Welcome to Nurse Kristin’s Notes on Cancer

It is my hope that I can write and share articles here that others may find useful. I have been a nurse for over sixteen years but a science geek all my life. As a nurse, not a doctor, my observations over the years are not to be considered medical guidance but are hoped to bridge the gap for patients and others, weaving together anecdotal clues and clinical observations, while considering hints and clues from pre-clinical research that may end up mattering quite a bit for some folks.

I apologize that while I try to simplify terminology, there will be times I write with words that are more scientifically specific, mostly due to my comfort with those but also to make sure I am as clear as possible about details. Many patients I work with tend to wish to share what we discuss with their doctors, nurses and others in their medical team.  Broad generalizations tend to end up being disregarded as not scientifically rigorous so I will do my best to achieve both goals: Information which may be well understood by a non-medically trained patient but also potentially helpful to the medical personnel they may wish to share the information with. I humbly anticipate that some articles will achieve these goals while some not so well. Please be gentle and constructive with your criticism.

The main reason I wish to write articles about cancer is that when I speak with patients on a daily basis, I find myself repeatedly explaining and attempting to teach the same things over and over.  Much can be written in articles or made into short videos for patients to read before our consultations and then to be used after to reinforce the information.  Typical consultations last over an hour and are dense with information. I struggle to not overwhelm people but inevitably I know I do. 

A person may reach out to me to discuss cannabis medicines, for example, but I spend at least half our time teaching about nutrition, Vitamin D, Omega 6/3 ratio in the diet and diverse supplements and repurposed drugs as well as reviewing the therapies they are using and other treatments which may have just been FDA approved or even just in a clinical trial.  This is because I commonly see people lacking information about these things and too often are using supplements wildly, same with repurposed drugs and dietary fats…. Well let’s just say that has become a very crazy space, with some patients guzzling olive oil, coconut oil and more because they think it is going to help them. And sadly some are not getting updated treatments because their oncologist may have missed some important details or just not be aware of new guidance.

Some of my sickest patients with the most aggressive cancers share with me that for a long time they had been eating vegetarian or ketogenic diets, with fat types often raising their Omega 6 to 3 ratios to levels higher than any other patients I work with.  I strongly support eating lots of plants and I do realize that keto diet may be appropriate for some, especially if carefully designed and perhaps used for a limited time to get obesity and/or diabetes under control, and some may find the keto diet does help them seem to slow their cancers or make treatments work better.  But too many times I see people get sicker and sicker and I really encourage them to get back to a more reasonable dietary pattern such as the Mediterranean Diet.  Moderation is usually important as is remembering that we humans are omnivores not herbivores.  Our bodies evolved to utilize animal products, not just plants.  Of course we can survive without meat but avoiding animal products in our diet means challenges not just for protein intake but also could mean that we don’t get enough active Vitamin A, and this can be a problem as not all of us have the genetic ability to efficiently convert plant Vitamin A, called carotenoids, into active animal Vitamin A, called retinoids.  I am not here to argue about diet, and I respect those who choose vegetarian diet and lifestyle, but I am here to point out that it is not easy to get it right. And if someone is fighting an aggressive cancer it may be that including small quantities of animal products such as oily fish, Omega-3 enhanced eggs or more may end up helping them to simply do better.

Before I will discuss cannabis in depth, I explain that we humans make cannabinoid chemicals somewhat similar to what the cannabis plants make, from the Omega 3 and 6 fatty acids we eat.  And that those fatty acids are used by our body to make different cannabinoids, in addition to other important chemicals.  While some may not have a cancer diagnosis where cannabinoids like THC would be sensible to use in high doses, beginning to correct the intake of Omega 3 and 6 fatty acids in the diet and with supplements may be appropriate for all.  Many are disappointed that I may end up telling them I really do not think high doses of cannabis would be wise to try but then feel better when I point out that by adjusting their fats in their diet they may actually be helping their body to produce cannabinoids that are hoped to do good work for them and to decrease those that may be causing problems, such as an excess of Omega 6 derived cannabinoids.  This focus on dietary fats is also important for those who may wish to use THC, such as in HER2-positive breast cancer, but cannot use THC due to work drug testing, living in a cannabis-illegal state or country or otherwise just can’t access good cannabis medicines or just do not wish to use them for diverse reasons.  Reducing Omega 6 to 3 ratio closer to 2:1 or even 1:1 in the diet is something everyone can and should do, is not costly, is not illegal and tends to lead to overall health improvement including mood, reduced pain and much more.  So, I plan to write articles and make short videos here over time that I hope will help to achieve this goal.

I tend to use too many words when I write and often ramble into explanations that likely could be edited to shorter and more efficient results.  I welcome constructive criticism, articles that readers may want to share with me and also beg readers to be gentle and forgiving of my faults which includes wordiness. Together I hope what I produce and share here is helpful and interesting to those either with cancer, caring for someone with cancer and their team of medical and nutritional providers. But please do not consider what I write here to be medical advice. I really want you to take what I share here and discuss with your local medical team and trusted caregivers to consider carefully.

I have seen patients who have profound tumor regression using cannabis preparations, especially with high daily doses of THC used. But I have also seen people get worse instead of better. And the use of high doses of cannabis medicines can definitely cause serious side effects such as adverse drug interactions, dizziness, heart rhythm disturbances, low/high blood pressure, blood thinning and immunosuppression. I have seen people who were trying desperately to use anything *except* standard conventional treatments and end up getting chemo-like side effects from their alternative protocols and repurposed drug protocols they self-designed and still their cancers keep getting worse and they then have to rush get the standard treatments they really needed. 

Sadly I keep encountering people who may have had their cancers diagnosed as only Stage I. They refuse surgery and/or other standard treatments. Some were likely curable at that point. But a year or so later they are now at the metastatic stage IV and there is really a very low chance of cure and the tools needed to control their advanced cancer may be harsher and may need to be changed over and over just to keep them alive as long as possible. So I will do my best to provide information over time that I hope will help people make better choices.  It will not be perfect and it will sometimes be messy.  And over time my conclusions and opinions will likely change.  We must grow, learn and keep an open mind or else we fail to adapt and improve.  I also will sometimes use the word client rather than patient and vice versa. Please don’t read too much into this or be offended. Let’s not waste time on arguing. Instead let it slide if you will and allow me some grace while I try to focus on sharing good information.

So, I will end this article by encouraging those who are interested to follow me here. In the meantime, read about lowering the Omega 6 to 3 ratio in your diet, ask your medical team to test your Vitamin D level and supplement if needed to keep your Serum 25OH blood test results around 55 ng/ml or about 125 to 150 nmol/L, eat more vegetables, get enough sleep, reduce stress when possible, get second opinions from specialists in your particular cancer if needed and to boldly ask for genomic testing of tumors if treatments are not working well or your cancer is rare or particularly aggressive.  Research into all of this is increasingly clear and productive and there is more hope than ever before.  As an old Hospice and Oncology nurse this makes me smile.  Over time we can start to reduce cancer occurrence, recurrence and improve outcomes for more people. Thank you for reading and your support.

Nurse Kristin

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