticals. This is what's so cool [02:02:00] that still across the board, you want it carbohydrate restricted, and then you can be incredibly exact and precise and individualized the rest of the time.

Yeah, I, that lends to my next question. So on a personal note, my mom has been trying to get into the state of therapeutic ketosis for the past four or five months. Right. And I think my area of concern with the ketogenic diet in her case, and I've witnessed this firsthand, is that in order for her to get into that therapeutic state, meaning her GKIs, to her below.

She really needed to dramatically reduce her intake of plant foods. And these vegetables, Dr. Nisha, weren't starchy by any means, but they still, but they still would knock her out of that state. And given that she has an ER positive breast cancer, I mean, you even talk about this in your book, but I know that cruciferous vegetables and fiber, right?

They're so critical in helping the body detox from excess estrogen. So. That's not [02:03:00] necessarily something I want her to have to reduce her intake of. So I really feel like we've been at a crossroads while, you know, I do want her to reap the benefits of being in that therapeutic state, but I don't want to compromise her intake of plants.

So we've kind of taken a step back and she's been incorporating fasting as you alluded to, as a means to improve her metabolic flexibility, especially on certain treatments like high dose IVC, but we're not necessarily. Myopically focused anymore on having that GKI of two or below and I think it that was so a couple things first of all there I you know But somebody trained and that would be looking at what the why you know, why is it tougher her to get into metabolic flexibility?

Well, it could be that some of the drugs she's taking for her process are Thwarting it so you have to work with with what you got, right? So be gentle because she doesn't as far as I know because I don't know all of her history I'm have like some of those cancers I talked about She may not need to be in a therapeutic level of ketones.

Like [02:04:00] she probably will do great with being in what we call a nutritional state of ketosis, somewhere between 0. 8 and two on her blood ketones, millimoles of her blood ketones and be still getting an optimal response. She may not be getting that GKI down to two or below, but as long as she's got the GKI under five, I'm a happy camper.

Okay. And so just to give you just your listeners, the average American's GKI, have you talked about this with everybody? Do you have a guess? Um, over eight, 25 to 30. No. Yes. Indeedy. That is crazy. I know. Right. And that's where you're like, Whoa, when you realize how bad. So one of our colleagues out there, he talks about the three fives.

Get your 5, your insulin under 5, and your, um, GKI under 5. And you are like bulletproof for everything metabolic. Cancer prevention, cancer treatment, Alzheimer's prevention, [02:05:00] schizophrenia treatment, I mean all the things that are metabolic in nature, if we all pushed our clients in the world to get below 5 on all those three things I listed, we, I would be out of a job.

I would hopefully be out of a job. So for your mom, because she may have some things that are just pushing against it pharmaceutically, she might also have some snips. Like perhaps she's got issues with her carnitine shuffle, scooching her fats. We need maybe help bust her fats across the cell membrane of her mitochondria to be more efficient.

In her Krebs cycle to make more ATP to see those little cart. Um, uh, ketones bump up. She may need to carbohydrate restrict strict a little bit further, but not necessarily bring up her fat, especially if it's not something she loves. And maybe she needs, if we've got some patients that just have, like, if they do have the PPAR alpha, that's what it was.

I knew it would come if I didn't think about it. If she does have that or an ACAP mutation or an ACSL one mutation, then she might do better using exogenous ketones. To give her that [02:06:00] little lift so she can eat more of those important, life giving, cruciferous giving veggies. Interesting. So she could augment with some exogenous to keep her humming.

But a little bit better. So those are just some examples in there might even be like, maybe that's why we look at her sleep pattern or her stress response, because I call it the three S's, sugar, stress, stress and sex. So insulin, cortisol, and hormonal imbalance, and just one to two nights of bad sleep will spike your insulin.

Yeah. So oftentimes that's a big one. So I'm wearing a. CGM, you might have her play with that and just start to experiment. So for me, when I go to sleep at night, I wake my husband up and he has a heart attack because my thing beeps in the middle of the night and I sleep through it because my blood sugar drops into the thirties at night.

Wow. No. Right. And I just started using this just for fine. I'm like, Oh, that's interesting. And then, um, when I'm on a massage table, when I'm in a deeply relaxed state, my glucose drops below well under the fifties easily into the thirties and forties. And that's when I [02:07:00] realized when I'm up, when I'm revving, like right now, let's just, I'll tell you like right now, cause I'm on, I'm excited.

I'm talking to you. My blood sugar is 99 right now and I haven't eaten. Yeah. Dr. Neysha, that I was just going to ask you that my, again, I mean, I keep referring to my mom because she's been my primary source of learning. She's her muse. She is. She is my muse. She, she consistently has elevated blood sugar levels.

And again, her diet is not one that's rich in sugar or carbohydrates. And i'm like mom even just stress and she's like i'm not stressed I'm, like it could be good stress that could raise your cortisol and boost your blood sugar Like i'm like revving with you. I'm like all excited. I'm on my pat. I'm on my passion purpose Woo at 99 and i'm in a fasted state at 11 49 a.

m. on a Friday morning, right? I'll break my fast after this. And so that's a really good example. And I've been eating a therapeutic ketogenic diet or therapeutic ketosis or carbohydrate restriction for 30 years, you know, in some form or fashion, more ketosis in the last, you know, [02:08:00] 10 or 12 years. But, but really for years, all of this and my vein of my blood sugar has nothing to do with what's at the end of my fork.

So interesting. So maybe that's helpful. Yeah, yeah, no, it definitely is. Well, the consensus seems to be that diets are really bio individualized and that reaching that state of metabolic flexibility will really vary by patient. However, are there certain foods that you feel very strongly about that patients should include in their diets?

I know you have a whole section dedicated to this in your book. Again, it's highlighted in my version and my copy right here, but I'd love to touch on maybe a few of your favorites. Sure. Well, I know because 50 percent of the population has a non functioning TP53 gene, which is a tumor suppressor gene. So that means half of us, which is also statistically significant because we're now expected to have half of us experience cancer in our lifetime.

That's a global statistic, not a naturopath statistic, right? So that's interesting. And once you have gone [02:09:00] through standard of care, your TP53 is even more damaged. That's just the nature of the beast. So one of my favorite, favorite, favorite ways to support TP53 expression is broccoli sprouts and watercress.

And those are things you can, plus it's such a fun, especially if you have littles at home, like you can all make sprouts together, make them into chia pets, like make fun, like do it kind of fun. Start to put them in on and everything, sprinkle them on salads, bring him in soups. Just take out, go by and grab a handful and chomp on them.

Really, really powerful. It will help support your TP 53 in a very. very powerful way. That's one of my favorites. The one thing that in the next edition of the book, if Jess and I can ever find the time. There's another edition coming. Oh my goodness. This is so exciting. We hope so. We want to someday, but we both say it.

We're like, okay, we'll have to take up drinking. It's a lot of work. Oh my goodness. We probably have like an extra thousand pages of content to [02:10:00] 2017. I'm sure. that's very relevant. There's only two things I regret that are in there today. One of them is about, hey, ketogenic diet is probably not a good idea for prostate cancer.

I would definitely qualify that. It's about the types of fats because ketone bodies are excellent for prostate cancer. It's just the means of which you achieve it is the, where we'd qualify that further. The second thing is our celebration of selenium via Brazil nuts. We need to pull that out of there because we've actually learned a lot that the form of selenium in Brazil nuts, the form of selenium and most supplements are actually highly toxic to the body and in some cancer types in particular prostate and some of the estrogen based cancers actually can be used as fuel.

for the cancer cell because most of them are selenomethionine based. So what we have learned is a form of selenium that we would place replace that within the book is called sodium selenite. S E L E N I T E. I would love for your listeners to go [02:11:00] down a rabbit hole of research on that. That by itself Induces apoptosis and basically all cell line studies, animal studies.

It also is really powerful to, it is, you know, selenium when in the proper forms protect the DNA. So another way here, I would look at maybe taking a sodium selenite supplement. And then the other one you talked about food, but I really think for me, I think of sunshine as food. Um, because ultimately we'd prefer everyone to get their vitamin D from the sun.

That's the most powerful, but if it's cold where you live or dark where you live and you can't get your skin exposed or you're a little still scared of the sun for whatever reason and you can't get two thirds or more of your body exposed to the sun every day for your 10, 000 units you need every day to hum along, you'll need some supplementation.

But ultimately, I really encourage everybody to get out there to do some good old vitamin D, um, from, from the sun, which is really powerful. And then that also kind of segues into high quality fats. Do not be afraid of the animal fats [02:12:00] unless you've got some really strong snips, some really strong epigenetics that show that maybe you should limit your animal fats, which there are some people who need to.

But for the most part, that's where we got our vitamin D was from the backstrap of animals that grazed out under the sunshine. Right? That, that, or from our, our chickens that ate, they're, chickens are little carnivores, you guys. They're little like baby pterodactyls. They are not vegans and they should not be eating vegan feed.

They need to be eating bugs and dead things and sometimes each other and their egg, like all the things, it's kind of disgusting, but. You get massive amounts of really good quality vitamin D from a high quality egg. Um, you get mass amounts of really good quality vitamin D for some organic, raw, pastured butter.

Um, and, and A2 dairy, especially goat or sheep, if you can tolerate that in small amounts, if you have genetics that allow for that, or really high quality lard or tallow. or backstrap of something that you've hunted, you know, for listening. So suddenly all my vegans, vegetarians are freaking out a little bit.

[02:13:00] Myself included. I was a vegan for seven years, a vegetarian for 25 years, took a long time to get my mind around this, but my genetics and my labs and my ability to heal my body and get the resources my body needed to heal were, it was really thwarted, um, because I let my dogma. Get in the way of my data.

And so I, I have to be flexible in my thinking as well as in my cellular function as well. Yeah. Again, Dr. Winters, this could be a whole other episode, but there is so much contention in the diet space right now. It's like, it's, it's really sad that like everyone has to be so extreme. Like I'm an omnivore.

I'm a fan of omnivory. I think it's the healthiest eating pattern. But. Um, and again, like there's benefits to everything in our diet, right? There's a time and place. Yeah, and exactly. And to that point too, I would like to touch on the topic of red meat consumption, because I know this becomes highly bio individualized.

And we know that animal protein obviously contains a lot of essential amino acids that plant protein doesn't contain. [02:14:00] But I also know that cancer patients, for example, with high ferritin levels, right? Again, my mom has very high ferritin levels. You know, should probably avoid red meat and other high iron foods.

Could you touch on why high ferritin tends to be high, or why ferritin tends to be high in cancer patients, and then perhaps some ways we can bring it down? I love this. You know, a lot of people think, because they look at when they're going through chemo, or you get your first labs run to start chemo, a lot of the doctors So, um, I think that there's, uh, nature paths included, functional and alter alternative included, we'll make a grave mistake of thinking that patients have low blood counts and we'll put them on an iron supplementation, which if you want to kill a patient quickly, that's what you do.

If you want to kill a patient quickly, you start transfusing them. You start putting them on, on blood transfusions. I can't even tell you the. Horrific number of patients have lost to well meaning practitioners that were unfortunately not thoughtful in their approach. And so ferritin is a measure of iron storage.

And what's interesting is even if somebody has low hematocrit, low hemoglobin, low red blood [02:15:00] cells, they may still, which in the cancer environment, more often than not, like if I had to give you a percentage, I would say more than 80 percent of patients dealing with cancer actually have high iron sequestration.

versus low, even when their blood counts look terribly low on the regular CBC. So when you add iron, which is an oxidizer, it's, it's like a blow torch on a gasoline tank. Okay. It will explode inflammation. Also, if there's a secondary infection. In the body, if there is a little bacteria in the body, it can put people in complete septicemia and kill them very quickly, which is the number one way that people die with when they're given iron transfusions is they end up dying of terrible secondary infections.

And also, they end up dying from something known as secondary hemochromatosis, which is a massive, oxidative, acute inflammatory process. So what we want to do is somebody has high iron storage, but low [02:16:00] blood counts. We can use things like IP6. Or lactoferrin to basically move that iron out of storage and put it into the red blood cells where it needs to be Without causing harm to the body like it doesn't add more It's just it's just like it's just shuttling around your endogenous levels of iron If you have somebody with a normal blood count with high ferritin you want to bleed them right?

That's where they go and donate a good whole pint of whole blood. Um, a therapeutic, a therapeutic phlebotomy. You'd be shocked at how difficult it is to get that done, to request that to be done, which is really unfortunate. And so if I have patients that I'm like, I literally have patients who've bled themselves.

We won't tell you how, but they've done it. Oh, my goodness. You know, those are the ways you do it because we can get that as soon as we get that ferritin down. We also drop copper levels, which dry and drive angiogenesis. We drop, we drop iron levels, we drop calcium levels, we drop inflammatory marker levels that are [02:17:00] really driving the cancering process at that time.

And so it can help the whole system cool right down. And so to your point, we don't want to add more insult to injury, like rush off and eat a bunch of bloody red meat Stakes during that time until we move your iron around appropriately. Right? Yeah. So you might stick with the whiter meats like fish and you know, poultry at that time.

Um, and then once you stabilize that iron storage, then you can go back to a high quality, please, organic regenerative, gas fed, fed, and finish. So you can get that, um, Omega-3 six ratio that you want. 'cause the CAFO raised animal protein is like a, anywhere from an 18 to a 30 to one of omega sixes, to omega threes, which is highly toxic.

No one should be eating that. Cancer or not, whereas a really good quality organic grass fed finished, um, has a profile closer to what we genetically evolved from, which is a 3 to 1 ratio, actually like a 3. because it's hard to really get back to what we were eating. [02:18:00] Yeah. Millennia ago. But you get much closer.

And so, but that's the piece of, I really appreciate you brought up the ferritin discussion because it's tricky. And so again, people need to test and assess. Yes, exactly. Never guess. And then know like, do I need to move stuff about in the building? Like calcium is a really good example. Everyone wants to take calcium levels or calcium supplements.

please never ever. Even if you don't have cancer, please don't. It will provoke a cancering process. Often the number one sign of cancer recurring or progressing is rising serum calcium levels. So the trick again is making sure it's in the right parts of the body, the right tissues of the body or out of the body altogether.

And that's what in the metabolic oncology space and the integrative oncology space, we know how to test for that, assess for that and address for that. Yeah, I love that. And interestingly, too, I just thought of this since we're talking about the topic of, of nutrition and plates. Last point I did want to talk about for nutrition.

I had a podcast episode with Jen Nolan, uh, who founded Remission Nutrition a few months ago, and she's actually been working with my mom. She's incredible, [02:19:00] Jen. Love her. Um, but we got into this great, conversation of how plant based doesn't necessarily mean vegetarian, right? And people have this sad misconception that like, Oh, plant based, you're vegetarian.

It just means that most of one's plate consists of plants, which I think is a really great approach. I also know that plant diversity is really key in terms of ensuring we have strong microbiome health. And you touched on the immune system before and over 70 percent of our immune system is in our microbiome.

So wouldn't we want to try to optimize our plant intake to create a strong immune system? You're with it. And I am such a, I mean, honestly, I am a natural inclined. vegetarian. I just am. And I was a naturally inclined vegan. I never liked animal products. I didn't as a kid. My mom, it tore, it tore, but it's actually probably what contributed to me getting sicker.

I was so malnourished. Right. And then what I did eat was so crappy, like I really put the wrong stuff in there. So I just added insult to injury. And by the time I figured that out, um, my [02:20:00] body was like, we need more building blocks because you're not doing it. So I can remember like bringing in like my first high quality egg.

And I felt like the lights just got a little brighter. And then over a couple of years, it was still taking a couple of years where I would have a little piece of fish. And then a couple years later when I could suddenly the only way I was able to eat dairy again, I couldn't eat dairy for 15 years until I got rid of all grains because it's also when I learned I had celiac disease and a corn allergy and there's enough gluten and oats that that triggered me off too.

So I learned things. I was living laboratory learning for myself. So now I'm the person who will tell you I could, I would rather eat a piece of cheese and a piece of bread any day because I felt like I had this whole gift open up for me by shifting, by listening and being mindful and tweaking my diet.

in a way that I needed. But still to this day, I'm always inclined to do veg first, lots and lots of it. And I look at my animal intake as a condiment versus the, you know, three quarters of the plate. And there are lots of bars out there doing carnivore and cancer. And I also caution that end because I see things with [02:21:00] mTOR and IGF one and insulin levels, especially with certain snips that I've watched.

You know, patients just go off the hinges with progression, and a few will do really great on it, but we use the data to guide us. So there are some patients that can thrive on vegan when done properly. There are some patients who can thrive on carnivore when done properly, but they're a teeny percentage of the population, a very in of one.

Most people fit into that omnivore category, and so for instance, if you come from a place of faith where Okay, I, I can't eat other animals, but like in India, for instance, dairy is a very huge part of their diet, right? So we make sure we get the quality dairy in there or other parts of the world where they're comfortable having eggs.

That's not a problem. That's not taking the, you know, you can get the nonfertile eggs. You're not taking the life of the animal. Like those are ways that you can kind of comprehend around your spiritual beliefs as well. So I just love that this conversation comes up to show that there are ways in which everything can be done really well.[02:22:00] 

really poorly and you can't just guess you really have to

Key areas that I really try to hone into my to my audience and again that being that one size does not fit all and I think in the age of social media and everyone voicing their opinions on what worked for them. I mean, someone might say a specific diet, you know, cause them to go into remission and that's wonderful for them, but that doesn't necessarily mean everyone else out there should should adopt it, right?

So. Nor does it mean that person should stay on that diet. Their body will tell them when they need something different and they are willing to listen. Absolutely. Wonderful. Well, Dr. Nisha, again, I mean, nutrition, we could spend hours chatting with you. One thing I also did, um, want to touch on with you is Integrative therapies or are integrative therapies and you've spoken about many different types of complementary therapies in your book with a heavy emphasis on mistletoe, [02:23:00] high dose IBC, hyperbaric oxygen.

We know there are so many different modalities patients can explore right from the ones I just mentioned to. Coley's toxins, hyperthermia, off label drugs. So, with that, based on what you've seen in patients, what would you say are the top three most effective ones across the board? Again, recognizing that everyone's personalized and has different cancer, I'm just curious.

Well, I think you nailed some of them. I mean, a therapeutic diet is the foundation. Right. And then mistletoe is kind of my second because it just seems to be so supportive across the board for all things. And then, I mean, then it's really the sky's the limit based on the individual. So it could be an off label drug.

It could be photodynamic therapy. It could be a hyperthermia combined with radiation. It could be a metronomic chemotherapy partnered with hyperbaric oxygen. It will depend very much on the individual. But for me, the 2 that kind of feel like they show up. Pretty much for every patient at some [02:24:00] point of their journey is a therapeutic diet and missile toe.

Um, and then often and then optimizing of vitamin D levels we alluded to. I think that's a really big player and there's a lot of really amazing, uh, utility of even high dose melatonin. Yeah. And these are tend to be very accessible and. approaches as well. So pe IBC or photodynamic thera or travel to get these th to be in out of the count or in places that are ver are some simple things yo

Big time. I guess I think therapeutic diet fasting is the gold standard. Yeah, no, truly. And I also know that you're, you're not against conventional treatment, right? You do state exactly. You do state there's a time and place for them. So I'm just curious. Could you provide maybe some examples in which You know, maybe there's some cases where you recommend a patient do radiation or chemo.

So for example, like, would you be more inclined to use radiation on a bone tumor [02:25:00] versus an organ? Well, I will tell you the place where it's most important to actually use radiation is if somebody has what they call a pathologic fracture in their bones, which a lot of cancers can do that. Over time, they can both the cancer itself can contribute to bone, you know, getting tumors into the bones or bone mets But also the treatments for cancer can weaken the bones, especially when they've used the preload of steroids So the bones become quite vulnerable and we get a fracture in places where it could be life threatening if it actually full on broke there is no other treatment but radiation for those fractures.

And so how we prepare a patient for it is we get them in a deep state of therapeutic ketosis because cancer cells are made, they basically ignore and defy radiation when insulin is high. So we want to get that, we want to get them insulin sensitized, which will get the cancer sensitized to the radiation.

Then we want to use massive doses of melatonin to sensitize the cancer cells to the radiation and also protect the [02:26:00] healthy cells. And then it's Followed by hyperbaric oxygen, which helps protect all the surrounding tissue. So that would be a really good example of how we can bring in the best of both worlds.

Very, very effectively. I love that. And I'm also curious Specifically within the area of breast cancer. What are your thoughts on the use of aromatase inhibitors? So again, my mom was put on tamoxifen for 10 years following her first diagnosis and that was quote unquote the gold standard. I think it still is today.

I think they've tacked on like a cdk 46 to that, but clearly it's cdk It's not bulletproof, right? Because her cancer recurred. So are there some Her cancer recurred because no one looked under the hood and looked into her garden. So that's where I want folks to hear that too. We kind of started our conversation, but, but it wasn't because she didn't do all the right things.

It's because they didn't find out the why of her cancer. And now she's on a different path of understanding that, but please continue. Yeah, exactly. No, that's, that's spot on. And [02:27:00] interestingly too, I mean, During her back in 2018 when this recurred it really I took a completely different look at everything She'd been doing up until that point in time.

I questioned Everything her oncologist had said, why was she on tamoxifen? You know, what else could we have done? And I came across all these other options of things that were shown to be just as, if not more effective than some of those, these aromatase inhibitors out there with fermented wheat germ being one of them.

Dr. Moss. published so many studies that basically found that it inhibited estrogen positive and estrogen negative breast cancer tumors better than tamoxifen. And it just, it's, it's just mind blowing. So what is your take on all these, again, conventional drugs specifically for ER positive cancers? Well, first of all, you want to test again.

So for instance, a person who had their initial diagnosis and their initial biopsy, There is a high rate of changeover that after a period of time, anywhere from six months and beyond of whatever treatment you're on, you become [02:28:00] resistant to that treatment and the cancer starts to morph. So people really should take a pause, whatever they're doing.

If something seems to be on the move again, you want to take a two week break and get a new blood or tissue biopsy. So you can get a fresh look at, Hey, we changed this animal to something else that might have different targets. So that's number one. Number two, we have, so like for Tamoxifen. So this is a really good question.

We actually can do a genetic test to see if the patient will respond, be a responder to Tamoxifen. So it's a CYP2D6 test, which is a single nucleotide polymorphism for one of the P450 enzyme pathways that shows whether a patient is able to metabolize and utilize this drug effectively. And for those who can't, which is about 70 percent of the population, Wow.

Okay. That actually can lead to a secondary cancer of uterine cancer and more side effects and more symptoms. So we need to be more sensitive and specific. These women and men deserve better. So number one, we do 2d6 testing. Number two, we also want to [02:29:00] evaluate for a proliferation score on their initial biopsy.

Like, is it under 20 percent Ki67? If it is, you might be questioning whether any additional treatment is necessary because that's a low pro, a low proliferating process that can likely be dealt with more through a terrain centric approach. Because what happens when you over treat those low proliferating scores, they come back with a vengeance.

Yeah. Okay. Because now you've made the terrain very sick. All right. And that's where you see metastatic disease. Like the woman that I'm doing a consult with later today, over treated in the beginning. The second thing is you brought up about aromatase inhibitors. Again, we can test for this, but here's something that's new in the literature in the last couple of years, brand new, like probably like the last year and a half.

If they have snips of ESR one and two, that's my mom. Yeah. And if they have even a tumor assay of an ESR one or two, they're actually contraindicated for aromatase inhibitors. Really? Yep. Interesting. So that one, and one of the things, so the studies you can just go and read about this, [02:30:00] they're just non responders to those therapies and it can also create, um, more of a mutation and proliferation.

And so then to your point of, they're saying, well, now we just kind of throw in a, you know, a, a CDK4, 6 inhibitor into the mix, guess what? You can test to see if the patient has a CDK4 6 target. If they don't, do not put them on those drugs because those drugs are insanely toxic. Every time I have a patient who gets put on those drugs that doesn't have that target, they end up with liver meth.

Right? I just have seen this so many times in my practice. I feel confident to say that, and that'll probably get me hate mail and maybe even threats from the FDA. But I'm telling you, you've got to be wise of what you're choosing to use. Do you have a target for that drug they're offering for you? And if you don't know, you ask them and you force them to test you before they put you on anything.

And then if it is a targeted area that you can use, then you want to do all things you can to support the toxicity of those. Because even if you have the target, they're still toxic, right? So that's the piece that I'm hoping I'm, [02:31:00] I'm just drilling into your listeners that please don't guess we have the technologies we have evolved so much in the, in the conventional medical environment that my job now is to make standard of care work better than it's ever worked before and help determine which patients are candidates for it.

or not, and to help prevent the almost 70 percent recurrence rate of anybody who's already had a cancer diagnosis and a cancer treatment that are expected to see it come back again. And so that's where I don't understand why these are that no one's like out in the streets, you know, raging against this, that this is what we have going on, especially knowing that 50 percent of us will meet this diagnosis in our lifetime.

We are not winning any wars here and is not a war to be waged. It is a process to be understood, individualized, personalized, and precisely targeted and treated. I couldn't agree more. And I think it's so sad that most oncologists, again, group their patients. Within groups. Right. Without even [02:32:00] testing. I mean, personal note, my mom's oncologist too.

It's, this is what the literature has shown. This is, these are the steps. Right. You go through CDK four six. Yep. You know, El Esra. It's an algorithm. It's an algorithm and it's, it's just, it's really sad. So I'm, I'm just, I'm so thankful for you and all the incredible work that you're doing in this space. Um, and quick side note too, 'cause I've always been curious, I don't know if you touched, I don't think you touched on this in your book, but what are your thoughts on off-label drugs, particularly like Meen Isol?

Yeah, well, I've been, so I've been at this since the nineties, right? I have watched the off label drug craze coming up. It is still a tumor centric tumor cell specific tumor metabolic pathway specific process. It takes no account of the terrain. And it will worsen the terrain. It's still a drug with inherent side effects.

So if you're going to use them, they need to be tested very specifically and thoughtfully to see if they are a fit for your process. So a drug like [02:33:00] Mibendazole has a beautiful time and place. A drug like, you know, metformin or a drug like doxycycline or LZN. But what's even cooler is we have more and more natural products coming out on the market that target the same pathways with less toxicity.

Interesting. So that's where the drugs teach us about the pathway. And we can create novel formulations and therapeutics and interventions to be of less toxicity to the terrain. Yeah. Yeah. I love that. Cool. Dr. Nisha, this has been so incredibly helpful. I do want to be conscious of your time. Again, I could spend hours chatting with you.

You're, you're just so brilliant. You're a wealth of information. And I'm just. I'm beyond grateful for everything that you've done. Well, I am just so grateful that you are such a go getter, that you are such an advocate for your mother, for yourself, for your community that follows you. I am super grateful for that because it takes of a tribe.

And I would love to see you maybe joining our advocacy program. You already are doing this naturally. I would love to see you being [02:34:00] one of our network members to, um, to really spread this word globally. And if any of your listeners are listening and are drawn to that, we have our physician training. And our advocate training, we offer two cohorts a year of each.

We're now up to 200 clinicians and over 300 advocates in over 29 countries to date. And our goal is to just continue to expand that and make the ripple that's required to change the cancer conversation. That's incredible. I think I also heard you mention you're working towards building some integrative centers in the U.

S. We've got our, our, um, our beta, our first, our, our, our first location will be in Southeast Arizona with the land has been donated and we're now in our capital campaign to build the first ever residential integrative oncology and metabolic, uh, hospital and research Institute on a 1, 200 acre. farm. And so it's somethimg anybody has the desire to with time, with expertise with [02:35:00] your wisdom, with yo reach out to us at M.

T. Wonderful. That's incredible. Absolutely incredible. Dr. mentors. And my last question for you, and this is the one I enjoy asking the most is what does being well and strong mean to you? I love that, you know, in the Webster's dictionary, they give a definition about health and they talk about it like, oh, health is an absence of disease.

And it kind of goes through, but there's this one part that seems to get left out of the equation. And it's about flourishing because health is not just an absence of disease. It's about having the vitality to do what you came here to do in the world. It's about finding joy and light, even in the darkest times.

It's about having gratitude for those lessons, lessons, lessons, and the blessings, right? Or blessings and the [02:36:00] lessons. And it's about connection to another and, and, and truly seeing the light in another individual and helping them see that light within themselves. For me, that is health and vitality. And, um, we're unfortunately falling very short of that and, and my hope and prayer is that folks will, if you don't, you know, I, I just saw a quote recently and I'm going to slaughter it, but basically says, if you look all around you and you only see darkness, you might be the only light.

And so my hope is that people start to realize it, step into it in whatever way you can, because it will reflect back to you. That was absolutely beautiful. I got the chills. I've gotten chills so many points during this conversation. So that's when you know it was a good conversation. Well, God kisses, right?

God winks. Yes. I love that. I love that. Well, again, Dr. Nasha, thank you so much for your time. I'm beyond excited to share this with listeners and I hope to have you on again soon. I hope so too. [02:37:00] And we'll definitely spread the word as well, Jacqueline. Thank you so much and all the best to you, your mother and all of your cherished listeners.

Thank you. Wonderful.