2 What To Do When You Have Been Diagnosed With Cancer.mp3: Audio automatically transcribed by Sonix
2 What To Do When You Have Been Diagnosed With Cancer.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Speaker1:
Welcome to the Cancer Secrets podcast. Changing the Cancer Paradigm. Hosted by Dr. Jonathan Steagall, a medical doctor and cancer specialist practicing in Atlanta, Georgia, deeply affected by his grandmother's death from stomach cancer, as well as patients he cared for in medical training, he realized there has to be a better way to treat cancer. Dr. Stegall has a unique and innovative approach to treating cancer called integrative oncology, combining modern medicine with alternative therapies personalized to each patient. This podcast is designed to educate, support and give you a positive voice you can trust. We invite you to join us on this journey as we seek to change the cancer paradigm.
Speaker2:
Welcome to the Cancer Secrets podcast. I'm your host, Dr. Jonathan Stegall. I'm so excited that you're here today. We're going to talk about a very important topic, and that is what to do when you've been diagnosed with cancer. This is an extremely important topic, and to be quite honest, it's one that most physicians and health care providers screw up, and that is because they fail to realize what patients are thinking and feeling when they hear those three words. You have cancer. Studies have shown that patients remember very little about that conversation after hearing you have cancer. Those who do remember the conversation tend to have a very negative opinion. Now, part of that is because hearing you have a cancer diagnosis is bad news. It's not pleasant. It's actually a very life altering moment for most people. However, a large portion of the problem is due to the fact that most physicians don't communicate that news very well at all. Now there's limited training in medical school and residency and fellowship regarding how to give bad news. And sadly, most doctors today are overworked and they're rushed and due to time constraints, as well as just an honest lack of empathy, they don't handle this conversation very well at all. So if you have gone through a negative conversation with your physician or health care provider due to a cancer diagnosis, I want to say I'm sorry. That's uncalled for, in my opinion.
Speaker2:
And for such an important conversation, we really do need to be handling it a lot better. When I have that conversation with patients, I first like to discuss exactly what a cancer diagnosis means immediately, especially if you've been the one that's been diagnosed with cancer and had to go through that conversation. Your mind immediately starts to play through a lot of scenarios. What did I do wrong? What do I need to do now? Am I going to be able to beat this? What about my family? Will I be able to afford treatments? All these are very natural thoughts and all of the emotions that go with that, including fear and worry and anxiety and anger. Those are very common as well. So the first thing I'd like to tell you to do right now is just take a deep breath. Truly take a nice deep inhalation. Do it very slowly, over about 5 seconds. Take a deep breath in so that not just your chest expands, but actually your stomach and abdomen expand. Hold it for a second and then slowly exhale, letting that breath out over about 5 seconds. This is really important because this is one of the key stress reduction techniques we like to talk about and employ. And when you take a deep breath, I want you to do this several different times. If when you're taking a deep breath, think about breathing in peace and assurance and confidence and think about breathing out fear and anger and negativity.
Speaker2:
Now, obviously, doing this once or twice is not going to dramatically change your outlook. But over time, when we couple this with really good research and really good decision making, we actually see a difference. So I want to talk a little bit more about what you should be doing when you're given a cancer diagnosis. First, I want you to focus on your support system. Now, that's obviously going to differ depending on who you are and where you live and what kind of relationships you have. But for most people, that support system is going to involve some sort of family member that could be a spouse, it could be a brother or sister, it could be a mother or father. It could even be children. Hopefully you have multiple family members who support you and love you and are there for you. But even if you don't, perhaps you have some friends who are willing to be a part of your journey, people who are willing to help you do research and perhaps even be a listening ear or shoulder to cry on. Perhaps your health care team is a good support system. For me personally, I always tell patients where your family, your your patient here in this office. We're family. And we're going to be with you through the ups and downs and everything that goes with a cancer treatment journey.
Speaker2:
I want to talk a little bit as well about being an open minded skeptic. Now, I talk about this a lot with my patients and you'll hear me say this a lot on our podcast episodes. But open minded skepticism is a perfect combination of being open to anything that we feel is going to help us. Whether it's a pharmaceutical, whether it's a surgical procedure, whether it's a radiation, whether it's diet, supplementation, you name it. We need to be open to anything that will give us potential benefit. However, we also need to have a healthy level of skepticism, and that skepticism should apply, whether it's a treatment that's, quote, proven or a treatment that maybe we don't have as much evidence for, or in some cases no evidence at all. And this open minded skepticism needs to be employed every step of the way. Anyone you talk to, any consultation you go on any Web page, you visit, any piece of advice you're given. Use this open minded skepticism to ask those key questions. Do I think this could help me? Is there some scientific evidence for this? Who else is use this? What kind of results can I expect? And this can guide you whether you're a patient yourself and you're trying to decide on the right treatment course or whether you are a friend or family member supporting someone else as they go through treatments. The first physician you probably spoke with was a medical oncologist, and in the United States, as well as most of the world, medical oncologists are trained to help diagnose cancer, as well as oversee the treatment of cancer.
Speaker2:
And, of course, are our most common therapies and procedures today for cancer treatment are surgery, chemotherapy, radiation and immunotherapy. And these therapies constitute the standard of care for various types of cancer. And these therapies, I do feel, have value. However, I feel that to focus solely on those therapies would be incorrect. And the reason I say that is because if we go back many years, Richard Nixon declared war on cancer in 1971 and he pledged billions of dollars toward cancer research. And we've spent those billions of dollars on cancer research in the decades since. And admittedly, we've learned a lot about cancer since then. We've advanced our knowledge considerably. Regarding cancer and how it develops and how it can be treated. But if we look at the data from the American Cancer Society, the death rate from cancer in the United States. Has only slightly decreased over the past 20 to 30 years. We have seen a slight decrease, but not by much. The incidence of cancer continues to rise and aside from just a few exceptions, we're not really doing well in the war against cancer. We're losing the war. There's no doubt about that. We're losing it badly. The last year, research on cancer statistics, they looked at 1.6 million new cancer cases, and that's how many occurred in the United States.
Speaker2:
And of those, many people went on to die. Approximately 600,000 deaths from cancer are expected to occur in the United States this year. The cancer rate in America now is approximately one in three, and that number is quickly approaching one in two. And this is not even taking into consideration the high incidence of side effects from these treatments. So we're clearly at a crossroads. We don't really know where to turn at times in health care when it comes to cancer. For most other diseases, we've figured out a way to either prevent them better or treat them better, or at least manage them better. And that's not true for cancer. So patients today are very confused. On the one hand, they truly want to trust their oncologists. They want to say, okay, you're the expert and I know you can help me and I want to trust you because my life is at stake. But on the other hand, patients are confused. They know the statistics. I'm sure you've heard how horrible cancer is. You've experienced it in a family member or a loved one or even yourself. And so the good thing about today is you have more resources at your disposal than ever, and the Internet has really allowed that to happen. So the great thing is, if you've been diagnosed with cancer, you can easily go online and find out statistics about your type of cancer.
Speaker2:
You can see what the survival rate is. You can look into treatment options. And the wonderful thing is that can include treatments that your doctor has perhaps recommended. But it may also include treatments that have not been discussed with you, things that are available to you and you can perhaps use in addition to those recommended treatments. Now, the downside is you can easily become overwhelmed. It can become information overload. And I describe this as attempting to drink from a fire hydrant. You can drink some water, but you're going to miss a lot as well and you're quickly going to get frustrated. And so one of my jobs as an integrative oncologist is to objectively review this information for patients. There's a lot of excellent information online about cancer and various treatments. There's also a lot of really bad information. And this gets us back to the idea of open minded skepticism. Let's be open to any treatment that we think will help, but let's also be skeptical and not just blindly accept a treatment simply because someone else thinks we should do it. This is where integrative oncology really shines. We aren't ignoring any aspect of health care which we think can help patients. So we're combining modern medicine, also known as Western medicine, with more Eastern approaches. Natural therapies, holistic therapies. Integrative oncology is truly a best of both worlds approach, and this is especially helpful when we want to balance effectiveness.
Speaker2:
With the overall health of the body, we shouldn't have to sacrifice one for the other. I don't believe that to treat cancer, we should have to harm our immune system and have significant side effects. But I also don't believe that purely natural approaches are usually going to be enough to kill cancer. So we combine both, and we do that in a very personalized way for each patient. Now I'm going to make an assumption about you, and that is that you're searching for answers. Now, whether you're a cancer patient or a family member or a loved one of a patient, you're probably looking for answers. And so with that in mind, I want to review a list with you. And this is a list I've created of traits and attributes you should look for in a cancer specialist. And these are all very important. Now, you may not be able to find a doctor who fulfills all of these criteria, but you should at least look for someone who fulfills most of them. And if you can't, I would strongly encourage you to look for a new provider. The first is that he or she possess a thorough understanding of the body's biochemistry and physiology. And we know that cancer is a very complex disease. All medical schools in the United States teach aspiring physicians about cancer, including how cancer cells form, how they grow and how they flourish.
Speaker2:
Now, this study of cancer requires many hours of learning about cancer across various disciplines. This includes anatomy, biochemistry, pathology, physiology, immunology, pharmacology, and a lot of other allergies. Now these principles are then applied to direct patient care in the hospitals and in clinics. Now, once a medical student graduates from medical school, and this is when the MD degree is awarded, he or she must choose a specialty. Now, those who ultimately plan to specialize in cancer treatment in adults must first complete a three year residency in internal medicine. And these grueling years of training include long hours and sleep deprivation. And I hate to even think back to those days, but they were very valuable because they provided a necessary foundation for becoming an expert in the care of patients and patients with a wide variety of illness and disease. And then after this training is complete, advanced training in oncology takes place. And this is where the specialization in cancer treatment truly occurs. So I feel strongly that cancer treatment should be primarily managed and conducted by a physician. And this means he or she must have attended medical school, earned an MD or D.O. degree, and completed residency training, preferably at a top institution, and then obtained the necessary advanced fellowship, training and experience in the treatment of cancer. Now there are plenty of other health care practitioners, such as naturopaths and chiropractors, acupuncturists, nutritionists who see cancer patients.
Speaker2:
And I feel that each of these providers offer valuable treatment modalities. But I don't feel that they should be the ones primarily managing a disease as complex and aggressive as cancer. Proper management of cancer requires the extensive hours of study in patient care only possessed by a physician. Now, with that said, I absolutely feel that other health care providers can play a very valuable role and should ideally be included in a treatment plan. The second attribute you should look for is that your physicians spend plenty of time listening to you. And as I mentioned earlier, an unfortunate reality in health care today is that most physicians are diagnosis and treatment focused. They're not patient focused. And there's a significant difference here. And even though it's subtle, it is important. All physicians must have the goal of being excellent diagnostician and providing outstanding treatment. But I would argue that the patient focused physician goes a step beyond and does these things in a way that honors respects and values each patient. And this is because the patient focused physician puts the patient and his or her needs first. Now, when I conducted research at Harvard Medical School on the doctor patient relationship, I sought to learn more about the sacred bond between doctor and patient and the effect that this can have on the ultimate treatment outcome.
Speaker2:
There are several ways in which you can evaluate any doctor to determine if he or she is appropriately focused on you during the encounter. The doctor first asks how you're doing or how you're feeling. You're given an opportunity to express any concerns at the outset of the encounter, and you're not interrupted after about ten or 15 seconds, as most patients are. You're asked about your treatment goals and what you hope to attain from treatment. The doctor's treatment recommendations are clearly communicated and thoroughly explained. You're given an opportunity to share your thoughts. And you're allowed time to have all of your questions answered. Now, I believe that the physician patient encounter should be a respectful dialogue. The days of a doctor dominated conversation where the patient is not given adequate time to talk or ask questions are over. If you're talked over or interrupted by your doctor, you should find another one as quickly as possible, because ultimately the job of your physician is to support you in receiving the treatment you prefer, which best meets your needs and wants. The next attribute. You should look for in a physician is that he or she obtains advanced lab testing. Now, one of the best ways to monitor cancer treatment is through lab testing. When cancer is first diagnosed. Lab tests called tumor markers are frequently ordered. And this is through blood testing. You're probably familiar with some of these examples, including.
Speaker2:
Ca 15 three. Ca 99. Ca 125. Ca 27.29. Afp, CEA and PSA. Now these each correspond to one or more types of cancer, and they're obtained at regular intervals during treatment to evaluate response to treatment. And while these lab tests are very important and should be used, they should not be our only way of evaluating a patient's cancer. Now imaging is certainly used by almost all oncologists as well, and this provides a very important piece of information regarding treatment response. But I do feel that there are certainly advanced labs that can be obtained as well. Now there are several of these, one of which is known as the economics plus test, also informally called the Greek test, because the lab which administers this test is in Greece. There are also others. There's one called the cancer profile or see a profile. This is through American metabolic laboratories in Florida. They do some excellent work to look at some innovative lab markers which allow us to monitor cancer. Another test I use routinely is known as the Caries Molecular Intelligence Test, and this is a test that actually looks at the genetics of a tissue sample from a biopsy or a surgery. And all of these tests are important because they either guide us in terms of potential treatment options or they give us valuable feedback regarding whether or not these treatments are working. Cancer needs to be proactively attacked, not reactively responded to.
Speaker2:
And this is an important distinction because we can't just simply wait around and wait for something bad to happen. Before we respond, we need to be very proactive and monitor many different pieces of information so that we ideally prevent any future problems rather than waiting until problems occur before responding. The next attribute you should look for in a physician is that he or she show genuine compassion. Now we know that most doctors care about their patients, but some definitely show more of a humanistic side than others. It's one thing for a doctor to be pleasant while reviewing your medical records and recommending treatments, but it's another thing to truly become invested in your care. I mentioned earlier that I view my patients like family and my team here in my practice. I know agrees with that. But unfortunately in most of the medical community. Doctors and nurses have been extremely limited in the amount of time that they can spend with patients. And part of this is due to our insurance system. I understand that. But but part of it is the fact that doctors seem to lose a lot of their empathy and interpersonal skills as a result of having such limited time with patients. And sadly, what seems to get left out of the doctor patient encounter are the emotional components which are so important. Many patients feel like their feelings and emotions are de-emphasized or even ignored altogether.
Speaker2:
So here are some questions I have for you. How much does your doctor know about you? Does he or she know where you grew up or where you're from? Has your doctor asked about your spouse, your family, your children, your loved ones? Does your doctor know what your hobbies and interests are? Does your doctor know what your religious beliefs are? Does your doctor know your goals? I make it clear to my patients that I am their advocate. They have someone who is going to lock arms with them and do their best to work toward a positive outcome. Make sure your doctor has this quality because you will need his or her compassion, support and devotion during the course of your treatment. The next quality you need to look for in a doctor is the ability to create personalized treatment protocols. Now, oncology tends to be all about a one size fits all approach. Now we know that that doesn't work. Under no circumstances do I endorse the idea of cookbook medicine, where one type of cancer automatically gets a specific treatment without taking other factors into consideration. But sadly, this is very common today. Doctors who merely look at a patient as a list of diagnoses that must be treated in a rigid and specific way are not going to be nearly as successful as doctors who look at each patient individually. This is because every patient is different.
Speaker2:
Lab testing available today. Tells us volumes about the genetics of a given patient's cancer cells. And these genetics are very different for each patient. We can take. Ten different patients, all with breast cancer. And the genetics are going to vary. Significantly. Now, how much sense does it make to treat those ten patients exactly the same way? The answer is it doesn't. As I said, every patient is different. Now, let's assume that those ten patients are given the exact same treatment. Now, what kind of outcome do you think we're going to have in those ten patients? Of course, they're not going to have the same response to treatment. The internal environments in those patients are different. The toxicities those patients are exposed to are much different. The nutritional factors are much different. So much goes into whether. A patient responds well to treatment or not. And we really need to look at the details. Think about the internal environment in your body. Think about the genes you have. Your unique anatomy. Pre-existing medical conditions, medications. You take your diet, your stressors. Your unique biochemistry and physiology are the result of a cumulative effect of everything you've been exposed to from the time you were born until now. And these exposures affect how your body responds to treatment. In essence, our internal environments are like snowflakes. No two are alike, so it only makes sense that no two patients should be treated exactly alike either.
Speaker2:
Now this brings up an important point. We know that 90 to 95% of cancer arises from the environment, from lifestyle factors, from the air you breathe to the food you eat, to the water you drink. Now I mention this because for many people, they feel like victims. They feel that they're the result of bad luck and misfortune that they have cancer. However, only five or 10% of cancers are due to inherited genetics. So that leaves us with 90 to 95% of cancers due to things we've exposed ourselves to. And this is important because we have a lot more control. Over our health than we tend to think. If less than optimal choices contributed to the development of cancer, then excellent choices can also help us beat cancer. So think back over the course of your own life. What kinds of things? Did you expose yourself to that maybe weren't helpful or perhaps even harmful? What kind of food have you been eating? Are you eating organic food? How stressed are you? Do you have a lot of stress in your work or in your personal life? What kind of home do you live in? Are you exposed to mold or potentially polluted air? Do you live in a big city? What kind of water do you drink? Is there a lot of fluoride and chlorine in your water? These are important questions to ask because. Although none of those things on their own cause cancer.
Speaker2:
The sum total of all of those things did create an environment for cancer. And that's true whether you've inherited some bad genes from your mother or father or not. So I'm not only referring to those of you who fall into the 90 to 95% category. But also those who are in that 5 to 10%, because we know that our genes are responding to their environment every single day. So my belief is that regardless of the hand we were dealt genetically. You can prevent cancer. And I also believe that regardless of your cancer diagnosis, now you can beat it and you have a lot of control over the outcome. And I want that to be empowering to you, because many patients feel like there's little to nothing they can do to affect the outcome. And I'm here to tell you, there's a lot you can do every single day to greatly help your cause. So getting back to the idea of. Finding a doctor who creates personalized treatment protocols. If you can find someone who is open minded to not only. Order that a CT scan or a PET scan. We're not only order those standard lab tests, but also someone who is willing to order more advanced lab testing. But finally, someone who's willing to use some innovative treatments, someone who's willing to use chemotherapy in a a safer way like we do when we do fractionated chemotherapy also called low dose chemotherapy.
Speaker2:
Insulin potentiation therapy where we're giving insulin to better target chemotherapy to cancer cells. Someone who's willing to give intravenous vitamin C. To give higher doses of minerals and antioxidants. A doctor who's willing to use high quality supplements in nutraceuticals. Someone who's willing to talk to you about the importance of nutrition and who doesn't just scoff at the notion that nutrition is important. Someone who is willing to talk to you about the importance of stress and emotions. The doctor who's willing to pray with you and discuss ways you can improve your mindset and reduce stress. There are many therapies. They are helpful and they work. This is why we call it integrative medicine. We want to use anything and everything we can to help us. Sir William Osler stated, The good physician treats the disease, the great physician treats the patient who has the disease. And this is one of my guiding principles. Now, moving on, another characteristic we've kind of touched on, but not enough, is the importance of nutrition. Now you want a doctor who places a priority on nutrition. Quite honestly, I'm amazed at the number of patients who tell me that their oncologist told them that nutrition doesn't matter. Now I suspect that this is the result of nutrition being under emphasized in medical training. However, for doctors who claim to practice evidence based medicine, it amazes me how many fail to recognize the abundance of research showing how important nutrition is.
Speaker2:
I view nutrition as the foundation of any good cancer treatment protocol. We know that cancer cells have unique behaviors not found in normal, healthy cells. Proper cancer nutrition will target these specific characteristics of cancer cells while also providing healthy cells with a nourishment and protection that they need. Now, one important component of nutrition is supplementation. While the things we eat and drink are vital and should comprise our nutritional foundation, they are not sufficient on their own to treat cancer. Now, by strategically adding high quality physician grade nutraceuticals such as vitamins, minerals, herbs, plant extracts and antioxidants to our cancer treatment protocols were ensuring that we're giving the body what it needs. It's a requirement that these supplements be of extremely high quality. I simply buying something you find online or in the health food store is not adequate. Studies have shown that some of these supplements may even be harmful and don't even contain what the label says they do. Our next attribute to look for in a cancer doctor is someone that views himself or herself as a consultant. Do you consider your cancer specialist to consultant? Does he or she provide you with the details of your cancer treatment, including why each treatment was chosen and what it's intended to do? Are you provided with potential outcomes, including possible side effects? Are you informed of all of your options? Armed with this information, you should be at the centre of the decision making process.
Speaker2:
I always tell patients that I will provide my recommendations in an honest and straightforward way, but that the treatment plan is one that we come up with together. Patient empowerment is crucial, especially when dealing with cancer. Although I'm an expert in this field, it is not my job to demand that you undergo certain treatments. Rather, my job is to provide as much information as possible in order to allow you to make informed decisions which you feel are best for you and your treatment goals. The next quality you should look for is finding a physician that tends to your spiritual needs. Has your cancer doctor asked you if you have any religious or spiritual beliefs? If not, it's a shame because there is a lot of evidence showing that patients who have a spiritual practice have better outcomes than those who do not. I feel strongly that your spiritual practice, whatever it is, should be a meaningful part of your cancer treatment journey. It should bring you hope and peace and should ideally be supported by those who are closest to you. For example, I'm a Christian. I pray for all of my patients. I'm also happy to pray with my patients. And I do so regularly. For those patients who share a different belief, I still do my best to support them in their beliefs by making sure that they're connected with others in their lives who provide them with spiritual guidance.
Speaker2:
My belief is its spiritual health cannot be separated from your overall health. It's an important component, along with your physical, mental and emotional health. Find a doctor who treats the whole person and supports you in your spiritual practice. One additional attribute, which I feel is very important, is finding a physician who recognizes the importance of a good support system. Now when it comes to cancer treatment, you can't go it alone. From the moment you hear those three life changing words, you have cancer. Having other support you in your journey is essential. And it's my hope that anyone going through cancer and treatment will have at least one advocate, whether it be a spouse, a sibling, a parent, an adult child, a relative, or even a close friend. Now, this advocate should ideally be available to help you in a variety of ways. Perhaps he or she can accompany you to appointments, especially those appointments that involve reviewing test results and discussing specific treatment options. This individual should be able to spend time with you, perhaps doing something fun or even just relaxing and talking. He or she should be able to show you affection. This can be as simple as giving you a hug or holding your hand. He or she should be able to lend a listening ear or a shoulder to cry on.
Speaker2:
And equally important, he or she should be able to celebrate your successes with you. As I mentioned before, my office staff and I pride ourselves on being an integral part of our patients support system. We like to say, Let us do the worrying for you. It's our job to take care of the little details regarding your cancer treatment. And I've structured my office environment accordingly. I feel that this is very important. Look for a doctor who supports you and encourages you rather than gets upset with you. Look closely at the office staff. See if they look like they enjoy their jobs or not. Ask yourself if those who are caring for you are service oriented. Seek out an office with a pleasing, calming environment rather than a cold, sterile one. The final attribute I strongly encourage you to look for in a doctor is making sure that he or she has a plan for proper follow up. Now we know that cancer is an extremely aggressive disease. Even when certain treatments are effective in killing cancer cells, the remaining cells are always looking for a way to continue to survive and grow. Therapies that have been effective might not continue working over time. We know that cancer cells can change forms. This is a process known as mutation. And this is the same process which creates a cancer cell from a normal cell. But mutation continues to occur over time if we're not careful.
Speaker2:
So we have to continually monitor the environment to make sure that's not happening. Now, there are several ways we should be monitoring cancer treatment effectiveness. And as I mentioned earlier, we can certainly get tumor markers, which are conventional lab tests run by virtually all oncologists. We can obtain imaging, including a PET scan, an MRI, a CT scan, an ultrasound, an x ray. But it doesn't stop there. We need to continue to get advanced testing, like I mentioned earlier, and we need to do this regularly and be proactive. Now. I always tell my patients that cancer is a lifelong diagnosis, even when we ultimately achieve normal blood work and imaging results. The moment we let our guard down is the moment cancer can once again obtain a foothold. As you can see, a lot goes into proper cancer treatment and management. You owe it to yourself to find a cancer specialist who has the training, knowledge and treatment protocols to meet your needs. In fact, you deserve it. I hope that this information has been helpful for you. As I said before, you don't deserve to feel like you're going at this alone. You deserve to have a really good support system and a team around you, and that should include your cancer doctor. In future episodes will be delving deeper into some different therapies and how they work and why they work, and how they can be incorporated into an overall integrative treatment plan. Until next time. This is Dr. Stegall.
Speaker1:
Thank you for listening to the Cancer Secrets podcast. If you were encouraged by this show, please share it with a loved one or friend. Help support the show by leaving us a rating and review on iTunes. The more reviews, the more friends like you can find the show. Finally, to learn more, visit us online at Doctor Stay Google.com. The Cancer Secrets Podcast. Changing the Cancer Paradigm.
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