Naren: Hello everyone, welcome to another episode of the Let It Flow podcast show. Here we’ll be discussing the book written by Dr Edmund Kwan called Let It Flow. In this episode this is part two of chapter four we are going to be talking about cancer and blood flow. Doctor Kwan, welcome.

Dr. Kwan: thank you very much there and I’m very excited to talk about the cancer today.

Naren: yeah I think cancer has been the disease that has kind of captured our imagination I guess over the last few decades. I mean there’s no person on the planet who doesn’t know someone who has cancer or you know either in their direct family or extended family. So what is the relationship between Cancer and blood flow doctor

Dr. Kwan: well let’s first just go over what cancer really is again you know it’s a obviously it’s a disease that all of us dread. We don’t we when when we think of cancer, we’re kind of correlating cancer with death, right?

Naren: yes

Dr. Kwan: so it is something that we try to stay away from as much as possible. So it’s very important, this is an important incredibly important subject and I think

Naren: and also we don’t understand cancer right, we feel like it’s like a black box you know

Dr. Kwan: Yes, and it’s something and the reason is because there is no cure for cancer until now. There is no cure we have not found the Cure and you know if you go historically about the cancer in 1971 our president of the United States Rich Nixon declared war on cancer thinking that all cancer will be wiped out by 1976. So that was a pipe dream, but but as you know that war is still being waged today, right, and we’re no closer really we’re really not that close to finding a cure for cancer and it’s been it’s been a mystery and and one of the things I think the problem is, I think we’re looking at one of the I think we’re looking at the wrong place in some respect

Naren: by the way what is cancer can you define it for us can you help a Layman understand it

Dr. Kwan: yes cancer I for just very simple simplest very simple definition is it’s one of our normal cells. So cancers are our cells normal cells transform into abnormal cells and why are they abnormal? Well the abnormal because they look different they’re not the they’re not the normal cell that begins. So it undergoes some kind of transformation into this abnormal cell. So normal cells for whatever reason and I’ll discuss why, why, that why what I believe happens is that is that so this transformation from normal cell to abnormal cells and they multiply but they don’t die, to keep multiplying and won’t die. This is a process is called apoptosis, where normal cells are built with sort of expiration date. They they live for x amount of time and then they die and they’re replaced with normal cells, but cancer cells are abnormal cells to begin with and then they multiply and they don’t die. So they just keep growing growing growing Without Limits, right, so this is cancer

Naren: so why is it bad though what’s what’s what what what about these cells that make it life-threatening?

Dr. Kwan: well they invade and they invade the local structures and they put pressure on them and they literally replace the functions of them, right, so and then they for instance if you get a liver cancer the the cells are replaced with the liver this cancer more and more and the function of the liver no longer functions like a liver but but the cancer cells once they become abnormal they don’t function like a normal cell. It’s one thing if they even function like a normal cell do they grow they grow out of control. They keep growing big big and they don’t the cells that they replaced which were normal are no longer functioning like this the normal cells. So those functions are lost

Naren: got it so let’s talk about cancer and blood flow

Dr. Kwan: yes so basically up to now and still today, how does the cancer form really, I think this is where the at the heart of the discussion really is, and for my discussion at least, because up to now the majority of the scientific Community still believes, believes, today that the that the cancer occurs because of genetic injury and copying or copying mistakes. I don’t know if you understand what that means that means that we have this set of genes that we all have we have this thing called DNA in our body and those DNA live in the nucleus. That’s the nucleus part of the part of our cells, our cells have our these these structures that that make up our body that and they have various organelles and inside and the nucleus is one of them in inside the nucleus, they house the DNA and the DNA in the nucleus are injured because whether there’s actually injury from toxins or some some irritant from outside or what the dnas have to constantly do is make copies of self, copies of a cell. This is called transcription for those of you who took biochemistry DNAs make a copy of itself as we live and it’s always making copying, it’s always copying itself and many believe that there’s a mistake that occurs as they copy and is and they believe that as we get older that there are more mistakes made, that’s what leads to cancer. So the cancer is simply DNA injuries. So their DNA if there’s DNA injury then it makes a it makes an abnormal DNA, a mutated DNA causes mutation and these mutation makes abnormal, abnormal cells from there and so they believe that this is the reason for cancer. I for me I I believe that cancer is a problem with the blood flow and I’ll explain why this is the case, because as I’ve already discussed below, and and as I discussed previously that the blood flow basically brings oxygen and nutrients to every cell in our body, every cell in our body is dependent on oxygen nutrients to thrive, but if those oxygen nutrients are somehow interrupted or diminished, then those cells will suffer, right, I think that’s pretty simple right that’s I think that’s that that applies to all the diseases we discussed. When the cells don’t get enough oxygen nutrients, they begin it to melt they begin to malfunction, those cells just simply either malfunctions or they they can even die, Okay, so so but I believe not only can they not just malfunction or die, I think there’s an option when the when there is lack of oxygen nutrient to sell. So first is they become they they don’t function properly and this makes sense if if you don’t provide enough oxygen nutrients, the cells will not perform their normal duties right. So this is simple so that’s malfunction I think that that’s what disease is, diseases really is that these cells don’t properly perform their function. So that’s one. Two is that they die. Yes like when you have a heart attack or stroke that part of the brain or that part of the heart muscle actually dies when you interrupt the blood flow and they don’t get oxygen nutrients at all, then those cells will die permanently. So death can occur right but I believe there’s another option, there’s another option called cancer. I think when you rob cells of oxygen and nutrients. I think you you you can have disease you can die but I believe the other way cleverly I believe this is a cleverly, cleverly, sort of adapted response by ourselves it’s an evolutionary I believe mechanism, adopted by ourselves to survive these situations. So if you have cells that don’t get enough oxygen nutrients instead of dying, well they could limp along disease that’s a possibility in most cells end up doing that, but also instead of dying instead of facing death. I think they want to escape death, because the basically cells are born with sort of a programming that they want to live. All cells want to live and and so what they do is, in order to survive this lack of oxygen nutrients, it undergoes this transformation, when the cells undergo this cancerous transformation, once it becomes cancer. It can live with low oxygen it can live with low oxygen environment. So I believe cancer is directly caused by hypoxia, or low oxygen state. So low oxygen forces our cells to actually transform into something else. Initially it does that without actually causing a mutation. Mutation generally when we talk about mutation, mutation means that the DNA has changed. The structure of the DNA change. DNA is made up of these what we call base pairs and these base pairs actually go out of sequence and that’s called mutation, but even before mutation, what are what our DNA can do is, when we’re faced with certain different situations, it can adjust it can turn on different parts of the DNA or turn off different parts of the DNA, and this is called DNA expression. This is a little more complex for a lot of people, but DNA doesn’t necessarily have to exactly transcribe exactly what’s there. It it it it it picks and chooses. So under certain situation, DNA is able to adapt, adapt, and and sort of change the cells so it can live with less oxygen but as this goes on longer and longer, it puts a lot of pressure on the cells because cells need to live with a lot less oxygen and really it forces the DNA, I believe it forces so lack of oxygen at the level of the cells they’re suffering it forces the DNA actually to mutate eventually, it first lived on with this by making adjustments, but however after prolonged amount of time, it actually forces a mutation. It forces a mutation in the DNA much like I believe if it’s like much like what happened in evolution, evolution of species you know even evolution of human being it actually forces a mutation and when the mutation occurs, all that mutation is doing is it’s it’s it’s it’s it’s changing the DNA to the cell and the cell now gets transformed into this cancer cancerous cell and now this new newly transformed cancer cells can live with a lot less oxygen. In fact cancers can live without oxygen cancers literally can live without oxygen meaning that they can make energy without oxygen at all. I think again many people don’t understand this our cells need to need oxygen to make energy, but you know at times we can make energy without oxygen and that’s called fermentation. In fact we do it our body actually does it at times, you know this is done by more sort of sort of our ancestors and bacterias do this bacteria’s do this. it uses this process called urease to you know they they use this fermentation to produce energy but even us when we don’t have oxygen in our body like when you run a 100 yard dash quickly, that that’s that we’re producing energy without oxygen. We’re producing energy without oxygen. They’re parts of our body that does it. When you produce energy without oxygen the by-product instead of with oxygen the by-product would be simply carbon dioxide and water which is harmless to our body. However when you produce energy through a process called fermentation, without oxygen you produce lactic acid. Have you’ve heard the lactic acid Naren, right?

Naren: yes, yes

Dr. Kwan: lactic acid is very harmful to our body, okay, so we must we do produce it and you know the pain that you feel when you walk upstairs in the thighs, that’s lactic acid building up in your in your muscle, because now you it’s the energy was created without the without energy. We can’t have so much of lactic acid you you’ll have what we call lactic acidosis and that’s lethal to to us. So so but however the cancer cells, cancer cells cancer cells can do this and produce lactic acid and use a process called fermentation, produce energy. However when they produce energy through this process of fermentation they’re producing a lot less energy, than through using using oxygen. That’s why our body wants to preferentially produce energy using oxygen because we can produce roughly about 18 times more energy using oxygen than without oxygen, right. So it’s a much much more efficient process so our body preferentially wants to make energy using oxygen. However if there’s no Oxygen around, for short spurt it will use fermentation. However this is not prolonged amount of time this is not compatible. However in a cancer cell when Once cancer when cells become cancerous, cancer cells can produce produce energy without oxygen. In fact even when you provide oxygen to a cancer cell it will not use oxygen, it will not use oxygen to produce energy and this is called Warburg effect, and it’s called the Warburg effect, because Doctor Otto Warburg back in the 1930s he won a Nobel Prize for doing this type of work on respiration. he found that the cells can become cancerous if you rob them of oxygen for for a period of time. The normal cells will transform into cancer cells and and and and and now it’s been some of his ideas have have lived on and and has largely been ignored and replaced by genetic theory cancer. So his idea of cancer was that that his idea of cancer was that not the new not the DNA but he felt that the he felt that the mitochondria was damaged mitochondria part of the cell the mitochondria or mitochondria are are part of our, our, cell that produces energy. It uses oxygen and sugar and produces a lot of energy that’s that’s used, used, by ourselves to produce to use it for all the processes that go on in our body. So we really need to make good amounts of energy and if cells don’t make energy, it will die. So in the absence of oxygen our cells cannot survive for a period of time without, without, it because it’s not producing enough energy and then you get built up with lactic acid which is very toxic to toxic to our normal cells. However for cancer cells can can live in this type of environment. So I believe really cancer is a is a, is an Adaptive response developed by our developed by these cancer cells to survive. No I believe cancerous transformation is a is a is a adaptive response by our normal cells normal cells to try to live through these harsh hypoxic environment except when it adapts to it it becomes cancer. So cancer cells unlike what most people think cancers are not foreign Invaders right, you understand that Naren, right?

Naren: yes

Dr. Kwan: cancers are not formed cancers are our body, right?

Naren: right

Dr, Kwan: they are our cells that have transformed into this totally different transformed into this different cell, right. So cancer cells are simply just our cells that has transformed into this type of cell I believe in order to survive this new environment of very low oxygen. So it could still make energy, it could still produce the energy in this type of environment and and live. Otherwise our normal cells would have died. So it’s a way our cells have used it’s an evolutionary sort of mechanism and I call this both Darwinian Lamar can evolution. Basically it’s an Adaptive Evolution that’s adapted by ourselves to survive through this. However obviously when your cells become cancer. The cells live on as cancer but are eventually kills the body right

Naren: right

Dr. Kwan: so the cell so it’s an it’s a mechanism cellular survival cells want to survive it transforms into into cancer and then it eventually kills us

Naren: Right

Dr. Kwan: it’ll continue to and the cancer cells will continue to continue to multiply and live on and live on and live on and so so what what I feel I call this sort of hypoxic theory of cancer, which means that I believe the Genesis of cancer, the Genesis of cancer the origin of cancer is not through these random genetic injuries or these copying mistakes, because those are when they think that it’s copying mistake or genetic injury that’s a random error, right, the thing that these are random. So anyone who are who’s unlucky will develop cancer, and while I’m not saying that doesn’t occur that can occur yes that can occur. I believe that can occur. These random copying mistakes can occur but I believe that’s more the minority of the case. I think majority of the cancers occur because of hypoxic injury to cancer, to cells or normal cells and normal cells in its quest to live on, it it transforms itself into cancer cells and once it becomes cancer cells it can live through these harsh conditions and especially low oxygen environment. However cancer cells need lots of the trade-off is that in order to make the same amount of energy as I said, in one sugar, one sugar molecule can produce with oxygen roughly 18 times more energy. So cancer cells need a lot more sugar to live to do well. So cancer cells really mop up a lot of sugar. So it’s got high demand for sugar. In fact there’s a we do a typically a scan on a patient with a with a with a Cancer and we will inject them with this sort of Sugar, Sugar molecule, that’s been tagged tagged. So it’ll glow, it’s called PET scan and then we take a picture we take these sort of like x-ray type of picture of it and where the cancers are these things light up because cancer cells are highly metabolic and uses a lot of sugar. So it lights up the areas where the cancers are cancer is you know, and so this this is a highly sensitive test used on many cancer cells called pet scan. So yes what is sugar is important in cancer treatment as well I believe that the sugar and the research has borne this out that Sugar, being on high sugar or having an elevated sugar causes increased risk of cancer and worsens cancer, and certainly we’ve shown that in diabetics, we’ve known this for many years the diabetics have much higher cancer rates and recently even a lay, lay, article was just recently published that which showed that that that being on a sugar diet, they said even drinking a third of a sugary drink a day, can lead to increased cancer risk. So there’s a real there’s a real risk of sugar associated with cancer, but when we talk about sugar what is sugar. Well, well, sugar is what I’m talking about is refined carbohydrate. I’m not talking about carbohydrates. Some people talk about high carb diet low carb diet. Well when I’m talking about when I talk about carbohydrate, I’m talking really about refined carbohydrate that people need to be staying away from. These are man-made sugar man-made carbohydrates. So what am I carbohydrates like even like even like, sugars, candies, and ice creams and and even bread and pasta these are sort of man-made refined carbohydrate that that will raise your sugar level, but certainly carbohydrates like vegetables and fruits and Grains they’re really good for you and so you should be be eating those food if you have cancer, but but there was an interesting study that was done on mice that was published that that showed that there was association between basically sugar levels and cancer. They did the the study where they had three groups of mice. First mice first group of mice had high sugar high sugar level high is high blood sugar level I’m talking about and this second group had normal blood sugar level, and the last group had low blood sugar level lower blood sugar level and so they watched as how they survived through this cancer. Well the ones with the highest blood sugar level died off quickly. The ones with normal blood sugar levels survived much better but however the ones with the low sugar level, survived the best. So in the in the in the my studies and in the animal studies there is some evidence to show that there is indeed some association with really good association between sugar and cancer and even cancer progression and even I want to move on to you know and what are some of the other things that we can do. So I believe that

Naren: Doctor let me summarise. Let me make sure I understood this. So step one you believe that cancer is not just an accident. It’s just not accidentally wrong copying of of cells but of but it’s really you know when, when, when, there’s not enough oxygen to the cells it tries to survive and when it tries to survive, it you know

Dr. Kwan: it becomes cancerous yes

Naren: it becomes cancerous

Dr. Kwan: I believe so what I’m just saying is cancer is not a random event

Naren: yes and the second point is

Dr. Kwan: there is a the reason. I’m saying that there is a reason for cancer and the reason for cancer is that the cells suffer hypoxia or lack of oxygen,

Naren: Lack of oxygen

Dr. Kwan: and when the when the cells suffer a lack of oxygen, they can’t make the energy is that they would normally. So for them to survive they turn to cancer, and they do this initially they have to do this with DNA initially without even changing DNA, which means a mutation they could do this so they do this initially and then and then given a period of time they actually the DNA actually mutates. So I’m not saying the DNA mutation is not involved in cancer. I just believe that it occurs after, after, the initial injury. So I’m just talking about what the Genesis or the origin. I’m not talking about that that the DNA is not involved in cancer. DNA is absolutely involved in cancer, however it’s not what causes cancer. So these random mistakes whether it’s a copying mistake or random injury, while that they can cause cancer they’re the minority. The majority of them is the initiation of majority of cancer is due to lack of oxygen to the cells and in the cells, a quest to survive this type of harsh environment, they transform, transform, themselves into cancer cells and then they can live with low oxygen or no oxygen

Naren: and the second point you made is you know cancer cells survive on less oxygen or no oxygen which means they use more sugar. So sugar tends to support cancer cells and when people have less sugar diet, perhaps you know just cancer cells have a less chance of surviving

Dr. Kwan: yes yes so yes so the cancer cells are very dependent on sugar to survive and and so you need to limit the limit General in order to prevent cancer and to survive through cancer

Naren: got it keep going

Dr. Kwan: and next next on this is a exercise I mean some of the things that we can do to combat cancer and exercise is a very important, important, subject I mean obviously the way we eat when we develop cancer and our lifestyle is important. I’m not discounting the fact that there’s a the chemotherapy or treatments for cancer is not important. Yes, they are important you you do need to do that where it’s appropriate. However in addition to that, I believe that you need to do these things as well and traditionally when and when cancer patients developed these Cancers and underwent either treatments or or surgery, they would really rest them saying that these cancer patients really needed a lot of rest to recover. However, recent days is showing that the patients who have cancer do much better when they exercise or increase their physical activity, because they found that in patients who, who, exercised had much better survival and had lower recurrence when compared to the cancer patients who did not

Naren: Why do you think that changes doctor? What well well

Dr. Kwan: I’ll go yes I’ll go over this right now and, and, and, this is what I want to really discuss because what exercise really does is exercise. So what is exercise, exercise, increases blood flow really that’s it it does couple of things exercises a couple of things it increases but the major thing is it increases blood flow. How does it do that? Well when you exercise your blood vessels your blood blood is pumping harder. Your body actually makes even more red cells when you exercise red cells are the ones that carry oxygen to cells. Your blood vessels dilate up, and your blood body actually even makes new blood vessels it’s called angiogenesis. When you exercise your body actually makes new blood vessels. So it’s it’s and it opens up the existent blood vessel. So these capillaries that we talked about that collapses when you have chronic inflammation, those capillary preside capillaries open up when you exercise. So exercise increases oxygen delivery to every single cell. Not only does it do that exercise, also lowers sugar level in your body. When you exercise the sugar has to be used up by the muscles. it’s metabolized, to produce energy. So when it does that it lowers the it lowers the blood sugar. In fact the best treatment for diabetes, the single best treatment for diabetes is exercise, really. I think people think it’s medication. It’s exercise really. Exercise is more effective in treating diabetic diabetics than than medication. So exercise or how does it do that where exercise increases your insulin insulin resistance insulin sensitivity. It actually lowers your insulin resistance how does it do that what do you mean it lowers your insulin resistance. Insulin resistance as you recall is that our cells no longer respond to insulin, but when you exercise, the cells respond to insulin much better. It responds much better so why it increases the uptake of sugar into the cell, it improves the uptake of sugar into the cells. So when you exercise you’re actually your insulin level will go down you don’t need as much insulin when you exercise. So your insulin resistance, goes away and your sugar level goes down. So exercise, when you do that of course all the damage that comes from elevated sugar goes away, right. So now that’s further benefit your blood vessel dilate you get decreased inflammation. You get less free radical formation. So all those benefits in addition to increasing oxygen. It also exercise also increases AMPK. It’s an enzyme that increases metabolism of sugar and fats. So even turbocharges the AMPK. So it not only helps you with the insulin not only delivers more oxygen, it even helps metabolize these substances you even better. So so just an interesting study with exercise and cancer, just like the previous study on sugar and cancer they did in the mice study they induced again these mice with the breast tumour, breast cancer and they divided into four groups the mice into four groups they they all have cancer now they all have breast cancer. So first group of mice they left them in the cage. Second group they gave them chemotherapy that targets the cancer. For third group they gave, they put an exercise wheel so the the mice can exercise. Third fourth group they put a a wheel, a exercise wheel as well as they gave them chemotherapy. So in the fourth group they did both. So the what was the finding of the study? Well they found that the after time the first group where they have now breast cancer and they’re just sitting in the cage, the cancer grew very large out of control. Second group where they receive chemotherapy, the cancer started slowing. So that’s to be expected right you’re giving chemotherapy to breast cancer, it’s it’s slows. So that was expected finding third group where they exercise them alone no chemo just exercise them alone the cancer started slowing just as much as the chemo Group, which was astounding finding, and the fourth group of course when they exercised them with chemo guess what happened the cancer shrunk. I mean slowed much much faster, right. So this is this is out of my study so we do have to be careful in transferring to to human beings, but this these kind of studies are many of these studies are out there and the way it does that so how does it do that? How does exercise or any of these things really improve or reduce cancer. Well if you look at cancer, cancer cells, I already talked about they exist in this part of the body that’s fairly hypoxic, right, cancer cells are hypoxic meaning they have low oxygen, you understand that Neran, right, they live in this area there’s already low oxygen. That’s why they became cancer, right. So Naren, you understand that that basically cancer cells exist in a sort of hypoxic environment right or low oxygen environment right?

Naren: absolutely

Dr. Kwan: okay so they’re kind of I believe they’re born in that kind of environment so they thrive in that environment because our cells can’t compete with these cancer cells okay because around that area there’s low oxygen our our cells normal cells need oxygen to survive whereas cancer cells can Thrive and flourish in a low oxygen environment because they can make energy without oxygen through a process called fermentation. So what happens is, when there’s low oxygen in any part of the body in general, especially around the cancer side like like tissues like cancer because there’s no Oxygen, it triggers our body when there’s low oxygen to make more blood vessels. It’s called angiogenesis. It causes the body to make more oxygen. There’s an oxygen gradient that occurs and new new blood vessels are formed around there and it’s to bring more oxygen to their area. I don’t I believe it doesn’t really benefit the cancer it only benefits the cancer because it can get more nutrients, but cancers don’t need more oxygen to survive. They just need more nutrients. So maybe it delivers more nutrients to the cancer cells, however what happens is that area is generally lacking oxygen and our cells just don’t, don’t, do well around that area. So cancer can thrive in that setting and expand. So by providing things like exercise where you’re increasing, you’re increasing oxygen delivered to that area, now you’re curbing that new blood vessel growth angiogenesis and you’re stabilizing, you’re stabilizing that cancer site, and they’ve shown this. When they examine the blood vessels around their in patients who ex patients with cancer who exercise those blood vessels guess what they change, they become much more stable. So you’re stabilizing the cancer side with good blood vessels rather than bad blood vessels then you’re actually delivering more oxygen to that area and rather than oxygen doesn’t kill cancer cells necessarily, it supports our normal cells so our normal cells are able to thrive in that area as opposed to before when there’s low oxygen it wasn’t it wasn’t competing well with cancer. So cancer whether there’s oxygen or not, it’s it’s there’s indifference for the cancer. Cancer can do well in oxygen environment as well as a low oxygen environment but however in a low oxygen environment, they don’t have to compete with our normal cells. So this is this has been shown this is not the not a theory. This is the fact that the the cancer side is stabilized when you exercise, the blood vessel the architecture of the blood vessels actually change. They become much stronger. Cancer blood vessels that the the cancer cells make and you’ll hear typically about this angiogenesis. These blood vessels that the cancer cells make are typically very fragile. Their their sizes are really chaotic and and these blood vessels are very dysfunctional around the cancer site. So it’s not normal blood vessels they’re forming, even if when they make nubla vessels so what the oxygen does is it stabilizes this whole environment and I believe that it it limits the cancer growth. Does that does do you understand that?

Naren: absolutely, absolutely.

Dr. Kwan: okay and then finally I just want to just finish off the cancer really with a discussion on on some of the other treatment of cancer that we have out there. Other than the typical chemotherapy and immunotherapy and other therapy and surgery. Of course it was always available and I’m not discouraging anyone to undergo those because right now those are the best tools we have. However I’m talking about in in many of these things in way of prevention and as an adjuvant therapy meaning that it’s an adjunct to what we’re already doing, okay. So as an adjunct I’m saying if you have cancer you need to eat right you need to really eat better and to eat a better diet. I believe you need to exercise the normal amount that that’s recommended for everyone out there about 150 minutes of exercise, three to five times a week. so these are these are just recommended, I and these are the things that in addition to undergoing whatever treatment you’re undergoing. I believe is absolutely necessary and especially in anyone who wants to prevent cancer but there’s one other thing that I believe that you can do, both in forms of if you develop cancer and to an extent to prevent cancer and that’s called metformin and so what is metformin and this is a medication. It’s a medication. It is a medication that treats diabetics especially type 2 diabetics. It’s a medication by known as a a group of medication a group called biguanide by it’s it’s dry from French lilac and this by Guanide called metformin has been really effective in treating type 2 diabetics around the world, and and I believe it’s the best form of treatment for type 2 diabetics. It’s got relatively low complication and and then one of the things that they found with metformin is that patients who who were on Metformin because if you have diabetes you could be on Metformin or it could be on other diabetic medication called the there are other diabetic other groups of diabetic mixes called sulfonyl urea’s and then other groups they found that the patients who took metformin who were diabetics lived 10 years eight to ten years longer they lived no they they outlived they lived outlived people who didn’t have diabetes and that’s really translating to eight to ten years more. So basically patients who have diabetes or outliving people patients without even diabetes and certainly far outliving those who were on sulfonylurea other classes of diabetic medication, and so they were looking at how does it do that. So really what the what the metformin is different than other medication other diabetic medication is the metformin how it works is it increases your insulin sensitivity. When you’re on Metformin your insulin level actually goes down. Unlike other diabetic medication like sulfonylurea where your insulin level goes up you’re actually making your pancreas produce more insulin. Metformin does not work in the pancreas. Metformin does now work in the pancreas like some of these other diabetic medications. It has nothing to do with how much your body how much your body makes insulin. Metformin how it works is it allows more sugar into the cells, into the cell that’s one of the ways so the more cell more sugars go into the cell. It also your liver it actually blocks the liver from making roughly 30 percent less sugar. You know the sugar is processed through the liver people in people don’t quite understand this hundred percent but pancreas is just makes insulin, but an insulin uses insulin is used to bring sugar into the cell but the our liver actually processes the sugar, meaning that when you eat, the sugar all these food goes through the liver and liver decides what gets stored as fat, what gets put out into the bloodstream so liver regulates blood sugar level in our body. It’s involved in the homeostasis as sugar and when you take Metformin, liver makes less sugar. It also some of the sugar also when you take Metformin, your body doesn’t absorb some of the sugar. So it gets Spilled Out into your GI and and you pass it on so you don’t absorb the you don’t absorb as much sugar when you take Metformin. So in essence metformin increases your insulin sensitivity which is great for your body, which means that your pancreas makes less insulin and it saves your pancreas from burning out as well. So what what they’ve shown is that the people who took metformin also developed a lot less cancer. 30 to 50 percent less cancer and that’s maybe one of the reasons why they’re living longer as well. So they’re developing less cancer and they’re actually saving the pancreas. So metformin is I believe is a powerful. So now the next step from here is what is the benefit of Metformin. Can people without diabetes take Metformin. I believe certainly people who have insulin resistance or pre-diabetes, again pre-diabetes is is the level where your sugar is elevated but not quite elevated enough to be maybe even taking medication, that’s called pre-diabetes and I believe that’s those are the patients that’s going to truly benefit from medication like metformin. It’s a very mild medication, it may cause some GI symptoms in the beginning and some people can’t tolerate these GI symptoms, most people can’t and to the rest of your body it’s very it’s got very low side effect and it’s one of the most commonly prescribed diabetic medication in the world. There’s a big study on the way right now looking at metformin and aging, anti-aging aspect of the of this it’s the only medication of its kind. It’s FDA approved study that’s being done right now. Using Metformin actually increasing the patients age, and this is talking about not just patients but people without diabetes. So I believe that metformin can help even people without diabetes or even pre-diabetes at all, because especially as we age all of us or even younger people many suffer from sugar problem whether we eat too much sugar or as we get older our metabolism slows our muscle mass decreases and we’re just physically less active and sugar builds up in our bloodstream and as I said before only way we can handle sugar, only way we can handle elevated sugar in our body, is to produce really more insulin one of the only ways to produce insulin and, and, so our pancreas is tasked to making more and more insulin to try to get that sugar level down and put and so I think it stresses our pancreas. So, metformin for all of us is going to even without the IBS it’s going to prevent and Studies have shown that people take Metformin, you have much lower incidence of developing diabetes, less incidence of developing diabetes if you’re on Metformin. So it kind of lowers and curves of of those pre-diabetics that’s going to go on to diabetics and even I believe in normal non-diabetic patients, normal patients, I believe it’s going to save our pancreas and prolong the development of diabetes because as we age really most of us are most of us have sugar problem and we also come to really diabetes as we become really older. So this will really and if you look at centenarians, people who live to be over 100 years old, they all have incredibly low insulin level. They don’t have diabetes they don’t have this problem. So I believe that diabetes is at the centre of this. So metformin really ends up helping in this way and right now it’s being trialled as a as an anti-aging and drug and there are a lot of studies on the way that show that metformin really reduces cancer, even in patients who have cancer, various cancers, including pancreatic cancer breast cancer these patients actually it can help as an adjuvant therapy in in in in in reducing the cancer or making the cancer smaller, or even even getting rid of their cancer, and it’s also certainly shown to reduce the recurrence of cancer. So this is a very powerful, I believe this is very powerful medication. I take I personally take it myself I take 500 milligram once or twice a day and I believe along with exercise along with diet I still take this. I believe it helps even in patients and I’ve recommended this metformin to all my friends, basically if they want to take it I prescribe it to them. I believe it’s that I believe it’s that powerful. So I think there’s a lot of research and the jury is still out right now as of today on truly 100 percent benefit of of this on cancer as well as on Aging but I think there are there are ample proof out there proofs out there that that there is tremendous upside and very low downside

Naren: absolutely. So, fundamentally everything comes down to cells absorbing oxygen and nutrients right.

Dr. Kwan: Yes

Naren: all these things you’re talking about that working against self-absorbing oxygen and nutrient is what causes disease, whether it’s cancer you know heart disease you name it but everything kind of points to that blood flow is important.

Dr. Kwan: yes absolutely and I’ll talk about metformin in depth in in the in the future future discussion in future podcasts but yes, I at the end of the day really every really chronic disease is related to lack of oxygen to the cells, lack of oxygen nutrients itself. Those cells are starved that can make it the appropriate amount of energy and they become diseased or they die or they become cancerous. So these things changes occur in order to adapt to this type of environment. So so the what’s at the heart of really our health is how our blood flows because blood flow is what carries the oxygen nutrients. It’s through our circulatory system with the vast network of vascular highways, I call them vascular highways, I call them vascular super highways that exist in our body that is carrying oxygen nutrients through blood Through Blood Through, Blood and through our blood vessels. So we need to preserve that system. We need to keep that system healthy, and I believe at the end of the day, it’s the it’s the destruction or the problem with that system that ends up causing all the damage to our body.

Naren: thank you so much doctor for this wonderful podcast and I want to thank our listeners. really really chapter 4 again from the book let it flow and you know share this entire podcast or clips from this podcast with your friends on Twitter on Facebook on Instagram, you name it, and and let’s start this conversation around, you know how we can hopefully take back our health. Whether it’s cancer whether it’s heart disease whether it’s diabetes. So thank you so much doctor for what you’re doing, for the community .

Dr. Kwan: thank you very much

Naren: I want to thank our listeners if you love this show kindly you know share it with your friends family post it on Facebook social media you know write a review for us of course I would strongly strongly recommend get a copy of the book. It’s called Let It Flow you can grab it from amazon. Com Let it Flow by Dr Edmund Kwan thank you Doctor Kwan

Dr. Kwan: oh yeah thank you very much