Transcript Disclaimer – Please note that the following transcript has been machine generated by an AI software and therefore may include errors or omissions.

Robin Daly
Hello and welcome to the Yes To Life show on UK Health Radio. My name’s Robin Daly and I’m hosting today’s show as usual. I’m also the founder of the UK charity the show takes its name from, Yes To Life, helping people with cancer learn about the benefits of integrative medicine. My guest today is fast becoming a regular on the show, Dr. J. William Lavalley. Today we’re exploring the relatively recent and important resource of repurposed drugs and speaking to Dr. Lavalley in the USA over the internet.

Dr LaValley
Hi Robin, it’s good to see you.

Robin Daly
Yes, great to have you back on the show again. And today we’re going to be talking about a subject that’s occupied your attention for quite a number of years, repurposed pharmaceuticals. So what I’d like to do is to look at the effect that the entry of this whole class of therapists has had in cancer, in cancer care, and to compare efficacy and shortcomings between pharmaceuticals and natural compounds when you’re trying to achieve some particular outcome. So just to start us in here, I thought for anybody not actually familiar with repurposed or off-patent drugs, it’d be helpful if you give the story behind them, how they’ve come within your species of practitioners such as you. Sure.

Dr LaValley
Well, I think it is different in various countries because it is essentially a term that has some confusion with regard to how drugs are regulated. The way the drugs are regulated in the US and Canada and in Europe and UK are a little bit different. But once a drug is approved in the various jurisdictions, I will talk to the US and Canada. I know it is a little bit different in the UK, but once it is approved, it gets a marketing approval. In the FDA, in the US, a drug gets approved to be marketed for a particular reason, for a particular treatment in a particular disease or symptom state. That is what is called its indication. On the documents describing the drug, that is called the label of the drug or in the UK the patent of the drug and that the drugs are then used for those reasons. And once they are on the market, physicians, prescribers can use those drugs for different reasons. They can repurpose the drugs for different reasons when they have science, evidence-based data that says, well, this drug may have value in this circumstance and in that circumstance that technically it is not approved for marketing by the drug company for that particular reason. It is called off-label prescribing or off-label prescribing in the US and Canada. In the UK, it is off-patent prescribing, so basically repurposing of the drugs when researchers use scientific experiments to say, well, I see a good desirable disease treatment effect or symptom treatment effect and that is not how it has been approved. I prefer the term repurposed pharmaceuticals because it is easier to understand how drugs, once they are available on the market, can be repurposed for various uses.

Robin Daly
So I think here in the UK all those terms are getting used, so I think that there’s maybe differentiating between when they say off-paid and they’re talking about the fact that they’re usually highlighting the fact that they are manufactured by anybody at this point because the company that invented them hasn’t got a paid note for them anymore and therefore they’re very cheap.

Dr LaValley
Yeah. Here in North America, they call that generic drugs.

Robin Daly
generic right okay so that’s you know they’re not necessarily generic drugs are they to be an off-label no option but but they often are right so so and how have they crept into the cancer field how’s this what’s the process whereby they’ve arrived because these we’re talking about drugs that have nothing to do with treating cancer yeah

Dr LaValley
That’s really interesting. So when the cancer researchers are doing research, they generally start what I call the data pyramid or the data mountain. They start initially using the various products, whether they’re therapeutic natural health products. So in the scientific literature, those are called natural products or pharmaceuticals, that they will then, in order to understand the activity, the behaviors, the attributes of cancers, they’ll use those molecules, the natural products of the repurposed pharmaceuticals in human cancer cells and animal cancer cells in test tubes. And it’s called in vitro. And from that data, say, well, there’s some interesting characteristics. Let’s test that molecule’s effect in human or animal cancer cells in animals called in vivo. So we have this large mountain of data where clinical trials are the gold standard tip of the data pyramid or top of the data mountain. And then we have the human and animal cancer cells data in animals and in test tubes, which I think of as the middle and base of the data mountain. And that actually there are, when you look at that with natural products and repurposed primary care, non-oncology drugs, there are tens of thousands of studies, and that the integrative medicine doctors are looking at that data for relevant treatment with their patients, while the medical oncology subspecialty is not permitted because of their standard of care, what are called the consensus guidelines standard of care, which are limited to the best data, the gold standard data, only clinical trials in humans, either a drug is on the market after it’s been proven through clinical trials in humans, or it’s in clinical trials in humans. So there’s a boundary between that top of the data mountain and the middle and base of the data mountain.

Robin Daly
Right, but there’s a lot of data down there. Interesting. The other route that I heard about in at least one case, I think, is kind of just raw observation. People who are taking a drug for one purpose find it has an effect on another. Actually, just by population statistics, they become less likely to contract another disease. Is that common or is that happened in many cases?

Dr LaValley
Well, I’m not sure how common it is. It is, however, once those hate studies, those observational studies are published, they become part of the evidence base, and they’re part of the evidence base that is important and not clinical trial. So that’s really where the boundary is. It is something been subject to a clinical trial and humans or not. So there’s observational studies, there’s a series of case studies that can be done, there’s the real world evidence, and there’s a lot of movement out in the field of putting that information for physicians and researchers to evaluate. So I think it’s very helpful and what we’ll see is that oftentimes then the cancer researchers back in the laboratory will say, oh, that’s an interesting observation in a case study. And so now let’s see what is that drug doing in human and animal cancer cells and test tubes and in animals as well.

Robin Daly
Right, right. Okay, so you’re somebody who’s straddled these two worlds for some time now between the natural medicines and the man-made pharmaceutical medicines. Yeah. So you’ve got an in-depth appreciation of the strengths and weaknesses of a vast number of approaches. Could you just introduce listeners to the way you work, what your aims are when you’re working with a cancer patient and your methods?

Dr LaValley
Sure. Brent question. So the vast majority of people that I see are already receiving or scheduled to receive or have received conventional oncology treatment, including the chemotherapy and then much more recently, the biologically targeted precision oncology drugs that are enormously helpful for many, many people. And what they’re looking for is in addition to that. And so that’s my emphasis is this area of the middle and base of the data mountain in which there are these vast numbers of studies that show that products that are already on the market, natural health product supplements. So molecules that are primarily plant extracts, but they can also be vitamins and minerals and even animal extracts where fish oil is a prime example of that, that show anti-cancer molecular effect and or anti-cancer cellular effect against the cancer cells in the human and animal cancer cells and test tubes and in animals. And that that data is not being used by their medical oncology doctors because medical oncology doctors are permitted to use that. And so it is essentially putting a framework of logic over that data and saying these tools, these natural products and repurposed primary care pharmaceuticals are already available. What is a rational, logical way of applying those in this case, in this kind of cancer for this person, so personalizing it. So it’s not a one size fits all. It’s a, well, how do we harness this data and apply it to personalize a protocol in this person’s case. And so that’s what I’m looking at. And the great value of the natural products and the repurposed pharmaceuticals is generally they have significant data showing that they target multiple different vulnerabilities in cancer cells and cancer stem cells. And the cells that are in the immediate microscopic environment around the cancer cells, which are called the tumor micro environment, which are induced by the cancer cells to essentially provide support and nutrients and unfortunately, immune protection, they essentially make the cancer lump invisible. And so there are these data that can target all of these and harnessing that data to make a rational range of treatment choices for people to obtain from their physician, their local prescriber. So I consult with and collaborate with local physicians in the UK and Europe or the US, Canada or around the world. So that then gives the patients direct access to this broad range of natural products and repurposed pharmaceuticals. The great value of this is that these natural products and repurposed pharmaceuticals are multi targeted so they can think network, molecular network targeted. The great problem or limitation with the natural products and repurposed pharmaceuticals is they’re weak. They don’t have a strong powerful anti-cancer effect in isolation by themselves or in a small number of them. So the data drives us to use a broad range to combine them to obtain overlapping molecular synergy and that synergy makes it such that the therapeutic amount, the amount of product that you actually consume is practical.

Dr LaValley
So you can take in a manner that remains well tolerated because if you don’t tolerate protocol. And work. Yeah. Exactly.

Robin Daly
Well, it’s interesting because in that way, it’s addressing one of the sort of well-documented shortcomings of most conventional treatments is that they don’t have a broad hitch like that. They’re actually very narrow. They may be powerful and they may have a big effect by just targeting one thing, but cancer, as we all know, is remarkably resourceful and that even when they’re really damaged in one area, all the rest will get into gear and can pull itself together around the back so it’s beat. So multi-targeting has got to be a good idea.

Dr LaValley
Absolutely. So because cancer cells are derived from healthy cells, so it’s the healthy cells that have changed. Healthy cells have this capacity to compensate, modify, and we call that robust, healthy, resilient. It’s a good thing, yeah. And that same capability doesn’t go away when the cell transforms into a malignant cell, and that’s what the cancer cell is attempting to do all the time, is survive. And because the DNA is mutated, and very importantly because it’s unstable, this is a major challenge because the great targeted drugs that we have that can eliminate vast numbers of cancer cells, well, once they eliminate those cells which are sensitive to that therapeutic intervention, whether it’s a targeted drug or a chemotherapy agent, the cells that remain, that are not sensitive to those interventions, to those drugs, they’re now resistant. They become the new 100%, and so that means that they have different vulnerabilities and have to be targeted with different therapeutic interventions. The value of the multi-targeting is interfering with and inhibiting the capability of the cells to adapt and adjust, essentially think of a big map, a street map, and there’s traffic on that street map, and now the cell, the traffic can’t go in this direction, so now it’s going to try to go through another pathway, and that’s part of how the analogy for how cancer signaling is attempting to adapt, and if you’re able to put impediments to that adaptation or that compensatory signaling, then we have an opportunity for greater control of the cancer for extended duration.

Robin Daly
So if you only have relatively simple guns, simple in terms of their ability to hit multiple targets, they can only hit one at a time, then it is a moving target you’re dealing with which you have to have different weapons for all the time. That’s right. Yeah, interesting.

Dr LaValley
And to be clear about the conventional cytotoxic chemotherapy, which is the older generation of chemotherapy, those do have multi-targeted activities. Very clearly they do. The problem or challenge there is they also hit, say, healthy cells and organs with same impact or similar impact, including in the immune system. And so you get then immunosuppression and difficulty because we’re not able to tolerate large doses for extended duration. And there’s a place in between where the natural products and the repurposed pharmaceuticals can be well tolerated for extended duration and have this molecular network targeting effect synergistically combining these therapeutic agents. And so what I am very clear in telling everyone that I have discussion with is that we’re doing this in addition to not instead of the conventional oncology treatment. And importantly, there are data that the medical oncology doctors are not being taught. And so from my point of view, what I think is through no fault of their own because they don’t have time, they’re very busy and have lots of demands on their time and attention. They don’t have the presentation of this material. That number of natural product supplements and repurposed primary pharmaceuticals can increase the sensitivity of the cancer cells to be eliminated by the various types of chemotherapy. And now we’re seeing some data also with the targeted precision oncology agents. And that’s a great value because the natural products are inhibiting that compensatory signal and that adaptation, which we call chemo resistance.

Robin Daly
chemoresistance, the Boca bear of chemotherapy. Yeah. Okay, so I suppose it’s got to be something like seven or eight years ago that these repurposed medicines first appeared on my radar. I’ve always found them a fascinating area. As I’ve been pushing to build middle ground between conventional medicine and what used to be called complementary and alternative medicine. So here you have conventional medicines being used to achieve aims that can practitioners have been working to achieve for decades. So, you know, I think the early adopters of the repurposed drugs got shot at from both sides, but I think it’s now beginning to, they’re beginning to be established. And over time, I think these repurposed drugs have actually played an important role in building that middle ground. Perhaps you could share your perspective on the trajectory of repurposed drugs.

Dr LaValley
Well, I think the repurposed drugs are very, very important. And because the drugs themselves have been developed and engineered to be effective at low doses, and because many of them are generic or off-patent, they’ve been around for a long, long time, we have a vast amount, a vast experience of their safety record. And we know about potential drug interactions. And so using these repurposed primary care pharmaceuticals for their anti-cancer effect, their anti-cancer molecular effect, their synergistic effect, sometimes with other repurposed pharmaceuticals, sometimes with natural products, that oftentimes the research shows their anti-cancer effect in various different types of cancer cells directly, and not at just one molecular site, or one molecular vulnerability, but often at multiple different molecular sites or molecular vulnerabilities, and so that this is a great resource for additional anti-cancer activity for further control of the progression of the cancer. In other words, targeting these multiple molecular signaling pathways that are pro-cancer, they’ve been activated to be pro-cancer, the issue becomes, how can we resume close to or back to normal signaling at that? And that’s the anti-cancer molecular effect at that molecular site or that molecular site. And that the repurposed primary care pharmaceuticals are widely researched, certain ones, not every drug, but a significant number of drugs that are widely prescribed by primary care prescribers, primary care physicians, family doctors, internal medicine doctors, pediatricians, primary care, not oncology drugs. And that doctors have great experience with these drugs, including drugs, non-steroidal anti-inflammatory drugs, antibacterials, antifungals, proton pump inhibitors, antihistamines, some of the older seizure medication, a whole range of medications that are widely prescribed by various prescribers who have experience and comfort with their safety profile. And that, I think, adds another dimension to good anti-cancer, logical, rational evidence-based control, evidence-based management of the progression of cancer. And the doctors are not, in general, being taught this information because once the drug becomes generic, there’s very little incentive within the pharmaceutical industry to educate about those interventions. And there’s not clinical trials. So we wind up with this, it’s kind of a difficult cycle, vicious cycle of, yeah, I don’t have that.

Robin Daly
just get parked outside, don’t they? Yeah, they’re out of the mainstream. It’s very interesting. But you know, what I’ve witnessed over certainly the last five years is that this is moving to the middle there. Some doctors have moved out of conventional medicine and started using these repurposed drugs. And in order to do that, they’ve had to adopt the thinking behind interpretive medicine, which is, of course, works much more on the metabolic model, which is not the model of mainstream cancer. You know, they’re talking about the somatic mutation theory there and dealing with genes, damaged genes. And within that context, these drugs don’t make a slight bit of sense. They’re just like, well, why would you do that? But, you know, they have got the evidence behind them that’s being sufficient to get some people to venture out of conventional medicine and begin to try them. And the further they go into that, the more they begin to understand what people have been doing with natural products for years, because they have just the same really, aren’t they, in some of the effects they can generate. Equally well, on the other side, we now have people who would have been entirely, you know, natural medicine are beginning to embrace repurposed drugs, because why? Well, they’re really helpful. That’s the only reason to do it. And this move towards the middle that’s happening here is, I find it fascinating. I say, you know, most integrative doctors in this country would now use repurposed drugs in some way or another, which definitely wouldn’t have been the case a very few years ago. So I had one of the doctors from the Care Oncology Clinic, which works with repurposed drugs on my show a few weeks ago. And he was telling me what that how they’re developing their clinic. And it’s, as I pointed out to him, it’s heading towards the direction of looking like an integrative clinic. But they’ve come from mainstream medicine. So very interesting direction everything’s taking because of this middle ground of these drugs. Absolutely.

Dr LaValley
and that they old the old way. So I’ve been involved with what this is now called integrative medicine functional medicine back in the early 80s when I jumped into it. It was holistic or alternative and then became identified as complementary medicine and complementary and integrative medicine. And now it’s evolved into integrative medicine functional medicine or integrative and complementary medicine. In describing it with people that I’m talking to either patients or other physicians is there’s two sides to the street and in the old days they didn’t talk to each other. They didn’t reach out with much communications and there was also in some areas still very much so a type of closed-mindedness about the other side of the street. Yeah both sides. Yeah there can be a lot of people who are doing natural medicine who say all of conventional medicine is wrong or bad and vice versa. And from the patient’s point of view the data doesn’t have that regulatory or biased boundary. The data is what it is. Right. So I look at it as how do we match the data about these therapeutic options these molecules when we’re talking about the repurposed pharmaceuticals or the natural health product supplements and how do we match that to this person’s circumstance. And so I think of it as being a bridge between those two sides of the street with one foot firmly on both sides of the street and that that’s really where things are inevitably evolving because the data is driving that the clinical outcomes are driving that their patient access is driving that we have all these supplement natural health product supplements on the market. What are the best ones to use and we have to be very clear that there are a significant small number of widely used natural health product supplements which is the data show are not a good idea in all who have a diagnosis of cancer that can unfortunately and unknowingly be pro cancer. And so that and that’s not something that’s widely educated about. And so we have to acknowledge what is if we’re going to be evidence based and we have to acknowledge what is in the evidence.

Robin Daly
Well, look, I really heartened to hear you bring in the patient at the beginning there. Yeah, a little. Because evidence-based medicine that is patient-centered, well, that’s as good as it gets really, isn’t it? If you’re prepared to properly look at all the evidence, way to evaluate it with no bias, no axe to grind that says, well, you know, it’s not natural, it’s a toxin, so we’re not looking at that. So not being prepared to look at the evidence of whether it helps or not. And equally well, not being prepared to look at natural products as just being a waste of space or even, you know, getting in the way of treatment and again, look at the evidence for what they actually do. Then you’re standing with the patients, getting the answer, will this actually help me or not? And, you know, and that’s the same thing as getting the best result. So, you know, it’s actually a win-win for everybody if people start being properly scientific like you are and actually just looking at the evidence that’s there.

Dr LaValley
I think we have to acknowledge that there’s a lot of things we don’t know, and that some of the natural products can have a greater likelihood of value, benefit, and some of them can have a significantly higher likelihood of undesirable effect that we would describe as bad, pro-cancer, and similarly with repurposed pharmaceuticals, if we look at the evidence that’s there and making it available to patients and their physicians, that that gives an opportunity to exploit the data for benefit of the patient and start dosing at low doses so that we’re able to identify when something is not well tolerated, because it’s not well tolerated. It has to be eliminated out of the treatment plan because it’ll cause the remaining part of the treatment plan, which is well tolerated, to now not be well tolerated because having identified what’s not well tolerated, so having a meticulous way to identify the dosing, that that rational way, a good way to use the treatment plan implementation for extended duration in order to essentially now have the molecular network control of progression of the cancer for extended duration, and that gives greater ability to tolerate, let’s say, even additional conventional treatment down the road, which could be of even greater benefit. There’s a whole range of testing that can provide additional insight into vulnerabilities that the cells have that could be employed by the oncologist that oncologists would not have otherwise thought of or had access to, so there’s a lot of benefits from using the middle and the base of the data mountain to further control in a manner that remains well tolerated for extended duration.

Robin Daly
Yep. OK, well, you know, it all makes complete sense to me. Do you as well patients when they want to do everything they can to stay well, to live as long as I can. So why on earth would you reject massive raft of potential help? So given that you’ve got this enormous palette of resources to help me with, I’m interested to look a bit more in detail into the criteria that you apply when making choices. I mean, just for example, if a drug and a natural product or both achieve pretty much the same aim, will you always go with the natural product to avoid the negatives that go with every drug? Give us a few ideas. Hello, that’s a good question.

Dr LaValley
So I think I can give some example, I can give an example about that in that commonly, and I think inappropriately, so commonly within the natural medicine community or integrative medicine community, that there’s the assumption or assertion that the natural product berberine is the same as the pharmaceutical metformin. Yes, I thought that. And that will often be used interchangeably. And here’s what the data show. The data show that there is a significant, important, and robust overlap. So think, remember in elementary school, we had in math class a Venn diagram where you have overlap and an overlap, I mean you have two sets, and then you overlap them, and in the middle is where there’s common ground, I mean one set and another. There is that between berberine and metformin. When you dig into the additional therapeutic targeting of metformin in cancer, cancer cells, cancer stem cells, and tumor microenvironment cells, that there is a broad range of therapeutic targeting with metformin that is in addition to and different than the broad range of targeting from berberine. Both products are beneficial if they’re tolerated. And that key phrase right there, if they’re tolerated, you asked me how do I make treatment recommendations, is that I’m very diligent about doing drug-drug interaction analysis, drug-drug interaction using professional grade drug interaction tools, drug interaction analysis platform to look at because we have a large amount of data about the drugs and their interaction. We have a very minimal amount of data about drugs and natural product interactions.

Robin Daly
about that. It’s a whole different ballgame. It’s like multiplying the problem by a thousand fold.

Dr LaValley
Yeah, it’s very, very different. And the issue there, there’s lack of resources applied to the drug natural product interaction, because you’re not getting pharmaceutical funding for looking at drug and natural product interactions. The natural product producers are doing that kind of research. They don’t have the funding for that kind of research. And very often, and this is, I think, an area that’s quite neglected, is that when you look at the data in various different natural medicines databases about possible potential interactions, that you’ll see a reference to or a statement that says there is the possible interaction or the other class of drugs. And that’s why it’s appropriate and why I recommend to everybody in the protocols that you start low and increase slowly and do so in a manner that is organized, very systematic, especially in the first three months or so, very systematic to be able to identify what is well tolerated and what is not when you ask me about how do I make the decisions about the repurposed pharmaceuticals. I’m looking at the range of items that I think might be applied. And then when running them through the drug-drug interaction analysis, I could see that there is a serious potential for adverse risk. And so I wouldn’t be recommending that one with that one. Or there’s generally four or five levels of risk that are identified. So the high risk, don’t do it. The risk where the next level down is modify the dosing. The next level down is, well, keep track of what you’re doing. In other words, observe closely for adverse interaction. Then the next level and the next level in which there’s generally no action that’s being recommended. But that in those top three levels, the first level, you know, think of it as a red flag, don’t do it. Then the next one, level two and three, well, we’re already starting at a low dose. We always start at low doses because we’re looking inherently for molecular network synergy. And that’s what the biology is already presenting to us. The old pharmaceutical model was one disease, one drug. That model, and I think we’re seeing that change now definitely in cancer treatment. But I think we’re going to see it writ large over all of disease treatment is multiple different combinations because we’re identifying multiple different vulnerabilities. And then the combining of drugs and natural products within, in this case, the drug-drug interaction analysis. With these old generic drugs, we have a massive amount of experience about the drug safety and how to start things low and increase slowly. And so I think it actually is beneficial to be able to use these drug-drug interaction analyses to then rank order prioritize the pharmaceuticals in those recommendations. And so that’s how I do it. Or the physicians with whom I’m collaborating.

Robin Daly
So, quite a balancing act. Yeah, I was interested, I was thinking while you were talking about the fact that there hasn’t been this research into drug natural product interactions, so there’s lots of potential pitfalls that have not been seen yet, but I was also thinking on the other side, there’s lots of potential synergies that have also not been seen yet.

Dr LaValley
Yeah, absolutely. Actually, the data shows more, there are data showing synergies. And when you dig into the literature synergies with natural products and other natural product synergies with natural products and chemotherapy synergies with natural products and repurposed pharmaceuticals synergies with repurposed pharmaceuticals and other repurposed pharmaceuticals. even 50 with natural products and or repurposed pharmaceuticals and radiation therapy. So the data is there if you’re looking for it and you know that field, but medical oncology doctors aren’t taught about the natural products. The radiation oncology doctors aren’t taught about the natural products or neither of them are taught much about repurposed primary care pharmaceuticals. And so that’s just how it is, the integrated medicine and that’s why my collaboration is with integrated medicine doctors because and for instance I had a medical oncology doctor a couple of days ago calling me about a patient of his and he was interested in the additional range of the molecular integrative oncology treatment plans and he couldn’t implement them. He thought it was beneficial for his patient to try it and he couldn’t implement it. So we have to find an integrative medicine medical doctor locally for that medical oncology doctor’s patient with whom I can collaborate with the integrative medicine doctor in order for that physician to receive a set of evidence-based treatment plan recommendations in addition to what the medical oncology doctor is administering to his patient.

Robin Daly
Well, you have to do whatever works at the time of a run around. But anyway, it’s good that he’s actually making space for it because that’s excellent.

Dr LaValley
You were asking, well, how do I make decisions? I’m always looking at management of risk. So what is this person’s greatest risk? Well, at that stage, very often the greatest risk is progression of the cancer and dying from the cancer. So that means what would be a value from the drug is lower in risk than progression of the cancer. And so if you make it in dosing, that’s well-tolerated, leaning on the synergies, because that’s really a core fundamental characteristic of this methodology is you’ve got to have these combinations to have value. And essentially, the network is the therapeutic value. And that people say, well, I’ll take all those natural products, but I won’t take pharmaceuticals. Well, why is that? Well, because they’re pharmaceuticals.

Robin Daly
And I’m not going to touch that conventional stuff, which is terrible. If you want to stay alive, if you want to stay alive, you keep everything on the table.

Dr LaValley
And that’s right. That’s exactly right. I get people who say, well, can I get just your integrated medicine treatment? My response is, don’t take anything off the table. And so the essence of personalized care, of customizing a treatment plan, is giving that range of options concurrently.

Dr LaValley
And then fitting it to them because a long list of things to take If some of them are well tolerated causes the whole thing to collapse on it. The whole thing falls apart. Yeah

Robin Daly
Yeah. Very interesting. OK, well look, we’re just about out of time. I just wondered if you want to do a summary, if you like, on the benefits of utilizing this middle ground we’ve been speaking about, rather than leaning over heavily one way or the other. You know, what are the benefits as a whole?

Dr LaValley
I think it’s important to use the science, the data, the tools that are already available. And people come to me into other integrative medicine physicians for something to do now that’s supporting their conventional treatment. And I think it is rational to use the evidence base to prioritize among the thousands of potential supplements that are out there and to make logical, reasoned choices as well as from the already available primary care pharmaceuticals, some of which are over-the-counter, most of which require prescription from a licensed prescriber, that those integrative medicine doctors can then provide an additional parallel track of treatment in concert with, not instead of, in addition to their conventional oncology treatment. And as that conventional oncology treatment changes over time, the treatment plans can adapt and adjust to that conventional treatment by either addition of natural products or deletion of natural products or repurpose pharmaceuticals, essentially reflecting the personalization of that person’s circumstance so that they’re getting evidence-based molecularly and network-targeted, a broad range of natural products and repurposed pharmaceuticals in addition to their conventional care, personalized, patient-centered, they’re using all these phrases that actually have significant meaning and that these are able to be well-tolerated day in and day out for extended duration through oral at-home administration in addition to whatever treatment they’re getting in clinic and that that is a rational usage of the tool, the science, the therapeutic agents that are on the market already, including the natural products or repurposed pharmaceuticals, and that it’s immediately available. I see that that then can help people have a significantly greater quality of life and significantly extended duration of life and that hopefully we can find funding to get clinical trials in this in really important tumor types that are vastly underfunded for those kinds of trials and that people are able to then I see them get down the road, get extended duration benefit where even some of the new targeted agents can be administered to them which they would not have otherwise had access to, that gives them even better extended duration. So it’s a way to bring all of these pieces together, understanding that medical professional communication and integration between or among the medical oncology doctors and the integrative medicine doctors at this point does not very closely exist. However, I see that the patient manages each doctor. The patient is the hub. Patient-centered care means that and importantly if you look into what the American Medical Association, the Canadian Medical Association has adopted about patient-centered patient participatory care means the patient’s preference matters and all of us in the Canadian Medical Association and the American Medical Association,

Dr LaValley
so I’m in both for a long time, that we’ve agreed to patient-centered care and that means the patient’s preferences matter. So if the patient is preferring to have this additional track then it’s important that the physicians understand and respect that and I think that’s growing now. Definitely more, much more than it was 30 years ago and 20 years ago.

Robin Daly
Glad to hear it. I don’t think it’s really having much effect here yet, but I have high hopes where we are making progress. Yeah. All right. Look, really fascinating stuff, Dr. Lavalley. Thanks so much. It’s actually a real pleasure to talk to a doctor who’s prepared to go down the road less traveled, but not necessarily as comfortable in the interest of patients. So fantastic. Thank you so much.

Dr LaValley
It’s always a privilege to have a discussion and to be in your podcast. So thank you for having me, Robin.

Robin Daly
What an interesting resource repurposed drugs have turned out to be, something worth consideration by anyone with cancer. Find out more about Dr. Lavalley and his work at lavallemdprotocols.com. Thanks for listening. Do look out for next week’s Yes To Life show.