October 16, 2024 • 37 mins
There are many cancer-relevant headlines, and Tina and Leah cherry-picked a few you need to hear. Is using Artificial Intelligence (AI) to help you determine a treatment plan a good idea? You can get answers from ChatGPT, but are they reliable? There are a few considerations, like source verification, addressing ethical considerations, and who you should (and should not trust to handle your medical information. Tina and Leah also discuss a recent study that found benzene in a third of available acne creams! Benzene is a well-known carcinogen. They also talk about the possible link between oral bacteria and head and neck cancers as they quote (and question) the party line regarding proper oral hygiene. Join us and see what you think of these timely topics!
Artificial Intelligence:
Don't believe the bots!
ChatGPT can't keep a secret
Oral microbiome and cancer(s):
US News and World Report: Gum disease can trigger cancer
The original study on oral microbiome and head and neck cancers
Put that toothbrush down! Why you should wait to brush after you eat
Acidity (esp. pH <5.6) leads to loss of enamel
Acne creams with benzoyl peroxide:
News release from the American Association for Cancer Researchers
Benzene found in a third of acne creams off the shelf from stores (the actual study)
Benzene is found in some canned and bottled beverages
A word from the beverage industry (2006)
The FDA's stance on benzene in beverages
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Leah (00:00):
ever since I started having hot flashes, I'm a big
fan of having that dessertbefore a meal.
Well, or not, you know, likehaving it with lunch or
something earlier in the day.
So I don't like wake up withnight sweats.
Tina (00:15):
yeah.
So you're saying if you have asugar too late in the night.
Leah (00:18):
Oh, it's, it's not just me.
It is a very common cause of, ofnight sweats and of waking up in
the middle of the night.
So yeah, keep that sugar as anafternoon delight, as they say.
Tina (00:31):
there you go.
Afternoon delight.
I'm Dr Tina Kaczor and as Leahlikes to say I'm the science-y
one
Leah (00:39):
and I'm Dr Leah Sherman and on the cancer inside
Tina (00:42):
And we're two naturopathic doctors who practice integrative
cancer care
Leah (00:47):
But we're not your doctors
Tina (00:49):
This is for education entertainment and informational
purposes only do not apply anyof this information
Leah (00:55):
without first speaking to your doctor
Tina (00:57):
The views and opinions expressed on this podcast by the
hosts and their guests aresolely their own
Leah (01:04):
Welcome to the cancer pod Tina,
Tina (01:23):
Leia,
Leah (01:23):
I think we're about to be replaced.
Tina (01:26):
what do you mean?
Leah (01:27):
I saw this article in Cure Today about somebody who entered
in some other medicalinformation to AI to CHAT GBT,
and CHAT GBT came up with theirintegrative treatment plan.
Tina (01:40):
Get out.
Leah (01:41):
No, I'm serious.
I sent, I forwarded you thearticle.
I don't think you've had achance to look at it yet.
Um, it asks, okay, so the personsays, I asked chat GPT to build
me a treatment plan forintegrative and Western oncology
based on me and my diagnoses.
It built me a side by side chartshowing me different options.
Tina (01:58):
Whoa.
Was it any good?
Did you get to see the chart?
Leah (02:02):
Yeah, no, it's right here.
Like it's, it has the chart andit has the integrative oncology
treatments, the Western medicaltreatments.
And then this person has, two.
Synchronous cancers and yeah, itdoesn't show the full thing, but
it has Western medicaltreatments as you know, one
column.
Tina (02:18):
Does it tell, does it tell the person where they got the
information from?
I mean, is chat GPT just usingthe entire web or is it going to
a reliable source?
Leah (02:26):
I don't know.
I don't know.
Uh, cause it doesn't show thefull chart or there's no little
asterisk or number next toanything.
When I've looked things up inchat GPT, and I've asked for
references, like I've asked forit to write something and I've
asked for references.
And then I go back and look atthe references.
They don't actually exist.
(02:46):
Like it makes up references.
And then I called ChatGPT out onit and it said, Oh no, we're
just providing ideas.
Tina (02:54):
So yeah, well, you know, I've been using a lot of AI for
research, right?
All sorts of perplexity,illicit.
I've got like a bunch of them.
Gemini.
by Google, is now telling youwhere it got the information.
So that's impressive.
It's actually giving you, like,we sourced this from, and it'll
give you a citation.
Leah (03:12):
Oh, I see that when you do like, I hate when I do a Google
search and then the AI comes upfirst, but it does.
There's like a little link nextto it.
And if you click the link,sometimes their little summary
is not exactly what the linksays.
And that's so dangerous.
Tina (03:27):
that's exactly what I was going to say about this whole
treatment plan.
I was like, well, how is someonewho isn't a medical oncologist
or a naturopathic oncologist orwhatever, who's not familiar
with the material, how is thatgoing to be checked to make sure
that it's accurate?
So, for example, like, what didthey say for this person to eat
and what was their diagnosis?
(03:47):
Yeah.
Leah (03:47):
So, okay, so they have a pancreatic NET, neuroendocrine
tumor, and it has their Westernmedical treatments.
And then for their integrativeoncology treatments, it says
ketogenic diet, herbal supportwith turmeric and ashwagandha,
acupuncture for symptom relief.
For their renal cell carcinoma,it says mind body practices,
(04:09):
reishi mushroom and green teaextract.
So it's pretty like.
Tina (04:13):
Okay.
I'm just going to weigh in rightaway.
Ketogenic diet It's a high fatdiet, ketogenic, no matter how
else you eat, you know, if youeat a vegan ketogenic or a meat
heavy ketogenic, either way,it's going to be 70 percent or
more of your calories from fat.
And if your pancreas is involvedin your diagnosis or your cancer
or any other condition, yourpancreas could be compromised.
(04:36):
The function of the pancreas isto secrete which is the enzyme
that breaks down fats.
So, you'd have to be under thecare of somebody, a
nutritionist, dietitian, who isextremely familiar with what you
would actually be able totolerate without putting a
burden on your pancreas, yourgallbladder, your liver,
Leah (04:56):
and from what I recall, patients with neuroendocrine
tumors tend to have diarrhea.
Tina (05:03):
depending, yes, what the neuroendocrine tumor is
secreting.
So the most common secretion isserotonin and serotonin will
lead to diarrhea,
Leah (05:10):
And so doing a high fat diet in someone who is
experiencing a lot of diarrheajust kind of seems like, eh,
maybe not the best idea.
Tina (05:19):
right?
So there's a lot of nuances thatgo into medicine and medical
decision making that I don'tknow.
I mean, eventually I'm sure AIcould do it if it was fed the
right source material, right?
So AI is only as good as itssource feeds.
And so is it.
Getting its sources from theNCCN guidelines for the medical
oncology part, for the actualtreatment part.
(05:41):
If so, then that's a good sourcefeed.
So, chat GPT is probably justnot right, the right AI to use.
It's too broad in its sourcefeeds.
Um, but I do think AI is aphenomenal tool for us.
I mean, I have been able to doresearch on topics with
citations looking through justMEDLINE so fast and so much more
(06:06):
information and just cut to thechase.
You know, what might take me aweek before I could do it in an
afternoon easily.
Leah (06:12):
I I mean I use it for outlines, Like if I need to
write a blog for a certainpodcast, I'll use it to just
kind of give me like aframework, and then I go in and
edit it and make it sound like ahuman wrote it.
And then if I have any sort ofreferences, I make sure that
they are actual references, andthey're not like these fake
(06:34):
ones.
But I just think it's, I don'tknow.
Okay, so let me go on.
Yeah, I think that mind bodypractices meditation yoga.
I mean, I think that's likepretty, it's great, but it's
pretty vague.
It's not really specific torenal cell carcinoma.
It's kind of good for everybody.
Um, so, uh, the person has livermetastasis.
And so the recommendation ismilk thistle for liver support.
(06:56):
and plant based diet.
So it's interesting because it'snot taking all of these
diagnoses and creating a plan.
It's doing one for each one.
So a plant based diet and aketogenic diet may be,
Tina (07:08):
challenging to get everything you need to get in a
day.
Leah (07:11):
Okay, so for pain and fatigue management, acupuncture
for pain, essential oils,lavender and peppermint are
recommended, and then reiki forfatigue.
So it's kind of vague.
Tina (07:21):
That's its whole program for integrative medicine.
Leah (07:23):
This is what I'm getting so far.
And it's like I said, not thewhole thing's listed, uh, immune
support.
We see adaptogens andnutritional support, and it
lists three vitamins.
vitamins D, C, and E.
There isn't any sort of linkicon or anything after this.
So I don't know where it'sgetting its information,
Tina (07:41):
Yeah.
Yeah.
Leah (07:42):
I don't, I don't know.
And I think this person wasprobably, I'm guessing, doing it
more for fun.
than anything else.
But I'd like to think therearen't people out there getting
actual medical advice fromChatGBT or AI.
Tina (07:57):
No.
And again, I mean, I think chatGPT is too broad and too
inclusive of all opinions outthere that it's being fed.
It could be fed nonsense, forall we know, but if you can
source feed in an AI is just sayonly use the following websites
and then use cancer.
net as the ASCO patient facing,site or, you know, various, like
(08:23):
what SIO, the Society ofIntegrative Oncology has some
really nice papers onintegrating safely.
So I guess controlling thesource feeds and then double
checking the answers would bethe only way to use it.
Leah (08:36):
With a human.
Yeah, but, but not doublechecking yourself.
Double checking with a human whoknows what they're talking
about.
Tina (08:43):
Yeah.
Yeah.
Which is basically what I dowhen I do research, right?
Like, I look up papers, I'll doa bunch of papers, I'll write
them all down, and then I'll goback to the actual citations.
I won't, I will never read aline and assume the citation
that they leave there iscorrect.
I go back to the actual originalpaper and say, is that what that
paper actually said?
You'd be surprised how often itdoesn't say what they just
(09:03):
interpreted it as saying.
Leah (09:05):
I know, but not everybody's as thorough as you
are, Tina.
I
Tina (09:08):
No, but that's, I
Leah (09:08):
like that's, but that's, and that's a big problem is
people will take it for facevalue.
They'll be like, well, this iswhat was compiled.
Um, I don't know, that's the, Ijust thought that was really,
um, kind of interesting.
Tina (09:19):
Yeah.
I think the use of AI to get usto the primary source is really
useful.
Instead of me finding a reviewpaper, finding the papers within
the review papers that I'minterested in going to those
papers and then going all theway, you know, I'm, I'm always
swimming upstream to the sourceof the material.
Leah (09:36):
that, that was my methodology, was finding,
finding a review paper, and thengoing to the other papers
within.
I was like, oh, they did allthe, they did all the legwork.
I'm good with that.
I'm, at this moment in time, onthis date, in this year, I am
fine doing that.
I'm not comfortable with WithAI, what I also thought was
(09:57):
interesting is this personvoluntarily uploaded their, um,
their imaging results
Tina (10:03):
Hmm.
Yeah,
Leah (10:06):
GPT for like them to translate it to human to human,
you know, to more lay speak.
Tina (10:16):
to the mere mortals.
Leah (10:18):
Which I think is interesting, but at the same
time, like, I don't know.
Tina (10:23):
Well I think that does bring up a whole other facet to
this, and that is, I think weshould be fairly protective of
our, of our information, our ownpersonal biological information,
whether it's 23andMe.
You know, everyone's uploadingtheir genetics there or whole
genome sequencing that's goingon right now.
Um, you know me, I've been alittle bit leery of the whole
(10:43):
thing for a long time.
I used a pseudonym.
I used a whole other name when Idid 23andMe.
Leah (10:48):
Oh, yeah, see, and I thought like, eh, whatever.
I mean, I did mine,
Tina (10:52):
Yeah, a little paranoia isn't a horrible thing, I
suppose, when it comes to thisstuff, because what was
happening and what did happenback in time is people with
BRCA.
mutations or deletions that ledto a higher risk of breast and
ovarian cancer, they were beingdenied life insurance.
So life insurance companiesbasically said, that's a
blacklist.
If that, if that is your, risk,if your risk of breast and
(11:14):
ovarian cancer is that high,we're not going to give you a
policy.
And it was legal to do so.
So I think that always stuck inmy,
Leah (11:21):
But did that change?
You said it was legal.
Has that changed?
Tina (11:25):
I don't know, I haven't updated my knowledge on the
topic.
Leah (11:28):
Oh, we should check with, um, ChatGPT and see what they
say.
No, because I, so I startedteaching a course on medical
documentation.
And one of the things I just hadmy first class, and one of the
things I pointed out is, therewas an article that led me to
this topic where you just don'tupload patient information.
Maybe somebody needs to know howto chart, how to write an
(11:50):
assessment.
Don't upload your patientinformation to AI to write your
assessment for you.
Tina (11:57):
Oh, yeah.
Leah (11:58):
and do not put any sort of patient information on there.
I mean, it's just, I don't know.
I just, I'm not, I'm nottrusting it entirely.
Tina (12:08):
Well, and there's a big difference between open source
and closed sources of AI too.
So chat GPT is an open sourceand they say so, like anything
you upload to that is nowpublicly available.
Leah (12:19):
Anything you search for in Google is now being added
Tina (12:22):
Yeah.
It's not true of all AIs.
Some of them.
I think Adobe has AI suite that,um, is.
Reportedly private, I don'tknow.
Leah (12:31):
I don't, yeah, I, I just, you, you can ask, chat, GPT.
Can you give me?
an outline for a soap format fora soap note, and that's fine,
but don't have it, fill it inwith your patient information.
Tina (12:45):
And if you do want to look at the literature, I think my
favorite tool currently isELICIT.
E L I C I T.
It does a nice job of pulling upfrom the medical literature what
you're looking for.
So you can ask it questions andthen it gives you summaries and
data and you have columns thatyou can expand on and continue
to ask.
Leah (13:04):
well, we should ask it to come up with an integrative
treatment plan.
Tina (13:07):
Well, it's not generative like that.
It's more of an assistant.
Leah (13:11):
Okay.
Okay.
Yeah.
Once again, you know, we'regoing to soon be out of jobs
because everyone's going to be,it's the next step from Dr.
Google.
Tina (13:19):
Yeah, here's the thing.
Yeah.
It's going to be hard to teachthe art of medicine to machines.
Not impossible.
And with enough data, theyprobably could figure it out.
But there is a lot of decisionmaking that goes on when you see
any doctor, it doesn't matterwho it is, that's not completely
in black and white on somealgorithm.
It's some.
Decision making based onexperience and the individual in
(13:42):
front of them, so I don't feelthreatened by AI I think AI is a
great tool, but I've had thisconversation with a lot of
people I feel like we're justall gonna be more productive and
more creative and it's gonnafree up our brains to do better
things be more efficient
Leah (13:55):
I just think in the wrong hands of somebody who's like,
I'm just going to ask it for anintegrative treatment plan and
then having someone follow itbecause it's not taking the
whole human into account.
It's just what you put into it.
So if you're like, well, I'm apatient with, you know, kidney
cancer, but I mean, it's notlooking at your labs.
It's not looking at, how you'redoing overall, any other
(14:17):
medications that you're taking.
It's not looking at, any ofthat.
Unless you put it in, but thenare you going to know what to
put in?
Like, and then you're puttingall your personal information in
there and then what?
Tina (14:29):
yeah.
That's why it's a, it's alearning curve going on right
now.
I think we're all learning.
Leah (14:44):
Well, what did you learn in the news, Tina?
Tina (14:46):
Um, I had a couple articles of interest to me.
Um, you know, one that I wassurprised about because I was
like, I thought we put thiswhole topic to rest a while ago
was, some acne creams are foundto contain a known carcinogen.
That was the headline.
on October 8th.
what they contain is benzene,which is a very well known
(15:10):
carcinogen.
There's no doubt that benzene iscarcinogenic.
Leah (15:14):
Well, benzoyl peroxide is like what you think of for those
acne creams that we used to useback in the day.
Tina (15:20):
well, they're still being used.
Um, there was a new one approvedin 2022 with, I don't remember
it was a five or 10 percentbenzoyl peroxide.
And so benzoyl peroxide in andof itself is okay.
It's when it gets used.
Heated that it breaks down intobenzene.
And so what this study did thatthey just did a an article on
the study went to stores andpulled these acne products off
(15:44):
the shelf and One third of themhad benzene levels that are
higher than what the FDA deemssafe
Leah (15:53):
So how hot does something have to be?
Because you're, where do youstore it?
Like, are you storing it in yourbathroom?
Like, how hot and steamy doesyour bathroom get?
Tina (16:02):
That's what made this interesting to me.
They pulled them off the shelffresh and a third of them had
too much benzene.
Leah (16:07):
But we don't know, like, what the truck was.
Like, how hot the truck was thattransported it, you know?
Tina (16:14):
Exactly.
yeah.
And then after that, so if onethird is already heated to a
point of creating too muchbenzene, where does it go from
there?
Like, what are you, are we doingwith it?
Like you put it in your car,your car heats up, you're going
to have more benzene formation.
The temperature they heated upjust to see, you know, elevated
temperature to 50 degreesCelsius, which super rough math
in my head is about 130.
(16:34):
degrees Fahrenheit, so higherthan body heat, but that said,
UV radiation and warmth from thesun definitely causes the
benzene formation on the skinand And if you have a sunscreen
under it, and then you put thisacne cream on, or the other way
around, the absorption goes upby about 60%.
Leah (16:52):
Oh, because of course you're going to put sunscreen on
your face.
Tina (16:56):
Right.
Especially the newly approvedone that they just came out with
where they say they say, well,avoid the sun.
And if you can't use sunscreen,well, unfortunately that just
speeds up your absorption of thebenzene.
The reason this is surprising tome, I'll tell you why, because
this whole, this whole Benzenecausing cancers.
We know this since, I mean,benzene's been around since, I
don't know, the late 1800s.
I mean, it's not a compoundthat's mysterious to us.
(17:18):
We didn't just discover it.
1930s, we knew zero should bethe limit.
Even the petroleum industrylooked at it and said, really,
zero is the only safe amount ofbenzene So it's so well
established that it's notrefuted by anybody, not even the
chemical industry.
Right.
Right.
Um, Back in the day, I want tosay early 2000s, sodium benzoate
(17:39):
was in beverages,
Leah (17:40):
Oh, that was the like in Mountain Dew.
Tina (17:43):
all sorts of them.
Yes.
And especially if the beveragecontained any vitamin C, it led
to benzene levels that werehigher than what was considered
safe in our drinking water.
Now, if really should be whatwe're going for.
I don't know why.
I think the FDA has like, Ithink it was 0.
8 parts per million that theythink is okay.
(18:04):
Whatever.
Zero is probably what we'reshooting for.
In any case, they didn't make itagainst the law.
They just made it a voluntaryIndustrywide base knowledge to
not create drinks using sodiumbenzoate, potassium benzoate,
and any form of vitamin C.
And if you did that, you wereless likely to form benzene in
(18:24):
the can and consume the benzene.
And, and the, the big hoopla wasbecause this was a lot of drinks
that were geared towardschildren.
So these were fruit juices, forexample, in the benzoate, in the
case of the drinks or thebenzoyl peroxide in the case of
the acne cream.
It's an antimicrobial.
So that's why they're putting itin there in the first place, and
there's a lot of other ways todo that.
(18:44):
But I guess this kind ofsurprised me, this whole, acne
cream with benzene, because Ithought it was put to bed, you
know, like, let's not createproducts that lead to benzene in
our bodies.
Leah (18:55):
Um, I want to, I want to chip in because of course, like,
I don't know, uh, Celsius toFahrenheit conversion.
So I typed it in.
It's 122 degrees, which is stillhotter than the human body.
But that is.
I mean, it's gotten to 120 inPhoenix.
You know, like that.
Isn't unheard of.
You leave your bag in the carwith your acne cream and it's
(19:19):
the summer and the car gets hot.
I mean, your car can get to 130as well, but 122 degrees.
Tina (19:27):
cars get up to 150 easy all the time.
Leah (19:30):
Yeah, but I just, I, I wanted to kind of clarify that
because 130 might seem like, oh,that's so hot, but 122, you
Tina (19:38):
Yeah.
Yeah.
The rough, the rough equation Iwas using, it works better for a
temperate climates is uh, whenyou see something in Celsius,
you double it and add 30.
It's, it's usually ballpark.
Leah (19:48):
Oh, I wasn't like questioning your math.
Tina (19:50):
No, no.
I'm just telling people.
Leah (19:51):
I was just, I wanted, I wanted to know for myself
because I'm like, how does shedo this in her head?
I don't, yeah, I, I, I use, Iuse the chat GPT for that.
No, I don't.
I use Google, but um, but Ijust, I, I really, I think like
122 in my mind is more like, oh,I can see that more than 130.
I don't know why.
(20:12):
It's just the way that my brainthinks.
Tina (20:14):
And you know, here's the thing.
Benzene is So.
toxic.
So.
The reason this is interestingis because one, the FDA just
approved this acne cream with agood amount of benzoyl peroxide
in the last couple of years.
So the authors of this paperthat did the actual research
said this, this instability ofbenzoyl peroxide, the
(20:35):
instability of it at hightemperatures that leads to the
carcinogenic substance inside isanalogous.
to that Zantac.
Remember years ago, Zantac wastaken off the market because it
can contain, um, NDMA, which isa known carcinogen, and the FDA
basically said we need to pullthat off the shelf because
(20:55):
Zantac was also something thatbecame carcinogenic after heat
exposure.
So it's completely analogous tothat.
And so the authors arementioning that because what
might happen over time is, Oh,did we say that was safe?
We're going to take that off themarket now.
So heads up.
Leah (21:11):
Yeah, and I, I just quickly searched to see, I
searched for benzene and acneproducts.
And I found just a summary ofthe article that said 38 out of
111 prescription or over thecounter products contain benzene
levels above the US Food andDrug Administration limit of two
parts per million.
And so 38 products, it's notjust like one or two brands.
Tina (21:35):
No, no, that's what I'm saying.
It's a third of the products onthe shelf.
Yeah.
And it is over the counter.
I mean, the one that it's as anew drug and new prescription is
higher levels, but over thecounter amounts of benzoyl
peroxide.
Definitely.
It's just one of those things.
Look at the label.
Is it on there?
Then maybe look for somethingthat doesn't contain that.
Leah (21:53):
And they also are recommending, um, just from
glancing at the article, coldstorage.
And so it said one acne product,the newer prescription triple
combination therapy already hasa cold shipping process in
place.
They just need to continue thatat home.
Tina (22:06):
Yeah.
So how do you do cold storage onyour face?
I mean, you're going to go outinto the sun.
You're going to, going to,
Leah (22:11):
Well, no, I mean, and, and I don't, for some reason, back
when I used to use acneproducts, I thought you weren't
supposed to use it during theday.
I thought it was something youput on at night.
Tina (22:20):
it said that most of these are recommended to be used twice
a day,
Leah (22:24):
Oh, really?
Tina (22:25):
once to twice a day.
Leah (22:26):
I mean, it used to be like that.
you know, white kind of color,so it's not like something, you
know, when you would kind of tryto blend it over your pimple,
you'd have like that white cast,like you're using zinc or
something.
So it wasn't really somethingthat people liked to use
Tina (22:39):
Yeah.
Yeah.
And there's a lot of reasons foracne to happen and it's not what
our topic of discussion, but um,high sugar in the diet
definitely makes it worse asdoes hormonal imbalances.
And so couple of things,
Leah (22:52):
And I found, um, people who have low Omega threes in
their diet as well, likeincreasing more Omega three
foods also seems to help.
But yeah, um, be kind to yourgut bugs and they'll be kind to
your skin.
Tina (23:05):
Yeah, it's a real issue for some folks, I mean, I do
feel for them if this is allthat has been working, but be
mindful, cold storage.
They have those little tinyrefrigerators now.
Have you seen those?
They're always like on Facebookand stuff.
They're like itty bitty things.
Leah (23:19):
in your bathroom, just have your, you know, you could,
you can have your, your nonsodium benzoate soda in there
next to your non benzenecontaining acne cream in your
bathroom waiting for you.
Tina (23:32):
I think they are calling them makeup refrigerators or
something like that.
Leah (23:35):
Really?
You're going to make me Googlethis makeup.
It's for your makeup.
Tina (23:41):
Yeah.
They're little tiny things.
They're like smaller than abackpack.
Leah (23:44):
Okay.
What's your other story, Tina?
Tina (23:47):
Oh, my other story.
Leah (23:48):
As I Google makeup refrigerator.
Tina (23:52):
My other story was something that caught my eye and
it was, An article on bacteriain the mouth, triggering head
and neck cancer.
this had to do with themicrobiome of the mouth and
keeping it healthy.
it was a pretty large study.
It was, uh, 160, 000 Americansfrom across the country.
(24:13):
And they were looking atvarious, lifestyle factors for
head and neck cancer.
And what they found was.
there was what they calledcompelling evidence that oral
bacteria are a risk factor forhead and neck squamous cell
carcinoma development.
Um, Their whole take home pointin my mind, the take home point
is to make sure that your oralcare is very good and that
(24:33):
you're not eating lots of sugar,that you're brushing your teeth,
that you're taking care of yourmouth.
That's probably the best we cando.
They didn't mention HPV that Iknow of.
I couldn't get the full article.
I just have the summaries andthe PR releases.
They didn't mention HPV and nowWhen I think of a biome, I think
(24:54):
of bacteria, archaea, andviruses, right?
Like, they're all livingtogether, like the ecosystem in
a forest.
You have all these differenttypes, um, of organisms.
So I don't know if this createsa permissive environment for
HPV, which we know HPV isdefinitely related to head and
(25:14):
neck cancers, HPV, humanpapillomavirus is clearly
related and that wasn't talkedabout.
They just talked about thebacterial species and how 13
oral bacteria were found to beassociated with the development
of these cancers.
So I just thought that wasinteresting.
Leah (25:31):
oh no, for sure.
And it, you know, like as we'relearning more about the
microbiome in general, like itkind of makes sense.
What I'm really curious about iswhat is the effect of using
mouthwashes?
You know, using like amouthwash, like how is that
adversely affecting your oralmicrobiome?
Tina (25:50):
That is a good question.
Leah (25:51):
You know, and obviously we're not dentists, so we're not
gonna really, know the answer tothat, but The other thing is a
tidbit and I don't know if I'veever mentioned this before but
somewhere I should find outwhere Somewhere I read that it's
not a good idea to brush yourteeth right after you eat like
to wait like 15 minutes I thinkthose 15 minutes or so because
(26:15):
of I don't know if it was likethe pH Levels in your mouth or
something, but you couldactually do more harm to the
enamel if you brush your teethright away So I'll try to look
that up and I will see if I canfind it But that was something
that I thought was reallyinteresting
Tina (26:31):
I've never heard that.
Leah (26:32):
Because I'm not one to like immediately.
I might immediately like flossmy teeth, but I'm not gonna
immediately brush my teeth
Tina (26:38):
Like keep your toothbrush and toothpaste in a holster.
And as soon as you're done, whipthem out.
Leah (26:44):
Well, I mean I remember kids at school, especially the
kids with braces They would goto school with their you know,
Tina (26:49):
Sure.
If you have braces
Leah (26:52):
yeah, but you could swish maybe just with water.
I don't know I never had braces
Tina (26:55):
or just don't smile for 20 minutes.
Leah (26:57):
Just don't smile for 20 minutes.
Tina (27:00):
Okay.
So I'm going to tell yousomething that's totally, um,
conjecture, but I kind of wonderwhen it comes to teeth health.
One of the reasons that we eatberries and anything that has
the color of nature, whatevercolor we're talking about,
especially the reds and theblues um, I kind of wonder if
one of their jobs in our mouthsis to make sure we don't get the
(27:21):
walled off biofilms of the badbacteria.
So a biofilm is basically acovering of sorts that protects
colonies or communities ofbacteria and those communities
can sometimes be pathogenic orcause cavities that kind of
thing My thought is, because weknow these plants contain
proanthocyanidins andbioflavonoids that break down
(27:43):
biofilms, I wonder if one of thebenefits that we don't talk
about enough is creating abetter biome in our mouth
because we chew these foods.
That's totally speculative.
But that's one of the things Ithink about when I'm brushing my
teeth and I, I know that there'spieces of blueberry in my teeth.
I'm like, well, it could beworse.
Leah (28:01):
I'm feeding my microbiome.
Okay.
So I found, I found it.
I had a look there like Colgateand Sensodyne had it on their
site too.
But, um, Columbia UniversityIrving Medical Center says that
it is recommended to hold off onbrushing, after consuming
anything acidic, whether it'sfruit, soda, juice, or sour
candy, because it weakens theenamel of the tooth.
(28:23):
And so they're recommendingwaiting about 30 minutes.
Whereas the toothpaste sitesrecommended 60 minutes
Tina (28:29):
Wait, wait, wait, wait.
So your mouth is acidic.
They're saying, don't gobrushing your teeth.
Leah (28:34):
right after having something that is more acidic.
Tina (28:37):
Whoa.
You would think that it'd be theopposite, that you should go
brush your teeth.
Like, what if your toothpastehas some bicarb in it?
Like it's.
Arm and hammer.
Leah (28:45):
I don't know.
I'm not, you know, talk, talk toColgate
Tina (28:48):
right.
We got to get a dentist on here.
This is,
Leah (28:49):
Yeah, no.
It says to use soft bristles andto wait.
Oh, it says, I always recommendrinsing with or drinking water,
which starts theremineralization process of the
enamel.
So.
Tina (29:01):
All right.
I have a question.
Leah (29:03):
What's the acidity level of your mouth?
Tina (29:06):
It should be, it should be just slightly acidic, if at all.
6.
5 to 7 point something.
Leah (29:11):
Okay, so if you drink a soda, what's it, what's the
acidity of a soda?
Tina (29:16):
Almost everything we drink is acidic.
Very few things are not acidic.
Soda, soda pop is down there.
Like if it's a Pepsi, it's waydown there, you know.
That's why you can, that's whywe can clean a battery, all that
corrosion with Coca Cola,because it's so acidic.
It's got the phosphoric acid init.
So I'm gonna guess, and you cantell me if I'm right.
Ready?
pH is gonna be between, It'sgonna be three, give or take.
(29:38):
Three to four.
For, for, wait, soda pops, it'sgonna be lower.
And for juices, four, give ortake.
Four or five.
Leah (29:45):
Coca Cola regular has the lowest pH of 2.
5 compared to other carbonatedor fruit beverages.
Tina (29:53):
Which is why you can't clean your battery with Sprite.
That phosphoric acid, by theway, and this acidic nature of
all of the soda pops withphosphoric acids in them, is the
reason that they're horrible forour bone health.
Because when you drinkphosphoric acid, Your body has
to buffer that phosphorus withsomething, and it prefers to do
(30:13):
it with calcium and your storageof calcium is your bone.
And so you'll, you'll find thecalcium.
You'll just pull it right out ofyour bone if you need to, and
then you'll buffer thatphosphoric acid you just drank.
Definitely makes the drink lessappealing, right?
How about juices?
Leah (30:25):
Oh, she says, I don't know, I just, so the golden
number for pH in your mouthshould be 5.
6 or above.
Tina (30:31):
Oh, 5.
6 is too acidic.
That's crazy acidic for saliva.
Leah (30:36):
So saliva has a pH normal range of 6.
2 to 7.
6, with 6.
7 being the average.
I'm just grabbing this fromquick searches.
Tina (30:44):
Okay, well, no, I'll agree with that.
I'll agree with those numbers.
Leah (30:47):
Okay.
Tina (30:48):
So, when I was a resident, and I would do weekly lectures
to patients and their families,we handed out pH paper on a
regular basis.
to the patients and theircaregivers.
And you know, sometimes it was10 people, sometimes it was 30
people, but kind of did thiscause I was a resident and it'd
be an interesting experiment.
And we would check saliva, havepeople drink a little bit of
(31:08):
water first, swish it around,sit there for a little bit,
check their saliva.
And I am here to tell you thatpeople with cancer definitely
had lower pH in their mouth.
active cancer.
Not shocking because canceritself creates acid.
It creates an acidic environmentand your body has to shed that
and it sheds it through yoursaliva.
It sheds it through your urine.
So yeah, the pH changesaccording to your physiology.
(31:29):
It's not just about your mouth,it's about your whole body.
Leah (31:32):
Well, there's this interesting, article from Loma
Linda University.
That about the key tomaintaining proper pH balance in
your mouth, so I will post alink to that, too.
Because that's the one where Igot the 5.
6 is ideal and it talks abouthow the changes after you eat
the Mineralization of the enamelall that stuff.
So I will include these links.
(31:52):
I will keep them on my phone
Tina (31:54):
I have a question for our listeners.
Does anyone know?
I have heard.
I didn't see this.
I haven't experienced it and Ihave visited Italy, but I have
heard that it is tradition toend the meal with a bit of
cheese, hard cheese.
And if that's true, I alwaysthought, well, maybe that is
helpful for their teeth becausethey're doing a calcium source.
Leah (32:14):
I think there are a number of European countries where the
dessert isn't sweet where it'sit's cheese, but
Tina (32:20):
That's interesting.
Leah (32:21):
I don't know, I don't know what the reason behind that is,
but yeah, no, I mean, and Ithink, you know, if you are able
to tolerate cheese, I thinkhaving it at the beginning,
middle and end of a meal is agood thing.
Because it's good.
But yeah, because I do rememberpeople, you know, posting things
about like being surprised thatat the end of a meal, they
(32:43):
didn't get a dessert.
They got a cheese plate orsomething.
I
Tina (32:46):
Mm hmm.
Yeah.
Yeah.
Like a little cheese plate.
Yeah.
Leah (32:49):
yeah, I think it is common in certain European countries.
Tina (32:51):
Anyways, maybe there are listeners who, you know, only 80
percent of our listeners are inNorth America.
20 percent are from Europe,Australia, et cetera.
So
Leah (32:58):
They can, they can send us a message and let us know.
Tina (33:01):
I figure people know more than I do about it.
Yeah.
Leah (33:03):
I think what they should do is go to our website and
click that little microphoneicon and leave us a message and
you know, talk to us about whatkind of cheeses do you have for
dessert.
Talk to me about cheese.
Tina (33:16):
Or what's the customary thing to do after a meal in
certain countries?
I mean, I think having dessertthat is sweet is not a good
idea, but that is what we areaccustomed to here.
Leah (33:26):
I know, but ever since I started having, hot flashes I'm
a big fan of having that dessertbefore a meal.
Well, or not, you know, likehaving it with lunch or
something earlier in the day.
So I don't like wake up withnight sweats.
Tina (33:42):
yeah.
So you're saying if you have asugar too late in the night.
Leah (33:45):
Oh, it's, it's not just me.
It is a very common cause of, ofnight sweats and of waking up in
the middle of the night.
So yeah, keep that sugar as anafternoon delight, as they say.
Tina (33:58):
there you go.
Afternoon delight.
Leah (34:03):
Anything else besides people going to our, our, our
website and hitting that recordbutton and leaving, leave us a
message.
I'm really surprised we haven'tgotten any voice messages.
Tina (34:12):
We did get one from Moses, but we haven't replayed it.
Sorry, Moses.
Leah (34:16):
So
Tina (34:17):
We got to just get coordinated to put it within our
recording here.
I
Leah (34:21):
maybe if we edit this, we will.
If we edit this.
Oh, we're editing this.
Tina (34:26):
was going to say, if here,
Leah (34:29):
When we edit this, we will add in Moses and his message.
Tina (34:34):
I'll tee it up.
Ready?
Here's Moses.
Leah (34:46):
That was awesome.
Thanks, Moses.
Tina (34:49):
Yes.
Thanks for taking the time.
But yeah, I would love to hearfrom more folks who are
listening, because I can see thestaff.
I can't see who you are.
I can see where people are.
I can see how long they listen.
Um, and we do have quite a fewlisteners around the world, like
I mentioned, so I'm, I'm excitedto engage more, which we need to
talk about.
We're going to be launching ourengagement soon.
Leah (35:08):
Not that we're engaged.
Tina (35:09):
Oh, Jesus.
Leah (35:11):
What do you mean our engagement?
Tina (35:13):
Oh, our, our listener engagement tools.
Yeah.
Yeah.
Leah (35:17):
Oh, like the membership?
Tina (35:17):
Yeah,
Leah (35:18):
Okay.
Tina, I'm
Tina (35:21):
Yeah, I love your layup, but not like that.
Leah (35:25):
I have to bring it to my husband.
So, um, yeah, and if you've madeit this far, today's episode,
please head on over to buy me acoffee, and,
Tina (35:37):
We'll buy you a coffee if you made it this far.
Leah (35:40):
this is, this is not advertising supported, as you
can tell.
This is supported by us.
This is total grassroots, and,Anything that we get from buy me
a coffee goes towards keepingthis a finely tuned machine that
it is.
Tina (35:56):
That's right.
That's right.
We are in season four.
So
Leah (36:00):
That's crazy.
Yeah, that's, that's wild.
Tina (36:03):
yeah, but I will, I'm happy to say we were finally
getting some love from Apple.
We're finally in the standingswhen you put in the word cancer
in your search and you'll,you'll see us there in the, in
the top 20, which is sayingsomething.
And there's over 3 millionpodcasts out there.
Available.
So, keep listening.
Leah (36:19):
Yay team! Go team! So on that note, I'm Dr.
Leia Sherman
Tina (36:26):
And I'm Dr.
Tina Kaczor.
Leah (36:28):
and this is the Cancer Pod.
Tina (36:29):
Until next time.
Leah (36:30):
Thanks for listening to The Cancer Pod.
Remember to subscribe, review,and rate us wherever you get
your podcasts.
Follow us on social media forupdates.
And as always, this is notmedical advice.
These are our opinions.
Talk to your doctor beforechanging anything related to
your treatment plan.
The Cancer Pod is hosted by me,Dr.
Leah Sherman, and by Dr.
(36:51):
Tina Kazer.
Music is by Kevin MacLeod.
See you next time.
ever since I started having hot flashes, I'm a big
fan of having that dessertbefore a meal.
Well, or not, you know, likehaving it with lunch or
something earlier in the day.
So I don't like wake up withnight sweats.
Tina (00:15):
yeah.
So you're saying if you have asugar too late in the night.
Leah (00:18):
Oh, it's, it's not just me.
It is a very common cause of, ofnight sweats and of waking up in
the middle of the night.
So yeah, keep that sugar as anafternoon delight, as they say.
Tina (00:31):
there you go.
Afternoon delight.
I'm Dr Tina Kaczor and as Leahlikes to say I'm the science-y
one
Leah (00:39):
and I'm Dr Leah Sherman and on the cancer inside
Tina (00:42):
And we're two naturopathic doctors who practice integrative
cancer care
Leah (00:47):
But we're not your doctors
Tina (00:49):
This is for education entertainment and informational
purposes only do not apply anyof this information
Leah (00:55):
without first speaking to your doctor
Tina (00:57):
The views and opinions expressed on this podcast by the
hosts and their guests aresolely their own
Leah (01:04):
Welcome to the cancer pod Tina,
Tina (01:23):
Leia,
Leah (01:23):
I think we're about to be replaced.
Tina (01:26):
what do you mean?
Leah (01:27):
I saw this article in Cure Today about somebody who entered
in some other medicalinformation to AI to CHAT GBT,
and CHAT GBT came up with theirintegrative treatment plan.
Tina (01:40):
Get out.
Leah (01:41):
No, I'm serious.
I sent, I forwarded you thearticle.
I don't think you've had achance to look at it yet.
Um, it asks, okay, so the personsays, I asked chat GPT to build
me a treatment plan forintegrative and Western oncology
based on me and my diagnoses.
It built me a side by side chartshowing me different options.
Tina (01:58):
Whoa.
Was it any good?
Did you get to see the chart?
Leah (02:02):
Yeah, no, it's right here.
Like it's, it has the chart andit has the integrative oncology
treatments, the Western medicaltreatments.
And then this person has, two.
Synchronous cancers and yeah, itdoesn't show the full thing, but
it has Western medicaltreatments as you know, one
column.
Tina (02:18):
Does it tell, does it tell the person where they got the
information from?
I mean, is chat GPT just usingthe entire web or is it going to
a reliable source?
Leah (02:26):
I don't know.
I don't know.
Uh, cause it doesn't show thefull chart or there's no little
asterisk or number next toanything.
When I've looked things up inchat GPT, and I've asked for
references, like I've asked forit to write something and I've
asked for references.
And then I go back and look atthe references.
They don't actually exist.
(02:46):
Like it makes up references.
And then I called ChatGPT out onit and it said, Oh no, we're
just providing ideas.
Tina (02:54):
So yeah, well, you know, I've been using a lot of AI for
research, right?
All sorts of perplexity,illicit.
I've got like a bunch of them.
Gemini.
by Google, is now telling youwhere it got the information.
So that's impressive.
It's actually giving you, like,we sourced this from, and it'll
give you a citation.
Leah (03:12):
Oh, I see that when you do like, I hate when I do a Google
search and then the AI comes upfirst, but it does.
There's like a little link nextto it.
And if you click the link,sometimes their little summary
is not exactly what the linksays.
And that's so dangerous.
Tina (03:27):
that's exactly what I was going to say about this whole
treatment plan.
I was like, well, how is someonewho isn't a medical oncologist
or a naturopathic oncologist orwhatever, who's not familiar
with the material, how is thatgoing to be checked to make sure
that it's accurate?
So, for example, like, what didthey say for this person to eat
and what was their diagnosis?
(03:47):
Yeah.
Leah (03:47):
So, okay, so they have a pancreatic NET, neuroendocrine
tumor, and it has their Westernmedical treatments.
And then for their integrativeoncology treatments, it says
ketogenic diet, herbal supportwith turmeric and ashwagandha,
acupuncture for symptom relief.
For their renal cell carcinoma,it says mind body practices,
(04:09):
reishi mushroom and green teaextract.
So it's pretty like.
Tina (04:13):
Okay.
I'm just going to weigh in rightaway.
Ketogenic diet It's a high fatdiet, ketogenic, no matter how
else you eat, you know, if youeat a vegan ketogenic or a meat
heavy ketogenic, either way,it's going to be 70 percent or
more of your calories from fat.
And if your pancreas is involvedin your diagnosis or your cancer
or any other condition, yourpancreas could be compromised.
(04:36):
The function of the pancreas isto secrete which is the enzyme
that breaks down fats.
So, you'd have to be under thecare of somebody, a
nutritionist, dietitian, who isextremely familiar with what you
would actually be able totolerate without putting a
burden on your pancreas, yourgallbladder, your liver,
Leah (04:56):
and from what I recall, patients with neuroendocrine
tumors tend to have diarrhea.
Tina (05:03):
depending, yes, what the neuroendocrine tumor is
secreting.
So the most common secretion isserotonin and serotonin will
lead to diarrhea,
Leah (05:10):
And so doing a high fat diet in someone who is
experiencing a lot of diarrheajust kind of seems like, eh,
maybe not the best idea.
Tina (05:19):
right?
So there's a lot of nuances thatgo into medicine and medical
decision making that I don'tknow.
I mean, eventually I'm sure AIcould do it if it was fed the
right source material, right?
So AI is only as good as itssource feeds.
And so is it.
Getting its sources from theNCCN guidelines for the medical
oncology part, for the actualtreatment part.
(05:41):
If so, then that's a good sourcefeed.
So, chat GPT is probably justnot right, the right AI to use.
It's too broad in its sourcefeeds.
Um, but I do think AI is aphenomenal tool for us.
I mean, I have been able to doresearch on topics with
citations looking through justMEDLINE so fast and so much more
(06:06):
information and just cut to thechase.
You know, what might take me aweek before I could do it in an
afternoon easily.
Leah (06:12):
I I mean I use it for outlines, Like if I need to
write a blog for a certainpodcast, I'll use it to just
kind of give me like aframework, and then I go in and
edit it and make it sound like ahuman wrote it.
And then if I have any sort ofreferences, I make sure that
they are actual references, andthey're not like these fake
(06:34):
ones.
But I just think it's, I don'tknow.
Okay, so let me go on.
Yeah, I think that mind bodypractices meditation yoga.
I mean, I think that's likepretty, it's great, but it's
pretty vague.
It's not really specific torenal cell carcinoma.
It's kind of good for everybody.
Um, so, uh, the person has livermetastasis.
And so the recommendation ismilk thistle for liver support.
(06:56):
and plant based diet.
So it's interesting because it'snot taking all of these
diagnoses and creating a plan.
It's doing one for each one.
So a plant based diet and aketogenic diet may be,
Tina (07:08):
challenging to get everything you need to get in a
day.
Leah (07:11):
Okay, so for pain and fatigue management, acupuncture
for pain, essential oils,lavender and peppermint are
recommended, and then reiki forfatigue.
So it's kind of vague.
Tina (07:21):
That's its whole program for integrative medicine.
Leah (07:23):
This is what I'm getting so far.
And it's like I said, not thewhole thing's listed, uh, immune
support.
We see adaptogens andnutritional support, and it
lists three vitamins.
vitamins D, C, and E.
There isn't any sort of linkicon or anything after this.
So I don't know where it'sgetting its information,
Tina (07:41):
Yeah.
Yeah.
Leah (07:42):
I don't, I don't know.
And I think this person wasprobably, I'm guessing, doing it
more for fun.
than anything else.
But I'd like to think therearen't people out there getting
actual medical advice fromChatGBT or AI.
Tina (07:57):
No.
And again, I mean, I think chatGPT is too broad and too
inclusive of all opinions outthere that it's being fed.
It could be fed nonsense, forall we know, but if you can
source feed in an AI is just sayonly use the following websites
and then use cancer.
net as the ASCO patient facing,site or, you know, various, like
(08:23):
what SIO, the Society ofIntegrative Oncology has some
really nice papers onintegrating safely.
So I guess controlling thesource feeds and then double
checking the answers would bethe only way to use it.
Leah (08:36):
With a human.
Yeah, but, but not doublechecking yourself.
Double checking with a human whoknows what they're talking
about.
Tina (08:43):
Yeah.
Yeah.
Which is basically what I dowhen I do research, right?
Like, I look up papers, I'll doa bunch of papers, I'll write
them all down, and then I'll goback to the actual citations.
I won't, I will never read aline and assume the citation
that they leave there iscorrect.
I go back to the actual originalpaper and say, is that what that
paper actually said?
You'd be surprised how often itdoesn't say what they just
(09:03):
interpreted it as saying.
Leah (09:05):
I know, but not everybody's as thorough as you
are, Tina.
I
Tina (09:08):
No, but that's, I
Leah (09:08):
like that's, but that's, and that's a big problem is
people will take it for facevalue.
They'll be like, well, this iswhat was compiled.
Um, I don't know, that's the, Ijust thought that was really,
um, kind of interesting.
Tina (09:19):
Yeah.
I think the use of AI to get usto the primary source is really
useful.
Instead of me finding a reviewpaper, finding the papers within
the review papers that I'minterested in going to those
papers and then going all theway, you know, I'm, I'm always
swimming upstream to the sourceof the material.
Leah (09:36):
that, that was my methodology, was finding,
finding a review paper, and thengoing to the other papers
within.
I was like, oh, they did allthe, they did all the legwork.
I'm good with that.
I'm, at this moment in time, onthis date, in this year, I am
fine doing that.
I'm not comfortable with WithAI, what I also thought was
(09:57):
interesting is this personvoluntarily uploaded their, um,
their imaging results
Tina (10:03):
Hmm.
Yeah,
Leah (10:06):
GPT for like them to translate it to human to human,
you know, to more lay speak.
Tina (10:16):
to the mere mortals.
Leah (10:18):
Which I think is interesting, but at the same
time, like, I don't know.
Tina (10:23):
Well I think that does bring up a whole other facet to
this, and that is, I think weshould be fairly protective of
our, of our information, our ownpersonal biological information,
whether it's 23andMe.
You know, everyone's uploadingtheir genetics there or whole
genome sequencing that's goingon right now.
Um, you know me, I've been alittle bit leery of the whole
(10:43):
thing for a long time.
I used a pseudonym.
I used a whole other name when Idid 23andMe.
Leah (10:48):
Oh, yeah, see, and I thought like, eh, whatever.
I mean, I did mine,
Tina (10:52):
Yeah, a little paranoia isn't a horrible thing, I
suppose, when it comes to thisstuff, because what was
happening and what did happenback in time is people with
BRCA.
mutations or deletions that ledto a higher risk of breast and
ovarian cancer, they were beingdenied life insurance.
So life insurance companiesbasically said, that's a
blacklist.
If that, if that is your, risk,if your risk of breast and
(11:14):
ovarian cancer is that high,we're not going to give you a
policy.
And it was legal to do so.
So I think that always stuck inmy,
Leah (11:21):
But did that change?
You said it was legal.
Has that changed?
Tina (11:25):
I don't know, I haven't updated my knowledge on the
topic.
Leah (11:28):
Oh, we should check with, um, ChatGPT and see what they
say.
No, because I, so I startedteaching a course on medical
documentation.
And one of the things I just hadmy first class, and one of the
things I pointed out is, therewas an article that led me to
this topic where you just don'tupload patient information.
Maybe somebody needs to know howto chart, how to write an
(11:50):
assessment.
Don't upload your patientinformation to AI to write your
assessment for you.
Tina (11:57):
Oh, yeah.
Leah (11:58):
and do not put any sort of patient information on there.
I mean, it's just, I don't know.
I just, I'm not, I'm nottrusting it entirely.
Tina (12:08):
Well, and there's a big difference between open source
and closed sources of AI too.
So chat GPT is an open sourceand they say so, like anything
you upload to that is nowpublicly available.
Leah (12:19):
Anything you search for in Google is now being added
Tina (12:22):
Yeah.
It's not true of all AIs.
Some of them.
I think Adobe has AI suite that,um, is.
Reportedly private, I don'tknow.
Leah (12:31):
I don't, yeah, I, I just, you, you can ask, chat, GPT.
Can you give me?
an outline for a soap format fora soap note, and that's fine,
but don't have it, fill it inwith your patient information.
Tina (12:45):
And if you do want to look at the literature, I think my
favorite tool currently isELICIT.
E L I C I T.
It does a nice job of pulling upfrom the medical literature what
you're looking for.
So you can ask it questions andthen it gives you summaries and
data and you have columns thatyou can expand on and continue
to ask.
Leah (13:04):
well, we should ask it to come up with an integrative
treatment plan.
Tina (13:07):
Well, it's not generative like that.
It's more of an assistant.
Leah (13:11):
Okay.
Okay.
Yeah.
Once again, you know, we'regoing to soon be out of jobs
because everyone's going to be,it's the next step from Dr.
Google.
Tina (13:19):
Yeah, here's the thing.
Yeah.
It's going to be hard to teachthe art of medicine to machines.
Not impossible.
And with enough data, theyprobably could figure it out.
But there is a lot of decisionmaking that goes on when you see
any doctor, it doesn't matterwho it is, that's not completely
in black and white on somealgorithm.
It's some.
Decision making based onexperience and the individual in
(13:42):
front of them, so I don't feelthreatened by AI I think AI is a
great tool, but I've had thisconversation with a lot of
people I feel like we're justall gonna be more productive and
more creative and it's gonnafree up our brains to do better
things be more efficient
Leah (13:55):
I just think in the wrong hands of somebody who's like,
I'm just going to ask it for anintegrative treatment plan and
then having someone follow itbecause it's not taking the
whole human into account.
It's just what you put into it.
So if you're like, well, I'm apatient with, you know, kidney
cancer, but I mean, it's notlooking at your labs.
It's not looking at, how you'redoing overall, any other
(14:17):
medications that you're taking.
It's not looking at, any ofthat.
Unless you put it in, but thenare you going to know what to
put in?
Like, and then you're puttingall your personal information in
there and then what?
Tina (14:29):
yeah.
That's why it's a, it's alearning curve going on right
now.
I think we're all learning.
Leah (14:44):
Well, what did you learn in the news, Tina?
Tina (14:46):
Um, I had a couple articles of interest to me.
Um, you know, one that I wassurprised about because I was
like, I thought we put thiswhole topic to rest a while ago
was, some acne creams are foundto contain a known carcinogen.
That was the headline.
on October 8th.
what they contain is benzene,which is a very well known
(15:10):
carcinogen.
There's no doubt that benzene iscarcinogenic.
Leah (15:14):
Well, benzoyl peroxide is like what you think of for those
acne creams that we used to useback in the day.
Tina (15:20):
well, they're still being used.
Um, there was a new one approvedin 2022 with, I don't remember
it was a five or 10 percentbenzoyl peroxide.
And so benzoyl peroxide in andof itself is okay.
It's when it gets used.
Heated that it breaks down intobenzene.
And so what this study did thatthey just did a an article on
the study went to stores andpulled these acne products off
(15:44):
the shelf and One third of themhad benzene levels that are
higher than what the FDA deemssafe
Leah (15:53):
So how hot does something have to be?
Because you're, where do youstore it?
Like, are you storing it in yourbathroom?
Like, how hot and steamy doesyour bathroom get?
Tina (16:02):
That's what made this interesting to me.
They pulled them off the shelffresh and a third of them had
too much benzene.
Leah (16:07):
But we don't know, like, what the truck was.
Like, how hot the truck was thattransported it, you know?
Tina (16:14):
Exactly.
yeah.
And then after that, so if onethird is already heated to a
point of creating too muchbenzene, where does it go from
there?
Like, what are you, are we doingwith it?
Like you put it in your car,your car heats up, you're going
to have more benzene formation.
The temperature they heated upjust to see, you know, elevated
temperature to 50 degreesCelsius, which super rough math
in my head is about 130.
(16:34):
degrees Fahrenheit, so higherthan body heat, but that said,
UV radiation and warmth from thesun definitely causes the
benzene formation on the skinand And if you have a sunscreen
under it, and then you put thisacne cream on, or the other way
around, the absorption goes upby about 60%.
Leah (16:52):
Oh, because of course you're going to put sunscreen on
your face.
Tina (16:56):
Right.
Especially the newly approvedone that they just came out with
where they say they say, well,avoid the sun.
And if you can't use sunscreen,well, unfortunately that just
speeds up your absorption of thebenzene.
The reason this is surprising tome, I'll tell you why, because
this whole, this whole Benzenecausing cancers.
We know this since, I mean,benzene's been around since, I
don't know, the late 1800s.
I mean, it's not a compoundthat's mysterious to us.
(17:18):
We didn't just discover it.
1930s, we knew zero should bethe limit.
Even the petroleum industrylooked at it and said, really,
zero is the only safe amount ofbenzene So it's so well
established that it's notrefuted by anybody, not even the
chemical industry.
Right.
Right.
Um, Back in the day, I want tosay early 2000s, sodium benzoate
(17:39):
was in beverages,
Leah (17:40):
Oh, that was the like in Mountain Dew.
Tina (17:43):
all sorts of them.
Yes.
And especially if the beveragecontained any vitamin C, it led
to benzene levels that werehigher than what was considered
safe in our drinking water.
Now, if really should be whatwe're going for.
I don't know why.
I think the FDA has like, Ithink it was 0.
8 parts per million that theythink is okay.
(18:04):
Whatever.
Zero is probably what we'reshooting for.
In any case, they didn't make itagainst the law.
They just made it a voluntaryIndustrywide base knowledge to
not create drinks using sodiumbenzoate, potassium benzoate,
and any form of vitamin C.
And if you did that, you wereless likely to form benzene in
(18:24):
the can and consume the benzene.
And, and the, the big hoopla wasbecause this was a lot of drinks
that were geared towardschildren.
So these were fruit juices, forexample, in the benzoate, in the
case of the drinks or thebenzoyl peroxide in the case of
the acne cream.
It's an antimicrobial.
So that's why they're putting itin there in the first place, and
there's a lot of other ways todo that.
(18:44):
But I guess this kind ofsurprised me, this whole, acne
cream with benzene, because Ithought it was put to bed, you
know, like, let's not createproducts that lead to benzene in
our bodies.
Leah (18:55):
Um, I want to, I want to chip in because of course, like,
I don't know, uh, Celsius toFahrenheit conversion.
So I typed it in.
It's 122 degrees, which is stillhotter than the human body.
But that is.
I mean, it's gotten to 120 inPhoenix.
You know, like that.
Isn't unheard of.
You leave your bag in the carwith your acne cream and it's
(19:19):
the summer and the car gets hot.
I mean, your car can get to 130as well, but 122 degrees.
Tina (19:27):
cars get up to 150 easy all the time.
Leah (19:30):
Yeah, but I just, I, I wanted to kind of clarify that
because 130 might seem like, oh,that's so hot, but 122, you
Tina (19:38):
Yeah.
Yeah.
The rough, the rough equation Iwas using, it works better for a
temperate climates is uh, whenyou see something in Celsius,
you double it and add 30.
It's, it's usually ballpark.
Leah (19:48):
Oh, I wasn't like questioning your math.
Tina (19:50):
No, no.
I'm just telling people.
Leah (19:51):
I was just, I wanted, I wanted to know for myself
because I'm like, how does shedo this in her head?
I don't, yeah, I, I, I use, Iuse the chat GPT for that.
No, I don't.
I use Google, but um, but Ijust, I, I really, I think like
122 in my mind is more like, oh,I can see that more than 130.
I don't know why.
(20:12):
It's just the way that my brainthinks.
Tina (20:14):
And you know, here's the thing.
Benzene is So.
toxic.
So.
The reason this is interestingis because one, the FDA just
approved this acne cream with agood amount of benzoyl peroxide
in the last couple of years.
So the authors of this paperthat did the actual research
said this, this instability ofbenzoyl peroxide, the
(20:35):
instability of it at hightemperatures that leads to the
carcinogenic substance inside isanalogous.
to that Zantac.
Remember years ago, Zantac wastaken off the market because it
can contain, um, NDMA, which isa known carcinogen, and the FDA
basically said we need to pullthat off the shelf because
(20:55):
Zantac was also something thatbecame carcinogenic after heat
exposure.
So it's completely analogous tothat.
And so the authors arementioning that because what
might happen over time is, Oh,did we say that was safe?
We're going to take that off themarket now.
So heads up.
Leah (21:11):
Yeah, and I, I just quickly searched to see, I
searched for benzene and acneproducts.
And I found just a summary ofthe article that said 38 out of
111 prescription or over thecounter products contain benzene
levels above the US Food andDrug Administration limit of two
parts per million.
And so 38 products, it's notjust like one or two brands.
Tina (21:35):
No, no, that's what I'm saying.
It's a third of the products onthe shelf.
Yeah.
And it is over the counter.
I mean, the one that it's as anew drug and new prescription is
higher levels, but over thecounter amounts of benzoyl
peroxide.
Definitely.
It's just one of those things.
Look at the label.
Is it on there?
Then maybe look for somethingthat doesn't contain that.
Leah (21:53):
And they also are recommending, um, just from
glancing at the article, coldstorage.
And so it said one acne product,the newer prescription triple
combination therapy already hasa cold shipping process in
place.
They just need to continue thatat home.
Tina (22:06):
Yeah.
So how do you do cold storage onyour face?
I mean, you're going to go outinto the sun.
You're going to, going to,
Leah (22:11):
Well, no, I mean, and, and I don't, for some reason, back
when I used to use acneproducts, I thought you weren't
supposed to use it during theday.
I thought it was something youput on at night.
Tina (22:20):
it said that most of these are recommended to be used twice
a day,
Leah (22:24):
Oh, really?
Tina (22:25):
once to twice a day.
Leah (22:26):
I mean, it used to be like that.
you know, white kind of color,so it's not like something, you
know, when you would kind of tryto blend it over your pimple,
you'd have like that white cast,like you're using zinc or
something.
So it wasn't really somethingthat people liked to use
Tina (22:39):
Yeah.
Yeah.
And there's a lot of reasons foracne to happen and it's not what
our topic of discussion, but um,high sugar in the diet
definitely makes it worse asdoes hormonal imbalances.
And so couple of things,
Leah (22:52):
And I found, um, people who have low Omega threes in
their diet as well, likeincreasing more Omega three
foods also seems to help.
But yeah, um, be kind to yourgut bugs and they'll be kind to
your skin.
Tina (23:05):
Yeah, it's a real issue for some folks, I mean, I do
feel for them if this is allthat has been working, but be
mindful, cold storage.
They have those little tinyrefrigerators now.
Have you seen those?
They're always like on Facebookand stuff.
They're like itty bitty things.
Leah (23:19):
in your bathroom, just have your, you know, you could,
you can have your, your nonsodium benzoate soda in there
next to your non benzenecontaining acne cream in your
bathroom waiting for you.
Tina (23:32):
I think they are calling them makeup refrigerators or
something like that.
Leah (23:35):
Really?
You're going to make me Googlethis makeup.
It's for your makeup.
Tina (23:41):
Yeah.
They're little tiny things.
They're like smaller than abackpack.
Leah (23:44):
Okay.
What's your other story, Tina?
Tina (23:47):
Oh, my other story.
Leah (23:48):
As I Google makeup refrigerator.
Tina (23:52):
My other story was something that caught my eye and
it was, An article on bacteriain the mouth, triggering head
and neck cancer.
this had to do with themicrobiome of the mouth and
keeping it healthy.
it was a pretty large study.
It was, uh, 160, 000 Americansfrom across the country.
(24:13):
And they were looking atvarious, lifestyle factors for
head and neck cancer.
And what they found was.
there was what they calledcompelling evidence that oral
bacteria are a risk factor forhead and neck squamous cell
carcinoma development.
Um, Their whole take home pointin my mind, the take home point
is to make sure that your oralcare is very good and that
(24:33):
you're not eating lots of sugar,that you're brushing your teeth,
that you're taking care of yourmouth.
That's probably the best we cando.
They didn't mention HPV that Iknow of.
I couldn't get the full article.
I just have the summaries andthe PR releases.
They didn't mention HPV and nowWhen I think of a biome, I think
(24:54):
of bacteria, archaea, andviruses, right?
Like, they're all livingtogether, like the ecosystem in
a forest.
You have all these differenttypes, um, of organisms.
So I don't know if this createsa permissive environment for
HPV, which we know HPV isdefinitely related to head and
(25:14):
neck cancers, HPV, humanpapillomavirus is clearly
related and that wasn't talkedabout.
They just talked about thebacterial species and how 13
oral bacteria were found to beassociated with the development
of these cancers.
So I just thought that wasinteresting.
Leah (25:31):
oh no, for sure.
And it, you know, like as we'relearning more about the
microbiome in general, like itkind of makes sense.
What I'm really curious about iswhat is the effect of using
mouthwashes?
You know, using like amouthwash, like how is that
adversely affecting your oralmicrobiome?
Tina (25:50):
That is a good question.
Leah (25:51):
You know, and obviously we're not dentists, so we're not
gonna really, know the answer tothat, but The other thing is a
tidbit and I don't know if I'veever mentioned this before but
somewhere I should find outwhere Somewhere I read that it's
not a good idea to brush yourteeth right after you eat like
to wait like 15 minutes I thinkthose 15 minutes or so because
(26:15):
of I don't know if it was likethe pH Levels in your mouth or
something, but you couldactually do more harm to the
enamel if you brush your teethright away So I'll try to look
that up and I will see if I canfind it But that was something
that I thought was reallyinteresting
Tina (26:31):
I've never heard that.
Leah (26:32):
Because I'm not one to like immediately.
I might immediately like flossmy teeth, but I'm not gonna
immediately brush my teeth
Tina (26:38):
Like keep your toothbrush and toothpaste in a holster.
And as soon as you're done, whipthem out.
Leah (26:44):
Well, I mean I remember kids at school, especially the
kids with braces They would goto school with their you know,
Tina (26:49):
Sure.
If you have braces
Leah (26:52):
yeah, but you could swish maybe just with water.
I don't know I never had braces
Tina (26:55):
or just don't smile for 20 minutes.
Leah (26:57):
Just don't smile for 20 minutes.
Tina (27:00):
Okay.
So I'm going to tell yousomething that's totally, um,
conjecture, but I kind of wonderwhen it comes to teeth health.
One of the reasons that we eatberries and anything that has
the color of nature, whatevercolor we're talking about,
especially the reds and theblues um, I kind of wonder if
one of their jobs in our mouthsis to make sure we don't get the
(27:21):
walled off biofilms of the badbacteria.
So a biofilm is basically acovering of sorts that protects
colonies or communities ofbacteria and those communities
can sometimes be pathogenic orcause cavities that kind of
thing My thought is, because weknow these plants contain
proanthocyanidins andbioflavonoids that break down
(27:43):
biofilms, I wonder if one of thebenefits that we don't talk
about enough is creating abetter biome in our mouth
because we chew these foods.
That's totally speculative.
But that's one of the things Ithink about when I'm brushing my
teeth and I, I know that there'spieces of blueberry in my teeth.
I'm like, well, it could beworse.
Leah (28:01):
I'm feeding my microbiome.
Okay.
So I found, I found it.
I had a look there like Colgateand Sensodyne had it on their
site too.
But, um, Columbia UniversityIrving Medical Center says that
it is recommended to hold off onbrushing, after consuming
anything acidic, whether it'sfruit, soda, juice, or sour
candy, because it weakens theenamel of the tooth.
(28:23):
And so they're recommendingwaiting about 30 minutes.
Whereas the toothpaste sitesrecommended 60 minutes
Tina (28:29):
Wait, wait, wait, wait.
So your mouth is acidic.
They're saying, don't gobrushing your teeth.
Leah (28:34):
right after having something that is more acidic.
Tina (28:37):
Whoa.
You would think that it'd be theopposite, that you should go
brush your teeth.
Like, what if your toothpastehas some bicarb in it?
Like it's.
Arm and hammer.
Leah (28:45):
I don't know.
I'm not, you know, talk, talk toColgate
Tina (28:48):
right.
We got to get a dentist on here.
This is,
Leah (28:49):
Yeah, no.
It says to use soft bristles andto wait.
Oh, it says, I always recommendrinsing with or drinking water,
which starts theremineralization process of the
enamel.
So.
Tina (29:01):
All right.
I have a question.
Leah (29:03):
What's the acidity level of your mouth?
Tina (29:06):
It should be, it should be just slightly acidic, if at all.
6.
5 to 7 point something.
Leah (29:11):
Okay, so if you drink a soda, what's it, what's the
acidity of a soda?
Tina (29:16):
Almost everything we drink is acidic.
Very few things are not acidic.
Soda, soda pop is down there.
Like if it's a Pepsi, it's waydown there, you know.
That's why you can, that's whywe can clean a battery, all that
corrosion with Coca Cola,because it's so acidic.
It's got the phosphoric acid init.
So I'm gonna guess, and you cantell me if I'm right.
Ready?
pH is gonna be between, It'sgonna be three, give or take.
(29:38):
Three to four.
For, for, wait, soda pops, it'sgonna be lower.
And for juices, four, give ortake.
Four or five.
Leah (29:45):
Coca Cola regular has the lowest pH of 2.
5 compared to other carbonatedor fruit beverages.
Tina (29:53):
Which is why you can't clean your battery with Sprite.
That phosphoric acid, by theway, and this acidic nature of
all of the soda pops withphosphoric acids in them, is the
reason that they're horrible forour bone health.
Because when you drinkphosphoric acid, Your body has
to buffer that phosphorus withsomething, and it prefers to do
(30:13):
it with calcium and your storageof calcium is your bone.
And so you'll, you'll find thecalcium.
You'll just pull it right out ofyour bone if you need to, and
then you'll buffer thatphosphoric acid you just drank.
Definitely makes the drink lessappealing, right?
How about juices?
Leah (30:25):
Oh, she says, I don't know, I just, so the golden
number for pH in your mouthshould be 5.
6 or above.
Tina (30:31):
Oh, 5.
6 is too acidic.
That's crazy acidic for saliva.
Leah (30:36):
So saliva has a pH normal range of 6.
2 to 7.
6, with 6.
7 being the average.
I'm just grabbing this fromquick searches.
Tina (30:44):
Okay, well, no, I'll agree with that.
I'll agree with those numbers.
Leah (30:47):
Okay.
Tina (30:48):
So, when I was a resident, and I would do weekly lectures
to patients and their families,we handed out pH paper on a
regular basis.
to the patients and theircaregivers.
And you know, sometimes it was10 people, sometimes it was 30
people, but kind of did thiscause I was a resident and it'd
be an interesting experiment.
And we would check saliva, havepeople drink a little bit of
(31:08):
water first, swish it around,sit there for a little bit,
check their saliva.
And I am here to tell you thatpeople with cancer definitely
had lower pH in their mouth.
active cancer.
Not shocking because canceritself creates acid.
It creates an acidic environmentand your body has to shed that
and it sheds it through yoursaliva.
It sheds it through your urine.
So yeah, the pH changesaccording to your physiology.
(31:29):
It's not just about your mouth,it's about your whole body.
Leah (31:32):
Well, there's this interesting, article from Loma
Linda University.
That about the key tomaintaining proper pH balance in
your mouth, so I will post alink to that, too.
Because that's the one where Igot the 5.
6 is ideal and it talks abouthow the changes after you eat
the Mineralization of the enamelall that stuff.
So I will include these links.
(31:52):
I will keep them on my phone
Tina (31:54):
I have a question for our listeners.
Does anyone know?
I have heard.
I didn't see this.
I haven't experienced it and Ihave visited Italy, but I have
heard that it is tradition toend the meal with a bit of
cheese, hard cheese.
And if that's true, I alwaysthought, well, maybe that is
helpful for their teeth becausethey're doing a calcium source.
Leah (32:14):
I think there are a number of European countries where the
dessert isn't sweet where it'sit's cheese, but
Tina (32:20):
That's interesting.
Leah (32:21):
I don't know, I don't know what the reason behind that is,
but yeah, no, I mean, and Ithink, you know, if you are able
to tolerate cheese, I thinkhaving it at the beginning,
middle and end of a meal is agood thing.
Because it's good.
But yeah, because I do rememberpeople, you know, posting things
about like being surprised thatat the end of a meal, they
(32:43):
didn't get a dessert.
They got a cheese plate orsomething.
I
Tina (32:46):
Mm hmm.
Yeah.
Yeah.
Like a little cheese plate.
Yeah.
Leah (32:49):
yeah, I think it is common in certain European countries.
Tina (32:51):
Anyways, maybe there are listeners who, you know, only 80
percent of our listeners are inNorth America.
20 percent are from Europe,Australia, et cetera.
So
Leah (32:58):
They can, they can send us a message and let us know.
Tina (33:01):
I figure people know more than I do about it.
Yeah.
Leah (33:03):
I think what they should do is go to our website and
click that little microphoneicon and leave us a message and
you know, talk to us about whatkind of cheeses do you have for
dessert.
Talk to me about cheese.
Tina (33:16):
Or what's the customary thing to do after a meal in
certain countries?
I mean, I think having dessertthat is sweet is not a good
idea, but that is what we areaccustomed to here.
Leah (33:26):
I know, but ever since I started having, hot flashes I'm
a big fan of having that dessertbefore a meal.
Well, or not, you know, likehaving it with lunch or
something earlier in the day.
So I don't like wake up withnight sweats.
Tina (33:42):
yeah.
So you're saying if you have asugar too late in the night.
Leah (33:45):
Oh, it's, it's not just me.
It is a very common cause of, ofnight sweats and of waking up in
the middle of the night.
So yeah, keep that sugar as anafternoon delight, as they say.
Tina (33:58):
there you go.
Afternoon delight.
Leah (34:03):
Anything else besides people going to our, our, our
website and hitting that recordbutton and leaving, leave us a
message.
I'm really surprised we haven'tgotten any voice messages.
Tina (34:12):
We did get one from Moses, but we haven't replayed it.
Sorry, Moses.
Leah (34:16):
So
Tina (34:17):
We got to just get coordinated to put it within our
recording here.
I
Leah (34:21):
maybe if we edit this, we will.
If we edit this.
Oh, we're editing this.
Tina (34:26):
was going to say, if here,
Leah (34:29):
When we edit this, we will add in Moses and his message.
Tina (34:34):
I'll tee it up.
Ready?
Here's Moses.
Leah (34:46):
That was awesome.
Thanks, Moses.
Tina (34:49):
Yes.
Thanks for taking the time.
But yeah, I would love to hearfrom more folks who are
listening, because I can see thestaff.
I can't see who you are.
I can see where people are.
I can see how long they listen.
Um, and we do have quite a fewlisteners around the world, like
I mentioned, so I'm, I'm excitedto engage more, which we need to
talk about.
We're going to be launching ourengagement soon.
Leah (35:08):
Not that we're engaged.
Tina (35:09):
Oh, Jesus.
Leah (35:11):
What do you mean our engagement?
Tina (35:13):
Oh, our, our listener engagement tools.
Yeah.
Yeah.
Leah (35:17):
Oh, like the membership?
Tina (35:17):
Yeah,
Leah (35:18):
Okay.
Tina, I'm
Tina (35:21):
Yeah, I love your layup, but not like that.
Leah (35:25):
I have to bring it to my husband.
So, um, yeah, and if you've madeit this far, today's episode,
please head on over to buy me acoffee, and,
Tina (35:37):
We'll buy you a coffee if you made it this far.
Leah (35:40):
this is, this is not advertising supported, as you
can tell.
This is supported by us.
This is total grassroots, and,Anything that we get from buy me
a coffee goes towards keepingthis a finely tuned machine that
it is.
Tina (35:56):
That's right.
That's right.
We are in season four.
So
Leah (36:00):
That's crazy.
Yeah, that's, that's wild.
Tina (36:03):
yeah, but I will, I'm happy to say we were finally
getting some love from Apple.
We're finally in the standingswhen you put in the word cancer
in your search and you'll,you'll see us there in the, in
the top 20, which is sayingsomething.
And there's over 3 millionpodcasts out there.
Available.
So, keep listening.
Leah (36:19):
Yay team! Go team! So on that note, I'm Dr.
Leia Sherman
Tina (36:26):
And I'm Dr.
Tina Kaczor.
Leah (36:28):
and this is the Cancer Pod.
Tina (36:29):
Until next time.
Leah (36:30):
Thanks for listening to The Cancer Pod.
Remember to subscribe, review,and rate us wherever you get
your podcasts.
Follow us on social media forupdates.
And as always, this is notmedical advice.
These are our opinions.
Talk to your doctor beforechanging anything related to
your treatment plan.
The Cancer Pod is hosted by me,Dr.
Leah Sherman, and by Dr.
(36:51):
Tina Kazer.
Music is by Kevin MacLeod.
See you next time.
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