DOCS TALK SHOP

In this episode, we explore some surprising benefits of hot and cold, including sauna, but also the heat of exercise, and one very surprising types of beneficial heat exposure. We start with the remarkable story of a man with an inherited mutation that gave him an extraordinarily high likelihood of developing early Alzheimer's dementia, yet decades, decades after he should have become ill, He hadn't. Did his lifelong job in scorching hot engine rooms provide some unexpected benefit? We travel the world for tidbits about heat and cold, and of course, somehow end up challenging conventional wisdom about meat, cholesterol, ApoE4, and brain health. We veer off again to look at one African cohort, where replacing just 200 calories a day of plant protein with animal protein was associated with about a 40% reduction in all-cause mortality. Join us for this globe-trotting episode!

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains

We physicians look outside the patient, to an expensive wearable, high-tech blood tests, or a brain MRI, to provide us with insights we hope we can use to relieve our patient's suffering. But what if some of the most powerful insights come from observations only a patient can make?

Gary Isaac Wolf, author of  The Quantified Self: Learning to Observe, joins Drs. Dawn Lemanne and Deborah Gordon to explore how ordinary people can turn self-observation into evidence. Real data. Something your physician can use, but can't get from anyone but you.

But before you haul out a notebook and begin writing down every ache and pain, listen up:

Gary Wolf discusses why tracking when you feel good can teach you and your physician so much more than repeatedly scoring how bad you feel. 

Learn how Wolf discovered that his own observations of a heart arrhythmia closely tracked a medical-grade Holter monitor, and gave him--and his cardiologist--a powerful insight that the Holter monitor left invisible, an insight that allowed him and his cardiologist to improve his treatment. 

Find out how you can use a pen, notebook, and three-step experiment to learn what expensive testing can miss.

Gary Isaac Wolf co-founded the Quantified Self movement, was an early WIRED editor and the first executive producer of WIRED Digital. His landmark New York Times Magazine article brought self-tracking to a broad audience, and his TED Talk has been viewed more than a million times.

Gary Isaac Wolf: Gary’s website
The book: The Quantified Self: Learning to Observe — book site and retailers · Workman/Hachette publisher page

The book is scheduled for publication October 6, 2026; the official book page currently links to Amazon, Barnes & Noble, Bookshop, Target, Walmart, Kindle, Apple Books and other retailers. (Quantified Self)

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains

What if our obsession with “dangerous” sun exposure is killing us?

If you (recklessly) leave your urban office for lunch, you are told to yank your hat down low. If you (again, recklessly) let your kids dash into the backyard, you are told to slather them in sunscreen—or learn to live with the guilt.

And yes, sun avoidance undoubtedly prevents some skin cancers, including the deadliest type, melanoma

But a recent study suggests lack of sunlight contributes to hundreds of thousands of deaths every year in the United States alone,  This is orders of magnitude more than the estimated 8400 annual deaths from melanoma.

In this episode, we discuss evidence linking sun avoidance to

• almost a million annual deaths in the US and Europe alone, four times more deaths than caused by all the shooting wars, globally, each year.
• increased risk of breast, pancreatic, colon, and lung cancers, as well as heart disease, high blood pressure, and stroke
• and, perhaps most surprisingly, to INCREASED risk of death in those already diagnosed with sun-induced melanoma.

Yes, you read that right; some melanoma deaths may be related to too little sunlight.  (But do understand that this is complex--sunlight DOES cause melanoma. Well, some melanomas are not caused by sun exposure, and we discuss those....)

Lack of sun exposure is not fixed by taking vitamin D, unfortunately. We explore the evidence that supplementing with vitamin D pills fails to remedy these terrible conditions, and what a thoughtful person can do instead, while staying safe.

We hope you enjoy this episode, and that it helps you enjoy the sun again--thoughtfully, of course. 

References and further reading:

1.   Sunlight: Time for a Rethink?
2. Benefits of oral Polypodium leucotomas extract in MM high risk patients (This is an ingredient in Life Extension’s Shade Factor, mentioned in this episode by Dr. Gordon).
3.  Uses of Polypodium leucotomos Extract in Oncodermatology  Calzari et al
4. Insufficient Sun Exposure Has Become a Real Public Health Problem. Alfredsson L, Armstrong BK, Butterfield DA, et al. International Journal of Environmental Research and Public Health. 2020;17(14):E5014. doi:10.3390/ijerph17145014.
5. Prospective Study of Ultraviolet Radiation Exposure and Risk of Cancer in the United States. Lin SW, Wheeler DC, Park Y, et al. International Journal of Cancer. 2012;131(6):E1015-23. doi:10.1002/ijc.27619.
6. An Estimate of Premature Cancer Mortality in the U.S. Due to Inadequate Doses of Solar Ultraviolet-B Radiation. Grant WB. Cancer. 2002;94(6):1867-75. doi:10.1002/cncr.10427.
7. Solar Ultraviolet-B Exposure and Cancer Incidence and Mortality in the United States, 1993-2002. Boscoe FP, Schymura MJ. BMC Cancer. 2006;6:264. doi:10.1186/1471-2407-6-264.
8. Ecological Studies of the UVB-vitamin D-Cancer Hypothesis. Grant WB. Anticancer Research. 2012;32(1):223-36.
9. Sunlight Exposure in Association With Risk of Lymphoid Malignancy: A Meta-Analysis of Observational Studies. Kim HB, Kim JH. Cancer Causes & Control : CCC. 2021;32(5):441-457. doi:10.1007/s10552-021-01404-6.
10. Adulthood Residential Ultraviolet Radiation, Sun Sensitivity, Dietary Vitamin D, and Risk of Lymphoid Malignancies in the California Teachers Study. Chang ET, Canchola AJ, Cockburn M, et al. Blood. 2011;118(6):1591-9. doi:10.1182/blood-2011-02-336065.
11. Is Prevention of Cancer by Sun Exposure More Than Just the Effect of Vitamin D? A Systematic Review of Epidemiological Studies. van der Rhee H, Coebergh JW, de Vries E. European Journal of Cancer (Oxford, England : 1990). 2013;49(6):1422-36. doi:10.1016/j.ejca.2012.11.001.
12. An Ecologic Study of Cancer Mortality Rates in Spain With Respect to Indices of Solar UVB Irradiance and Smoking. Grant WB. International Journal of Cancer. 2007;120(5):1123-8. doi:10.1002/ijc.22386.
13. Does Sunlight Prevent Cancer? A Systematic Review. van der Rhee HJ, de Vries E, Coebergh JW. European Journal of Cancer (Oxford, England : 1990). 2006;42(14):2222-32. doi:10.1016/j.ejca.2006.02.024.
14. Heliovaccination: Solar mediated immunity against cancer. Uzoigwe CE. Experimental Dermatology. 2020;29(5):477-480. doi:10.1111/exd.14087.
15. Beneficial Health Effects of Ultraviolet Radiation: Expert Review and Conference Report. Riedmann U, Dibben C, de Gruijl FR, et al. Photochemical & Photobiological Sciences : Official Journal of the European Photochemistry Association and the European Society for Photobiology. 2025;24(6):867-893. doi:10.1007/s43630-025-00743-6.
16. A Blueprint for the Primary Prevention of Cancer: Targeting Established, Modifiable Risk Factors. Gapstur SM, Drope JM, Jacobs EJ, et al. CA: A Cancer Journal for Clinicians. 2018;68(6):446-470. doi:10.3322/caac.21496.
17. Proportion and Number of Cancer Cases and Deaths Attributable to Potentially Modifiable Risk Factors in the United States, 2019. Islami F, Marlow EC, Thomson B, et al. CA: A Cancer Journal for Clinicians. 2024 Sep-Oct;74(5):405-432. doi:10.3322/caac.21858.
18. Cutaneous Melanoma. Joshi UM, Kashani-Sabet M, Kirkwood JM. JAMA. 2025;334(23):2113-2125. doi:10.1001/jama.2025.13074.
19. Sunlight, Vitamin D and the Prevention of Cancer: A Systematic Review of Epidemiological Studies. van der Rhee H, Coebergh JW, de Vries E. European Journal of Cancer Prevention : The Official Journal of the European Cancer Prevention Organisation (ECP). 2009;18(6):458-75. doi:10.1097/CEJ.0b013e32832f9bb1.
20. Lessons Learned From Paleolithic Models and Evolution for Human Health: A Snap Shot on Beneficial Effects and Risks of Solar Radiation. Reichrath J. Advances in Experimental Medicine and Biology. 2020;1268:3-15. doi:10.1007/978-3-030-46227-7_1.
21. PS-Vitamin D. American Academy of Dermatology (2022).
22. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer With Healthy Food Choices and Physical Activity. Kushi LH, Byers T, Doyle C, et al. CA: A Cancer Journal for Clinicians. 2006;56(5):254-81; quiz 313-4. doi:10.3322/canjclin.56.5.254.
23. Vitamin D, Sunlight and Cancer Connection. Holick MF. Anti-Cancer Agents in Medicinal Chemistry. 2013;13(1):70-82.
24. Survivorship. National Comprehensive Cancer Network. Updated 2026-04-08.
25. Keratinocyte Carcinoma. Wehner MR. JAMA. 2025;:2840731. doi:10.1001/jama.2025.18749.
26. Public Awareness and Behaviour in Great Britain in the Context of Sunlight Exposure and Vitamin D: Results From the First Large-Scale and Representative Survey. Burchell K, Rhodes LE, Webb AR. International Journal of Environmental Research and Public Health. 2020;17(18):E6924. doi:10.3390/ijerph17186924.
27. Behavioral Counseling to Prevent Skin Cancer: US Preventive Services Task Force Recommendation Statement. US Preventive Services Task Force, Grossman DC, Curry SJ, et al. JAMA. 2018;319(11):1134-1142. doi:10.1001/jama.2018.1623.
28. Lifetime Sunburn Trajectories and Associated Risks of Cutaneous Melanoma and Squamous Cell Carcinoma Among a Cohort of Norwegian Women. Lergenmuller S, Rueegg CS, Perrier F, et al. JAMA Dermatology. 2022;158(12):1367-1377. doi:10.1001/jamadermatol.2022.4053.
29. Cancer Prevention and Early Detection Facts & Figures. Rick Alteri, Deana Baptiste, Emily Butler Bell, et al. American Cancer Society (2025).
30.  
31. Skin Cancer, Irradia

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains

Cancer treatment is simple, right?

Kill as many cancer cells as possible, as quickly as possible.

In some cases, that may be exactly the wrong approach.

In this episode, Dr. Dawn Lemanne and Dr. Deborah Gordon explore a surprising idea emerging from evolutionary biology, ecology, and mathematical oncology: in some metastatic cancers, aggressive treatment may unintentionally accelerate the growth of treatment-resistant cancer cells.

Using examples ranging from DDT-resistant boll weevils to metastatic prostate cancer, they discuss:

• Why cancer treatments stop working in advanced cancers

• How cancer cells evolve resistance

• How treatment-sensitive cancer cells actually help control more dangerous treatment-resistant cancer cells 

• The concept of "competitive release" and how treatment can unintentionally remove the competition that restrains resistant cancer cells

• How new blood tests called circulating tumor DNA (ctDNA) allow physicians to monitor cancer in real time

• The emerging field of adaptive cancer therapy, in which treatment intensity is adjusted in response to the cancer's evolutionary behavior

• The research suggesting that overtreatment can sometimes shorten, rather than prolong, cancer control

Along the way, they explore groundbreaking work mathematical oncologists and cancer evolution researchers, and discuss a radically different way of thinking about advanced cancer—not simply as an enemy to destroy, but as an evolving ecosystem whose behavior may be influenced and, in some cases, steered.

This conversation applies to advanced metastatic cancers that cannot be cured with current treatments. It does not challenge the importance of aggressive treatment for cancers that remain potentially curable.

The question explored in this episode is simple:

Can killing more cancer cells sometimes make cancer worse?

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains

In today's episode, we welcome back a familiar and popular guest, Andy Baxter, who has an impressive resume as rower, rowing coach, and particularly insightful rehabilitation specialist. What Dr. Lemanne and I have particularly appreciated about his work is his focus on not just rehabbing an injury, but going beyond rehab.  He is a master at how to safely build both strength and resilience, good for avoiding both dementia and cancer. He'll talk about about his exciting new and innovative techniques for achieving those goals. Welcome back, Andy!

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains

In this episode, we’re joined by Debra Zaslow—author and storyteller—who shares her personal experience with hormone replacement therapy, including some immediate and unexpected effects that took her by surprise.

From that starting point, we explore several unexpected ideas:

•  Estrogen alone may reduce breast cancer risk in certain groups 
•  Not all “progesterone” is the same—synthetic versions can behave very differently 
•  The way a hormone is delivered (pill vs patch vs topical) can significantly change its effects 
•  Hormones are often prescribed without measuring levels—unlike almost every other hormone in medicine 
•  Many key hormones, including estrogen and testosterone, are made from cholesterol 

Dr. Deborah Gordon and I revisit hormone therapy in response to your strong interest in the topic. The conversation moves from lived experience to clinical nuance—how different formulations behave, why dosing and monitoring matter, and how to think more precisely about risks and benefits, especially in menopause and in more complex settings like cancer history.

A candid, grounded discussion for anyone trying to make sense of hormones beyond the headlines.

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains

In today's episode, we have the distinct pleasure of speaking with Dr. Tommy Wood, whose new book, The Stimulated Mind, will be available soon. We explore his concept of developing greater head space. That's not hat size, but rather our cognitive reserves as we head into older age. We talk about the kinds of brain training and brain resting that are most helpful for our brain health and function. Dr. Woods also talks about his work coaching elite athletes. He shares his insights about getting better results when we remember compassion, both with ourselves and with others. One fascinating item is we learn why an experiment that put glasses--eye glasses--on owls shows us the one missing ingredient that makes it difficult for aging brains to learn. And more importantly, how one specific simple change in attitude turned old owl brains into spring chickens, forgive the pun, able to learn as easily and as well as young owls. Join us for a fascinating discussion and a preview of Dr. Wood's forthcoming book, The Stimulated mind. Enjoy.

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains

 In today's episode, we explore the controversy regarding ultra-processed foods, starting with an attempt to define just what those are. That's actually not been carefully approached yet. Then we look at the more serious attempts to construct ways to measure and precisely discuss the hazards of ultra-processed foods and ways we might rectify those. We range far afield from our esoteric medical school lectures all the way back to our own childhood eating experiences. We talk about the role of wise choices with any foods, including fast foods. And yes, you can eat those wisely or less wisely. We circle back several times to the importance of some basic home cooking skills and habits. We invite you to listen to this episode and enjoy.

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains

In this episode we discuss one of our favorite pasttimes – exercise—and the relationship between exercise and health. Of course it’s no surprise that exercise is recommended for its health benefits, for people at any age and any level of fitness.  Dr. Gordon and I both prescribe exercise as one of the most important parts of our routine patient care.

 Today though we dive into what has surprised us both:  the hazards of ??too much?? exercise. 

 When might exercise have a dark side, when should we think twice about our exercise habits? And how might we tweak our exercise routine to get the most benefit from the time we do spend being active. Join us as we pore over some of the details.

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains

Treat ADHD, lower Alzheimer’s risk?

The episode explores emerging evidence that simply having ADD/ADHD raises lifetime Alzheimer’s risk—yet appropriately treating it in adults, often with low-dose stimulants, seems to push that risk back down. How can the same class of drugs be both feared as “brain-burning” and yet potentially brain-saving—and what does that mean for people already in midlife?

Treating prostate cancer successfully with--testosterone? 

Listeners are introduced to a first-in-oncology “directed evolution” case in metastatic prostate cancer, led by Dr. Lemanne’s team, where high-dose testosterone was deliberately used to expand treatment-sensitive cells—and only then was hormone blockade re-introduced. But did this radical, counterintuitive maneuver actually work?

Emotional trauma in youth as a hidden Alzheimer’s driver? Dr. Gordon discusses links between youth emotional trauma to higher rates of Alzheimer’s decades later, even in people who appear to have “moved on.” Is this just correlation, or should early emotional trauma be considered a subtle form of brain injury that can and should be addressed?

Do you go to bed later on weekends, by just 1-2 hours, but make up for it by rising later?  If so, you'll want to know that you may be increasing your risk of breast or prostate cancer.  This episode explores that research.

Have you heard of the new Alzheimer’s blood tests, that improve as the patient improves, allowing better direction of treatment? 

Dr. Gordon walks us through the ATN panel (amyloid-beta, p-tau, neurofilament light), now accessible through routine laboratory tests, along with galectin-3 as a tau-clustering, inflammation-linked marker, and a new infusion drug (TB006) targeting that pathway. But can these numbers really be moved in the right direction with targeted lifestyle and medical interventions—and what happens when they are?

Enjoy this unusual episode! 

And write to us. We read every email.

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains