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Heather Shaff's avatar

Thank you for this, and for your work! I’ve been living these strategies, working with an oncology metabolic nutritionist to reduce my sky-high risk of breast cancer recurrence (early detection allowed me to avoid chemotherapy and radiation).

I cannot bring myself to take tamoxifen and introduce a Level 1 carcinogen into my body, so have been using the tools you’re writing about to make my body as inhospitable to cancer as possible.

Cancer is a metabolic disease, so it makes sense that our treatment arsenal should include metabolic protocols. Thank you for writing publicly about this.

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Hannah Brown's avatar

This was so helpful to read. As a patient of cancer, this really helps me understand it better. Thank you for writing this and for the work that you do, you’re truly changing and saving lives 💕

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Victorious Val's avatar

Dr. Flora, I loved this. Thanks for writing. I was not in remission as I originally thought and had residual cancer, but it took 10 years to build speed before it gave me issue, and I attribute that to my specific diet and exercise routines. I think it really helped me, and I plan to write about it soon. - Victorious Val

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Vicky MD MPH's avatar

A really nicely laid out framework for oncology 2.0! So clear and accessible.

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Daniel Flora, MD, PharmD's avatar

Thanks Vicky, it’s a work in progress!

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Roben Wrampe's avatar

Thank you for this; I look forward to reading all of your articles. My husband has metastasized neuroendocrine tumors (stage 4) so some of the conventional wisdom is counter indicated or comes with big asterisks when we can find info (and there is more info now than our 1st go-around in 2010) so I read thru that lens. I’m hoping to see information on reducing hormone loads besides ‘bananas increase serotonin’ as it’s the biggest battle we have remaining.

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Keagen Hadley's avatar

Great post. I am looking forward to your deep dive on intermittent fasting. I have used it to help taper off my SSRI's and lose 30 pounds in the last year.

I attribute my wife's home cooking and IF to nearly all my physical successes over the last 12 months. I can't wait to hear your take on it and how it applies to cancer treatment.

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Terri Hansel's avatar

As a former AND current cancer patient I have been thinking quite a bit about this topic. Considering my genetic testing was negative I question why I got cancer again after 12 years - first one being hormone positive and this one being triple negative. If not genetic must be environmental! I am very interested in what lifestyle changes I can make to reduce my risk of reoccurrence. Looking forward to more writings on the topic.

Thank you for this important work!

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Daniel Flora, MD, PharmD's avatar

Thank you for sharing your story Terri. I hope these articles are both helpful and empowering for you. Feel free to post questions or specific topics you would like to see discussed. We are all in this together.

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Whitney Teschner's avatar

Thank you for your generous work!

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Moro Balakrishnan's avatar

Is there no place for repurposed drugs in your proposed scheme of things on cancer cure/management ? If so, it is both a surprise and a matter of regret. Just because they haven’t followed the formal route, the reported substantial work on drugs like Ivermectin, Fenbendazole and a few others cannot be disregarded. If cancer is not one disease, these drugs also do not work only on a single pathway. They have multiple mechanisms that can cross paths with the multiple pathways of cancer. That is why they are reportedly so efficient. Financially, the current standard treatments and care remain very expensive, simply unaffordable for perhaps three quarters of world’s cancer patients. In middle class and poorer homes, the treatments can cripple the family financially for two generations. So, any new approach to cancer must carry the weight of affordable costs. Also, the treatment requires specialised centres, closing the options for many far flung families. Cancer cure should be brought to the realms of outpatient care or simple visits to doctors. There is no denying that these repurposed drugs carry these virtues of affordability and accessibility.

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Daniel Flora, MD, PharmD's avatar

We use off label and repurposed drugs when they have basic safety and efficacy data to support their use in humans. When a cancer patient asks you what the risks and benefits of a treatment are we cannot answer “I don’t know.”

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Moro Balakrishnan's avatar

Do you look for basic safety and efficacy data of off label/repurposed drugs only from rigorous formal trials ? Where they are not available, do you consider anecdotal experiences also on their merit ? Actually for most repurposed drugs, general safety data is already available and plenty of user experience in their indicated use. Efficacy data in its use in cancer has to be built up - either by formal trials or from anecdotal reportings. We know that the first one is difficult to organise for these repurposed drugs and many possible, inexpensive, effective therapies languish as a result. How frequently and readily do you use such off label/repurposed drugs ? Would welcome some details, including your preferred drugs, if such information can be shared.

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Daniel Flora, MD, PharmD's avatar

Anecdotes are not evidence. They’re uncontrolled, often biased, and usually can’t be verified. But case reports—and especially case series or observational cohorts—are different. These are structured, peer-reviewed accounts of something unusual or noteworthy in clinical practice. They don’t prove cause and effect, but they can help generate hypotheses. Many important advances in medicine have started this way: a single case that raised enough curiosity to warrant further study. Over time, if a pattern holds across more patients, we may see it tested in larger observational studies, pilot trials, and eventually randomized trials. That’s the difference: anecdote is the end of the road for most claims, but in medicine, a good case report is often just the beginning.

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Moro Balakrishnan's avatar

Advances in medicines need not be from only from new molecules which necessarily have to go through the stages of evaluation before being approved and brought to patient bedside. It can also be finding new uses for long existing molecules, where such extensive evaluation is not necessary, particularly from the point of view of safety. There are many such examples - the most recent GLP-1 drugs. They were, I am sure, were thoroughly evaluated for the original indication T2D, but they are now block buster weight loss drugs in which indication, I am sure, they didn’t undergo 100% screening once again. Half the needed inputs were already available from the original indication. People who tried these repurposed drugs did so only on the basis of some clinical insights of both the drug and the new indication, here cancer. Anyway, I will leave the issue to your clinical judgements. Thanks for your patient replies. I am not a medical doctor, but an old PhD in organic chemistry with industrial research career and with some reading interests in medicine in retirement. Best wishes.

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Jules Henry Rivers's avatar

One day science shall reach a point of acknowledging the trauma-based cancer where deeply rooted issues generate it via somatization. Clearing these unconscious issues is the best prevention. This is what we do www.shape-my.life

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Laura T RN BSN's avatar

Wonderful article. Thank you.

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