Dr Chadi Nabhan, MD, is an oncologist who has been involved in litigation cases with Monsanto and he’s joining us today to talk about glyphosate, cancers of the gut, and how to prevent and treat cancer. He took care of cancer patients for 20 years where he focused on lymphoma. He then went back to business school and got an MBA in healthcare management. He now works at a molecular profiling company that profiles tumors to understand the underpinning of the DNA and the RNA of cancer so that doctors can figure out the best way to treat their patients.

The Evolution of Chadis Career

At the beginning of my career, I was very interested in novel therapies. I wanted to get involved in new treatments for lymphoma whether that be in clinical trials or bringing them to my patients. Through this, I became interested in two aspects:

- One is called real-world evidence. This means that sometimes patients are treated in clinics and the real world differently than the patients that were in clinical trials. In the trials, everything is organized, coordinated, and precise. And then a drug gets approved and it becomes available for physicians to treat then everything becomes different. In the real world, you don't always treat in the same dose and you don't do the scans at the same exact time. I became interested in patterns of care in the real world how they vary from clinical trials and how can we really make sense of what happens in the real world.

- I also became interested in geriatric oncology. The reality is that more cancer patients are diagnosed over a certain age and the majority of cancer deaths are over a certain age. Statistically speaking, most cancers are in patients over the age of 65 and most die or over that age as well. We have to pay attention to this field because we need to see how older patients get treated.

When you deal with cancer for so many years there are a lot of stories to tell. This is a story that got me interested in oncology: When you are in residency, you are nervous and don’t know much. You are going into a patient's room and getting their vitals. I walked into a patient's room who had ovarian cancer, she was in her mid-40s, and she looked like an angel. I was asking her how she was doing and she said “Do you think I’m going to live until Christmas?” It was October and I wasn’t prepared to answer. I told her I didn’t feel fit to answer and she said “Don’t worry, I just look forward to seeing your smile tomorrow” Right then and there I realized the importance of human connection.

The human aspect of the relationship is more critical than science. Science is important for progress but the human connection is also important. Right then and there I fell in love with the relationships you form with your patients with cancer. When your health is jeopardized by whatever health issue you have, you are in the most vulnerable time. Health is the most precious thing that you have. Imagine you are in this vulnerable state and you have to trust a human that you just met for the first time with your health and treatment decisions. It's a privilege to take care of people.

formation of tumors which can be cancerous

What is Cancer?

Our body is composed of various organs and every organ is composed of cells. These cells are usually present in a very harmonized manner. They grow and multiply > then they die and are replaced by new cells. There is a balance between cell survival and cell death and something happens that tips the balance off. So either the cells continue to grow and don't die naturally or the balance of growth and death is completely off. This leads to the formation of tumors which can be cancerous. Cancer is an imbalance between cell survival and cell death. It can happen in any organ because every organ has cells.

You may be wondering, “Why is the balance tipped off?” This happens for a variety of reasons but generally, there are mutations that occur in our body in the structure of the cell and the backbone of the cell. Think of a building, it has bricks and walls but they can get damaged.

> There are external factors that could damage the bricks and it’s the same thing with cells. Sun exposure could damage the skin, smoking, pesticides, and herbicides are all external factors that affect these cells.

> There are also internal factors such as a mutation that’s inherited from your parents.

> Then there are certain things pertaining to wear and tear as you get older. Sometimes buildings are just 100 years old and the repair mechanism is damaged. Our body is an amazing machine because even if the cells are damaged, we can repair them. Once we get older, this ability dwindles. But I don't believe age by itself causes cancer. We have to look behind the curtain.

Preventing and Treating Cancer

When we ask how to treat and prevent cancer, it implies that cancer is one entity which is not the case. We can all agree that cancers are different, so I think there are certain risk factors that are more applicable to certain cancers and not others. I haven’t heard of smoking increasing the risk of brain tumors but we all know that smoking increases the risk of lung and bladder cancer. This doesn’t mean It's okay to smoke but It's important to recognize that the cancer as an entity differs and depends on the organ so the treatment and risk factors differ.

There are certain general factors that are common sense that we should all try to adhere to. Alcohol is an interesting substance because there is some data on it increasing the risk of breast and pancreatic cancer but it’s not clear what type of alcohol. I always say from an alcohol standpoint be a minimalist.

Exercising and staying fit is very important. There are 14 cancers that have been linked to obesity. You can still enjoy food but do this in a healthy manner. Exercise doesn’t mean you need to do a marathon, you could take a brisk walk. There are certain professions that have increased risk of certain cancers too.

With treatment, every cancer is different. The most common types of treatments are surgery, radiation therapy, chemotherapy, immunotherapy, hormonal, and targeted. The ones you select and what you do depend on the cancer Itself. For example, Lymphoma is not treated surgically but breast cancer is.

Cancers of The Gut

First, we start off with colon cancer, and the best way is to divide this into two categories:

The first category is colon cancer from the genes that are passed on through the family. Usually, this is what we call the Lynch syndrome. This is when patients have a mutation in genes called the mismatch repair genes. When this occurs, they develop the risk of having colon cancer. These patients should get colonoscopies often in their lives.

The second category of colon cancer isn’t caused by genes. It evolves from polyps inside the colon. These polyps usually start forming at the age of 45 and above. The guidelines in the United States are to undergo colonoscopies at the age of 45 and then repeat every 5-10 years. Patients with Chrons and UC have a higher risk of developing colon cancer and it’s important to discuss this with your doctor.

As far as what might cause colon cancer, there have been some studies on red meat, low fibre diet, and things of that nature. You can criticize every study so I tell my patients to eat healthily and be realistic.

Cancers of the upper GI tract in the stomach and the esophagus are more prevalent in Asian countries. It’s been hypothesized that this is because of the spicy diet that they have with a lot of smoking and alcohol. There are certain ulcers that occur in the duodenum and the stomach. They are caused by a bacteria called H Pylori which increases the risk of certain ulcers in the stomach and the first part of the small intestine. There is also some data that shows H pylori may be a cause of some gastric cancer as well.

The Introduction to the Monsanto Trial’s

I never considered myself an expert witness but as serendipity has it, I ended up testifying in 3 major trials. Monsanto manufactures Round-Up and the main ingredient in it is a chemical called glyphosate. Round-up has been used by Monsanto commercially in the USA since 1974. In the mid-90s, Monsanto introduced something called round-up ready seeds. These are GMO which means:

- The farmer can spray round-up on the weeds and it would kill them

- They can also spray it on their crops and the seeds are not affected or damaged

This caused the usage of round-up to increase and this means it is present in our food because the farmers are spraying corn, wheat, beans, and more. This wide use led the World Health Organization and a subdivision called the International Agency for Research on Cancer to research whether glyphosate had any carcinogenic potential. They gathered some scientists and looked at the published evidence, animal studies, and human studies. Then they issued a report in March 2015 that glyphosate is a probable human carcinogen which means it increases the risk in some patients to develop cancer.

After that, lawsuits started happening and patients who were heavily involved in round-up usage started connecting that the lymphoma they had was because of the round-up that they used. Because of my experience with lymphoma, I was contacted by one of the firms in 2016 asking me if I was willing to look at the evidence and testify on behalf of the patients. Most of the data was in non-Hodgkins lymphoma and as I investigated this, I was convinced of the relationship between the two and I agreed to testify. Each of these trials was won by the patients.

The History of Glyphosate

Glyphosate was discovered in the 50s by Swiss chemists and was subsequently patented by Monsanto in the 70s. A few scientists who worked for Monsanto discovered that it was a mineral chelator and had the capability to kill weeds. Monsanto patented it, added surfactants, water, and other soluble chemicals to it and it became round-up. Surfactants are foamy materials that make the glyphosate more sticky and go onto the weeds instead of the skin.

How Long Has Glyphosate Been in Our Food System?

It started making its way in the mid to late 90s. This is when it started being sprayed on all of the crops. In the trials I testified in, I mostly read and researched lymphoma cancer and glyphosate, but we should ask ourselves if is it possible that some of the ailments we are seeing in today's world may be related to the use of glyphosate and round-up. It is the most used weed killer in the world. Once the roundup-ready seeds became available, this gave farmers the ability to have airplanes spray round-up all over the fields because they no longer feared that they were going to damage the crop. This is in cereal, bread, corn, and many other foods. The next question we have to ask is: Is glyphosate causing leaky gut, autoimmune conditions, and affecting other things beyond cancer?

If you are spraying it into the environment, it is going to get into the waterways and affect livestock. It is almost impossible to avoid. - Kriben Govender

How Do We Avoid Glyphosate?

The fact that it is hard to avoid should not be an excuse that we do not have a solution. At some point everyone smoked. There were doctors smoking in commercials. It may be ubiquitous but we should have a solution. There is a big opportunity for someone who is innovative to bring a product to the market that can kill weeds without damaging the environment and people.

Monsanto has always argued that round-up is safe because the EPA in the United States has said it is safe. I respectfully disagree with the EPA. If you look at the original document, they said that it was carcinogenic. Then they changed their position without any new data. There's an opportunity for citizens to lobby and put some pressure on the regulatory agencies and demand more from the manufacturers. They need to demand more studies and put the safety of their citizens front and center.

The beauty of capitalism is that consumer has the ability to influence the behavior of manufacturer through their wallets. Which products are you choosing? We aren’t going to completely eliminate glyphosate but just like with any other chemical, dose level matters. By reducing this in our lives, it will mitigate the risks. - Kriben Govender

Toxic Exposure Book

I had no idea how big this was going to be but I realized the impact when I read the science, and internal documents about Monsanto's email communication, ghostwriters, and behavior. There were many other expert witnesses who were part of the team and we all did our part to expose the truth. In one of the court testimonies, the Monsanto lawyer asked me why I didn’t go around the world telling people about this. Which led me to decide to write a book for the public. It took me three years and it’s written in an easy-to-understand manner. I wanted to educate people on what happened to the first 3 patients that took Monsanto to court through my lens.

The first trial was huge and at that same time, Bayer was acquiring Monsanto for 63 billion dollars. I think Bayer underestimated the power of litigation and the power of patience. Their stocks went down by ⅔ they have lost so much in market cap. The Wall Street Journal called this acquisition one of the worst business decisions in history.

The Estimated Payout in Damages in the 3 Trials

These three trials led to a large settlement of around 11 billion dollars for over 100,000 patients. It's one of the largest product liability settlements in US history. The first verdict Johnson vs Monsanto, was 289 million dollars. The next trial Hardiman vs Monsanto was at 89 million and this was the trial that Monsanto decided to take all the way to the United States Supreme Court but they refused. The third trial was an elderly couple that won 2 billion dollars. Bayer still refuses to acknowledge that this could cause cancer in some patients and they don’t want to put a warning label because it affects profits.

Health is Wealth

Health is priceless. Although all of the patients got money in this settlement, they didn’t get their lives back. We do not know the full effect on the soil microbiome and how it’s affecting us long term so be careful using this product even in small amounts in the garden. The best part about capitalism is that we vote with our dollar. Eventually, these unhealthy products will come off the shelf if we aren’t buying them. Make sure to choose organic if you can, your health is priceless.

Chadi’s Gut Health Tip

We need to avoid artificial chemicals in our food. I didn't believe in that too much when I started my career but the more I learned the more I changed my mind. There is nothing wrong with admitting there is a better way to do things. Support small farmer's markets instead of industrialized nations that don't have your health at the center of their minds. Share this post with a friend who could benefit from this information!