Ep.158: A Plastic Surgeon Talks About Breast Cancer Prevention with Dr. Kristi Funk

This transcript has been edited for clarity.

Robyn:  Hey everyone. It’s Robyn Openshaw, and welcome back to the Vibe show.

I know we’ve done a few episodes lately about imaging for detection of breast cancer and breast implant illness and some other related topics. But today I’m bringing in my new friend, Dr. Kristi Funk, who is a board certified breast cancer surgeon. And she and her husband are cofounders of the Pink Lotus Breast Center in Beverly Hills.

She’s a standard-of-care doctor and that’s not the usual around here (besides my friend Tony Youn, who is a plastic surgeon. We had one other integrative surgeon, didn’t we, talking about breast imaging.

She does breast surgery all day, every day. And she also is trained in minimally invasive diagnostic and treatment methods for all kinds of breast disease. She is Sheryl Crow’s doctor, and she is Angelina Jolie’s doctor, so you can read between the lines there. She actually practices in Beverly Hills, which explains that.

Last year she came out with a book (I love the title of it), it’s Breasts: The Owner’s Manual: Every Woman’s Guide to Reducing Cancer Risk, Making Treatment Choices, and Optimizing Outcomes. And when I was talking to her in Oregon, she told me that her book has already, in one year, been translated into like 20 different languages.

She’s also in the last two and a half years gone 100% vegan after studying what is the best cancer preventative diet. And she arrived conclusively at the idea that animal products are cancer causing, and plants are cancer preventing.

She’s a graduate of Stanford university as an undergraduate. And then she went to UC Davis School of Medicine to get her medical degree. She did residencies in Seattle and a fellowship at Cedar Sinai in Los Angeles. So she’s an amazing surgeon, who A-list celebrities are seeking out.

What’s really interesting about Dr. Kristi Funk is that she’s getting more and more interested in prevention and in helping women upstream rather than just when it’s time for a mastectomy.

So welcome to the Vibe show, Dr. Kristi Funk.

Dr. Kristi Funk:  Hey Robyn, I’m so happy to be here.

Robyn:  You’re super busy, and it’s very kind of you to take a few minutes for us. We’ve been really deep lately on the Vibe show, with several episodes from your colleagues around the country, on breast implant illness. We’ve talked about breast cancer imaging because there’s quite the ferocious debate about that.

I probably won’t go super, super deep with you on those, but I want to talk to you about your take on what we need to stay out of your office. I know that you really care about women; you’re not just trying to drum up business for more mastectomies.

Women are terrified. They’re terrified of breast cancer. I have a feeling you’re going to tell us some things today that might contradict other interviews I’ve done here on the Vibe show. And I don’t care; we just want the truth. We want your take.

We had Sydney Singer talk about bras, and a connection there that he believes his research has a link between bras and breast cancer. I’m curious what you think about that if you’ve dived into it. I know there’s other people who are really, really critical of his research.

I’d love to talk to you about diet because you’re one of the few surgeons who even acknowledges that there is a link and who’s actually studied it, bothered to take the time to really dive into the prevention aspects.

I want to thank you for stepping outside of just doing breast surgeries to ask why? Why are all these women that I’m sure you’ve grown to care about getting breast cancer? And how we can decrease that number.

Let’s start with, how did you become a Beverly Hills plastic surgeon?

Dr. Kristi Funk:  Well, not plastic breast cancer surgeon. Right? I do the oncology, yes.

Robyn:  Okay. So you didn’t get the board certification in plastics?

Dr. Kristi Funk:  No, no. I’m a surgical oncologist.

Robyn:  So very, very specific to breast surgery. Okay.

Dr. Kristi Funk:  I’m in breast surgical oncology.

Robyn:  And how did you get so interested in that? So

Dr. Kristi Funk:  This is funny.

I did my surgical residency in Seattle, and that time was filled with laparoscopy, where they do surgery through tiny little portholes and watch it on a camera. But it was brand new. Literally my attendings would push me out of the way to learn themselves. So I never learned it. It was so spanking new.

I knew that was the future of surgery, was to do laparoscopy, thoracoscopy. I wanted to do a fellowship in minimally invasive surgery, so I’d be prepared for my future, and I scoured the country and decided on the best one for me at Cedar Sinai Medical Center.

I arrived all gung-ho about the esophagus and the stomach because those were my favorite organs. And the director of that looked at me and said, “So, when you interviewed, I forgot to tell you what you’re going to do with your career. You’re going to run the breast center here.” I was like “… What?”

But to tell you the truth, he gave me an option to transfer to their breast cancer surgical fellowship instead of the MIS, minimally invasive one I was doing. I could see that the breast center at Cedar Sinai was run by five men over 50 and they clearly needed some estrogen over there and they hadn’t found any people in the country that were working out for them.

He literally offered me the directorship on a platter if I would do the fellowship. But to be honest, at that moment — high off of my five years of training where I could put your heart literally on bypass in 40 minutes after cracking your chest open — I was like, “Breast surgery? That’s easy.”

I had to do some soul searching and realized that it was a point of pride for me to want to be technically challenged. After thinking it through, there’s no woman that ever sees me that thinks, “Oh, she’s just a breast surgeon.”

This has become such a passion for me. And God knew what he was doing when he directed me to that fellowship and that directorship. So I stayed at theaters for seven years and then my husband and I launched our own standalone breast center in Beverly Hills in 2009.

Robyn:  I can’t imagine all the things that run through your head when you get the breast cancer diagnosis, but I would imagine that I would feel much more calm and reassured if somebody on the home team was giving me my advice and maybe even doing a surgery.

What is it like to work with women who’ve just been diagnosed with breast cancer? Has it increased your compassion? What’s that done?

Dr. Kristi Funk:  It’s increased my compassion for others and for the struggles they go through. It’s widened my eyes to the beautiful resilience that women display more often than not. And it’s, for the time being, made me grateful for my own health and my family’s health, because my immediate family is completely well and functional and we don’t have advanced cancer to battle every day.

It makes me appreciate eyes that see and legs that walk, because you do take those things for granted until you get sideswiped by the threat of death, and you realize that you are not invincible and that life is finite for us all.

What I’ve loved most about my career is the opportunity to come alongside a woman in what she perceives to be her darkest, scariest and loneliest moment, feeling often confused and then misunderstood by those around her as she tries to navigate all these difficult decisions. And for the women who choose me to hold their hand and guide them through that darkness until they see the light, that has been my reason for being.

Between my job (which doesn’t feel like one), and between the revelations of my book Breasts: The Owner’s Manual, which you alluded to at the top, they changed my perspective on how much control we have over this disease. And it has radically altered the degree of hope and empowerment that I am able to impart to these women who trust me with their care.

This is basically my assignment in life, to preach this message of maximal risk reduction or recurrence reduction for those already affected by breast cancer. And so the sooner everybody just does what I say this the sooner I might be able to get a different assignment. [Laughter]

Robyn:  As soon as everybody just does what you say. We’re going to dig into that because you actually talk a lot about prevention (which I’ve never encountered a breast surgeon who does that) and I want to get into that.

What do people think about breast cancer that’s wrong? What’s a big misconception that you’re always dealing with?

Dr. Kristi Funk:  The biggest misconception is literally, “Breast cancer doesn’t run in my family. That’s not our thing. I’m not at risk for it.” Totally false, nothing could be further from the truth.

It is true that some people do have family histories laden with breast and ovarian cancer, which heightens our suspicion that they carry one of these inherited genetic mutations like BRACA or PALB2, et cetera. When you have an inherited mutation, yes, your risks are astronomically higher than every woman walking, which is one in eight before you layer in some risk factors, right? All of us, one in eight, we’re born with that risk. And then about five to 10% — and that’s the shock — only five to 10% of all people with breast cancer can blame it on an inherited genetic mutation.

In point of fact, 87% of women with breast cancer don’t have a single first degree relative with breast cancer. That shocks people, to realize that upwards toward 90% of all breast cancer on planet Earth has nothing to do with inherited genetics or having a strong family history.

That begs the question, “What does it have to do with? And my deep dive into tons of nutritional science and lifestyle medicine has revealed that it’s largely diet, nutrition, alcohol, exercise, obesity, hormone replacement therapy, emotional stressors, and environmental toxicities that contribute to breast cancer.

The awesome thing about that crazy long list is that every single one of those is, to a greater rather than lesser degree, is able to be controlled by our choices. Every time we lift fork to mouth, every time we decide what to wear, how to think, how to breathe, how to love, we are either moving toward cancer or away with every choice.

Robyn:  I pay lots of attention to the published literature, probably less than you, but I pay a lot of attention to it. And I doubt that we could even back up whatever opinion we give to this question with actual science. But what do you think is a bigger deal? The way you live your life, being forgiving, peaceful, kind, not indulging in tons of anger and conflict or how organic and plant-based your diet is, which one’s a bigger deal?

Dr. Kristi Funk:  Diet.

Robyn:  Hmm. Interesting. Well, let’s talk about diet then.

I think you gave us bad news and good news. Bad news: even if nobody in your family has got breast cancer, you could still totally be at risk. For diet and lifestyle factors, breast cancer rates are going through the roof. That’s really depressing. However, the flip side of that is — I love that you turned at sunny side up — that means you can have some control over it.

What is the best diet for breast cancer prevention?

Dr. Kristi Funk:  Hands down the best diet is a whole food plant-based diet. Overloaded with fruits and vegetables, legumes, beans, peas, lentils, nuts and a hundred percent whole grains. Drinking lots of green tea and other teas and water and minimizing or eliminating alcohol. That’s your snapshot.

Robyn:  These days there’s a lot of debate about what whole foods plant based even means. In fact, I had a colleague who told me that 50% meat is plant-based as long as the other 50% is, like you said, greens, vegetables, fruits, legumes, nuts and seeds.

What does that mean to you? Because I find even the ketogenic diet people think they’re eating a plant based diet. I feel like that term has been hijacked by everybody. That’s the one thing we absolutely know that nobody debates — except for maybe the carnivore diet people, but they’re the fringe — that we all need to eat a lot of plants.

For cancer prevention, where do you land on that? Like a hundred percent vegan? Is 80% plants a plant based diet? What do you think?

Dr. Kristi Funk:  I think to the degree that you make a change towards more plant-based eating, you are knocking down your cancer risk. I myself have always been Miss Little Straight-A Student, got all the questions right and the extra credit too. So when I did my deep dive into nutrition and realized the dramatic health benefits of plants and the astounding illness-causing reaction to consuming the animal protein and animal fat, I — myself, my husband and three sons — went 100% vegan.

I believe that’s the best diet, but I don’t think you have to get an A++ to live a healthy life. If you’re having mostly cheeseburgers and fries and overly processed foods and tons of refined sugars and tons of bacon and beef and chicken and fish all day long, and then butter on top of your cheese et cetera, and you maybe have 21 meals a week, you make seven of them — one a day — a totally plant-based meal, and then to the other two meals that day you purposefully add an extra fistful of spinach or leafy greens onto the plate? Whoa. You just took a D to a B minus, and I’m thrilled.

Robyn:  I think you and I have a similar take on it, which is that incremental improvement is improvement.

I think people who have followed me for years might be surprised to know that I don’t eat animal products and haven’t for many, many, many years. Can’t say I’d never do. But I might go months without eating any animal products.

I should mention that you and I actually met in person at Ocean Robbins’ retreat, where you were a speaker and I was his guest there. And he very much advocates for people eating more plants and less animal products. And you practice what you preach.

How does that go with raising triplet sons?

Dr. Kristi Funk:  Oh my gosh. They are a delight to be around in this new vegan venture of ours.

We’re coming up on two and a half years of 100% whole food plant based. And I would say they are the biggest advocates. They are so cute. We will go to, say, the Whole Foods and we’ll be shopping. And then Justin is pulling me over, “Come here, come, mom, mom, mom, mom!” And I come over to that ode to the gods of cheese, that whole central mass of tower of otherwise delicious, amazing cheeses that I used to have a whole section in the fridge that was like, “mom therapy drawer, keep out,” with five year aged gouda, and manchego, the Brie, et cetera.

He’s like, “Mom, come here, look.” And then he whispers to me, “They don’t know.” Oh! [Laughter] I was like, “Alright, I’ve got it. I’ve got it in this kid.”

He’s like, “Mom, I’m telling you, so-and-so has Lunchables every single day. She is so going to get diabetes.” They get it, they get it.

I had a revelatory moment. I did a deep dive — as I mentioned a few times — into all this nutritional science.

You have to realize as a doctor that all of us are so busy. We go through med school, we go through residency. I also did a fellowship. So that’s… I can do math! 10 years after college of nonstop. Like no holidays, no breathing, head in this medical world, immersed, fully immersed, and we didn’t get a lick of nutrition! Not a word! Maybe the Krebs cycle, or how ADP happens, but that’s it, right?

Then you get into your real life with a bunch of debt and you’re so excited to finally be the one in charge. You get to take care of people. And you focus in on your quote unquote “job,” like whether it’s cardiologists making sure you don’t have high blood pressure, or me, a breast surgeon, making sure there’s no mass in there and if there is to get it out right? On and on.

And we work. There’s no nine to five, it’s like nine to nine. And then you go home and you want to be a wife and a mom, or maybe work out yourself, et cetera… Who is going to sit down and pour over nutrition journals for some pearl that they don’t even think is there because, if it were so darn important, it should have been told to me at some point in the decade prior!

We grow up to just be a hammer and a nail and we do what we do.

By the way, I would say there’s no reward for preventive pearls of wisdom. There’s no reimbursements. We all have overhead and we have to make ends meet. It just doesn’t foster a lifestyle for the current physicians of our country to understand that there are preventive strategies available for every disease that they treat.

Having said that, I do said deep dive because I needed to be right. Right? Triple A+ girl coming to write this book, did not want to be incorrect or wrong. I literally have every single fact in my book backed with a scientific reference. Now, of course, we all know there can be counter papers and other opinions and views, but mine is not an opinion per se. I have references behind everything I say.

I went into the science simply to prove that I was right, that eating Mediterranean diets that are largely chicken, turkey and fish [is healthier]. I hadn’t had red meat since I was 10. I totally avoid the carbohydrates, even the complex carbohydrates; bread, pasta, rice and potatoes were out of my life since I was a 13 year old, because I was a teen in the eighties, the early eighties. And believe me, you were a carbohydratephobe. I stayed that way and then was like any good mother would be, teaching my kids to be carbohydratephobes.

That particular day that we went vegan, I had taken the day off work. I was largely absent when I wrote that entire half year. So I thought I’d go downstairs and make their lunch for school. I literally took an organic turkey breast– sliced processed meat turkey breast — and rolled it up like a little cigarette and put five of those slices in their lunch, no bread, and then I threw in some lettuce and tomatoes.

I went upstairs and immediately read the IARC ruling from July 2015, which I know you’re familiar with; basically, you’ve got these 22 researchers from 10 different countries looking at 800 epidemiologic studies literally just to answer the question, does red meat cause cancer? Does processed meat cause cancer? Those are two questions.

They came out and said, “Absolutely. Carcinogenic to all humans is all processed meat.” You kind of know that bacon’s not too healthy, bacon, sausage, hotdogs… okay fine. But really? My sliced turkey breasts that I just sent my three angels to school with, is on the same list as tobacco plutonium and asbestos?

They came home — I heard them in the house — I run downstairs, I’m like, “Come here boys!” We go to the fridge. I flung the doors open with characteristic flare and said, “Boys… We’re going VEGAN!” They were like, “Yeah! … What is vegan??

We emptied out — I kid you not — four bagfuls to the brim, paper bags to the brim, with animal-based products. From my non-fat Greek yogurt to my feta crumbles, a big salmon filet I had just bought in the frozen section. I had organic veggie burgers (there’s cheese and milk in there that I wouldn’t have suspected), on and on. Four bags. We bring it over to my 85 year old parents who live a mile away. And we’re like, “Here, it’s too late for you.”

 [Laughter]

I don’t believe that, by the way, it’s never too late for anybody, but my depression era parents would never speak to me again if they found out I threw all that perfectly good food away. Perfectly carcinogenic food away.

Robyn: It reminds me of when I said on Facebook about 10 years ago, about what I do with my kids’ Halloween candy. I let them go out and have the ritual and they get their pillowcase full of candy, and when they get home I give them 20 bucks for it and I dump it in the trash. And people on Facebook were like, “Why don’t you take it to a homeless shelter?” So many people were saying that they thought that was a horrible thing to say. And I’m like, “Why would I want to poison the homeless people?”

Dr. Kristi Funk:  Right, exactly. That’s funny. I know. Send it to our troops. There’s that whole plan. I’m like, can we send apples?

Robyn:  If you need a spirit guide as the boys head into teenager land, give me a heads up. I would totally be happy to help you. I would love to write a book just about the transition of raising teenagers. Your kids are in the best stage. They’re in latency phase where — I told you this when we were talking, when we were in Oregon — right now they see their parents as their role models, and they look to you and you’re [a hero], but you know, they’re heading into that phase where peers will be their main lodestar and they’ll mostly just want to do with their peers do.

But I love that you said made the big pronouncement, “we’re going vegan!” when they were seven because they were like, “Yay, this must be fun!” And I bet I have Andy was right there with you on it. But the hilarious thing is I totally have this pretty famous video where I talk about how not to make a pronouncement if you have teenagers. Like, do not ever say, “We’re going vegan!”

 [Laughter]

Dr. Kristi Funk:  I can see how that’s true. I’m so going to have you on speed dial in three years.

Robyn:  It’s like, okay, at seven, yes, you can make an announcement, “We’re going vegan,” and they’ll all do the happy dance. But when they’re 17 you don’t make an announcement, “We are going vegan.” But I love it.

By the way, there’s a book by Michael Gregor — just to your comment about carb fear — called Carbophobia. There’s a new word for your vocabulary. Have you changed your mind about carbohydrates? I’m not talking about the bread, but carbohydrates in general.

Dr. Kristi Funk:  Oh yeah, absolutely. Hundred percent whole grains. Even breads, to be honest, the bread too.

Speaking of my hero, Gregor, I learned from him that if you take total carbohydrates and divide that number by the fiber and if the number is five or less, that’s a good one to choose. That’s important when you’re doing a little bit of what I call “cheat food,” where it’s packaged. Breads, and some cereals, if you look at that; you’ll be hard pressed to find a cereal that’s going to be five or less and doesn’t taste like cardboard. The breads are like Ezekiel bread, Dave’s killer bread, and then all those German and European little breads that you could stand on and they wouldn’t move.

Robyn:  [Laughter]

Dr. Kristi Funk:  They’re all going to be five or less. So that’s a nice guide for you. But yeah, potatoes, sweet potatoes, all the squashes… All the complex starches are back in my life and I’m loving it. And not fatter for it.

Yup. Yup. That’s, that’s the thing; we have to un-brainwash you and I and all the people who grew up in the 80s, thinking that fat was going to kill us. And now we’re going to have to un-brainwash all the people who think that carbohydrates are bad for them because of all the high fat lovers of this last decade.

Robyn: I have a totally sideways question for you because I’m worried that I’ll forget to ask you this.

I don’t know if I told you; I flew all over the world and studied at 20 different alternative cancer treatment clinics. They didn’t all just treat cancer, but cancer was a major focus or I wouldn’t have gone there. 20 different clinics all over the world. There’s one of them that I go back to every year since I started that research project. I’ve been back like every year for eight years, and I take some of my followers with me every year. And we’d love to see you there sometime. It would be amazing.

Several of the doctors told me — and I don’t know of any documentation of this — that people form probably detectable (if we were constantly getting MRIs or whatever, which obviously would be a bad idea, but if we had just like some kind of magical body scanner) we probably have detectable masses, if we’re being tested three to four times in a lifetime, of cancerous tumors that the body actually breaks down. It breaks them down and metabolizes.

I wonder what you think about that, because the whole point of it is not can you prove this, or can you not prove this? But these doctors who treat cancer holistically feel that your body is constantly breaking down cancer, and when you have a cancer that actually makes you sick, and is detectable enough that it develops its own vascular system and you end up in a surgeon’s office having a mastectomy or whatever, it’s just that your immune system went down and this one got out of hand.

Do you think that’s possible? That we all have these masses and our body’s amazing immune systems are actually breaking down cancerous tumors?

Dr. Kristi Funk:  I have a strong agree and disagree reaction to everything you just said. Parts of it I think are undeniably true, and actually already proven in some of the science. And others, there’s too much speculation.

The idea that you can call it five detectable tumors that could come and go throughout your life, there’s no basis in public science for that. There’s no group of people who’ve got a PET/CT every year for 50 years straight and showed that fact. So we don’t know that.

I will say, as you just said in passing, by the time the tumor is detectable, it’s a pretty crappy villain. It has engineered its own blood system. Angiogenesis, a new blood flow coming to feed it and fuel it. And it’s created a tumor micro environment. It’s bathing itself in all of the inflammation and free radical DNA damaging cells and high estrogen levels and IGF1 growth hormone. It’s bathing in this stuff at the time that it’s now detected.

You’re going to be hard put to reverse that process when it’s been crafting it’s exit strategy to become a metastatic cancer for probably 10 years prior to that day that you detected it.

If you live so well and just had a moment of immune system deficiency where it had to look the other way because of some emotional or other physical stressor, and now the cancer burst into appearance? That was a decade long process. So you’ve been looking the other way for a while I would suggest.

I think it’s hard to reverse an established invasive cancer. We have proof, thanks to Dean Ornish, that you can reverse the established insight to an early stage prostate cancer just by dietary and lifestyle changes. Eating a vegan diet and some other healthy behaviors such as stress management, group support and daily exercise.

So yes, you can reverse cancer.

The way I see it is a seed and soil phenomenon. A better belief that I have is that we all have cancer cells flying around, basically all the time. But there are single cells here and there, trying to get that network of food and proliferation drivers that it requires in order to become a detectable mass. That, I think, we can create an immune system that is so expert at detecting and destroying those cells that you never get a detected cancer. Does that make sense?

There’s a big difference between five detectable cancers disappearing as you get healthier than billions, right? In your lifetime, billions of rogue single cells that your immune system — because you arm it, you equip it with weapons of a healthy diet and lifestyle — is able to seek and destroy those single cells.

We know, for example, if you take a one-centimeter cube of invasive cancer in the breast, it will send out 3.2 million cancer cells into your bloodstream every 24 hours. So if you think that through, why isn’t every single woman who’s diagnosed with breast cancer — invasive breast cancer, and there are 66,000 this year — why aren’t they all diagnosed stage four? Or how come they’re all not stage four by Christmas? Right?

The answer is, an intact immune system is scouring these rogue cells and getting rid of them with one pass through your body. It’s a hard task for a breast cancer cell to land in the liver and then make liver it’s happy home because it doesn’t have its nutrients there. Now it has to start again, from one cell to two to four to eight and so on.

I think that the people that you are talking to are right, that we absolutely have the power to reverse existing malignant disease, but I don’t think this idea of five detectable cancers coming and going throughout our lifetimes is accurate if we could have that crystal ball.

Robyn:  I’m glad you mentioned that you feel like the cancer is there for 10 years before it’s detected, on average. I’ve heard other surgeons, and, in that research all over the world, the more holistic-leaning doctors say seven or eight years. But I’m going to quote you on that because for me, what I do with that information is, when you get diagnosed, take a minute. Take a minute to look at your options, interview different doctors, consider what the path is you really want to take.

I’ve talked to so many cancer patients, especially in that long research, the three-and-a-half-year research junket that I did, who regretted the choices that they made because they felt like a gun was to their head. And they just got this thing that’s going to kill him. And a cancer that that’s been there for 10 years can also start growing very rapidly, and the dynamics have changed.

What do you think about people who get this surgery and their doctor says they got it all? Is there any such thing? And some holistic physicians say there is no such thing as stage one cancer. Do you have opinions on these things?

Dr. Kristi Funk:  Oh yeah, there’s a such a thing as stage one cancer, and there’s such a thing as we got it all.

When you say that, you don’t know until 30, 40, 50, 80 years later when that person dies, and if they got an autopsy and there’s nothing there, then you can say, emphatically, “I got it all.”

But the truth is, stage one breast cancer, for example, has a 99% five-year survival rate. That doesn’t mean that you die year six. We just use these barometers because it reflects, if you’re diagnosed today, your chances of you being alive in five years with the stage one breast cancer is 99%. That reflects current treatment strategies.

If I tell you 20-year survival rate, well, 20 years ago we didn’t even have Herceptin, and the survival rate was way worse. That’s why we use these five year things.

I absolutely think you can cure early stage cancers. I don’t think having rough cells flying around in your bloodstream makes you stage four. That just means your immune system has some work to do.

So that might be what people are referring to when they say… what exactly did you say? They’re metastatic at diagnosis?

Robyn:  There’s just some functional medicine doctors who feel like there’s no such there’s no thing. There’s no such thing as detecting somebody at stage one. It’s always metastatic. You can always find it in other places in the body. We just don’t have that power to figure that out. But it’s just a theory that’s out there.

Dr. Kristi Funk:  No. I think there are rogue cells flying around, and with a good immune system and with people who have room for improvement in their diet and lifestyle… And obviously the Western medicine pathway of — not surgery cause that’s just local to the initial play, this idea that they’re seeing there’s cells out there — the chemotherapy (and for breasts, the anti-estrogen therapy) that people are taking can also be agents that can destroy out those little guys hiding somewhere trying to make a surprise appearance.

There’s one thing I do want to tell you. When your tumors get to a detectable size, they have created a number of cells. That does change. Like you were saying, at the time of diagnosis, you have time. And I agree with you; take a deep breath and you do have time to search out your ideal team so you don’t make irreversible decisions you later regret.

On the flip side, there’s strong data. A 2016 analysis of all the U S cancer databases showed that in over 94,000 cancer patients, the five year survival rates were 4.6% lower in those who waited over three months versus less than one month to have to have their surgery. Interestingly, that was only seen in stages one and two, not stage three.

So, it’s like stage three, you have more time to think. It’s so backwards thinking. But if it’s more advanced, you could take more time to think about it, presumably because your system’s already pretty burdened with all the tumor cells. But in stages one and two, there’s a pretty significant difference in the five year survival rates.

And then there’s another subset of that — well it wasn’t a subset — it was women that were 18 and over. The other group was just 66 and over. The post-menopausal — 66 and over — the all comers, 115,000 women, 18 plus, the survival rate dropped 3% by waiting over three months versus less than one month for surgery. And again, only for early stages.

You have a solid four weeks if you have a stage one or two to make a decision about what your next step is. Beyond that, you should probably hurry up.

Robyn:  Hm. Interesting. Must be that one by the time it’s diagnosable, the cancer has some momentum. It’s moving pretty fast, is all I can think.

You mentioned in a list of things that increase your risk, you mentioned hormone replacement therapy. And I wonder what you have to say about that.

We’ve had several functional medicine docs on here, including my own, talking about bioidenticals versus the synthetics. I think you’re probably talking about estrogen, but tell us what you have to say about hormone replacement.

Dr. Kristi Funk:  Hormone replacement… you just have the handle menopause very wisely and individually, because people’s risks are different. We can’t disregard that huge study from 2002 that came out from the Women’s Health Initiative that took over 16,000 women, randomized them to placebo versus Prempro. It was this drug that came from horse urine. That was the HRT that was being used. It was a combination of estrogen and progesterone.

That study was, as an emergency, halted at 5.2 years because for ethical reasons, they couldn’t continue. Why? There were 26% more breast cancers in the HRT versus placebo users along with more heart attack, strokes, blood clots, and dementia. Now, they had fewer colon cancers and fewer hip fractures. So there’s some protective effect there. And in response to that, a whopping 33 million HRT prescriptions disappeared from the U.S. between July and fall of 2002

Robyn:  What happened to them?

Dr. Kristi Funk:  The study! The study came out, it got published that HRT was causing breast cancer and heart attacks and dementia. They dropped the HRT completely from millions of women. And the very next year, 2003, saw an unprecedented drop in breast cancer incidents by 7% just in that one year. And it was essentially all in post-menopausal, estrogen-driven cancers.

That same year, 2003, the UK put out their 1.1 million women study, which followed that many women, and found a 66% increase in HRT use. So there’s no doubt that HRT will increase breast cancer risk. But that was a combo of estrogen and progesterone and that was not the plant-based, bioidentical hormone years.

Then the next question of, what about estrogen only? They had arms for those in both those two studies, and the estrogen-only factors out like this:

Overall, if you just take just estrogen replacement (the reason why you can do that, by the way, is only if you don’t have a uterus. If you have a uterus and take estrogen, you use progesterone so you don’t get uterine cancer; if you don’t have a uterus because you had hysterectomy and you take estrogen only) you will actually decrease your risk of breast cancer by 23%.

But it went up 57% if you took that HRT in the first five years of being menopausal, which, hello, is when you’re hot flashing your way to a divorce and need it, or you took it for a total of more than 10 years.

It really isn’t looking good for estrogen, with or without a uterus, which leads us to the BHRT, the bio-identical hormone question.

(I really want to say that my yummy soy and yams, which comprise a lot of the BHRT-making, is going to be healthy for you).

But the truth is we just don’t know. There are no randomized controlled trials that are looking at the VHR2 substances that chemically match your naturally occurring steroids, including progesterone and estradiol and estrone and estriol. We just don’t have the studies there and they’ve been changed, right?

We don’t know if they reduce or surpass the problem, we saw in that big 16,000-person study with the Prempro, and whether they’re compounded by a pharmacy- or FDA-approved BAHRT, which is available in various dosages and combinations of preparations and routes of delivery. It could be a cream, it can be an insert, it could be a pill. We just don’t know the differing effects on risk to an individual person.

To all of that, I say we then land again on the individual lady in front of me. What are her symptoms? Because a lot of people just say, “It’s just hot flashes. That’s my thing. But I am miserable. And that’s leading to insomnia because I wake up sopping wet and then now I’m tired all day and now I’m getting depressed and I have mood swings.” So it’s really not just hot flashes.

Those women should, I think first try just a few other things that have been proven scientifically to help reduce hot flashes. Acupuncture, soy consumption, which is an extremely anticarcinogenic, anti-estrogenic based food (that will shock a lot of listeners probably because they’ve heard the opposite about soy).

Menopause Miracle is my favorite; it’s a three Asian herb blend that has three randomized controlled trials behind it, against placebo. There are no bad side effects. And in over 90% of women, literally all 12 major symptoms of menopause improved to the point that they felt fine.

Robyn:  I think you told me Menopause Miracle is this blend you were very excited about it. You’re bringing that over. And they can get it from you, can’t they?

Dr. Kristi Funk:  They can. Yes. At Pinklotus.Com; our store elements has that product and others that are all very high quality and where there’s science behind them. We vet all those products (certain things like, you know, a comfortable postoperative bra that we sell isn’t going to have science behind it). But yes, we’re really excited about our store.

We’ve got a number of very functional products for women that help before, during and after a breast cancer diagnosis. That help take care of menopause symptoms, like Menopause Miracle. We have a number of CBD infused oils and sprays for both menopause side effects and chemotherapy side effects. We have our Cosmo Companion, which — we should talk about alcohol — for alcohol drinkers that is a very smart supplement to take.

Our multivitamin called Multi Must Have was engineered; over a year of thought and work went into creating the perfect vitamin for women. And also for people who largely or entirely eat whole food plant-based. It has extra of the things that we might lack as vegans.

Robyn:  It’s pinklotus.com, Dr. Funk’s website. Menopause Miracle is that 12 herb blend that she is talking about. I thought that my readers would like to hear about that.

It’s funny; I told you that I went through menopause just overnight — instant menopause, had no symptoms, no hot flashes, nothing, never have had any — at age 41. And you’re the only person who’s ever told me anything positive about that. You told me I have lower risk of breast cancer because of that.

Dr. Kristi Funk:  You have 40% less breast cancer because of that. And the reason why you were so asymptomatic is, you are mirroring our Asian sisters in Japan and China. They are is still living a simpler life with less processed foods and meats and cheeses, et cetera. They’re eating a traditional Asian diet. They don’t blink when they go through menopause. And that’s largely because of all the plants and the soy that they’re consuming.

Robyn:  I think, mostly, women don’t talk about their menopause symptoms because there’s a lot of weirdness about it and shame about it. That in your book, tell us a little bit about your book Breasts: The Owner’s Manual.

Dr. Kristi Funk:  This book is in the book about menopause and symptoms and relief. There’s a lot of taboo topics that I bring up, especially living life after chemotherapy and cancer and things that have to do with a decreased libido, the painful dry vagina and body image issues and how things affect you on so many levels. From the physical, it springs forth right into the mental. And then fatigue and attitude and parenting and loving… It just all gets intertwined.

The majority of the book is actually really fun and empowering. I go through what your breasts are all about, because they’re these two things perched on your chest, front and center, your entire life. Women know surprisingly little about these breasts of theirs. I give the 411 on breasts, and we talk about myths that people have surrounding all sorts of things. From bras and breast size to cell phones and microwaves and underwire bras.

Then we dive into food: what to eat, what not to eat, all the lifestyle behaviors that affect breast cancer risk. And then there’s some meaty chapters at the end of the book on, what imaging should I be doing? And if I get diagnosed, here are all the ways to treat and cure it. Then we hone in on certain subsets of choices for you.

Then Living Life After Cancer, the paperback — which came out October 1st, 2019 — has a bonus chapter, chapter 11, which is called Create a Cancer Kicking Life. And I’m really proud of this chapter because it puts it all together in a very actionable way.

I create this orchard of life, these nine trees that I believe every woman should plant in the orchard of her life to bring forth the most fruitful, bountiful existence she ever thought possible or imagined. And it is achievable and it’s not difficult. It’s literally just a few drops of water at a time, tending to your life. That’s also in the paperback book.

Robyn:  I love the metaphor of the nine trees.

You’ve touched on a couple of things I want to get your CliffsNotes on.

First of all, bras: I sort of teased that in the beginning. What do you think of Sydney Singer’s research? Do you think that there’s a link? To me it seems sort of logical that if your breasts are bound up — like they really haven’t been throughout history, for cosmetic reasons and just kind of our weirdness in North America that]they have to be all bound up — it makes sense to me logically that if your lymph is trapped for decades, 16, 18 hours a day or whatever is, does that predispose you to breast cancer? Do you think that’s just a bunch of bunk?

Dr. Kristi Funk:  I think this has no grounding in breast anatomy or physiology.

It does initially sounds super plausible, to the point where I did my own deep dive for the book before I wrote it (again, I never just used my ideas that I had existed in my brain for 20 years of being a breast cancer surgeon; if I had, I would have told you to spit miso right out of your mouth because I incorrectly told the world to avoid the phytoestrogen and soy until I wrote the book) similarly, I did really look at all the research on bras.

I get the concerns, like you were just saying; this tight binding bra that might compress the lymphatic system of the breast, which leads to toxins building up within the breast tissue itself, deleteriously altering the cells. But, actually, we treat breast lymphedema — which is a surgical or radiation-induced blockage of lymphatic fluid in the breast that infrequently occurs, but occurs enough that I’ve seen it a bunch after surgery and radiation — we treat that with, among other things, breast compression to push the lymphatic fluid out of the breasts and stop the buildup.

Other smart-sounding hypotheses include the idea that the underwire itself conducts environmental electromagnetic fields. But even if that antenna theory were true, these non-ionizing EMF that come from things like underwire bras or cell phones or microwave are not strong enough to create DNA breakage. So basically whatever you want to wear in terms of breast support, I support you. With or without a wire, with or without a bra.

Robyn:  Okay. I was hoping you were going to tell me the fact that I hate wearing a bra and therefore (I almost never do) it was going to help me with my breast cancer risk, but, rats.

Dr. Kristi Funk:  No, it won’t. But it will make them sag faster.

 [Laughter]

Robyn:  Well, it’s like when I hit my face with a tennis racket and split my lip open, and Tony Youn, our colleague Tony Youn, plastic surgeon, volunteered to jump on a plane and fly and take care of it. And I was like, “Dude, I’m turning 50. I’m on the downhill slope. It doesn’t matter anymore.” Kind of like you taking the processed turkey to your parents. I’m like, “It really doesn’t matter what my face looks like right now. We’re on the downhill slope.”

Dr. Kristi Funk:  Oh, you’re so beautiful. I didn’t even notice your sewn up lips.

Robyn:  Oh yeah. I didn’t get sewn up. That’s the whole point. It was just like, eh, nah.

Dr. Kristi Funk:  I bet you just superglued at yourself, huh?

Robyn:  No, you couldn’t. I looked into that and you couldn’t, so I just live with the scar. And it’s like you said, you don’t even notice. Who cares?

Quickly, I want to just ask you a couple of things and I know that these are big topics, but we’ve had a few people on the show talking about breast imaging and screening for breast cancer. Do you think that the reason mammography is in all of the oncologists offices — and many other doctors’ — is because it’s really the best imaging? Do you think that the risk and the exposure of radiation is worth it, or do you think it’s just what they invested in so they’re sticking with it? Or some combination?

Dr. Kristi Funk:  Combination. It is not by any means the best way to look at a breast. I can’t believe that in this day and age, where we hurdle through the air 10,000 miles above the ground at 500 miles an hour in a seated upright position, that we can’t look inside a breast and see what’s in it.

We go to the moon; how do we have all these technological advances, and yet the breast is mysterious, and we rely on imaging (which is inaccurate 30% of the time)?

Having said that though, we have what we have and that’s mammography, ultrasound and breast MRI. Not a fan of thermography, and I think there’s too much radiation exposure in some of these other modalities, that are infrequently used any way so your listeners might not know about them, but it’s like a PET scan for the breasts. Other things are available, but not widely [used].

So, what do I think? I think that this is what we have and so we must use it. Mammography isn’t bad at detecting cancer. It’s just not as good as it should be.

Here’s the deal with the radiation exposure. If you screen 10,000 women every year from the ages of 40 to 74 years old with a mammogram, that radiation exposure will cause 8.6 cancers, but it will detect 860 cancers.

In other words, mammography finds 100 times the number of cancers than it causes. And there’s nothing under the microscope about that radiation-induced cancer that declares itself, “Hi, I’m from your mammogram from 2022.” You won’t be able to blame a mammogram on your particular cancer. But that’s the pro and con. Odds are in your favor that you’re being helped by the mammogram and not hurt.

Societies differ all over the place as to when to start, when to stop, how often to get it, every other year. The American Society of Breast Surgeons has looked at all that data, and I agree with them. It’s basically a cost-benefit analysis that makes people come up with differing recommendations.

There’s a number of deaths from breast cancer per year that don’t include breast cancer surgeons or oncologists [opinion]. They are sociologist, epidemiologists, people looking at the bottom line and making these recommendations in an impartial way, without an individual woman or a particular practice in mind.

They tolerate, for example, if it takes 1900 mammograms to save one life, that’s not worth it. That is why your taskforce did stop the recommendation for mammos between 40 and 50 years old, because that would be the rate of saving the life. But when you start at 50 it takes about 1300 mammograms to save a life. In their computerized model way of thinking, that was worth it.

You have to realize that’s how these recommendations get thrown out there. It’s just a small group of people who decide what’s worth it. And you can make that individual choice for yourself.

In my opinion, I believe — as does the society I belong to — that the most lives will be saved by doing mammograms every year from age 40, without stopping or skipping until you think you’re going to die in the next five years.

Robyn:  Okay, so you recommend annual mammograms.

Annual mammograms for normal risk women starting at age 40.

Dr. Kristi Funk:  If you’re dense-breasted — which your mammogram will tell you; it’s not just how you feel your breast feels to yourself because most women think their breasts are dense because they’re kind of firm and lumpy and confusing, but only 50% of women, five zero, will have dense breasts and in those women, the mammography is a little less accurate — you should combine that with screening ultrasound.

There are new laws in place in most every state that would require insurance to pay for that screening ultrasound if you’re dense-breasted. If you layer on top of density extra risk because of family history or having a gene mutation or personal other risk factors that elevate you over a 20% lifetime risk, we would recommend breast MRI.

I don’t recommend it every year, except for people whose risk is 40% or greater; between 20% and 40%. I discuss it with the patient. They can certainly do it every year. I don’t think that the gadolinium that’s injected into your veins as an annual exposure is smart or safe. So we do it every other year, every three years, even every five, depending on what the woman wants to do.

Robyn:  What about trying to get around the need for a mammogram before an ultrasound and trying to go straight to ultrasound. We have people bringing this up. What do you think about that?

Dr. Kristi Funk:  If you’ve at least had one mammogram that shows your breast tissue is dense, you can ride on that. That the ultrasound is indicated. Or, you can just pay cash. People pay cash. And ultrasound isn’t prohibitively expensive for many people. So if your insurance denies it, you can just pay for the ultrasound.

Robyn:  And do you think that going straight to an ultrasound gives you less exposure? A lower risk, but better imaging?

Dr. Kristi Funk:  No. Ultrasound is no risk. It’s sound waves. There’s absolutely no detrimental effects, so that’s awesome. But ultrasound alone will miss somewhere around 40% of cancers. And it will almost next to never find a stage zero insight to cancer, which is obviously the most durable and you never need chemo and rarely need a mastectomy.

That is mostly detected by only a mammogram. Not ultrasound, not my hands, not MRI, as clustered calcifications. Little white flecks on your mammo that are growing or changing or brand new from your last one. That’s a real critical thing that sets mammo apart from everything else. It’s finding stage zero cancer.

I could then spend another chunk of time talking about, is that worth it? Do we really care if we have an insight to cancer? Is that ever going to grow to the point where it causes your death? Because overdiagnosis and overtreatment is a massive problem in the breast cancer state.

Robyn:  It seems like it’s a massive problem and at least now they’re not calling some of those insights to cancers cancer, right? They’re allowing for the fact that they may be metabolized by the body and not so many mastectomies have stage zero and stage one breast cancer, now. That seems like a less invasive step in the right direction. Or what do you think about that?

Dr. Kristi Funk:  Yeah, for sure.

There was a fascinating study that I came across from like 2015 where they had about 850 breasts in autopsied women. They died from a car accident or something, and they were never diagnosed with breast cancer in their lifetime. Okay.

This is shocking: In the women between 40 and 50 years old, 39% of the breasts had DCIS. And in the women who were 50 to 70 years old, 10% had DTIs. Where did it all go? 75% of the DCIS disappeared! I think the critical age gap there that we humped over the age of 50 — so we’re now pre- versus post-menopausal — and something in the change in the hormonal move of you in your body is going to allow your immune system to identify and destroy these DCIS cells.

Or, you stop feeding it and fueling it with (80% of all breast cancer, by the way, is been fueled by) estrogen. So if you cross over into menopause and don’t supplement with estrogen, then that existing estrogen-driven DCIS will fizzle out and die without its cancer field.

Robyn:  What I want to point out about that study, because Chris Wark, our mutual friend Chris Wark, told me about that study a couple of years ago and I think it’s fascinating. The age group you said, 40, to what?

Dr. Kristi Funk:  40 to 50, 39%

Robyn:  Let’s just put a pin in that for a second.

I hope you understood what she was saying, because she’s talking really quickly about an important study where they’re looking at car accident victims, or people who died of some kind of accident. I believe is what it was. And did y’all get that? That 39% of them between the age of 40 and 50 had what the cancer industry would call “insight to cancer.” 39% them had that.

That actually is what gives rise to a lot of my curiosity about, do we often have cancer that we are just metabolizing? And which also gives rise to that whole conversation that — we won’t go down that rabbit hole — the whole overtreatment thing. I just often wonder if the body is metabolizing cancer all the time.

Dr. Kristi Funk:  Oh, it absolutely is.

You’ve got normal cells humming along happily, right? And all of a sudden, in a matter of days, what was normal becomes mutated. By the sun’s UV rays, by cigarette smoke, by carcinogenic food (AKA animal products) and this mutated cell transforms into a seed. Whether or not that seed takes root and becomes a full blown cancer, capable of destroying your life, depends on the soil in which the seed lands. That soil you have control over whether it will help the seed flourish or fail.

The one thing we didn’t talk about is that the cellular response, what actually happens when you chew and swallow a piece of chicken, or a chunk of cheese. What happens inside of you, without any more help from you, is that estrogen levels skyrocket. IGF1, which is the biggest growth promoter of every cell in your body, IGF1, skyrockets. Inflammation abounds. Angiogenesis is stoked (we talked about that, new blood vessel formation), and your immune system gets hit.

Your theory of, we all have cancer flying around: it’s absolutely true.

When you eat animal products, your immune system, your cancer seeker and destroyer, is taking a hit. It’s too busy with the oxidative stress you’ve just cost inside your body to let the antioxidants that you’ve also consumed in smaller or greater quantity to do their thing. The antioxidants are too busy taking care of the oxidative reaction that the animal food just caused. S.

Quickly — because this is such a brilliant, beautiful study, and if you’ve never heard this one, Robyn, you’ll never forget it — they took a hundred people and they gave them a standard American diet for breakfast. Steak and eggs, pancakes and bacon. And they measured oxidized cholesterol, LDL levels, hourly, as a measure of the oxidative stress response to that meal. Up, up, up, up, up, lunch, hamburger and fries, up, up, up, up, up, dinner.

These people are going to bed every single night with fewer antioxidants than when they woke up. Your body can only take that for so many decades until, finally, whatever gets hit the most becomes your killer. So if it’s your arteries, heart attacks and strokes and Alzheimer’s. If it’s your pancreas burned out, diabetes. If it’s your breasts, breast cancer, right?

Here’s the beauty of the study. Next day, same people, same sad meal with one change: a cup of strawberries. Up, up, down, down baseline, hamburger and fries, one cup of strawberries. Up, up, down, down. Just the antioxidant capacity of a cup of strawberries, which had to deal with battling the oxidative stress of that bad meal, was able to completely neutralize it in a matter of hours, to get you ready for your next meal.

But what if the meal had been steel cut oats and a bunch of berries? What if the lunch had been a gorgeous big salad with a ton of lentils and sunflower seeds, et cetera?

Then it would take a very short moment for the oxidative stress that even plants cause inside of you to get neutralized. And those nutrients in the food get absorbed inside your bloodstream, go coursing through your veins, saturating every single cell — including rogue cancer cells or little tiny wads of cancer in that liver that no one’s found yet — and it does everything opposite. Anti IGF1, anti-estrogen, anti-angiogenesis anti-inflammation, seeking and destroying out the cells. Or nourishing your good cells.

It sounds like it could be false, but it’s proven in people. And people with debilitating coronary artery disease, wheelchair bound with oxygen in their noses. If they would just get rid of the animals and eat plants and exercise daily and decrease their stress, these blocked arteries open, wide open again.

Dean Ornish showed, with angiographic perfect picture proof, July 21st, 1990s, in the Lancet — most reputable journal in the world — that you can reverse coronary. The number one killer of you and everybody you love. We don’t need to die from coronary artery disease. And yet that big revelation was like sad and forgotten. I went to med school two years later; I never heard a thing about that study until I wrote my book.

Robyn:  Interesting. And if you go back and listen to everything that Dr. Funk just said about what happens via that study that you’re talking about, these are mechanisms of action that she’s talking about. Related to eating meat and different animal products, cheese and flesh that don’t have anything to do with whether they are grass fed or organic or free range. I’m not saying that that doesn’t help. I’m just saying those mechanisms of actions she listed happen regardless of there being higher quality animal products.

It’s clear to me from — I didn’t actually even know that study — from thousands of studies that the vast majority of us need to eat less animal products and more plants.

I’m really glad you’re out there talking about it, because it’s so unusual to hear it from a breast surgeon and I’m just really grateful that you’re out there being brave and speaking up about it, publishing your book.

We’ve talked about your book, but I know you also — to close on this — you should talk about your live event coming up. And I know that you’re going to choose 10 winners from my audience to get the live stream of your live event that’s happening next April.

Tell everybody where they can follow you, where they can get more information; remind them of your website and what about that live stream opportunity for next April.

Dr. Kristi Funk:  Thank you Robyn. Yes, everybody, I’m so excited. Please follow me at Dr. Kristi Funk — D. R. K. R I. S. T. I. Funk as in F as in Frank, UNK — Dr. Kristi Funk, and the website is pinklotus.com. You just go to the homepage, you’ll see all the things we offer.

We’ve got our breast center, our free foundation for low income, uninsured women, our amazing store with products that will change your life, and our PowerUp community which is filled with blogs and education and socialization opportunities within the website there. Breast buddies who help counsel and encourage newly diagnosed women from the viewpoint of someone who’s been there, done that. And we’ve got Facebook profiles and you can sell by trade your old scarves and hats on our breast-less platform. Please check out PowerUp and join us there.

The summit! Cancer kicking summit is coming in April, 2020 and I am so excited about this.

We are going to do a deep dive into the soil of your life and really take a good, hard look in an exciting high energy way at how you think, and how you love, and how you learn, and what you believe. Are you meditating? Are you moving enough? What are you eating? What are you not eating? Are you fasting? Are you giving back to those you love into the world in general? Because those are the key factors to living the most cancer free, most energetic, most loving, and wonderful life that you ever could create for yourself.

Join me there, and I am excited to give away 10 free live streaming passes to your listeners, Robyn. Sign up at pinklotus.com/summit.

Robyn:  Wonderful. Thank you so much. This has been really fascinating. And thanks for coming on the Vibe show, Dr. Kristi Funk.

Dr. Kristi Funk:  Thank you Robyn!!