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The Environment of Cancer

10/27/2021

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Dr. Siddhartha Mukherjee on cancer:

​Each person’s body, and the organs within it, provide an array of microenvironments for a potential cancer to grow, or not grow. A question that I think has been relatively neglected in cancer therapy until recently, one that Stephen Paget touched on so long ago, is: How do we change the cancer microenvironment to make cancer cells more susceptible to chemotherapy?

We’ve spent an enormous amount of time thinking about the genetics and the genomics of cancer cells and how to direct therapies against the gene products they make. But I’ve always been more interested in looking at their microenvironment—their home.

​Why is it that the cancer cells can exist in a particular environment, and can you change the homes that foster these cells, allowing them to live and survive? Why do certain cancers only metastasize to certain places in the body? What about those homes allow those cancers to exist? Why don’t they go to other places?


This is the question that I ponder often when it comes to our patients who are fighting cancer. 

HOW CAN WE CHANGE THE INTERNAL ENVIORNMENT OF OUR BODY TO MAKE IT HARDER FOR CANCER CELLS TO LIVE AND SURVIVE? 

Studies on this are of course difficult and varied but in general we do know a few environments inside the body that affect cancer cells. In his manuscript: Immunity, Inflammation, and Cancer, Dr. Sergei I. Grivennikov, explains: Inflammatory responses play decisive roles at different stages of tumor development, including initiation, promotion, malignant conversion, invasion, and metastasis. 

This would stand to reason that if we improve our natural inflammatory response and immune function that we could decrease our risk for certain types of cancer. How do we do that? I like to think about this in a few areas: 
  1. Activity
  2. Nutrition
  3. Chemistry - Medication, Supplementation and Compounding
 
For number 1. What activities could you do that would improve your immune system and inflammatory systems? 
  • Exercise - Exercise promotes significant improvements in clinical, functional, and in some populations, survival outcomes and can be recommended regardless of the type of cancer - Stout NL, Baima J, Swisher AK, Winters-Stone KM, Welsh J. A Systematic Review of Exercise Systematic Reviews in the Cancer Literature 
  • ​Cyclical Prolonged Fasting - Prolonged fasting (>3 days) and Fasting Mimicking Diet programs have been shown to be effective at improving inflammatory markers such as IGF-1 and C-Reactive Protein. They also show benefits with total body fat, glucose and cholesterol. These and other markers affected by fasting or fasting mimicking diets, have been strongly implicated in age-related diseases such as cancer. 
  • Whole Body Cryotherapy - Studies done on athletes, atherosclerotic risk patients and inflammatory disease patients have shown that consistent exposure to whole body cryotherapy can alter the expression of inflammatory markers. This is similar to the effects of fasting above where if we can perform activities that mitigate risk factors we achieve some level of impact on our overall risk and recovery from diseases such as cancer. 
  • PEMF Therapy - Pulsed Electromagentic Field Therapy has been studied in a variety of cancer types. It has been shown to improve cytotoxicity of breast cancer cells when combined with other therapies and decreases the stability of tumor cells allowing easier treatment. PEMF Therapy increase oxygen delivery to the cells in our body improving cell health and potentially decrease abnormal cell growth in the process. 

Nutrition in cancer could be a book in itself but quite a bit of research has been done on types of diets and cancer: 
  • The Ketogenic diet, a high-fat, low-carbohydrate diet with adequate amounts of protein, appears to sensitize most cancers to standard treatment by exploiting the reprogramed metabolism of cancer cells, making the diet a promising candidate as an adjuvant cancer therapy.
  • Plant Based Diets or vegetarian diets may also confer some improved risk of cancer.  In the study: Tantamango-Bartley Y, Jaceldo-Siegl K, Fan J, Fraser G. Vegetarian diets and the incidence of cancer in a low-risk population. Cancer Epidemiol Biomarkers Prev. 2013, researchers found statistically significant benefits to cancer risk in vegetarians and the lacto-ovo-vegetarian diets seem to confer protection from cancers of the gastrointestinal tract.
  • Adding Protective Foods to your healthy diet can also help improve your risk profile. Foods such as broccoli sprouts and other crucifer sprouts contain high amounts of sulforaphane which has the potential to improve the liver’s ability to detoxify environmental pollutants, carcinogens and other toxins.  Increase your consumption of sprouts in addition things like:
    • Carotenoids, or carotenes, found in red, orange, yellow, and some dark-green vegetables
    • Polyphenols, found in herbs, spices, vegetables, tea, coffee, chocolate, nuts, apples, onions, berries, and other plants
    • Allium compounds, found in chives, garlic, leeks, and onions
    • Antioxidants. Examples include beta carotene, selenium, and vitamins C and E. Antioxidants protect against oxidants, which are substances that can lead to cell damage.

Lastly chemical change with medications, compounds and supplements is vital to our prevention and treatment of cancer. 
“For a century we’ve been looking for magic bullets, but maybe all we need is a series of pretty good bullets. So that’s a different sort of thinking process.” – Bob Gatenby
  • Dr. Gatenby explains this phenomenon using a drug called Abiraterone, the idea is to use drugs that already exist, but use them better
    • ​Without taking this completely deep I'd just like to say that great advances have been made in neoadjuvant therapies, immunotherapies and other medical treatments. These can make the internal environment around the cells much more advantageous for us to fight and kill the cells. 
Other supplements and compounds that could help with cancer prevention are:
  • Vitamin D3. Research continues to demonstrate that vitamin D deficiency not only directly increases risk of some cancers, but it can also lead to other risk factors
  • Omega-3s. Found in fatty fish and some nuts and seeds, these essential fatty acids have been shown to help reduce cancer risk and improve recovery from cancer treatment.
  • Bitter melon. Extracts derived from this small fruit with bumpy green skin show great promise against pancreatic and breast cancers in particular.
  • Medicinal Mushrooms. Including (but not limited to) turkey tail (Trametes versicolor), maitake (Grifola frondosa), and reishi (Ganoderma lucidum) provide anti-carcinogenic effects.
  • Curcumin. This is the biologically active polyphenolic compound found in the spice turmeric is a great systemic anti-inflammatory. 
  • Folate, biotin, choline and inositol, niacin and vitamin B12 are all B vitamins that help in the cancer fight. Niacin has been shown to kill cancer cells. Egg yolk, greens and whole grains are the best sources.​

Join The Fight

I hope that like me, if you hear some of the research on cancer prevention and treatment it gives you some sense of direction and control with the genetic cards you are given when it comes to something like cancer. I truly believe that the more research we put into all of these areas the better our prevention, treatment and survival of something like cancer can be. 

I hope you'll join in this fight to continue raising money for more and better research for cancer. 

Derrick Hines, DPT, MS OMT
Sources: 
Immunity, Inflammation, and Cancer (nih.gov)
​
Science Journals — AAAS (prolon.it)
A Systematic Review of Exercise Systematic Reviews in the Cancer Literature (2005-2017) - PubMed (nih.gov)
Physical Activity and the Risk of Liver Cancer: A Systematic Review and Meta-Analysis of Prospective Studies and a Bias Analysis - PubMed (nih.gov)
Microbiome in cancer progression and therapy - PubMed (nih.gov)
Possible role of diet in cancer: systematic review and multiple meta-analyses of dietary patterns, lifestyle factors, and cancer risk - PubMed (nih.gov)
Whole-Body Cryotherapy Decreases the Levels of Inflammatory, Oxidative Stress, and Atherosclerosis Plaque Markers in Male Patients with Active-Phase Ankylosing Spondylitis in the Absence of Classical Cardiovascular Risk Factors - PubMed (nih.gov)
Whole-Body Cryostimulation Improves Inflammatory Endothelium Parameters and Decreases Oxidative Stress in Healthy Subjects - PubMed (nih.gov)
The effect of prolonged whole-body cryostimulation treatment with different amounts of sessions on chosen pro- and anti-inflammatory cytokines levels in healthy men - PubMed (nih.gov)
PEMF Fights Cancerous Tumors - PEMF-TECH
PEMF and Breast Cancer - PEMF-TECH
Vegetarian diets and the incidence of cancer in a low-risk population - PubMed (nih.gov)
Ketogenic diet in the treatment of cancer - Where do we stand? - PubMed (nih.gov)
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Top Sleep Improving Hacks

10/20/2021

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We've talked about what you need to STOP doing to get better sleep but lets look at a few things you can START doing improve your sleep.
  1. Morning Sunlight - getting sun exposure 1st thing in the morning sets your circadian rhythm so that your internal clock knows when to release waking and sleeping hormones correctly. Spend your first 15-20 minutes of the day in the sun.
  2. Meditation - I’ve seen few things change sleep quality like 20 minutes of daily meditation. I’ve seen this one activity DOUBLE people’s deep sleep numbers as measured on their Oura ring. Add a meditation session to your daily routine and your brain, health and sleep will thank you.
  3. Night-time Tea - Part of telling your body to shut down comes from your nightly routine. The cornerstone of that routine should be a nightly tea ritual. The Tea Ritual in question is the sleep inducing combination of Chaga mushroom tea, Ashwagandha Power, a tablespoon of apple cider vinegar and a tablespoon of local honey. Drink your tea and write out your next days to-do’s and any thoughts and you’ll soon drift into never-never land. Watch It here 
  4. Restorative Sleep Supplements - While there are many sleep supplements on the market the one I find most beneficial for sleep quality is glutathione. This is your body’s master antioxidant and when taken right before bed it gives your night repair and restoration a good boost. My sleep tracking shows about a 20-40% improvements in deep sleep when I take half of my daily glutathione supplement before bed. (For those who asked this is the one I take) Magnesium is another amazing sleep aid. Try 200-400 mg of Magnesium Glycinate for the best sleep improvement benefits. Apigenin is also great to help people sleep all the way through the night.
  5. Blue-blockers - I tend to write or edit before bed so I am looking at a screen at some point in the last hour of my day. I’ve cheated the system by using blue-blocking glasses to block out the blue light and maintain proper melatonin production. Ra Optics makes an extremely high quality blue-blocker for higher end option but I’ve found this $20 amazon purchase to serve me wonderfully.
  6. Track - for something so important to our health and wellness few people actually have a good idea of how they are sleeping. Start tracking your sleep and adjusting your routine to maximize results. I use the Oura ring to track mine but their are many different sleep trackers on the market but I’d definitely recommend something that has an airplane type mode where you can shut off the Bluetooth signal when you go to sleep and allow the sync to happen later. There is some data to suggest that WiFi and Bluetooth signals can disrupt quality sleep and cell recovery.


Lets put this all together - if you can wake up walk outside and do a 20 minute meditation while you sit in direct sunlight you are off to a great circadian start. Once your (consistent) bedtime comes you fix your Cha-gandha tea concoction and throw on your blue-blockers to jot down tomorrows todo list. Then preparing for bed pop your glutathione and magnesium supplements. Lastly put on your favorite sleep tracking device and let your body have 7-8 hours of uninterrupted recovery, rejuvenation and recharging.

While this is certainly not an exhaustive guide it does give you a lot to do. I'd recommend that you just add one activity to your daily/nightly routine. Pick the one thing you think you can be consistent for at least 30 days. As you start sleeping better you may feel the need to add or subtract a few others to be a real overachiever. The important thing is you start.

If you have any questions or would like to hear a bit more of the trouble shooting side of sleep let me know. Sweet dreams!

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Stop Sabotaging Your Sleep

10/13/2021

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Are you ruining your sleep before you even lay down? 

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Poor sleep is associated with increased rates of chronic pain, stress, anxiety, risk of Alzheimer’s, cancer, diabetes, weight gain, dementia, and countless other problems. Poor sleep is basically negative for you in every way. Your brain, body and emotions all function worse if you don’t get good sleep. Yet, research tells us that more than 50% of people don’t get quality sleep at night.

Today we are going to start you down the path to fix that. Before you start adding habits that will improve your sleep it is often much more beneficial to correct the things you are doing wrong first! Basically learn what you need to stop doing before you start trying to add some new activities in. 

Top 6 habits that are ruining your sleep quality:
  1. Too much caffeine - There are many people who are very slow caffeine metabolizes to the point where if you drink 4-6 cups of coffee (keep in mind 1 mug is usually 2 cups) then they still have high amounts of caffeine in their body when they try to shut down. If you don’t know your caffeine metabolism but you don’t sleep well you’d do best to have <2 cups of coffee and do it before noon.
  2. TV/Phone Screens in bed - when bright lights particularly of blue wave length stimulate your eyes, your brain assumes that light is coming from the sun. This delays your body's natural production of melatonin (the sleep hormone) for up to 90 minutes. SO when you play on your phone getting ready for bed for those 10-30 minutes your body won’t be ready for sleep hormonally for another hour and a half! If you must have screen time we’ll get into how you can cheat later but for now start limiting screen time the last hour before bed.
  3. Sleeping too hot - most people make the mistake of keeping the thermostat in their house too high at night. Research says that you should sleep between 64-68 degrees to get the best quality sleep. This is because the temperature drop is one part of what stimulates your body to shut down and get into deep, restorative sleep. Turn that temperature down!
  4. Irregular bedtimes - Yes as adults we need bedtimes too! If you change the time you prepare for and go to sleep each night your body can’t find a good rhythm. Many people change their bed time depending on the day of the week and their body hates them for it. Keep a more regular bedtime and try to change it by no less than 60 minutes on the weekends and watch your sleep quality continue to improve.
  5. Not expending enough energy during the day - if you aren't burning calories, moving a lot or exercising then your body won't have as strong of a signal to shut down for recovery. I find that I sleep the best when I do zone 3-4 type of exercise (fairly intense HIT type exercise) but some research shows benefits to zone 2 or slow cardio training.
  6. Staying inside all day - not getting a moderate amount of sunlight during the day will ruin sleep very quickly. Your natural circadian rhythm relies on you getting sunlight during the day. Even just 30 minutes of sunlight will help to regulate your circadian rhythm. 

Next week we'll dive into some of the habits you can add to your daily routine to get the best sleep of your life. In the meantime start cleaning up the bad habits that may be ruining your sleep!
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    Derrick Hines, D.P.T. is the owner of Acadiana Pain and Performance Rehab. The information in this blog is personal opinion and not to be used as medical advice.

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