{"id":21712,"date":"2025-01-10T20:41:12","date_gmt":"2025-01-10T20:41:12","guid":{"rendered":"https:\/\/peraltafinancing.com\/alternative-medicine\/rhr-revolutionizing-cancer-treatment-with-dr-chris-apfel\/"},"modified":"2025-01-10T20:41:12","modified_gmt":"2025-01-10T20:41:12","slug":"rhr-revolutionizing-cancer-treatment-with-dr-chris-apfel","status":"publish","type":"post","link":"https:\/\/fivemor.com\/?p=21712","title":{"rendered":"RHR: Revolutionizing Cancer Treatment, with Dr. Chris Apfel"},"content":{"rendered":"<p> <br \/>\n<\/p>\n<div>\n<p><b>In this episode, we discuss:<\/b><\/p>\n<ul class=\"wp-block-list\">&#13;<\/p>\n<li>Dr. Apfel\u2019s background and personal journey into cancer research<\/li>\n<p>&#13;<br \/>\n&#13;<br \/>\n&#13;<br \/>\n&#13;<\/p>\n<li>The important first steps to take after a cancer diagnosis<\/li>\n<p>&#13;<br \/>\n&#13;<br \/>\n&#13;<br \/>\n&#13;<\/p>\n<li>The SAGE Oncotest: Innovation in cancer treatment selection<\/li>\n<p>&#13;<br \/>\n&#13;<br \/>\n&#13;<br \/>\n&#13;<\/p>\n<li>Why you should consider integrative oncology<\/li>\n<p>&#13;<br \/>\n&#13;<br \/>\n&#13;<br \/>\n&#13;<\/p>\n<li>Promising innovations to know about<\/li>\n<p>&#13;\n<\/ul>\n<p><b>Show notes:<\/b><\/p>\n<p><noscript><iframe loading=\"lazy\" title=\"RHR: Revolutionizing Cancer Treatment, with Dr. Chris Apfel\" width=\"840\" height=\"473\" src=\"https:\/\/www.youtube.com\/embed\/0Ze-8rpJRYs?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/noscript><\/p>\n<p><iframe loading=\"lazy\" style=\"border: none;\" title=\"Libsyn Player\" src=\"https:\/\/chriskresser.com\/revolutionizing-cancer-treatment-with-dr-chris-apfel\/about:blank\" width=\"100%\" height=\"90\" scrolling=\"no\" allowfullscreen=\"allowfullscreen\" data-rocket-lazyload=\"fitvidscompatible\" data-lazy-src=\"https:\/\/html5-player.libsyn.com\/embed\/episode\/id\/33738902\/height\/90\/theme\/custom\/thumbnail\/yes\/direction\/backward\/render-playlist\/no\/custom-color\/87A93A\/\"><\/iframe><noscript><iframe loading=\"lazy\" style=\"border: none;\" title=\"Libsyn Player\" src=\"https:\/\/html5-player.libsyn.com\/embed\/episode\/id\/33738902\/height\/90\/theme\/custom\/thumbnail\/yes\/direction\/backward\/render-playlist\/no\/custom-color\/87A93A\/\" width=\"100%\" height=\"90\" scrolling=\"no\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/noscript><\/p>\n<p>Hey everybody Chris Kresser here, welcome to another episode of <i>Revolution Health Radio<\/i>. We live in the era of precision medicine, with many exciting innovations in diagnosis and treatment. Yet in many ways, cancer care lags behind. It remains pretty hit or miss, with only about a 30 percent chance of efficacy overall. There are new, relatively new diagnostic methods like genomic testing, but only one in four patients have actionable mutations to benefit from those therapies. And even if you are one of those one in four patients, the therapies aren\u2019t guaranteed to work. So there\u2019s really still quite a lot of room for improvement in cancer screening and treatment and follow up. And that\u2019s why I\u2019m really excited to welcome Dr. Chris Apfel. He is an MD, PhD, and MBA, a very highly educated guy who\u2019s a physician, clinical researcher with over 100 published, peer reviewed papers, including a six factor clinical prediction model published in the <i>New England Journal of Medicine<\/i> that led to the development of the Apfel score, which is a clinical calculator used universally. He kind of wrote the textbook on this to predict the risk of postoperative nausea and vomiting. That was his original area of focus. But he became interested in cancer diagnosis and treatment when his father was diagnosed with lung cancer. He had already lost his mother to ovarian cancer. And when his dad was diagnosed with lung cancer, he opted to forego any therapy after having witnessed his wife really suffer from chemotherapy and just a sort of blunt instrument approach to treating her disease. And that drove Dr Apfel to want to find more effective means of diagnosing, or more specifically determining what treatments tumors would respond to, and thus increasing survival rates dramatically. So that really initiated a new effort. He left the clinical department at UCSF where he was, got an MBA from Wharton to complement his scientific education, and started SageMedic, a new company dedicated to this kind of precision cancer testing and optimizing the therapeutic approach based on the specific characteristics of the tumor. So I really enjoyed this conversation with Dr Apfel. I learned a lot. I wasn\u2019t familiar with this test. It has the potential to be a game changer. Some of the most recent clinical data suggests it can roughly double the chances of a successful outcome, and it\u2019s unlike any other test that\u2019s available right now. So cancer continues to increase as a cause of death. I expect that will continue to be the case in the next several years, and so it\u2019s more important than ever for us to have new tools to be able to increase our chances of overcoming it. So in this podcast, we talk about what the SAGE Oncotest is, how it works, what types of cancer it works for, how you can get the test if you have cancer, you or a friend or family member, what drugs or treatments the SAGE Oncotest tests for and some of the other new innovations on the screening and treatment side in the cancer world that Dr Apfel is excited about. Like I said, I learned a ton in this interview. I\u2019m really excited to be aware of these tools now to recommend in my network, and I hope you learn a lot as well. So without further delay, let\u2019s dive in.<\/p>\n<p><b>Chris Kresser:<\/b> Dr. Apfel, thank you for being here. It\u2019s a pleasure to have you on the show.<\/p>\n<p><b>Chris Apfel:\u00a0 <\/b>Thank you for having me.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>So I always love to start with just the guest\u2019s personal story and background. I came to this work through my own struggle with chronic illness and also watching a grandparent struggle with a heart attack and all the consequences of that. And I know you have your own personal story as well. So what got you interested in cancer research in the first place?<\/p>\n<h2 class=\"wp-block-heading\"><b>Dr. Apfel\u2019s Background and Personal Journey into Cancer Research<\/b><\/h2>\n<p><b>Chris Apfel:\u00a0 <\/b>Well thank you very much for asking. I have a medical background. I studied medicine way back in Germany and was very interested in clinical research. So my question was always what improves patient outcomes? So I\u2019ve studied, run a lot of clinical trials and published over 100 peer reviewed papers and developed a clinical prediction model that is now textbook knowledge in the field of anesthesia and perioperative care. So that\u2019s not oncology. And as a result of that, I basically got recruited to the US, and when a big paper came out on a 5000 patient study that we conducted in Europe and then was published in the <i>New England Journal of Medicine<\/i>, and I had some nice offers at the Cleveland Clinic, at Harvard and Stanford and and I chose the University of California in San Francisco because that\u2019s actually one of the premier institutions that are really thinking of how can we really have global health and improved health for everybody? It\u2019s a wonderful institution. And I continued my research there until my dad was diagnosed with lung cancer, and it was relatively clear he said to me, well, unless you can promise me the therapy is going to work, I don\u2019t want it. And the background was that my mother has passed away from ovarian cancer. The conventional treatment, the chemotherapy basically destroyed her and made her miserable, even into her last months of life and it was actually only then that I realized even today, cancer treatment is largely hit or miss. We all like to believe the future is here now, but when one of your loved ones is affected, what you often realize is we\u2019re still living in the past. And that struck me, and so, because I\u2019ve also been an intensivist and in the ICU, if somebody has a sepsis, so a serious infection that is in the blood, we usually take the specimen, a blood specimen, we cultivate the germs, and then we put antibiotics on it to understand which one is the most effective treatment. And you really need to see what works best in order to understand what you want to give to the patient. And you can\u2019t do this just with genomic testing, because that\u2019s a very reductionistic approach. So the whole organism, like a bacterium, is basically more than the sum of its parts. And that\u2019s actually especially true in the field of cancer. And the idea that what\u2019s still the current standard of care is you take a biopsy, it\u2019s thrown into formalin to preserve it. The tissue is then fixed and dead, and then you try to extract a molecule to predict which therapy would work, had you kept this tissue alive, and had you actually found it out. It\u2019s a very indirect method. It has an appeal of mechanisms of certain molecular pathways. But in what way this is really relevant for that individual patient is not always clear. We call it, it\u2019s called precision medicine, and it has led to the development of wonderful targeted therapies that actually have shown effectiveness for some patients, but unfortunately, only for a minority of patients. So unfortunately, according to the National Cancer Institute\u2019s MATCH trial, the abbreviation for molecular choice, molecular analysis for therapeutic choice. According to the trial, only one out of four patients have so called actionable mutations. So have genetic alterations for which we have drugs that are more likely to work than others. And what we often forget is even then, the targeted therapy often doesn\u2019t work. So this reductionistic approach ignores that the whole cell and the whole tumor is much more than the sum of its parts. It\u2019s not just the DNA, it\u2019s also the DNA expression, it\u2019s a metabolomics, it\u2019s a proteomics, it\u2019s the extracellular matrix, it\u2019s the micro environment of the tumor that all affects whether this tumor will respond to a certain therapy or not. And you cannot with no matter how much AI you throw on this, you cannot predict this with genomic testing. And so I was asking my oncologist, why can we not just take the patient specimen out, divide it up and test it in vitro to understand what would work best? And that\u2019s actually when my journey started.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>Go for it, right? And you did. So before we talk a little bit more about what you developed with the SAGE Oncotest, let\u2019s linger a bit more on the standard model of care for cancer. I believe, from the statistics I\u2019ve seen, you\u2019ve got, even in this era of precision medicine, you\u2019ve got about a 30 percent chance of efficacy with treatment. And you also just highlighted some of the issues with focusing exclusively on genomic testing. Only one in four patients have actionable mutations that would even benefit from that therapy, and then the therapy itself may not work, even if you\u2019re one of those lucky one in four patients. So what are some other challenges right now that somebody who\u2019s diagnosed with cancer faces in the standard of care? And what are some of the strengths of the standard of care that we can take with us forward into a new generation of cancer diagnostics?<\/p>\n<h2 class=\"wp-block-heading\"><b>Important First Steps After Diagnosis<\/b><\/h2>\n<p><b>Chris Apfel:\u00a0 <\/b>Yeah, I think what\u2019s really important is that if you have the diagnosis, you probably should take your life into your own hands. You cannot just rely on what\u2019s been established. More often than not, you actually have to do something. So [my] first recommendation for anybody who has a diagnosis [is to] assemble a support structure. You most likely don\u2019t have a medical background. All those technical terms don\u2019t make sense to you. And the first time you hear this diagnosis, you are emotionally overwhelmed. You may not, most of this you may not understand and when you go home, you actually don\u2019t, most people don\u2019t remember exactly what was said, and it\u2019s emotionally extremely stressful. My advice, number one, would be [to] develop a support structure. Have your partner, have your friends with you, and seek out patient advocacy groups, because you need to actually, basically understand what\u2019s going on to kind of navigate the system. So there are brochures on your disease. You need to know what type of cancer this is, is there a certain subtype? What stage is it? What are the treatment options? And it reminds me of an advisor of ours, Dr. Archelle Georgiou, who has written a book titled <a href=\"https:\/\/www.amazon.com\/Healthcare-Choices-Steps-Getting-Medical\/dp\/1442260335\"><i>Healthcare Choices<\/i><\/a>. And she also has a wonderful podcast, <a href=\"https:\/\/podcasts.apple.com\/us\/podcast\/speak-up-for-your-health\/id1713122476\"><i>Speak Up For Your Health<\/i><\/a>. And what she says is you need to understand your condition, what are the alternatives of the treatment, what are the risks, what\u2019s the experience, and also understand that it\u2019s your body, it\u2019s your health. So you may actually prioritize, for example, quality of life versus longevity or minimally or maximal invasive interventions very differently than anybody else. It\u2019s your choice. It\u2019s your decision. And you want to be able to understand how can you navigate the healthcare system? How can you communicate with your healthcare providers? What can they do? What can they not do? And this book also has very nice decision making tools at the end. So think through this, assemble a support structure with patient advocates. And then there\u2019s one other thing that I actually would like to emphasize, get a second opinion. It\u2019s actually a very interesting study by Dr. Snyderman and colleagues from the Memorial Sloan Kettering Cancer Center that actually has shown that if you actually look at second opinions, they can improve a patient\u2019s outcome in roughly 23 to 57 percent of cases. It\u2019s actually a pretty powerful study. And so that is, this would be the first step. Try to get your head around and try to understand it, because most likely than not, if you want the best possible outcome you want to be proactive and mindful about that. If you are in an early stage, you have a little melanoma, or you have a little lump in the breast, very often, with a surgical removal you could be cured, and you will know. So a chance to cut is a chance to cure, so to speak. In an early stage, stage one, cure rates are above 90 percent, 95 percent. We do exceptionally well in breast cancer. Actually, in one of the exceptions for the US healthcare system, in breast cancer, we actually outperform other Western countries, which is a surprise to me, but it has to do with the aggressive screening. So if it\u2019s an early stage, you\u2019re most likely fine. Unfortunately, our system is not set up for early screening. Even though there are now pan cancer screening tests, they\u2019re not covered by insurance. People don\u2019t know about it, and so very often you get diagnosis stage three, stage four, and you really need to be searching for what you can do in order if you want your outcome to be better than the average.<\/p>\n<blockquote class=\"wp-block-quote tweet is-layout-flow wp-block-quote-is-layout-flow\"><p>&#13;<\/p>\n<p>Dr. Chris Apfel joins Chris Kresser to discuss the SAGE Oncotest, a breakthrough in precision cancer care. Learn how personalized testing is doubling treatment success &amp; improving outcomes. #CancerCare #Oncology #PrecisionMedicine #Chriskresser<\/p>\n<p>&#13;\n<\/p><\/blockquote>\n<p><b>Chris Kresser:\u00a0 <\/b>Yeah, I\u2019m 100 percent in agreement with you. I\u2019ve been involved as a patient, as a clinician, as a family member of the healthcare system for many, many years, and I\u2019ve seen so many instances where people who were willing to advocate for themselves or perhaps advocate for a family member, had such a better outcome as a result of that, because, as you pointed out, nobody knows what their priorities, what a given person\u2019s priorities are better than themselves. And oftentimes in the healthcare interaction, assumptions are made by the clinician perhaps has a certain perspective or a certain bias towards treating a certain way, being very aggressive, let\u2019s say, and the patient, that may not be how they want to approach it. But without informed consent or without seeking other opinions, or without really understanding the full range of options, they just take that route because it\u2019s what the doctor suggested, even though it wasn\u2019t the best route in their particular situation. So I definitely agree with that. Let\u2019s talk a little bit now about this SageMedic and the Oncotest, and going back to what your father\u2019s oncologist said, or the question that you asked your father\u2019s oncologist and what came of that.<\/p>\n<h2 class=\"wp-block-heading\"><b>The SAGE Oncotest: Innovation in Cancer Treatment Selection<\/b><\/h2>\n<p><b>Chris Apfel:\u00a0 <\/b>Right. So it was actually quite interesting, because I also have a biostatistical background. I looked into the literature trying to examine the biopsy, the fresh biopsy, and grow the tumor in vitro. That actually is not a new idea. That actually has been tried before 40 years ago. And interestingly, if you can actually grow the tumor that\u2019s been kind of well established, and you put different drugs on it, you can actually say, with roughly 80 percent what works best. One of the challenges, why this has never become standard of care, was that it is very hard to grow the tumors. Very often you may not have proliferative material in the biopsy and actually in the majority of cases, those tumors, these ex vivo experiment didn\u2019t grow. So if they grow, then you can actually measure which drug is best to inhibit the growth. But if they are basically very slow growing, or don\u2019t grow at all, or get infected or die off, then you don\u2019t have a result. And so what we said is there must be a way to have those results faster and not be dependent on the tumor growth. Because we don\u2019t just want to inhibit that it\u2019s growing and staying there, we actually want to succeed. We want to win this battle. We want to basically kill the tumor. We want a complete tumor response, and we want long-term survival. That\u2019s actually what I would want to have. And so we developed a technique where we can actually get this biopsy shipped to us overnight. We create hundreds of micro tumors within one day. They are similar to the original tumor and then we drug them with often dozens of drugs to understand which drug or which drug combination is most effective in killing your cancer. And with this approach, we have a result back for you and the oncologist within seven to 10 days in over 90 percent of cases. And we have some data that suggests this can double the patient\u2019s chance of a tumor response and significantly increase quality of life and survival.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>Amazing. So it sounds like the innovation was around creating a plurality of the tumors rather than waiting for them to grow. You\u2019re doing a bunch of micro tumors, and that allows you to do it much more quickly and not be dependent on the tumor growing as previous method was focused on.<\/p>\n<p><b>Chris Apfel:\u00a0 <\/b>Yes, yes. That\u2019s one of the interesting things, yes.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>And what, are there particular types of tumors that you tend to have more success with in this approach and types of tumors that tend to be more difficult or more resistant to this approach?<\/p>\n<p><b>Chris Apfel:\u00a0 <\/b>So the beauty about our platform is that it is more or less tumor agnostic. So we can test triple negative breast cancers. We can test colorectal cancer. We can look at liver metastasis, just on a core needle biopsy. I have a strong interest in ovarian cancer, because my mother passed away from ovarian. So we do a lot in ovarian cancers. We have actually done stuff for glioblastoma. We also have done stuff for rare cancers or cancers of unknown origin. That\u2019s actually where our platform really thrives, in particular when this is a late stage a metastatic or recurrent cancer or the therapy has stopped working, then you don\u2019t wait. You don\u2019t want to wait until it\u2019s too late. You actually want to act now. Get a biopsy. See where we can get a biopsy to have that shipped to us, so that we can provide you with the options that are most likely to be effective for you.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>So let\u2019s talk a little bit about those therapies. What kind of drugs are being tested, and are you also testing a combination of drugs, which, of course, some oncologists like like to do?<\/p>\n<p><b>Chris Apfel:\u00a0 <\/b>Yes. And so we have, what we normally do is the following. And let me also take one step back. If you are diagnosed and you are scheduled for surgery, that\u2019s actually the best opportunity to get a specimen to us, and you need to contact us ahead of time, because otherwise the specimen is thrown into formalin and the tissue is dead and can no longer be tested. So that needs to be arranged beforehand and that way you don\u2019t need an extra biopsy, and you have plenty of material for testing. So I\u2019ll give you one example. So let me walk you through ovarian cancer. There are, I would like to say roughly five to 10 chemotherapies that are more or less standard of care. Usually it\u2019s a doublet therapy. We test the single compounds as well as a combination. But there are also so-called PARP inhibitors. And these PARP inhibitors are often given for maintenance, especially when the patient is BRCA one or two positive. And so we also take testing the PARP inhibitors. And then there are, some of the drugs are often pro drugs. So we test these drugs that are the active metabolites of that. And so we have the panel that is within the NCCN guidelines number one. That\u2019s the first priority, because oncologists primarily are sort of bound to work within a framework, and the National Comprehensive Cancer Center Network, NCCN, has guidelines for oncologists which drugs to choose based on the tumor type or subtype. And so we test those first so that the oncologist can choose, I would like to say, can select the superior care within standard of care, because then it\u2019s easier for the oncologist to implement it, number one. Number two, if there is a recurrence, we have an extended panel, these are usually another 12 patent drugs. But what we also do, and that\u2019s actually has recently come up, we also look at repurposed drugs. It\u2019s very interesting. There are drugs that are commonly used. Metformin is an example. Disulfiram is an example where we have seen. Lovastatin. So statins. There are repurposed drugs that are used for other purposes where your tumor may be very sensitive to. And that should not be a substitute. It should be an add on. It should be integrated into your care to maximize the chance that you get actually a complete response.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>That\u2019s great, because I know several oncologists who are using those repurposed drugs with great success. So it\u2019s great to hear that you test for them. So where does this test fit within like the healthcare system today in the United States, for example? If a cancer patient wants to get this test, does their oncologist need to order it? Can they request it through their oncologist? How would somebody go about getting it?<\/p>\n<p><b>Chris Apfel:\u00a0 <\/b>Right. So it needs to be ordered by a physician. It could be your integrative oncologist, and we would need to get a specimen to our lab. So if you are scheduled for surgery, you speak with the, either the surgeon or your GP, or whoever is organizing this care, and that person can order the test. And then we will also communicate with the surgeon or the proceduralist how to get the specimen. Usually one should also involve pathology, it depends. But it\u2019s ideal if the specimen is directly put during the surgery into the sterile tube, just to make sure that it is sterile. It needs to go through pathology anyway for regulatory purposes, but then that\u2019s the easiest way. The other way is, let\u2019s say you already had your surgery, or you are late stage, and you had already a biopsy, you already had the first and second line therapy, and it\u2019s not working. You may have a lymph node that could be easily removed in your groin, in your axilla, or in your neck, or you may have some fluid collections. Ovarian cancer patients sometimes have so-called ascites which is fluid collection in the belly, and that can be drained and out of this drain that\u2019s usually routine of care, we can get the specimen. If you have something else. Let\u2019s say you have a glioblastoma, you may actually and there is new compression, you may need a re-operation. That\u2019s another opportunity to get the specimen. Or if need be, you can have an exploratory procedure or a biopsy of a liver metastasis, and we can get the specimen as well.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>Okay, so multiple options there. What has been the response that you\u2019ve received in the professional community? I know sometimes there\u2019s resistance to innovation or skepticism. It seems to me that this is a very welcome innovation, given what it offers and in terms of cancer diagnosis, but I\u2019m just curious what that\u2019s been like.<\/p>\n<p><b>Chris Apfel:\u00a0 <\/b>So it\u2019s exceptionally welcome and appreciated by surgeons, cancer surgeons, surgical oncologists. They understand the limitations. In particular, gynosurgeons know about these limitations of genomic testing, and because gynosurgeons in this country often also do the chemotherapy, and they often are then faced with these difficulties, what now, they are more open to send tissue to you and especially when we are talking about a later stage. The traditional I would like to say oncologists that are more, I would like to say, boxed into the standard treatment paradigms of genomic chemotherapy or genomic testing with target therapies, or let\u2019s add some immunotherapy, they are usually very strongly minded towards what\u2019s covered by insurance and what\u2019s considered standard of care. And if it\u2019s outside of this realm, a patient really needs to speak up for herself in order to get it done. And sometimes it requires that the patient is looking for different oncologists. And at the end of the day, it\u2019s your own life, and you have to speak up for your health.<\/p>\n<h2 class=\"wp-block-heading\"><b>Integrative Oncology<\/b><\/h2>\n<p><b>Chris Kresser:\u00a0 <\/b>Yes, this is what we were talking about before, being your own advocate. And I think that\u2019s true in so many areas of medicine, but particularly in cancer where the stakes are very high and it\u2019s important that people understand that there are these limitations. I think most clinicians have a good heart and are doing it for the right reason, but they often are victims of the system as well. They perhaps feel bound to a certain standard of care, or they\u2019ve just become accustomed to doing things in a certain way. They maybe don\u2019t have as much time as they should have to stay current with the research, and abreast of all the newest diagnostic procedures and treatment. And so, as you\u2019ve said, when it\u2019s your life that you\u2019re, that\u2019s at stake, or the life of a family member, it really pays off to ask a lot of questions and even be willing to step outside of the current model to find the right path forward.<\/p>\n<div class=\"wp-block-group is-style-callout has-light-primary-background-color has-background\">\n<div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<p><strong>Like what you\u2019re reading?<\/strong> Get my free newsletter, recipes, eBooks, product recommendations, and more!<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p><b>Chris Apfel:\u00a0 <\/b>Right and as you mentioned, stepping out of the current model, one thing that I would also recommend, and I think you\u2019ll probably like that comment is, consider an integrative oncologist. So I, for example, have had some contact with Dr. LaValley, and he is an integrative oncologist who actually has really a depth of expertise in terms of which repurposed drugs or alternative treatments can work through which pathway. So I like him a lot. The other thing is, many major, I would like to say, academic centers now have integrated oncologists. There is, for example, a very interesting talk from Dr. Lorenzo Cohen, who is originally, who is at the MD Anderson Cancer Center. And he gave a talk at the Moffitt Cancer Center at some point, and he talked and quoted a study from, I think it was Dr. Barbara Anderson, from Ohio State. And she and the title is something like psychological interventions, or impact on psychological interventions on patients with breast cancer. And what she was doing is, I think she looked at over 200 patients, the randomized control trial, and she looked at over 200 patients who had breast cancer surgery and lymph node resection. So basically regional stage, and she was showing that with stress reduction, mood improvement, exercise, plant-based diet and treatment adherence, she could double the chance of, or can reduce, could actually cut the risk of recurrence and death by half.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>I believe it.<\/p>\n<p><b>Chris Apfel:\u00a0 <\/b>So if that would be a drug, it would be a billion dollar drug. And it\u2019s something that multiple, it would be the biggest blockbuster. But there is stress reduction, exercise, plant-based diet. There is no money in it. There is no industry behind it. And so there is a lot you can do on your own by thinking about how what you can do for your own health to strengthen your immune system through exercise and to avoid junk food. If you think about that, in infusion centers, very often they offer candies and other stuff that is high glucose that cause glucose spikes. And we know that sugar loves glucose. The system is sometimes so anachronistic you need to put it into your own hands.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>Yeah, it\u2019s backwards. Yeah. I had Dr. Lise Alschuler as a guest on my show. She\u2019s a professor of clinical medicine at University of Arizona, and is on the faculty of Arizona Center for Integrative Medicine. She\u2019s an integrative oncologist, and we chatted a lot about these topics, and there\u2019s so much that people can do and evidence based interventions too. A lot of times people who are entrenched in the dominant paradigm will just sort of scoff at these integrative interventions and claim that there\u2019s no evidence behind them. But that\u2019s not true. The study you cited is one of many studies that support these diet and lifestyle interventions. It\u2019s generally best to combine them with other standard methods of care, and you get the best outcomes that way. But again, this really boils down to personal choice. We all have a right to choose what path we want to take based on our values and our worldview, and it\u2019s really important to know what the options are, so that you can make an informed choice. Dr. Apfel, I wanted to ask you just before we finish up, any other medical innovations, either on the diagnostic side or the therapeutic side that you\u2019re tracking right now that are promising cancer care?<\/p>\n<h2 class=\"wp-block-heading\"><b>Promising Innovations to Know About<\/b><\/h2>\n<p><b>Chris Apfel:\u00a0 <\/b>Yeah, I think there are two I would like to say. There is screening, there is now a pan cancer screening test from Grail. And if you think about that, we are currently screening for breast cancer, for colorectal cancer, for melanoma, perhaps some of them, and then prostate perhaps, and even their PSA is not a good marker. There is now the Galleri test that can actually detect a wide range of cancers at a much earlier stage. And if you keep in mind that if you\u2019re in stage one or stage two, your survival is 80 percent. If you\u2019re at stage three or four, your survival may be below 20 percent. So you really want to catch it early, because the tumor actually takes about 10 to 20 years to grow. Most tumors, not all of them. And so, you really want to, if you are, let\u2019s say, at my age, I\u2019m now above 60, the chance that there would be something in my body that may become relevant in five to 10 years, that chance is already five percent. So I have made it for me, I\u2019m paying out of pocket, and I\u2019m doing this once every five years. I\u2019m not paranoid about this every year. And then the other alternative is complement and alternate that within whole body MRI. Not going crazy on it, just looking, just checking that for early detection. And then there is the other part is when you, if you are diagnosed, if this treatment doesn\u2019t work, or something like that, the number one, I think, the next biggest innovation is SageMedics ability to really understand which therapy can work best for your body or for your cancer, actually. And then once you have that, and you have the selection, there is a liquid biopsy test from, for example, Signatera or Personalis, where you can actually test for minimal residual disease. You can actually see whether now once you have those treatment options, you can actually see how your body is responding to it, and you can react much faster than with any imaging results. So those are the, I would like to say, the three main areas that I find interesting. Screening, early screening, in asymptomatic people above 60, or if you have any other reason why your risk should be increased, that\u2019s one part. The second part is, if you are diagnosed, make sure a fresh specimen comes to Sage. Do also be active in your lifestyle changes, in exercise, nutrition, relaxation techniques. Consider integrative oncology, and then once you have your treatment, make sure you have your finger on the pulse whether the treatment is working.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>And that\u2019s where the liquid biopsy comes in.<\/p>\n<p><b>Chris Apfel:\u00a0 <\/b>Yeah.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>This has been fascinating. I\u2019m really excited to learn about this Oncotest and be able to recommend it to patients and the providers in our network. Where can people learn more about the tests, Dr Apfel?<\/p>\n<p><b>Chris Apfel:\u00a0 <\/b>Yes. So it\u2019s at <a href=\"http:\/\/sagemedic.com\">SageMedic.com<\/a>. Sage is S-a-g-e, like the person you are talking to or the plant. <a href=\"http:\/\/sagemedic.com\">SageMedic.com<\/a>. Not medical, just one word, <a href=\"http:\/\/sagemedic.com\">SageMedic.com<\/a>. And there\u2019s also a phone number you can call and get further information. And I can also provide you with some other information that provides you an overview of what we are doing in our, how our solution works.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>Great. And this would be a good resource if a patient is interested in this test, and their provider\u2019s maybe not familiar with it, but open minded and willing to learn more, there\u2019s a section on the website for physicians, I see.<\/p>\n<p><b>Chris Apfel:\u00a0 <\/b>Right. It might be best if you, for example, contact us to kind of see where are you in your journey. Does it make sense? And we could then help you to kind of figure out, is there, can we get a specimen from somewhere and when? Then once you\u2019re armed with that information, then go to your oncologist or to your other physician to get it prescribed, and we can help you with that as well.<\/p>\n<p><b>Chris Kresser:\u00a0 <\/b>Yeah, that\u2019s a great recommendation. Just minimize the friction and the number of steps and make it as easy as possible for them to buy in. Great, well thank you so much for your time, Dr. Apfel. I really enjoyed this conversation. I know that our listeners are going to be excited to learn about this just to increase the options and increase the likelihood of surviving what can be a challenging and life threatening diagnosis. So thank you for your work in this field, and thanks everyone for listening. Send your questions to <a href=\"https:\/\/chriskresser.com\/podcastquestion\">ChrisKresser.com\/podcastquestion<\/a>.<\/p>\n<\/p><\/div>\n<p><script type=\"cd917c403975096239035fb7-text\/javascript\">\nsetTimeout(function(){ !function(f,b,e,v,n,t,s){if(f.fbq)return;n=f.fbq=function(){n.callMethod?\nn.callMethod.apply(n,arguments):n.queue.push(arguments)};if(!f._fbq)f._fbq=n;\nn.push=n;n.loaded=!0;n.version='2.0';n.queue=[];t=b.createElement(e);t.async=!0;\nt.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window,\ndocument,'script','https:\/\/connect.facebook.net\/en_US\/fbevents.js');\nfbq('init', '162088684321454', {\n});\nfbq('track', 'PageView');\n}, 3000);\n<\/script><br \/>\n<br \/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In this episode, we discuss: &#13; Dr. Apfel\u2019s background and personal journey into cancer research &#13; &#13; &#13; &#13; The important first steps to take after a cancer diagnosis &#13; &#13; &#13; &#13; The SAGE Oncotest: Innovation in cancer treatment selection &#13; &#13; &#13; &#13; Why you should consider integrative oncology &#13; &#13; &#13; &#13; [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":21713,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11764],"tags":[14369,14367,3007,14366,14365,14368],"dealstore":[],"offerexpiration":[],"class_list":["post-21712","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-alternative-medicine","tag-apfel","tag-cancer","tag-chris","tag-revolutionizing","tag-rhr","tag-treatment"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - 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