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

Robin Daly
Hello and welcome to the second series of Cancer Talk, the podcast that explores the benefits of integrative oncology, an approach that brings together standard oncology practice for the raft of lifestyle and complementary approaches in order to provide broader, more holistic care to improve quality of life and outcomes for people with cancer. I’m Robin Daly, founder of Yes to Life, the UK’s integrative cancer care charity, and one of the hosts for the podcast. Series 1 of Cancer Talk was aimed at initiating conversations about integrative oncology and bridging the gap between mainstream and integrative medicine practitioners. And the Series 1 episodes are still available from Yes to Life .org .uk forward slash podcasts and major podcast platforms.

Dr Penny Kechagioglou
Hello, I’m Dr Penny Kechagioglou. I’m an NHS Clinical Oncologist and co -host for the broadcast and in addition to treating patients with all the regular modalities in use within healthcare, I have a passion for integrating evidence- supported lifestyle and complementary medicine into patient protocols. I’ve witnessed first have the enormous benefits this can deliver to patients and their carers. So in Series 2 of the broadcast we are planning focused conversations with healthcare professionals, working directly with people with cancer and applying integrative oncology in contemporary clinical practice with the aim of strengthening the clinical voice and evidence for integration, influencing the wider community including academia and research and beating the case for an integrated UK model of care.

Robin Daly
I’m delighted to be back hosting another Cancer Talk with you.

Dr Penny Kechagioglou
Hi Robin, great to see you again.

Robin Daly
So, for this edition, we’ve got a revisit from a previous guest, Professor Robert Thomas. So, Robert’s a clinical oncologist. He’s well known for his innovative research work into the use of natural compounds in cancer, also for his books, most recently, How to Live. But he has some other news that’s prompted us to invite him back for us to hear more about. Welcome, Rob. So, I want to get stuck straight into the headline here. Please tell us about your new appointment.

Professor Robert Thomas
Well, I’m still going to be an oncologist, so I’m staying in Cambridge and Bedford for three days a week, and I’m still going to be a professor of sports, medicine and nutrition at Bedford University. But I’m pleased to announce that two days a week, I will be leading integrative oncology at the Royal London Hospital for Integrative Medicine, which is based in Great Ormond Street near Queen Square. Fantastic.

Dr Penny Kechagioglou
Billions. Congratulations.

Robin Daly
Rob. Thank you. Congratulations. Great news and another hat you’re going to have on there. You’re going to be a busy man. Correct. So I wanted to talk about the ROHAM a bit. It’s a considerable resource but it’s maybe not as well known as it might be considering its size, its history and of course its unique position as part of UCL. So can you give us a bit of an overview of what’s on offer at the hospital?

Professor Robert Thomas
Well yeah, as you said in your introduction, I’ve been interested in lifestyle medicine, in studies where you look at nutritional interventions, gut health, so forth, and in the past, the RLHIM, as we nickname it, was much more complementary. So he’s even called the Royal Homeopathic Hospital, but that name’s been dropped because although they still do a little bit of homeopathy, that is a very minor part of what they do now. What I like about them is they’re mainly trying to integrate with other faculties within UCLH, and that could be the sports department, the oncologist, rheumatologist, and they’re trying to see how a more holistic approach to the patient could help their outcomes and certainly help patient satisfaction.

Professor Robert Thomas
So on the oncology side, we’ll be trying to, instead of having ad hoc referrals for holistic care, we’re trying to set up pathways so that if you get, say breast cancer for example, you will come to us and we will talk to the patient about pre -habilitation, you know, if anything it could be exercise, it could be, we do, we will be recommending things like acupuncture and mindfulness, and certainly nutritional interventions, gut health interventions. So we feel there’s a, you know, it’s a good opportunity now with a lot of the research coming through to actually, you know, make this more mainstream. Fantastic. And that’s why I went for the post.

Dr Penny Kechagioglou
Sounds like you are transforming the service. I mean, that will be, as an oncology speaking, first of its kind, right?

Professor Robert Thomas
I think, well, Genesis Care, as you well know, Penny, were pretty much the leaders in this. I mean, I think you and I were both involved in trying to get, well, getting, succeeding, actually, getting Penny Braun pathways integrated into care. And I think, is it 14 hospitals? Yes. And many of them have now gyms and exercise professional and nutritional advice. And they do offer some complementary therapies such as acupuncture. So yeah, so it’s not new on the private side. And certainly, as far as I can see from the feedback I’ve had from Genesis, the patients really appreciated that integrative care. They felt that, you know, their mind and body was looked after rather than they were just a slab of meat. So on the commercial side, they see it as an advantage. Now, on the NHS side, back to your question. Yes, I don’t think that there are any NHS hospital, and we all sort of dabble in it. I mean, I very much into exercise referral, and we have nutritionists and things, but it would be if we succeeded it.

Professor Robert Thomas
Yeah, I think UCLH will be a first, I hope.

Robin Daly
Fantastic. Now it’s a massive step forward and do you feel that with it being a separate hospital you’ll still be able to get a good degree of integration into the program? Do you think it’s going to work as a pathway in that way?

Professor Robert Thomas
Well, part of the sort of run -up for the interview, what I was trying to do is feel the ground amongst oncologists, amongst, well, it’s actually under the umbrella of Queen’s Square, which is, as you know, the National Neurology Hospital. So there’s quite a lot of, you know, quite severe brain tumors and problems there, and it’s linked to Great Ormond Street. So lots of children with cancer were coming out of that and living with the late toxicities. So both of those people I spoke to, and especially the financial side, said they were very keen to keep it on board. They see it as an asset and they see potential. But, you know, part of the initial part of the job would be to talk to oncologists and say, you know, would you be able to write joint protocols? And, you know, there will be some logistical issues, getting patients seen on time. The Institute of Sports Medicine is in Tottenham Court Road, and they see also that as another jewel in the crown of UCLH.

Professor Robert Thomas
So I’ll be trying to work with them to take patients for pre -hab and rehabilitation.

Robin Daly
Well, it seems massively significant to me that they’ve appointed you as an oncologist to run the show. You know, you have obviously a complete in with the oncology fraternity within UCL. You can talk to them direct and convince them that this is a useful asset to them.

Professor Robert Thomas
I hope so. I mean, at the moment, the people, Sosie Kasab, who I’ve taken over from, who’s enormously popular and a larger -than -life personality, is sort of taking a lot of cases from the oncologists who very much want to talk about just complementary therapies. And she used to give a little bit of homeopathy, not too much, but she used to prescribe things like Iscador and acupuncture. So there are still people in the team which do that. So that will be available to patients, but I will be not really involved so much in that. So it may be a bit of a transition when I’m doing the clinics, people expecting something different. So that’s the first hurdle which we’ll have to come across.

Robin Daly
So it’s quite a radical revamp of the whole positioning of the hospital you’re looking at, in fact.

Professor Robert Thomas
Yeah, I mean, they’ve still got the same philosophy. The philosophy is to support what the patient wants. And as you know, with the new biological treatments and the PD -L1 inhibitors, there is a lot of evidence that patients who are healthier, who have better gut health, exercise more in a better frame of mind, do better. They respond better physically to these drugs. They have less toxicities. You know, I think this should be routine throughout the whole NHS. I’m hoping if we can get it in UCLH, it will maybe show it can be done. And I think that’s where the priority is, is to get better responses to oncology drugs with less toxicity and higher cure rates. And that’s where the money, you know, the funding comes from.

Dr Penny Kechagioglou
And I guess with your research background, Rob, you have your best place, I guess, to run clinical trials moving forward.

Professor Robert Thomas
Absolutely. They do actually a lot of clinical trials in RLHIM. I was very pleasantly surprised and there’s an enormous enthusiasm from the team and there’s certainly more backup than I’ve got already. So yeah, I’d be delighted to run some more trials. The trial I’m doing at the moment is looking at gut health and prostate cancer, which we recruit to 250 patients within six months in Cambridge and Bedford. We were massively pleased with the enthusiasm we got of patients to enter that study. Yeah. And the next phase of that, that’s sort of in the process of collecting the last few patients’ data and writing it up hopefully in time for asco urology next year. So and I don’t want to preempt the results, but it’s very likely to show that gut health is a very important factor in prostate cancer development and progression. As you can imagine, it’s just not been demonstrating a double -blind randomized trial.

Professor Robert Thomas
Yeah, he’s actually proved it. But the next step is to go on to look at people on androgen deprivation, so Zolodex or ProSTAP or whatever, because we know that damage is gut health. Try to maintain gut health and see if you can prolong the duration of control. Now, there is a big urology team in UCLA. There’s a lot of people on androgen deprivation, so that would, you know, obviously I’d need to speak with them and get everyone on board. But I’m hoping if I can present in asco urology and then convince the urological oncologists in UCLA, and I think that would be a very significant study and very cost -effective for the NHS. If we can delay when you go on to live -in treatments and keep someone under control for longer, I mean, you’re talking hundreds of millions of pounds for a very cheap intervention, and also an intervention which improves quality of life and reduce the side of it, and like most interventions, which do the opposite. They were right.

Robin Daly
See you later. Amazing.

Dr Penny Kechagioglou
Massive opportunity though to make that aspect mainstream, isn’t it? As patients come through the clinic they have now the opportunity or very soon to meet a team that be able to offer those lifestyle interventions. That’s really superb.

Professor Robert Thomas
I hope so. I hope so. As I said, it’s not happening yet. But I think the enthusiasm that and I think you’re an you’re an oncologist. I mean, you’ve always been more interested in the whole patient approach. But I think the tide is turning. I mean, five, 10 years ago, I was sort of scoffed at for suggesting people should exercise during radiotherapy. And now it’s sort of routine in Genesis have built gyms next to their radiotherapy suite. So, you know, the attitudes are changing. You know, the paternalistic approach to oncology is being replaced by more of a conversation with the patient and listening to what they are willing to do. That’s right.

Robin Daly
Excellent. Well, it does sound like a massive opportunity you’ve got there, as you say, sort of tied into UCL. There’s so much going on there that you can tap into. It should be an option to expand your work enormously, but also, as you say, to make a case for things which has been hard to make a case for up to now, of genuine integration, bringing benefits to the NHS.

Professor Robert Thomas
Yeah, and I take a big barrier. At the moment, they’re very, very rigid on the funding for what we can and can’t do. And obviously, to get into prehab and all these other things, there will be, I think, some difficult conversation with the fund holders. But I’m hoping, you know, we can convince them the cost effectiveness of all this. And, you know, maybe, you know, going down the line, trying to apply for grants for everything, you just get your time will just be sucked into admin. And I’m not that sort of person, you know, for our nutrition intervention studies, I just go to companies and say, supply this to me free. I go to the statisticians and say, how much is it and I’ll go to the local golf club and raise, you know, 5000 pounds.

Professor Robert Thomas
So I get things done in a sort of different way than applying for major grants, which just tie you up. I just want to get on with the trials and get the results rather, you know, show off about that I’ve raised this and that out of these grant applications and then take three years to finish the study.

Robin Daly
Yeah, no, it’s a problem. Great funds with a huge price to pay for having it. It’s questionable as to whether they’re worth it. Exactly.

Dr Penny Kechagioglou
Rob, you mentioned about the other component, obviously the history of the hospital, the homeopathic component, the mistletoe therapies, and you said those are going to continue as well. Do you see a point when they will come together?

Professor Robert Thomas
Some people get a lot of support from things like homeography. They don’t they don’t actually get that on the NHS. It’s sort of they have to buy their prescriptions and and they get some sort of funding. There are very few people who support the unit. And so this is not something which is paid for through the NHS, but it is available if people want it. You know, whether you say it’s largely a placebo effect, but, you know, at the end of the day, some people want it. And I think it’s as a place which is offering holistic type care. I think that’s I’ve got no objection to that. There is some evidence for mistletoe. I mean, it’s basically a polyphenol rich plant. Whether it’s any better than, you know, the food supplement, which has got polyphenols, and it is difficult to say. But again, if people are already on mistletoe and they feel they’re getting a support, I know ASCO has recognised it in their guidelines for patients on palliative treatment. So, you know, and it’s got lots of trials around it.

Professor Robert Thomas
So again, but that’s a private prescription which patients have to pay for. So there’s also, you know, there’s reflexology, there’s cognitive behaviour therapy and acupuncture. As you know, there’s many indications for acupuncture, which most of them have got some valid studies behind it. And we’ve got Mike Holmes there, who’s the head of the British Acupuncture Society. So, you know, he really knows what he’s doing. And what I’m hoping to do is, you know, people refer to remorals Sloan -Kettinge and Barisava centres around the world looking for their guidelines on, say, acupuncture or cognitive behaviour therapy or exercise. Now, you know, I think that’s a shame of what’s happened to some of the British institutions over the years. They’ve sort of shrunk and these big American ones have taken over. This hospital has been around for 100 years and it’s got, you know, King Charles as its patron.

Professor Robert Thomas
It should be up there with the top. Right. And that’s what, you know, I want people to sort of be able to click on the website and download, you know, the guidelines for various strategies, you know, how to look after yourself. Working with other organisations, working with Yes to Life and, you know, the British Society of Lifestyle and Medicine, sort of pull it all together. And it’s a lot of clever people in Britain just to try to pull it into, well, not just one resource, but other resources.

Robin Daly
Yeah, I love your ambitions. Sounds great. Yeah, marvelous. So the thing that’s clear from what you said, okay, people at this point are still going to have to pay for their mistletoe treatment, but they are going to get a complete package of lifestyle measures, good scientifically based lifestyle measures included in their NHS treatment or being one of your successful, which if that’s true is astonishing, isn’t it? weekend of the weekend

Professor Robert Thomas
I hope so. I mean, I had, as I said, you know, I’m hoping that this is an opportunity to just be a series of ad hoc referrals and it’s more pathway driven. But I did have, I’ve already had a patient, the small four example, who had possibly, you know, PSA relapse, possibly the development of early metastatic prostate cancer. And he hadn’t, nobody really talked to him about lifestyle measures. And he was actually 79. And we’re talking about going on to hormones. And I said, look, you know, what you need to do is, you know, exercise first thing in the morning and take some kimchi. You’ve never heard of kimchi. You know, you’ve never heard of kefir. You know, you need to improve your gut health. Stop putting sugar in your tea and coffee. You know, have you had your vitamin D levels measured?

Professor Robert Thomas
No, you know, go in the sun. You know, these are all sort of basic things you and I take for granted. But many people haven’t even talked about them. I said, why don’t you do that for a few years? If your PSA is not growing up, we can perhaps hold off the hormones. You know, and he was very appreciative. You know, he was saying, you know, this is exactly what I want to hear. And and also being an oncologist, you should then say, well, look, if I’ll get you a PET scan, if you need one. And if it shows a solitary metastasis, we can we can use some stereotactic radiotherapy. And if it comes metastatic, we could use apolutimide. So, you know, you’re speaking the same language on both sides of the fence, I hope.

Robin Daly
Yeah, that’s so important.

Dr Penny Kechagioglou
It’s a great message and a very powerful one, and I’m sure for patients coming to see you. It’s a great motivating factor as well. By following that lifestyle, actually, you can make a difference. As you say, there are many, many people, probably the majority, who don’t know that.

Professor Robert Thomas
Exactly. I saw another patient recently, he’s a very big city executive actually, and he searched me out and he said, you know, up till now, everyone’s just said there’s nothing I can do. And his personality would not take that. And, you know, there is evidence for lifestyle medicine and interventions, as you know, so it’s not just saying they’re there, everything’s going to be all right. I mean, you know, there is evidence behind it. And he was, again, he felt so empowered by just having the conversation that he did have some control, and that in itself, whether that’s a placebo effect or whatever, I don’t know, you tell me, but that in itself is powerful, isn’t it?

Robin Daly
I think it is and it doesn’t matter if you call it placebo effect or whatever if it works it’s good. Yeah, exactly.

Professor Robert Thomas
Thanks, Mike.

Robin Daly
Yeah, but the language you’re talking there where, as you said, from both sides of the fence, you’re just offering the patient what’s the best thing for them right now, and that’s the kind of, that’s the measure of it, which is really being, that’s patient -centered medicine. That’s what it is. It’s actually not, we do this, so you’re going to get it. But actually, what’s best for you now, and it’s marvelous. I mean, that’s what we feel that everybody in Britain should be offered.

Professor Robert Thomas
Exactly

Dr Penny Kechagioglou
So from a clinical perspective, Rob, how do you feel combining all your roles together and how do you feel, you know, the rest of the world, your peers are going to see?

Professor Robert Thomas
I don’t know, well, I think you’re okay with it. So I’ve got one on quality.

Dr Penny Kechagioglou
I admire you and I am, you know, I was so happy when I heard about your new roles. Yeah, but that’s me.

Professor Robert Thomas
Okay, so I’ve got one on board, that’s the start. I think, you know, it’s, in UCLA, I’ve met a few oncologists and they seem to be quite happy, you know, they’re willing to have a dialogue. In Bedford, you know, my colleagues are very much on board. I think even in Cambridge now, there was a bit of resistance against exercise and nutritional interventions. But even, I mean, now there’s a big gut health sort of signature project going on in one of the research institutes where there’s about 10 very clever PhD students analysing stool for different bacteria and trying to find out which is the golden bacteria which will improve our response to immunotherapy. So, you know, there’s a lot going on on the research side and that’s filtering back into the clinic. So people are now seeing, you know, that this is important. And as I told you this, the president of ASCO stood up, just before COVID, it must have been quite a long time ago.

Professor Robert Thomas
And he said, you know, we need to be looking at lifestyle interventions, gut health as a priority. And this was in his opening speech to ASCO in front of 44 ,000 oncologists. You know, the message is changing, but you’re right, it’s not there yet. Yeah.

Robin Daly
and dragging his heels a bit. But anyway, it’s great to hear that it is changing and it’s great to hear you’re managing to find open doors. But as I said, I think being an oncologist is fantastic from that point of view. One thing I wanted to ask, I mean, you’re giving a very oncology slant of the Royal London Hospital for Integrated Medicine. It’s not just for cancer of course though, is it? So how does this all fit together? Is it actually taking us or leading towards cancer particularly just because they’ve taken you off? Or is it still going to be all -encompassing?

Professor Robert Thomas
Saul, who’s the director of the Institute, he has an allergy clinic and he sees patients with menopausal symptoms and fibromyalgia. So all that will still continue. But my specific role, because it’s only two days a week, is just looking at the oncology. But there is a bit of a crossover, because for example, I mean, I need to learn all this. As you know, that many patients on aromatase inhibitors after breast cancer, and some men on angina deprivation have quite a lot of joint pains. Now at the moment, as far as I can understand, they don’t allow funding for referral for aromatase inhibitors side effects, but they do allow funding from fibromyalgia. We know that part of the side effects for AIs is very similar to fibromyalgia. So it’s a case of, you know, working together on those two clinics. So hopefully, there will be crossover and getting the expertise from, you know, acupuncture and other therapies, which help other non -cancerous diseases.

Robin Daly
Right. Okay, well look, I was just wondering at the end, I was saying at the beginning how, you know, you’re well known for pushing the boundaries on evidence for nutritional interventions and that kind of thing. Do you want to just tell us the latest things you’re working on? Uh, yeah, well, we’ll do

Professor Robert Thomas
We did two things, and I think I’ve been on your show talking about the COVID intervention. So we did a double -blind, randomized trial on people with long COVID effectively, giving them a phytochemical -rich supplement, which is now called phytov b by the manufacturers, which have things like chamomile, citrus bioflavones, tea, I’ll forget, there’s about five different ones now. And they were designed to have prebiotic properties, but also direct antiviral properties. And that was combined with a probiotic, megalaptobacillus, vitamin D, and inulin complex in a double -blind fashion. And not surprisingly, we saw that, you know, we know that people have, some people have poor gut health with COVID and that contributes to symptoms. We know that low vitamin D levels contribute to worse symptoms.

Professor Robert Thomas
And, you know, we were getting this through in March when, you know, this wasn’t actually that well known, but it was known in the scientific community. They were still telling people not to have vitamin D at that point nationally, but we managed to get it through. And we clearly showed that this intervention, quite dramatically in some cases, improved their long COVID and they got back on their feet very rapidly. And so from that, we thought, well, we know that these, well, the probiotic supplement with the vitamin particularly worked because we measured vitamin D levels and they went up. So from that, we thought, well, what other part of oncology has an issue with gut health? And there’s a lot of animal studies coming through now showing that when you give men and deprivation, their gut health changes for the worse.

Professor Robert Thomas
And we know that when it gets, there’s more dysbiosis, that’s when it’s associated with treatment resistance. So instead of jumping straight into that cohort, I thought, well, let’s just do a study of men on active surveillance because there’s lots of them and they’re very keen to take part in studies and just see if improving their gut health could bring the PSA down, improve their urinary symptoms, improve their erectile dysfunction. And we’re also doing an endpoint of strength. I’m working with Professor Rob Newton from Bond University in Australia, who’s very into grip strength and exercise and cancer, and also Stacy Kenfield from Southern California, who’s one of the gurus of exercise in the world. And they helped me design the study. So we’re looking at exercise levels and grip strength and seeing if that correlates also with slower progression. And it was very interesting, this study, because we thought, well, we’ll just do a study of the probiotic versus placebo.

Professor Robert Thomas
But we then worked with three patient support groups, including Melton, Mulberry, and Bedford and Cambridge. And they said, well, and part of the study was they need to stop all of the supplements, but they refused to do it, which shows you need patient participation in the design. Yes. And they said, well, you, and I said, I want everyone on the same level field before I give them the probiotic or placebo, otherwise we will know, you know, what’s what. And they said, well, you design us the best phytochemical rich supplement and give it to us free. And then we’ll be happy to have the probiotic or placebo. We’re not stopping everything. So we could have used the same ingredients of pomme tea from 14 years ago. We know that that did have some effect, but we thought there’s food technologies improved.

Professor Robert Thomas
We know that other some other foods like cranberries also showed to reduce PSA. We know ginger is a bio enhancer and improves the absorption of phytochemicals from other foods. And there was about six percent got a bit of indigestion. So it’s actually ginger is good for that. So we basically came up with a new supplement called your phyto, which has pomegranate green tea, turmeric, broccoli, cranberry, ginger, whole foods. But also it’s one of the first supplements in the world, which actually has some extracts of the same foods. So we’ve enhanced the power of it or the concentration of it by, say, having extracts of turmeric with whole turmeric. So you’re getting the whole foods, giving the whole spectrum. And then we’re boosting the phytochemicals where we think the ones have the best anti cancer properties.

Professor Robert Thomas
So everyone gets that free and their patients love it. So they can drop everything else, they’ll get it free. And then they they’re randomized to the probiotic or placebo. So we’ll know for sure whether the probiotic has an effect. We’re also seeing PSA before and after trial entry. We’ve done an interim analysis of that, and we’ve already seen a very significant flattening of PSA, an improvement of symptoms, which we never saw before. And that is quite remarkable. We think the improvement of the symptoms is to do with a reduction in inflammation in the body and possibly the addition of the cranberry will help.

Dr Penny Kechagioglou
And do you measure that reduction in inflammation, or is that something that you’re going to do next?

Professor Robert Thomas
we do to a certain, not as much as I’d hoped, it was an excellent question, we are using C -reactive protein and neutrophil to lymphocyte ratio, but as you know that’s not the best marker of information. So, you know, I’m not really expecting that to be different, I mean I’m hoping it would be, but looking at the previous papers of those two markers, there’s so many other things influence those that it’s going to be difficult to see a difference between the two, but we’ll see. But we are measuring exercise, we’re measuring grip strength, but yeah, and we’re not measuring specifically gut health as well, we’re measuring symptoms and quite, you know, how much wind they have, how much, you know, how bloated they feel, how much energy they have, so there’s sort of surrogate markers of gut health.

Professor Robert Thomas
I mean, in an ideal world, I mean for trials to recruit rapidly, you don’t want to mess around with people too much, you know, the grip sense patients like, the question is they’re happy to fill out an extra blood test is fine, but if you start doing too much it interferes with the recruitment.

Robin Daly
There it is.

Dr Penny Kechagioglou
The important thing is that symptoms are improving, you are measuring really the living outcomes of those patients, which is the important part.

Robin Daly
world and absolutely and also I mean potentially you’re looking at an extraordinarily cheap way of extending the good quality life of millions of men so it’s a fantastically worthwhile pursuit.

Professor Robert Thomas
Yeah, thank you. I mean, you know, obviously, in the trial, we have to use supplements, because it has to be objective, and you have to give someone something. But you know, the end is, is it? I mean, we’ve done it, we know that the whole group is improving. So there will be an improvement. It’s just we don’t know yet whether the probiotic improves more than the placebo. But you know, the ethics committee worked with us very closely on this and said, what do you tell people at the end of the study? Well, at the end of the mainly, we say, these six foods helped. So you need to eat more of these. And gut health, well, if it did show that helps. And this is how you help your gut out, you know, you reduce processed sugar, you eat more kimchi and kefir, you exercise in the morning, you cut out processed meat, and you know, so that’s what the advice we give them.

Professor Robert Thomas
And then of course, the manufacturers who supply the supplements free to us, they’re free to sell them, you can’t promote them, because they’re not drugs. They’re free to sell them. And if patients choose to want to take extra something, they’re willing to do so. But I think the take home message is that a nutritional intervention helps and they can interpret that how you how you want to. Fantastic.

Robin Daly
All right and we look forward to the outcome of that. How long do we wait?

Professor Robert Thomas
Well, I mean, this was the beauty of getting patient, I mean, this is the first time I’ve got three patient advocacy groups to look at a trial protocol. And it actually was the first trial which went through ethics first time. And I think it was because of the patient input. And then because of that, we’ve actually approached 250 patients and only six patients declined to enter the study. So we rattled through it very quickly. And we finished now recruiting and the last patient will come out in August. And then we’re hoping to write it up for ASCO Urology, which will be in February next year. We’ll know the results before that, but we wanna… Well, what do you think, Penny? Is that a good one for you? I’ve never been there. I’ve been to ASCO main one, but… Be a next…

Dr Penny Kechagioglou
excellent one

Professor Robert Thomas
Do you think it’s good? Excellent.

Robin Daly
Fantastic. Well, that incredibly low dropout rate tells you that from the public’s point of view, you’re onto the right thing.

Professor Robert Thomas
I think you’re right there. It does help they get a free supplementise, of course. There’s maybe a financial, but that’s what you need to look at in trials. There’s the GAP4 study, I don’t know if Penny you’re aware of that one, which is run from California. They got a £7 million dollar grant, multinational. They were supposed to get 300 people in. It’s still flounding around at 40 patients after two years. And it’s incredibly complicated. You’re getting patients to run on treadmills with ventilators on their face and things. I think sometimes you design a study and they’re trying to be too clever. You’ve just got to give what patients want and they want to get the results as well.

Dr Penny Kechagioglou
As you say, keep it simple, simple outcomes that have a meaning and make it easy for patients.

Robin Daly
I hope a lot of other professionals of this think you might take a leaf out of your book Professor Thomas

Dr Penny Kechagioglou
I do have to ask, there are a lot of patients that are going to hear about your appointment and your role and from the area where I work, Rob, how are you going to cope with the surge of people?

Professor Robert Thomas
Well, yeah, I mean, I’m not that young anymore. So the advantage, which is not good, but the advantage of being slightly older is you do have more flexibility. So, you know, if the road does actually take off, you know, then I have the opportunity of maybe dropping further sessions at Cambridge, you know, but obviously because of the uncertainties, you don’t really know where it’s going to go. But you’re right, Penny, if, you know, if the workload does go up and then you could either impont a second person or I could do more hours, you know, maybe yourself could come down to second. You never know.

Dr Penny Kechagioglou
Never know. It’s not if, it’s when it does. All the best in your new role, what can I say?

Robin Daly
Yeah, absolutely. Yeah, absolutely. Best wishes for a massive success and and may all your ambitions come to fruition. So yeah, thank you very much for coming and telling us about it today.

Professor Robert Thomas
I really appreciate you inviting me, but also that you’re around, you know, you’re the type of organization, you know, if you need to expand or speak to people or get advice from, that’s exactly what Yes to Life is there for. So, you know, I don’t feel alone, not just in UCLA, but, you know, the rest of the country.

Robin Daly
Thank you for listening to Cancer Talk. Do subscribe and look out for the next edition of our podcast. And if you have friends and colleagues interested in the development of UK Cancer Care, do pass on the details of Cancer Talk. Goodbye.