Episode 113 | Jan 16, 2025

Root Cause And Cancer, With Dr. Chadi Nabhan

What role do environmental toxins play in chronic disease, and how can we foster hope and resilience in cancer care? In this episode of Health Coach Talk, Dr. Sandi is joined by Dr. Chadi Nabhan, a distinguished oncologist, author, and advocate, to explore these critical questions. Together, they discuss his groundbreaking work linking glyphosate to cancer, his experiences during the Monsanto litigation trials, and his commitment to empowering patients and caregivers with knowledge and support.

“At the end of the day, when this person is diagnosed with cancer, they need your ears. And that piece is so important. I don’t think today we’re doing a good job at this… Patients really want someone who they can trust and they can communicate with.”

Dr. Chadi Nabhan

Dr. Nabhan’s journey from clinician to advocate was shaped by his role as an expert witness in the high-profile lawsuits against Monsanto. His research on glyphosate, the active ingredient in Roundup, uncovered its links to non-Hodgkin lymphoma, inspiring his book Toxic Exposure. This deeply personal account highlights the importance of transparency, the challenges of confronting corporate interests, and the need to address environmental causes of disease.

His latest book, The Cancer Journey, reflects his dedication to simplifying complex medical concepts for patients, caregivers, and healthcare professionals alike. Drawing on his experience in the courtroom and the clinic, Dr. Nabhan crafts a compassionate guide to navigating cancer with clarity and humanity. Through storytelling and plain language, he offers readers the tools to better understand their journey while fostering resilience and connection.

For health coaches, this episode reinforces the importance of empowering clients to take charge of their health and advocate for themselves in the face of daunting diagnoses. Dr. Nabhan’s work demonstrates how listening, building trust, and supporting clients’ emotional well-being can create transformative experiences. These principles align closely with the role of health coaches, who bridge the gap between medical care and meaningful, personalized guidance.

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Transcript

Dr. Sandi Welcome back to “Health Coach Talk,” and I have the pleasure of having a special guest. He is a distinguished physician. His name is Dr. Chadi Nabhan, and welcome to the show.

Dr. Chadi: Thank you. So good to be with you. Appreciate it.

Dr. Sandi So, I’m excited to talk with you and our audience, our health coaches and just people who tune in, practitioners, those interested in what’s going on in the world of medicine and how health coaching interacts with that. You have a book that you wrote several years ago, and you have another one. So, these books are “Toxic Exposure” and your new one is “The Cancer Journey.” So, I wondered if you’d start out by just sharing about these books. What motivated you, first of all, to write a book about toxic exposure?

Dr. Chadi: Yeah, “Toxic Exposure” was a book that was not planned. Things just happened with serendipity. I became involved as an expert witness in the Monsanto Roundup litigation trials. Monsanto is a big agricultural company that was acquired by Bayer in 2018. But Monsanto, they make Roundup, which is herbicide. It’s basically the most used weed killer in the world.

And a research study was published in 2015 or 2016 linking Roundup, the chemical ingredient of Roundup, which is called glyphosate, to a form of cancer called non-Hodgkin lymphoma. At the time, I was at the University of Chicago, where I did a lot of work with non-Hodgkin lymphoma, which is a form of cancer of the immune system and the lymph glands.

And I was contacted by a couple of law firms that were representing patients that were in the process of suing Monsanto, because they were saying that the lymphoma they developed were related to their heavy exposure to Roundup. At the time, I wasn’t really sure of the relationship. I wasn’t familiar with it, so I agreed to research it and look into it.

And as the more I researched, the more I was convinced that there is a linkage between Roundup, and glyphosate, and non-Hodgkin lymphoma. So, I agreed to help the law firms and the patients that were suing Monsanto. And I was an expert witness in several litigation trials, mainly the first three trials that were filed in the U.S. against Monsanto.

As these trials were evolving, I really felt strongly about sharing the information with the world, with patients, families, with the general public. I came to realize so many things that I was not aware of, and I felt it is a duty of mine to do my best to share it with as broad of an audience as possible.

So, I decided to write the book. The book, “Toxic Exposure,” talks about these three litigation trials that took place in 2018 and 2019, what happened behind the scenes. I take the reader through my experience, how I came to link between Roundup and lymphoma and cancer, what happened in the courtrooms and depositions with lawyers. I talk about the Bayer’s acquisition of Monsanto. I explain all of these things. So, that is really everything that happened but from my lens as a physician and as an expert witness. I felt it was important to share that.

Dr. Sandi This is an incredible story, and kudos to you for writing this book. And as a physician, I think that you are really, in some ways, a renegade, because I’ve been in this field a long time and worked with many physicians. Actually, the idea is just we’ll just diagnose and we’ll treat. But really looking at the root cause, and especially something that has to do with an environmental toxin, is not on their radar.

So, it’s what’s considered alternative or you’ve gotten a lot of pushback. So, I just wonder what was the response from the medical community. You were at a very conservative… University of Chicago is a very esteemed, very conservative institution.

Dr. Chadi: Yeah. Obviously, I testified and I worked in my personal capacity. I was not representing anyone. But you’re right. Most physicians, the majority of us, what we do is we diagnose, and we focus on treatment, and taking patients through the treatment and hopefully getting them through it.

There are situations where we ask about the cause. And many times, we don’t know the cause. Sometimes we do, like the usual suspects of tobacco smoking and things like that, but a lot of times, frankly, we don’t know the cause of what actually caused it.

And you’re absolutely right. There’s a sense of nihilism or sense of the environmental things, the agriculture thing, the food thing, things like that are really being exaggerated. They’re not really important and all of that.

I never really had the nihilism, but I admit I didn’t have the in-depth knowledge at the time of all of these things. But because the question was, “Well, can you research this and tell us if there’s a link?” And I was very intrigued by this, because as I was researching, I realized how ubiquitous the use of this herbicide is in the world. And I started thinking, “My gosh, if this is being used all over, is it possible that maybe for some patients I’ve taken care of, this may have caused it?” It’s not wrong to ask that question, so I did.

And I think the pushback I got was from folks who have a little bit of hypersensitivity or aversion to litigation lawyers. Understandably, I think sometimes lawyers who sue, whether corporations or physicians, they get this bad rep or they’re doing this… They call them ambulance chasers, whatever it is, right?

But the reality is it’s almost like putting all of the bad apples in one basket, and that’s really not fair. We would want to have lawyers who are able to represent patients and innocent people and people who are left behind when needed. So, I did get push back from some of my colleagues who say, “Well, these lawyers, they just want to blame everything on everything so they can make a big buck.” I think that that’s where the pushback I get. The other pushback I got is that while you can’t ever be certain or sure of that relationship, and that’s really why I wrote the book. I’m like, “Well, read the book,” and I show you in the book how I came to that conclusion.

Dr. Sandi So how did that then lead to your next book, which you just released, “The Cancer Journey?”

Dr. Chadi: Yeah. And thanks for asking. By the way, kudos to you and what you’re doing with the health coaching, because “The Cancer Journey” is a drop in the bucket of what you are doing in trying to help people and other coaches through the entire process, because “The Cancer Journey” is a book that I wanted to write for everyone, that wants to know more about cancer, wherever they are in the journey. They could be a patient, they could be a family member, they could be the caregiver, they could be the health coach, they could be the physician, they could be the nurse, they could be the pharmacist, they could be somebody who’s just curious.

And I looked around and I really felt that there are lots of books on cancer but many of these books are a bit more textbookish kind of thing. A little bit more dry. And they don’t always speak the patient’s language. They are a bit higher level, where I think a lot of patients and common people demand simplicity. And they want to see more simplicity in the conversation.

During the litigation trials, when I testified in Monsanto trials, I had to really simplify complex things to the jury. In three major, very highly visible clinical litigation trials, I had to really look the jury in the eye and explain to them something very complex. These are not necessarily folks trained in medicine, or oncology, or cancer.

And I really noticed something about myself, which is I have that ability of simplifying a complex topic and bringing it down a notch where we can have a conversation about it that we are on the same level and on the same understanding. And I knew that, from taking care of many patients, I always try to simplify things for them.

So, I thought, you know what? Let me write a book where I talk through the entire journey. I’m going to put myself in the patient’s shoes and imagine myself what happens as I go through the journey but then explain every process in a simple language, plain language. And I want to use stories. I want to bring stories that I have vividly memorized in my brain of a lot of people I took care of to illustrate certain concepts or certain aspects.

So, I think it is a combination of things. Number one is my ability to tell stories, which I got from the Monsanto trials, the simplification of things. And I think there’s a need. I think essentially… I don’t want to say that the book is a drop in the bucket of coaching, but essentially if there’s a patient who is going through something and they need to have guidance how they go through it, hopefully they can pick up the book and say, “Well, I can understand it a bit better, if there’s a caregiver or there’s somebody else.” So, that’s really how these came together and that led to the release of “The Cancer Journey” a few weeks ago.

Dr. Sandi It’s so needed. I believe that we have the best in Western medicine if you need surgery, if you have cancer, if you have a tumor removed, a procedure done, or the best treatment for the cancer. But what about that journey of that individual? And have we lost bedside manner? Have doctors become just so proficient in their specialty but they’ve lost that art of really connecting? Because they’re caring, but they have so many demands to be documenting everything in the medical record. They’re pressed for time to see patients. They’re busy. And often people don’t feel like their questions are fully answered. They don’t feel heard or they leave like, “What did he just say? What did she just tell me?”

And that’s where coaches can come in to be that advocate for them. And I think the main thing is to help people to feel empowered, to have the sense of self-efficacy that they have control. And when I worked in psychosocial oncology, I saw so many times when someone felt like they had a caring doctor, when they felt they had that support, that was the key, someone who could convey hope. Not like, “Oh, you have six months to live, get your affairs in order,” but this is something that, “We’ll do it together. We’ll have this journey together.” And it sounds like you really embody that with your patients.

Dr. Chadi: Yeah, patients really want someone who they can trust and they can communicate with. Step back a little bit and think about. The most precious thing that we have is really health. None of the things matter… Every single thing that we enjoy in life, material things, you can’t enjoy them if your health is really threatened, right? It doesn’t matter.

And think about the psychology of what happens when someone is diagnosed with cancer. You’re being diagnosed with a very serious disease. No matter what the prognosis is, it’s still serious. And you are going to meet a stranger. Essentially, you may have developed a rapport with your psychologist, psychotherapist, primary care doctor, but you haven’t had an oncologist. Now you’re going to meet a new person when your health is threatened.

So, you’re in the most vulnerable time of your life when you are being diagnosed, you’re meeting a new person, and you need to establish that rapport and connection very fast. It’s a lot that goes on in patients’ minds. That’s why what they need in situations like this, in the beginning, the science is important, the data is important, the treatment plan is important, but they want to feel that connection. They want to feel, “When I’m actually telling that person something, I’m not being dismissed. I am being listened to. There is some eye contact. It’s not the person have their back to me and tick, tick, tick on the medical record and I’m talking about my symptoms.”

When I was diagnosed with cancer, which happens a lot, I realized the pressure. I realized the administrative burden on physicians and nurses and everything. But at the end of the day, when this person is diagnosed with cancer, they need your ears. And that piece is so important. And I don’t think today we’re doing a good job at this.

Dr. Sandi I agree wholeheartedly. And I’ve seen, as older physicians have retired, those ones who were old school, who did have connections with their patients. Younger doctors, I’m seeing this, and I don’t want to categorize and stereotype, but they’re not taught that. And it’s all in the technology.

I certainly think with AI, it’s very valuable. I just heard someone say, “Today, if someone is not using AI to assist with diagnosis, it’s almost malpractice because there are so many advantages.” So, I want you to comment about what AI will be useful for, what you see so promising, and then how can we still maintain this good patient care, seeing the individual, not their disease, not their cancer.

Dr. Chadi: Let’s put artificial intelligence under the umbrella of innovation and technology, right? We must use technology as we evolve. The way we are even talking, me and you, through a Zoom and a podcast and doing all of this, maybe it wasn’t there 20 years ago. The way you even possibly…you probably are able to meet people today virtually and give them help and be able to communicate with them. And 20 years ago, it wasn’t the case. So, we apply technology in our day-to-day lives every day. We use translation. We use Google Maps. We use navigation. We apply technology every single day.

In medicine, we’ve always lagged behind a little bit in technology just because we’re a bit set in the way we do things. So, we’re more on the laggards pace, like we just take our time. We also have the skepticism. We’re a bit skeptic about certain things, all that.

So, within technology, AI is not really an evolving field anymore. Every single program you hear, every single TV station you tune to or article you read, it’s talking about AI. Artificial intelligence is simply, obviously, trying to make the machines that we use hopefully do more than what we normally utilize them for. And hopefully, they are becoming more intelligent, close to human intelligence.

I think that, if we use it properly, we should be able to enhance the work of the physician without jeopardizing that piece you alluded to, Sandi, the communication part, the connection part. And I’ll give you an example. It would be very nice, let’s say I’m seeing a patient in the clinic. Instead of me being so occupied in writing the notes and typing the notes because I have 25 or 30 notes to do, maybe there’s an AI technology that is capturing that and I’m just sitting down close to the patient, eye to eye, having the connection. We’re both speaking naturally, and the AI is capturing the essence of the conversation. And then it could be copy-pasted into the electronic health records or something like that.

This enhances my relationship. It doesn’t take away things. Maybe there’s a way that AI could allow me to think about… I have patients I’m seeing in clinic or you have patients and so you have people that you’re seeing. And the AI is able to look at algorithms, certain characteristics of each of these individuals, and give you, for example, warnings of certain things.

Let’s say I’m seeing a patient in the hospital, and the patient is leaving the hospital. By using AI technology, I’ll be able to tell if that patient is at high risk of coming back in the hospital in the next week or not. So, maybe I could implement certain things to reduce that risk.

There’s a lot of elements in the way we use AI that I think could enhance what we are doing. And I think if we apply it right, it’s going to be a good ancillary thing that will help the way we communicate with patients.

Dr. Sandi Absolutely. I agree 100%. So, it’s not either/or, but it’s using technology to support the therapeutic alliance and to make your life easier. I think the use of dictation devices and ways that you can have things recorded, entered into the chart where you don’t have to be doing all that yourself, those are great innovations that will also help with physician burnout and also have more time to actually be with patients.

And we’re seeing it now with health coaches who can be reimbursed for remote physiological monitoring. So, for an FDA-approved device, they can monitor the incoming data that people are using on their at-home devices and report back to the clinic what they’re seeing, patterns in the data. So, there are so many promising things on the horizon.

Dr. Chadi: Absolutely. That’s really the key. We need to get technology in a way that is going to enhance what we do, improve what we’re trying to do, not take away from it. I always think, why are we trying to do this? It’s either we want to make life easier for patients and better, or we want to be able to improve the outcomes. Sometimes you may not change the outcome. You can’t really change the disease course, but maybe you can change the experience. There are certain things and metrics that we can apply, but I’m a firm believer that the AI technology, Sandi, is not going anywhere. It’s going to be utilized very much more. In fact, I’ve decided to possibly write a third book on AI and cancer care. I don’t know where it’s going to go. We’ll see, but I really feel strongly that we’re going to apply AI in all aspects of the way we take care of patients.

Dr. Sandi Yeah. I mean, if you have at your fingertips now access to… Yeah, sure, you can search PubMed. But if you have AI that’s going to give you access to all of this research, all of this data, all the clinical trials that are taking place in a way that’s very efficient and you can… Precision diagnostics. I think there’s been some studies where the robot was better at diagnosing than the human…

Dr. Chadi: Yeah, it’s possible.

Dr. Sandi …because they could see things that a human cannot. But I think, as we’ve talked about, one thing we cannot replace is that human, that heart-centered human connection. There was a recent study that was looking at health coaching. This was for patients who were diagnosed with cancer in various stages. And while they didn’t change the biomarkers dramatically, but what changed dramatically was the sense of self-efficacy and this feeling like, “I have hope and I’m able to feel resilient, that I can express gratitude and more movement towards post-traumatic growth.”

And I’ve wondered, in your history of treating patients, if you have seen people who have had that cancer diagnosis and actually see it as a gain for them, that they were able to turn their life around or perhaps, again, could have gone to a different career or appreciate family or what really matters most to them.

Dr. Chadi: I have actually. I’ve seen a lot of this. Maybe I’ll share a couple of stories.

Dr. Sandi Mm-hmm, that’ll be great.

Dr. Chadi: I took care once of a man who was pretty… He was in corporate America. I think he was more involved in investment banking and Wall Street and the financial markets. And then he was diagnosed with cancer and started having those family issues as well. And he just basically changed his entire career. He’s like, “I need to do something.” And being a good financial planner or investment banker is good. We all need people who are good at what they’re doing but he’s like, “You know what? I’m going to go back and teach.”

And he just felt more fulfillment as a teacher. It just fulfilled his life more, and he felt life is short, “I want to just feel I am doing something, and being a teacher of high school students is something that’s just going to give me more fulfillment.” I recall seeing a patient who unfortunately passed. He had a pretty bad cancer, and his daughters both went into nursing because they saw, when I had met them, they were still in high school. And they decided to take a career in nursing because they saw how nurses take care of the patient, and their availability, and they explain things. It had a career impact on them for sure.

I also have seen situations where cancer has brought families together. There are times where kids or other relatives who are estranged from each other rally behind the individual as the cancer brings the family together. The flip side, though, unfortunately, I have seen scenarios where being a caregiver is very taxing on some people. It did lead to people breaking up if they were in relationships. You see the good and bad, unfortunately, but I saw way more good than bad when somebody is diagnosed with cancer.

Dr. Sandi You are a really special physician, and I think that the stories you shared are just really showing how it is having that relationship. What you’re describing, being able to really know a person, to know their story, it is just…that in itself can be healing.

Dr. Chadi: I always wanted to know the person behind it. It’s so important. This individual could have been us. They had dreams, they had family, they had people, and overnight now they are actually being told they’ve got cancer. They’re going to come to the hospital, scans, lab work, chemotherapy, radiation therapy, who knows? And just knowing that person and their aspirations, and then hopefully getting them to be fulfilled.

Dr. Sandi Yeah, and this is bringing back memories of when I did work in psychosocial oncology. And I would go to somebody at bedside in the hospital, and they were expecting someone because I wore lab coats. They thought I was on the medical team for that side of it.

Dr. Chadi: You are in the medical team.

Dr. Sandi We would just laugh. I’d hear their story. I’d talk about their grandchildren. The family would come in. I actually had recipes in my coat pocket for broth because they wanted, “What can I do? Okay, we’ll go home and make some chicken soup and some nourishing food and bring it in. Or get some pictures, have the grandkids draw some pictures, paste them up all around the room.”

And it was just getting to know them and hearing their stories. Often imagery, how did they imagine, how did they see themselves having some sense of whether it was spiritual connection or hope or what they wanted, or pain relief in some way, some imagery that was helpful. But at the end of the day, it was just listening, where they felt heard, where they felt my only role was just to sit and listen to their stories.

Dr. Chadi: They need somebody to listen, for sure.

Dr. Sandi Yeah. Well, this has been a fascinating conversation. And again, the books are “Toxic Exposure” and the new one, “The Cancer Journey.” And, Dr. Chadi, where can people find you?

Dr. Chadi: In many of the Starbucks coffee shops in the NorthShore, Deerfield, Northbrook, and Lake Forest. Really, that’s where I do my writing. But I have a website, chadinabhan.com. And then my books are available everywhere. If they’re interested, they can go to Amazon and they’ll find “The Cancer Journey,” and they can find also “Toxic Exposure.” And I’m easily available. They can really reach out to me anytime by email through the website, anywhere, and I’m happy to help in any capacity that I can.

Dr. Sandi Well, it’s wonderful getting to know you. I’m so glad I went to that book signing that you had at our local bookstore and got to meet you. And we can start this fabulous connection.

Dr. Chadi: Thank you so much for everything that you are doing. What you’re doing is really amazing, and I really appreciate everything you’re doing. A lot of people are benefiting from what you’re doing.