I regularly get asked questions such as “can Functional Medicine help for… (insert condition name here)”.
Functional Medicine is not condition-specific. It can address every issue of human physiology. Admittedly, we’re not trauma or acute injury physicians and if there are emergencies, broken bones or surgery required then this is precisely the arena in which conventional medicine excels. Go to hospital.
For everything else, and potentially to decrease the drastic cost burden on the NHS, there’s Functional Medicine.
That means that for all of our epidemics of chronic illnesses, autoimmune conditions, digestive complications, ‘syndromes’, lifestyle diseases and also the mental health illnesses which are becoming more prevalent – Functional Medicine can help.
The reason it can help is precisely because of its holistic nature. It’s such a shame that the word ‘holistic’ has become associated with somewhat esoteric or ‘woo-woo’ concepts, because it literally just means that we look at the human being as a whole. Because we do this, and understand symptoms of illness as a consequence of a dysfunction of the body in response to its environment, we can offer guidance in a huge variety of conditions.
Within Functional Medicine we’re not treating symptoms, we’re treating people. Whilst illnesses all look different on the surface, underneath there is a world of similarity in that they all arise out of systematic failures within the body.
What About Cancer?
Cancer is a complicated topic, fraught with emotion and fear. It is perhaps, as a whole, the most researched and well-funded area of medicine.
And yet cancer is not just one disease or condition. Cancer can affect multiple organs, sure. But it can also take various forms, arise for numerous reasons and be wildly different in the way it ‘behaves’. For this reason, it is hard to classify cancer as either chronic or acute. In truth, it can be both.
There are also debates about the origins of cancer. Much like the hypotheses around weight gain (insulin vs. calories anyone?!) there are arguments regarding whether cancer is a genetic condition or a metabolic one – but the dichotomy is a false one. As with almost all of the illnesses I treat and manage on a daily basis (my patients and my own) the conditions are a combination of genetic susceptibility combined with environmental/metabolic mismatches. i.e. our genetics make us vulnerable to certain environmental triggers.
As with all things health, however, this too is a drastic oversimplification. Take any form of chronic illness and there will be those campaigning for singular causes and a one-problem genesis of the complaint.
This is why Functional Medicine is ridiculously complex – because human physiology is complex and as such requires less of a reductionist or mechanistic mindset and more of an approach which can interpret the behaviour of the human body in the context of the environment and situation in which it is placed.
For this reason, debating whether cancer is metabolic and/or genetic in origin is not the reserve of the Functional practitioner. Instead, this is perhaps the one area where there is a clear indication that some mechanism in the body has gone awry and the body is distressed. For cancer growth this is based in a flaw in the natural ‘killing’ of dangerous self-cells – a situation in which our body has allowed cancerous and damaged cells to proliferate rather than forcing them to die.
Cancer is different, therefore, to many of the conditions we deal with. Like a virus or pathogen, the resolution of cancer is eradication of the ‘enemy’. But unlike a pathogen, cancer tissue is our tissue – living, growing and being fuelled by our own bodies. By the time cancer is evidenced, particularly if it is aggressive, there is less of a need for deep evaluation of how it came about (that can happen later if necessary) and more of a need to step in and intervene immediately to halt, and hopefully reverse, the disease trajectory.
The problem is that different cancers are different metabolic beasts. However there are unifying factors: inflammation (obviously – this is the mainstay of most illnesses) and oxidative stress (obviously – this damages cells, and cancerous cells are damaged cells).
As Functional Medicine deals with inflammation and oxidative stress on a regular and routine basis this makes it perfectly suited to supporting in cancer treatment and cancer care.
Miracle Cures in Functional Medicine
Any longterm followers of my blog will know that I take issue with some of the work of The Angry Chef (Anthony Warner). I often don’t disagree with his points, but I do disagree with the sweeping brush with which he paints everyone in the healthcare industry by semantically puling apart arguments based on his projection onto what they’re actually saying, rather than bothering to stop and identify the message behind their language… (sorry, mini-rant over).
However, his latest article in his series on Ketogenic Diets had a point (which he made too strongly and with too much vitriol but was a relevant one).
Functional Medicine basically uses nutrition and lifestyle, along with judicious supplementation where required and some more comprehensive testing for the complex cases. Nutrition is our basis because food builds our bodies and consuming the wrong food for us (which can vary widely on the specifics) can create metabolic and functional distress.
It gives the impression that food is a miracle cure-all. And, to be honest, in my practice it really can be.
But to be more honest, it equally might not be the panacea – as my own life will attest to.
Ketogenic diets are all the rage at the moment – and they are this year’s “Miracle Cure All”. Most specifically, for cancer…
Even longer-term readers will know that I abandoned a 20-page e-book on ketosis because it was too fraught with caveats, considerations and provisos for individuality. The cancer argument was a big part of this. There is a lot of truth, a lot of lies and a lot of confusion with ketosis. It has specific applications, sure. It has serious consequences, absolutely. It suits different people differently – absolutely. So it’s personalised? Well, duh – of course – that’s the whole point of Functional Medicine… but with ketosis there’s a world of complexity on top of this because it is a relatively new thing when talking about it in the wider context. It’s been used in some settings for decades. For general wellness the science is absolutely in its infancy. And for cancer, this is a recent evolution which shows promise but really cannot be peddled as a panacea and a miracle.
The truth about ketosis is a lot more bland than most people think… we really just don’t know enough about it. (yet).
The debates go a little like “it’s perfectly natural” to “it’s too stressful” to “it’s an emergency state so not healthy long term” to “it’s perfect evolutionary survivalism” to “it starves cancer cells – yay!” to “but what about the microbiome” and “what about the thyroid” and “what about our female hormones? Isn’t it just a ‘good for the guys’ thing?!”
Arguing for the mechanistic value of ketogenic diets goes like this: in a state of a lack of glucose for fuel the body will switch metabolism to utilising fat in the form of ketone bodies. This is a survival mechanism and is really ‘healthy’ (again simplified but that’s the essence). The relevance to cancer is that some cancers’ (really, please NOTE THE SOME) can ONLY use glucose for fuel and so will die with a lack of this fuel in the body.
This argument is flawed because humans aren’t mechanistic, as we’ve already established. The metabolic mechanism does work, sure – it can be measured. But the longterm effects of living entirely within this metabolism quirk really hasn’t been studied. Additionally, the starvation mode which kicks in the ketone body production may (or may not) be stimulated by a stress-based response involving cortisol… which short term is great (way-hay, the survival advantage) but long term might be really, really bad – we just don’t know. Also… men vs. women biologically are VERY different – and the hormonal situation when practicing ketosis is .. well … unclear…
Arguing for the ‘evolutionary mismatch’ theory of ketogenic diets goes like this: ketosis can now be achieved using supplemental ketones (i.e. you feed your body with the ketones rather than produce it from your fat stores). You can do this even whilst consuming glucose-releasing carbohydrates. This is evolutionarily and metabolically impossible as a human and completely flouts the idea above, that ketones are the metabolic and cellular energy alternative to glucose. Having both present is biologically impossible and therefore ‘unhealthy’.
Hmm… hang on a second – this is also a bit of a weird argument. Just because it didn’t happen prehistorically doesn’t mean we can’t cope with it physiologically. The only reason it didn’t happen in ancestral man is because it wasn’t possible to achieve that energy balance. Now we can, chemically. This doesn’t automatically make it ‘bad’ or ‘unhealthy’. It just makes it exogenous (from outside the body). And humans have been manipulating biology with chemicals for millennia… (coffee, anyone?)
But these circular arguments and debates can go on all day. The truth is that ketosis is, as all good diets are, a fabulous therapeutic tool for certain illnesses and health conditions precisely because it does cause metabolic shifts. In health conditions, rather than weight loss or mental focus arguments, the ‘exogenous ketone’ usage is even more vague and under evaluated. But in its pure, nutritional form the most important health condition we know ketosis can tackle is epilepsy – this was how the whole ketogenic approach was developed and initially used.
And yes, another health condition it can help to tackle is certain cancers. Yup I said it. It can help with cancer. For certain cancers, those which are driven by the metabolism of glucose in faulty mitochondria which feed off the carbohydrates in the diet, there is almost no doubt that starving your body of glucose and switching on the survival mechanisms of ketosis will alter the fuel available for the cancer. And likely cause cell senescence – the cancer cells will die.
So ketosis is obviously our Miracle Cure …
Oh no, wait a minute…
It’s just not, guys. And even if it proves to be eventually, when the long-term science is there (which, though I love Dom D’Agostino, it’s just not right now) we – at the moment – have very little knowledge available publicly to understand what we’re doing when we put cancer patients on a ketogenic diet.
Yes, there are anecdotal cases of patients experiencing miracle benefits of the ketogenic diet. Some patients put their cancer into remission. Some patients halt progression. Some patients prevent relapses. Interesting to me are the stories about how much better some patients have been able to cope with their chemotherapy treatment by putting their bodies into a state of ketosis prior to it. Rather than being ill for days and fundamentally weak, they had energy and strength. This surely is nothing to do with the metabolic effect of ketosis on cancer – but the metabolic effect of ketosis on the rest of the body’s energy supplies. All of which is really, really, really intriguing…
Supportive Functional Medicine
But there is no way that ketosis is, at this moment in time, a miracle replacement for allopathic medicine in the treatment of cancer. In reality it will never be. And here is where I part ways with Mr Angry Chef.
I don’t know of anybody that I respect within the ketosis, Functional Medicine, biohacker or ‘alternative wellness’ community promoting ketosis as a cure for all cancers.
I don’t know what he read or who he’s listening to but even the most extreme keto advocates have moderated their stance and now advocate cyclical ketosis for the healthy individual, longer term but not indefinite for the overweight and offer it as a little ‘jump-start’ to the metabolism, if you will.
The fact that ketosis metabolically shifts the body is not in doubt. In many cases this can benefit those who have serious health conditions such as epilepsy, obesity, neurodegenerative conditions – and, yes – cancer. It can be used for many (even the healthy) as a short term, ‘autophagy’ strategy. But equally there are some people for whom that’s a really, really, really bad idea. Some cancer forms really aren’t glucose-hogs and will be benefited by the stress shift that occurs in ketosis. This isn’t something you can play around with.
And NOBODY who is qualified to speak on this topic is saying that it is. There are some unqualified people spouting internet nonsense about it, yes. But, hello – this is the Internet. It is not policed and it is not full of moderate, intellectually educated individuals who know what they’re saying all the time. Does that make us all charlatans peddling false hope? Categorically not…
More than this – Functional Medicine practitioners, and even those who advocate ketosis for some cancers, are not talking ONLY about the ketogenic diet. Literally all we do, all day, is ameliorate inflammation, oxidative stress and physical malfunctions by treating the body as it needs to be treated and nurturing any systems that are suffering and causing issues. Our toolkit for this is myriad and all of us use a bit of everything to help.
When it comes to cancer, our supportive and therapeutic treatment modalities might include, in combination with dietary strategies, hyperbaric oxygen, ozone therapy, floatation tanks, sauna detoxes, exercise strategies, mindfulness practices and meditation. Our nutrient-dense dietary approaches are absolutely not going to harm anyone – and may or may not include ketosis but will always include food that is scientifically proven to nurture, nourish and heal the human physiology.
And, to my mind, the role for Functional Medicine – regardless of the techniques employed – is about supportive healthcare for anyone whose body is in distress.
Believe it or not, we don’t hate the conventional doctors. Even me (and I have every reason to). I work ALONGSIDE and in a supportive role for conventional therapies when it comes to cancer. Because that’s just common sense. Sometimes we need the big guns – the chemo and the radiotherapy, the nasty chemicals and the horrendous drug-based protocols. Sometimes we need the surgeries and the procedures. Sometimes we have to value the advances in modern medicine that make our survival so much more possible today than in previous decades, let alone previous centuries.
But those procedures (and the hospitalisations they demand) are taxing and draining on bodies that are not in the best of health to begin with. They are toxic and come with collateral damage.
Where Functional Medicine comes in is not to hold up an extreme diet as a miracle cure, though this nutritional approach might be a perfect tool within an individual’s journey. Instead, it is an approach which individually assesses each person’s physiology and supports them through one of the most stressful experiences a human body can endure – however that individual will be best supported.
Within Functional Medicine we meet the patient where they’re at – and meet their body where it is, providing it with what it needs.
In cancer care, Functional Medicine is an adjunct to the allopathic model of treatment. Practitioners can ensure that the body is nourished, the detoxification pathways are working, that nutrients are sufficient for the trauma that is being undergone and that inflammation and negative side effects are kept to a minimum. Sometimes extreme chemotherapy treatments are not necessary, often they are. Regardless, our Functional approaches can provide every element of healthcare AROUND the extreme treatment to give the patient the best possible chance of positive outcomes.
This may or may not involve ketosis but this will always involve a dedicated, individualised attention of a practitioner who understands your case, your lifestyle, your mitigating health factors and your specific cancer.
If cancer has touched your life then you will know how all-encompassing and far-reaching the effects can be. If you would like support from someone who can assist you holistically, I would encourage bringing a Functional Medicine person on board to join your care team. They will have a different view from your consultants and doctors, but they will always work collaboratively to support you – the patient – and provide you with the care you need in all areas of your life: as a person, not just as a cancer patient.
If you would like to contact me about cancer – for yourself or a loved one – do get in touch with me today, just click here.