Cancer and the Host – A Functional Medicine Perspective

I recently listened to a fascinating series of podcasts called The Longevity Roadmap offered by Dr. Mark Hyman and his Ultrawellness Center. In one particular episode, Dr. Hyman and other specialists spoke about the specific approach that Functional Medicine (FM) takes on cancer. Here are the highlights:

• Obesity has overtaken smoking as the number one cause of cancer worldwide and in the US, up to two thirds of adults and one third of children are overweight/obese (BMI over 25) which is contributing to the growth of many cancers. In the younger population, there is an increased rate of colon cancer and it’s now known that obesity and toxins from foods and the environment create inflammation and shift our microbiome which can trigger cancer growth.

• Sugar is a trigger for inflammation and it not only fuels obesity but puts us at risk for 13 types of cancers. It’s becoming commonly known that the main underlying causes of all age-related disease (including cancer) is insulin resistance – which includes heart disease, dementia (often referred to as type 3 diabetes), diabetes and sarcopenia (muscle loss).

• Not all pre-cancer cells develop into cancer cells. We are always producing pre-cancerous cells in our body but our lifestyle choices ultimately determine whether these cells become invasive cancer.

• There are two parts to cancer – the cancer itself and the “host” in which the cancer grows. The host is what you can influence to make your body an inhospitable place for cancer cells.

• The Functional Medicine (FM) approach to cancer acknowledges that conventional medicine like chemotherapy, radiation and surgery are necessary, but these treatments should be combined with optimizing our biology to boost the immune system and make it unfriendly for cancer growth.

• FM looks at a systemic approach to find the trigger or cause of cancer. The FM clinician will want to understand the triggers that started the cascade of events leading to cancer formation, so a strong personal history is an essential foundation. This approach looks holistically across seven dimensions: gut and digestive processes, immune processes, energy and mitochondrial function, toxin load, cardiovascular and transport system, hormones and neurotransmitters throughout the body, and structures from mitochondrial membranes to the bones. The symptoms the patient has represents an imbalance in one or more of these systems so it’s important to evaluate all of them to determine the person’s risk of getting cancer. Like the soil that surrounds the plant, the terrain in your body which are all these systems influences how the cancer cells grow and proliferate.

• Three important tests that FM physicians may order include:

• A complete nutritional analysis that looks at 125 nutritional markers and biomarkers for metabolic dysregulation, inflammation, oxidation and toxins.
  • A digestive and microbiome analysis looks for markers of inflammation and imbalance of important bacteria, presence of infection and toxins in stool.
  • A DNA analysis looks for variations (called SNPs) in the gene blueprint that will predispose you to physiological abnormalities leading to chronic disease and cancers. Once these SNPs are identified, you can change your lifestyle and nutritional plan with targeted supplements to account for this variation so it doesn’t lead to chronic disease or cancer. These tests look at the pathways like oxidation, inflammation, methylation and detoxification and its variations. For example, if you are like me and have what is called the COMT variation (SNP) leading to estrogen by-products not being metabolized well which can lead to an increased risk for breast cancer, your FM doctor can create a nutrition and supplement plan to manage this so you remain cancer free.

• Given that up to 30% of cancers are caused by a poor diet, one of the most powerful ways to keep your body’s terrain healthy is through what you put in your mouth. A Mediterranean diet is optimal because of the focus on fish, vegetables, whole grains, nuts, seeds, legumes and olive oil with minimum amount of meat, good dairy and severe limits on sugar and carbs.

• Risk of cancer is influenced by our genetics and our environment. Our genes are not our death sentence as 90% of cancers being expressed as disease are influenced by our environment. Even with cancer risk genes, we can change how they are expressed. So, it’s important to have a healthy diet, not smoke, keep a healthy weight, promote detoxification and eat whole foods that are nutrient dense.

• Nutrient enhancements should also be considered to support the body’s terrain. We can influence our epigenetics – the expression of our genes through the foods we choose.

• Antioxidants – like vitamin C, CoQ10 and Omega 3 fatty acids to fight oxidative stress/damage.
  • Detoxification support – supplements like glutathione, silymarin, N-acetyl cysteine and calcium d-glucarate (for estrogen metabolism).
  • Immune support – mushrooms like turkey tail and minerals like zinc, selenium along with vitamin D.
  • Targeted supplements – wormwood is a compound that can suppress the endothelial growth factor and vascular generation of cancer cells.
  • Berries – Black raspberries make it less likely for pre-cancerous cells to progress into invasive cells.
  • Green tea – contains the active compound EGCG that has anti-angiogenesis properties and prevents growth of blood vessels of cancer cells. Cancer cells need angiogenesis for the blood vessels to grow and feed the cancer cells.
  • Similar to green tea, the key component sulforaphane in cruciferous vegetables can also inhibit tumor production.

• Fasting is good for cancer: In general, cancer cells are dependent on glucose metabolism –so it feeds on sugar. When you fast and your body goes into ketosis, this starves the cancer cells and shrinks them.

• Fasting is a good way to support autophagy (cleans out old damaged cells) and we need autophagy to get rid of abnormal cells.
  • Excessive eating triggers inflammation leading to insulin resistance and a higher rate of cancer.
  • Fasting and reducing the amount of food has been shown to improve longevity as it lowers levels of inflammation and oxidative stress in our body.
  • A lot of research has been done on cancer and fasting and even 13 hours of fasting is associated with a decreased risk of cancer. It’s important to give the body the time to rest and let the body heal and work on getting rid of damaged cells.
  • A fasting mimicking diet around cancer treatment has been shown to be effective in the initial results of this ongoing clinical trial. This diet suggests cutting calories for three days before and after treatment so healthy cells can adapt to being in ketosis while cancer cells become vulnerable. It’s important to work with a registered dietician when considering fasting or a fasting mimicking diet as part of the protocol to obtain optimal results.
  • Fasting along with a ketogenic diet has been shown to starve cancers like melanoma and pancreas. When your body is in ketosis, it shuts off cancer cells’ life supply and they cannot grow.

• Our body has the ability to repair itself but a good diet and protective nutrients (like phytochemicals, vitamins, essential fatty acids and minerals) are important. We need a nutrient dense, plant rich diet with lots of activity, good sleep and stress management to enhance our immune function. Enhancing this with nutrient therapies will facilitate our detoxification systems to promote elimination of carcinogens and other toxins.

• We also need to get rid of heavy metals, pesticides, phthalates, BPA and other chemicals that erode our health. It’s amazing the amount of toxins we eat – rule of thumb is if you can’t pronounce it, don’t eat it!

• We need to eat mostly whole foods without labels and drink clean water. Even choosing where we live has an impact as certain regions are known to have higher rates of cancer.  The National Cancer Institute has the stats on cancer for every state.

• Also be careful what you put on your skin as lotions, soaps and cosmetics can contain parabens, BPA and other compounds that wreak havoc on our health. Read my blog on what to avoid when choosing skincare products.

• We have the opportunity to reduce the burden of suffering from cancer with proper testing and guided lifestyle choices. Diagnostics like colonoscopy, mammograms, prostate exams are all good but these are geared for early detection and not prevention. We need to focus on the host where cancer grows – that’s what FM does.

• FM is an emerging science and its systems-based approach is focused on looking for the cause, not just treating the symptoms. Two people with the same cancer could have different reasons for how it developed and two people with different cancers could have the same reasons. So we need an individualized approach to treating cancer.

• Powerful therapies like immunotherapy can be enhanced through a FM approach. Immunotherapy is designed to activate your own immune system to fight cancer. However, it doesn’t always work because your gut health regulates your immune function. So if you have a poor microbiome and insufficient good bacteria, the immunotherapy won’t be effective. However, if you feed your gut with good bacteria foods that are rich in polyphenols and other bioactive compounds, your gut bacteria will thrive and immunotherapy will be effective. Again, it’s critical to treat the host (the terrain), not just the disease.   

If you would like to learn more about preventing or managing cancer, Dr Hyman’s Longevity Roadmap 8-part Series is offered here.