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Episode 4
The Doctor's Farmacy: House Call

The Functional Medicine Approach To Cancer and Cancer Recurrence with Dr. Elizabeth Boham

Open the Podcasts app and search for The Doctor’s Farmacy. If you’re viewing this site on your phone, you can just tap on the

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Numerous things can contribute to cancer development and cancer recurrence. Studies show diet, exercise, thoughts, feelings, and environmental toxins all influence the initiation, growth, and progression of cancer. And when it comes to treating cancer, we are good at cutting it, burning it, and poisoning it with surgery, radiation, and drugs, but many doctors fail to treat the root cause of the cancer. Functional Medicine empowers patients and practitioners to achieve the highest expression of health by working collaboratively to address the root causes of disease. For example, a Functional Medicine practitioner might say that yes, we still need radiation and other conventional approaches, but what else can we do?

In this mini-episode, Dr. Hyman is joined by Dr. Elizabeth Boham to discuss the Functional Medicine approach to cancer and cancer recurrence prevention. Dr. Boham shares patient cases as well as her own experience with a breast cancer diagnosis.

Elizabeth Boham is a physician and nutritionist who practices functional medicine at The UltraWellness Center in Lenox, MA. Through her practice and lecturing she has helped thousands of people achieve their goals of optimum health and wellness. She witnesses the power of nutrition every day in her practice and is committed to training other physicians to utilize nutrition in healing. Dr. Boham has contributed to many articles and wrote the latest chapter on Obesity for the Rankel Textbook of Family Medicine. She is part of the faculty of the Institute for Functional Medicine and has been featured on the Dr. Oz show and in a variety of publications and media including Huffington Post, The Chalkboard Magazine, and Experience Life. Her DVD Breast Wellness: Tools to Prevent and Heal from Breast Cancer explores the functional medicine approach to keeping your breasts and whole body well.

In this episode, Dr. Hyman and Dr. Boham discuss:

  • Dr. Boham’s personal experience as a breast cancer patient and how it led her to begin practicing Functional Medicine
  • The use of ketogenic and fasting-mimicking diets to treat and prevent cancer
  • Why Functional Medicine looks at markers such as blood sugar and insulin levels, inflammation levels, toxic load, nutritional status, stress levels, and genetics to identify the underlying risk and cause of cancer
  • Using diet and supplementation to influencing gene expression
  • Why obesity is linked to estrogen-related cancers such as breast, uteran, and prostate
  • Environmental toxins and cancer
  • Dr. Boham’s Breast Wellness video “Tools to Prevent and Heal from Breast Cancer.” Stream the video online here or visit http://www.drboham.com/order and use the code “breast30wellness” to receive 30% off your DVD purchase.
  • For more information visit drhyman.com/uwc

I hope you enjoyed this conversation as much as I did. Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, MD

Guest

 
Mark Hyman, MD

Mark Hyman, MD is the Founder and Director of The UltraWellness Center, the Head of Strategy and Innovation of Cleveland Clinic's Center for Functional Medicine, and a 13-time New York Times Bestselling author.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

 
Dr. Elizabeth Boham

Dr. Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women’s Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine.

Show Notes

  1. Top 5 Tips for Preventing Cancer
  2. I Did Everything Right…But I Still Got Cancer
  3. Breast Cancer Risk and Prevention
  4. My Top 5 Supplements for Breast Health
  5. Breast Wellness by Dr. Elizabeth W. Boham
  6. The UWC Team Shares Why Functional Medicine Matters to Them | A Personal Interview with Dr. Elizabeth Boham
  7. The Harm of Statins and the Right Diet for Cancer Prevention
  8. 5 Strategies to Prevent and Treat Cancer
  9. Dr. Elizabeth Boham on Breast Cancer, Women’s Wellness and Becoming the CEO of Your Health
  10. 10 Strategies to Prevent and Treat Breast Cancer

Transcript

Dr. Mark Hyman:
What we’re talking about in functional medicine is true prevention. Whether you’ve already had it and you want to prevent it from coming again. Or you have a family history you’re worried about. You actually can map out what’s wrong and fix those things. And it makes a big difference.

Dr. Mark Hyman:
Hey everybody, it’s Dr. Mark Hyman. Welcome to this special episode of The Doctor’s Farmacy. That’s pharmacy with F. F-A-R-M-A-C-Y. A place for conversations that matter. And if you’ve got cancer or anybody in your family has cancer you better listen to this House Call. This mini episode because in this series of special episodes of The Doctor’s Farmacy called House Call, I sit down with the UltraWellness Center physician, Medical Director, Dr. Elizabeth Boham. To discuss how we as functional medicine doctors tackle specific conditions that we see at our practice every day.

Dr. Mark Hyman:
And Dr. Boham is an incredible doctor. She’s been my colleague for over 20 years. She’s an exercise physiologist and nutritionist, and a doctor. Which is a rare combo. And I’m so pleased to have her here on The Doctor’s Farmacy.

Dr. Elizabeth Boham:
Thank you, Mark. Thanks for having me.

Dr. Mark Hyman:
So cancer is a very big topic. And we can’t cover it all in 30 minutes. But you have a unique experience that has informed your way of thinking about cancer. Because when you’re 30 and you’re now, can I say 50?

Dr. Elizabeth Boham:
51, yeah. You can say it.

Dr. Mark Hyman:
You add cancer.

Dr. Elizabeth Boham:
I did.

Dr. Mark Hyman:
And when I first met you had really short hair because you just had chemo and all the treatments that cause you to lose your hair. And you actually figured out how to make sure that you weren’t going to get cancer again. And a lot of people knock, knock, well it’s been 21 years. I think you’re good. But it’s interesting I remember these patients coming to the practice. And one of them had like breast cancer and she had colon cancer. And she had three cancers. And the doctor was like, well, we’re just going to do screening. We’re just going to see what happens. Good luck you had your chemo, radiation, surgery and now there’s nothing you can do except wait. And we’ll do a active surveillance.

Dr. Mark Hyman:
It’s not active, nothing. It’s active, nothing. You do nothing. And there’s no plan of what to eat. Or how to figure out why you got the cancer. Or what to do about it. So whether you’re wanting to prevent it, or you’ve had it and you want to prevent get it again it’s important to do a holistic look at biology.

Dr. Elizabeth Boham:
It really is because all of us are individuals. And for me, my undergraduate and graduate degree was in nutrition. And I was an exercise physiologist and I loved to eat right and exercise. Right? So I was doing those things. But there were aspects that I needed to really focus on in terms of me being able to prevent a recurrence of cancer or another type of cancer.

Dr. Elizabeth Boham:
So yeah, I was 30. I had a triple negative breast cancer. I don’t have any family history of breast cancer. It was aggressive. I was very lucky that I found it early as I did. But I did go through a surgery, chemotherapy, radiation. And-

Dr. Mark Hyman:
All the fun stuff.

Dr. Elizabeth Boham:
Aye yai yai.

Dr. Mark Hyman:
The poison. Poisoning, burning, and slashing.

Dr. Elizabeth Boham:
Yeah. And then came out on the other side. And I was like, okay I’ve got to really figure out why did this happen to me. And what can I do to prevent this from happening again? Or how can I help my patients?

Dr. Elizabeth Boham:
And when I first went to AFMCP it was after I started working at Canyon Ranch in Lenox. And where I met you and-

Dr. Mark Hyman:
[Inaudible 00:03:27] functional medicine training program.

Dr. Elizabeth Boham:
Exactly. And it was just like this light bulb went off in my head. Where I was like, okay this makes so much sense. I want to think about this in a totally different way. We’ve got to look at how all the different systems in the body impact if you’re going to develop cancer. We’ve got to pay attention to the terrain in the body. The soil, the things that are feeding the cancer cell. And so each person it’s different. For me I had to really focus on supporting my microbiome and detoxification and stress. But for somebody else it might be really working on reversing insulin resistance.

Dr. Mark Hyman:
Or diet.

Dr. Elizabeth Boham:
Right. Or so there’s, it’s really important to have a real personalized approach here.

Dr. Mark Hyman:
I agree.

Dr. Elizabeth Boham:
And it makes a huge difference.

Dr. Mark Hyman:
Yeah, it does. And I think what I want people to understand is that we strongly support the use of traditional cancer treatments. Whether it’s chemo, radiation, or surgery. But it’s not enough because it’s treating the cancer not the patient, and the soil in which the cancer grew. So functional medicine is an approach that really treats the soil so the cancer can grow back, or that you won’t get in the first place. And I think that’s a really unique approach. It’s not either or. It’s not like, oh just have green juice and your cancer’s going to go away. Forget that. You need to deal with it. But using supportive treatments it works better.

Dr. Mark Hyman:
We have a colleague and a friend who recently had a throat cancer. And it’s 50/50 on that. But he did a ketogenic diet when he was going through treatment. Now there’s a lot of science on this.

Dr. Elizabeth Boham:
There is.

Dr. Mark Hyman:
And one of top cancer specialists, Siddhartha Mukherjee, who’s wrote The Emperor of All Maladies is doing a lot of research on ketogenic diets and cancer. And he came up to me once. He’s Mark, we made an amazing discovery about cancer. I’m like, what is that? I said, is it sugar? He was like, how did you know? I’m like, yeah, well it beats the cancer. And he said, we’re finding that using chemotherapy along with ketogenic diets or even the fasting mimicking diet, different approaches, intermittent fasting. Can actually help the chemo, radiation work better. They have higher cure rates. And then, and so-

Dr. Elizabeth Boham:
Because it puts those cancer cells, they’re stressed in those situations. So they can’t survive as well. And so the chemotherapy kills those cancer cells in those, when somebody’s on a ketogenic diet or a fasting, mimicking diet. Those cancer cells are more at risk. And so they die off.

Dr. Mark Hyman:
Because they only eat sugar. They can’t live on fat. So we can, we have like a, we’re hybrid.

Dr. Elizabeth Boham:
Yes.

Dr. Mark Hyman:
So we can run gas or electric.

Dr. Elizabeth Boham:
Right. Right.

Dr. Mark Hyman:
Well, same thing with your body. You can run on carbs or on fat. And when you run on just fat it changed your metabolism. And the cancer cells only run on sugar. So they don’t, they starve. So this is just one example of the kinds of things we do in functional medicine to help our patients do better through treatment. And actually prevent it after, and to actually not get it in the first place. So people feel sort of helpless about this. But there’s so much we know about what causes cancer, the things we can measure and test for, and things that you sort of discovered on your own. And I think it’s sort of shocking for people to understand that traditional medicine just doesn’t even talk about this. Right?

Dr. Elizabeth Boham:
Right. They’re so focused on the cancer at the acute time. Which is important. But we’ve also got to really work on let’s prevent it for coming back. Let’s prevent it from [inaudible 00:06:49] in the first place.

Dr. Mark Hyman:
And the dietary advice is terrible you get cancer centers. I have a friend who was a top radiation oncologist at MD Anderson which is like the top cancer center in the world. And he was like, our nutritionist I’m just struggling. Because they say if you have breast cancer don’t eat tofu. But you can load up on ice cream.

Dr. Elizabeth Boham:
Right. Which is so backwards.

Dr. Mark Hyman:
And I’m like what? Eat the tofu, forget the ice cream. He’ll say stop drinking wine. Or don’t eat ice cream or sugar which is driving the cancer cells.

Dr. Elizabeth Boham:
Right. Right. Creating a terrain in the body which is feeding cancer.

Dr. Mark Hyman:
Yeah.

Dr. Elizabeth Boham:
Right?

Dr. Mark Hyman:
Right.

Dr. Elizabeth Boham:
So absolutely we’re looking for all those things that may create a terrain that will feed cancer. Whether it’s high insulin, high blood sugar, high insulin levels in the body. High inflammatory markers. So high inflammation in the body. Which will drive cancer cancer.

Dr. Mark Hyman:
Yeah cancer’s inflammatory. People don’t realize that.

Dr. Elizabeth Boham:
Absolutely. Right. So we look for that. We test for markers that measure inflammation. And then we’ll look to try to figure out why is there inflammation? And what can we do to lower it? For some people, it might be the insulin resistance that’s driving the inflammation. For somebody else it may be the gut. And imbalances in the microbiome that’s driving the inflammation. So we really want to look deeper.

Dr. Mark Hyman:
Or toxins.

Dr. Elizabeth Boham:
Absolutely.

Dr. Mark Hyman:
So when you go to a traditional oncologist they’re just looking at the pathology and not looking at the biology. Right?

Dr. Elizabeth Boham:
Yep.

Dr. Mark Hyman:
And they don’t actually look at the terrain which is your nutritional status, your stress level, your level of toxic.

Dr. Elizabeth Boham:
Your sleep.

Dr. Mark Hyman:
Right? Your sleep.

Dr. Elizabeth Boham:
Yeah, your toxins.

Dr. Mark Hyman:
Your microbiome, your genetics. I mean they look at some genetics. But it’s not the kinds of things we look at which are more functional things and not the BRCA gene which is… It’s interesting the BRCA gene, back in the ’40s they sort of have records around this. And then the risk of cancer was like 30 percent if you had the BRCA gene. Now it’s like 70 percent.

Dr. Elizabeth Boham:
Right.

Dr. Mark Hyman:
Why is that same gene? Because the environments different.

Dr. Elizabeth Boham:
Environments.

Dr. Mark Hyman:
Our diets different, toxic load is more, stress is more. All these other variables are affecting the gene expression. So even if you have the genes you’re not necessarily predestined to get something.

Dr. Elizabeth Boham:
Right. So we call the BRCA gene like a high impact gene. Right? It increases risks substantially of breast cancer. But so many women don’t have the BRCA gene and still go on to get breast cancer. So we also look at these low impact genes. Genes that we can really influence with the environment. Genes that aren’t going to cause a huge increase in risk of cancer. But if you got multiple different ones together they can influence your risk. And what’s most important with those low impact genes is we can really influence how they express themselves with our environment.

Dr. Elizabeth Boham:
So we can influence the expression of some of our genes by eating a diet that’s really rich in our cruciferous vegetables, in sulforaphane.

Dr. Mark Hyman:
The broccoli family.

Dr. Elizabeth Boham:
Yeah. The broccoli family. So, and we can maybe influence how these genes work by different supplements or different changes in diet. So I had a woman who came to see me. She was 42. And she had an estrogen receptor positive breast cancer. And she went through surgery. And then they did Tamoxifen. And she came to see me because she wanted to prevent this from coming back. So she’s like, I really want to figure out why this happened and want to prevent it from coming back.

Dr. Elizabeth Boham:
And so we did a multiple different evaluations on her. And one of the things that showed up was when we did some genetic testing, again, those low impact genes. We found a variation in the COMT gene. And the COMT is a gene that encodes for this enzyme, catechol-O-methyltransferase.

Dr. Mark Hyman:
A big mouthful.

Dr. Elizabeth Boham:
Which is that.

Dr. Mark Hyman:
It has to with what?

Dr. Elizabeth Boham:
Yeah. It has to do with methylation. Right. But it’s been found-

Dr. Mark Hyman:
What’s that?

Dr. Elizabeth Boham:
Methylation just means the transfer of these methyl groups. Which come from a lot of our folate, our B vitamins, like folate. Which is in all of our foliage, our green leafy veggies.

Dr. Mark Hyman:
Yeah. [Inaudible 00:10:47] carbon and [inaudible 00:10:47] hydrogens. It has to be shared between different chemicals in the body. And if it’s not working you get all kinds of problems. Whether you get cancer, you get dementia, you get heart disease, you have depression. So these have to be working.

Dr. Elizabeth Boham:
Yes. And so if this enzyme doesn’t work as well because of your genetic predisposition. Then your estrogen in your body doesn’t get broken down and gotten rid of as well. It can become more cancer producing. It can change in a way that’s less healthy for the body. And so we know that we can influence, we can influence that gene when we give a diet that’s rich in folate, all those green leafy veggies. We can sometimes influence that gene with, we also can give like a methylated B vitamins. I think this is-

Dr. Mark Hyman:
Special forms of B vitamins. [Inaudible 00:11:39] going to the grocery store you get folic acid or B12. It may not be the right form to actually activate these things or bypass these enzymes that aren’t working so well in the body.

Dr. Elizabeth Boham:
Yeah. We have a concern about folic acids which is the synthetic form of folate. So folate can be what we get in our food. Right? Our foliage, our green leafy veggies. Lots of other foods too. There’s a synthetic form called folic acid. Which actually has been associated with maybe an increased risk of cancer. There’s some concern about this synthetic form. And that’s found in a lot of not the highest quality, not the vitamins we use. Right? So it’s found in some B vitamins and multivitamins that we’re not going to choose to use because for some people they can’t utilize it in their body.

Dr. Elizabeth Boham:
What you really want to look for is a methylated form of folate. So this type of folate that’s activated. That’s found in a lot of our food. When we’re eating folate rich foods it’s going to be high in this methylfolate. But if you’re taking your supplements, if you’re taking a multi or a B complex, you want to look to make sure it’s a methylated form of folate. Because the body, for certain people that’s more necessary than others, but the body it has an easier time utilizing it. And that helps with this whole estrogen metabolism process.

Dr. Mark Hyman:
And just to back up on that. Some people think there’s something called estrogen. There isn’t. There aren’t estrogens.

Dr. Elizabeth Boham:
Yes, that’s true.

Dr. Mark Hyman:
And they’re all a little different. And some are more prevalent in early life. Some in reproductive years. Some in menopause. And they all have to be metabolized by the body. And it’s sort of like going down a pinball machine, you don’t know where it’s going to go. And some people don’t have good detoxifying mechanisms for all this estrogen. And then they get sort of estrogen toxicity.

Dr. Mark Hyman:
And I think one of the things that’s really striking about what you’re saying particularly in terms of breast cancer is that this woman had estrogen receptor positive breast cancer. And what that means is that this is an estrogen sensitive breast cancer. It feeds on estrogen. Right? And so the beautiful thing about functional medicine is that we can one, test for all these metabolites. And figure out how to change the pin ball thing so it’s going down the right pathway to be anti cancer versus pro cancer. And we use lifestyle, diet, supplements, all kinds of things to do that.

Dr. Mark Hyman:
But what’s really important to understand is that a lot of us are out of balance. And we have imbalances in our hormones and we make too much estrogen. And maybe not on progesterone. And that leads to symptoms of estrogen overload.

Dr. Elizabeth Boham:
Yes.

Dr. Mark Hyman:
And I remember medical school this isn’t a very nice way to talk about patients. But we remembered how do we remember the profile of someone with uterine cancer. Fat, 40, and fertile. Right. And-

Dr. Elizabeth Boham:
Yep. Right. Which is essentially saying high estrogen.

Dr. Mark Hyman:
And if you’re overweight you make higher estrogen.

Dr. Elizabeth Boham:
Right.

Dr. Mark Hyman:
Obesity’s linked to cancer. It’s linked to breast cancer. Insulin resistance and prediabetes is linked to breast cancer and many other cancers.

Dr. Elizabeth Boham:
We have this enzyme aromatase in our fat cells. And aromatase takes other hormones and turns it into estrogen. And this happens in men and women. So when you have more fat cells, you have more aromatase. And so you have more estrogen. And so that then is why, or maybe one of the reasons why that obesity, having more fat cells, is linked to estrogen related cancers. Which would be breast, uterine, prostate is definitely related to this higher estrogen level in the body for example.

Dr. Elizabeth Boham:
So, one of the things everybody can do is make sure their body fat percentage is lower. Right? Because that helps with lowering estrogen levels.

Dr. Mark Hyman:
And we actually have a whole strategy for one, assessing this in functional medicine. Which is not what your traditional doctor will do if you go to breast cancer treatment. And we have a whole strategy for how to balance out your hormones. Right?

Dr. Elizabeth Boham:
Yes.

Dr. Mark Hyman:
So things like diet, exercise, stress reduction, working on your microbiome, the right nutrients, getting your toxins to screw up your hormones. All these things. Fixing your liver. It’s going to all really help, fiber.

Dr. Elizabeth Boham:
Yeah. We really want to pay attention to those xenoestrogens. Right? Those are those toxins from the environment that act like estrogen in the body. So those are environmental toxins, things we know about. Like BPA, plastics, parabens, pesticides. They-

Dr. Mark Hyman:
You put your sunblock on your get all these parabens. May be you’re causing cancer.

Dr. Elizabeth Boham:
Right. Right. And because they can bind to their xenoestrogens, they’re chemicals from the environment. But they can bind to the estrogen receptor in the body.

Dr. Mark Hyman:
So they’re like hormone mimickers.

Dr. Elizabeth Boham:
Yeah.

Dr. Mark Hyman:
And they’re effective and powerful extremely low doses. So I’m not that exposed to pesticides. I’m not getting that much parabens or whatever. They work in a microscopic dose to have a macroscopic effect. And they’re synergistic. So people say, oh this one chemical maybe it’s not so bad in animal studies. But we’re exposed to hundreds or maybe thousands of these chemicals all at the same time. And our different abilities to detoxify them effect our risk. And in particularly in cancer, we know that these chemicals are associated with cancer.

Dr. Mark Hyman:
So how when someone comes in with, let’s say breast cancer, what are the kinds of tests we’ll do? What are the recommendations you’d make? And you have a whole incredible DVD. I encourage everybody get. Tell us about the DVD.

Dr. Elizabeth Boham:
So it’s called Breast Wellness. And it’s tools to prevent and heal from breast cancer. And it looks at the functional medicine approach to breast health.

Dr. Mark Hyman:
And where can they get that?

Dr. Elizabeth Boham:
They can get it at my website, drboham.com. They can also download a free ebook there. I think it’s also on Amazon and Vimeo. It’s everywhere right.

Dr. Mark Hyman:
There you go. There you go.

Dr. Elizabeth Boham:
Actually, it’s on our ultrawellnesscenter.com too.

Dr. Mark Hyman:
UltraWellness Center [crosstalk 00:17:19].

Dr. Elizabeth Boham:
Yeah. So, but you’re looking at that comprehensive approach and treating that individual patient. Right. And we’re focusing on is there toxins that we need to lower? You were mentioning that aspect of toxic load which I think is really important. Because we know that sometimes it’s not just one toxin. But it’s a little bit of a lot of different toxins. So we can look at things, we can measure things like is there high oxidative stress? Right?

Dr. Mark Hyman:
That’s like free radicals. Right?

Dr. Elizabeth Boham:
Yeah. Right. Which could indicate, which would indicate an imbalance between the antioxidant levels in the body and the free radical production. And so sometimes when somebody has oxidative stress that just means that they’ve either produced too much free radicals because of toxins or infections.

Dr. Mark Hyman:
Or they don’t have enough antioxidants.

Dr. Elizabeth Boham:
Or they don’t have enough antioxidants. Right. Through, because they’re not eating enough of the phytonutrients that are, the plant foods that are rich in antioxidants. And so when we see that, when we see that oxidative stress, which we can measure. We really work to lower it with a phytonutrient rich diet. Sometimes we then have to look to see, well why is it high in the first place?

Dr. Mark Hyman:
Yeah.

Dr. Elizabeth Boham:
Right. That’s asking that question. Is there some infection? Is there some toxin? Because you’ve got to figure out why so that you can help with-

Dr. Mark Hyman:
Is there insulin resistance? Pre diabetes?

Dr. Elizabeth Boham:
Insulin resistance. Yep. Yep. Weight. That belly fat.

Dr. Mark Hyman:
Gut issues. You talk about how you measure the poop of patients with breast cancer. Why is that relevant?

Dr. Elizabeth Boham:
Right. Because… I know right? You’re like, how is the poop connected to… Well in fact-

Dr. Mark Hyman:
Well there’s the microbiome in the breast.

Dr. Elizabeth Boham:
Yes. Right. And they’re finding that the microbiome in the breast is different in women who have breast cancer. So there’s so much more we’re going to learn here. But in the gut, we know that if there’s an imbalance in the microbiome there can be an imbalance in this enzyme called Beta-glucuronidase. It can increase. Which can then lead the body to absorb back more of the estrogen. And then puts you in this situation where you’re more estrogen dominant or overloaded.

Dr. Mark Hyman:
So basically there’s like overgrowth of these bugs that shouldn’t be there that produce this enzyme.

Dr. Elizabeth Boham:
Yep.

Dr. Mark Hyman:
That then when the estrogen is detoxified by the liver and dumped in there in the bile, which is how your body gets rid of excess estrogen. It sort of unpacks it a little bit. And then you end up reabsorbing it. And so you get this increased reabsorption of estrogen, high levels of estrogen in breast cancer.

Dr. Elizabeth Boham:
So we’re looking at that level. We can measure that. And we can measure just the imbalances in the microbiome. Which are in fact impacting that level as well as multiple other things in the body.

Dr. Mark Hyman:
Yeah. Given the view of functional medicine which looks at root causes and systems. The fact that antibiotics cause breast cancer is not a surprise.

Dr. Elizabeth Boham:
No.

Dr. Mark Hyman:
Right?

Dr. Elizabeth Boham:
And I had, as a kid I was on multiple rounds of antibiotics for urinary tract infections again and again and again. And then that just was probably the thing that, along with some of my genetic predispositions and some toxins really allowed my body to not work in an optimal way. Yeah. You know?

Dr. Mark Hyman:
Yeah. It’s so powerful. So we actually, through things like lowering sugar and starch in the diet, through things like adding sort of fibers to help a gut flora. Things like certain anti cancer foods, like flaxseeds.

Dr. Elizabeth Boham:
Yep.

Dr. Mark Hyman:
We can actually, and broccoli family, vegetables, you were talking about. We can really have an impact then. Exercise and stress reduction. We put together a whole plan for people.

Dr. Elizabeth Boham:
Yes.

Dr. Mark Hyman:
It doesn’t leave them feeling so hopeless and helpless. And like, I just have to wait around to my next scan or my next mammogram. And cross my fingers. And stress out for the next six months or a year. You can actually be empowered to understand what your biology is doing. What the imbalances are, how to fix them. And is there a guarantee you’re never going to cancer? No. But you’re stacking the deck in your favor. And you’re understanding the imbalances that are driving cancer. And you’re changing the soil.

Dr. Elizabeth Boham:
Changing the soil.

Dr. Mark Hyman:
And that actually won’t allow the cancer to grow.

Dr. Elizabeth Boham:
Yeah.

Dr. Mark Hyman:
Right? So that’s a really powerful model that should be part of traditional oncology. And there are some centers of oncology that are integrating this. But it’s unusual.

Dr. Elizabeth Boham:
Yeah.

Dr. Mark Hyman:
So let’s take the next, a little bit and talk about the next case of a patient who hasn’t had cancer. But was terrified because there was tons of cancer in their family.

Dr. Elizabeth Boham:
Yes, so. Right. So this was a 48 year old gentleman. And he had not had cancer yet. But he had a sister with breast cancer. There was stomach cancer in his family. There was colon cancer in his family and prostate cancer. And so he wanted to do whatever he could. He wanted to create that terrain where cancer was less likely to grow. And we also did genetic testing with him. Again, not those, not the big genes. But some of those low impact genes. And we found a variation in one of his genes called the GSTM1 or glutathione S-transferase gene.

Dr. Mark Hyman:
Yeah. I got that problem.

Dr. Elizabeth Boham:
Yeah. And me too. I’m in that club too.

Dr. Mark Hyman:
Well, potentially people who have this specific gene actually are much more likely to be in hospitals and sick and have issues.

Dr. Elizabeth Boham:
Yes.

Dr. Mark Hyman:
Right?

Dr. Elizabeth Boham:
Yeah.

Dr. Mark Hyman:
And just to back up before you get too much more until it. I just want to sort of help people understand what genes are. So you have like 20,000 genes. And it’s basically this genetic code that is a three letter code of… Is a gene. So you have, let’s say four letters and computers are one to zero. Your biology is four. Like it’s four, ACTG. So, if there’s a variation of that code it may not be a mutation. It’s just a slight variation. It’s sort of like in America we spell color C-O-L-O-R. In the U.K. they spell it C-O-L-O-U-R. So similar but it has different effects. And that is something we can do something about. Right? If you have the gene for down syndrome you can’t do much about that.

Dr. Elizabeth Boham:
Right.

Dr. Mark Hyman:
Right. If you have a gene, like for the glutathione you can influence its function, hence functional medicine. And change the way those genes are expressed through things like diet and exercise. And lifestyle and supplements. And detoxification, all kinds of strategies that we use. And so we check genes that typically aren’t checked. And we see where does this person have the potholes? And how do we help them avoid them?

Dr. Elizabeth Boham:
Yeah. So this, glutathione is this master antioxidant and detoxifier in the body. And we know, like you mentioned when people are, have a defect in this gene, in the GSTM1 they don’t tolerate toxins as well from the environment. Because their body is not as able to take their, to make as much glutathione. And then take, use the glutathione to get rid of the toxins.

Dr. Mark Hyman:
Sort of Glutathione like sulfur smelly, sticky. It’s like flypaper. And all the nasty toxins stick to it. And then your body gets rid of it.

Dr. Elizabeth Boham:
Yes.

Dr. Mark Hyman:
But if you have low levels you’re screwed.

Dr. Elizabeth Boham:
Right. Right.

Dr. Mark Hyman:
And me.

Dr. Elizabeth Boham:
That’s why-

Dr. Mark Hyman:
That’s why I got mercury poisoning.

Dr. Elizabeth Boham:
And one of the reasons you can have low levels is because you have some variations in these genes. And so for people like that we really want to support. We really want to support. We want to support detoxification with everybody. But with those people we really focus on supporting how well they can produce glutathione. And, so we will really focus on things like sulforaphane.

Dr. Elizabeth Boham:
Sulforaphanecomes from your cruciferous vegetables. And it helps-

Dr. Mark Hyman:
Broccoli, collards, kale, Brussels sprouts, cabbage. This is like basic stuff in food that actually has powerful anticancer compounds. And sulforaphane is one of those. They’ve even studied it at Johns Hopkins. They have supplements you can take. We have that on our online store. It’s really effective.

Dr. Elizabeth Boham:
Yeah. That’s one, that’s actually one supplement I take every day. There’s a bunch I take every day. But that’s one I always take. Because it really, it helps the body with production of that glutathione. And, that really, as we said, helps with pulling those toxins out of the body.

Dr. Mark Hyman:
And there’s other stuff that you can take aside from things like garlic and onions and the cruciferous vegetables. There’s a lot of supplements we use in functional medicine that, they’re not replacements for a healthy diet. But they have helped to produce different molecules in the body and help different functions.

Dr. Mark Hyman:
So NAC L cysteine is one of the building blocks of glutathione and helps increase it. In fact, when I was in the ER as a doctor, because I worked in the ER for years. I learned that if someone came in with a liver failure from Tylenol overdose we gave him this quote drug which was called Mucomyst or NAC L cysteine which smelled terrible. It tasted terrible. We made him drink it. I guess a suicide attempt wasn’t enough. And so they… When I started doing functional. They’re like, wait a minute this is incredible. This is just a supplement you can get in the health food store. And they even are studying it for kidney failure that’s caused by dye when you’re got an X-ray. And they actually can prevent kidney failure by giving them this cheap supplement.

Dr. Elizabeth Boham:
NAC. Right.

Dr. Mark Hyman:
Yeah. So it’s really important-

Dr. Elizabeth Boham:
I think that’s really important about supplements. I think that what’s really, they can be so beneficial when they’re targeted and used for that individual person and what their needs are. And I think that’s really sort of a take home here with supplements. Is that, we can’t… Well some people take the kitchen sink. They take a lot of different things and just hoping that one of them is going to be the right one for them. But one of the things we can do, especially with some of this genetic testing we’re talking about. And some of this evaluation that we’re looking at from a functional medicine approach. Is we can, we can really focus on okay for this individual person, what are the ones they really need to focus on? What’s the food they really need to focus on? What are maybe some supplements that they need to focus on to help them get to their optimal health? And that’s, I think when we see them work even better.

Dr. Mark Hyman:
Yeah. And there’s amazing stuff that also has being looked at in terms of detoxification, [inaudible 00:27:05] cancer treatments like high dose vitamin C IV. Which we do at the UltraWellness Center. Can be extremely effective as an adjunct treatment to traditional cancer therapy to reduce the risk of the cancer not responding to the chemo, or afterwards to prevent it from coming back. So there’s so much that can be done.

Dr. Mark Hyman:
And I think, one last point I want to make is that we think of the tests we do in medicine as prevention. So a mammogram is prevention. Colonoscopy is prevention. The prostate exam is prevention. They’re not prevention. They’re early detection. So you have to actually already have the problem before you find it positive. Which is good. It’s a screening test and you find it early enough you won’t die. That’s great. But it’s not true prevention.

Dr. Mark Hyman:
What we’re talking about in functional medicine is true prevention. Whether you’ve already had it and you want to prevent it from coming again. Or you have a family history you’re worried about. You actually can map out what’s wrong and fix those things. And it makes a big difference.

Dr. Elizabeth Boham:
Absolutely.

Dr. Mark Hyman:
Yeah. So just to recap here. We are so inundated with cancer. And there isn’t anybody that hasn’t been touched with it. My family, I had my sister and my dad both have cancer. And they were sort of late stage when they discovered them which is hard to do anything about. But I don’t want people to feel disempowered because with functional medicine and using that lens, and the kinds of work we do at the UltraWellness Center we can map out what the imbalances are. What the risks are. We can design a personalized treatment program for you that actually tests the things that matter.

Dr. Mark Hyman:
Whether it’s your nutritional stuff. We’re looking at Beta-glucuronidase and your poop. We’re looking at heavy metal levels or pesticide levels. Or looking at insulin. Or looking at the methylated nutrients that you need. Or your glutathione levels. We check all of that. And that helps us to create a personalized roadmap for you. Along with other things we recommend. Dietary recommendations.

Dr. Mark Hyman:
Because we know so much about diet and cancer. And that was such a big… At Cornell where you went. And I remember I took a nutrition course. And I had a book. It was like from the national cancer [inaudible 00:29:08]. And it was called Diet and Cancer. This was back in the ’70s. And, we know a lot about this. I remember speaking to my oncology attending when I was doing my oncology rotation in medical school. And I said, what percentage of cancer do you think are diet related? And I thought he was going to like 10 percent, 20 percent. He was like 70 percent. I was like, whoa, because that’s good because it means we can do something about it.

Dr. Elizabeth Boham:
We can do stuff about it. Absolutely.

Dr. Mark Hyman:
So if you have cancer or you know someone with the cancer and you want a different approach I would encourage you to check out somebody who’s trained in functional medicine. Again, we’re happy to see what UltraWellness Center in Lenox. And you can go to ultrawellnesscenter.com. We have great resources on our site. You can go to drhyman.com/uwc. Where we’ll give you a handout on the kinds of things we’re talking about. So you can sort of get started.

Dr. Mark Hyman:
And that’s it for this week’s case study in the House call with Dr. Elizabeth Boham. If you enjoy this mini episode of The Doctor’s Farmacy please share with your friends and family on social media. Subscribe wherever you get your podcasts and leave a comment I’d love to hear from you. And we’ll see you next time on The Doctor’s Farmacy.

Dr. Elizabeth Boham:
Thank you, Mark.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

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