Decipher The Link Between Breast Cancer And Hormones

Jennifer Simmons, MD

I’m happy to. I do realize, first of all, thank you so much for having me on today. I do realize that I come from a  unique position, and I am so grateful for that. I originally come from a breast cancer family, and so because of the tragedy that I witnessed at a  young age, I do not remember a time when I didn’t know about breast cancer and didn’t know about the devastation of breast cancer. When I was 16 years old, I lost my first cousin to breast cancer. At that time, I kind of dedicated my life to making an impact in this space. I became a surgeon, and I became the first scholarship-trained breast cancer surgeon in Philadelphia. I spent 20 years as a cancer surgeon, working specifically with people with breast cancer. At the same time, I was running an ad for an accredited cancer program. I spent a long time in that conventional medical space. But in 2017, I got my diagnosis, did not opt for conventional treatment, and went on my journey, learning about functional medicine. Once I did that, it was a bell that I couldn’t unring. I completely shifted how I went about helping the breast cancer population.

I left the surgery in 2019, and I opened Real Health, M.D., which is a functional medicine oasis for anyone at any point along their breast cancer journey to help them restore health. In functional medicine and integrative oncology, we kind of use everything. I marry everything that I learned in the conventional medicine space in terms of how to combat cancer. However, the conventional medical approach is tour-centric. It is focused on the tumor. I understand that, with my understanding of physiology and functionality, health is not the absence of disease. Health is optimal function, and the only way that we achieve optimal function is by ensuring that the system is working properly and correctly. It is the combination of, yes, we have to acknowledge the tumor, but the tumor is in everything, and the tumor is every bit as much a part of you as any other part of you. It is about helping the woman in front of you or the person in front of you, because unfortunately, men do get breast cancer, too, but it is about helping that person in front of you to restore balance in their life because cancer is a normal response to an abnormal environment. There’s something that is triggering the cells to think that they’re unsafe, and they go into survival mode. That is essentially what cancer is: being a functional oncologist, integrative oncologist, or whatever you want to call her title, I help restore a person to health, whatever that means for them.

Michael Karlfeldt, ND, PhD

That is the thing: as we are then addressing the tumor or addressing the lump that you’re seeing or recognizing the impact of whatever treatment that you’re doing, are you then losing total ground because you’re so tumor-focused and forget about building health, restoring balance, restoring whatever it was, or correcting whatever it was that drove that tumor? I think that is beautiful. Give me a little bit of information. There are several different ways I want to talk about hormones. I want to talk about testing. I want to talk about the latest and greatest and also some hormone deprivation and the impact that has on the body. Tell me a little bit about what it looks like when a person comes to you.

Jennifer Simmons, MD

Where do I start?

Michael Karlfeldt, ND, PhD

Yes, where do you start?

Jennifer Simmons, MD

That is a great question. It is not going to be the same for everyone except to say that I start with history because the main thing that everyone needs is to arrive at their why. Because unless we correct the why unless we correct the reason why the cancer developed, what is to stop the cancer from coming back? Once you get rid of the original tumor, what is the next manifestation of the illness? Because for everyone, cancer is a symptom. It is a symptom or manifestation of some kind of imbalance in the body. Where I start with everyone is asking why, like what happened, and I look at their history from the time that they were born or even the time that they were in utero in their mother’s uterus up until today. I’m looking for clues. So often people come to me and say I’m healthy, except I have breast cancer, and we’ve become so detached from our health that that state somehow makes sense to us, and we do not know what it means or what to do. We’ve lost the ability to understand what health is, and we are not in touch with ourselves anymore. What I do is kind of help people understand and paint a picture. that same person who had difficult periods, gut problems, constipation, and acne, struggled with fertility, had irregular cycles, and now is presenting with breast cancer, I help them to see that this didn’t just happen. Almost everyone. When you talk to them about the year before their diagnosis, they’re going to have the straw that broke the camel’s back. There is going to be a job, a change of illness, caring for a loved one, a death, a divorce, and a move. Sometimes it is a marriage. Sometimes, some things are especially stressful. They do not all have to be sad things, but some things are especially stressful, and we are not built for chronic stress. When you add chronic stress to the toxic soup that we live in, because we live in an increasingly toxic world, when you add that together, that ends up being the perfect combination for cancer development.

I’m helping people to arrive at their why I’m looking deeply into their history to pick up clues of what I should be looking for and then I use functional testing to determine what needs to be adjusted, helped, and supported. Our bodies have an inherent ability to heal themselves and sometimes we just need to get out of our way. We need to give our body, what it needs, and we need to take away those things that are interfering with our inherent ability to function. it is a little bit of detective work, and everyone’s story isn’t the same, but the approach to everyone is the same in that I kind of want you to tell me everything and then I’ll decide what’s important and not important because when you allow people to kind of tell their own stories, that is great. But they often tell it with a significant amount of bias and they do not understand how important everything is. we are kind of trained in the conventional medical world to segregate things into different organ systems. For instance, people do not understand that they’ve been suffering from chronic sinus issues for years and years and years. But they won’t mention that when they’re telling their breast cancer stories and what they do not realize and what goes off in my head when they tell that story is, oh, you had chronic sinus issues. How many rounds of antibiotics have you had? We know with each round of antibiotics, we increase the likelihood that we’re going to get cancer.  this is something that we do not frequently talk about.  so someone wouldn’t can someone wouldn’t give automatically give you information on their sinuses because they wouldn’t connect it. it is about taking in all the information and connecting the dots.

Michael Karlfeldt, ND, PhD

That is the key: If you do not find the drivers, like you’re saying, why? You know what? The cancer doesn’t just show up because there is a reason. So you can’t just isolate the cancer from yourself. You get to see what transpired. It is not just this past year. It is something like you’re saying that maybe the last year was the straw that broke the camel’s back. But there were a lot of straws built up over time. Yes. until last time.

Jennifer Simmons, MD

When I talk about finding the reason and getting to the root cause, so many people respond. I know that they’re coming from a place of fear and guilt. But so many people respond by saying, Do not blame the victim. Trust me, that is not what this is about. This isn’t about saying, like, wagging the finger, and you did this, and so you got breast cancer. The vast majority of the things that happen throughout people’s lives are completely involuntary; they’re things that they are unaware of, and we do not connect them. But I say that even people who smoke do not smoke to get lung cancer. We know that it is a consequence, but they do not smoke to get lung cancer. No one lights up a cigarette, saying, Wow, I hope that I get lung cancer here. Eating in a certain way, living in a certain environment, not exercising, being sedentary, and not prioritizing sleep—this isn’t about blame; it is about opportunity because if we know that these things are difficult for you, we know where the work is and how to help you. It is not about blame or shame. It is about identifying opportunities for health. When you pursue health, by the grace of God, disease goes away.

Michael Karlfeldt, ND, PhD

One of the important things is that this kind of relates strongly to breast cancer, and I mentioned a little bit earlier that we’re going to talk about it. As hormonal optimization and a healthy individual. Their hormones are where they need to be. A lot of people rely on them to support themselves, using identical hormones. Let’s say a person has a hormone, estrogen or progesterone receptor, that is positive. What is your take in regards to that?

Jennifer Simmons, MD

Well, let’s talk about hormone balance first. When we talk about hormone balance, we have to think of it in two separate areas. We have to think about premenopausal hormone balance and postmenopausal hormone balance. In the premenopausal population, women who have not yet reached menopause, and I’m going to put the perimenopausal women like the women who are becoming symptomatic, I’m going to put them closer to the postmenopausal population. But in the premenopausal population, the way that you know that your hormones are balanced is that you have regular menstrual cycles. You do not suffer with your menstrual cycles; you do not have headaches; you have energy; you’re sleeping well; and you’re moving well. You’re able to do what you want to do when you eventually pursue pregnancy. You do not have any difficulties with pregnancy. You do not have any difficulties carrying a pregnancy. You do not lose pregnancies. All of that is indicative of hormone balance. If you’re having irregular cycles, if your cycles are painful for you, if you’re suffering from mood disturbances in and around your cycles if you have acne if your hair is falling out—all of these things are signs that you do not have hormone balance. That is someone who needs investigation and help. Help balance your hormones. It is not just estrogen, progesterone, and testosterone that I’m talking about, because the truth is that our hormones are a symphony and a balance between cortisol, your thyroid hormones, your sex hormones, and melatonin. There’s a whole symphony going on there that if you’re having disturbances and all those things that I talked about before, that is the time to work on that because that unattended person that winds up in my office with the breast cancer right because they’ve had that inflammation that is disturbing their hormone balance for some time, and at the end of that road is a breast cancer diagnosis.

Michael Karlfeldt, ND, PhD

My question is, do you work upstream when there’s an imbalance in the hormones, and you think the pituitary hypothalamus, most thyroid, adrenals, and all of that? Looking at progesterone, estrogen, testosterone, DHEA, and all of that, is it safe? Let’s say you work on correcting upstream. Things look good, and they just need to have that boost with bioidentical hormones to feel good. Is it safe in your mind to do that with the concern of a breast cancer diagnosis?

Jennifer Simmons, MD

I do not have any concern about giving people hormone replacement if you’ve proven that they are, for whatever reason, having premature ovarian failure or they’re menopausal. It may not be premature, but they have ovarian failure. There is no evidence to support the idea that those people are at increased risk from hormone replacement, and it doesn’t even have to be bioidentical. The numbers are not that different in this synthetic hormone replacement. Here’s the thing. There are people who you put on hormone replacement that are going to get breast cancer, just like there are people who you do not put on hormone replacement that are going to get breast cancer. We’re just talking about modifying your risk. The things that you can do to modify your risk are: you can follow a whole-food, unprocessed, low-glycemic, plant-based diet. You can make sure that you’re getting proper and frequent movement throughout the day. You can use stress management techniques. You can mind the toxins in your environment and try to decrease your exposure to environmental estrogen. That is of tremendous importance for everyone. You can have detoxification practices in place. You can prioritize sleep. All of these things will be tremendous factors in who does and does not get breast cancer. But what is not changing that risk factor is who does and does not go on hormone replacement. There is no more incidence of breast cancer in the hormone replacement population than there is in the general population. Hormone replacement is perfectly safe, and I am a huge advocate for it. As Anna Cabeca would say, menopause is mandatory, but suffering is optional. I do not think any woman should have to suffer from menopausal symptoms.

Michael Karlfeldt, ND, PhD

I love that. Because there are so many health concerns that come along with non-optimal hormonal levels, like your heart, your bones, your skin, your brain, and your mood. Life can just become miserable without the appropriate support in that area.

Jennifer Simmons, MD

Even if you’re not having what we call the lifestyle effects of menopause, the lifestyle effects are mood disturbance, loss of sexual desire, or painful intercourse from vaginal atrophy. Most people consider those to be secondary. That is the stuff that you’re supposed to just white-knuckle your way through. But even if you do not have those, it is undeniable that estrogen is protective of the heart and protective against cardiovascular disease, which is by far and away the number one threat to a woman’s life from 40 years of age onwards. More women will die of heart disease than breast cancer. in every decade of a woman’s life from 40 on. We have to think about protecting the heart. We know that hormone replacement after menopause is protective against cardiovascular disease. It is also protective against osteoporosis. None of the bisphosphonates come close to the protection that estrogen gives a postmenopausal woman, of course. None of them even come close. I could argue that they make things worse for people because we see a whole host of atypical fractures. Every single year, the number of women who die of a complication of a fracture is equal to the number of women who die of breast cancer every single year. yet we are not talking about it. We have the solution. We have the solution. It is putting people on post-menopausal hormone replacement. In addition, it protects your brain, so it protects against Alzheimer’s, which is most women’s greatest fear. So even if you do not have the hot flashes and the mood swings and the loss of libido and the vaginal symptoms, even if you do not have them, I can still make a sound argument for putting you on hormone replacement after menopause. I have no concern that I’m going to increase your risk of getting breast cancer.

Michael Karlfeldt, ND, PhD

If an individual has the diagnosis you feel, you would feel confident that that would still be a good idea.

Jennifer Simmons, MD

For that person, I am taking extra special care to make sure that they do not have a hormone metabolism problem. I’m looking at their genetics. I am looking at how specifically they are metabolizing their hormones, what pathways they’re using, and making sure that I’m giving them everything they need to support those hormone metabolism pathways. Those are also the people for whom you have to be extra careful about exogenous estrogens. You have to make sure that these people are filtering their water, that they’re not drinking out of plastic, that they’re not cooking in nonstick, that they’re not storing in plastic, that they’re not using fragrance, and that they’re not using traditional health care products or personal care products. These are the people that they want to be supervised and vigilant about—those exotic estrogens, those xenoestrogens. If that is in control and you’re supporting them with detoxification when they have detoxification measures in place, those are the people that I’m comfortable supporting.

Michael Karlfeldt, ND, PhD

Yes. and these xenoestrogens, or exogenous estrogens, people don’t recognize the quantity that they are exposed to continuously from all of this income. Then, if you divide radical hormones by hormones, you know that you can’t compare.

Jennifer Simmons, MD

It is like a fraction, and it is controlled. However, I think we need to do a much better job of educating people on where the real risks of breast cancer are coming from. Because our hormones haven’t changed. Like thousands and thousands, millions of years. Our hormones haven’t changed. The only thing that has changed is our environment. We are not living on our mother’s earth. We’re certainly not living on our grandmother’s earth. Our numbers look diabolical next to theirs. This is why we’re not suddenly making more estrogen; estrogen is not the problem. Our endogenous estrogen is not the problem. Estrogen does not cause breast cancer. I can’t say that enough. I’m going to shout it from the rooftops to anyone and everyone that will listen. Estrogen does not cause breast cancer, and it is ridiculous to think that it does because if estrogen caused breast cancer, we would see the preponderance of the disease in the populations of women that have the most estrogen: teenagers, people in their twenties, and pregnant women. But that is not where we see the disease. When do we see the disease? When estrogen is scarce, we see the disease when people are post-menopausal, which is when the majority of breast cancer happens in the postmenopausal population where estrogen is scarce. But what’s not scarce in that population is estrogen.

They build up in people. They’re stored in our body; they’re stored in our fat; they’re stored in our bone marrow; and they’re stored. This is changing our physiology. It is changing our internal environment, and it is causing toxicity. That is where the source of all of this breast cancer is. Once again, we’re seeing breast cancer younger and younger because our parents, like my mother, did not have to deal with a fraction of the toxins that we have to deal with now all day, every day. As you said, they surround us. So, you have kids who, from the moment they came out, were on formula in plastic bottles, and it started there. We know that there are over 250 toxins identified in cord blood. This is like before we even hit the outside world: 250 toxins were identified in cord blood. and it just gets worse from there.

Michael Karlfeldt, ND, PhD

The issue becomes these xenoestrogens, the exogenous in plastic, and all of that. They stimulate the estrogen receptors so much stronger than our normal ones, which we make ourselves. If we are deficient in our hormones, then we’re going to have less of the weaker stimulation on those receptors. We are only going to have these strong, exogenous factors from our make-up, from our chemicals, in our environment that are driving that cancer. By optimizing the hormonal system and then opening up the detox pathways like you’re doing, you’re going to create a completely different environment.

Jennifer Simmons, MD

That is exactly right. You have to put less in. As you were saying, it is kind of like a lock-and-key mechanism. A normal estrogen molecule will hit the receptor and do what it is supposed to do. Because it is shaped correctly, it is going to dissociate. But the xenoestrogens are going to be shaped differently, and they’re going to get into the receptor, just like sometimes you can put the wrong key into a door, but you have a bugger of a time getting it out. That is the same thing that is happening: these xenoestrogens are locking on to the receptor, but they’re staying there, and they’re not dissociating at the same rate that a normal estrogen molecule would. So they’re overstimulating, and this is the problem, and they are outnumbering our endogenous estrogen, especially in the postmenopausal woman who’s estrogen whose endogenous estrogen is so depleted.

Michael Karlfeldt, ND, PhD

Talk to me a little bit about one of the strategies, which is things like Tamoxifen, where they are working on blocking your estrogen or your hormones, and women feel horrible about it, but they feel they have to do this to be able to reduce my risk for breast cancer. But then the risk for other cancers increases.

Jennifer Simmons, MD

That is exactly right. Because, for anyone who is hormone-phobic, Tamoxifen is an estrogen. That is why we see the side effects of Tamoxifen as DVT because they act just like estrogen. Estrogen can increase blood clots in some women, and tamoxifen, while it acts protectively in the breast, actually has the opposite effect in the uterus. In the uterus, it has an overstimulatory effect. We see an increase in uterine cancer in women who are on Tamoxifen. While it does decrease the recurrence rate of breast cancer, there’s only a fraction of women who respond favorably to Tamoxifen. That is for a couple of reasons. The first is that tumors are not necessarily homogeneous. In the average tumor, some of the cells will look one way, but not all of the cells will look the same way. Maybe Tamoxifen is an appropriate drug to help prevent some of the cells in the cancer. It is not going to be protective against all of the cells in the cancer. The other thing is that tamoxifen is in its active form. When you take tamoxifen, it has to be converted in the liver to its active form, which is called endoxifen. That work is primarily done by one of our CYP enzymes. It is called CYP3A4. If you are someone who has an active CYP3A4 enzyme, you can make that conversion. But there are lots of us who have a genetic makeup that prevents us from having a very active CYP3A4 enzyme, and in those people, they’re taking tamoxifen and getting no benefit.

There is no benefit. It is all a side effect. if that has to be then detoxed through the estrogen pathway, so it is even putting more burden on the system with no benefit. I would rather see someone with a hormone-positive tumor do their very best to get the xenoestrogens out of their environment. Stop putting in so many estrogens, and then work on their detox pathways. Know how their detox pathways work, and support their detox pathways as much as you can. Making sure that you have a healthy gut beta-glucuronidase, which is an enzyme made by some harmful bacteria in the gut, is a disease that will interfere with your ability to clear out those estrogens, and you’ll just resource them and get higher toxicity. having a healthy gut, and also making sure that you have support for our estrogen detoxification systems. Eating lots of cruciferous vegetables helps with phase one detoxification and then phase two detoxification, making sure you have adequate levels of B6, and B9, which are folate, B12, and magnesium. All of these things end up being important. That is why we’re so focused in the functional world on making sure that you have adequate nourishment because it is all these nutrients that help our body do what it is supposed to do.

Michael Karlfeldt, ND, PhD

Study-wise, what is kind of the latest and greatest about this field? What are they exploring? Is this something new that has come? Because you have your finger on the pulse.

Jennifer Simmons, MD

Yes. I do not think we have a lot of new things in treatment. We have new drugs approved all the time, and people get excited about an increase in three months of survival. I do not get excited by studies like that. I think that three months is meaningless, especially when those three months are not quality—three months at all. Listen, I’m not spending anyone’s time on them. If you want to take a drug that is highly toxic but gives you three more months to live, God bless you. I think that you should have access to it and do whatever you want to do. I do not want this to be interpreted, as I do not think people should have access to drugs. But there is a population study out of Great Britain of 500,000 women, and they looked at survival according to year of diagnosis. They broke it up by studying women from 1990 to 1999, from 2000 to 2004, from 2005 to 2009, and from 2010 to 2015. What’s promising is that we do see survival increasing with every five years that we get ahead, so that women who are diagnosed with breast cancer now have a much greater five-year survival rate than women who were diagnosed in 1999. Now, there are a couple of caveats to that. The first thing is, when we look at women diagnosed before 2010, we were not identifying women with HER2-positive disease, which ends up representing somewhere between 13 and 18% of women with breast cancer. If you’re not identifying the HER2-positive population and not using anti-HER2 therapy, you are going to see decreased overall survival, especially in the first five years, because that represents an aggressive disease.

The wonderful thing about having anti-HER2 drugs on the market is that they leveled the playing field. They kind of took that positivity away. We think that it is something to celebrate that we have anti-HER2 therapies on the market. The other thing that we have to talk about is that over that time, our screening has increased tremendously, both in terms of the number of women that we screened and in terms of our ability to pick up changes in the sensitivity of screening mammograms. This is a double-edged sword because the number of women that we’re diagnosing is exponentially higher. We’re diagnosing 2 to 3 times more women with breast cancer. That is partially because our environment is becoming more toxic and partially because our screening is just getting better. The thing is, the same number of women die every year of breast cancer, and that has been stable. I worry that we are diagnosing and treating a whole group of women who may not need to be diagnosed and treated. Maybe our screening is a little too sensitive, and maybe there are more people with breast cancer who do not need to be treated. If our screening methods were benign and our treatments were benign, it would be a different story. But we’re using X-rays or mammograms to screen for breast cancer. Over a woman’s lifetime, we’re going to cause some of those cancers, and our treatments for breast cancer surgery, which certainly is not a benign treatment, are especially harmful to women who have a mastectomy because those women will never, ever forget that they have breast cancer for the rest of their lives. If you have a mastectomy, no matter how great your reconstruction is, there will never come a day following your surgery when you won’t remember that you have breast cancer. I think that takes an emotional toll, and even with breast-conserving surgery, it is still deforming. Then, in addition to the other treatments, you add radiation, which on the right side causes lung fibrosis.

It damages the rib cage on both sides. You can have a fracture from a very minor trauma, like coughing or anything like that. There is significant morbidity associated with rib fractures. On the left side, the heart is underlying the field. You get accelerated cardiovascular disease, and that is a disease that is far more deadly than breast cancer in every generation. Radiation is not a benign treatment. Then we started off talking about the fact that our treatments often make people a lot less healthy than they were when they got their breast cancer diagnosis. Chemotherapy is front and center there. We drastically interfere with people’s health during chemotherapy. We take their immune system out, and we take their gut out. In doing so, we make people quite sick. The recovery from chemotherapy is not insignificant. For some people, the effects of chemotherapy affect the quality of their lives. For the rest of their lives. So it may be necessary, but there are so many measures that we can take to protect people while they’re getting chemotherapy. We’re not taking those measures. That is a big problem. And then, of course, there is the hormone blockade and all the problems associated with hormone blockade. We’re taking a whole group of women who were identifying these minuscule screen cancers that may or may not have ever become clinically relevant. We’re subjecting them to a lot of treatment that they probably didn’t need and that will adversely affect their health for the rest of their lives.

I have an issue with that. I  do. I think that we need a different screening paradigm, but I do not think that we should be using a test that causes cancer to screen for cancer, especially as liberally as we’re using it. Think about when we developed the mammographic screening program in the 1970s. We intended for people to have a mammogram every year, but for the vast majority of women, that is not happening. They’re having two mammograms a year, and they’re having that for multiple years in a row. You know that all this radiation adds up. It is not insignificant, and it is just staying in people, increasing their toxic burden, and in a person who’s already close to their ability to clear their toxins or just worsening their toxic load. I think that we need to rethink our screening program, and we also need to rethink our criteria for who does and doesn’t need to be treated. I hope that the focus in the future is on developing a genetic test that identifies which tumors need treatment and which do not.

Michael Karlfeldt, ND, PhD

If somebody lumps, then comes the question: yes, we talked about lumpectomy, mastectomy, radiation, and chemotherapy. Then you have the reconstruction, and then the choice between, Am I going to do an implant? Am I going to do it for my tissue? What if I do not have enough for my tissue to be able to do the reconstructive kind of walk through that process a little bit through me, you know what? What should a woman think? Should they opt for the lumpectomy? Should they say no to radiation? Should they say no to chemo? Where is the tipping point, and what is the risk with breast implants? You know what? Walk through that a little bit.

Jennifer Simmons, MD

First of all, I do not think there’s any increased risk of breast cancer. Just from having breast implants alone, we can talk about breast implant illness, but that is a whole separate category. However, I do not think that there’s an increased risk of breast cancer in people who have breast implants because of their implants. When you have breast cancer and a lump, you have the option of doing whatever you want to do. There is no increased survival in mastectomy over lumpectomy. The vast majority of women opt for mastectomy out of fear. That fear is supported by the medical community. I think that people are way too fast to recommend having a mastectomy. I fully believe in breast-conserving surgery. I think that the majority of women with early breast cancer do not have aggressive biology. These women would probably be fine with lumpectomy alone, but it is not the standard of care. If you have a lumpectomy and you are being treated within the confines of the conventional medical system, they are going to almost insist that you undergo radiation. However, the data on radiation is pretty clear in that it does not increase survival.

It may decrease your risk of local recurrence, meaning having the tumor come back in the breast, but it does not impact survival. For me, it is all about survival. I’m not going to accept therapy that is going to interfere with my long-term health if it doesn’t impact my survival. Now, as far as chemotherapy is concerned, there are tests to identify who does and doesn’t benefit from the addition of chemotherapy. I think it is generally accepted that if you have a triple-negative tumor, this is quite aggressive biology, and by definition, you would benefit from chemotherapy. I think the only time that it is not offered is for very small triple-negative cancers. I do not so much believe in treating size over biology. I think that biology kind of trumps everything, and the vast majority of triple-negative cancers have very aggressive biology. The fact that you found it small is just a function of time more than anything else when we’re talking about hormone-positive disease. For a positive disease, the archetype is a kind of definitive test to say who will and who will not benefit from chemotherapy. But when I work with people, I do like to take steps a little bit further. If I have someone who I believe has aggressive biology and, in general, I’m running in RG CC, that is a great test, and that is going to tell me specifically about your biology and your risk of having metastatic disease. It is also going to tell me what therapies are going to be effective for you, and you just continue to monitor that over time. It allows you to customize your treatment not only with traditional chemotherapeutic agents but also with natural agents. So for people who have aggressive diseases, and certainly for people who are not responding to treatment, that is my go-to space for how we proceed forward in a positive direction.

Michael Karlfeldt, ND, PhD

That is wonderful. Well, Dr. Simmons, it has been such a pleasure. You’re such a wealth of knowledge and information. I’m so glad that you’re functioning in this space versus your prior profession. You can just have a greater impact. Thank you so much for all of this.

Jennifer Simmons, MD

Thank you. It is my pleasure to be here. My favorite thing to talk about, and I only hope that people come away from today realizing that you have so much more power than you think and that the key to health is in your control, and you just need to kind of rise to that occasion and know that the power is in you.

Michael Karlfeldt, ND, PhD

I love it. For people who want to find you, where do they go?

Jennifer Simmons, MD

Now, you can find my website at realhealthmd.com, and you can follow me on social media. It is Dr. Jenn Simmons, and my Jenn has two Ns. I do have a Facebook group where you can ask questions and be part of our community, and it is called Keeping Abreast with Dr. Jenn. You can just head over to that Facebook group. We’re happy to have you there. Stay tuned for my podcast, which will be out very shortly.

Michael Karlfeldt, ND, PhD

I love it. That is wonderful. Thank you so much, Dr. Simmons. Thank you.

Jennifer Simmons, MD

Thank you. My pleasure.