Rebekah Kelley: Welcome to the Humanized podcast, all about personalizing your health. I’m your host, Rebekah Kelley, and today our topic will be, Can you Prevent Cancer Recurrence, with naturopathic physician Dr. Amy Rothenberg. Before I introduce Dr. Rothenberg, I want to remind everyone to subscribe and get all the other variety of casts in audio, video and transcription at HumanizedHealth.com. I’d also like to thank our lead sponsor, Village Green Apothecary, at MyVillageGreen.com.

Dr. Rothenberg is a licensed naturopathic physician who has been working with patients since 1986. In her practice, she utilizes therapeutic nutrition through food and supplementation, botanical medicine, homeopathy, exercise, mindfulness, and other lifestyle modifications to create individualized patient plans. Dr. Rothenberg is also a writer and teacher, and she has a new book, You Finished Treatment, Now What?, which is a roadmap for lifestyle and natural medicine approaches to address health challenges that persist after cancer care and to reduce the risk of recurrence. Written for cancer survivors/thrivers, those who care for them, as well as healthcare providers, You Finished Treatment highlights the evidence for an integrative approach to healing. As a cancer survivor/thriver herself, she makes sense of an overwhelming topic in a user-friendly, accessible way, providing actionable information and inspiration.

Thanks for being back with us, Dr. Rothenberg.

Amy Rothenberg: Thank you very much for having me.

Rebekah Kelley: So, some patients ask, if I already had cancer, does my lifestyle really matter?

Amy Rothenberg: That’s a question I have all the time, everything from people who smoke to eat very unhealthy, sort of standard American diets, et cetera. They’ll say, well, the worst thing already happened. Does it matter? Do those things really matter? And I can assure you a hundred percent that those things do matter, that improving one’s lifestyle and diet and removing certain things that are known carcinogens can definitely impact your chance of survival.

So, it’s never too late to change. Incremental change that is enduring is helpful. We always start slowly, we figure out where the leverage points are with a patient, where we can make those changes to help them feel better, and also to live better lives, healthier, longer lives.

Part of my job, I feel, is to empower people, empower people to realize the absolute capacity they have for improving their health, and then also give the plan, but then also act as a cheerleader to help the person to stay true to the plan, and make it in a way that is accessible to that person and their basic nature. There are finances, the support systems they have in their home and work and communities. You can make a wonderful plan, but if a person won’t do it, or won’t stay with it, it doesn’t really help. But the answer to your question is, it’s never too late to improve your lifestyle to help impact your chance of having more cancer-free time and having a better quality of life.

Rebekah Kelley: Can natural medicine and lifestyle approaches really help prevent recurrence? And if so, what are those kinds of things that you would recommend that they do, so they are going to help?

Amy Rothenberg: There’s wonderful research on the impact of certain lifestyle approaches to help reduce the chance of having recurrence. So we know that exercise is high on that list, and the anti-inflammatory diet is high on that list – you can listen to the previous episode with me about that. We also know that removing toxins from the environment in our home, in terms of our personal care products, our cleaning products. The foods that we eat also can help to reduce recurrence because we’re removing things that are challenging for our systems to detoxify from. We also know that spending time working on the microbiome and creating a microbiome that is really robust and diverse can help to support optimal immune function. And cancer survivors, like everybody but in particular, are very dependent on a well-functioning immune system to be able to go after any wayward cells, any cancer cells that are trying to set up shop. So we know that’s another thing that we can do. We also know that getting adequate rest can impact your immune function, so that’s another key area. We also know that the mind and the head game and the psychological aspects of being alive… when people are under a lot of stress and have that long-lasting stress response, that also impacts immune function.

So there are many leverage points that we have with patients to try to look at what is their life like right now, and where are places that we can help them so they have better chances to go longer without a recurrence, or maybe not have a recurrence ever again and die when they’re very old of something else.

Rebekah Kelley: I love that. So, if there were things like, let’s say there’s three things that you could do that are at the top of what can help people with their odds for not getting cancer again, what would those… because you mentioned a bunch of things, right? So it sounds like to me it’s a radical, in a way, lifestyle change, but for the better, right? All the things that you mentioned sound great. Being very careful about your stress levels, being careful about what you eat, detoxifying your environment. Those are things that are really good for anybody, right? Generally. Especially for someone who has already had some challenges. So what would be those things that you would recommend that are kind of at the top, if someone’s going to look at that?

Amy Rothenberg: The very top thing, if you can only do one thing, would be to exercise. If you already exercise, you might want to consider ticking it up a little bit more, more aerobic, include some resistance training, do something that’s more stretching like yoga, qigong, Tai Chi, something like that.

The second thing that I would say is that if you smoke, you have to figure out how to stop smoking. There are smoking cessation programs at many local boards of health, the American Cancer Society has a smoking cessation program that’s free to the public, you can find it online. So there are ways to get tools and support to quit smoking. Vaping, as well. It’s not better to vape. That’s a myth. It’s also very bad for people.

The other piece that’s kind of connected for a lot of people with smoking is drinking. There’s very good evidence that over-consuming alcohol is a very strong risk factor for a number of kinds of cancer. So what does that mean? For a woman, that means one drink a day is okay, for a man, two drinks. Not more than that. And I would say for people who’ve already had cancer, the safe amount of alcohol to drink, sadly, is zero. That doesn’t mean you can’t have the occasional glass of wine, but I would not have that be part of a regular daily cycle, partly because of the sugar content. A lot of alcohol has quite a bit of sugar, and we know that sugar is not great for the immune system to function at its optimal place.

And then thirdly, I would say shifting away from processed foods, foods that are high in trans fats, foods that are overly processed, that have additives, preservatives, and shifting as much as you’re able to find and afford an organic, plant-based diet, with lots of fruits and vegetables, nuts and seeds, healthy oils, and your basic lean proteins. Those would be the main things.

And then if I could add one more, it would be to really take a look at your sleep and your capacity to sleep enough, and sleep well. When we sleep, it gives the body an opportunity to reset and to get organized, and for the immune system to work better, for us to process the stress that we have, for our minds and our hearts to sync – that’s the s-y-n-c, not s-i-n-k – to sync periodically, which I think is so good for the human condition in general.

So there are a lot of things that we can do that are, I would call low-hanging fruit. And if you find a naturopathic doctor who can help you, or an integrative medicine doctor who can help you, it’s not all about taking a fistful of vitamins. That’s part of a natural medicine approach for cancer survivors, but honestly, there’s so much more related to lifestyle that has a very, very long reach and a lot of research to support it. I’m not making it up or hopeful and wishful about these things. There’s some really wonderful evidence to show that these kinds of approaches do impact quality of life as well as health outcome.

Rebekah Kelley: Wow. So I really like that you’re kind of talking about the personalized nutrition medicine aspect of this, right? Obviously humanized health, right? And taking a look at yourself and what it is that you’re dealing with and how to address that. Do you have your book? Can you…

Amy Rothenberg: I do. I have it right on my lap. You Finished Treatment, Now What? A Field Guide for Cancer Survivors, and you can find it anywhere books are sold. Softback like this, hardback, ebook and audio are also available. So, I hope people will read it and share it with the people that they know and love who need it. I feel like I have an incredible opportunity as a cancer survivor myself and as a naturopathic doctor to bring together the conventional and the natural medicine approaches to help people. People are suffering unnecessarily. They’re alive, which is fabulous, but they don’t feel very good and they can’t enjoy the things they once enjoyed. And I do think that for most every person, there’s possibility and opportunity for improving health related to cancer care. And also, honestly, there are many people that are living with cancer, perfectly productive lives, feeling kind of “good enough” – people living with cancer. This book is also for you, because the very same approaches that we would use for survivors, meaning a person who’s completed care and they’re well now, no evidence of disease, are the very same things that you would do if you were living with cancer – with a few exceptions so you don’t interfere with current treatments, but for the most part, many of the lifestyle recommendations there are have wonderful evidence to back up their adoption.

Rebekah Kelley: I have a question, because we have a couple of minutes left, and you brought up sleep, and rest, and how important that is. And I know a lot of times when people are stressed and dealing with a lot of things, sometimes it’s hard to sleep, right? Because, you know, it can disturb one’s rest. In your book do you give people tips on what they can do to address those kinds of things that are facing them?

Amy Rothenberg: I do, I have a whole chapter, which is called “Get Your Rest.” Many people, not only cancer survivors, have trouble sleeping. I feel like it’s a trouble of our times. Part of it has to do with our computers and screens and the blue light and all of that. Part of has to do with access to too much work. Part of it has to do with too much stress. So another chapter of the book, which is on the head game and how to build and work with tools to help us get and stay more balanced, also impacts and positively affects sleep. We also know that exercise early in the day, and a routine, all the “sleep hygiene” things, do help. We have an epidemic of dependence on benzodiazepines and other drugs that are hard to get off of. I have many people who live a perfectly healthy lifestyle, but don’t think anything about taking trazodone or something like that to sleep. I have worked with many people like this to help wean off these medications. These medications were never intended to be used in the long run. They were supposed to be used in the short term, and they do, used in the long run, have a side effect profile, parly related to cognitive decline, that’s very concerning. So some of the natural medicine approaches include using things like melatonin and magnesium, sort of nutritional supplements. Others are using botanical medicines, things like lavender that can be very relaxing, whether taken or diffused, and a few other approaches that are related more toward helping balance the adrenal glands and the hypothalamus we call the HPA axis, and we can help to balance that, which can help reduce the stress response and help to improve quality and length of sleep. Sleep is probably the greatest drug of all time [smiles and nods].

Rebekah Kelley: I love my sleep and when I can’t have it, it’s a very frustrating thing. So I’m so glad you’ve addressed that in your book. Thanks so much, Dr. Rothenberg. These are really valuable insights. Dr. Amy Rothenberg can be found at www.dramyrothenberg.com. I’m going to spell that. That’s D R A M Y R O T H E N B E R G.com. Let me remind you to subscribe and get access to all our Humanized videos, podcasts and transcriptions from all of our thought leaders on personalized health at HumanizedHealth.com. Thanks for being with us.

Amy Rothenberg: Thank you for having me.