00:00:04: The Biorevolution podcast.

00:00:06: Your hosts.

00:00:07: Luise von Stecho.

00:00:08: And Andreas Röchler.

00:00:11: The Biorevolution podcast, welcome.

00:00:14: Today, cancer, I

00:00:16: can.

00:00:16: Our guest today, Steffi Walter.

00:00:19: She's a medical doctor, cancer survivor.

00:00:22: And she's in a leading role with one of the world leading pharmaceutical companies.

00:00:28: Obviously, you can

00:00:30: Google her,

00:00:30: but for today, we explicitly... chose not

00:00:34: to talk to her

00:00:35: in her professional capacity, but much rather ask her about her personal story, her book, of course, her advice for people finding themselves in a similar situation.

00:00:46: Welcome, Steffi.

00:00:47: Thank you so much for the invitation.

00:00:49: Very excited to be here today.

00:00:51: Welcome, Yusie.

00:00:52: Hello.

00:00:55: Obviously, today we will be up close and personal, but also at the same time, I mean, we're the Bio Revolution podcast, and therefore we will reflect the latest developments in cancer treatment and drug development, of course.

00:01:11: For starters, we have, as always, quotes coming this time from Easy and from Steffi, who starts.

00:01:19: I will start with I think what can be identified as the core of this really excellent book and we'll get into why I find that excellent and would recommend that to people finding themselves in a similar situation and actually also their relatives and friends.

00:01:35: And this quote is find the right expert for your cancer and be the expert for yourself, which I think is really great.

00:01:43: And maybe I can hand over to you, Steffi, to also give us a quote from the book.

00:01:48: Sure.

00:01:48: So the one quote I really like because I often talk to cancer patients and they asked me what to do.

00:01:55: And my favorite quote here is, choose a medical team that you trust.

00:01:59: And this should be your top priority and should be the one thing you focus on.

00:02:05: I want to add more if I can, because I think this is also something that I really liked in this book.

00:02:10: And I think something that in, I think my profession and probably also in your profession, when we from a pharmaceutical perspective, from a biotech, from a research perspective deal with for example, survival statistics, you see a statistic and you see like an average number, but you don't see the patient.

00:02:31: And I think this is something that you bring out very nicely in the book.

00:02:34: And I also really like that quote, statistical data is not your destiny.

00:02:38: when you're diagnosed with cancer, you should aim to escape these statistics and position yourself at the long end of the survival curve.

00:02:45: And I think we'll get into that in a second.

00:02:48: But I really like this aspect that a statistic means an average of all the people who have ever been treated in a certain situation.

00:02:57: That does not mean that it will be the same for the single person.

00:03:00: And I think this is something really to be aware of.

00:03:03: Absolutely.

00:03:04: Absolutely.

00:03:06: Name of the book is The Eight Essentials for Overcoming Cancer.

00:03:10: Cancer I Can.

00:03:11: Why its eight will get to that?

00:03:13: But I have really the pressure to ask this question up front.

00:03:19: How much do you Do you think would it help if there wasn't a shame game around cancer in our society?

00:03:28: And I believe you have a US perspective as well, because you worked there and I believe the beginning of your story happens there as well, that the take on cancer, the general take on cancer is very different in the US than it is here.

00:03:44: We actually, I believe, could save lives if there wasn't shame associated to it, right?

00:03:51: Yeah, I think that's a good observation.

00:03:54: So I started going through breast cancer myself being diagnosed in the US.

00:03:59: And then I came back to Germany.

00:04:02: And the way cancer is dealt in with in the society with colleagues in school, it's different, I would say.

00:04:09: I would say in the US, people are more open, more outspoken.

00:04:12: Of course, it always depends on individual personality.

00:04:16: But here in Germany, I often feel that people are ashamed.

00:04:20: and sort of try to hide it that they have cancer or went through cancer that somebody in the family has cancer.

00:04:27: And associated with that is then the individual guilt.

00:04:32: Oh my goodness, I was diagnosed with it and what did I do wrong, that notion, but also then a bit the feeling of missing out and searching for help.

00:04:43: And I think there's so much help out there and that would be my encouragement.

00:04:47: Of course, it's a private decision how to reveal the diagnosis.

00:04:51: But in terms of seeking and asking for help, I think there are lots of opportunities.

00:04:55: Absolutely.

00:04:56: And I mean, we have to face that.

00:04:58: If I talk about my gender, half of men will have cancer at a certain point in their lives.

00:05:05: I had a cancer diagnosis roughly thirty years ago for myself and turned out it wasn't.

00:05:11: cancer after all.

00:05:12: But I appreciate the shame game around it because it's in a societal context.

00:05:19: It's very, very much, as you mentioned, the guilt part.

00:05:23: And the moment you look for professional help is a game changer in itself, I think.

00:05:31: Yeah, it can help you to find the right cancer team.

00:05:34: It can help you to get access to novel treatments, but also maybe your surrounding needs support as well, your family as well.

00:05:43: So that can be, this is a source of support that you can access.

00:05:48: And by the way, when you mention men, every third woman will get the diagnosis of cancer in their lifetime as well.

00:05:55: So in a sense, you can ask, maybe it's not a question of if someone would get cancer, maybe a question of when.

00:06:03: And if everybody is ashamed, yeah, we are hiding something.

00:06:07: And I think something that I mean, you also bring out in the book and that we know the earlier the diagnosis, the better the possibility to treat and the higher the survival rate.

00:06:17: So of course, not being Scared to ask for help as early as possible and starting treatment and the right treatment as early as possible I think is a very important step in this journey to get the best possible outcome.

00:06:31: What I have to say what I really liked about this book so often in the space of cancer Let's say help books.

00:06:38: the focus is very much on lifestyle and on mental health and this is As you point out in the second part, the second four essentials, really, really important, obviously, good sleep, good mental health, good exercise and diet, of course, are very important.

00:06:55: But there's also the aspect, the other aspect to it, to find the right treatment, find the right treatment center and find the right team.

00:07:02: And I think this is something that very few or at least things that I have come in contact with in the past, very few help or advice, guidance is focused on.

00:07:12: And I think this is, of course, tremendously important to also get these steps right, find the right people who can support you in a medical capacity and also learn maybe how to speak the right language there.

00:07:25: I think, of course, we are in a or you are a medical doctor from your background working in this profession.

00:07:32: There is, of course, the benefit of already having this knowledge.

00:07:35: What would you recommend to someone who maybe does not have.

00:07:39: the right vocabulary and the right maybe background to even know where to start asking the right questions.

00:07:48: And being diagnosed puts someone in a complete state of shock.

00:07:53: So the rational thinking is very much affected.

00:07:56: And people, usually what they do is they go to Google and then it becomes even worse because then a number of unqualified information is out there.

00:08:06: And if you don't have a medical background yourself or don't know anyone, I would say try to speak to someone who has a medical background.

00:08:14: And maybe this can be a challenge for or someone who has in the immediate surrounding, not a doctor who has it on speed dial, but then ask someone who knows the doctor and then try to organize yourself and then see, look, what have you understood?

00:08:30: this is I think the first step.

00:08:32: and then what would you recommend?

00:08:33: where should I go?

00:08:35: because when you're initially diagnosed or when there's the suspicion you're very much dependent on the person organizing the further route and I think there's a huge difference to which cancer center you go.

00:08:48: if they are following the guidelines or not.

00:08:50: So try to speak to doctors privately.

00:08:53: Have a small chapter on this.

00:08:55: Ask them, look, if you were encountering this information, what would be a sensible next step?

00:09:12: Thanks a lot.

00:09:12: So maybe we can go through, you have this nice summary of cancer I can.

00:09:19: So what these letters actually stand for.

00:09:23: And as we said, you have the beginning where it is really about finding the medical help that cancer and then the I can where it's more focused on the individual and what you yourself and your support system can do in this situation.

00:09:39: And I think the C so the first stands for calm down.

00:09:42: So this is really the question of what you do when you're faced with this terrifying diagnosis and what it actually means for an individual, I think to keep your mind straight and be able to make the right decisions and not be motivated or paralyzed even by the fear that such a diagnosis can mean.

00:10:06: Yeah, so this idea about calming down is exactly right as really finding an inner peace and trying to think straight so that you do not take decisions that decrease your likelihood of a good outcome.

00:10:20: And I think then if you look at the fact is it sounds weird.

00:10:23: Yes, cancer can be death threatening, but it's not an immediate medical urgency and very, very rare cases it is.

00:10:31: But usually when there's a suspicion Cancer is a long-term disease, and this is what people have to recognize.

00:10:37: So even if there is a severe or a malignant tumor, it is not that you are going to die within the next couple of days.

00:10:46: It's not like you are waking up in an emergency, you have a heart attack.

00:10:50: This is in terms of the health risk, way more urgent.

00:10:53: So recognizing this, that you have time to really think about what options are there is, in a sense, a very good and important step.

00:11:03: And then one of the feelings is also why did I get cancer?

00:11:08: Patients blame themselves.

00:11:09: I should not have smoked, drunk, drunk this, eaten this.

00:11:13: And the thing is on this one, you cannot change the past.

00:11:17: There's nothing.

00:11:17: you can and you can change a lot of things, but you cannot undo the diagnosis yourself.

00:11:23: Also focusing on the things that you can't control.

00:11:26: Can you tell us real quick how long did it take you?

00:11:30: as an MD, as a professional, who knows such an awful lot about diseases, including cancer.

00:11:37: Yeah, well, you know, I was diagnosed on a Friday afternoon and then my world fell apart and I came home completely devastated.

00:11:46: I had an appointment with my girlfriends in the city and I drove home.

00:11:50: I don't remember how I got home, but then I had this conversation with my husband.

00:11:56: And that was the really most terrifying moment, really recognizing this is a disease, it will not go away.

00:12:03: And then on the next day and after terrible night, I thought, okay, this is not there, but how do I get rid of the cancer?

00:12:11: Yeah, what is now my plan?

00:12:12: Yeah.

00:12:21: Do you have like for someone who gets such a diagnosis?

00:12:25: and as we just learned from the statistics, this will happen?

00:12:28: probably to many, if not most people in their lifetimes.

00:12:31: And if it doesn't happen to themselves, it will happen to a loved one and a close one.

00:12:37: Like a first response, what you can do to maybe regulate your system and be a little bit, yeah, to achieve this calm.

00:12:46: I think there are individual coping mechanisms.

00:12:49: I just like this breathing through.

00:12:51: and really looking at the facts, right?

00:12:54: And then also making sure that you have really understood what you have been told.

00:12:59: And there comes of course then the challenge of managing medical vocabulary, but is it a suspicion of cancer?

00:13:07: Is it a confirmation of cancer?

00:13:09: What cancer type is it?

00:13:11: And so on.

00:13:12: So I think as first of all, yes, it's a serious situation, but it's not.

00:13:17: everything is lost.

00:13:18: Now the question is how focus your energy on how you can get rid of cancer.

00:13:22: Which I think might lead us to actually the second part of the essentials, which is the A, ask for help.

00:13:29: What kind of help should we ask for?

00:13:33: I think to ask for professional help is you have to regulate your own feelings.

00:13:38: And then again, if this notion of panic and inner calmness reaching out to someone that you trust and either it's a relative or a friend and really making sure you have found this calmness and that the argumentation is rational.

00:13:52: I think that's the number one.

00:13:54: And then my tip I mentioned earlier, talk to doctors privately, say, look, this is the piece of diagnostic I have understood.

00:14:02: Where would you go?

00:14:04: I have this recommendation.

00:14:05: I mean, the initial physician should lay out a plan.

00:14:08: They should not just say, hello, you have cancer.

00:14:10: That's it.

00:14:11: Then they said, this is my proposal for the diagnostical steps of this.

00:14:16: And then you can say, this is what I understood.

00:14:17: But is this a good plan?

00:14:19: Yes or no?

00:14:20: Yeah.

00:14:20: So talking to them and checking, and this can speed up the entire process as well.

00:14:27: from experiences within the family and other people who are close, I can tell that it's often, I think, for many people very, very difficult to understand, not only the diagnosis, sometimes even the type of cancer that they have, but also the treatment course that is laid out.

00:14:45: Do you have any ideas how that, I don't know if it's the same in the US and if it's maybe also a little bit of German problem, but I think It's often, especially for older people, very difficult to understand really the perspective of, I mean, you have very different types of cancer that have different levels of progression, different levels of aggressiveness.

00:15:07: And some might mean that you have a very short average survival time and others might mean in fifteen years something might happen.

00:15:17: Getting these things out of the conversation, I don't feel that this is always the case.

00:15:23: Do you have any advice how to ask the right questions, maybe or how to maybe get coaching or something to be able to ask the right questions?

00:15:33: Yeah, so I have listed a few questions in my book.

00:15:36: The first one is what type of cancer is it that would be very much important?

00:15:41: How severe is the situation?

00:15:43: And then most importantly, what are the next diagnostic steps?

00:15:47: And then how do I get the appointments?

00:15:49: Very basic one.

00:15:50: This sounds so basic, but that's the number one.

00:15:53: is finding your pathway through the diagnostic jungle.

00:15:57: And I would say Germany is pretty good organized for most cases.

00:16:02: observing in the US, it's more do it yourself.

00:16:06: So actually, this can take a long time.

00:16:09: I came across some statistics that the time to treatment actually is prolonged.

00:16:15: And every week that you're losing can also harm the outcomes.

00:16:20: So therefore, I would say if there is the suspicion of cancer diagnosis, that someone should really go faster than about confirming it.

00:16:28: Yeah.

00:16:29: Absolutely.

00:16:30: Next question would be name the disease.

00:16:32: Yeah, the next essential, not the next question, which comes from basically what we've just been discussing, right, to really dive into what the specifics of.

00:16:42: Yeah.

00:16:43: And then it's like also patients when they hear cancer, they're blanking out.

00:16:47: So, but is it cancer or is it a tumor?

00:16:48: Is it a malignant tumor?

00:16:50: Is it a benign tumor?

00:16:51: I mean, there are things that can be just a growth of mass, but it will never spread.

00:16:57: Yeah, lipomas, for instance, right?

00:16:59: So really getting a biopsy, really getting the facts right.

00:17:04: And then this can be one.

00:17:07: set of diagnosis.

00:17:08: Sometimes it's worthwhile also to go for a second confirmatory diagnosis, especially if it's a complicated case.

00:17:16: And then it's also a question, which treatment center is conducting the initial diagnosis?

00:17:22: There came across some statistics.

00:17:24: There are variances, sometimes up to thirty percent.

00:17:27: So if there's a rare cancer, it is worthwhile asking for a second opinion.

00:17:33: In countries like Germany, this is also reimbursed by the insurance also in the US, so it can make sense.

00:17:41: And I can imagine, especially as you say, if it's not, I think there are... very prevalent types of cancer that a lot of people have in a certain set up and then they are very unique very rare types and I think also the rare.

00:17:56: It is the more likely it will be that talking to the specialist or one of the.

00:18:02: few specialists that are around can really be very helpful for you.

00:18:07: What you of course also mentioned in the book, the type of cancer, the staging, but also the molecular profile that the cancer has will also determine the type of treatment that you get.

00:18:17: Absolutely.

00:18:18: And

00:18:18: better you understand it.

00:18:20: Something that you point out, and that's of course really true, is that cancer is really the forefront of medical research.

00:18:27: I would say it's the field or at least that's my feeling from the last ten years working as a consultant for Pharma and Biotech.

00:18:34: It's the field where the most innovation happens the fastest.

00:18:37: So where you really have a lot of novelty coming in like really completely new treatment approaches that have change the disease for certain types of cancer, really drastically, for example, the immunotherapy for skin cancer patients, also cell therapies, for example, for rare blood cancers.

00:18:58: So there's really, we are at the forefront of innovation with this.

00:19:02: So knowing if you're applicable to one of these innovative treatments, or if they're actually mainstay treatments that work really well, is of course nice to know and requires a good understanding of what type of tumor you have.

00:19:16: Yeah, and this also speaks to the fact that more and more options will be available in the next years.

00:19:22: So if you have a cancer that might not be treatable today, we have more options in the next year and even more options in five years.

00:19:31: So if the current conclusion is this is something we cannot treat adequately, I think there's so much hope because as you said, so much money is gone there from the pharmaceutical industry, but also from the governments, from all institutions, cancer is the top priority in terms of research field.

00:19:47: That's so amazing.

00:19:48: I mean, we address this fast-paced development in this podcast on a regular basis.

00:19:53: But at the same time, I mean, we both, Schleffi Meet at a pharma conference once a year in the past years and what is reflected there, what is in the pipeline right now as we speak in cancer treatment is just breathtaking.

00:20:08: I ask myself the question, how can you as a patient even know of the current developments, right?

00:20:15: Yeah, I would say you should go to a cancer center that knows this.

00:20:21: So I think as a patient trying to even for me and I just had.

00:20:25: breast cancer, so to speak.

00:20:27: I mean, it is impossible to understand all the options and investigate yourself.

00:20:32: So I would really encourage finding a treatment center who does this for you, who has the state of the art therapies available and also can specify for your individual case.

00:20:43: I think one interesting aspect also if you have the right experts is that if you might have a disease that doesn't have a current treatment option, they will at least consider the possibility of rolling someone in a clinical trial, which can be very helpful.

00:20:58: And they might also recommend, for example, for an early access or compassionate use program.

00:21:03: Again, these are pre-approval programs of medication that is not on the market yet, but has shown benefits and trials.

00:21:11: And these things, because there is so much happening, there are also a number of.

00:21:16: such options that have not been approved yet so they are not fully tested means there are more risks when it comes to both the efficacy and the safety but at the same time they might be promising for a certain patient and if you have a specialist they will know if you might be eligible for such a trial which I think also is quite important.

00:21:37: In this context, I want to share a patient story that really touched me, a patient that I met in myeloma, and he had late stage blood cancer and was treated in California.

00:21:47: Nothing was available.

00:21:48: And then he came across a therapy that was only in early stages, CAR-T.

00:21:52: And he discussed it with his treatment team, but the studies was not yet in the United States.

00:21:58: So he himself flew to China with Google Translate with his wife.

00:22:03: And he tried this and said, well, I have nothing to lose because there's There's no treatment option.

00:22:07: He did stem cell transplant, everything.

00:22:10: And then they tried cartoon him.

00:22:13: and then the doctor came back with Google Translate and said, you are cured.

00:22:18: And then he said, well, my Noma can't be cured.

00:22:20: And this must be a Google Translate mistake.

00:22:23: And they said, well, to our current knowledge, you know, your blood work is normalizing.

00:22:28: And now, this was years ago, CAR-T has been studied and tested for many more patients, but that was one of the patient's story that really encouraged larger companies to invest in that space.

00:22:40: Wow, what a story.

00:22:41: And also this shows, I mean, two things.

00:22:43: I think, one, how individual the care should be and also how much it matters as a patient to advocate for yourself.

00:23:01: I think we touched upon eradication quite a bit, so you have the fine descent of eradication.

00:23:06: But I think also rehabilitation, which is something I think that is often maybe a little bit neglected, that people say, okay, now you had the surgery, you had the chemo, but this takes a toll on the body, right?

00:23:19: Yeah.

00:23:20: And this is like really managing the side effects and the after effects very well.

00:23:24: And there are structured therapies in theory out there, but then it's again, depending on which treatment center you are, which brings me to if sometimes patients focus on one single physician only.

00:23:36: And as cancer is a systematic disease, meaning it's affecting the whole body, that it's worthwhile really finding a cancer.

00:23:44: team of experts that you trust.

00:23:47: If you only go for a center because of one single physician, this physician can get sick himself or even move the institution, but really making sure you are in a good institution where there are also the other colleagues out there.

00:24:01: You need actually a team of experts, not only the surgeon, the oncologist, the radiotherapist, then also physiotherapist, like really a care center team that helps you.

00:24:13: And I think there are differences in quality, unfortunately.

00:24:17: Seldom, the hospitals reject patients.

00:24:19: Everyone says, yes, we can treat you, but here it's worthwhile investigating if they use guidelines and state-of-the-art therapy, accredited cancer center, that's something patients should look for.

00:24:32: So I think we wrapped up the more medical part and I think the equally important part is what you can do yourself, right, in terms of lifestyle, in terms also of mental health to support yourself and maybe also you have a family, right?

00:24:47: I mean, it doesn't take a toll only on yourself.

00:24:49: It takes a toll on everyone who's close to you and can be quite tough for both sides to navigate a situation like that.

00:24:57: So where would you say so we have the I think the the essential of I say mentally strong.

00:25:03: where would you say you would focus on both let's say in terms of internal mental strengths but also when it comes to the relationships.

00:25:13: Yeah.

00:25:13: And there was one sentence that really struck me when I was speaking to a friend, who was gynecologist at the University of Cologne, and she said, look, I'm not going to lie to you, the next eighteen months will be terrible, but this will go away.

00:25:29: and then you will have your life back.

00:25:30: And I said, well, you know, I'm running my offense.

00:25:32: I said, well, eight months is long, but it's only, you know, it's a limited time frame.

00:25:38: And I don't want to be defined by cancer.

00:25:40: I want to have.

00:25:42: this is a period of my life, but it will go over.

00:25:45: So my mission is cure.

00:25:47: Yeah.

00:25:47: So I was looking for a care team who's also going for a cure.

00:25:51: And I was very fortunate.

00:25:53: that I didn't have metastasis yet, but still.

00:25:57: even you can also live long with metastasis, right?

00:26:01: So I think you have to find a plan is like what is your goal?

00:26:05: and cancer is an inexperience, but it's not the entire life.

00:26:09: So rearranging that thought also to finding this inner strength.

00:26:14: And I've seen when I was practicing as a physician, the patient needs to have the motivation to heal, right?

00:26:21: And also this ambition.

00:26:23: And if a patient has given mentally up, the best medicine of the world cannot help this patient.

00:26:29: So there is a not very well scientifically understood, but there's a correlation between mental strength and immune system as well.

00:26:37: So finding that in a strength and having that vision, how does a success look like for the patient?

00:26:42: I think that's what I'm discussing in that chapter.

00:26:46: What I'm wondering about, so I'm touching a little bit on a tougher subject, on the already tough subject, but would you have advice for people where it does, I mean, as you say, if you have metastasis and if you have a bad prognosis?

00:26:59: And as we said in the beginning, you are part of a statistic.

00:27:03: It does not tell you where in the statistic you will fall.

00:27:06: It can be better, but realistically, it can also be worse, right?

00:27:10: Do you have any... advice for staying strong if let's say the diagnosis is pretty dire and it's very hard to formulate the cure as the goal.

00:27:21: Yeah, and if your prognosis would be a twenty percent chance of survival, then you could say, well, then I'm the twenty percent.

00:27:30: Yeah, what should I be?

00:27:31: the eighty percent?

00:27:32: And if you look at someone who I admire, who went through a cancer, Lance Armstrong, he was told he had a diagnosis of twenty percent because he had already metastasis in many organs, right?

00:27:45: So there is always patients that can beat the odds.

00:27:49: And it's, I think, about beating the odds.

00:27:51: And then it's a question, what is your original state?

00:27:55: How you go into the disease?

00:27:56: You cannot compare with all the other patients.

00:27:59: It depends also what your individual health was at the beginning and co-medication and so on.

00:28:06: And then, again, find the cancer team who can increase your odds.

00:28:11: Yeah.

00:28:12: You also outline in the can.

00:28:14: So in the last three essentials, the lifestyle modifications, which I think is something that a lot of, as I said, like advice or help books focus on, but I like that you have a quite balanced view there, right?

00:28:27: So the question of how much does it help to eat a healthy diet to exercise and also to normalize your sleep, which is something that we're learning more and more, right?

00:28:37: That this is really, really important.

00:28:40: Yeah, so on the nutrition.

00:28:42: I really learned a lot when I was doing research on this book because I thought I had a healthy nutrition before.

00:28:48: I think there's a lot of things on your... daily intake on everything that you do that can stimulate the immune system.

00:28:56: And it's also not revolutionary when you think it's about green vegetable, but also trying to eat not so much meat and also watching out in terms of the calories and sugar and also discussing how good is alcohol actually.

00:29:12: But if you think about it with every meal, you can boost.

00:29:16: your immune system.

00:29:17: So it is something that you can do as a patient.

00:29:21: It's definitely worthwhile looking into this.

00:29:24: Why would you not?

00:29:25: I mean, if you're just purely, I mean, Western medicine is absolutely essential to overcome cancer.

00:29:31: That's my perspective.

00:29:32: But why would you not add on your weapons to fight the cancer with these other tools?

00:29:38: It's sort of giving up a chance.

00:29:41: So this is why I would encourage and it has to fit.

00:29:44: to your individual lifestyle as well, but there are little changes and there are some really good examples.

00:29:51: When you look at the studies, the number of vegetables that they can make a difference.

00:29:56: The one thing that I really found limited research on was the value of exercise and that's the topic I really liked about.

00:30:04: and when I went through this harsh treatment, my oncologist always said, well, you're one of the fittest patients.

00:30:11: I didn't need much of the co-medication that was offered.

00:30:15: I actually threw it all away.

00:30:16: And I believe it really, it depended on me continuing to run and to weightlifting.

00:30:23: For instance, if you go through a big surgery like mastectomy, why don't you train yourself before that?

00:30:30: Yeah, because it is a huge invasive surgery and the recommendation in the American guidelines is actually patients should also under treatment do moderate exercise, but this is hardly introduced.

00:30:43: Yeah, and I think this is also hardly something that you see people do who don't already exercise a lot before.

00:31:01: Back to the diet.

00:31:02: I think this is exactly as you say, right?

00:31:04: It's a very important compliment to the medicine that you get.

00:31:10: I also think that eating well also makes you feel better, which I think when you're already getting a lot of poison can be quite good, right?

00:31:19: You have the right type of food to at least... I mean, a lot of chemotherapy can make you quite nauseous, right?

00:31:26: So to have the right type of food at least to not make it worse.

00:31:31: And at the same time, as you say, I think anything that's inflammatory like alcohol is generally a very bad idea.

00:31:38: Yeah, and on the nutrition, it's also about watching the weight a little bit because a side effect is that you can gain tremendous weight, especially if you have to take cortisone, it just increases hunger.

00:31:50: And that is associated with other problems.

00:31:53: And the idea is be the expert for yourself.

00:31:56: So have a feeling what is good for you and what is not good for you.

00:32:00: And if you monitor this a little bit, again, it can improve the outcomes.

00:32:05: So when I was still in research like ten years ago, there was a lot of research also going on around like sugar deprivation completely, which in some studies should promise.

00:32:16: at the same time.

00:32:17: I think there is also the worry that you also need to have some sustenance, right?

00:32:22: To go through this therapy especially.

00:32:25: if you say exercise is an important step of it, going through the therapy and kind of starving yourself at the same time, I think it's a very bad idea.

00:32:33: And I think some people took the conclusion that just completely depriving yourself of any carbohydrates could be a good idea.

00:32:40: And I would argue without.

00:32:42: I think this in general literature around lifestyle effects on disease is always very difficult, right, to interpret.

00:32:50: So I think here I would speak more from feeling than from clear statistical knowledge, but I would say having enough calories and enough balanced calories would be a very good idea rather than depriving yourself of a specific type of nutrient.

00:33:07: I agree.

00:33:09: I think the last step is something that is very... beyond the essentials of cancer, something that for our health is just generally very important, which is to sleep well, which is, I think, easier said than done, especially if you're in a life-threatening stressful situation.

00:33:26: Do you have any advice?

00:33:27: I'm listening intensely now

00:33:29: because

00:33:30: I'm over sixty and sleep deprivation is a topic for me personally.

00:33:34: So

00:33:35: I'm listening.

00:33:36: This is actually the key lifestyle change that I actually adopted because I didn't realize how important sleep is.

00:33:43: So I am coming from a lifestyle where five hours of sleep was enough and I didn't feel tired.

00:33:51: So this is how I train my body.

00:33:53: But then really looking into research, if Sleep was called healing.

00:33:57: I think more people would pay attention to it, right?

00:34:00: And if you see with our busy lifestyles, what is cut is always sleep.

00:34:06: But if you say, OK, this is actually a priority.

00:34:08: My body needs this rest.

00:34:10: My immune system needs to booster.

00:34:13: And I get stronger and I'm fresher the next day.

00:34:16: If you make it a priority, it's like also booking time to sleep.

00:34:21: And I'm a fan of the sleeping device where you really track your sleep.

00:34:25: I have a ring that helps me.

00:34:26: And my husband makes fun of me.

00:34:28: You need a ring that tells you how well your sleep is led by.

00:34:31: It reminds me that I should go to bed for a certain hour.

00:34:36: And also the quality of sleep is important, not only the hours, but then really the brain relaxation is better if you have this certain cycles of sleep, right?

00:34:47: So I'm tracking and looking at this, okay, did I dream enough?

00:34:51: So to speak in Trumpoff, did I get enough REM sleep?

00:34:54: And this has a So many positive effects that outweigh the two hours that I would steal from it and do something else.

00:35:03: Yeah.

00:35:03: So I think that most tricky part is then going to bed regularly because our lives are not regular with travel.

00:35:10: So trying to build it in said, well, this is when I'm going and I also like to go out and I have, you know, longer meeting friends and events.

00:35:19: actually sleep ahead nap in the afternoon when I have a long day.

00:35:23: I actually do a nap before.

00:35:25: So it is a bit like eating when you say, well, I need to eat this and this and I'm getting very unproductive if I'm not eating at the same when I'm not sleeping.

00:35:35: Even though you can overplay it with coffee and various things.

00:35:40: Very good.

00:35:42: Yeah, it's a good overview.

00:35:43: And I think for me, and I think this is something also maybe you can relate to becoming or going from an expert in a field or an expert in general in a medical field in pharma into a different role.

00:35:59: And I think something that for me happens quite often is that I'm being asked for advice by friends, by family.

00:36:05: And I think this is something that I see with many of my friends who work in the industry, that you are in a position where you also have to carry quite wait, let's say, in giving advice and discussing these situations.

00:36:19: And I think the way you wrote the book, I think that the first essential is calm down.

00:36:23: And I think this goes throughout the book that it has this calming tone and also pragmatic energy, which I like about it, because staying calm and staying rational, even if you're faced with something that is pretty dire, as you say, on the one hand, improves your chance of survival, but on the other hand, also will make your day-to-day life much easier and also that of the people around you.

00:36:47: It's an important, good way to approach this topic.

00:36:51: I really like that.

00:36:52: Steffi, I have one question for you and one question for both of you for closing.

00:36:58: One is, I mean, the book as we record this is brand new, but still, how's the reception?

00:37:03: What are the first comments of people who read this beyond us?

00:37:07: So please.

00:37:09: Yeah, no, I think the reception is pretty good.

00:37:12: It's audible on Amazon.

00:37:14: So I can see there are readers in the US, there are readers across Europe.

00:37:18: That's why I wrote it in English.

00:37:20: So I have France and Italy and Germany.

00:37:23: And what I'm hearing is people find a resource of systematic help.

00:37:28: Everyone is taking something different out.

00:37:30: Many patients who have been diagnosed already found a research center, but then in terms of reviewing what are the further treatment steps, they find some good advice there.

00:37:40: Also, I have readers who are not diagnosed with cancer, but who read it because of what lifestyle changes are important to prevent cancer.

00:37:49: This is also a source of readers.

00:37:51: And then a few who are going through doctors, actually, who like the the scientific facts are displayed and they use it then to communicate with their patients.

00:38:04: Yeah, wonderful.

00:38:05: And I think the real, the huge benefit is, as Louisa pointed out before, to treat it rational if you have a diagnosis like this.

00:38:15: And this is priceless, I think.

00:38:17: Last question for both of you.

00:38:19: When will it be over?

00:38:20: When will cancer be over?

00:38:22: I mean, we don't like it anymore.

00:38:23: I think we'd never liked

00:38:25: it.

00:38:25: That's true.

00:38:25: That's of course not.

00:38:27: Well, I think there's an unfortunate balance between, I mean, the statistics show, right?

00:38:33: I mean, the chance of getting cancer and this doesn't mean that it has to be also terminal cancer.

00:38:39: I think it's often that it's a diagnosis that you get at an older age and this differentiation of dying with the disease rather than from the disease.

00:38:48: So I think this is also true in many cases.

00:38:51: But I think that since we are getting older and older, I think the chance to accumulate, I mean, a stochastic disease, right?

00:38:59: So it happens by the accumulation of multiple mutations.

00:39:03: So the older we get, the higher the chance that at some point we will get it.

00:39:09: I think the treatments are getting much better and they're in parts getting curative, but not for all types of cancer.

00:39:16: And there are some that are still very, very hard to treat, especially cancers in the brain, where surgery often is not the same type of option as it would be another type of tissue.

00:39:27: So I would say it will probably stick with us.

00:39:32: That said, I mean, there are types of animals that don't get cancer or get it very rarely.

00:39:38: So maybe we have to learn from those.

00:39:40: But I think our fast-paced metabolism is stunning in the way of that, unfortunately, a little bit.

00:39:46: Looking at the animals and looking at the Lance Armstrong's of this planet, of course, that's what we need to do.

00:39:52: Steffi, your take on curing.

00:39:54: I mean, I like the expression of easy saying dying with but not from the disease.

00:40:02: Yeah, so I can tell you my friends in the industry and I myself, we are working on eradicating cancer.

00:40:09: This must be the goal.

00:40:10: Yeah.

00:40:10: So currently it's progressing.

00:40:12: more and more people are getting cancer for the reasons you said.

00:40:16: But what we have currently in terms of therapies is about treating patients with cancer better or detecting it earlier.

00:40:23: This is not eradication, eradication.

00:40:25: And I had a chat with chat GPT on my way here, I said, what would it take to eradicate?

00:40:31: And it all boils down to really understanding the onset of the disease.

00:40:36: And the idea of cellular reprogramming is something we have not covered.

00:40:42: Certain cancers are curable when you think of vaccines, avoidable.

00:40:45: Yes, but if somebody has cancer, how can you reprogram the cell?

00:40:51: This is the piece we need to pay more attention and research on to enable this.

00:40:57: And there are like other diseases.

00:40:59: humankind has been suffering on polio, myelitis is one.

00:41:03: And really, if you understand the onset of the disease, then you can also reverse it.

00:41:07: And what I have to say, I really like that point.

00:41:10: I think there are types of cancer that are really reduced because we understand better where they come from.

00:41:15: For example, HPV related cancers, which based on the vaccine are reduced drastically.

00:41:22: So understanding what is the source, as you say, of the cancer, I think also, for example, we learned about massive UV exposure, and I think this changed during our lifetime massively.

00:41:33: We learned other risk factors.

00:41:35: The problem is now we're getting new types of risk factors, like for example, obesity can also be a cancer risk, for example.

00:41:42: So we have, we just get new problems, but at the same time, I think recognizing the sources.

00:41:49: is already very helpful.

00:41:50: Yeah, and another approach, so recrogramming is the one, but the other thing is then really activating the own immune system.

00:41:57: Because when you think about every healthy person has mutated cells, but they are detected by their own immune system.

00:42:04: So if you were able, and cancer cells have cellular strength to hide from the immune system, if we're able to activate the immune system to find these mutated cells, this could also be a curative approach.

00:42:16: And so many times recently is I have to say we have to do a second episode with Steffi, I think, because we didn't cover half of the ground, but we don't want to lay too much burden on our listeners and viewers at that time, so I think we didn't promise too much.

00:42:34: up close and personal, on the one hand side, on the other hand side, research and latest developments.

00:42:39: Really encouraging, I think, for everybody who suffers from cancer.

00:42:44: So many, many thanks, Stephanie.

00:42:46: Thank

00:42:47: you very much.

00:42:48: And we will, of course, link the book in the show notes so you can go to Amazon and have a look yourself.

00:42:54: Or is it available only on Amazon or?

00:42:57: It is available on Amazon, yes.

00:43:00: But in all the countries, so yes.

00:43:03: So again, many thanks.

00:43:04: As always, please subscribe to our podcast and like us on Spotify or any place else who listen to us or watch us on YouTube, for instance.

00:43:14: And the show notes will be pretty lengthy, I think, easy this time and researchable at

00:43:21: science-tales.com.

00:43:23: Thank you so much.

00:43:24: It was a pleasure talking to you.