Integrative oncologists discuss everything from medicinal mushrooms to genetic testing of dog cancer tumors. The future of dog cancer treatment is bright!
Integrative oncologists Dr. Kendra Pope and Dr. Trina Hazzah discuss the current state of integrative and holistic oncology for dogs and their hopes for the future. Topics include:
- The shift in veterinary medicine toward a more integrative approach
- The need for education of vets on dosing and using cannabis (and ongoing legalization issues)
- Clinical trials to prove effectiveness of integrative therapies
- The value of real-world evidence
- Herbal treatments
- Genetic testing for tumors
Visit https://dogcanceranswers.com to read the full transcript.
About Today’s Guest, Dr. Trina Hazzah:
Trina Hazzah completed veterinary school at Tuskegee University School of Veterinary Medicine. She completed a 3-year residency in medical oncology at the Veterinary Oncology and Hematology Center, in Connecticut. She has also completed the requirements to be a Certified Veterinary Chinese Herbalist from the Chi Institute of Traditional Chinese Veterinary Medicine.
Dr. Hazzah developed an interest in cannabis medicine during her quest for finding effective integrative approaches for veterinary cancer patients. She has spent the last half a decade reading through available literature, attending multiple cannabis conferences and symposiums, while also learning from cannabis physicians. She is the president and co-founder of the Veterinary Cannabis Society, the first US-based non-profit, 501(c)(3) organization building awareness of cannabis as medicine for pets. After almost 15 years of practicing medical oncology, she switched her focus to cannabis medicine full time and started a cannabis consulting service, called Green Nile, Inc.
Her website is https://drtrinahazzah.com
About Today’s Guest, Dr. Kendra Pope:
Dr. Pope completed veterinary school at the University of Florida. She began her training in holistic therapies at the Chi Institute for Traditional Chinese Veterinary Medicine and completed certifications in veterinary acupuncture, Chinese herbal therapy, veterinary food therapy, and Tui-na prior to graduation. Dr. Pope went on to complete a three-year residency in medical oncology at the University of Pennsylvania. She successfully obtained board certification in her specialty of oncology and became a Diplomate of the American College of Veterinary Internal Medicine in 2015.
Dr. Pope has ongoing interests in herbal medicine, intravenous nutrient therapy, mistletoe therapy, as well as all innovative and novel integrative oncology approaches. Dr. Pope is preparing for certification as a Registered Herbalist, the highest accreditation offered in human herbal medicine. Dr. Pope is currently involved in numerous clinical trials serves as president of the American Board of Veterinary Botanical Medicine as well as on the Board of Directors for the World Association of Traditional Chinese Veterinary Medicine.
Her website is drkendrapope.com
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This episode is sponsored by the best-selling animal health book The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity by Dr. Demian Dressler and Dr. Susan Ettinger. Available everywhere fine books are sold.
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[00:00:00] >> James Jacobson: Today’s show is brought to you by the bestselling book, The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. It’s available everywhere books are sold in both paperback and digital editions and on the publisher’s website at DogCancerBook.com. Use coupon code PODCAST on that website to get 10% off The Dog Cancer Survival Guide today.
[00:00:29] >> Dr. Trina Hazzah: Can you imagine how helpful that would be from a conventional oncology standpoint, from a cannabis perspective, and from an herbal perspective? So what I would do is you – to be able to see your patient and say, what do I need to adjust to get my patient’s immune system better. Their endocannabinoid system healthier.
Other aspects, their liver healthier, whatever it may be. And then how do I look at that patient and their tumor and figure out what drugs I need to use from a conventional and integrative perspective to- that would work best for that patient.
[00:01:04] >> Announcer: Welcome to Dog Cancer Answers, where we help you help your dog with cancer. Here’s your host, James Jacobson.
[00:01:12] >> James Jacobson: Hello friend, and welcome to Dog Cancer Answers. Today, we are joined by two unicorns of the veterinary profession, Dr. Kendra Pope and Dr. Trina Hazzah. Why do we call them unicorns? Well, these are two of the four integrative veterinary oncologists in the United States. That’s why we think of them as unicorns.
We’re going to explore what is going on in holistic and integrative oncology today, as well as new developments on the horizon. Now, this is a longer episode because we get into a great conversation, but it is worth every second of your time, so please grab a beverage as you listen. And a tech note for regular listeners to Dog Cancer Answers: you’ll hear a short segment in this interview where the audio quality is just not up to our normal standards at Dog Podcast Network. And that is because we ran into a little technical glitch while we were recording, but we decided that the content is so important and something that you need to hear, we included that short segment in this overall interview. You’ll hear it. Dr. Kendra Pope, Dr. Trina Hazzah, thank you so much for being with us on our first, and hopefully not last, holistic integrative veterinary oncology panel. Welcome.
[00:02:36] >> Dr. Trina Hazzah: Pleasure to be here.
[00:02:37] >> James Jacobson: So by way of introduction, I will let you do the heavy lifting. Both of you have been on our show before but can you give us a short elevator introduction for yourself Dr. Hazzah?
[00:02:50] >> Dr. Trina Hazzah: Sure. Veterinary Integrative Oncologist in Los Angeles, California, worked at VCA West L.A. for, God, about 11 years, and recently just left to start a cannabis consulting service where I’m offering pet parents what I call a harm reduction education guidance where I’m helping them figure out safe avenues to implement cannabis for a variety of different conditions. Not just cancer, but other conditions as well, of course, I get a lot of cancer cases, which I, I think feel very near and dear to my heart considering I spent most of my life being, um, in the oncology space.
And that’s honestly, most of my interest is cannabis in cancer, for sure. And the ability for cannabis to have anti-cancer effects and support the patient from a quality of life perspective as well. Um, and then I also am the co-founder and president of a nonprofit called the Veterinary Cannabis Society, which is the first 501(c)(3) non-profit dedicated to education and advocacy for cannabis for pets.
[00:03:51] >> James Jacobson: And Dr. Pope?
[00:03:52] >> Dr. Kendra Pope: I am also an Integrative Veterinary Oncologist. Trina and I are very much kindred spirits and soul sisters. I am a practicing integrative oncologist in New Jersey. Uh, my practice was started in 2017, and purely all integrative medicine. I leave the conventional medicine to the conventional doctors.
So I’ve been blessed that every patient, every day, is on herbs, real food, nutritional support, all the good stuff. And one of the real special interests of my clinical practice and my personal goals is to really show through clinical trials about why this stuff works because all of us practicing it know how important it is. We know, we see it every day, the difference that it makes, but our conventional community just doesn’t understand, they need to see it in trials. And so I’m working with different organizations, private funders, things like that to put together different research projects so that slowly over time, we’re going to be able to actually shift the needle and show the conventional community how important all of this is.
[00:04:52] >> James Jacobson: Well, that’s a good way to begin. What is the landscape right now between folks who have your mindset, your orientation in terms of an integrative approach to oncology, and your colleagues who are traditional ACVIM boarded oncologists here in the US?
[00:05:10] >> Dr. Kendra Pope: Good question and good timing because Trina got us a panel at the Conventional Oncology Conference this year. So they actually are having us on for an expert panel to talk with them about that. So the landscape is shifting, they’re interested, they’re open, they want to hear about us, they want to hear what we’re doing. So it’s actually fortuitous that you asked that question because it’s time.
[00:05:33] >> Dr. Trina Hazzah: Yup.
[00:05:34] >> James Jacobson: This is an annual conference. When, when is that?
[00:05:36] >> Dr. Trina Hazzah: It’s uh, October, if you want to know the exact date and exact time… no, it’s it’s October.
[00:05:41] >> James Jacobson: Okay. It’s still a couple months away.
[00:05:42] >> Dr. Trina Hazzah: Yeah. October 13th, 14th. I think it might be the 14th we’ll probably do it, um 2022. Yeah.
[00:05:48] >> James Jacobson: And I saw you applauding, Trina. I think that this is a big thing, because up until now, there has not been all that much love for your approach.
[00:05:58] >> Dr. Trina Hazzah: Yeah, I think, I think something that Kendra, and Erin, and myself, like we’ve talked about for a very long time, right? How do we get the conventional oncologists to open up their minds and be- because the pet parents have very open minds and want to do all of this, and there’s just not enough of us to go around.
Right? And so to just to be able to educate them on the topic so they can help guide, um, these pet parents to figure out, you know, who to see, are there other, if there are holistic vets to see that they can use in conjunction with their services if they’re just not comfortable doing all of it. I think some of the work you did Kendra with Yunnan Baiyao, like has at least allowed, I think most veterinary oncologists use Yunnan Baiyao now.
Like we slowly get them into Yunnan Baiyao, uh, not just Yunnan Baiyao, I’m-Yunity is, is your, your jam, like out of University of Pennsylvania like, I think that those two are probably compounds that are used in veterinary oncology by conventional oncologists all the time. They’re comfortable. There’s some science, there’s actually research behind it. There’s clinical trials. There’s in-vitro trials on Yunnan Baiyao. We out of VCA West LA, our previous resident published a Yunnan Baiyao, uh, prospective study. And so there’s stuff out there on that. But there’s so many other things that we do within the veterinary integrative oncology space that need to be put out there. And there’s actually preclinical in-vitro trials on those as well, on tons of the traditional Chinese herbs. And so I think that vitamin D, Kendra you can speak to, there’s definitely publications on that. So I think just getting them educated is a big part of it, because I think a lot of times they don’t even know there’s anything out there from the research perspective.
[00:07:36] >> Dr. Kendra Pope: Yes.
[00:07:36] >> Dr. Trina Hazzah: And then there’s, I think there’s also, you have to talk about real-world evidence. I mean, there’s something to be said about that too. And a lot of what we do in veterinary oncology is based off of our experience. It’s not always based off of publications. There’s a limited amount of prospective good trials done in veterinary oncology.
So so much as we get experience in certain things that we talk about it and share, and folks are doing different protocols on the conventional side, why not consider the same for the integrative side?
[00:08:04] >> James Jacobson: To what extent did the pandemic impact the ability and the, you know, the difficulty for dogs to go in and get traditional rounds of chemo? To what extent did that impact the openness and the receptivity that you’re beginning to see from boarded oncologists?
[00:08:21] >> Dr. Kendra Pope: I don’t know that I necessarily saw something specific. The way that I saw the pandemic impact it the most is that patients that probably should have been able to get into an oncologist for life saving measures up front weren’t, and so unfortunately probably passed away sooner than they should have. Because the reality, and I think the misconception for a lot of pet parents, is that they can forego conventional treatment completely, especially if they have very sick animals. The kind of area where integrative medicine, I think, wins is always the long game.
You know it’s the short game that chemo and radiation and surgery win for us, and then they lose the long game. And it’s, in my opinion, that’s where we pick up and we carry, you know, the team. So I just think, unfortunately, what the pandemic has done is it’s overburdened all veterinarians. And so patients that should have gotten in to see conventional oncologists unfortunately were waiting six weeks, eight weeks, 12 weeks even. So I think that’s been what I’ve seen.
[00:09:23] >> James Jacobson: Let’s take the Yunnan Baiyao as a case study because Kendra you were involved in helping to get that more widely accepted because of the work you did at the University of Pennsylvania right?
[00:09:34] >> Dr. Kendra Pope: Um, the I’m-Yunity trial was done at the University of Pennsylvania when I was there. And then the Yunnan Baiyao research was done at the University of Florida.
[00:09:43] >> James Jacobson: Okay.
[00:09:43] >> Dr. Kendra Pope: Which I was there when it was going on, but I wasn’t part of that trial.
[00:09:46] >> James Jacobson: So is that a template for how other natural products, or I don’t even know what category you want to put Yunnan Baiyao in – and let’s, I guess, talk about what it is for our listeners who are not familiar with it and what types of cancer it works on – but the broader question is how has that been sort of a gateway to get oncologists to, to see its use across the board?
[00:10:10] >> Dr. Kendra Pope: It’s a good question, because I think that it brings up both the strengths and the limitations of herbal research, which I know Trina will be able to speak to from the cannabis space for sure. So the, um, strength of it is that it was a well-designed trial published out of a well-known university that showed that this herbal formula, which is proprietary, um, originally created to stop bleeding, we actually only know 85% of the ingredients because it is proprietary. Um in-vitro, the dose correlated to the number of cancer cells that were dying.
Um, when the paper came out, my resident intern at the time said, "Well you could pour dirt on a cancer cell and kill it too." So the major criticism is that of, what is, uh, many in-vitro trials is that will it correlate to an actual animal, will it actually kill cancer cells in an animal? And so that is the main criticism. However, the reason that oncologists like it is because it’s a well-designed published trial out of a well-known university.
And so it gives them something to hold onto when someone says, why are you doing that? And they can reference that paper. When it comes to studying herbs, the Western approach to clinical research is based on single constituents or, or breaking it down to photopharma chemistry and photopharmacology, and cannabis research does this beautifully where all the individual compounds are looked at on their individual basis and then as a whole with the entourage effect.
But a lot of herbalists will tell you that when they practice herbal medicine clinically, not only are they not using individual constituents of one plant, they’re using all of the constituents of multiple plants. And so when it comes to putting together clinical trials from a clinical trial design perspective, that gets very messy.
Um, so in my opinion, when doing those types of trials for that type of medicine, you really need to be looking outside of the box and probably looking at different data points and end points and parameters. And it requires a little bit of a different trial design. There are people doing that, and it comes down to, you know, quality of life parameters, um, probably blood work changes, monitoring tumor responses. So I think that in order for holistic and integrative medicine to truly be accepted by the conventional community, there will have to be some degree of shift in acceptance to what is considered high quality trials, because fundamentally, it will be very difficult for us to do it the same way we do with our pharmaceutical products.
[00:12:52] >> James Jacobson: But then the question becomes financial in part, doesn’t it, because it’s extremely expensive to do these high quality studies that are usually underwritten by big pharmaceutical companies because they have the margins that are necessary. Whereas if you have a natural compound or an herbal compound, you know, Yunnan Baiyao being sort of an exception because you only know 85% of the ingredients, but you know, it would be easy for someone to basically knock it off, whereas if it’s a proprietary thing protected by IP, the pharma companies have the budget and they’ll invest in it. So how do you reconcile that? And I know, Trina, you have a lot of thoughts on that because this is definitely the case with marijuana, and CBD, and THC.
[00:13:37] >> Dr. Trina Hazzah: Yeah, no, I think it’s, I think it’s a very difficult position because, I think Kendra brought up a good point about the quality of life part too. I think that if the endpoint is just survival time, we’re probably going to lose, right? Like, but if you look at the amount of improvement in quality of life, it’s astounding, it’s astounding.
Like, and you look at the clinical trials that have been done for cannabis based clinical trials. And then you look at the end-stage cancer clinical trials. The quality of life is like unbelievably different for these patients that are on cannabis. I mean, from sleep to depression to pain, to be able to interact, perception of their cancer, perception of end of life.
I mean, all the things that our pets deal with too, um, has been proven time and time again. And it’s not just with CBD, or just, not just with THC. It’s with, you know, usually a full spectrum cannabis plant. The problem is, is that a lot of these are retrospective studies too, or observational studies and things like that where they’re not all on the same compounds.
So I think for cannabis, because what, what we see in a clinical setting, you know you go to these conferences where there’s tons of human cannabis physicians, and they’re talking about their, their their daily life of working as a cannabis physician. No one’s just prescribing CBD by itself because it was found in-vitro to be effective.
They’re looking at the synergies and the additive effects between all the different molecules to get the optimal effect for that patient. And so how do you do that is you have to create – the way I look at it is you probably have to do crossover studies, right, and then you’d have to be able to do compounds that are really robust in cannabinoids and terpenoids and so forth, put them together and then look at various parameters and not just, again, survival time for a cancer patient or what’s happening in a Petri dish.
It’s, what we’re seeing in the patient is very, very different. And I think it will take time. I think finances are a big part of it, but I’m talking about the legal aspect is a huge part of that with cannabis. And that’s why, even in the human clinical trials, they’re using, you know, NIDA, it’s a type of cannabis that’s grown out of the University of Mississippi. They’re only stuck using the one particular cannabis that is basically a CBD, it’s like an isolate, or a THC isolate. You’re getting like these isolates.
[00:15:56] >> James Jacobson: It’s just one of the many compounds that are in it.
[00:15:58] >> Dr. Trina Hazzah: 750 compounds found in the cannabis plant and you’re getting one, maybe two. That’s not what the average patient is getting, that has prostate cancer or breast cancer.
They’re going to dispensaries and they’re seeing cannabis doctors that are putting them on a robust, you know, cocktail of different cannabinoids and terpenes and flavonoids. So I think that it’s happening, right. But when big pharma comes in, which it’s already happening, right, there’s big pharma coming in and creating some of their own interests.
What I think we’re seeing, honestly, is we’re proving that CBD isolate, like they did for Epidiolex, the first FDA approved, right, CBD product, is uh basically a CBD isolate. Right? And they showed that it was effective for two different seizure conditions. Guess what, if you were to add in a little bit of THCA or CBDA or whatever it may be, you may end up being really effective for some of those conditions.
Because talking to some of the cannabis physicians out there, they’re like Epidiolex is not working as well as some of the stuff I’m able to get from a local dispensary. Right? But insurance covers it because it’s FDA approved, right. And so I think there’s a lot of hoops to jump through, I think clinical trials are tricky when it comes to botanical medicine, and I think a lot of the reason is, is that we look for really the additive and entourage effect for so many of these traditional like Chinese herbs, Western herbs, cannabis, that I think it’s very hard unless it’s a very thoughtful process. And I’ll say one last thing, and then I’ll let Kendra speak, is that I think that either the companies, the pharmaceutical companies, the universities that are doing that, aren’t necessarily going to the experts in that field.
They’re creating it on their own and they don’t understand what’s happening in real world. So they say, I put together this really great protocol or this study design, but it’s not – if they had gotten Kendra’s opinion or gotten my opinion, I would say, Hey guys, tweak it like this because it’s not gonna work, and this is why. Cannabis needs to be stepped up in a dosing fashion, you’re gonna make all your dogs intoxicated. You need to do this. But I think there’s a disconnect between the practicing integrative doctors and the people that are in doing research that aren’t actually practicing and seeing what’s happening in the real world. And I think our assistance will really benefit them in study design and really trying to make a more impactful study design.
[00:18:07] >> James Jacobson: Kendra, what are your thoughts specifically about the financial component of this?
[00:18:11] >> Dr. Kendra Pope: All the points that Trina made for sure. And when it comes to the financial part about it, I think that just like with the trial design and the data points that’s we’re collecting and the endpoint that we’re looking at, I think that it just requires us to look at it differently and be a little bit more innovative.
In my opinion, there are some natural funding, there’s a specific subgroup of the NIH that’s for natural compounds. And so that’s where a lot of the integrative and holistic researchers go to get funds on human side, but there are a lot of platforms now for things like crowdfunding and public interests, um, that are very interested in this space because they understand it’s underserved from a financial perspective.
I think that there’s also people that are motivated to donate to causes like this because they realize that pharmaceutical companies and industry drive research and that it’s not necessarily about the real problems and the real needs. I may have mentioned this before on the last podcast that we had, but there was a publicly funded clinical trial that was all from small donations from pet parents, that was looking at how long a rabies vaccine lasted in typical dog populations, and over a million dollars in small donations was raised. And they proved that a single rabies vaccine lasts over eight years in 80% of dogs. And that was just from pet parents that knew that they shouldn’t be vaccinating their dogs every three years and they wanted more information about that. So I think that there’s real opportunities there from a crowd funding perspective. When you talk about clinical trials and the cost to do it in humans versus the cost in animals, it’s substantially less expensive to do it in animals. One, because there’s not as many hoops to jump through as there are in clinical trials with people, but also because unfortunately our pets don’t live as long.
So we get data faster than we do in people. And so for example, I had a grant funded trial for acupuncture in 80 dogs, and the entire grant was about $40,000. I spoke to a human colleague and he told me that same exact trial with same amount of patients would have been $1.5 million in people. So it’s substantially less expensive to do it in animals.
I do believe that there’s motivation from the public and crowd funding, and I do believe that there’s donors out there that are looking to support these types of causes because they understand that there’s no, you know, big money like there is with pharmaceutical companies. So I think that it just requires us to be innovative like it always has with everything that we do as holistic practitioners.
[00:20:33] >> James Jacobson: That is fascinating on so many levels, but let me follow up on the rabies study that was done that said that it lasts for eight years on average. Has that now become accepted among the veterinary community?
[00:20:43] >> Dr. Kendra Pope: No, no, no.
[00:20:45] >> James Jacobson: Okay. I was like, good research, cheap study, but still not accepted.
[00:20:48] >> Dr. Kendra Pope: So there was a paper published, and I need to get the exact source because I see people cite it all the time, um, but they say that it takes 17 years of consistent scientific data to change clinical practice. That’s how long it takes.
[00:21:05] >> James Jacobson: Wow. Okay. Well, luckily for you and for so many people who are going through dog cancer, they’re willing to kind of, like, maybe not do things that are fully vetted with all the scientific literature.
Let’s take a short break here and we will be right back with the latest in integrative cancer treatment options. Stay tuned.
So, what are you all most excited about these days in terms of treating cancer in dogs from an integrative approach?
[00:21:40] >> Dr. Kendra Pope: Most excited about. Do you have one Trina?
[00:21:42] >> Dr. Trina Hazzah: I think genetic testing. Like I really like the genetic testing part of it, like Fidocure, Vidium, like, what they’re doing, I think there’s a lot to be said about that.
I think that this has been going on in human medicine for a period of time, and we got on board, and obviously there still needs to be more research and there needs to be more, there needs to be clinical trials, there needs to be all of these things, right? But – and this treatment arm of it is a little different, right?
Like, it’s not always as accurate, that it could be a different driver than we suspect it to be on the test. But, you know, I obviously, I think from a cannabis perspective too, that, you know, a lot of the mutations that occur, or gene upregulations could be down-regulated by certain cannabinoids, right. And so if I was able to know certain things that were upregulated, like just, this is like my dream, right? You do a genetic testing on a dog on their actual body, right. So, you know what their, either cytochrome p450 system, meaning theirmetabolizing, you know, enzymes are in their liver, uh, do they have any certain mutations like Border Collies or Collies or whatever they, what we already know to test.
Are there anything we need to know about the patient from an endocannabinoid system. Do they normally have lots of endocannabinoids? Are they deficient? Do they have too many enzymes? If you could look at the patient as a whole and say, I know them from a genetic standpoint, and then I look at the tumor from a genetic standpoint, can you imagine how helpful that would be from a conventional oncology standpoint, from a cannabis perspective, and from an herbal perspective? So what I would do is you, to be able to see your patient and say, what do I need to adjust to get my patient’s immune system better, their endocannabinoid system healthier, other aspects, their liver healthier, whatever it may be, and then how do I look at that patient and their tumor and figure out what drugs I need to use from a conventional and integrative perspective to, that would work best for that patient. And that, in my opinion, that’s like true personalized medicine, because you’re looking at them genetically, and their tumor genetically, and then you’d really be able to figure out – I would say, I don’t have a conventional option here that will target this, but Kendra showed me a paper that, you know, this particular herb can do this, or vitamin C might be helpful for this, or cannabinoids – not CBD, but CBG is a huge TRPM8 antagonist, I, and TRPM8 is really elevated, or I have overexpression of Id-1, I need a lot of CBD in this product because you don’t have a conventional drug that will actually do that. So it’s really giving them a full, personalized medicine approach, not just from a diagnostic perspective for, but from a treatment perspective that I think will be beyond fascinating, but really, really effective if done properly.
And it’s going to obviously take time for that to happen, but that’s what I’m clearly very excited about, right now, talking about.
[00:24:38] >> James Jacobson: That’s interesting. Kendra, I will ask you that question in a moment, but let me follow up on that, Trina, in terms of that super personalized approach, where you’re starting with the genetic testing. Again, to bring it down to dollars and cents, how expensive might that be compared to the traditional, you know, $5,000 to $8,000 or whatever we quote for, you know, standard of care?
[00:24:59] >> Dr. Trina Hazzah: Well, it’s like a shooting in the dark approach, that’s what you’re saying, right? You’re saying, well, how do you compare shooting in the dark versus knowing what you’re really needing to attack? So I don’t even know if you can compare the two, to be honest with you. From a diagnostic perspective, I think as things get more precise there’s going to be points where we’re not going to have to do CTs and MRIs and, and x-rays every three months, we’re going to be able to do a blood test and be able to figure out, if there’s cancer recurrence, where it is in the body.
I bet you’ll be able to locate it soon enough. Um, so I think that actually from a cost perspective – and I think it’s combining the right companies to do it. It’s not gonna just be one. It’s going to be one to look at endocannabinoid, one to look at if there’s live cancer cells in the body, one to evaluate an algorithm to evaluate where is the cancer cells.
So again, you’ve now taken away so many of the staging tests that we do that are over thousands of dollars, that we do every three months on some of these patients. And then from a treatment perspective, what if it’s requiring herbs and a targeted therapy, and not, you know, $8,000 worth of chemo that’s somewhat shooting in the dark because carboplatin should work for this tumor because it works in a human breast cancer, but geez, they have different mutations, it doesn’t seem to work as well. And you know, I think that, to be honest, I’m not sure that we’re going to be spending a whole lot more money.
And again, I’m just kind of guessing this right now, but I think that there’s a chance that you actually may be much more accurate in your diagnostic and treatment approach for not, I don’t know, not that much more money if done properly.
[00:26:30] >> James Jacobson: Fascinating.
[00:26:31] >> Dr. Trina Hazzah: Yeah.
[00:26:31] >> James Jacobson: Kendra.
[00:26:32] >> Dr. Kendra Pope: Trina and I have geeked out about the whole pathways and the mutation stuff.
I mean that’s like where our oncologist meets our holistic side, you know, it’s like the pathways geeking out how the herbs work with them.
[00:26:41] >> James Jacobson: P53!
[00:26:42] >> Dr. Kendra Pope: Yeah, exactly. And so I love that she said that because it reminded me of something that I’m really enjoying and excited about too, and it’s a springboard for what she’s saying: it’s going from the tumor centric approach to patient care to the patient centric approach to cancer care.
Conventional oncology is tumor centric. It’s based on the diagnosis of cancer you have, it has nothing to do with the patient that’s in front of you. It just has to do with what the clinical diagnosis is. And in my experience, that’s not how you win the war at all. And so what I find really fascinating and I’m really excited about is a lot of the markers that we could use to detect what’s the underlying metabolic dysfunction of these patients.
So whether that’s looking at immune markers, like C-reactive protein and vitamin D, whether that’s looking at acid base status with things like their first morning urine pH, whether that’s looking at, um – some of these, we do have tumor markers for, not nearly as many as they do in people, but, to go back to your question about the dollar and cents part, these diagnostics are readily available in people. You can go get liquid biopsies all the time, tumor markers all the time.
[00:27:46] >> James Jacobson: Liquid biopsy, that’s great. I like that.
[00:27:48] >> Dr. Kendra Pope: Yeah! And as technology has changed, the prices come down and down and down and down. And so I anticipate that the same thing is going to happen on the veterinary space. You know, for us to get these, I think FidoCure does like a hundred markers or something, it’s very expensive. And in people now, you know, that main panel that they do, I want to say it’s like $250 if your insurance doesn’t pay for it.
So I think that us having this shift and recognizing that this tumor centric approach to patient care does not work, it’s very non-specific, like Trina was saying, it doesn’t take any of the specifics of the patient into consideration, is actually in my opinion, missing the most important part of the cancer, which is that the cancer is from the patient.
It’s not an outside external source that’s come in and invaded the body and taken over. It is developed from the imbalances and pathology in the body. And in order for you to ever get control of that, you have to restore those balances. And in my opinion, that’s something that’s been completely missed.
[00:28:46] >> Dr. Trina Hazzah: Yeah.
[00:28:47] >> James Jacobson: What you are both speaking of is so fascinating. And I know a number of our listeners at this point are being like, that’s what I want to do for my dog! So we’re gonna take a break, but when we come back, I want to have your thoughts on the best way that our listeners can find folks like you to help guide them through this process, because this is a new area.
We’ll be right back.
We are back. So what we were talking about before the break is all these really interesting things that I think appeal to a lot of the people who listen to this show. And so if you have a cancer diagnosis, and you got it from the GP, and you may have gone to an oncologist, or maybe not, what is the first step if someone’s thinking I really want to go this integrative approach?
[00:29:35] >> Dr. Kendra Pope: So I always tell owners, and I think that this is something that is really difficult, is to take a deep breath and then to start strategizing. Because, that cancer, although it may feel like it popped up overnight, it may feel like you have to do something about it tomorrow, in most instances, you have some period of time where you can strategize and get your team together, because that’s the most important thing.
Oftentimes owners only seek one conventional opinion, it may be impossible to seek more than that, but sometimes that’s important, especially if you’re dealing with a non-traditional type of cancer, or maybe the oncologist that you met is recommending a treatment that’s not aligned. And oftentimes that’s not too aggressive. In my experience, a lot of times owners are, feel frustrated because they feel that a veterinary oncologist has already given up on their pet before they’ve even started. So finding an oncologist that is aligned with how aggressive you want to be and what you want to do, and also open to your interest in integrative medicine is what I think is most important.
To find other practitioners in your area that can support you, there’s many holistic veterinarians. There may not be ones that are integrative oncologists, obviously, because there’s only a handful of us, but a lot of them can consult with us, or consult with other people that do things like what we do and help to put a treatment together.
So what I always suggest owners do is to take a deep breath, to understand that that cancer has probably been developing for at least a few years, you know, on the microscopic level, up to where it is now, and that you have time to get a good plan in place so that when you’re ready to run, you have all those people on your team that are going to tell you how to do that.
[00:31:22] >> James Jacobson: So your advice is to start with a holistic veterinarian who can consult with an integrative oncologist.
[00:31:29] >> Dr. Kendra Pope: Or, you know, the reality is that the – and Trina can speak to what she thinks the most, I guess, um, valuable part that we add to it – is that we can give both sides of the opinion.
[00:31:42] >> Dr. Trina Hazzah: Yup.
[00:31:42] >> Dr. Kendra Pope: The patient can still get a lot of the same treatments with a holistic veterinarian as they could with us. It’s just going to be… a lot of my clients call me the quarterback.
[00:31:53] >> Dr. Trina Hazzah: Yup.
[00:31:54] >> Dr. Kendra Pope: You know, I’m kind of assessing the field and calling the plays. But the people on the field are doing the routes. So you can oftentimes get the same result without necessarily having that one person exactly on your team.
[00:32:10] >> James Jacobson: Trina?
[00:32:11] >> Dr. Trina Hazzah: I agree. I think that the team is a big, big part of it. I mean, that’s true with human medicine too, right? Like you don’t just have an oncologist, you oftentimes have an internist, and a gastroenterologist, and there may be a radiation oncologist, and acupuncturist. And I think that it’s, it’s tough to find an integrative oncologist, there’s probably four of us or something in the country right now.
Um, so to say, oh, just go find one. No, that’s not fair.
[00:32:34] >> Dr. Kendra Pope: Yeah.
[00:32:35] >> Dr. Trina Hazzah: But there are amazing holistic vets that know a lot about cancer. And I think also just deciding what feels right to you as an owner, right? Like there’s no right or wrong. And I think that if you go to somebody, whoever it is, and they push you to do something you’re not comfortable with, and the way you’re not comfortable is, you’ll just know it doesn’t feel right. You don’t know why, but it just doesn’t feel right. I don’t know if I want it to be that aggressive, or ooh, I kind of wanted to be more aggressive than that, that’s just not enough. It’s really finding the personality that gives you what you need. I mean, really, some people want more of a handholding, but don’t want an aggressive approach, and others don’t want any hand holding and they just want to go straight forward and they don’t care, win or lose, I’m going for broke. Right? You know, working at such a large hospital, we had different oncologists. And what was really nice about that is people would come to me and they would say, oh my God, thank God I found you. I just didn’t want to go and do like, a bone marrow transplant, and this, with only 25% chance of cure, I, my dog is 15 years old. I didn’t think that, whatever it would be, or a nine year, I don’t think it was right. Or financially, I couldn’t do it, and you’re actually listening to all of it and trying to put it all together and provide me with a plan that, you know, seems to be more suited for what I’m looking for. But I have other people that have come to me and said, I want that, like, full fledged, go for broke.
And I’d say, you know, I might not be the best fit for you. I can support you in that. But if you want that, like, person by your side, that feels exactly as you do – because for me, quality of life is so important that by the end, when we’ve done everything we can, I want you to have some quality of time with your pet. If you never have any quality time and at the end, there’s nothing left, I feel like we went too long. That’s not fair, for them or for you. But everyone feels different. There’s what probably 500 oncologists, 450 oncologists now? I don’t know how many there are, there’s many of them, you will find the right oncologist for you and that’s super important, is making sure that you guys have the same kind of vibe and the same thoughts on what’s important to you for your pet. And from the holistic side, there’s many more holistic vets than there are oncologists. And so I believe that you’ll find a holistic vet, even if you find a conventional oncologist that wants to go full fledge but you want a little bit of someone to help with chemotherapy induced nausea through acupuncture, through herbs, cannabis medicine, uh, vitamin D testing ’cause your oncologist doesn’t do that, whatever it may be. I do think that thank goodness, nowadays, you’re able to find a little bit, you may find an acupuncturist, and you might find a Chinese herbalist, and then you might find an oncologist, and, I think just what Kendra said about creating that perfect team, I really think prepares you for whatever the future holds. Because you have your, your peeps, if you will, to really kind of take you to wherever that will be, and I think from a integrative perspective, the earlier we get involved, I think gives us the best chance for longevity as well. If we’re really close to the end, it’s tough for our herbs and our botanicals to do as much as they can do once we can get there earlier and really support the immune system and figure out some of those deficiencies within the patient. In my experience is we can get them further along than just the conventional route in ignoring those big, big deficiencies that are the true cause many times of what created the cancer in the first place.
[00:36:06] >> James Jacobson: What do you think that general practitioners, you know, regular vets, we’ll call them, could do to make themselves more integrative in their approach? Because clearly the, the marketplace is demanding it.
[00:36:19] >> Dr. Kendra Pope: That’s an interesting question, because I completely agree with you that the marketplace is demanding it. Karen Becker just wrote The Forever Dog and it became a New York Times bestseller, the first ever in the animal space, and it’s all about what we do. And so as humans, and millennials, become more aware of the toxic world we live in and what you need to do to live a longer life, a healthier life, they innately want to do the same for their animal. I think that your question specifically about what can general practitioners do to be more focused on integrative medicine, in my opinion, I don’t think that that’s realistic. I think that especially the pandemic has shown how bulletproof the profession is, and how inundated these GPs are. I mean, GPs in my area are booking out for dentals six months out. There’s not even appointments.
[00:37:10] >> Dr. Trina Hazzah: Right.
[00:37:10] >> Dr. Kendra Pope: And so I think to ask, and to wonder when they’ll be interested in learning more new things is completely unrealistic.
I think it’s more about the business owners and these large corporations – and to me, that’s like, makes me nauseous thinking about corporates running holistic practices – but someone recognizing the financial gain that is there and figuring out how that paradigm can work. Because the big difference – and I noticed it specifically going from working in a large oncology practice, that was a very conventional practice to opening my own – is that the charges and the way that you price things are different because you’re not charging for these large procedures, you’re charging for that time that like Trina was talking about where you’re sitting with the owner, mulling through all the details, going through all the history, formulating this beautiful protocol. You’re paying for that intellectual property.
And so that’s a very different paradigm than hurry up, come in and send me $50, and we’re going to charge you $600 for this exam. So there has to be either a shift in the paradigms of these conventional practices to be able to capture charges appropriately, or we’re just going to keep doing what we’re doing, which is we’re going to be these adjuvant support systems that are separate from all those businesses. And we’ll flourish because there’s a need and a market.
[00:38:30] >> Dr. Trina Hazzah: I think this is kind of, Jim, how you started it is like, well, for GPs, what could be done differently? I think that they’re so educated on the preventative health for dental disease. They’re so educated on the preventative health for obesity, preventative health for skin, whatever it is. What about preventative health for cancer for God’s sake?
Like there are ways that we need to educate in that environment too. And so if it’s going to be a big corporation, if it’s going to be Kendra going there and teaching, or me teaching on the importance of preventative oncologic medicine, like, is there a way to do that? Absolutely. I a hundred percent believe it.
I think all those mutations, all those genetic alterations, all those things, some of them are preventable. Some of them are. And so having the conversation about really healthy immune systems, and conversation about diet, conversation about environment, and so forth. Like why not? We’re talking about teeth for God’s sake.
We’re talking about other things, but we’re not talking about trying to – especially in high risk breeds, right? Like-
[00:39:41] >> James Jacobson: Golden Retrievers or Boxers.
[00:39:42] >> Dr. Trina Hazzah: Bernese, or whatever, Flat-Coated Retrievers – or whatever. I mean, we could name them in our sleep, right. I mean, it’s so sad, I see a Bernese Mountain Dog going for a walk as a, you know, a five month old puppy down my street, and I cringe, and I just want to hug it and kiss it and hope it makes it through.
Right? Like – and I think many oncologists feel that way, right. And, and so what about preventative care in that regard? And so that’s really important in the education. Us coming out with, you know, diagnostics, how can we find cancer sooner. So that’s one part of it, but how can we try to prolong and keep them healthy and keep their immune systems robust, and do over vaccination, right, it may not be in that level, right? And so a paper, like what you just described Kendra, came in, coming out, is very helpful to support that. And so I do think education on a kind of a preventative cancer level is very, very poor. Doesn’t mean, when I say preventative, maybe prolonging is a better word in some of these cases, but perhaps preventative could actually be the case in, maybe for some of them as well.
[00:40:43] >> Dr. Kendra Pope: That’s so true.
[00:40:43] >> James Jacobson: Well, will you ladies come back and have a discussion specifically about that thing? Because I think prevention and reducing the likelihood of getting cancer is something that every dog owner who has gone through it wants to know and wants to better with and, I think that would be invaluable.
[00:41:03] >> Dr. Kendra Pope: Of course.
[00:41:04] >> Dr. Trina Hazzah: Yeah. There’s a lot of information. Even in the human side, there’s a lot of information, right? I mean, you think about the, I always think when I was studying for boards as an oncology resident, I was reading through all of the TCC, the transitional cell carcinoma stuff, right. Remember that Scottie paper looking at like green leafy vegetables and colorful vegetables reducing the risk of TCC in Scotties. There you go, right? Like-
[00:41:25] >> Dr. Kendra Pope: Yep.
[00:41:25] >> Dr. Trina Hazzah: Perhaps, you know, really introducing good phytonutrients at a young age, with good flavonoids and anti, you know, oxidant properties and things like that, when, prior to when the cancer’s there, so we’re not just focused on anti-cancer, I think could be really, really helpful.
But from an education standpoint to these veterinarians that are out there every day, not knowing, you know, what to discuss with pet parents as a preventative mechanism in that way. Sometimes they say, well, you can’t do anything. Just wait and see if it happens, you know? And that’s not fair either.
[00:41:55] >> Dr. Kendra Pope: Yeah.
[00:41:56] >> James Jacobson: Kendra Pope, last words.
[00:41:57] >> Dr. Kendra Pope: Oh, I get the last words! I always find that it’s really important to remind owners that they are their pet’s advocate and they inherently know what the right thing to do is. I think that when they have an animal that’s diagnosed with cancer, they feel very helpless. But they absolutely positively will make the right choices.
They know what the right thing to do is. We’re here to help you, but at the end of the day, you’re their mom or their dad, and you’re going to make the best choices and we completely support you and believe in you.
[00:42:27] >> James Jacobson: And last words from you, Trina. I’m sorry, it was just Kendra’s last words.
[00:42:31] >> Dr. Kendra Pope: Perfect.
[00:42:32] >> Dr. Trina Hazzah: No, I totally agree with Kendra of course. I mean, I think that you have to go with your gut. Always go with your gut, go with what, what feels right. And that’s including when you pick your team, right. Go with your gut. What I’d always say is pick the option that you would regret the least, right? You don’t ever want to regret and think about that for the rest of your life – I should have done this or done that. Go with the one that feels right, which is usually the one you regret the least. I mean really, right, like that tends to be how it is and I think it’s a really tough road. It’s a really, really, really, really tough road, and just know you’re not alone. There’s a lot of people going through it and we’re all here to support you, and you’ll make the right decision. Just go with your gut for sure.
[00:43:10] >> James Jacobson: Trina Hazzah, Kendra Pope, I so adore you both. I think what you provide is such an important refreshing voice for so many people. Thank you both so much for being with us on Dog Cancer Answers.
[00:43:23] >> Dr. Kendra Pope: Thank you.
[00:43:24] >> Dr. Trina Hazzah: Thank you.
[00:43:26] >> James Jacobson: And thank you for listening to this episode. It certainly was long and interesting, and to me, at least, it was exciting because there are so many tools at our disposal across the full spectrum of veterinary medicine from conventional treatments, like chemotherapy or surgery and radiation, to more holistic treatments like herbs and acupuncture. If we can invest in clinical trials like Dr. Kendra Pope is doing to narrow down what options work the best in each situation, well then hopefully someday we can see an end to dog cancer. Please visit our website at DogCancerAnswers.com to check out the show notes for all the links and resources mentioned in today’s program.
That is DogCancerAnswers.com. I’d also like to invite you to subscribe to our newsletter, Dog Cancer News, which comes out three times a week. You can find that at DogCancerNews.com. And if you have a dog who has just been diagnosed with cancer and you need some support, you are welcome to join our Facebook support group at DogCancerSupport.com.
It’s a free community and it is extraordinary. It’s a vibrant place full of people who understand what you are going through now. I encourage you to check that out, again that URL is DogCancerSupport.com. Well, that is it for today. I’m James Jacobson. On behalf of all of us here at Dog Podcast Network, I’d like to wish you, and your dog, a very warm, Aloha.
[00:45:12] >> Announcer: Thank you for listening to Dog Cancer Answers. If you’d like to connect, please visit our website at DogCancerAnswers.com or call our Listener Line at (808) 868-3200. And here’s a friendly reminder that you probably already know: this podcast is provided for informational and educational purposes only.
It’s not meant to take the place of the advice you receive from your dog’s veterinarian. Only veterinarians who examine your dog can give you veterinary advice or diagnose your dog’s medical condition. Your reliance on the information you hear on this podcast is solely at your own risk. If your dog has a specific health problem, contact your veterinarian.
Also, please keep in mind that veterinary information can change rapidly. Therefore, some information may be out of date. Dog Cancer Answers is a presentation of Maui Media in association with Dog Podcast Network.
Dr. Pope completed veterinary school at the University of Florida. She began her training in holistic therapies at the Chi Institute for Traditional Chinese Veterinary Medicine. Dr. Pope went on to complete a three-year residency in medical oncology at the University of Pennsylvania. She successfully obtained board certification in her specialty of oncology and became a Diplomate of the American College of Veterinary Internal Medicine in 2015.