1 00:00:02,560 --> 00:00:08,160 Speaker 1: This is let's be clear with Shannon Doherty. Hi everyone, 2 00:00:08,400 --> 00:00:10,799 Speaker 1: this is let's be clear with Shannon Doherty. Please welcome 3 00:00:11,000 --> 00:00:15,840 Speaker 1: doctor Laurence Piro, Doctor Pierro. I brought you my best friend, 4 00:00:16,880 --> 00:00:20,920 Speaker 1: and she was a stylish she was fantastic. I loved her. 5 00:00:21,040 --> 00:00:22,880 Speaker 1: She taught me how to travel. We went to St. 6 00:00:22,920 --> 00:00:26,760 Speaker 1: Barts every year, like we had a very very very tight, 7 00:00:26,880 --> 00:00:32,240 Speaker 1: tight tight relationship. And she ended up getting cancer. I'm 8 00:00:32,280 --> 00:00:37,720 Speaker 1: obviously not asking you to divulge anything, but her cancer, 9 00:00:38,159 --> 00:00:40,200 Speaker 1: you know, was more advanced than mine at that time, 10 00:00:40,240 --> 00:00:45,560 Speaker 1: and I remember her describing certain symptoms that she had 11 00:00:45,840 --> 00:00:48,720 Speaker 1: and I would like two days later, by the way, 12 00:00:48,880 --> 00:00:52,800 Speaker 1: just talking about it right now, thanks you. It gets 13 00:00:52,840 --> 00:00:55,480 Speaker 1: me just talking about it. I'm starting to get those 14 00:00:55,720 --> 00:00:58,800 Speaker 1: weird nice things that'll go away the minute I stopped 15 00:00:58,800 --> 00:01:02,680 Speaker 1: talking about it. It's so bizarre, but you kept saying 16 00:01:02,680 --> 00:01:08,320 Speaker 1: to me like, you cannot associate your cancer with hers. 17 00:01:08,920 --> 00:01:12,160 Speaker 1: There are two different cancers. And if you look at 18 00:01:12,680 --> 00:01:15,400 Speaker 1: her path, then you're going to walk her path like 19 00:01:15,920 --> 00:01:18,160 Speaker 1: you have to walk your own path and she has 20 00:01:18,200 --> 00:01:22,520 Speaker 1: to walk her own path. And when you first set 21 00:01:22,600 --> 00:01:24,640 Speaker 1: me down and really had that conversation with me, I 22 00:01:24,760 --> 00:01:29,479 Speaker 1: was like wow, Like I heard that, and then the 23 00:01:29,520 --> 00:01:33,000 Speaker 1: pains like went away. It was all a mental thing. 24 00:01:33,560 --> 00:01:36,840 Speaker 2: And I remember, actually the first time I said that 25 00:01:36,880 --> 00:01:40,040 Speaker 2: to you was before you ever or at least before 26 00:01:40,080 --> 00:01:43,840 Speaker 2: you ever verbalized anyway. Yeah, experienced some of the same things. 27 00:01:43,920 --> 00:01:47,720 Speaker 2: I just knew to anticipate that, and I said that 28 00:01:47,880 --> 00:01:51,600 Speaker 2: you cannot compare yourself. The minute I understood what her 29 00:01:51,640 --> 00:01:55,360 Speaker 2: scenario was, I knew that you would look at that 30 00:01:55,440 --> 00:01:58,640 Speaker 2: scenario and assume that that was your path. And because 31 00:01:58,680 --> 00:02:04,160 Speaker 2: everybody does. I mean, fortunately many people are. Everybody's exceptional 32 00:02:04,200 --> 00:02:08,880 Speaker 2: in some ways, but we're all very common in other ways. 33 00:02:09,040 --> 00:02:11,519 Speaker 2: In terms of our human reactions. We're all very common 34 00:02:11,560 --> 00:02:15,000 Speaker 2: because we're all part of the same you know, same community, 35 00:02:15,040 --> 00:02:18,360 Speaker 2: of the same gene pool, the same organism. And so 36 00:02:18,840 --> 00:02:21,720 Speaker 2: I knew that that would be a thing, and and 37 00:02:21,800 --> 00:02:24,600 Speaker 2: it was, and each step of the way, you know, 38 00:02:25,160 --> 00:02:27,680 Speaker 2: so that we had to keep repeating, especially because you 39 00:02:27,720 --> 00:02:30,640 Speaker 2: were you know, you were a very good friend. So 40 00:02:30,680 --> 00:02:33,280 Speaker 2: when you're a very good friend, you spend time talking. 41 00:02:34,080 --> 00:02:36,640 Speaker 2: You know. It's kind of like support groups. I mean, 42 00:02:37,680 --> 00:02:41,600 Speaker 2: support groups can be so great, but they have to 43 00:02:41,639 --> 00:02:47,360 Speaker 2: be refereed carefully, and the composition of a support group 44 00:02:47,400 --> 00:02:51,280 Speaker 2: has to be chosen carefully because you know, sometimes it 45 00:02:51,320 --> 00:02:53,480 Speaker 2: can do damage and sort of help if it isn't 46 00:02:53,600 --> 00:02:56,200 Speaker 2: you know, refereed carefully, and the people in the group 47 00:02:56,240 --> 00:02:59,160 Speaker 2: are not common enough because if you're you know, if 48 00:02:59,160 --> 00:03:02,720 Speaker 2: you're someone with adjuvant breast cancer and you know, with 49 00:03:02,800 --> 00:03:05,600 Speaker 2: a eighty five or ninety percent chance of cure, and 50 00:03:05,639 --> 00:03:09,840 Speaker 2: you're in a group with metastatic breast cancer patients, you know, 51 00:03:10,000 --> 00:03:14,360 Speaker 2: you may be seeing, you know, a picture that is 52 00:03:14,400 --> 00:03:20,200 Speaker 2: so frightening. You know that it's hard psychologically. So the sharing, 53 00:03:20,240 --> 00:03:22,440 Speaker 2: the group share thing and the industry I think is 54 00:03:22,560 --> 00:03:26,480 Speaker 2: very complicated, and especially in today's day of social media 55 00:03:26,520 --> 00:03:29,119 Speaker 2: and all that, because anyone can reach out to you 56 00:03:29,680 --> 00:03:32,120 Speaker 2: and share with you, and again you don't you're not 57 00:03:32,160 --> 00:03:35,280 Speaker 2: really validating their data. I mean in this case of 58 00:03:35,280 --> 00:03:38,360 Speaker 2: your friend, of course you were, but if someone meets 59 00:03:38,400 --> 00:03:41,080 Speaker 2: you on the internet, you know, and is sharing data 60 00:03:41,120 --> 00:03:43,680 Speaker 2: with you, you can't really validate their data. And we 61 00:03:43,800 --> 00:03:47,960 Speaker 2: all leave pieces out of stories. I mean, even we're 62 00:03:48,000 --> 00:03:50,480 Speaker 2: not talking about cancer, right if you're talking about, you know, 63 00:03:50,840 --> 00:03:54,440 Speaker 2: your friend who did something to you one day about 64 00:03:54,560 --> 00:03:55,960 Speaker 2: you know, what happened to a party or something like 65 00:03:56,000 --> 00:04:00,680 Speaker 2: that people nate by nature tell their side of the story, right, 66 00:04:00,760 --> 00:04:04,160 Speaker 2: So sometimes that leaves out a couple of beats that 67 00:04:04,280 --> 00:04:06,720 Speaker 2: might change other people's view of it. But when they're 68 00:04:06,760 --> 00:04:09,360 Speaker 2: telling their cancer story, they do the same thing. They 69 00:04:09,400 --> 00:04:12,680 Speaker 2: sometimes leave out some beats because no one wants to 70 00:04:12,720 --> 00:04:17,240 Speaker 2: be on the pathway that's leading to the bad outcome. 71 00:04:17,520 --> 00:04:20,000 Speaker 2: Everyone wants to be on the pathway leading the good outcome, 72 00:04:20,040 --> 00:04:24,240 Speaker 2: and so you sometimes leave things out, and therefore the 73 00:04:24,279 --> 00:04:30,080 Speaker 2: person listening can't really adjudicate the story straightforwardly, right. 74 00:04:30,320 --> 00:04:34,360 Speaker 1: And also there are you know people you said earlier, 75 00:04:34,920 --> 00:04:38,080 Speaker 1: there are people that they're just like warriors when it 76 00:04:38,080 --> 00:04:40,279 Speaker 1: comes to their protocols, and it doesn't matter. They just 77 00:04:40,400 --> 00:04:43,159 Speaker 1: keep on a protocol. You know, I think there was 78 00:04:43,200 --> 00:04:46,880 Speaker 1: only one protocol that I complained about. Every other protocol 79 00:04:46,920 --> 00:04:50,520 Speaker 1: it didn't matter what that we were on together. Yeah, 80 00:04:50,680 --> 00:04:52,680 Speaker 1: didn't matter what the side effects were, I was okay. 81 00:04:52,760 --> 00:04:55,920 Speaker 1: And then there are other people like my friend who 82 00:04:56,480 --> 00:05:00,720 Speaker 1: you know, blew through protocols incredibly incredibly quickly. It was 83 00:05:00,800 --> 00:05:05,960 Speaker 1: like if if there was anything sort of uncomfortable. There 84 00:05:05,960 --> 00:05:10,200 Speaker 1: are people that with a little bit of discomfort, they 85 00:05:10,800 --> 00:05:12,920 Speaker 1: they don't want to stay on a protocol as opposed 86 00:05:12,960 --> 00:05:16,560 Speaker 1: to realizing that like the more protocols you blow through, 87 00:05:17,320 --> 00:05:21,839 Speaker 1: the less options you have because there's only so many protocols. 88 00:05:22,600 --> 00:05:26,880 Speaker 1: What's really interesting to me is all the suggestions I think, 89 00:05:26,920 --> 00:05:29,919 Speaker 1: and I've spoken to you about this, of that I 90 00:05:30,000 --> 00:05:34,240 Speaker 1: get from people, you know, the chemo or this or 91 00:05:34,279 --> 00:05:38,800 Speaker 1: that that is killing me Western medicine, that I need 92 00:05:38,800 --> 00:05:41,600 Speaker 1: to be on you know, CBD, or I need to 93 00:05:42,000 --> 00:05:45,800 Speaker 1: you know, uh, if I just go on a raw diet, 94 00:05:45,920 --> 00:05:48,200 Speaker 1: or if I just do this, or I just do that. 95 00:05:48,279 --> 00:05:52,839 Speaker 1: Oh my friend took you know, I remectin and they're 96 00:05:52,960 --> 00:05:55,680 Speaker 1: completely cured of cancer. And I'm like, yeah, but they 97 00:05:55,680 --> 00:05:58,839 Speaker 1: were also in a clinical trial, Like how are you saying, 98 00:05:58,960 --> 00:06:02,160 Speaker 1: is that I remectin opposed to the clinical trial? Like, 99 00:06:03,800 --> 00:06:06,760 Speaker 1: you know, it's such an interesting and I think a 100 00:06:06,839 --> 00:06:12,120 Speaker 1: lot of people with cancer probably have this conversation with themselves, 101 00:06:12,160 --> 00:06:14,240 Speaker 1: and I've had it with myself and I've had it 102 00:06:14,279 --> 00:06:20,880 Speaker 1: with you. There's a vast amount of misinformation and just 103 00:06:21,040 --> 00:06:26,400 Speaker 1: information in general that's really hard to sift through because 104 00:06:27,040 --> 00:06:34,039 Speaker 1: there are so many stories and proclamations that this alternative 105 00:06:34,640 --> 00:06:41,560 Speaker 1: medicine cured somebody of stage four cancer and so your 106 00:06:41,600 --> 00:06:46,560 Speaker 1: brain has this very curious moment where it's like, well, 107 00:06:46,880 --> 00:06:50,839 Speaker 1: should I be using a dewormer like they use on horses? 108 00:06:51,000 --> 00:06:53,359 Speaker 1: Is that what's going to cure me? Like that was 109 00:06:53,400 --> 00:06:56,159 Speaker 1: the latest one I got recently, And then you just 110 00:06:56,200 --> 00:07:01,120 Speaker 1: start sort of knocking your head going stop it, you know, 111 00:07:01,320 --> 00:07:02,440 Speaker 1: like science is science. 112 00:07:02,640 --> 00:07:04,880 Speaker 2: There's so many levels to that. I mean, first of all, 113 00:07:05,360 --> 00:07:08,279 Speaker 2: you one hundred percent right. I mean, on the surface 114 00:07:08,320 --> 00:07:11,280 Speaker 2: of that kind of conversation, people cant say, well, gee, 115 00:07:11,320 --> 00:07:13,520 Speaker 2: I don't know. My doctor treats me to like a statistic. 116 00:07:13,560 --> 00:07:15,680 Speaker 2: He says, we're going on this protocol and it has, 117 00:07:15,880 --> 00:07:19,640 Speaker 2: you know, forty two percent effectiveness. And yet I talk 118 00:07:19,720 --> 00:07:23,040 Speaker 2: to this person and they're talking about this alternative stuff 119 00:07:23,440 --> 00:07:25,680 Speaker 2: and they tell me about people that have been cured. 120 00:07:26,200 --> 00:07:29,600 Speaker 2: But the reason that doctors don't talk about just people 121 00:07:29,680 --> 00:07:32,840 Speaker 2: who've been cured because those are anecdotes. You have to 122 00:07:32,880 --> 00:07:35,360 Speaker 2: study something in a disciplined way to find out if 123 00:07:35,360 --> 00:07:38,760 Speaker 2: it's random or if it's an actual effect. And most 124 00:07:38,880 --> 00:07:42,280 Speaker 2: of the alternative things are not studied that, and they're 125 00:07:42,280 --> 00:07:45,880 Speaker 2: all driven by anecdotes and not to dismiss those, and 126 00:07:47,240 --> 00:07:49,640 Speaker 2: they can feel empowering to a person who's in a 127 00:07:49,680 --> 00:07:52,040 Speaker 2: bad situation. I get that, but at the end of 128 00:07:52,040 --> 00:07:55,920 Speaker 2: the day, you're vulnerable, and when people are promising you 129 00:07:56,720 --> 00:08:00,240 Speaker 2: things effectively, I mean they're effectively kind of promising this 130 00:08:00,360 --> 00:08:03,920 Speaker 2: by saying this one person had this. I mean, they're 131 00:08:03,960 --> 00:08:06,240 Speaker 2: hanging out there the possibility that that might be you. 132 00:08:06,760 --> 00:08:10,080 Speaker 2: It's in some ways, you know, not intentionally, it's meaning 133 00:08:10,080 --> 00:08:11,560 Speaker 2: to be helpful, but it's kind of praying on your 134 00:08:11,600 --> 00:08:15,720 Speaker 2: vulnerability in some ways. And then if you choose not 135 00:08:15,760 --> 00:08:17,880 Speaker 2: to do any of those things, because you just said 136 00:08:17,880 --> 00:08:20,240 Speaker 2: I'm going to be sensible and you know, look at 137 00:08:20,240 --> 00:08:22,240 Speaker 2: the data and all that. But then if you decide 138 00:08:22,280 --> 00:08:25,080 Speaker 2: not to do those things and your outcome isn't good, 139 00:08:25,400 --> 00:08:28,200 Speaker 2: then you self flagellate yourself. Well, maybe if I had 140 00:08:28,280 --> 00:08:31,880 Speaker 2: done the Eye of Newt and all of that right, 141 00:08:31,960 --> 00:08:35,040 Speaker 2: that you would have been okay. And so it also 142 00:08:35,120 --> 00:08:39,440 Speaker 2: has that second layer of difficulty and judgment and all 143 00:08:39,440 --> 00:08:43,600 Speaker 2: of that's difficult. You know, I didn't realize, despite a 144 00:08:43,640 --> 00:08:48,560 Speaker 2: long career, I didn't realize just how humbled people get 145 00:08:48,960 --> 00:08:53,400 Speaker 2: with suggestions until I took care of Farah Faucet and 146 00:08:53,440 --> 00:08:56,280 Speaker 2: when I was on the journey with Pharah. You know, 147 00:08:57,440 --> 00:09:01,000 Speaker 2: so many people strangers were writing or just left and 148 00:09:01,080 --> 00:09:05,280 Speaker 2: right and whatever like with you, and she said, she 149 00:09:05,440 --> 00:09:07,840 Speaker 2: just told all of them, just send this to my 150 00:09:07,920 --> 00:09:12,200 Speaker 2: doctor and he'll sort this out. So you realize that 151 00:09:12,280 --> 00:09:16,600 Speaker 2: besides eight thousand additional emails a day that I got, 152 00:09:17,280 --> 00:09:21,680 Speaker 2: my office was filled to the ceiling with packages of 153 00:09:22,480 --> 00:09:26,959 Speaker 2: bottles and pills and things and blankets and prayers and whatever, 154 00:09:27,320 --> 00:09:29,800 Speaker 2: which is moving. To see how many people care. It 155 00:09:29,840 --> 00:09:33,520 Speaker 2: was just beautiful moving, but it was a morass in 156 00:09:33,600 --> 00:09:37,120 Speaker 2: terms of any patient if they were actually trying to 157 00:09:37,160 --> 00:09:41,640 Speaker 2: sort out all of that stuff. But people don't fully 158 00:09:41,720 --> 00:09:45,000 Speaker 2: realize is each time you have to open your thinking 159 00:09:45,160 --> 00:09:49,960 Speaker 2: to another thing which might work, you're reliving your diagnosis, 160 00:09:51,080 --> 00:09:54,319 Speaker 2: just reliving the whole initial process of the diagnosis and 161 00:09:54,360 --> 00:09:57,680 Speaker 2: what might work. When you're having to tear into each 162 00:09:57,720 --> 00:10:02,640 Speaker 2: of these individual suggests, and when it's thousands, it's overwhelming. 163 00:10:02,760 --> 00:10:06,280 Speaker 1: So yeah, I mean that part doesn't bother me because 164 00:10:06,280 --> 00:10:10,960 Speaker 1: I don't really like ever relive the diagnosis. But I 165 00:10:11,080 --> 00:10:16,760 Speaker 1: think what I'm more worry about is I understand enough 166 00:10:16,880 --> 00:10:20,520 Speaker 1: to look at some sort of suggestion that somebody gives 167 00:10:20,559 --> 00:10:25,599 Speaker 1: me and either research it myself or have the conversation 168 00:10:25,720 --> 00:10:29,320 Speaker 1: with you because a lot of times great you know, 169 00:10:29,400 --> 00:10:33,120 Speaker 1: I believe in also natural medicine. I believe in homeopathic 170 00:10:33,240 --> 00:10:36,240 Speaker 1: Like I think that's fantastical. Yeah, you just have to 171 00:10:36,280 --> 00:10:40,040 Speaker 1: make sure that the properties that are in that homeopathic 172 00:10:40,480 --> 00:10:46,160 Speaker 1: herb or whatever isn't counteracting what your normal cancer med 173 00:10:46,920 --> 00:10:49,480 Speaker 1: is then doing. Like that's a big thing that people 174 00:10:49,559 --> 00:10:52,640 Speaker 1: who give you the such suggestions don't realize, is that 175 00:10:52,679 --> 00:10:56,400 Speaker 1: there is natural stuff out there, but it can literally 176 00:10:56,559 --> 00:11:00,079 Speaker 1: kill essentially what your chemical medicine is on. 177 00:11:00,400 --> 00:11:03,200 Speaker 2: That is, anything you're doing should be in addition to 178 00:11:03,400 --> 00:11:06,760 Speaker 2: and not instead of right right. And then rule two 179 00:11:07,440 --> 00:11:09,040 Speaker 2: is what are the drug interactions? 180 00:11:09,600 --> 00:11:10,360 Speaker 1: Drug interaction? 181 00:11:10,640 --> 00:11:13,240 Speaker 2: And I'll tell you I took care of a young 182 00:11:13,320 --> 00:11:18,560 Speaker 2: man who was really an amazing, credible young man and scholar, 183 00:11:19,360 --> 00:11:24,319 Speaker 2: and he unfortunately developed a very difficult cancer situation. And 184 00:11:25,000 --> 00:11:29,760 Speaker 2: his girlfriend at the time of diagnosis and then they married. 185 00:11:29,840 --> 00:11:33,200 Speaker 2: During the course of his care, someone and her family together, 186 00:11:33,280 --> 00:11:36,440 Speaker 2: they decided he had a feeding tube at this particular 187 00:11:36,480 --> 00:11:39,440 Speaker 2: point in his journey, and they decided that they would 188 00:11:39,960 --> 00:11:42,640 Speaker 2: try to be helpful to him. They would stop feeding 189 00:11:42,720 --> 00:11:46,120 Speaker 2: him the liquid diet that was the well balanced diet 190 00:11:46,200 --> 00:11:48,880 Speaker 2: and all that, and they would feed him just like 191 00:11:49,080 --> 00:11:55,160 Speaker 2: yogurt mixed with antioxidant berries and different things. And I 192 00:11:55,320 --> 00:11:59,160 Speaker 2: always told this young man that if you know, if 193 00:11:59,200 --> 00:12:02,040 Speaker 2: you are scared, you know, just call me and I 194 00:12:02,080 --> 00:12:05,840 Speaker 2: will come. You know, just if you're scared of what's happening, 195 00:12:06,720 --> 00:12:10,000 Speaker 2: just call and I will come. And so one day 196 00:12:10,040 --> 00:12:12,840 Speaker 2: he called me and he said, I think I'm dying. 197 00:12:13,360 --> 00:12:16,520 Speaker 2: I said why, and he said, because I'm bleeding from 198 00:12:16,559 --> 00:12:18,400 Speaker 2: my nose, and I'm bleeding from my mouth, and I'm 199 00:12:18,400 --> 00:12:21,760 Speaker 2: bleeding from everywhere. And you know, this was somebody in 200 00:12:21,800 --> 00:12:24,480 Speaker 2: his twenties, right, and he had seen all these horror 201 00:12:24,480 --> 00:12:28,000 Speaker 2: films where you know where that's what happens, and so 202 00:12:28,320 --> 00:12:31,000 Speaker 2: he could only conclude that that meant he was dying. 203 00:12:31,600 --> 00:12:33,480 Speaker 2: So I said, I'll be right there, and I drove 204 00:12:33,559 --> 00:12:38,640 Speaker 2: there and I walked into the room and I looked 205 00:12:38,640 --> 00:12:42,240 Speaker 2: at the scenario and it was interesting that something else 206 00:12:42,280 --> 00:12:44,040 Speaker 2: I did which was kind of interesting. There was so 207 00:12:44,120 --> 00:12:47,360 Speaker 2: much the room was so amped up, and I lifted 208 00:12:47,440 --> 00:12:50,480 Speaker 2: up the sheet, you know, so his feet were there, 209 00:12:50,760 --> 00:12:53,480 Speaker 2: and I asked the nurse. We had like around the 210 00:12:53,480 --> 00:12:54,960 Speaker 2: clock nurs as. I said to the nurse, do you 211 00:12:54,960 --> 00:12:57,920 Speaker 2: have some lotion here? And I was actually wearing was 212 00:12:57,920 --> 00:13:01,040 Speaker 2: a summer and I was wearing like jeans and flip 213 00:13:01,040 --> 00:13:03,080 Speaker 2: flops at a T shirt or something. I don't think the 214 00:13:03,240 --> 00:13:04,680 Speaker 2: nurse knew I was the doctor. 215 00:13:05,480 --> 00:13:08,080 Speaker 3: So I walked in the room and said, lift up 216 00:13:08,120 --> 00:13:10,680 Speaker 3: the thing exposing and Feeta said, do you have lotion? 217 00:13:11,040 --> 00:13:13,040 Speaker 3: And I think the nurse was so confused. So I 218 00:13:13,080 --> 00:13:16,320 Speaker 3: just squirted some lotion on his feet and I started, actually, 219 00:13:16,840 --> 00:13:19,880 Speaker 3: you know, massaging his feet because I knew he needed 220 00:13:19,920 --> 00:13:22,040 Speaker 3: to calm down, you know, so we could sort this 221 00:13:22,080 --> 00:13:23,600 Speaker 3: out because he was just petrified. 222 00:13:23,640 --> 00:13:26,560 Speaker 2: Right, So well, I'm asking questions, Well, I'm just you know, 223 00:13:26,640 --> 00:13:28,640 Speaker 2: putting this lotion on his feet and massaging his feet, 224 00:13:28,640 --> 00:13:31,240 Speaker 2: which you know, if you're you ever get a foot massage, right, 225 00:13:31,280 --> 00:13:33,719 Speaker 2: I mean, it makes your whole body just calm down, 226 00:13:33,720 --> 00:13:36,280 Speaker 2: all the tension go away. So I'm asking questions, well, 227 00:13:36,320 --> 00:13:38,560 Speaker 2: what about this and what about that? And what have 228 00:13:38,640 --> 00:13:40,719 Speaker 2: you been feeding? Have you been taking these? And I'm 229 00:13:40,720 --> 00:13:44,080 Speaker 2: asking of all the people in the room, and and 230 00:13:44,120 --> 00:13:47,040 Speaker 2: that's when they told me that they had changed the diet. 231 00:13:47,120 --> 00:13:50,280 Speaker 2: And I said, well, I said to him, listen, you 232 00:13:50,360 --> 00:13:54,880 Speaker 2: have vitamin K deficiency from your diet. That is why 233 00:13:54,920 --> 00:13:57,720 Speaker 2: you're bleeding and you're going to be fine. I sent 234 00:13:57,760 --> 00:14:01,000 Speaker 2: his mother to the pharmacy to get some Vita McKay 235 00:14:01,040 --> 00:14:03,160 Speaker 2: that I called in and prescribed you to the Via McKay. 236 00:14:03,360 --> 00:14:06,839 Speaker 2: All the bleeding stopped and he was okay for that moment. 237 00:14:07,000 --> 00:14:09,439 Speaker 2: I mean, he still had obviously cancer and cancer treating 238 00:14:09,440 --> 00:14:11,880 Speaker 2: the rabbages of it. But the point is is that 239 00:14:12,360 --> 00:14:15,719 Speaker 2: you know, a very very well meaning and well intentioned 240 00:14:16,960 --> 00:14:21,320 Speaker 2: change in things without fully discussing it, you know, resulted 241 00:14:21,360 --> 00:14:25,040 Speaker 2: in a very very scary moment for this this young man. 242 00:14:26,360 --> 00:14:31,080 Speaker 1: That's poor thing. Which is a really interesting segue because 243 00:14:32,360 --> 00:14:35,360 Speaker 1: I was going to talk to you about the fact that, like, 244 00:14:35,920 --> 00:14:39,240 Speaker 1: maybe the white coat doesn't know everything, and then I 245 00:14:39,320 --> 00:14:44,080 Speaker 1: hear that story and I'm like, maybe they do. You 246 00:14:44,120 --> 00:14:49,560 Speaker 1: know what I'm saying, like, because you do understand, you know, 247 00:14:49,960 --> 00:14:54,160 Speaker 1: drug interaction, and you do understand vitamin deficiency, and you 248 00:14:54,200 --> 00:14:56,920 Speaker 1: do understand what somebody is needing and they're feeding to 249 00:14:59,120 --> 00:15:03,040 Speaker 1: and you know, you do understand the different protocols and 250 00:15:03,080 --> 00:15:07,040 Speaker 1: how they're going to help. So it's not necessarily segue. 251 00:15:07,080 --> 00:15:10,720 Speaker 1: Isn't necessarily about that a white coach doesn't know everything, 252 00:15:10,760 --> 00:15:14,520 Speaker 1: because I think they know quite a bit. I think 253 00:15:14,640 --> 00:15:18,800 Speaker 1: it's more that it's okay, And it's what I love 254 00:15:18,840 --> 00:15:23,480 Speaker 1: about our relationship, right, is that I've never felt as 255 00:15:23,520 --> 00:15:27,840 Speaker 1: if I couldn't question something. I never looked at you 256 00:15:28,200 --> 00:15:33,920 Speaker 1: and thought I just need to accept what he's saying 257 00:15:33,960 --> 00:15:36,480 Speaker 1: to me and putting in front of me, keep my 258 00:15:36,560 --> 00:15:41,400 Speaker 1: mouth shut and do what he says. I've always engaged 259 00:15:41,440 --> 00:15:44,520 Speaker 1: with you and said like, hey, but I was just 260 00:15:44,560 --> 00:15:48,120 Speaker 1: looking at this, and there's this and this and this 261 00:15:48,200 --> 00:15:51,520 Speaker 1: and this as other additional data, and you're like, well, yes, 262 00:15:51,800 --> 00:15:54,920 Speaker 1: but that data then comes with this data like you 263 00:15:55,040 --> 00:15:56,880 Speaker 1: have to do a little bit more digging, or you 264 00:15:56,920 --> 00:16:00,400 Speaker 1: have to do this or that. I don't think enough 265 00:16:00,600 --> 00:16:07,920 Speaker 1: people have a healthy conversation with their doctor. And some doctors, 266 00:16:08,200 --> 00:16:12,120 Speaker 1: not you, but some doctors I think make a patient 267 00:16:12,360 --> 00:16:15,440 Speaker 1: feel as if they don't have the time for the questions. 268 00:16:15,800 --> 00:16:19,720 Speaker 1: But I also think that the patients don't demand the time. 269 00:16:20,320 --> 00:16:23,680 Speaker 1: And if a doctor doesn't know that you are needing 270 00:16:23,720 --> 00:16:26,280 Speaker 1: that time desperately, then he's not going to give you 271 00:16:26,280 --> 00:16:29,080 Speaker 1: that time because he's got fifty other patients to go see, right, 272 00:16:29,720 --> 00:16:37,720 Speaker 1: So that it's perfectly okay to respectfully but strongly have 273 00:16:37,760 --> 00:16:41,920 Speaker 1: a conversation and demand more time and do your own 274 00:16:41,960 --> 00:16:48,040 Speaker 1: research and push back up against an opinion, because ultimately 275 00:16:48,200 --> 00:16:51,240 Speaker 1: it is our lives and our bodies and our decision. 276 00:16:51,760 --> 00:16:54,480 Speaker 1: So we have to be comfortable with everything and have 277 00:16:54,560 --> 00:16:56,040 Speaker 1: no regrets going forward. 278 00:16:57,440 --> 00:17:01,320 Speaker 2: So when the Internet came into being, prior. 279 00:17:01,120 --> 00:17:03,000 Speaker 1: To now, everybody's a doctor. I mean, I have a 280 00:17:03,040 --> 00:17:06,719 Speaker 1: freaking degree, don't you know they? 281 00:17:07,200 --> 00:17:13,399 Speaker 2: Prior to the Internet, all medical knowledge was in medical books, 282 00:17:13,840 --> 00:17:17,919 Speaker 2: and medical books were only sold in bookstores to doctor 283 00:17:17,960 --> 00:17:21,399 Speaker 2: the medical people, so not only I think the Merks 284 00:17:21,480 --> 00:17:24,720 Speaker 2: Manual or something like that was maybe the only real 285 00:17:25,040 --> 00:17:29,320 Speaker 2: authoritative type of a book that lay people had. So 286 00:17:29,560 --> 00:17:33,400 Speaker 2: the doctor was viewed as the keeper of all medical 287 00:17:33,440 --> 00:17:37,120 Speaker 2: knowledge and there were no other vehicles. When the Internet 288 00:17:37,200 --> 00:17:42,879 Speaker 2: came into being, I remember so vividly doctors being so 289 00:17:43,000 --> 00:17:45,639 Speaker 2: inflamed because a patient would walk in with a print 290 00:17:45,680 --> 00:17:50,399 Speaker 2: out of you know, seventy five pages and instead of saying, 291 00:17:50,760 --> 00:17:54,960 Speaker 2: I have joint pains and rash, I think I have 292 00:17:56,359 --> 00:17:59,400 Speaker 2: you know what is that? What is joyt pains and rash? 293 00:17:59,400 --> 00:18:02,600 Speaker 2: Could it be lubas? Are going to be lying? They'd 294 00:18:02,640 --> 00:18:05,360 Speaker 2: walk in and PLoP down seventy five pages and say 295 00:18:05,440 --> 00:18:07,960 Speaker 2: I have a lime disease, and here's why, right when 296 00:18:08,000 --> 00:18:11,520 Speaker 2: maybe they more likely had lucas or something. Doctors were 297 00:18:11,560 --> 00:18:15,800 Speaker 2: so insulted by that they would grab the papers and 298 00:18:16,119 --> 00:18:17,800 Speaker 2: throw them in the trash in front of the patient 299 00:18:17,840 --> 00:18:20,280 Speaker 2: and say, this is what I think of the Internet 300 00:18:20,720 --> 00:18:25,000 Speaker 2: boom like that. They were just enraged. And so I 301 00:18:25,080 --> 00:18:29,159 Speaker 2: watched that going on, and I realized that I was 302 00:18:29,240 --> 00:18:33,359 Speaker 2: living through a sea change and that medical knowledge was 303 00:18:33,400 --> 00:18:36,720 Speaker 2: now going to be widely available to everyone, and people 304 00:18:36,760 --> 00:18:39,520 Speaker 2: were not looking for me to be a professor. And 305 00:18:39,560 --> 00:18:41,560 Speaker 2: you see, this is where the white coat comes in. 306 00:18:41,720 --> 00:18:46,520 Speaker 2: That white coat is symbolic of somebody being a professor 307 00:18:47,359 --> 00:18:50,440 Speaker 2: and a sign of authority. And I realized people didn't 308 00:18:50,480 --> 00:18:53,760 Speaker 2: want me to be a professor and the keeper of authority. 309 00:18:54,280 --> 00:18:57,200 Speaker 2: They wanted me they didn't want to be on my team. 310 00:18:57,760 --> 00:18:59,800 Speaker 2: They wanted me to be on their team. 311 00:19:00,160 --> 00:19:02,320 Speaker 1: That's craft what a beautiful way of saying it. 312 00:19:02,600 --> 00:19:04,240 Speaker 2: And that's when I took off my white coat. And 313 00:19:04,280 --> 00:19:07,000 Speaker 2: I've never put it back on because I think it's 314 00:19:07,080 --> 00:19:10,960 Speaker 2: too strong of a symbol of an old time role 315 00:19:11,080 --> 00:19:14,479 Speaker 2: for a doctor. And I think everybody's on their own journey, 316 00:19:14,520 --> 00:19:18,760 Speaker 2: and as long as you accept responsibility for your decisions. 317 00:19:19,320 --> 00:19:20,600 Speaker 2: I will go with you on your journey. 318 00:19:20,640 --> 00:19:20,720 Speaker 4: Now. 319 00:19:20,760 --> 00:19:22,520 Speaker 2: I'm going to try in every way I can to 320 00:19:22,600 --> 00:19:25,680 Speaker 2: talk you into what I think is the best thing 321 00:19:25,800 --> 00:19:28,199 Speaker 2: based on the data and everything I understand, and to 322 00:19:28,240 --> 00:19:30,560 Speaker 2: tell you why. But at the end of the day, 323 00:19:30,680 --> 00:19:34,040 Speaker 2: even if it's alternative or not not typical or not 324 00:19:34,160 --> 00:19:36,600 Speaker 2: the best choice, I'll go on that journey with you 325 00:19:36,640 --> 00:19:41,040 Speaker 2: as long as you understand that we're deviating. And I 326 00:19:41,080 --> 00:19:43,760 Speaker 2: think one of the reasons why you and I have 327 00:19:43,880 --> 00:19:48,520 Speaker 2: that relationship from the beginning is that I try always 328 00:19:48,520 --> 00:19:51,919 Speaker 2: when I'm telling someone about what we should do, I 329 00:19:51,960 --> 00:19:56,280 Speaker 2: try to always say, we have three options here, or 330 00:19:56,320 --> 00:20:00,560 Speaker 2: four options here, or two whatever, so that even though 331 00:20:00,560 --> 00:20:03,120 Speaker 2: I've already made up my mind based on the data 332 00:20:03,160 --> 00:20:06,199 Speaker 2: so what I think would be best, I'm presenting the 333 00:20:06,240 --> 00:20:08,960 Speaker 2: field of view of how I went through my decision 334 00:20:09,000 --> 00:20:12,240 Speaker 2: making process, and I share my decision making process with you, 335 00:20:12,320 --> 00:20:14,520 Speaker 2: as as you and I have done many times, right 336 00:20:14,600 --> 00:20:18,479 Speaker 2: to say, so, here's the four paths. I like this 337 00:20:18,480 --> 00:20:20,119 Speaker 2: one for this reason and that reason, I like this 338 00:20:20,160 --> 00:20:22,400 Speaker 2: one for that reason whatever, And then I've ruled out 339 00:20:22,440 --> 00:20:24,560 Speaker 2: these and these, and that leaves us here and between 340 00:20:24,600 --> 00:20:28,160 Speaker 2: those two one spares hair in one doesen, so let's 341 00:20:28,160 --> 00:20:31,080 Speaker 2: spare hair or whatever. How I mean, However, the situation is, 342 00:20:31,480 --> 00:20:36,720 Speaker 2: and I think that you know, people doctor strutu comes, 343 00:20:37,160 --> 00:20:39,480 Speaker 2: you know, grab the authority because it's kind of what 344 00:20:39,520 --> 00:20:41,720 Speaker 2: the job teaches you to do. But if you actually 345 00:20:41,720 --> 00:20:44,159 Speaker 2: give the authority over to the patient, they very quickly 346 00:20:44,200 --> 00:20:45,000 Speaker 2: give it back to you. 347 00:20:45,520 --> 00:20:49,320 Speaker 1: If you right, Yeah, well, because it's human nature, right, 348 00:20:49,440 --> 00:20:53,440 Speaker 1: Like human nature is to want to be in control, 349 00:20:53,480 --> 00:20:56,800 Speaker 1: and especially if you're sick, you want to feel like 350 00:20:56,840 --> 00:21:00,399 Speaker 1: you have some semblance of control. So if you're given 351 00:21:00,440 --> 00:21:04,560 Speaker 1: that control the way that you do it, you definitely 352 00:21:04,600 --> 00:21:06,680 Speaker 1: give it back because you're because then you don't need 353 00:21:06,720 --> 00:21:08,639 Speaker 1: to like fight for it exactly. 354 00:21:08,880 --> 00:21:11,000 Speaker 2: And if you ever do want to really exert it, 355 00:21:11,080 --> 00:21:14,800 Speaker 2: because in opposition to what his or her recommendation is 356 00:21:14,840 --> 00:21:17,720 Speaker 2: for you, you know that they'll glad fully give it 357 00:21:17,760 --> 00:21:20,880 Speaker 2: back to you, like you're handing it back saying, Okay, 358 00:21:21,280 --> 00:21:24,240 Speaker 2: you've proven that you can handle the authority for me. 359 00:21:24,320 --> 00:21:25,960 Speaker 2: But if I want my authority back, by the way, 360 00:21:26,000 --> 00:21:27,840 Speaker 2: it's just on loan to you, So I'm going to 361 00:21:27,920 --> 00:21:28,560 Speaker 2: take it back. 362 00:21:28,640 --> 00:21:28,880 Speaker 1: Yeah. 363 00:21:28,920 --> 00:21:31,040 Speaker 2: If I get to a different place and a different 364 00:21:31,040 --> 00:21:31,760 Speaker 2: set of decisions. 365 00:21:31,880 --> 00:21:34,400 Speaker 1: I also think that it's really unique about you as 366 00:21:34,440 --> 00:21:38,080 Speaker 1: a doctor that I really encourage the listeners too. And 367 00:21:38,119 --> 00:21:41,240 Speaker 1: it doesn't matter if you have breast cancer, any other 368 00:21:41,320 --> 00:21:43,879 Speaker 1: kind of cancer, any sort of illness, or you're just 369 00:21:44,520 --> 00:21:47,400 Speaker 1: you know, going to a general doctor. I really encourage 370 00:21:47,400 --> 00:21:50,040 Speaker 1: you to, you know, get to know your doctor. Like 371 00:21:50,600 --> 00:21:52,320 Speaker 1: doesn't mean you have to go to Italy with them, 372 00:21:52,440 --> 00:21:57,400 Speaker 1: but that might be an extreme, but you know, engage 373 00:21:57,440 --> 00:22:00,399 Speaker 1: and get to know and be very honest with your 374 00:22:00,440 --> 00:22:04,240 Speaker 1: doctor about your lifestyle and everything else because at the 375 00:22:04,320 --> 00:22:09,480 Speaker 1: end of the day, it allows more leeway in that relationship. 376 00:22:09,520 --> 00:22:14,560 Speaker 1: And for instance, the infusions that I'm currently on right like, 377 00:22:15,160 --> 00:22:19,040 Speaker 1: there came a point where I said, hey, I want 378 00:22:19,080 --> 00:22:21,840 Speaker 1: to try something. I want to try not getting the 379 00:22:21,880 --> 00:22:26,760 Speaker 1: anti nausea. I think it's prolonging my sickness. Once I 380 00:22:26,800 --> 00:22:29,600 Speaker 1: get the infusion, I don't want fourteen days of feeling 381 00:22:29,640 --> 00:22:31,520 Speaker 1: like I have to throw up for twelve days. I 382 00:22:31,560 --> 00:22:33,320 Speaker 1: just want to throw up and get it over with. 383 00:22:33,880 --> 00:22:36,760 Speaker 1: Maybe this will work, maybe it won't. And I remember 384 00:22:36,760 --> 00:22:40,080 Speaker 1: there was a nurse who was very against it. And 385 00:22:41,080 --> 00:22:45,560 Speaker 1: I waited for you, and I texted you and you 386 00:22:45,640 --> 00:22:48,320 Speaker 1: came in. I go super early in the mornings. As 387 00:22:48,359 --> 00:22:50,200 Speaker 1: you know, I'm a weirdo. I go at like six 388 00:22:50,320 --> 00:22:54,800 Speaker 1: thirty seven o'clock in the morning, and you, you know, 389 00:22:55,640 --> 00:22:58,879 Speaker 1: looked at me and said, if that's but you know 390 00:22:59,040 --> 00:23:01,840 Speaker 1: me now, And that's the difference is that we now 391 00:23:02,040 --> 00:23:03,880 Speaker 1: know each other and we have a shorthand. 392 00:23:04,480 --> 00:23:06,920 Speaker 2: And you know that I know that you know your 393 00:23:06,920 --> 00:23:09,000 Speaker 2: body like no one else. I've seen it over and 394 00:23:09,000 --> 00:23:10,960 Speaker 2: over again. Well, I mean that's true of everybody, but 395 00:23:11,680 --> 00:23:14,760 Speaker 2: you're like a you know, savant in that regard, and 396 00:23:14,960 --> 00:23:17,680 Speaker 2: what you're wanting to do is completely anathetical. Like there's 397 00:23:18,200 --> 00:23:21,560 Speaker 2: no reason to think taking a three day and a 398 00:23:21,640 --> 00:23:27,040 Speaker 2: nausea injection is like prolonging the nausea. I mean, just 399 00:23:27,080 --> 00:23:31,600 Speaker 2: like antithetical to traditional medical thinking. But I've seen time 400 00:23:31,640 --> 00:23:34,359 Speaker 2: and time again you have weird reactions to medicines, and 401 00:23:34,400 --> 00:23:36,440 Speaker 2: you figure it out for your own body, and when 402 00:23:36,440 --> 00:23:39,200 Speaker 2: we do it, it works out. I'm like, that's again, Well, 403 00:23:39,200 --> 00:23:42,760 Speaker 2: like I said to the nurse, she will take responsibility 404 00:23:42,760 --> 00:23:45,080 Speaker 2: for this decision if it doesn't work out, Well, there's 405 00:23:45,119 --> 00:23:46,919 Speaker 2: no there's no reason to hear. 406 00:23:47,600 --> 00:23:49,919 Speaker 1: If you get very sick, you just have to like 407 00:23:50,000 --> 00:23:51,639 Speaker 1: you have to come in We're going to have to 408 00:23:51,640 --> 00:23:53,720 Speaker 1: get you in my d drip, like you have to 409 00:23:53,760 --> 00:23:56,840 Speaker 1: stay hydrated. And I remember I called you and I 410 00:23:56,880 --> 00:23:59,520 Speaker 1: was like, uh, I think it's working, Like I'm not 411 00:23:59,800 --> 00:24:01,440 Speaker 1: as sick for as long. 412 00:24:01,680 --> 00:24:03,879 Speaker 2: But we took we tried all different anti nausous, we 413 00:24:03,920 --> 00:24:07,880 Speaker 2: tried steroids, we tried to check every everything. Yeah, and 414 00:24:07,880 --> 00:24:11,359 Speaker 2: and and so why not because you have this instinct 415 00:24:11,560 --> 00:24:13,560 Speaker 2: and you were right and most people know they But 416 00:24:13,720 --> 00:24:15,600 Speaker 2: it's the same thing I always laugh about. You know, 417 00:24:15,600 --> 00:24:17,720 Speaker 2: when patients I'll always have to get their blood drawn 418 00:24:18,080 --> 00:24:23,399 Speaker 2: before the doctor's appointment, and some phlebotomists will insist that 419 00:24:23,440 --> 00:24:25,600 Speaker 2: they're going to draw somewhere because it's the best vein, 420 00:24:25,600 --> 00:24:28,480 Speaker 2: and the patient will say that vein doesn't work. I'm 421 00:24:28,520 --> 00:24:30,560 Speaker 2: telling you that vein doesn't work. You need to go 422 00:24:30,640 --> 00:24:33,760 Speaker 2: over here, and they won't listen to them because it's 423 00:24:33,800 --> 00:24:37,240 Speaker 2: like I'm the phullbottomist and I know the right veins whatever, 424 00:24:37,600 --> 00:24:40,520 Speaker 2: and listen. If a patient demonstrably tells you where to 425 00:24:40,560 --> 00:24:55,200 Speaker 2: draw their blood, do it because they know their body. 426 00:24:56,720 --> 00:25:00,800 Speaker 1: This is a tough one, Okay. When you try patients 427 00:25:00,840 --> 00:25:03,720 Speaker 1: for years, does it take a toll on you when 428 00:25:03,720 --> 00:25:06,840 Speaker 1: you lose them. The second part is or are you 429 00:25:06,960 --> 00:25:09,520 Speaker 1: able to stay detached? And I know that that's a 430 00:25:09,640 --> 00:25:10,800 Speaker 1: no from you. 431 00:25:11,880 --> 00:25:12,080 Speaker 4: Right. 432 00:25:12,359 --> 00:25:16,119 Speaker 2: So the thing about this topic that I feel so 433 00:25:16,160 --> 00:25:21,000 Speaker 2: strongly about is that I have an obligation to bring 434 00:25:21,040 --> 00:25:26,040 Speaker 2: the best knowledge, the best individualized thinking, the best strategic thinking, 435 00:25:27,640 --> 00:25:30,879 Speaker 2: and all the best resources anywhere in the world to 436 00:25:31,000 --> 00:25:37,159 Speaker 2: a patient's journey of healthcare, cancer treatment. But at the 437 00:25:37,240 --> 00:25:40,760 Speaker 2: end of the day, their outcome is encoded in the universe, 438 00:25:41,720 --> 00:25:45,000 Speaker 2: and so my job, above all else is to make 439 00:25:45,040 --> 00:25:48,840 Speaker 2: sure that they have a journey that's closest to the 440 00:25:48,920 --> 00:25:51,360 Speaker 2: journey they want to have, as close as I can 441 00:25:51,440 --> 00:25:56,280 Speaker 2: make it. And that is where I derive my sense 442 00:25:56,320 --> 00:25:59,960 Speaker 2: of gratitude and sense of joy from, is making sure 443 00:26:00,119 --> 00:26:02,520 Speaker 2: or that as we go along that journey, after having 444 00:26:02,560 --> 00:26:04,720 Speaker 2: brought all the best resources and the best you're thinking 445 00:26:04,760 --> 00:26:07,360 Speaker 2: and all that. But you know, that's just the basic 446 00:26:07,560 --> 00:26:11,600 Speaker 2: program to me, that I can make the experience as 447 00:26:11,720 --> 00:26:14,879 Speaker 2: much what they want it to be as possible. And 448 00:26:14,920 --> 00:26:21,120 Speaker 2: that includes the dying process. You know, you enter alone 449 00:26:21,119 --> 00:26:25,600 Speaker 2: and you leave alone. You can't really help someone enter well, 450 00:26:25,640 --> 00:26:29,439 Speaker 2: you can just try to catch them, but you can 451 00:26:29,600 --> 00:26:33,480 Speaker 2: help someone fly away well. And everyone has very different 452 00:26:33,560 --> 00:26:37,679 Speaker 2: ideas about what that process should be for them. But 453 00:26:37,800 --> 00:26:39,600 Speaker 2: as a doctor, I think the most important thing is 454 00:26:39,640 --> 00:26:42,359 Speaker 2: to listen to them and talk about it and try 455 00:26:42,359 --> 00:26:45,040 Speaker 2: to even make that part of their journey. You know, 456 00:26:45,400 --> 00:26:48,560 Speaker 2: if you think about the most vulnerable position that there 457 00:26:48,680 --> 00:26:51,040 Speaker 2: is in the world is when you're flying away and 458 00:26:51,119 --> 00:26:53,560 Speaker 2: if you don't have people around you who will listen 459 00:26:53,600 --> 00:26:56,919 Speaker 2: to you and try to help you make it the 460 00:26:56,920 --> 00:27:00,760 Speaker 2: way you want it to be. But a terrible, terrible 461 00:27:00,880 --> 00:27:06,879 Speaker 2: tragedy and closure that is so I am thrilled that 462 00:27:07,080 --> 00:27:10,160 Speaker 2: I've been able to treat people who've gotten care from diseases. 463 00:27:10,200 --> 00:27:12,639 Speaker 2: I'm thrilled that I've been able to develop medicines that 464 00:27:13,359 --> 00:27:17,240 Speaker 2: have cured some people and very much you know, prolonged 465 00:27:17,280 --> 00:27:22,560 Speaker 2: the lives of other people. But I'm equally honored to 466 00:27:22,640 --> 00:27:26,600 Speaker 2: have helped people die well, because it's one of the 467 00:27:26,640 --> 00:27:28,840 Speaker 2: most intimate things you can do in life as a doctor. 468 00:27:30,240 --> 00:27:34,120 Speaker 1: And in all your years of treating patients and being 469 00:27:34,160 --> 00:27:39,879 Speaker 1: in the medical world, have you ever witnessed like a 470 00:27:39,920 --> 00:27:40,640 Speaker 1: true miracle? 471 00:27:41,560 --> 00:27:45,359 Speaker 2: Well, you know, that's a funny word. I certainly have 472 00:27:45,480 --> 00:27:51,840 Speaker 2: seen people have responses that exceed anything you could see. Yeah, 473 00:27:52,040 --> 00:27:55,680 Speaker 2: they seem miraculous. And I'm a big you know, I 474 00:27:57,320 --> 00:28:00,520 Speaker 2: have a big spiritual presence as a person, you know, 475 00:28:00,640 --> 00:28:03,359 Speaker 2: like I really very much, you know, part of me 476 00:28:03,480 --> 00:28:07,840 Speaker 2: lives in that kind of spiritual existence. So I don't know. 477 00:28:07,920 --> 00:28:10,120 Speaker 2: I mean, it's a complicated word for me, because when 478 00:28:10,119 --> 00:28:14,160 Speaker 2: I think of miracle, I almost think of like somebody somewhere, 479 00:28:14,480 --> 00:28:17,879 Speaker 2: you know, waving a wand and making magic and making 480 00:28:17,920 --> 00:28:22,560 Speaker 2: something happen, you know. And I don't understand like what 481 00:28:22,600 --> 00:28:27,000 Speaker 2: it looks like behind the behind the curtain, you know, 482 00:28:27,280 --> 00:28:30,560 Speaker 2: of miracle making. So I don't know if things are 483 00:28:30,600 --> 00:28:34,520 Speaker 2: really miracles. But I do know that I've seen unexpected results. 484 00:28:35,080 --> 00:28:38,440 Speaker 2: I do know that a person harnessing their spiritual and 485 00:28:38,560 --> 00:28:42,920 Speaker 2: creative and loving energy can change the course of disease, 486 00:28:44,080 --> 00:28:47,520 Speaker 2: and people living in a dark and negative and uh 487 00:28:47,840 --> 00:28:50,720 Speaker 2: you know, critical and unhappy place can change the course 488 00:28:50,720 --> 00:28:54,040 Speaker 2: of disease. So I do believe that there are factors 489 00:28:54,080 --> 00:28:58,560 Speaker 2: beyond our control, and whether they're all biologic and physiologic 490 00:28:58,800 --> 00:29:01,840 Speaker 2: or where some of them are all so universe and spiritual, 491 00:29:02,120 --> 00:29:05,040 Speaker 2: I personally believe very much in an order of the universe, 492 00:29:05,040 --> 00:29:09,000 Speaker 2: and I believe that the universe, you know, that we 493 00:29:09,120 --> 00:29:15,520 Speaker 2: are mindful people, and sometimes we allow our mindfulness to 494 00:29:16,680 --> 00:29:19,920 Speaker 2: think that we know best for ourselves. But I'm quite 495 00:29:19,920 --> 00:29:21,840 Speaker 2: well aware that there seems to be an order in 496 00:29:21,880 --> 00:29:24,640 Speaker 2: the universe, and if you turn yourself over to the 497 00:29:24,800 --> 00:29:27,680 Speaker 2: order in the universe, you often wind up in a 498 00:29:27,720 --> 00:29:31,280 Speaker 2: way better place than you would have had you continue 499 00:29:31,320 --> 00:29:35,080 Speaker 2: to plow forward your own, you know, limited thinking about 500 00:29:35,080 --> 00:29:38,080 Speaker 2: where you belong. And so I try to always, you know, 501 00:29:38,440 --> 00:29:40,680 Speaker 2: turn my will over to the universe and follow the 502 00:29:40,680 --> 00:29:43,840 Speaker 2: clues to get to the place where I think maybe 503 00:29:43,840 --> 00:29:46,760 Speaker 2: I'm supposed to belong. And I try to always you know, 504 00:29:46,840 --> 00:29:49,280 Speaker 2: help patients, you know, on that same journey too. 505 00:29:50,080 --> 00:29:53,200 Speaker 1: So with all the money pouring into cancer research, why 506 00:29:53,360 --> 00:29:57,440 Speaker 1: is chemotherapy and actually is it still to go to 507 00:29:57,600 --> 00:30:02,640 Speaker 1: treatment when it causes you know, obviously a lot of weakness, 508 00:30:02,720 --> 00:30:04,520 Speaker 1: a lot of pain, a lot of side effects. 509 00:30:05,000 --> 00:30:10,920 Speaker 2: Well, chemotherapy is largely derived from natural sources like the 510 00:30:11,000 --> 00:30:13,920 Speaker 2: taxanes or other sorts of things, and some were chemically 511 00:30:13,960 --> 00:30:18,680 Speaker 2: modified and some were synthesized, but they were all focused 512 00:30:18,720 --> 00:30:23,760 Speaker 2: on kind of interfering with DNA or other critical pathways 513 00:30:23,800 --> 00:30:27,400 Speaker 2: to make a cell die, and in fact they're very 514 00:30:27,440 --> 00:30:31,600 Speaker 2: effective at doing that. But the necessary side effect is 515 00:30:31,600 --> 00:30:35,120 Speaker 2: that other cells that are dividing can also de that 516 00:30:35,200 --> 00:30:37,720 Speaker 2: causes the side effects. Right. So the side effects are 517 00:30:37,760 --> 00:30:39,880 Speaker 2: caused by like a lot of times when people get 518 00:30:39,880 --> 00:30:44,640 Speaker 2: mouth sores and ulcers or diarrhea, rectal pain, that sort 519 00:30:44,640 --> 00:30:47,040 Speaker 2: of thing, it's because the mucosa lining of the bowel 520 00:30:47,120 --> 00:30:50,480 Speaker 2: are cells that are always turning over, so they die 521 00:30:50,520 --> 00:30:54,920 Speaker 2: more readily in response to chemotherapy. In fact, we've had 522 00:30:55,160 --> 00:31:01,520 Speaker 2: an amazing you know revolution in two areas treatments, So 523 00:31:01,640 --> 00:31:06,040 Speaker 2: in sequencing the human genome and identifying you know, mutations 524 00:31:06,080 --> 00:31:09,000 Speaker 2: that are existing in cancers and then identifying drugs that 525 00:31:09,440 --> 00:31:13,760 Speaker 2: affect those mutations. That's been miraculous at creating a non 526 00:31:13,840 --> 00:31:21,040 Speaker 2: chemotherapy pathway. And immunotherapy has been an unbelievable breakthrough with 527 00:31:21,200 --> 00:31:24,640 Speaker 2: drugs that you know, allow the immune system to see 528 00:31:24,680 --> 00:31:27,840 Speaker 2: cancers in the way they were overlooking them before and 529 00:31:27,920 --> 00:31:31,680 Speaker 2: now can actually kill them and clean them up. And 530 00:31:31,720 --> 00:31:34,720 Speaker 2: they all have their other different side effects because you know, 531 00:31:34,760 --> 00:31:37,160 Speaker 2: you can't you can't rev up the immune system to 532 00:31:37,400 --> 00:31:41,640 Speaker 2: cancer cells without expecting that they might actually attack some 533 00:31:41,680 --> 00:31:44,840 Speaker 2: other cells too, right, some of your good cells exactly, 534 00:31:45,000 --> 00:31:47,320 Speaker 2: And it's so they're different side effects and chemotherapy with 535 00:31:47,360 --> 00:31:49,640 Speaker 2: the side effects on the left. So whenever we're going 536 00:31:49,680 --> 00:31:52,600 Speaker 2: to be manipulating with physiologic processes, we're going to get 537 00:31:52,640 --> 00:31:57,080 Speaker 2: side effects. They're even vaccines now, you know, for cancer. 538 00:31:57,160 --> 00:31:58,880 Speaker 2: And what was interesting to me is when one of 539 00:31:58,880 --> 00:32:04,160 Speaker 2: the first vaccines that ever showed benefit to advance cancer patients, 540 00:32:04,160 --> 00:32:09,800 Speaker 2: which is called provenge for or prostate cancer. It was 541 00:32:10,360 --> 00:32:12,600 Speaker 2: interesting how little all anybody ever said was why don't 542 00:32:12,600 --> 00:32:14,920 Speaker 2: we have a vaccine for cancer? And then the vaccine 543 00:32:14,960 --> 00:32:18,000 Speaker 2: was developed, and how low the adoption rate was of 544 00:32:18,040 --> 00:32:21,160 Speaker 2: it for a whole variety of reasons that are probably 545 00:32:21,200 --> 00:32:25,040 Speaker 2: beyond the scope of this discussion. But there are many 546 00:32:25,120 --> 00:32:29,440 Speaker 2: different lanes. There are huge breakthroughs, and you know, and 547 00:32:29,560 --> 00:32:33,160 Speaker 2: cancer has become a chronic illness. You know, it used 548 00:32:33,200 --> 00:32:35,840 Speaker 2: to be you know, pretty much your cured or it's 549 00:32:35,840 --> 00:32:38,520 Speaker 2: a fatal illness in a fairly short period of time. 550 00:32:38,960 --> 00:32:43,000 Speaker 2: And now people can live for years and years and 551 00:32:43,040 --> 00:32:48,240 Speaker 2: sometimes decades with low grade cancer being manipulated from time 552 00:32:48,280 --> 00:32:53,000 Speaker 2: to time with various pills or infusions. 553 00:32:52,600 --> 00:32:54,600 Speaker 1: And immuno therapy. Like I know that you and I 554 00:32:54,600 --> 00:32:58,400 Speaker 1: have discussed im therapy a lot. I always really liked 555 00:32:58,440 --> 00:33:00,440 Speaker 1: the idea because sort of the way that I looked 556 00:33:00,480 --> 00:33:03,480 Speaker 1: at it was, you know, it was it was basically 557 00:33:03,520 --> 00:33:07,680 Speaker 1: like the Navy seals of cells going in and like 558 00:33:08,080 --> 00:33:12,040 Speaker 1: just you know, killing all the the bad cells. But yes, 559 00:33:12,120 --> 00:33:15,160 Speaker 1: they do sometimes knock off, you know, some other really 560 00:33:15,160 --> 00:33:17,840 Speaker 1: good cells, someone like me. 561 00:33:18,640 --> 00:33:23,600 Speaker 2: Your particular set of characteristics a breast cancer doesn't respond 562 00:33:23,720 --> 00:33:28,720 Speaker 2: very well to immunotherapy, and then your particular markers. Beyond that, 563 00:33:28,800 --> 00:33:32,240 Speaker 2: there are specifically markers that tell you if your cancer 564 00:33:32,400 --> 00:33:34,400 Speaker 2: might be likely to be susceptible. So even if you 565 00:33:34,440 --> 00:33:38,320 Speaker 2: have a cancer that's not that susceptible, if you show 566 00:33:38,440 --> 00:33:42,080 Speaker 2: these immune markers that say it would be susceptible, then 567 00:33:42,280 --> 00:33:45,040 Speaker 2: there might still be a chance. But your immune markers 568 00:33:45,200 --> 00:33:48,360 Speaker 2: are even say your tumber wouldn't respond. Now that doesn't 569 00:33:48,360 --> 00:33:53,239 Speaker 2: mean that with you know, other immunological advances that are 570 00:33:53,240 --> 00:33:55,720 Speaker 2: coming down the lane, that's not an option. But that's 571 00:33:55,720 --> 00:33:59,400 Speaker 2: not an option because there are some situations where cancers 572 00:33:59,440 --> 00:34:01,520 Speaker 2: respond and when they have the markers that say they 573 00:34:01,520 --> 00:34:06,160 Speaker 2: won't respond, and combinations sometimes work. So there's more stuff 574 00:34:06,160 --> 00:34:10,719 Speaker 2: coming every single day there there we're understanding new ways 575 00:34:10,800 --> 00:34:15,359 Speaker 2: to use these genetic defects and molecular markers, and every 576 00:34:15,400 --> 00:34:18,280 Speaker 2: single day we're learning how to manipulate the immune system more. 577 00:34:18,760 --> 00:34:22,120 Speaker 2: And there's these certain kind of immune system where we 578 00:34:22,360 --> 00:34:25,279 Speaker 2: take T cells out and T cells out of your 579 00:34:25,320 --> 00:34:29,319 Speaker 2: body immune cells, and we in the laboratory make them 580 00:34:29,480 --> 00:34:32,200 Speaker 2: into warriors against your cancer and then fuse them back 581 00:34:32,239 --> 00:34:37,279 Speaker 2: into you called you know, TILL cells, and there are 582 00:34:37,320 --> 00:34:40,480 Speaker 2: other version of car T cells and all that. There's 583 00:34:40,520 --> 00:34:42,160 Speaker 2: just a huge amount of research going on with that, 584 00:34:42,200 --> 00:34:44,800 Speaker 2: and they're quite miraculous treatments in some cases and in 585 00:34:45,000 --> 00:34:48,680 Speaker 2: other cases not. But we're learning how to empower them 586 00:34:48,719 --> 00:34:51,400 Speaker 2: differently so that maybe in the cases where they're not effective, 587 00:34:51,440 --> 00:34:54,360 Speaker 2: they will become so. And so that whole, that whole 588 00:34:54,480 --> 00:34:59,160 Speaker 2: field I think is really really important. And if someone 589 00:34:59,160 --> 00:35:02,000 Speaker 2: can live long we're in a in a remission or 590 00:35:02,040 --> 00:35:04,080 Speaker 2: a partial mission for a period of time, that may 591 00:35:04,080 --> 00:35:06,440 Speaker 2: be something that you know, really comes to roosts for 592 00:35:06,480 --> 00:35:10,640 Speaker 2: their particular situation that isn't available today. And then you know, 593 00:35:10,719 --> 00:35:13,320 Speaker 2: tons of these, like I said, molecular markers. And even 594 00:35:13,480 --> 00:35:16,520 Speaker 2: as we talked about earlier in your case, we you know, 595 00:35:16,600 --> 00:35:20,439 Speaker 2: we didn't think of her to express her. We didn't 596 00:35:20,480 --> 00:35:23,640 Speaker 2: really think that much about that category as being anything important. 597 00:35:23,719 --> 00:35:26,640 Speaker 2: But it turns out her to expressors respond to the 598 00:35:27,120 --> 00:35:30,360 Speaker 2: drug addibody con you get this targeted her too. So 599 00:35:31,000 --> 00:35:35,040 Speaker 2: and we had unbelievable results with your situation, and you know, 600 00:35:35,160 --> 00:35:38,040 Speaker 2: to to talk about what you were mentioning earlier about 601 00:35:38,040 --> 00:35:40,920 Speaker 2: our decision to stick with it. You know, the situation 602 00:35:41,200 --> 00:35:44,719 Speaker 2: was that we you know, we had cancer in some 603 00:35:44,880 --> 00:35:48,760 Speaker 2: critical places that if it were to get out of hand, 604 00:35:49,960 --> 00:35:53,239 Speaker 2: it could cause us to lose precious time. Then we 605 00:35:53,320 --> 00:35:56,799 Speaker 2: might not regain in terms of because when cancer is 606 00:35:56,800 --> 00:35:59,920 Speaker 2: growing in an organ, it can cause that organ to dysfunction, 607 00:36:00,640 --> 00:36:03,759 Speaker 2: and if that organ dysfunctions, they could be game over. 608 00:36:04,120 --> 00:36:07,080 Speaker 2: And so you're always at this juncture where is the 609 00:36:07,120 --> 00:36:10,120 Speaker 2: amount of cancer in that organ such that if we 610 00:36:10,280 --> 00:36:15,279 Speaker 2: keep going on this when we're not sure if it's working, 611 00:36:15,560 --> 00:36:19,120 Speaker 2: we're taking we're hoping that it's stable, like we're seeing 612 00:36:19,160 --> 00:36:22,680 Speaker 2: the same amount of disease because we stopped it into 613 00:36:22,680 --> 00:36:25,799 Speaker 2: stability and now we're going to turn around into response. 614 00:36:26,160 --> 00:36:28,440 Speaker 2: But there's also the possibility that was like a brief 615 00:36:28,560 --> 00:36:30,719 Speaker 2: pause and it's going to keep growing, and then if 616 00:36:30,719 --> 00:36:32,719 Speaker 2: it keeps growing, are we going to get to that 617 00:36:32,800 --> 00:36:35,680 Speaker 2: place where the tumor burdens so great that the organ 618 00:36:35,760 --> 00:36:39,239 Speaker 2: dysfunctions and then we lose precious time or we're out 619 00:36:39,239 --> 00:36:41,839 Speaker 2: of the game. And that's where we were talking about 620 00:36:41,880 --> 00:36:44,640 Speaker 2: a little bit to some extent, not exactly that situation, 621 00:36:44,760 --> 00:36:47,719 Speaker 2: but somewhat that situation. We were talking earlier about whether 622 00:36:47,840 --> 00:36:51,440 Speaker 2: to stick with this treatment, and we had scans that 623 00:36:51,480 --> 00:36:54,680 Speaker 2: were showing us not as much response as we would 624 00:36:54,680 --> 00:36:57,640 Speaker 2: have expected. By that time. You were having a lot 625 00:36:57,640 --> 00:37:00,560 Speaker 2: of side effects, but yet the tumor markers were going down, 626 00:37:01,160 --> 00:37:04,520 Speaker 2: and so we said, look, we're going to assume that 627 00:37:04,560 --> 00:37:07,520 Speaker 2: the tumor markers are telling us the story and the 628 00:37:07,560 --> 00:37:10,439 Speaker 2: scans are lagging. And we turned out to be right. 629 00:37:10,960 --> 00:37:13,640 Speaker 2: But we also had that challenge too, and are we 630 00:37:13,680 --> 00:37:17,880 Speaker 2: getting enough brain penetration that it's really going to work 631 00:37:18,080 --> 00:37:19,160 Speaker 2: there as well? 632 00:37:19,239 --> 00:37:19,479 Speaker 1: Right? 633 00:37:19,600 --> 00:37:23,319 Speaker 2: And that was really the more most concerning part to me, 634 00:37:23,600 --> 00:37:28,200 Speaker 2: is that is that that scenario, like a little something 635 00:37:28,239 --> 00:37:30,359 Speaker 2: showed up there and so we're like, does that mean 636 00:37:30,400 --> 00:37:34,680 Speaker 2: it's failing? And it turns out no, it was. It 637 00:37:34,719 --> 00:37:37,400 Speaker 2: was ultimately responded just a. 638 00:37:37,400 --> 00:37:38,279 Speaker 1: Little bit more time. 639 00:37:38,440 --> 00:37:52,960 Speaker 4: Yeah, are you hopeful for a cure? 640 00:37:53,880 --> 00:37:58,600 Speaker 1: And if so, at like how far out? I mean? 641 00:37:58,640 --> 00:38:02,239 Speaker 1: There are new amounts of different cancers right there. There 642 00:38:02,239 --> 00:38:06,239 Speaker 1: are there are vaccines for some that you mentioned, there 643 00:38:06,280 --> 00:38:08,080 Speaker 1: are kind of cures for. 644 00:38:08,080 --> 00:38:12,120 Speaker 2: Some, they're definitely cures. Podgkin's disease is very careable, right. 645 00:38:12,800 --> 00:38:16,040 Speaker 1: So the ones that are you know, extremely tough to 646 00:38:16,120 --> 00:38:18,680 Speaker 1: cure lung cancer for instance. 647 00:38:18,400 --> 00:38:21,560 Speaker 2: Right listen, melanoma just the answer to your question, my 648 00:38:21,640 --> 00:38:25,759 Speaker 2: hopeful of a cure absolutely, I mean it would be. Yeah, 649 00:38:26,400 --> 00:38:28,120 Speaker 2: you know, this is be a challenging business if you 650 00:38:28,160 --> 00:38:31,840 Speaker 2: didn't have optimism. But you know, we're the ANSWER's Clinic 651 00:38:31,920 --> 00:38:35,080 Speaker 2: is a you know, it's a very renowned center for 652 00:38:35,320 --> 00:38:39,759 Speaker 2: many things, but chief among them melanoma and immunotherapy, and 653 00:38:40,080 --> 00:38:43,680 Speaker 2: and us having played us instantial role in the opening 654 00:38:43,719 --> 00:38:47,840 Speaker 2: and beginning of the field of immunotherapy. And there's a 655 00:38:47,880 --> 00:38:53,000 Speaker 2: time period when when stage four melanoma was a universal death, 656 00:38:54,040 --> 00:38:58,760 Speaker 2: nothing more than that, right and just and and stage 657 00:38:58,760 --> 00:39:02,640 Speaker 2: four melanoma people can be of all the disease disappear 658 00:39:02,800 --> 00:39:06,279 Speaker 2: and live for years, maybe being cured. I don't know, 659 00:39:06,760 --> 00:39:09,080 Speaker 2: you know, if they're cured or if we just reduce 660 00:39:09,160 --> 00:39:11,480 Speaker 2: the cells downs at such a low level and harnessed 661 00:39:11,480 --> 00:39:13,920 Speaker 2: the immune system and whatever that they never come out again. 662 00:39:14,160 --> 00:39:16,120 Speaker 2: But the point is is they can now live their 663 00:39:17,280 --> 00:39:19,799 Speaker 2: whole and tiple life in some ways. And I mean 664 00:39:19,840 --> 00:39:22,680 Speaker 2: that's we never thought that we would see that in 665 00:39:22,760 --> 00:39:25,759 Speaker 2: a disease I don't know. I mean, like twenty years 666 00:39:25,800 --> 00:39:28,680 Speaker 2: ago in melanoma or three years ago melano doctors would say, 667 00:39:29,440 --> 00:39:32,520 Speaker 2: you know, like what's your favorite place in the world, Oh, Hawaiira, 668 00:39:32,719 --> 00:39:35,120 Speaker 2: you should go there. You should go there, get your 669 00:39:35,120 --> 00:39:37,799 Speaker 2: will set up before you go that. They literally said 670 00:39:37,840 --> 00:39:39,680 Speaker 2: that to people with this kind of melanoma. And now 671 00:39:39,719 --> 00:39:43,239 Speaker 2: people even with brain metastaites in melanoma, are you know, 672 00:39:43,520 --> 00:39:46,800 Speaker 2: completely disease free for decades and therefore, you know, perhaps 673 00:39:46,800 --> 00:39:50,000 Speaker 2: the cured. We're always you know, as a doctor, you 674 00:39:50,040 --> 00:39:52,319 Speaker 2: don't want to hold out false hope, and so we're 675 00:39:52,320 --> 00:39:56,920 Speaker 2: always hesitant to say that cure word, you know, in 676 00:39:56,920 --> 00:40:00,600 Speaker 2: some situations, just because we don't want to be leading. 677 00:40:00,760 --> 00:40:02,960 Speaker 2: But we are eternally hopeful. 678 00:40:05,640 --> 00:40:08,319 Speaker 1: So we know that. Obviously, we just discussed that not 679 00:40:08,400 --> 00:40:11,839 Speaker 1: all cancers are curable, but early detection is always the 680 00:40:11,880 --> 00:40:15,439 Speaker 1: best chance you have. Is there a test that you 681 00:40:15,560 --> 00:40:19,840 Speaker 1: recommend that it's comprehensive, and obviously that depends on the 682 00:40:19,960 --> 00:40:22,560 Speaker 1: kind of cancer that you have, like for women breast cancer, 683 00:40:22,600 --> 00:40:26,040 Speaker 1: I'm assuming it's a mammogram, right, it's the first place 684 00:40:26,080 --> 00:40:29,920 Speaker 1: you start, right. What about for you know, other forms 685 00:40:29,920 --> 00:40:30,840 Speaker 1: of cancer. 686 00:40:30,640 --> 00:40:34,960 Speaker 2: Well, if you're a smoker, there's something called the screening 687 00:40:35,040 --> 00:40:37,759 Speaker 2: lung CETA and those that have been shown to be 688 00:40:37,840 --> 00:40:41,600 Speaker 2: effective in picking up early cancers. So that's if you're 689 00:40:41,600 --> 00:40:44,839 Speaker 2: a non smoker, it's all more difficult because routine chest 690 00:40:44,960 --> 00:40:48,560 Speaker 2: X rays don't necessarily show much benefit. 691 00:40:48,960 --> 00:40:50,880 Speaker 1: And what about like prostate cancer. 692 00:40:51,400 --> 00:40:53,480 Speaker 2: Prostate cancer, we have the p S a test and 693 00:40:53,600 --> 00:40:56,520 Speaker 2: blood and it's a very sensitive test, and when that 694 00:40:56,600 --> 00:40:59,200 Speaker 2: shows an increase, then people are able to get an 695 00:40:59,280 --> 00:41:02,400 Speaker 2: MRI of the I think having you know, regular doctor 696 00:41:02,480 --> 00:41:06,000 Speaker 2: visits and getting there's a whole kind of template of 697 00:41:06,040 --> 00:41:11,319 Speaker 2: screening tests. You know, depending on your gender and both 698 00:41:11,360 --> 00:41:14,319 Speaker 2: your signed gender at birth and your acquired gender and 699 00:41:14,400 --> 00:41:17,960 Speaker 2: all of those you know, different things. It's there's a 700 00:41:18,000 --> 00:41:23,000 Speaker 2: whole set of things that you can do from screening 701 00:41:23,040 --> 00:41:28,040 Speaker 2: cts and PAP smears and HPV tests. I think one 702 00:41:28,040 --> 00:41:30,080 Speaker 2: of the biggest preventative things people should be doing is 703 00:41:30,080 --> 00:41:33,320 Speaker 2: getting HPV vaccinated if you're not. I mean, the HPV 704 00:41:33,480 --> 00:41:36,560 Speaker 2: virus accounts for five percent of all the cancers in 705 00:41:36,600 --> 00:41:40,919 Speaker 2: the world cervical cancer and women anal cancer, and men 706 00:41:40,960 --> 00:41:44,560 Speaker 2: and women mouth cancer and men and women penal cancer, 707 00:41:44,640 --> 00:41:47,680 Speaker 2: and men five percent of all the cancers in the 708 00:41:47,719 --> 00:41:50,560 Speaker 2: world caused by a virus infection. That if you get 709 00:41:50,840 --> 00:41:55,680 Speaker 2: vaccinated against the most common causing, most common cancer causing strains, 710 00:41:56,200 --> 00:42:01,160 Speaker 2: you can prevent that, right, So that's incredibly you know important, 711 00:42:01,680 --> 00:42:05,120 Speaker 2: you know, prevention item, I think, and in terms of 712 00:42:05,160 --> 00:42:09,200 Speaker 2: overall prevention, I think, you know, achieving your ideal body 713 00:42:09,239 --> 00:42:12,399 Speaker 2: weight is incredibly important because you know, body fat creates 714 00:42:12,400 --> 00:42:18,520 Speaker 2: an inflammatory state that contributes to heart disease, diabetes, and cancer. So, 715 00:42:19,360 --> 00:42:21,880 Speaker 2: you know, a lot of people like to focus on 716 00:42:21,960 --> 00:42:25,480 Speaker 2: dietary composition and I love that and it's important, but 717 00:42:25,520 --> 00:42:29,080 Speaker 2: the truth is, dietary composition it's not that important. If 718 00:42:29,120 --> 00:42:30,920 Speaker 2: you have way too much body fat, I mean, get 719 00:42:30,960 --> 00:42:33,480 Speaker 2: your body fat down because that's going to control the 720 00:42:33,480 --> 00:42:37,320 Speaker 2: inflammatory condition. And then at that point then the value 721 00:42:37,400 --> 00:42:40,839 Speaker 2: of your dietary composition becomes super important, right because you've 722 00:42:40,840 --> 00:42:44,360 Speaker 2: eliminated that inflammatory thing. If you have this massive obesity 723 00:42:44,400 --> 00:42:48,399 Speaker 2: inflammatory state, it almost doesn't matter how much kal you eat, 724 00:42:48,600 --> 00:42:52,319 Speaker 2: you've got this inflammatory state that's totally pro cancer all 725 00:42:52,400 --> 00:42:57,320 Speaker 2: the time, so that exercise seems to have an independent protective, 726 00:42:58,160 --> 00:43:01,480 Speaker 2: you know component, separate from just it's a weight loss component. 727 00:43:01,560 --> 00:43:03,960 Speaker 2: So I'd say, you know, exercise regularly. Look, we were 728 00:43:04,000 --> 00:43:06,360 Speaker 2: meant to move, We were meant to move, and it 729 00:43:06,440 --> 00:43:11,200 Speaker 2: changes that whole physiological structure. And then there are various 730 00:43:11,280 --> 00:43:15,400 Speaker 2: anti inflammatory things that you can take and do you 731 00:43:15,440 --> 00:43:19,359 Speaker 2: know from you know, turmeric, baby aspirin if you don't 732 00:43:19,400 --> 00:43:22,359 Speaker 2: have reasons why you can't take aspirin and other kinds 733 00:43:22,360 --> 00:43:25,839 Speaker 2: of things. So I think, you know, I think there's 734 00:43:25,840 --> 00:43:30,120 Speaker 2: something to that whole anti inflammatory scenario for people in prevention. 735 00:43:31,560 --> 00:43:33,640 Speaker 2: And you know there are you know, the other things 736 00:43:33,680 --> 00:43:35,840 Speaker 2: from there, but yes, there are things that could be done. 737 00:43:36,040 --> 00:43:39,360 Speaker 1: And being honest with yourself one with your doctor, like 738 00:43:39,520 --> 00:43:44,480 Speaker 1: don't ignore signs. If something doesn't feel right, go have 739 00:43:44,520 --> 00:43:47,719 Speaker 1: a conversation with your doctor. That seems to be a 740 00:43:47,800 --> 00:43:48,880 Speaker 1: very important one to think. 741 00:43:49,040 --> 00:43:52,520 Speaker 2: If you have anal bleeding, don't let somebody just chalk 742 00:43:52,560 --> 00:43:56,640 Speaker 2: it up to hemorrhoids. Have somebody look look. And if 743 00:43:56,680 --> 00:43:59,359 Speaker 2: you're having a colonoscopy, here's here's the most important to you. 744 00:43:59,360 --> 00:44:02,920 Speaker 2: You're having a lenoscopy, you say to your doctor, I 745 00:44:02,960 --> 00:44:05,840 Speaker 2: want you to be sure and examine my anus. Okay, 746 00:44:05,880 --> 00:44:08,279 Speaker 2: Now that sounds like a strange thing to have to request, 747 00:44:09,200 --> 00:44:11,240 Speaker 2: but the truth is is that a lot of times 748 00:44:11,280 --> 00:44:13,839 Speaker 2: doctors just put the scope in and look and they 749 00:44:13,840 --> 00:44:17,760 Speaker 2: don't they don't actually examine that area. And anal cancer 750 00:44:17,880 --> 00:44:20,759 Speaker 2: is one of the things caused by HPV and it 751 00:44:20,840 --> 00:44:25,000 Speaker 2: requires a visual exam and a finger exam, and you 752 00:44:25,040 --> 00:44:28,080 Speaker 2: can completely miss the anal area with the scope right. 753 00:44:28,320 --> 00:44:32,160 Speaker 2: And by the way, a lot of it is very 754 00:44:32,160 --> 00:44:34,880 Speaker 2: embarrassing for a lot of women because they feel like 755 00:44:34,960 --> 00:44:37,440 Speaker 2: if you get anal cancer, it means that you were 756 00:44:37,440 --> 00:44:40,919 Speaker 2: having sex there. Women can get anal cancer never having 757 00:44:40,960 --> 00:44:44,200 Speaker 2: had anal sex because vaginal secretions that are affected the 758 00:44:44,360 --> 00:44:48,160 Speaker 2: HPV virus can pool in that area and infect that area. 759 00:44:48,640 --> 00:44:52,680 Speaker 2: So don't let anybody embarrass you into not asking for 760 00:44:52,719 --> 00:44:56,440 Speaker 2: the right exams and screen so you don't have that. 761 00:44:56,800 --> 00:44:57,800 Speaker 2: So that's what happened. 762 00:44:57,920 --> 00:45:00,680 Speaker 1: You heard it here, guys, Let's be clear. 763 00:45:03,040 --> 00:45:06,000 Speaker 2: What a way I add. We started at the top 764 00:45:06,080 --> 00:45:08,200 Speaker 2: and we handed at the bottom of the bottom. 765 00:45:08,760 --> 00:45:14,959 Speaker 1: When they went high, I went left. Doctapiro, I love you, 766 00:45:15,560 --> 00:45:19,399 Speaker 1: and you know your brain is impressive and you're a 767 00:45:19,440 --> 00:45:25,279 Speaker 1: wealth of information, and I deeply appreciate our relationship as 768 00:45:25,680 --> 00:45:29,880 Speaker 1: doctor patient, and I deeply appreciate our friendship, which is 769 00:45:29,920 --> 00:45:33,440 Speaker 1: a total other side thing. Thank you so much. 770 00:45:34,520 --> 00:45:36,480 Speaker 2: I love you as well. I do are you. You're 771 00:45:36,520 --> 00:45:39,920 Speaker 2: amazing and every day your inspiration to me. 772 00:45:40,840 --> 00:45:43,200 Speaker 1: Well, thank you. I know you're just you know, gonna 773 00:45:43,280 --> 00:45:47,000 Speaker 1: keep plugging away until you know you want me to 774 00:45:47,040 --> 00:45:47,920 Speaker 1: live to like ninety. 775 00:45:48,000 --> 00:45:50,520 Speaker 2: I know that at least a couple of more trips 776 00:45:50,520 --> 00:45:51,839 Speaker 2: to you Italy for sure. 777 00:45:53,280 --> 00:45:54,960 Speaker 1: Sardinia is next, right. 778 00:45:54,840 --> 00:45:57,640 Speaker 2: Exactly, we have to get to the places we missed exactly. 779 00:45:58,400 --> 00:46:01,120 Speaker 1: All right, you guys, thank you so much much for 780 00:46:01,840 --> 00:46:04,719 Speaker 1: listening in to Let's Be Clear with Shannon Doherty and 781 00:46:04,880 --> 00:46:08,640 Speaker 1: with my very very very special guest, doctor Lawrence Piro 782 00:46:08,880 --> 00:46:12,760 Speaker 1: of the Angelus Clinic. Check it out. It's a pretty 783 00:46:12,760 --> 00:46:15,960 Speaker 1: phenomenal place. I know that a lot of my fans 784 00:46:16,000 --> 00:46:20,040 Speaker 1: have actually contacted him, and I saw one in his 785 00:46:21,320 --> 00:46:25,319 Speaker 1: waiting room, and it makes me very happy because I 786 00:46:25,360 --> 00:46:29,480 Speaker 1: think he can answer a lot of questions and be 787 00:46:30,520 --> 00:46:33,439 Speaker 1: the kind of provider, the care provider that so many 788 00:46:33,480 --> 00:46:36,400 Speaker 1: of us need. All right, bye, thank you for listening 789 00:46:36,480 --> 00:46:37,160 Speaker 1: to Li's Be Clear.