The Medical Advisor

Chemotherapy remains one of the most widely used treatments in oncology. In theory, it should kill cancer cells by targeting their rapid division. In practice, especially in metabolically driven tumors , its benefits are often temporary, limited, or accompanied by paradoxical consequences that may worsen outcomes in the long run. In fact, there's growing evidence that chemotherapy can: Select for metabolically resilient cancer cells , Reshape the tumor microenvironment to favor dissemination , and Even reactivate dormant cells that seed metastases — a key driver of mortality in cancer. ( onedaymd.com ) science.org Here’s why. 1. Chemotherapy Targets Division — Not Survival Standard cytotoxic chemotherapy is designed to kill rapidly dividing cells. This principle assumes that tumor cells are always proliferative. But many cancers — especially those driven by metabolic adaptation and resilience — contain subpopulations of cells that are: Slow-cycling Metabolically flexible Capable ...

In this interview (below), Dr. Stasha Gominak, 1   a neurologist and sleep coach, explains the curious synergy between vitamin D deficiency, a changed microbiome and poor sleep. I met Dr Gominak at the American College for the Advancement in Medicine’s annual meeting in 2019 in Nashville. Her lecture was about ways to improve your sleep. I thought I was aware of most of them, but the connection between vitamin D and sleep surprised me. Gominak’s research suggests lack of vitamin D causes impairment in your brain stem’s ability to produce normal sleep. So far, she’s treated more than 7,000 patients with her innovative “sleep repair” approach. She’s also published scientific papers on her theories. Vitamin D Deficiency Linked to Sleep Disorders Gominak had no interest in vitamin D, initially. She was fascinated by sleep, and was trying to figure out why so many young and otherwise healthy patients were having such trouble sleeping. Many also had sleep apnea. Over time, it be...

I recently interviewed Dr. Cate Shanahan (video below), a board-certified family physician who is a leading authority on nutrition and human metabolism. Her new book, "Dark Calories," discusses the dangers of seed oils — often referred to as the greenwashed term vegetable oils — insulin resistance, and the importance of proper nutrition for optimal health. Shanahan describes how early in her career as a family physician, she felt deeply unsatisfied with her ability to help patients with chronic diseases (1): "I felt like the part of my practice that was around the chronic disease management, that part felt so false and so hollow, and I really questioned whether or not I was making any difference or even doing good at all." Ultimately, however, these early career frustrations led to important nutritional insights. A personal health crisis in 2002 led her to dive deep into nutritional research, particularly around essential fatty acids ...

Insulin resistance (IR) sits at the crossroads of metabolic disease, cardiovascular risk, neurodegeneration, and increasingly, cancer biology. In oncology, IR is associated with higher recurrence risk, worse outcomes in breast, colorectal, pancreatic, and prostate cancers, and poorer tolerance to therapy. If you are searching for: The best diet for insulin resistance How to reverse insulin resistance naturally Evidence-based supplements for insulin resistance The link between insulin resistance and cancer outcomes This guide ranks interventions by strength of scientific evidence, effect size, and clinical durability . This framework aligns with recommendations from the American Diabetes Association and the European Association for the Study of Diabetes, with oncology-relevant context. What Is Insulin Resistance? Insulin resistance occurs when cells (especially liver, muscle, and adipose tissue) respond poorly to insulin, forcing the pancreas to produce more insulin to maintain normal b...

Purpose: Provide an evidence-aligned, safety-conscious framework for optimizing vitamin D status as part of metabolic oncology care. Scope: Adjunctive optimization only. Not a replacement for standard oncologic therapy. 1. Conceptual Framing Vitamin D (cholecalciferol → 25[OH]D → 1,25[OH]₂D) functions as a steroid hormone acting via the vitamin D receptor (VDR) in immune cells, epithelial tissues, and metabolic organs. In metabolic oncology, sufficiency is pursued to support: Immune modulation Inflammation regulation Insulin sensitivity Cellular differentiation signaling Evidence does not support high-dose pharmacologic vitamin D as a primary anticancer therapy. 2. Baseline Assessment Protocol Before initiating supplementation: Laboratory Evaluation Serum 25-hydroxyvitamin D (25[OH]D) Serum calcium Albumin (for corrected calcium) Creatinine / eGFR Optional: PTH (if deficiency suspected) Risk Stratification Higher likelihood of deficiency: Obesity (BMI ≥30) Darker skin pigmentation Lim...