51 Cancer and COVID-19.mp3: Audio automatically transcribed by Sonix
51 Cancer and COVID-19.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Speaker1:
Hi and welcome to the Cancer Secrets podcast. I am your host and guide, Dr. Jonathan Stegall. Cancer is like a thief who has come to steal, kill and destroy. I have personally seen it wreak havoc on patients, friends and even my own family. But I am on a mission to change the cancer paradigm. Who? The practice of integrative oncology cancer treatment that integrates the best of conventional medicine with the best of alternative therapies backed by science and personalized to each patient. You need a positive voice you can trust. This podcast will share valuable information to give you practical hope for a better outcome. So I invite you to join me on this journey as we seek to change the cancer paradigm together. Hello and welcome back to the Cancer Secrets podcast. I'm your host, Doctor Jonathan Seagal. This is season four and episode number 51. In today's episode, we'll be discussing COVID 19 and how it relates to cancer. On January 9th, 2020, the World Health Organization announced a mysterious coronavirus related pneumonia in Wuhan, China. There were only about 60 documented cases so far at that point. On January 20th of last year, several cases of novel coronavirus were reported outside of China, including Thailand and Japan. This prompted the Centers for Disease Control to begin conducting screenings at several airports in the United States, including JFK, San Francisco and LAX. The following day on January 21st, the CDC confirmed the first coronavirus case in the United States.
Speaker1:
A resident of Washington state was the first case in this country, having returned from Wuhan. Approximately one week prior, at this point, additional information had been released from China about the novel coronavirus. It was thought to have originated in late 2019, possibly from bat to human transmission. On January 23rd, Wuhan was placed under quarantine after an additional 300 people were infected with the virus and an additional 13 people had died. China made the unprecedented move of closing off Wuhan and its population of 11 million people approximately one week later on January 31st of 2020. The World Health Organization issued a global health emergency. Human to human transmission was quickly spreading, with cases now found in China, the United States, Germany, Japan, Vietnam, Thailand and Taiwan. On February 2nd, global air travel was restricted. The following day, on February 3rd, the United States declared a public health emergency due to the coronavirus outbreak. At this point, nearly 10,000 cases of the virus had been diagnosed worldwide with more than 200 deaths. By late February 2020, the Centers for Disease Control stated that the COVID 19 virus was heading toward pandemic status. In case you're wondering, the three criteria for a pandemic are illness, resulting in death sustained person to person spread and worldwide spread. On March 11th, the World Health Organization declared COVID 19 a pandemic. Just two days later, our president declared COVID 19 a national emergency.
Speaker1:
On March 25th, mathematical models based on social distancing measures implemented in Wuhan showed that extended shutdowns could possibly delay a second wave of the virus and, quote, flatten the curve, end quote. Since that time, we've witnessed additional restrictions, including lockdowns, restrictions on social gatherings and quarantines. We're all aware of the recommendations for masks, improved hygiene and social distancing. At the time of this recording, the United States has seen 28 million cases of COVID 19 and 500,000 deaths worldwide. There have been 111 million cases and roughly 2.5 million deaths from COVID 19. Over the past year, we have learned a great deal about this virus. Unfortunately, along with this new information has come a great deal of misinformation. People are understandably very confused and do not know what to think. And I will say there's obviously a lot of COVID 19 fatigue as well. On some level, we're tired of hearing about it. We're tired of dealing with it. But it's really important that we talk about what the science actually says about COVID 19, not just from a public health perspective, but also as it relates to cancer. So today, I'm going to discuss what we know to be true about COVID 19. As always, you can count on me to be objective and honest with you. I do not have an agenda here other than to give you truthful and actionable information. We know that COVID is particularly harmful to those with weakened immune systems.
Speaker1:
One of my concerns from the outset was that cancer patients would be especially susceptible to COVID 19 in terms of increased risk of complications as well as risk of death. My concern was based on the fact that cancer patients already tend to have compromised immune systems. In addition, patients undergoing immunosuppressive treatment, such as chemotherapy, especially at the full doses used in conventional oncology, are likely to be at even more risk. Fairly often in the pandemic, a study was conducted to evaluate COVID 19 outcomes in patients with cancer. This article, which was published in the Journal of Clinical Oncology's Global Oncology publication, evaluated thousands of patients with cancer from Asia, Europe and the United States. It found that patients with cancer have worse clinical outcomes from COVID 19 compared to patients without cancer who have COVID 19. In other words, patients with cancer who contracted COVID 19 were at higher rates of admission to the intensive care unit, as well as having a higher risk of death. Additional research, which is published in the journal Nature, found that cancer patients infected with COVID 19 within the first year of a cancer diagnosis were at a significantly greater risk of death from COVID patients with a solid tumor, such as breast, colon or lung were nearly twice as likely to die from COVID 19 compared to those without cancer. Even worse, patients with a liquid cancer such as leukemia or lymphoma were found to be four times as likely to die from COVID.
Speaker1:
Dr. Nathan Burger, an oncologist and professor at Case Western Reserve University School of Medicine, commented, quote, The combination of the virus and cancer is synergistic in leading to mortality. The death rates are much higher than they are for either of the diseases alone, end quote. That's a sobering statement. In addition, patients already diagnosed with cancer were often forced to delay necessary treatment due to a shifting landscape within health care. When it comes to cancer, time is of the essence. A study last year in the British Medical Journal examined deaths due to cancer treatment delay. Sadly, the researchers found that just a four week delay in cancer treatment caused a statistically significant increase in mortality for seven different types of cancer, including breast, colon and lung. Another impact COVID has had on cancer is the way it has impacted cancer screening for several months. Last year, people scheduled to undergo routine cancer screening were forced to delay medical care due to the pandemic. Unfortunately, this resulted in delayed or missed cancer diagnoses in many patients. A study released in the January 2021 edition of JAMA Oncology found that routine screenings for cancers such as colorectal, breast and cervical were down more than 90% compared to previous years. Unfortunately, the harm caused by this will be seen for years to come in the form of people being diagnosed with more advanced and or complicated cancers.
Speaker1:
This is truly sad. In addition, cancer research dollars were either diverted or placed on hold due to the pandemic. The sum total of all of this is unfortunate for cancer patients and their families and for those of us in the medical profession who are trying to win the war on cancer. Now that we've discussed the burden of COVID 19 on society and how it affects cancer patients, let's talk about some practical things that you can and should be doing to protect yourself. First, please be diligent about taking care of your health. We all know the importance of proper hygiene, including washing our hands and covering our mouths when we cough or sneeze. If you're feeling sick or run down, please do not come in close contact with other people. There has been much debate on the Internet regarding masks and whether or not they're effective in reducing the spread of COVID. The CDC recommends wearing masks in public settings, including at events and gatherings and anywhere you'll be around other people. This is based upon extensive research performed thus far a study released in January 2021, which was entitled An Evidence Review of Face Masks Against COVID 19. Summarized the research as follows quote, The primary route of transmission of COVID 19 is via respiratory particles, and the preponderance of evidence indicates that mask wearing reduces transmissibility, end quote. The study authors went on to say that public mask wearing is most effective at reducing spread of COVID 19 when compliance is high.
Speaker1:
And as we all know, compliance has not been high throughout society on a consistent basis for the last year. Now it's important to note that compliance does not just mean wearing a mask, but wearing the right kind of mask and wearing it properly. The ideal choice of mask is one that has two or more layers of washable, breathable fabric, which completely covers the nose and mouth and fits snugly against the sides of the face without any gaps. Masks with a nose wire are helpful to ensure a tight fit. Wearing a mask not only protects you from others who might be sick, but also protects others in the event that you are sick. In addition to the steps above, I believe vitamin D supplementation is essential. Research published in the September 3rd, 2020 edition of JAMA Network Open found that patients with vitamin D deficiency based on lab testing performed within the prior year were 77% more likely to test positive for COVID 19 than those with normal vitamin D levels. Another study from fall 2020 concluded that vitamin D deficiency was a predictor of poor prognosis in patients with severe COVID 19. Another study in a nursing home in France concluded, quote, Vitamin D supplementation was associated with less severe COVID 19 and a better survival rate, end quote.
Speaker1:
Finally, a study in South Korea concluded that deficiency in vitamin D could weaken the immune system's ability to fight COVID 19 and thus result in progression to severe COVID disease. To complicate matters, there have been other studies which showed no effect from vitamin D supplementation. A 2020 study in the Journal of the American Medical Association evaluated patients with moderate to severe COVID 19 infection. These patients were all sick enough to require hospitalization. In approximately 90% of these patients required supplemental oxygen but were not on mechanical ventilation. The average vitamin D level, using the 25 hydroxy vitamin D marker was approximately 21 nanograms per milliliter. This is considered vitamin D deficiency based on a normal range most labs use, which is between 30 and 100 nanograms per milliliter. The patients in this study received vitamin D3 treatment and the average vitamin D level in patients improved. Remember, they started at a level of approximately 21 nanograms per milliliter, and after the vitamin D3 treatment, their levels improved on average to 44 nanograms per milliliter. The study found that patients receiving vitamin D3 supplementation showed no significant difference in study outcomes, including length of stay in the hospital requirement for ICU admission or mortality rate. As you can imagine, this study received a significant amount of press with a headline stating that Vitamin D is not beneficial against COVID 19. However, I have several issues with this study. First, this study only evaluated patients who were already sick enough to be in the hospital with COVID 19 to the point that they needed additional oxygen support.
Speaker1:
Second, this study tells us nothing about the potential value of vitamin D supplementation in reducing one's chances of getting COVID. Nor does it account for Vitamin D's potential to prevent a mild COVID infection from becoming more severe. It's not surprising to me that all of the patients in this study were quite deficient in vitamin D at baseline. I suspect that their vitamin D deficiency played a role in their requiring hospitalization for COVID. And finally, although the study participants vitamin D levels improved from 21 nanograms per milliliter to 44 nanograms per milliliter, this is still not optimal. Vitamin D research points to an optimal vitamin D level being at least 50 nanograms per milliliter, if not 60 milligrams per milliliter with the upper end of the optimal range being 80 or even 90 nanograms per milliliter. I believe that vitamin D is essential for immune health, whether we're talking about cancer or COVID 19, because we can't get enough from the sun. I recommend supplementation to achieve optimal levels. I found that about 10,000 international units, which is abbreviated I use of vitamin D three per day to be the right amount for most people. If you haven't checked your vitamin D level, ask your doctor for a 25 hydroxy vitamin D. This is often abbreviated 20 5-0. Vitamin D.
Speaker1:
This will help you establish a baseline. Since it's a fat soluble vitamin, meaning that it's stored in body fat, it is possible to have vitamin D levels that are too high, so more is not better. By establishing a baseline supplementing with high quality vitamin D three supplementation, ideally one that also includes vitamin K to increase absorption and having routine testing. Of your 25 hydroxy vitamin D level, you will be well on your way to optimizing your vitamin D level. Now let's talk about the COVID vaccine. At this point, over 64 million doses of the COVID vaccine have been administered in the United States. It's important to note that the clinical trials for the Pfizer and Moderna vaccines did not include patients undergoing cancer treatment. This is because the main objective of these studies was to see if the vaccines were safe and effective in people with healthy immune systems. Make no mistake, these COVID vaccine trials were extremely detailed and thorough. It might seem like corners were cut since the trials were conducted so swiftly, but that is simply not the case. The mRNA vaccine technology was actually put in place in years prior. The existing research, coupled with never before seen vaccine funding totaling $18 billion, allow this research to take place. In the Pfizer vaccine trial, 44,000 test subjects were included. Half of these or 22,000 receive the vaccine, whereas the other 22,000 did not. Of the 22,000 people who did not receive the COVID vaccine, 162 were subsequently diagnosed with COVID.
Speaker1:
Meanwhile, of the 22,000 people who did receive the COVID vaccine, only eight people were subsequently diagnosed with COVID. The Moderna trial included 30,000 test subjects. 90 patients in the placebo group, which was the group not receiving the vaccine, were diagnosed with COVID 19, whereas only five patients who received the COVID vaccine were diagnosed with COVID 19. Based on these results, both the Pfizer and Moderna studies concluded that the vaccines were 95% effective in both studies. Each patient received two doses of the vaccine. Both vaccines were well tolerated. There were no significant or life threatening reactions. Some test subjects had mild side effects, including injection site pain, headache, muscle aches and fatigue. The side effects were more common with the second dose of the vaccine, which makes sense because the immune system was primed after the first dose and ready to go when it saw a second exposure, which was the second dose of the vaccine. This is exactly what we want when teaching the body to mount an immune response against COVID. There are additional vaccines on the horizon currently being researched, including one manufactured by Johnson and Johnson and another by AstraZeneca. We don't have as much information about these vaccines yet, but research thus far indicates that they are effective against COVID 19, but likely not quite as much so as Pfizer and Moderna vaccines are.
Speaker1:
The National Comprehensive Cancer Network has released guidance regarding the safety and efficacy of COVID 19 vaccination for those patients with active cancer, as well as those recovering from cancer. They strongly recommend that cancer patients and cancer survivors be vaccinated. In patients undergoing chemotherapy, the recommendation is to wait until the absolute neutrophil count, which your oncologist should be monitoring regularly, has recovered. This is important since we want to make sure the immune system is capable of mounting a strong immune response. For those undergoing a stem cell transplant or receiving treatment known as chimeric antigen receptor T cell therapy. It's recommended to wait three months following therapy to have the COVID vaccine. For those undergoing major surgery is recommended to delay COVID vaccination for 1 to 2 weeks after surgery. It's important to note that we don't have much information yet about how the vaccine works in patients with severely compromised immune systems. I believe that a compromised immune system presents a less than ideal scenario when receiving the vaccine, but the hope is that the body is still able to mount enough of an immune response to provide protection against future COVID infection. I'm recommending that my patients receive the COVID vaccine. I feel that it's a very good vaccine based on excellent technology. It combines efficacy and safety, which is exactly what we want in a vaccine. Based on the science, the potential benefits outweigh the potential harms. And in case you're wondering, know the COVID vaccine can't alter your own DNA.
Speaker1:
It doesn't contain a microchip to track your movements, and it doesn't contain 5G technology. It won't make you infertile, and it can't give you COVID since it doesn't contain, live or killed COVID virus. As always, please speak with your doctor about the COVID vaccine to determine if you're a good candidate for it. If you have a history of severe reactions, especially to vaccines, please let your doctor know as this might be a reason for you not to be vaccinated. Wow. We covered a lot of information in this episode. I hope you found this to be helpful. I hope this helps to clear up some of the things you may have heard about COVID and answered some of the questions you probably had. I am truly honored to be able to share my knowledge, research and clinical experience with you. As a reminder, please subscribe to the Cancer Secrets podcast to be notified when new episodes are released. We have some great shows planned and I can't wait to share them with you. If you're enjoying these podcasts, please take a minute and provide a review on iTunes, Spotify or wherever you listen to podcasts. Finally, please share this podcast with your family and friends. All previous episodes are available for free on our website at Cancer Secrets dot com or wherever you listen to podcasts. Thank you so much. Until next time. Bye bye.
Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.
Automatically convert your mp3 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.
Sonix has many features that you’d love including transcribe multiple languages, generate automated summaries powered by AI, automated subtitles, powerful integrations and APIs, and easily transcribe your Zoom meetings. Try Sonix for free today.
