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Women’s Work
Show #263 - Date: 21 Jun 2020

Dr Nina Fuller-Shavel, trained in both conventional and functional medicine, has set up an integrative clinic with a focus on supporting women with breast cancer

Categories: Integration & the NHS, Lifestyle Medicine, UK Doctors & Clinics

Other content on this website featuring this person (including links to providers mentioned in this show):

Provider Find Dr Nina Fuller-Shavel in the Life Directory
Radio Show Team Effort 19 Nov 2021
Radio Show Systematic Learning 18 Jun 2021
Radio Show A Step Change 28 May 2021
Radio Show Society News 28 Mar 2021
Radio Show Nourish-Support-Connect 4 Oct 2020
Podcast BSIO - A Force for Change 24 May 2022

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Robin Daly: Hello and welcome to another Yes to Life show on UK Health Radio. I’m Robin Daly, host for the show for the last five years, as well as founder of the UK charity Yes to life, that provides support to those looking to integrate complementary and lifestyle medicine into their treatment protocol. My guest this week is someone I’ve only recently become aware of.
She’s highly qualified in both conventional and lifestyle medicine and has a clinic not far from Winchester, where she specialises in supporting women with breast cancer through treatment and beyond. I’m speaking to Dr Nina Fuller-Shavel over the internet in Stockport. Thanks so much for coming on the show today.

Dr Nina Fuller-Shavel: Thank you for having me Robin.

Robin Daly: To me, you’re part of a clearly defined army of people who are changing the face of medicine right now. This army consists almost exclusively of women who have all faced some serious health issues themselves. They found that conventional medicine either had no answers or at least insufficient answers for them and they’ve regained their health through approaches they’ve found for themselves.

Then they’ve got outside to train themselves, often very highly indeed as in your case, and are now helping others with a whole broad range of chronic conditions that characterised public health in 21st century Britain.

Would you tell us about your particular story? What led you on this journey to become an integrative doctor?

Dr Nina Fuller-Shavel: I think my journey started quite early on if I think back to my childhood. I was born in Belarus – that side of the world is quite big into herbal medicine, and nutrition is also a very, very big part of our lives. Fresh food, seasonal living and herbal medicine was probably part of my life from very early age. My Nan, for example, grew most of her own food. There was actually a bit of a barter system in the village, so properly old school.

When I came over to the UK, it was quite an interesting experience I have to say. Boarding school food did not endear me to British cuisine in any way, shape or form. I was like, ‘I don’t recognise this as food. What is this stuff?’

Then I really got into long distance running. I really enjoyed sports at school and I did swimming and tennis and running. As I went on to study natural sciences at Cambridge, I did a bit more competitive long distance running and started thinking how I can fuel my body properly for sport, on the sports nutrition side of things. Then I went to work in London doing really long hours in medical education, teaching doctors about various things from medications to liver disease. During that time I found it very tricky working between 10 and 16 hour days, anything between five and six days a week for quite a long period of time. And I crashed. I had a really big decline in health and they diagnosed it as chronic fatigue syndrome.

I very rapidly realised that chronic fatigue syndrome is a useless label that tells me nothing about the underlying causes of what your fatigue actually is. Then through my own journey, I found out a lot more about nutrition. Instead of making it about the sports side of things, it’s much more about how do I recover from this? Conventional medicine doesn’t have any answers for chronic fatigue syndrome so what do I do to support myself?

Luckily over the period of six to nine months, I came out of that. It was very much about restoring my HPA or adrenal access and reading some Sarah Michael’s work. I then decided I wanted to train in nutrition. I trained at the Institute of Optimum Nutrition while I was still working.

Then I was like, well, nutrition is great, but I need to know more about medicine. I need to know how to treat the complete spectrum. I decided to go back to Cambridge again and did my second degree there and did a graduate course in medicine. But while I was doing that, because I did my nutrition in a very much functional medicine way, and that’s very much root cause-based approaches, I did other trainings all throughout with the Institute of Functional Medicine and some other UK based providers in terms of keeping myself up to date.

Then it came to the end of my medical degree, went into junior doctor world and I was going, ‘Oh, hold on a second my two worlds collide rather badly together’. I can’t believe this, here I am being called to the patient’s bedside with a blood sugar of 22. And there’s a massive packet of tacks next to them. I’ve got to drop everything and rush to this medical emergency. Just this fundamental lack of awareness in the medical world about nutrition and the power of that. In all of my medical trainings throughout Cambridge, which is an amazing medical school, but we only had two hours in years and years of training.

Robin Daly: Unbelievable.

Dr Nina Fuller-Shavel: It shocked me to the core because what I was realising is that because of my previous background in natural sciences and nutrition, I was looking at things in a very, very different way. I don’t look at people as diagnostic boxes. I very much look at the whole physiology. We also look at healthcare rather than sick care.

The more I worked in the kind of the sick care system actually caused me to become sick myself. That time I went off with breast cancer. I went through conventional treatment, but I very much supported myself through everything I could throw it at as well. I went through six months of chemotherapy, two surgeries, and luckily it’s all in remission now, but another encounter on the patient side was when I was sitting there in the chemo lounge, there was literally no advice. The advice was so basic and bland on anything you can do to support yourself. You expect to just hand over all of your power to the gods of medicine and say ‘right, you fix me.’

The problem is that we know that patients who are diagnosed with cancers need to take some control of the situation, do something to help yourself. We also know that chemo and other modalities like radiotherapy have significant side effects for which again medicine does not have an answer. But there is research and certainly both mechanistic and very early human research that shows what we can do to support ourselves through the process.

Alongside my conventional treatment, I use nutrition. I used acupuncture. I used herbal medicine. I used yoga and mindfulness. I threw the book at it and in the process, my plastic surgeon who did my reconstruction after my breast cancer surgery and my oncology surgeon and my oncologist were quite amazed about what the process of supporting yourself truly brings to the table.

They’ve started recommending to people that they do look at other way of supporting themselves. I’m very lucky. I had an amazing team at the Royal Marsden Hospital. I’m going to be eternally grateful to them, but it’s brilliant because I think it’s opened out discussions and opened our eyes to what you could really do.

Robin Daly: You are in a very unique position there in a way where you’ve got training in nutrition and functional medicine, you’ve got training in orthodox medicine and now you’re the patient. That is a very rare combination in fact, and it put you in this extraordinary position to get people to open their eyes and ears to something new.

There are so many people we know who would hope that their oncologists would be interested in what they’re doing because it’s helping so much. But that’s not the case. They’re almost universally not interested and the very best response to any of them will ever get is, ‘great, well, what you’re doing seems to be working fine. Just keep on with it.’ That’s a really good response, but they will never get interest. Excellent that you were able to do that and I hope that you’re able to further that.

Dr Nina Fuller-Shavel: Actually since then, one thing that I’d realised personally for myself, it’s been a bit of a wake up call that my two worlds probably don’t work that well together and I really need to come out of the NHS and actually do a bit of innovation within my own system. After completing some further training, after my breast cancer treatment I’ve decided to come out of the NHS and I now run Synthesis Clinic, and that’s a functional, integrated medicine practice in Hampshire.

I take mostly breast cancer cases in terms of the oncology side of it, although we also take care of gut health and other women’s health issues. That’s been really very interesting because I try and collaborate and bring the team as much together as possible. I speak to my patient’s oncologist if they are open for the conversation, or I can write to them, and I coordinate my care with the whole team.

I think there is a benefit to me having gone through it. I feel what it’s like to be on treatment. I’ve been there with chemo. I know how sick you feel and I know also what can help them or what doesn’t help. But also quite often the oncologists then speak to another doctor, and I know probably not necessarily the right thing to do, sometimes just speaking the common language and me pointing them in the direction of, some of the public trials and some of the things that I found work, my clinical practice can push people’s envelope a little bit and open their eyes a bit further.

Robin Daly: Very interesting. I wondered if you mind talking a little bit more? An area that interests me very much is the different worlds of orthodox medicine, complementary medicine, and men and women working in those and being patients in those in fact. I mentioned in the outset of the army of people who are taking the role that you are, are nearly all women.

The background of complementary medicine is women’s medicine by women, for women. That’s what’s happening and it is changing, but very slowly. It’s a tragedy as far as I’m concerned. Because men make fantastic complementary practitioners, men make great patients in as much as they benefit enormously from what everything that lifestyle and complementary medicine can offer.

It’s a tragedy on both sides of that that’s not happening. On the other side there’s another tragedy happening, which is that my experience is that, whereas you’ve come along there and you’ve made a difference as a woman by presenting a different face of what’s possible for patients, you’ve introduced it as a professional. In oncology generally I understand there are now more women professionals than men. But nonetheless, they’ve taken on the role of the traditional oncology mantle, the one that’s been handed down, which is a sort of top down rather abusive system.

Some of the worst interactions between oncologists and patients are actually with a woman oncologist. They’re even worse than the men. That system doesn’t seem to have been changed by it so far, particularly in the introduction of this other way of looking at medicine, which incorporates care and empathy, and a whole view of a person doesn’t seem to really infiltrated into oncology yet, which I’m very disappointed about, but I really hope it does soon.

Dr Nina Fuller-Shavel: It’s a tricky situation. I think we’re still very much at the very earliest stages of any of this changing. If you thinking about integrative medicine and integrative care, the US leads the way in that. If you think about closer to us in Europe, Germany wins too.
But certainly within the UK, we’re way far behind. We’re just about opening our eyes in GP and NHS that lifestyle medicine isn’t the soft option and that it does actually make a big difference. You can reverse pre-diabetes with lifestyle and you don’t need to keep everybody on metformin.

I think we really are just peeking into that area and I think it’s too early, unfortunately, to see those changes permeate all the way through the culture. You also have to think a little bit about all the female consultants have had to go through: a really rough culture.

Robin Daly: I know! It’s a rough culture, exactly. That’s why I call it abusive. I think the inspiration, which so many young people go into learning to train to be a doctor who want to help people – they’ve got all the right motivation and everything else and want to care for people who are in terrible circumstances. A lot of that is just knocked out of them in the first three years. I’ve heard it from people themselves who’ve been through it.

It’s just like being part of the army! ‘We’re gonna toughen them up,’ and it’s terrible. When are we going to stop doing this? It’s so out of date. It’s the way everything ran in the 1930s, but it should be just something that’s left in the past now.

Dr Nina Fuller-Shavel: I think there’s some early changes coming towards us. We’re looking more at physician resilience. My wonderful friend and colleague Dr Sally Moorcroft set up a program that’s looking at building physician resilience.

Ultimately if physicians and doctors don’t take care of themselves and we don’t actually learn to build resilience, are we going to burnout of compassion, fatigue, and our patients don’t deserve that. They don’t deserve us being burnt out and unable to offer empathy because that’s ultimately what we’re there for. We have the mechanistic way of practicing medicine. We’ve lost the art of medicine. We’ve lost the art of being able to relate human-to-human, not just patient in bed 2.1 with a chest infection.

I’m seeing more and more, I like to think, positive changes. There’s the British Society of Lifestyle Medicine that is furthering people’s opinions of lifestyle medicine. The more I can do from the clinic to try and collaborate with local researchers and local organisations to show people that this approach works, and works for people.

One of my cases for example, is an amazing lady. She’s got triple negative breast cancer that’s metastatic. And like you said about the approach people encounter Robin, is she sees oncologists and she’s had this disease for five years plus, and they keep saying to her “Oh, you must have a weird, slow growing triple negative cancer” and I say “no, no, it’s not, it’s not a weird, never been described, slow growing, triple negative.”

The aggression is being slowed down and tempered by everything we throw at it, both from the convention medicine side and everything I throw at it from the integrative medicine side and everything she’s doing herself. I’m with you completely – the curiosity about this should be there because we need to know what works. We know all our stats about chemo; we know our stats about radio. What about combining that? What about the quality of life?

The information – a lot of it is out on PubMed. It’s just, we’re not looking as clinicians. We should be looking at what else we can do to keep our patients more whole, more resilient and more empowered through the whole process.

Robin Daly: But a lot of our hard-worked oncologists, if you told them that they were uncaring, they would be very shocked to hear that and would probably deny it. You can see why. But in fact, to ignore that the entire gamut of natural science that enables patients to go through chemotherapy in a way which is far, far less horrendous and far less damaging in the long term. Just to ignore the whole thing and just give them some more drugs to manage the side effects, which have side effects themselves is uncaring. That’s the fact. So, it’s an odd world that we have, but I’m very pleased that you point out that, whereas it seems like a situation in some cases where it’s all about the oncologists and they’re just having the life they want, and everybody has to fit around them. In fact, it’s hell for them as well.

Dr Nina Fuller-Shavel: It’s very tricky. I think the other thing we’ve got to realise, having worked in NHS myself, it is immensely draining, particularly in the early years. I could be the only doctor on call outside of A&E for all of the medical wards in the district general hospital. Me. Maybe my registrar would have been in A&E dealing with someone, so I would have had literally no help. If someone decides to have a cardiac arrest on one side of the hospital and someone decides to have another emergency on the other, at that point you reach an almost mechanistic way of approaching the problem and what has to be fixed because you’re firefighting all the time. That’s our system of medicine – it has been built on a maladapted acute medicine system.

When Bevan created the NHS, it was very much acute medical work. You’re thinking about post WWII, lots of acute medicine problems, lots of infections, and it’s great our medical model works very well for these things. If you’ve broken a leg, you’re sorted.

The problem is we now no longer live in that world. We live in a world where noncommunicable disease, chronic disease is absolutely rife. And for that, we don’t have a clear answer because the acute medicine model breaks down at this point. That’s where systems biology has so much to offer. Looking at the wide angle, looking at the natural health care research, looking at lifestyle and bringing all of this together. I’m a big believer in the fact that we don’t need to throw any babies out with the bath water. We just need to learn to co-exist happily and respect each other’s expertise and knowledge.

Robin Daly: Exactly. Thank you for that. Coming back to your work – one of your main things is supporting women with breast cancer. In your own experience, what were the greatest gaps in care that you needed to find help with during your treatment?

Dr Nina Fuller-Shavel: Nutrition was one that really shocked me. If I didn’t have my background, I would find it really dire and lacking. And that’s at the one of the top cancer hospitals.

The advice says eat a balanced diet. Well, what is a balanced diet? Chocolate in each hand? There’re biscuits in the chemo lounge and you think where is good quality advice on what to eat and what you can do to support yourself. There really wasn’t any. The other thing important is I don’t think there’s enough awareness about anything that can be done to support your blood counts, for example, during chemotherapy.

I regularly put in a number of things to support my patients’ blood counts so they don’t have to have their chemo delayed if they keep dropping them. But there wasn’t anything apart from the usual GCSF injections that anyone would even consider. The problem is as patients go through chemotherapy, what we certainly know from research particularly in breast cancer is that they drop muscle mass, they can gain fat and that has a prognostic significance. But because of the lack of dietary advice or anything else, you’re finding, actually, I’d like to know at the front end of my treatment, if what I’m going to be going through is going to affect my survival and can I do to support myself.

That was probably the biggest gap – just good, solid advice on nutrition.

Robin Daly: Well, I have to say the Marsden still puts out a big warning to people not to consult those nasty nutritionists who might give them unqualified advice about cancer and nutrition. But you’re right. It’s a scary territory and I think that support of the immune system is one of the massive negations of orthodox medicine. I remember when I set up Yes to Life, there was a 700-page report by I think it was Cancer Research UK on medicinal mushrooms, almost the whole of it positive as to its capacity to support the immune system, and it was already several years old, I think at that time, that report. So it’s not like they don’t know anything about it.

But would they use mushrooms in oncology wards? No, well it’s not a drug, we don’t use mushrooms here! It’s an absolute tragedy that something as simple, cheap and effective as that is completely and utterly ignored.

Dr Nina Fuller-Shavel: And the other thing is when we think about medicinal mushrooms – culinary mushrooms are medicinal. You can go and buy your cheap mushrooms in your supermarket and put it in your stir fry along with your broccoli and other things. I think we do have to realise, and again, that’s where I sit in between both of us, but what I know is a huge amount of research that oncologists have to get through just on the conventional drugs.
The amount of trials that are coming out every year, it’s huge. So when you consider all of this professional development, the answer really possibly in our system, isn’t that the oncologist has to know about all these things, it’s that they’re willing to work in a team who have the expertise to use these things safely and effectively in combination with treatment.

Robin Daly: Yes I agree. That’s how it should work.

Dr Nina Fuller-Shavel: Otherwise you can’t expect oncologists to take on board all of the stuff that even I have trouble keeping up with.

Robin Daly: No, I absolutely agree with you. You can’t expect them to be functional medicine practitioners as well. But they need to open their minds to the idea that there are other people who are also very skilled, also very professional and can also help a lot.

Dr Nina Fuller-Shavel: No, I agree. I think collaboration is a big thing. Even within my own clinic, I don’t expect to do everything myself. I’ve got a health coach who helps people implement nutrition changes. I’ve got an amazing psychologist who I work with very closely. I think teams are the way to go and we should think about multidisciplinary teams wider than the occasional oncology in the NHS. We can build those into integrative centres of care that are much farther along in other countries.

Robin Daly: Probably all of those shortcomings come from the way in which health is viewed, in which cancer is viewed. If the body is viewed in a kind of reductionistic way or cancer is viewed as a tumour that’s got to be killed or cut out, then the treatment is going to reflect exactly that view. What you were finding, I’m guessing, is that your view of your own health needs wasn’t being reflected by the system of health care, or at the best it was only being partly reflected. And so you were led to look elsewhere.

In fact, you already had some of your own resources to look to, unlike most people, which was very lucky in a way. The good news these days is there are increasingly well-established and trustworthy places where people can go and look for that kind of extra help. Would you agree that these gaps in care have always been there, but up until recently, most people have simply had to accept what they were given?

Dr Nina Fuller-Shavel: Yeah, I would think so. I think these days we have a lot more education available to us. We’ve got accessible information from all over the world. Arizona University has an integrative medicine centre where both patients and clinicians can take online programs on integrative cancer management.

There’s a number of different resources that are available. People are looking. I think there’s much more activation within ourselves as a patient group that we do want to have a say in our health care. Maybe our parents’ generation of going “yes, sir. no sir. I’m not going asked any questions. I have no idea why I’m taking this drug.”

Robin Daly: That’s simply not good enough anymore. Is it?

One thing you have written yourself, which is obviously very important to you, which speaks to me of a different view of medicine, is that you talk about tackling root causes, not just plastering over symptoms.

That seems to me somewhere where you feel orthodox medicine is doing something in many situations, which is not your approach at all, or it doesn’t reflect your view of health.

Dr Nina Fuller-Shavel: Absolutely. I think that’s again where the shift comes from acute to chronic medicine. If you think about even the conventional approach, the acute medicine treats the cause.

Acute medicine, if you’ve got a chest infection, they’re going to treat you for pneumonia and then you’re going to get better. But chronic medicine, our drugs don’t treat the root cause very much anymore. They treat some aspects of our physiology but they don’t address why disease arose in the first place.

I see it with everything from the whole Covid discussion. We should treat the terrain. We should treat the body as a whole system and actually look at the environment. That’s tumorigenic what is it about the environment? What combination of genetics, lifestyle and other factors has contributed to an environment where our own defence, in terms of immune defence, natural cancer defences don’t work anymore. If they fail, why do they fail? What can we do to support ourselves back out of it? And my thing about recurrence management, isn’t just, “oh well, let’s just go for annual surveillance or whatever surveillance program you want.” It’s let’s look back. Let’s look at maybe some of the personalised medicine aspects. Let’s look at the genetics of your oestrogen metabolism, for example. Let’s look at the family history. Let’s look at the lifestyle. What combination of lifestyle could have potentially contributed to increased risk of your immune system not being good enough or suppression of your responses? And how can we make these all better?

We’re creating a completely different body environment where we haven’t just cut out the cancer and just left a vacuum then and go, “hey, that’s it. You’re done.”

Robin Daly: But you know, it’s, it seems common sense to me, but it isn’t the kind of ethos is it.
The question of why people got cancer is simply not asked. People are able to still say, “oh, it’s just bad luck,” despite the fact that statistics are completely out of control and now half of us are predicted to get cancer. It’s an astonishing kind of world we live in.

Dr Nina Fuller-Shavel: Well, I don’t think we can properly say, “oh, it’s just bad luck,” because actually the World Cancer Research Fund very clearly states that over 60 per cent of cancers are prevented by lifestyle intervention. It can be prevented. I think that’s something that we definitely need to look into, but again, it’s not made it to the mainstream.

Lifestyle is being thought of as a soft option. Drugs are the proper medicine. But actually chronic disease gets created every day. Ultimately, if you’re thinking about it, cancers grow over years or decades. Chronic disease – what choices you make every day impact our risk. What we should do about it should be done every day.

Robin Daly: Very good point. Thank you.

You’re trained in and offer a broad range of approaches. They’re clearly aimed at filling the gaps in care that you’ve experienced. Is there one of those approaches or areas of care that you feel is more important than all the rest? And if so, why?

Dr Nina Fuller-Shavel: It’s like asking me to pick a favourite child! I can’t!

Robin Daly: No, no, if you haven’t got an answer, then you haven’t that’s fair enough. But, maybe you have?

Dr Nina Fuller-Shavel: I don’t think it’s the approach itself in terms of therapeutic modality. But I would say functional medicine.

It’s a route-based approach and that, to me, is the most crucial thing because you can use it in conventional medicine. You can use medication, and I sometimes do, where you target the root cause, but it’s having that mindset of going: I’m going to look at all of you, all of your physiological system as a whole human being everything together, and I’m going to target the roots rather than playing whack-a-mole with drugs.

Robin Daly: So let’s say here I am; I’m a woman with breast cancer. I’ve literally just heard the news that I’ve got cancer. I’ve got no idea what’s ahead of me but I’m scared stiff of the treatment and what it may involve. I’m scared stiff of not knowing whether it’s likely to work or not. This is a big question I realise, but just say that by chance, I call you up on day one. I’ve just been diagnosed. What, how and when are you able to help along the way? In what ways?

Dr Nina Fuller-Shavel: I change my approach depending on the treatment is chosen on the conventional side as well, very much so. But I think from day one, I always recommend a Mediterranean style, high phytonutrient diet, that’s got to be the cornerstone of whatever you’re going through because that provides you with the building blocks, the nutrients you need to actually keep your body as healthy as possible throughout.

And then for example, if someone is going into surgery within the next couple of weeks, which quite often happens if they’ve found a locally contained tumour, then we would very much look at prepping for surgery and surgery rehab. And during that time I would optimise someone’s protein status in particular.

Lots of women aren’t aware that – having sufficient but not excessive protein intake is very important around recovery from surgery and chemotherapy, because both of these things increase your protein requirement. It’s about then supporting them through it and finding them a very good rehab specialist.

There’s amazing stuff in terms of pink ribbon approaches and other things that can help you regain your shoulder mobility post-mastectomy and lymph node surgery to a really good level. The key thing is to do it preventatively rather than wait until problems arise later.

We build a program from the very beginning. If we were going into chemo, my approach is phased very much about in terms of what is appropriate for chemotherapy. For example, I don’t use probiotics because they’re not considered safe with chemotherapy. But I might be able to use probiotics later on when we are rebuilding the gut after chemotherapy has completed. But I will then use very specific rotating regimes according to the chemo cycle, in terms of supporting blood cell counts, make sure people get adequate nutrition, if their appetite or their ability to digest food has been impaired by chemotherapy. That’s very, very important.

Gentle movements throughout, helping people find movement that works for them, that doesn’t exhaust them, but you’ve got to keep moving because one of the main predictors of profound cancer-related and chemo-related fatigue is stopping moving. You can do anything from yoga and restorative yoga, which is very gentle stuff, to tai chi to other things.

You can find something that you can do however sick you feel, and that will actually help you feel better. That’s kind of the other things that I do. Herbal medicine, I use a fair amount of medicinal mushrooms, whether it’s dietary form or in other forms. We use that as well with patients.

Against the radiotherapy, you then go into very specific challenges here in terms of skin protection. Sometimes there’s some local things that can be done as well as helping with radiotherapy related fatigue.

You kind of chop and change depending on the stage of treatment and what the person in front of you needs. There isn’t a protocol. I treat people, I don’t treat protocols.

Robin Daly: It’s interesting – the mindset. Let’s go back to when I first set up Yes to Life – most of the people we talked to literally had every drop of chemo their body was able to take, being irradiated to the point of being fried, and there was nothing more on offer.

Then they turn up at the door asking for help. That has changed over the years. The likelihood of somebody doing what I suggested of ringing up somebody like you on day one is far greater than it was. It does happen, which is marvellous, because of course there is a mindset which still goes, well, I’m going to get the conventional treatment done and then I’ll start all that stuff. That mindset is still around. And of course the people who know what’s possible hold their head because of course they’ve actually just ditched the whole of integrative medicine, which is the combination of the two things and what can happen if they’re used together.

And that’s a total tragedy for them that they’ve done that. So of course, to have the opportunity to talk to somebody on day one is marvellous for anybody who has this knowledge. I’m just interested – is that common for you to be able to do that?

Dr Nina Fuller-Shavel: It’s becoming more common I would say. Most of the time, if I think about the proportion of breast cancer cases I get, most of them would be either just before or after surgery.

They probably have had a couple of weeks to process things. They’re looking to support themselves, in a different way and then when they go back to see their surgeon, I’ve had some really great responses as well. We mustn’t tar everybody with the same brush.

I’ve had some amazing oncology surgeons who were so impressed with how the patient is actually better having had breast cancer than they were feeling before. Then they were like, “Oh, okay, that can happen,” and they will take that on board. But yes, the vast majority are probably not day one. I would say that’s a very small proportion, probably under 10%. Most of the time it’s around surgery or just post surgery.

Robin Daly: Well, that’s very good though. Isn’t it? That’s excellent. Certainly around the beginning anyway, that’s the time when you can really start to help. And so, that’s marvellous and that is very good that people have that mindset now where they don’t just turn up to chemo and get on with it, and then a week later they find they’re on another planet, drugged to death, you know? They wouldn’t even be able to think about consulting anybody else. So it’s very good that that’s the case. That shows a change in the public culture, if not in the medical culture.

Dr Nina Fuller-Shavel: Absolutely. All the amazing work that organisations like yours have done into educating people about the fact that there are things that can help.

I love to see stuff in the mainstream medical journals. In the last couple of years there have been publications in oncology journals about the integrative approach to breast cancer, for example, and I can see acupuncture being recommended. I think there is far more of certainly the ASCO, the American Society for Oncology, is bringing in some guidance on integrative medicine, which I find brilliant because you can then hopefully pass all of these alone to our colleagues and help spread the word.

Robin Daly: That’s certainly true. There are one or two things which have caught the attention of the mainstream world, which are straight out of alternative medicine. All of a sudden they’re there, gut health being one of them. Where was that in conventional medicine even three or four years ago? It just didn’t exist and suddenly it’s like, well, this drug works 50 per cent better if you do this. That’s been pretty extraordinary, I think.

And the other one that has been around in oncology forever, but is the place you don’t go, is that all dietary approaches to cancer are being completely attacked to death as being piffle until the ketogenic diet came along, which has actually started to be taken seriously. It’s a breakthrough really. It has opened the door to the fact that there is some connection between diet and cancer. Would you believe it? It is making its way in there, you’re right.

Dr Nina Fuller-Shavel: Gut health is a huge one. That’s where all of my specialties of the clinic – gut health hormones, women’s health and mental health and wellbeing – all come together because our gut is an absolute epicentre for all of this. From the breast cancer point of view, we know that having a certain amount of antibiotics in life may slightly increase your risk of getting breast cancer and may potentially increase your risk of recurrence.

If we’re thinking about restoring people’s gut post chemotherapy – it’s absolutely crucial because we know that a significant amount of oestrogen recycling goes on in the gut. Your bacterial balance is going to affect what goes on. It’s called enterohepatic circulation. It’s something I never learned about in medical school, but it’s all over the journals.

Robin Daly: It’s so important and all of it comes back to a very basic faith in the systems that are there already in us, that are inbuilt systems that actually work better than any kind of thing we can do.

But the thing we can do is support those systems and get them to work as well as they can, which I think we have a lot of power to do using our intellect in exploring the resources that are out in the world to improve our own internal resources. I think as a whole world, we’ve learned a massive amount in the last 25 years where science has started to take this stuff seriously. 25 years ago most people who worked in this field because they intuitively felt this was the right place to go.

That nature had a lot of the answers and we did have a system that wasn’t self-destructive and could heal itself and all these kind of things – that it was a slightly airy fairy world. Now there’s a huge amount of science to back it up as well. Its position has shifted significantly.

Dr Nina Fuller-Shavel: I find it really fascinating. From my perspective, I look to all sorts of different sources of information and I look at some of the herbs that have always been used in traditional Chinese medicine and Ayurvedic medicine for literally hundreds and hundreds of years. It’s fascinating because of course now China’s putting lots of these herbs through screening and molecular biology and finding out exactly why they work, which is fascinating.

I think it’s brilliant because ultimately those systems were observational systems of medicine whereby you were pattern-recognising. You would see something and go, this is a pattern. I can now correlate it very much to actually what’s going on in my physiological world.

We can say someone’s got a deficiency. I can say their HPA or adrenal axis is dysregulated, for example and you can correlate all of these things. You can take observational systems of medicine that basically figured out in the absence of any other science of what worked, and now we can actually put the science behind it and say this is why it works. It’s because of ginsenoside or this particular thing.

There’s a danger in that as well because what we mustn’t do is we must not become reductionist in our approach. The danger of digging into all of these molecular chemistry is for us to forget that nature has created these compounds to all function together. By taking one out and using it in high doses is going to have a very different effect to the actual whole plant complex.

Robin Daly: Thank you for bringing that back in. It’s very important isn’t it? Nature as a whole can’t be ignored.

A piece of broccoli is more than the sum of its ingredients. What a fascinating topic! Look we’re right out of time. I really enjoyed that. It was real fun. Thank you so much. We’d love to have you back again sometime. I’m sure there’s lots more we can talk about but thanks so much for your time today.

Dr Nina Fuller-Shavel: Thank you for having me, Robin.

Robin Daly: Bye.

I’m sure there are many of you listening who would have loved to have been able to gain the interest of your oncologist in the integrated medicine approach in the way that Dr Nina was able to due to her medical standing. This intensely frustrating situation of being locked into an exclusively drug culture in health care is an ongoing tragedy that both the patients and the providers are the victims of.

All I can say is to encourage you, if you’re someone going through cancer, to look for opportunities to make your oncologist aware of the massive potential for improving the lot of their patients that they’re overlooking. Show them the signs, point out the ways in which you’re benefiting.

Obviously there’s no mileage in getting into a confrontation with a closed door but if you sense the slightest opening, why not use the opportunity? The Yes to Life website has had some upgrades recently and one of the great new features is a searchable page for the Yes to Life show. There are now over 250 shows available, but the growing problem has been one of the accessibility – finding the material of all the guests you’re interested in.

Well, I’m delighted that this has been addressed with this new search page. Go to Scroll down the home page and click where it says Yes to Life Show. There you’ll find details of the current show, but also most of the last five years’ shows. Some of the earliest ones are still being added with search boxes that allow you to look for subjects, guests, or keywords. Each result is linked directly to the show on listen on demand on UK Health Radio.

I’d also like to remind you of the ongoing fortnightly live forums now taking place within Wigwam, the Yes to Life cancer support group. Look on for details of the upcoming forums and recordings of past forums.

Next up will be an exciting presentation and Q&A on mushroom bioscience – not to be missed! Just take a look under events at to reserve your place at this free forum.

Thanks so much for listening today. I’ll be back again next week with another Yes to Live show here on UK Health Radio.


Kindly written by Literary & Transcript Editor Maria Mellor