Transcript: Cancer Doctor Dr. Dawn Mussallem on The Mel Robbins Podcast

You then woke up from surgery, but it sounded like you just kind of went on with your life.

So I want to just say, what did the doctors tell you to do? Because you said, “I followed the medical advice.” But you also did a second thing, which is instead of focusing on the cancer, you focused and tripled down on the healthy aspects of your life.

And so let’s just first talk about what did the doctors say you should do that you did. And then let’s talk about what are the healthy things that you focused on.

DR. DAWN MUSSALLEM: Yes. So the doctors said, “I’m going to do chemotherapy.” And I didn’t question it. I knew my body needed chemotherapy. Here I am in the specialty of integrative oncology, where I really use evidence-backed natural therapies to help to mitigate the toxicities of treatment, to improve the outcomes of treatment and also reduce other chronic diseases. I knew that I needed the chemotherapy to get rid of this cancer.

MEL ROBBINS: So were you studying cancer medicine? Is that why you went to medical school?

DR. DAWN MUSSALLEM: I have a fascinating background. Before I went to traditional medical school, I actually went to naturopathic school. And my undergraduate training was in exercise physiology and nutrition.

MEL ROBBINS: Okay.

DR. DAWN MUSSALLEM: So this has just been weaved into my spirit and soul since I was actually a little girl. As a young kid, people would ask, “What do you want to be when you grow up?” I said, “I want to live to be 100 years old.” I just loved wellness. I was actually obsessed with it. I thought it was the coolest thing.

MEL ROBBINS: How old are you right now?

DR. DAWN MUSSALLEM: 51.

MEL ROBBINS: Well, that’s fantastic. If I were betting on anybody living to 100, it would be you.

DR. DAWN MUSSALLEM: I think so, for sure.

A Lifelong Passion for Wellness

MEL ROBBINS: And there’s a lot that I know that we can learn from you, both in terms of the medical research and the way that you tripled down on healthy living and vitality and things that are accessible to all of us.

So you started out as a naturopath. You had dreams and ambitions as a little kid of living to 100. You’ve always been obsessed with a healthy lifestyle. But then, holy cow, 26. If you look at somebody that can just trot up Camelback twice and that’s already super healthy and has a very positive attitude, those two things and a cancer diagnosis don’t seem to go together.

DR. DAWN MUSSALLEM: Right. I mean, there’s—you just do this analysis immediately. You’re like, “What did I do wrong?” That’s the natural thing. The “Why me?”

Everyone sees me in this external vision as, “Oh, my gosh, she’s so positive. I bet she never has a bad day.” I cried. I sobbed. Like, what did this mean? But it was very momentarily. I knew, “Hey, I don’t have time for this. I’ve got to kind of figure out what my strategy is going to be.”

And I hired the doctors I could trust once I was given the diagnosis. And I really don’t care when doctors—I think it’s not a good idea when doctors give a finite number of how long you’re going to be on earth. Because I don’t think we can really do an accurate prediction. Especially nowadays, we have so many advancements for cancer treatment. We’re seeing people being cured left and right.

Who are we to predict how long someone’s going to live? So I tell my patients often they find it’s very off-putting when an oncologist shares with them, “You have X amount of time to live.” And I tell my patients, when you go meet with that oncologist, say you don’t want to have that number if you don’t want that number. And you deserve to have the number if you want it.

But for me, I would have kind of rather not had that number, but I didn’t let it get in my head.

Treatment and Maintaining Vitality

And so I had to do chemotherapy for almost six months. And then I had to do a bone marrow transplant because this was before the immunotherapies, the rituximab or any of those treatments were available. So did the bone marrow transplant.

And I remember every morning I set my alarm for 4 a.m. in the hospital. They brought all my medical studies to the hospital so I could study. My oncologist had a bicycle in my room and a bicycle at the nurse’s station.

So at 4 a.m. I would kind of sneak out of the room, sit on that bike and watch the sunrise in Arizona. It was gorgeous over the mountains, but this was remarkable. And I feel it in my body, like tiptoeing, sliding that glass door and spanning the room and seeing all these other people in their beds.

And I’ll describe it. They were so sick in an effort to be alive. But again, I attained my vitality without pause. And it was how I lived. And it’s exactly what I really work with my patients in doing today.

And you’ve got to remove that turbulence. You’ve got to come to this in a place of just joy and empowerment. Like I have autonomy over this diagnosis. This is my job right now to show up for myself. And it worked beautifully.

MEL ROBBINS: Okay, I got to unpack this.

DR. DAWN MUSSALLEM: Okay.

The Power of Perspective

MEL ROBBINS: Okay, let’s do it. Dr. Mussallem, you’re 26 years old and you painted such a vivid picture. And I can actually picture in my mind the 26-year-old you in a hospital bed, popping up like a jackrabbit, running down in your gown to the nurse’s station, hopping on a bike, looking out the window.

And I can also picture walking past all the other rooms and kind of peeking in and seeing people like just near death, or at least with the defeated “I’m dying” energy. Which is certainly a very rational and expected response to a scary diagnosis, to very debilitating treatment. But you did the opposite.

And I have two questions around this. When the doctor said you have three months to live, how did that change your aperture in your mind in terms of what a typical 26-year-old thinks about versus what you then thought about when somebody said you have three months to live?

DR. DAWN MUSSALLEM: Yeah. So when I heard it, I kind of tucked it away. Like it was tucked deep into my soul. It was still with me, but it wasn’t controlling my choices or my actions. I wasn’t living in fear by any means. I was living through the lens of “Let’s be fully alive.”

What I would say is hearing that elevated my existence to the degree that every single thing that I would experience was elevated. The grass wasn’t just green, it was magnificently green. The clouds were just always more voluminous than they probably ever were. The warmth of the sun just felt so warm and encompassing and just like it is today. But I just loved people.

I remember one situation, it was—I was at a McDonald’s actually, which doesn’t sound very healthy, right? Like it’s probably a really good example for people to hear. But I went to McDonald’s and I got a coffee. I love coffee. It’s actually very good for you. We can talk about that.

And there was a homeless gentleman sitting outside. I’ve actually never shared this story. And he was young and he was about 19 years old. And I sat down and I had my coffee, went and bought him breakfast and we just talked.

And what I learned in my experience of being diagnosed with cancer, if I wasn’t diagnosed with cancer, you know what I did? Went and got my coffee and rushed off to go study selfishly, right? But instead I had this knowing, like, “Hey, pause. Let’s spend time with this human being.”

And he just taught me so much about life, like so much about being present. And he was so still. He had this beautiful energy. And that’s something that I think describes my existence—this energized stillness where I’m like a live wire, but inside there’s like this ultimate stillness and harmony that is just so important.

Exercise: The Foundation of Cancer Recovery

MEL ROBBINS: So I just want to make sure that as you’re listening or watching, you kind of get the magic of what Dr. Mussallem just shared, which is in getting that three month—how would you even say it? Like in being told that you had three months to live, it brought what mattered into focus and made the things right in front of you about life that give you energy and that’s beautiful and that are worth living for, way more magnified.

And you leaned into that. And what I want to know is what are the healthy things that you focused on when you got that stage four cancer diagnosis?

DR. DAWN MUSSALLEM: Exercise, number one. Even during chemotherapy, oh my gosh, I started feeling so much better because the tumor started shrinking. So it was like, holy cow, I can breathe again. So yes, I still exercise.

The exercise research centered around cancer is incredibly exciting. We didn’t really know it back then, but it’s likely why I’m alive today, because I really still continued that exercise. Not high intensity. I just did what I could do. Because the cancer treatments are dropping your blood cell counts, you’re oftentimes anemic, and you are tired.

So I listened to my body when I rode that bike. It was so I didn’t worry. There was no ego attached. I was just moving my body. I share with my patients, “I know you’re exhausted, but I need you to go walk at least five or ten minutes after each meal. I need you to push yourself.”

This is not easy, but we have a choice, and sometimes we have to push ourselves. And in doing that, we can get energized. And so that is what I recommend. Number one is move your body. It is critical. Very, very important.

The other thing with exercise people don’t realize is it uses up that stress, a lot of adrenaline. If you think back to the caveman, the saber tooth tiger would jump out. The caveman would outrun it, right? And he’d sleep like a baby at night.

And us, we don’t have the saber tooth tiger, but we have all these stressors. Whatever it may be, maybe it’s not cancer. It could just be the stress of life, and we’re just wound up so tight with the anxiety. So that exercise helps the mood, it helps beat the cancer, and actually augments the treatment response.

We now know it’s magic. We know that in breast cancer that exercise can improve breast cancer outcomes. I mean, are you ready for this? Gives me chills. Almost 50%. I mean, this isn’t a little number. This is like a magical number.

There was just an amazing colorectal cancer study showing that exercise is looking as favorable as chemo. This doesn’t mean it replaces chemo. It means we do it together so we can cure cancers.

Food as Medicine During Treatment

MEL ROBBINS: So you focused on exercise. Were there any other healthy habits leaning into vitality that you did when you were diagnosed with stage four cancer?

DR. DAWN MUSSALLEM: Oh yes. Food is medicine, and this was really before the whole focus on food really became apparent. But it’s also been something that’s been very special to me. So I continued eating that healthy diet. And even in the days when I didn’t really feel up to it.

The chemotherapy changes how things taste in your mouth. It’s very metallic. Oftentimes you get sores. And with the type of treatment I had, you have a bunch of mouth sores. So it hurts. Ouch.

But this is the blessing in this. I know what that was like. So when I sit down with patients, I can be very mindful and think, “Okay, I know where she’s at in this treatment. I see how she’s talking to me. Her mouth obviously hurts. Let’s touch on this, and let’s figure out some food swaps.”

Or maybe she’s having scrambled eggs with cheese on a piece of white bread with butter and a piece of turkey sausage. That’s not the end of the world, probably, but there’s a lot healthier way that I would like that woman to eat.

So I’ll do a swap. I try to flip what she’s eating in a way that it’s still something she’s accustomed to, something that she looks for, something more savory. She’s not looking for something sweet in what she usually eats. It will give her something a little bit healthier to eat that would maybe more in line with her cancer treatment to give her some of the phytonutrients that comes from plants that can help to make her feel better and maybe even improve those treatment outcomes.

The Power of Acceptance

MEL ROBBINS: So you’ve talked about exercise, you’ve talked about tripling down on healthy foods, because food is medicine, as you just said. You also talked about your attitude, really lasering in on how beautiful the sunrise is instead of focusing on the cancer diagnosis. Anything else that you leaned into when you were diagnosed with stage four cancer?

DR. DAWN MUSSALLEM: Yeah, you know, acceptance. You can’t fight it. You have to accept it. You have to work to accept it. It’s really hard at first, but if you fight it, you’re just going to be in that battle longer.

And oftentimes I’ll read that people say “she battled with cancer.” There was never a battle. It truly was just this grace of acceptance and then moving in the direction I knew I had control over. And that was where I showed up for myself with healthy living and let the doctors do what they did best.

Food: The Leading Cause of Death in America

MEL ROBBINS: You know, there’s this super famous quote from—I can never say this word. It’s like Hippocrates or Hippocrates.

DR. DAWN MUSSALLEM: How do you say this? Hippocrates.

MEL ROBBINS: Thank you. Perfect. Thank you. You know, Mark Twain said it takes a simple mind to spell a word one way. I say it takes a simple mind to say a word one way. So, Hippocrates, thank you.

The ancient Greek physician said, “Let food be thy medicine.” And I hear you say this all the time. Is there data to back up the assertion that food can prevent or heal diseases?

DR. DAWN MUSSALLEM: Absolutely. There’s overwhelming evidence that food is a big problem in our country today with the levels of chronic disease we have. And in fact, in the Journal of the American Medical Association in 2022, what they publish is that food is the leading cause of death in our country.

MEL ROBBINS: Wait a minute. Food is the leading cause of death in the United States?

DR. DAWN MUSSALLEM: Yes.

MEL ROBBINS: What does that mean, Dr. Mussallem?

DR. DAWN MUSSALLEM: It’s a massive driver with the consumption of ultra processed foods. 60% of our diet is ultra processed foods. 67% of our children’s diet is ultra processed foods.

And so what’s happening with that? There’s additives in those foods that just aren’t good for our body. Those foods aren’t good for our gut microbiome. And then when we eat that much food that’s fake, there’s no room for the healthy stuff. So you’re weeding out the opportunity to get the stuff that matters.

Every time you put food in your mouth, you have an opportunity to be a healthier version of yourself or an unhealthier version of yourself. So you really want to pay attention to that. And it doesn’t have to be perfect. This is never about perfection, but it’s in an effort to be more consistent about doing better, is what I would say. And have joy over that.

Sometimes they have women come in and they are what some would consider eating the perfect diet, but they feel like they’re hostage to that diet and they’re not loving it and they’re not having joy over it. So it’s really trying to find the healthy foods that you enjoy the taste of.

MEL ROBBINS: You know, I often wonder, I mean, that’s a startling statistic that the leading cause of death in the United States is food because it’s ultra processed. You know, there’s all this obsession with labeling things organic. I’ve often wondered, wait a minute, don’t we have this backwards? Shouldn’t we be labeling things chemical and everything else is just food?

DR. DAWN MUSSALLEM: I know.

MEL ROBBINS: You know, in fact, speaking of food, you have a list of foods that prevent cancer. You can explain why they prevent cancer. And so I want to bring them in, and then we’re going to walk step by step through each one and have you explain how a particular food that you eat will help you prevent cancer.

DR. DAWN MUSSALLEM: Let’s do it.

MEL ROBBINS: Let’s do it.

Cancer-Fighting Food #1: Frozen Berries

All right, let’s bring that in. So the first thing I see is a bowl of berries. Let’s talk about frozen berries. Why do frozen berries prevent cancer?

DR. DAWN MUSSALLEM: Berries are incredible. And it’s such an easy way to start your day. And a lot of people worry because berries can be expensive, especially if they’re fresh. And so what I tell patients is don’t worry. Just buy them frozen.

And the frozen wild berries, they don’t need to be organic. They’re wild. They’re growing in nature. So get those frozen wild berries. This is a beautiful mix of berries here, which I love, and I really try to have my patients do a cup a day. These are loaded with anthocyanins.

MEL ROBBINS: What is anthocyanin and why does it matter?

DR. DAWN MUSSALLEM: It’s this powerful phytonutrient.

MEL ROBBINS: What’s a phytonutrient? What does that mean?

DR. DAWN MUSSALLEM: I know, it’s crazy. Phyto is the color. The color in these vegetables and fruits. And the nutrient is what’s going to help feed our body everything that we want to help to—again, anything we eat, we can try to turn on all these activations that can help to mitigate cancer from forming. And if you have it, we can help to turn off some of those genes as well.

So there’s research with berries that’s so exciting, both for breast cancer prevention as well as breast cancer survivorship. You won’t believe this. For every two servings a week, it can reduce the risk of breast cancer. And for breast cancer survivors, for every two servings a week, it can reduce the risk of dying from breast cancer by 25%.

MEL ROBBINS: 25%.

DR. DAWN MUSSALLEM: That’s a huge number.

MEL ROBBINS: Two servings of frozen berries a day.

DR. DAWN MUSSALLEM: A week. A week. A week.

MEL ROBBINS: That’s it.

DR. DAWN MUSSALLEM: That’s it.

MEL ROBBINS: 25% reduction.

DR. DAWN MUSSALLEM: 25%. This is in the Nurses Health Study. Such cool data, right? And they’re delicious.

You know, this is what’s interesting about modern food, though, is there are many people that will taste these berries and they will not taste how delicious they are, because the food today is so adulterated with chemicals, and they make the food so that it has extra flavor on the palate.

And so it can take a little bit of time as people are transitioning to a healthy diet to adjust their palate so they can appreciate the taste of food. And what I see that’s so unique to cancer patients is when you have that cancer diagnosis, your mortality is being threatened. You’re ready for change.

And it seems that switch flips immediately. It seems like they start tasting the beauty of their food so much more quickly than patients that I may happen to see that have no active cancer. It takes them much longer to find the harmony and pleasure of how this wonderful food taste.

So I just want people to be patient when you start tasting these foods, especially if you’re used to the ultra processed foods, you may not notice how amazing these taste. I have patients say, “Oh my gosh, I didn’t know strawberries tasted so good.” It’s really cool. Takes them a while to let those fake foods kind of flush out of their system and they start to appreciate it.

So berries. Guess what? These purple sweet potatoes. Can we talk about those?

Cancer-Fighting Food #2: Purple Sweet Potatoes

MEL ROBBINS: Yes. So let’s talk about the purple sweet potatoes. Dr. Mussallem, why do purple sweet potatoes prevent cancer?

DR. DAWN MUSSALLEM: First of all, it’s my favorite food. I’m just here to say, if tomorrow is my last day, Mel, and you said, “Dawn, what can we serve for your last meal?” I’d say just bring me that purple sweet potato. Just heat it up a little bit though.

MEL ROBBINS: That’s it. You just cooking it and you don’t do anything fancy with it?

DR. DAWN MUSSALLEM: Yes. I eat them. I eat one every single day. I eat one every day. Look at this. I mean, it’s so cool. When you cook these, it gets more purple. So I love the berries, right?

MEL ROBBINS: Yep.

DR. DAWN MUSSALLEM: There’s 150% more anthocyanins in these purple sweet potatoes than there are in those berries.

And I love the Blue Zones. I think the Blue Zones deliver such a beautiful message. These are the places in the world where people live to be 100 years old. They thrive, they flourish with low levels of chronic disease. I don’t think we need to get into the nuances of the research, but we see this pattern and trend.

And in Okinawa, Japan, this is one of the areas of the world where women live the longest. So we got to love that, right? They love these purple sweet potatoes. So have a purple sweet potato.

The Power of Anthocyanins in Fighting Cancer

MEL ROBBINS: So tell me about the word anthocyanin. What does it do in your body that helps prevent cancer and cure disease and have you live a longer life? What is anthocyanin like? I can’t even say it. But what is it doing in your body?

DR. DAWN MUSSALLEM: You’re saying it perfect. So anthocyanins, like many of these other phytonutrients we see in these vegetables and fruits that we have here, they have the opportunity to come into our body. And what we have is we have tumor genes that will be turned on, and we have tumor genes that can be turned off. That’s how they function with the cancer.

And these different molecules can help to either make cancer turn off so that it’s not likely to have this proliferation, or they can even turn on things called tumor suppressor genes. These tumor suppressor genes help to be the brakes on any cancer. So you have this really beautiful kind of symphony and orchestra going on in your body at a genetic level. It’s very cool.

MEL ROBBINS: And that purple potato can turn off the genes in your body that are causing cancer. And they can turn on the genes in your body that naturally break the cancer. That’s crazy.

DR. DAWN MUSSALLEM: It’s exactly right. So imagine if you’re doing a diet that’s 60% ultra processed food, and you’re not consuming any vegetables and fruits. Guess what? So this sounds easy, right? We have this here and I mean, it’s making us hungry, right? It smells delicious.

Would you believe that 90% of Americans aren’t getting what they need in terms of vegetables and fruits?

MEL ROBBINS: I believe that. I hate that, but I believe it.

The Shocking Statistics on Vegetable Consumption

DR. DAWN MUSSALLEM: I didn’t believe it. So I did a study at Mayo Clinic in my cancer center. Guess what I learned? 95% of our patients aren’t getting the recommended vegetables and fruits. 95%. Every day I come in, the majority of my patients, at best, are getting two to three servings of vegetables and fruits a day.

So the recommendation, it was a great study. And what this study did is it reviewed two prospective studies, meaning studies where people were moving forward and they measured how much vegetables and fruits they consumed. And then they reviewed additional studies in a meta analysis. So this is a really high quality study of another 24 to 26 studies that they reviewed, which is really awesome.

And what they showed us is that people who had two or less servings of vegetables and fruits a day versus people who had five. Those people that had five had a 10% reduction in dying from cancer, a 12% reduction in dying from heart disease. There was another really fun fact. There was a 35% reduction dying from respiratory disease. It made me scratch my head. I was like, what does that mean? That’s what I said. I said, what does it mean?

MEL ROBBINS: What does that mean?

DR. DAWN MUSSALLEM: Well, let’s think about COVID. There was some cool COVID research. There was a study last year that showed people on more of a plant based diet, a vegan diet, vegetarian diet, just got more plants, that they had less COVID occurring.

And during COVID there were some healthcare studies and they showed that yes, indeed, people on more of these plant based diets had less moderate to severe COVID. And people who were on more animal predominant studies where they were missing out on some of this, they had a three and a half fold increased risk of more severe COVID.

MEL ROBBINS: I want to make sure I’m tracking because that was jaw dropping research.

DR. DAWN MUSSALLEM: It’s crazy.

MEL ROBBINS: So you’re saying that first of all, based on the research study that you did at Mayo, that cancer patients are not getting the recommended daily amount of vegetable servings that they need and 90% of cancer patients are not doing it. That’s number one.

DR. DAWN MUSSALLEM: All of America. 90% are doing it in my own cancer center. 95%.

MEL ROBBINS: 95%.

DR. DAWN MUSSALLEM: 95%. And this was a group. I also looked at the food insecurity. It wasn’t part of this population, so it wasn’t driven by food insecurity. It’s driven by busy lifestyles and the fact that we just don’t make time.

MEL ROBBINS: Or you don’t know, you don’t realize the power of food to heal and prevent. And I just want to make sure that as you were listening, because I know you’re going to be sharing this with people in your life who need to hear this research and who need to understand how what you eat is medicine. And there’s research.

The fact that there was a 10% decrease for people who had five servings of these kinds of vegetables a day.

DR. DAWN MUSSALLEM: Of dying from cancer, it’s major. And this is so easy. So this is a cool story. So a lot of folks, food is expensive right now.

MEL ROBBINS: Yes.

DR. DAWN MUSSALLEM: And especially when you go to the grocery store to buy it. So I had a woman that actually did have food insecurity. She’s doing amazing and she had a lot of chronic diseases, gets diagnosed with breast cancer and said, “Hey, you need to help me. I want to change.”

She did a garden. You know what she does now? She goes online, she teaches people how to garden. It gives me chills. She transformed her cancer diagnosis into this deep meaning and purpose of helping others realize, “Hey, food doesn’t have to be expensive. You can grow it in your own backyard.”

The Power of Cruciferous Vegetables

MEL ROBBINS: Dr. Mussallem, why do vegetables like cauliflower, brussels sprouts, broccoli, why do these prevent or cure cancer?

DR. DAWN MUSSALLEM: These are some of the most powerful vegetables when it comes to breast cancer. And there’s so many fun facts with it. So, you know, some vegetables are a little bit better raw than cooked. And this is actually one of them, the cruciferous vegetables. And a lot of people are like, “Ah, but it’s so gross.”

MEL ROBBINS: Okay, so crudité plate. Let’s see the. Go ahead and pick up the cauliflower.

DR. DAWN MUSSALLEM: So if we look at this cauliflower and broccoli, these are beautiful cruciferous vegetables. And maybe when I’m ready to cook these, I’ll chomp on a few of these before I cook it. And you know why?

MEL ROBBINS: Why?

DR. DAWN MUSSALLEM: Because when they’re raw, there’s an enzyme in them called myrosinase.

MEL ROBBINS: Okay, myrosinase.

DR. DAWN MUSSALLEM: Myrosinase.

MEL ROBBINS: Okay.

DR. DAWN MUSSALLEM: And that enzyme is really magical for trying to absorb the phytonutrients that are in the broccoli, the cauliflower, the brussels sprouts, the arugula, better and more effectively.

Now, if you forget about it or you’re at a restaurant and they bring your steamed broccoli, no sweat. But, you know, it’s kind of fun to think, how can I get the most out of this vegetable that possible? Eat it raw. Or if you want to eat it cooked, just nibble on a little bit raw before you cook it.

MEL ROBBINS: Now, let me ask you a question, though, because I have heard somewhere, I don’t know where, that you got to avoid the broccoli and cauliflower on a crudité plate because it’s very hard for your gut to digest it. But you’re saying in the case of preventing cancer, curing diseases, living a more vital life, it’s okay, or do you just chew it 100 times versus 10 times? Or what are your thoughts on that?

DR. DAWN MUSSALLEM: You know, that’s so interesting. And a lot of people may struggle with this in the beginning because their gut microbiome is a mess. So the more we introduce these foods into our dietary pattern, the better you do with it.

But listen, everyone is an individual, and some people may struggle with eating these raw. Some people may not tolerate broccoli. You should listen to your body and the harmony of your body. There’s a lot of internal wisdom in the body. So if a woman comes in and says, “Oh, I can’t stand broccoli,” I said, “Let’s not consume it. Let’s look through the other cruciferous vegetables that you can enjoy.”

MEL ROBBINS: Brussels sprouts, arugula, cauliflower, cabbage.

DR. DAWN MUSSALLEM: Everyone loves cabbage. It’s one that seems to be very frequently appealing to patients when I visit with them. But there’s so many to choose from. And the easy thing, ChatGPT is free. Go in and say what cruciferous vegetables are out there, you know, and it’ll give you a long list of cruciferous vegetables and pick one. Try to eat them raw.

MEL ROBBINS: When you cook it, you don’t lose the power it has to help prevent or cure cancer.

DR. DAWN MUSSALLEM: You’re still going to get benefit, but you’re going to get a little bit more if you have a little bit of raw before you do it, because you’re going to get that enzyme.

Now there’s a little hack you can do. Okay, dry mustard seed, the seasoning. If you decide you just want to cook these and you don’t want to nibble on any raw, put some dry mustard seed. Just sprinkle it on top. Once it’s cooked, it actually tastes delicious. And that dry mustard seed will help you absorb it.

MEL ROBBINS: Fantastic. I’m going to do that when I get home.

DR. DAWN MUSSALLEM: So cool. Another thing that I’ll often do is I’ll already have the broccoli steamed, but I do a salad with some arugula in it and arugula. It doesn’t matter what you do. It doesn’t have to be exactly the broccoli. If you just want to have any cruciferous vegetable at the same setting, just try to do some of your cruciferous raw.

That’s the message. And if not, put some dry mustard seed on it. Let’s get all the bang for our buck, if we can, from these amazing ingredients. And it’s really cool what they do. So when it comes to breast cancer, it helps to make estrogen into a less proliferative form, into a more…

MEL ROBBINS: What does proliferative mean?

DR. DAWN MUSSALLEM: You know, when we think of the breast tissue, we think of the fact that the breast tissue itself can be in a proliferative state where cells can grow more. Got it. And what the broccoli can do is it can transition the estrogen actually in our body to a form of estrogen that doesn’t cause that proliferation.

Proliferation is growth. So you can imagine if something’s upregulating growth, that’s not a good thing. Right. We want things that try to turn off that growth, and it keeps that in check.

There’s many other things that the cruciferous vegetables do. It’s like a master at detoxification. So often I have patients say, “I’m going to go do a detox. But what do you recommend?” I say just eat healthy food. Get some broccoli. It’s your natural detoxification. You don’t have to go spend a bunch of money on a fancy detox. And I would actually rather people do it a more natural, safe way than go and put themselves through a major detox. So I just do it with the natural foods.

The Magic of Beans and Fiber

MEL ROBBINS: Tell me about the black beans there. Let’s talk about beans. And why do they prevent cancer?

DR. DAWN MUSSALLEM: So beans are really awesome. So there is so much benefit. This is an amazing plant protein. But when you think about plant protein, you’re not just getting protein, you’re getting fiber. And fiber is obviously in all of these plant foods, you only get fiber from plants. And fiber is magic. I mean, oh, my gosh, we could talk for two hours on fiber. It’s so important.

And you hear a lot right now, “Get protein, get protein, get protein.” So, yes, you need protein. There’s no doubt you need protein. But the problem is the majority of Americans, just like the vegetables and fruits, they’re fiber deficient. 95% of men are fiber deficient and about 91% of women are fiber deficient. This is a massive problem.

There was just something called, we call an umbrella review, meaning they did this very exciting review of all of the data to date. This was just published this year, 17 million person years in the study. And what it showed us is that there’s class one evidence, this is the highest quality evidence we have in medicine, that fiber can help to reduce dying from any cause, dying from heart disease. It can also reduce the risk of dying from pancreas cancer. In this class one evidence. What it’s really exciting.

There was another study, another review of the data that was just published that showed that fiber can help to reduce the risk of cancer by 22%.

MEL ROBBINS: Okay, hold on. Fiber can help reduce the risk of cancer by 22%.

DR. DAWN MUSSALLEM: 22%. But we have 90%, over 90% of people that aren’t getting enough. So let’s talk further. So I always think about food swaps with people. How can we maybe just swap one thing out? You know, you don’t have to do beans at every meal. And a lot of people say, “Oh, my gosh, you’re making me gassy.”

Well, just start slow. You don’t need to do too much and cook them really good. So let’s talk about this a little more. There’s an enzyme in beans. This is so fun. It’s like, food is medicine, right? I love this. It’s fun fact. So there’s this enzyme called raffinose, and that’s the gassy one.

MEL ROBBINS: Raffinose is the gassy.

DR. DAWN MUSSALLEM: It sounds like it’s such an ugly word. Raffinose. That’s why you want to soak beans. So if you buy them dry, it’s such an inexpensive, so much less expensive.

MEL ROBBINS: Buy the beans dry, put them in the crock pot overnight.

DR. DAWN MUSSALLEM: Soak them. You got it. You want to soak them and then rinse them really good and then cook them.

MEL ROBBINS: That’s why we need to rinse them really good.

DR. DAWN MUSSALLEM: You’re rinsing off that Raffinose.

MEL ROBBINS: Oh, so we’re getting rid of the gas.

DR. DAWN MUSSALLEM: Getting rid of the gas.

MEL ROBBINS: Got it. Okay.

DR. DAWN MUSSALLEM: If you get gas, you kind of ask yourself, did I soak them long enough? And rinse them now. I’m really busy. I know a lot of people listening are busy. I oftentimes just do canned beans. And so you want to rinse all that stuff off that it was soaking in. Rinse them, rinse them, rinse them, and then heat them up. That’s why. That’s why people get gas.

MEL ROBBINS: Keep the juice.

DR. DAWN MUSSALLEM: Okay.

MEL ROBBINS: I don’t want the juice because I don’t want the juice in my body. You know what I’m saying? Okay.

DR. DAWN MUSSALLEM: I have to share another study. Can I keep going, please? Okay, so this one is super cool. So when we think about red meat, a lot of times people talk about how a carnivore diet can improve things like diabetes. This is very interesting. So there was recently a study published, and what it showed is that red meat and processed meat drives the risk of diabetes by about 60%.

MEL ROBBINS: Wait, processed meat and red meat drives your risk of diabetes to 60%?

Red Meat and Diabetes Risk

DR. DAWN MUSSALLEM: Yes. What? Yes. And so this is the people that had the most versus the people that had the least. Any of these studies, when you hear people talking, you always want to scratch your head and say, I wonder what they’re comparing it to. And oftentimes it’s the most versus the least.

So if you have a little bit of red meat, say, one, two, three servings a week, that’s not going to cause you to have diabetes. But if you’re having red meat three times a day, every day, that’s a big problem.

So what the study showed us was really cool. We’re talking about these food flips, right? If you flip out one serving of red meat or processed meat a day for beans or nuts, you reduce that risk of diabetes by about 30%. I mean, how easy is this?

Think about if you’re doing like a Mexican meal where you have some meat that you put seasoning. Skip the meat. Do the beans, put the same seasoning in it, it’s delicious. If you’re doing soup, you can put maybe a few pieces of meat. If you really like that meat stock flavor, right, it’s not going to hurt you. What about with beans?

MEL ROBBINS: Are all beans created equal? Are there beans that you like better?

DR. DAWN MUSSALLEM: No. Do what you like, do what you like. Do what’s unique to you. I find in my patients, they seem to tolerate lentils and split peas initially.

MEL ROBBINS: Best and then just as much benefit lentils and split peas do.

DR. DAWN MUSSALLEM: What is you do which one you enjoy the most. I know for myself personally, I don’t tolerate kidney beans. They make me feel icky. I will never have a kidney bean in my house. Black beans I love and lentils, they’re so yummy.

So it’s really exciting. And sometimes I’ll work with patients and I’ll have them. I just had a woman this week who I gave her this suggestion. She’s still doing it. She does steel cut oats with some lentils in it and then she adds some cherries when she cooks it. And she loves it. It’s how she gets her protein.

She’s very committed to a whole food plant predominant diet. And she loves getting some of those lentils as her protein source in the morning. So you can get really creative with these things. They take on the flavor of whatever you’re cooking.

Why Edamame Prevents Cancer

MEL ROBBINS: Dr. Mussallem, why does edamame prevent cancer?

DR. DAWN MUSSALLEM: Really exciting data. So this is the biggest myth that’s out there.

MEL ROBBINS: Biggest myth that’s out there.

DR. DAWN MUSSALLEM: Biggest myth that’s out there, that edamame causes cancer.

MEL ROBBINS: What?

DR. DAWN MUSSALLEM: So the majority of your listeners are going to be like, I think Mel said that wrong. Mel just said, why does edamame prevent cancer? Mel is right. 100%. Edamame are amazing.

So, but several decades ago there was research done in rodents and we’re not rodents, right? So this is how lab data can get very dangerous. You hear these things in the lab or in the turbulence. Preclinical meaning pre, before the clinic. In this lab data that these lab studies are preventing X, Y and Z disease. These studies need to be replicated in the human being.

So in these lab studies with rodents, they showed that, yes, consuming too much soy actually caused mammary tumors. I remember this, remember this, don’t eat soy, it’s going to cause tumors in your breast tissue. That was the worst science ever. Because humans do not metabolize soy the way that rodents do.

We could use our common sense with this. We could look to Asia. We see in Asia people have very low levels of cancer in their breasts. Very, very low levels. And so if we really apply it to the human data, the research is beyond exciting.

There are very few things we can consume that God forbid you ever got breast cancer would reduce your risk of dying. And edamame are one of those. And one of the most influential times you have that edamame is you’re a young girl, and if you’re a man, it’s not going to make you grow boobs. And if you’re a young boy, it’s going to be very protective for his prostate, too.

So we know that soy is also good to reduce the risk of prostate cancer. There’s even some research that says it reduces the risk of lung cancer. And it’s amazing for the gut microbiome.

But let me talk about breast cancer, because a lot of women with breast cancer avoid soy. Even though we know this data, that it looks protective, they avoid soy. Well, the American Cancer Society’s 2022 data on nutrition and exercise update dedicated three paragraphs to the safety of soy and breast cancer survivors.

And it didn’t just show safety in this beautiful meta analysis. It showed that there was a 25% reduction in breast cancer coming back. And this was most pronounced in women with the most aggressive type of breast cancer when it’s estrogen receptor negative. But even if women had estrogen receptor positive breast cancer would still benefit.

So it’s really amazing. And how this works is there’s two receptors in the breast. The estrogen receptor beta is where that soy likes to bind. And remember, we talked about proliferation. That’s when we turn off the proliferation is estrogen receptor beta.

MEL ROBBINS: So when the soy binds with the beta, it turns off the proliferation of estrogen, which increases the spread of cancer. And by turning it off, you’re preventing it from coming back, and you’re also fighting it, if you have it exactly right.

DR. DAWN MUSSALLEM: And then, you know, our natural body’s estrogen binds to the estrogen receptor alpha preferentially, and that’s when that turns on this proliferation.

MEL ROBBINS: So beta turns it down, alpha turns it on.

DR. DAWN MUSSALLEM: You got it? Got it. So cool.

MEL ROBBINS: Okay, so explain that part again about the alpha.

DR. DAWN MUSSALLEM: What does it do? That’s where the body’s natural estrogen would bind. That turns on this proliferation. So the soy does this really favorable thing at the level of the breast, we get protection, and that’s exactly what we see in these studies. And it’s a plant protein, so it’s super cool. So how many women, I mean, hot flashes, right?

Edamame and Hot Flashes

MEL ROBBINS: Yes.

DR. DAWN MUSSALLEM: What do we do with those?

MEL ROBBINS: I had one last night. I literally was sleeping at the hotel with my leg outside the comforter in order to try to regulate my temperature. Yes. What am I eating? Well, you’re not. What do I need to eat? Dr. Mussallem, for hot flash.

DR. DAWN MUSSALLEM: Would you start eating these right now? So I already eat.

MEL ROBBINS: I need to eat more edamame. Clearly. I order it when I’m out and occasionally I’ll make it at home, but I need to eat. I’m about ready to take that cup of it and just throw it back right now.

DR. DAWN MUSSALLEM: I love it. So this is amazing. You know when patients come in to see me and they have their hot flashes, which I’m working with women. 75% of breast cancers are estrogen receptor positive. So these women are on anti estrogen medications from the age of 20 all the way to late 80s. I see women and so they have massive hot flashes.

Oftentimes the number one thing I start with is soy. There’s great research done by Neal Barnard. He’s repeated the study twice to show that edamame, a half a cup a day, in addition to eating a healthy plant based diet reduced. You ready for this? It reduced moderate severe hot flashes. You’re on the edge of your seat by 88%. Wait, what? Crazy. Wait.

MEL ROBBINS: All I have to do is have a half a cup of edamame and I could experience an 80% decrease in hot flashes.

DR. DAWN MUSSALLEM: 88% reduction in moderate severe hot flashes. He repeated this study and there was another one that showed as high as 92% reduction.

MEL ROBBINS: Dr. Mussallem, you know what I say.

DR. DAWN MUSSALLEM: Let’s eat some edamame.

MEL ROBBINS: Yeah, pass me the damn edamame right now. It gets better.

DR. DAWN MUSSALLEM: It’s even better. So in this study, you know what else they showed us?

MEL ROBBINS: Tell me.

DR. DAWN MUSSALLEM: Their moods felt better, but even better, their libido picked up.

MEL ROBBINS: Oh my gosh, they felt sexy again. Chris is going to be shoving this at me like, eat some edamame, Mel.

DR. DAWN MUSSALLEM: Yeah. I have a funny story. I actually did a talk for this super bowl last year right around Valentine’s Day. And I presented this data and they said, I’m buying edamame on my way home. You know, every man there. So it’s pretty cute. But yeah. So eat your edamame. It’s a great source of plant protein. It’s delicious. You can do edamame. You could do tofu, you could do tempeh, you could do soy milk, you know, super easy.

MEL ROBBINS: I like the edamame.

DR. DAWN MUSSALLEM: I do too.

MEL ROBBINS: I do too. So now I’m getting my fiber. I am getting my amino acid, leucine profile protein count. I’m also getting my hot flashes decreased by 80%. I’m binding to my beta whatever they were called in my breasts. So it’s turning down the cancer and estrogen stuff. I can’t explain it quite like you did, but I kind of understand it. And my mood’s going to be better. I think you just saved my marriage.

DR. DAWN MUSSALLEM: I hope so. And my hot flashes and my…

MEL ROBBINS: Well, we’re celebrating our 29th wedding anniversary this weekend, so.

DR. DAWN MUSSALLEM: Oh, that’s beautiful. Happy anniversary.

MEL ROBBINS: Edamame can always make it a little better. I’ll be eating it every day. Let’s talk about kiwi.

The Power of Kiwi

DR. DAWN MUSSALLEM: Oh, kiwi.

MEL ROBBINS: So I see kiwi.

DR. DAWN MUSSALLEM: Oh my God.

MEL ROBBINS: Why does kiwi prevent cancer? And I see you smiling. You love kiwi. Tell me why you love kiwi so much, Dr. Mussallem.

DR. DAWN MUSSALLEM: These little things, they’re so cute, but they help with regularity, meaning poop. So I would say 90% of women coming in to see me, they’re not having any bowel movements and they feel bloated, they feel full. I mean, it’s just, I can’t imagine how people feel. Some people say they don’t have a bowel movement for 10 days. How it. Oh, it’s horrible.

It’s really bad because when that poop sits inside you, you’re autointoxicating. You’re reabsorbing all those chemicals into your body. Wait, what?

MEL ROBBINS: Hold on a second. So when you’re constipated, the waste, which is poop, is just sitting there in your system. You’re reabsorbing the waste that’s trying to get out.

DR. DAWN MUSSALLEM: Yeah, it reabsorbs.

MEL ROBBINS: What?

DR. DAWN MUSSALLEM: Yes, it’s very. You want to get rid of that waste. You ideally, you know, people are supposed to have a bowel movement after each meal.

MEL ROBBINS: You’re supposed to have a bowel movement after each meal.

The Importance of Regular Bowel Movements

DR. DAWN MUSSALLEM: No one does that because in America we’re in this fast pace. We kind of as kids learn that. No, you go maybe after breakfast when you’re home and maybe after dinner if you’re lucky. No one typically is going after each meal, but ideally that’s best.

Oftentimes, patients transition to this more plant predominant diet and they’ll call my nurse and say, “I think something’s wrong. She put me on this diet and I’m pooping. I’m having a bowel movement after each meal.” And the nurse is like, “Oh, no, no, no, she loves that.”

So this is cool though. So let’s say someone is just struggling, they are constipated for whatever reason. Maybe it’s their treatment. We give Zofran for nausea for cancer patients. It causes a lot of constipation. Kiwi. Two kiwi a day after about a week or two can help you with that constipation.

MEL ROBBINS: Why?

The Power of Kiwi

DR. DAWN MUSSALLEM: It just helps with the different sorts of soluble fibers and mucinous fibers and proteins and whatnot that are in this. It helps with it, but it’s better than that. At the level of DNA, these are rich in vitamin C, but at the level of our DNA, it can help to reduce oxidative stress.

You know, think about an antioxidant. We take antioxidants to fight cancer. We take all these expensive pills and powders, right? Just eat your kiwi. But I love this with the skin, right? The skin is so great because it’s more fiber for you. So this is a wonderful food to add in. It helps the overall diversity of what you’re consuming.

MEL ROBBINS: Now, why does a kiwi prevent cancer?

DR. DAWN MUSSALLEM: It’s super cool. So this really gets on the cellular level, which can you imagine? That’s how cool food is.

MEL ROBBINS: Medicine.

DR. DAWN MUSSALLEM: It’s so cool. So at the level of DNA, it can reduce oxidative stress. So we go and we buy antioxidants. We spend all this money on whole lot.

MEL ROBBINS: What is oxidative stress? I see it on packaging, but what actually is it?

Understanding Oxidative Stress

DR. DAWN MUSSALLEM: So oxidative stress is what comes from us, from everything as simple as breathing oxygen from the environment to having any stressors in life. They’re just really living. We get this oxidative damage that builds up. Certain foods can even kind of cause this trigger as well.

But what these little magical fruits do is they go in and they help to turn off that oxidative stress. They come to the rescue.

MEL ROBBINS: So life basically has turned on the oxidative stress in your body at a cellular level. And you eat a kiwi, and not only is it helping you with constipation, but it’s flipping the switch off on stress at a molecular level exactly.

DR. DAWN MUSSALLEM: It’s at the level of our DNA, our genetic makeup. It’s super cool, and it helps to repair that DNA. So it’s really a magical fruit. But it’s like this with all these vegetables and fruits. These all have these magical powers within these phytonutrients and molecules that just help the body and rescue it.

The body has such wisdom to heal itself. But we just have to give it the tools to do this.

Raw vs. Cooked Vegetables

MEL ROBBINS: And is it better if these are raw? Do you get more benefit if you’re eating these raw? Clearly just eat them. But if you can just pop fresh kiwi in your mouth, if you can do it that way, it’s better.

DR. DAWN MUSSALLEM: Exactly. So there’s two vegetables that are better cooked, and that’s carrots and tomatoes. And both of those are actually better with a little fat. You get more of that lycopene, you absorb it in the tomato, and the beta carotene in the carrot.

So those are two vegetables that would be better to cook them than raw in terms of extracting all those phytonutrients. I mean, I love raw carrots, so I eat them all the time. It doesn’t mean don’t eat raw carrots. It just means if you really wanted to go and rehabilitate all the benefits and how you would extract those phytonutrients, best cook them in a little bit of olive oil. Nice extra virgin olive oil.

It’s Never Too Late to Change

MEL ROBBINS: Amazing. And is it true that even if you have a patient that comes in with a cancer diagnosis to your practice and they’ve really just let themselves go? I mean, I think for women in particular, as we’re taking care of everybody else and we have a really busy life and it’s easy to get the stuff grab and go and not find time to exercise, even if you’ve made kind of…

Now that you’re realizing, “Oh, my God, I got to put the boxes down and the cans away, and I got to get back to a really more sensible whole food diet,” can you really reverse the stuff that you’ve done? Can your body really kind of flip the switch even if you’ve let yourself go for a while? Is this available to all of us at any age?

DR. DAWN MUSSALLEM: Oh, I love this. You ready? Yes. Get on the end of your seat because you’re going to for this one.

So, you know, if we’re young, in the age of 20, and we start eating better, yeah, you can imagine for women, we can add 11 extra years to our life. For men, 13 years.

MEL ROBBINS: Wait, hold on a second. Say that again.

DR. DAWN MUSSALLEM: Yeah. So if you’re 20 and you say, “Hey, I’m listening to this show and we’re going to start eating all these vegetables and fruits and more whole grains, plant proteins, just a little bit better,” doesn’t mean you need to be vegan. You can add 11 years, if you’re a woman, onto your life expectancy. Of healthy years. If you’re a man, 13 years.

But it gets better. Can I keep going? Ready? If you’re in your 60s. So you really beat yourself up.

MEL ROBBINS: Yep.

DR. DAWN MUSSALLEM: You’re 60, you get your breast cancer diagnosis. Uh oh, you can add eight years life expectancy.

MEL ROBBINS: Wait, what?

DR. DAWN MUSSALLEM: Wait, it gets better. Okay, here’s the goal. Ready for a drum roll? You ready? Yes. If you’re 80. I have consultants and they’re 80. “Why am I seeing you? I’m 80.” Granted, she’s outlived the life expectancy of most women in our country. “Can you really help me?” I say I absolutely can.

And here’s a study that proves that you can have 3.4 years of life expectancy. It’s so cool.

MEL ROBBINS: Just through the changes in food.

The Science of Healthy Aging

DR. DAWN MUSSALLEM: Yes. By eating healthier. It’s truly amazing. So healthy living really comes with its own benefits. And we see in this science, this is longevity central now, everywhere on social media, every big city you go to, it’s anti-aging clinics everywhere you go.

And these programs must be built on healthy living because there’s no magic bullet that’s going to help you age healthy and feel wonderful in that time, like healthy living will. And we know that about 75% of that healthy aging equation is modifiable. It comes from our lifestyle.

So it’s so important to really lean in, show up for ourselves. It’s never too late, even if you have this cancer diagnosis. And we know if you are diagnosed with cancer, you know, that can be a hard time for some people. They’re busy with their treatment, they don’t feel good and they’re processing a lot.

And the cancer research really says, you know, it really kind of starts in these studies about a year after the diagnosis. I want my gals to get as busy as they can at the time of diagnosis because we know that if we can get as busy as we can during treatment, that they just feel better, they have improved quality of life.

There were two recent studies that explored this and they were very fascinating small studies, but they give us a snapshot of how cancer patients do during treatment. And one actually did a whole food plant only diet, like a vegan diet. They supplemented them with some protein powder. And what they showed is, yes, these patients during chemo had less fatigue. That’s what I see in my patients.

MEL ROBBINS: As you’re listening, I want you to think of every 20 year old in your life. I want you to think of anybody in your life that has gotten a cancer diagnosis. I want you to think of anybody in your life in your 60s and your 80s that may or may not have taken good care of themselves.

And I want you to share this episode with them because it’s an act of love. It is a generous gift to give the gift of Dr. Mussallem to the people that you care about.

So we’ve talked so much about the foods that you can eat that activate the natural intelligence in your body to prevent or cure cancer. Let’s talk about the top five foods that we should avoid that cause cancer.

Foods to Avoid: Ultra Processed Foods

DR. DAWN MUSSALLEM: Yeah. You know where I’m going to start, right?

MEL ROBBINS: No ultra processed foods. Okay, so anything in a box?

DR. DAWN MUSSALLEM: No, not necessarily what I said, because we are in a busy, fast paced life. So we need easy solutions. Me included. Right. So what I do is I spend a lot of time in the grocery store and I tell my patients, “Listen, you’re going to too. This takes time.”

MEL ROBBINS: Okay, what am I looking for when I’m in a grocery store?

DR. DAWN MUSSALLEM: You’re going to look at that ingredient list on the box, on the package. Whatever it is you’re buying that’s not in the produce aisle. So as soon as you go in the aisle, you know, when you’re on the perimeter, it’s kind of like whole food. As soon as you’re in the aisle, let’s look at those labels and see what’s in the ingredient list.

If there’s words in there that you’re like, “What the heck is that?” Put it back on the shelf.

MEL ROBBINS: Okay.

DR. DAWN MUSSALLEM: You just don’t need it. So look for those ultra processed foods on the ingredient list with words that we have no clue what they are.

You know, there was a study that was really, really fascinating. It was done out of the UK and it showed that, you know, almost 30% of the food by weight was ultra processed food. And for every 10 point increment increase in that ultra processed food, yes, it certainly drove the risk of cancer.

But this is a really startling statistic. It drove the risk of dying from breast cancer by 16% and increased the risk of dying from ovarian cancer by 30%. These numbers create almost a visceral response. Almost makes me sick to share that because that’s really harsh to think that fake food can have that kind of impact.

And we know that it drives risk of chronic diseases, these fake foods, diabetes, heart disease, all these things. Number one killer of women and men is heart disease. And we know these ultra processed foods just wreak havoc there too.

The Danger of Mono and Diglycerides

There was another study when we start to think about, well, what constituents are ones I really need to be careful of. So there was another study done among 92,000 individuals from France. They followed them for almost seven years. Okay, here’s another one. This is a hard one to believe. It drove the risk of breast cancer with the consumption of mono and diglycerides.

MEL ROBBINS: Whoa. Mono and diglycerides.

DR. DAWN MUSSALLEM: Listen.

MEL ROBBINS: Okay, what is it?

DR. DAWN MUSSALLEM: This is in everything. So you know those wrap sandwiches that we make?

MEL ROBBINS: Yes.

DR. DAWN MUSSALLEM: Either, you know, they’re healthy, we’re doing a good job. We’re trying to eat a healthy veggie wrap. Many times these wrap sandwiches to get it so it rolls nice.

MEL ROBBINS: Yes.

DR. DAWN MUSSALLEM: They add that mono and diglyceride to make it roll nice.

MEL ROBBINS: Mono and diglyceride. That’s what I’m looking for.

DR. DAWN MUSSALLEM: Mono and diglycerides drove the risk of breast cancer by 24%. Okay. Prostate cancer. It drove the risk by 46%.

MEL ROBBINS: Did you hear that? Gentlemen do not eat that.

DR. DAWN MUSSALLEM: But listen, these mono and diglycerides are in a lot of stuff. So we have people that hear maybe what I’m saying, “Oh, maybe I should be vegan.” That is not my message. My message is whole food plant predominant. That’s really where I want people to be, is that whole food component.

The vegan ice creams. I had a patient before I came here yesterday, she was doing vegan ice cream, thinking she was doing good. You know, I just had to say, “Just do the regular ice cream. How often do you do it? Just once a week. Enjoy your ice cream. You don’t need the fake stuff.”

MEL ROBBINS: Because there’s a lot of fake stuff and a lot of that stuff.

DR. DAWN MUSSALLEM: Just because it says vegan doesn’t mean it’s healthy. Look at the ingredient list. Get rid of those mono and diglycerides. Carrageenan drove breast cancer risk by 32%. For a long time, we found this a lot in plant milks. You know, people are trying to be healthier. And then we find these ingredients that aren’t good are in these foods.

So take a look at the ingredient list. It’s really, really important. And just try not to do those chemicals that wouldn’t otherwise be good for your body.

MEL ROBBINS: What are the other ingredients? If you had to have five that we’re really looking for on the back of an ingredient list. Don’t go near it. One of them was the mono.

DR. DAWN MUSSALLEM: Yeah. Mono and diglycerides.

The Impact of Artificial Sweeteners on Cancer Treatment

MEL ROBBINS: Mono and glycerides. The other one was the Carangians. Caringians. Give me a couple others.

DR. DAWN MUSSALLEM: You know, and the food colorings. You know, at the government policy level, they’re really starting to get rid of food colorings. There’s so many ingredients on the ingredient list. They kind of try to twist around that it’s really hard to even know what these ingredients are anymore. So it’s such a huge umbrella and net of words that are on there.

I just typically say, let’s just try not to do the foods that we bring into our home that have these words that we have no clue what they are. There was a study that was looked at this weekend. I actually called my good friend Dr. Sarah Chumsree. We do a lot of studies together with gut microbiome. She’s big into immunotherapy and man, this is scary.

It said individuals on immunotherapy who consumed sucralose. So these are in these sugar free beverages. We didn’t think that these things actually seemed as sinister, you know, as a lot of people point them out to be. They’re definitely not a health food. But do they really cause harm like people point them out to be? Probably need a lot of it to really cause harm.

But they found that the sucralose reduced the effectiveness of immunotherapy in the treatments that are curing cancers. That the sucralose messes with the gut microbiome. This is what it’s suggesting. So this is a shout out. Let’s really try to skip these artificial sweeteners. Lean in on something like dates or use honey or maple syrup. Or if you’re on more of a calorie restriction, look at stevia or monk fruit.

Even when you buy those, take a look at the ingredients because guess what? In this natural food industry, everyone’s coming to the market and some of those foods are a little more processed than they should be.

Natural Sweetener Alternatives

MEL ROBBINS: So the stevia is okay, the monk fruit is okay.

DR. DAWN MUSSALLEM: Green light here and there.

MEL ROBBINS: Green light, green light. But you with a product with stevia or monk fruit, you still want to look and see is there something else scary hidden in there?

DR. DAWN MUSSALLEM: I think so. You know, there’s some of these packets of the stevia that add erythritol. I will be first to say I think that research was exaggerated. You would need a lot of erythritol to really cause a true problem in terms of cardiovascular health.

MEL ROBBINS: But you still want to avoid it.

DR. DAWN MUSSALLEM: Exactly. And it gives you a lot of GI upset. So why do it? It’s going to make your belly feel bloated. Anything that has that “ol” on the end is usually a sugar alcohol, sorbitol, erythritol and your belly is just going to hurt. You know, if you do too much sugar free candy and you’re like, it feels like you have razor blades in your stomach. So just be cautious with those sugar alcohols.

Again, not all of them are definitely doing harm that we know of for sure. The erythritol is one that’s definitely on the watch list because it seems to make platelets, the cells that help to clot the blood. It seems to make them a little stickier. But again it would take so much. It’s more of a cellular reaction in the body in response to stress that releases some erythritol.

If you consume it, does it do the same thing? That’s what we need to find out. Some of this research is done in isolated situations in the lab that when applied to the human and doesn’t really work directly in that mechanism but still you don’t need it.

MEL ROBBINS: Got it. And so if you’re looking at something derived from dates or honey or bananas or something like that, or stevia without the erythritol or however you say it, or monk fruit, we’re good.

DR. DAWN MUSSALLEM: Exactly. Medjool dates, I mean it’s God’s candy. They are so healthy and they don’t drive your blood sugar up. It’s the coolest thing. They almost have this insulin sensitizing feature. So if children want a delicious snack, take a medjool date, take the pit out and put a pecan in the middle. It’s like heaven. Amazing.

Foods to Avoid for Cancer Prevention

MEL ROBBINS: And other than ultra processed, what are the top foods Dr. Mussallem to avoid because of cancer?

DR. DAWN MUSSALLEM: So processed meat kind of in the processed foods and maybe. But processed meat is a Class 1 carcinogenic. That’s right. So it’s linked to the increased risk of several cancers, but it especially drives that risk of colorectal cancer. I mean this has been a lot of stuff, right? So this is pepperoni, this is sausage, this is bacon, this is even chicken nuggets. This is lunch meat.

MEL ROBBINS: You are out for the charcuterie board. I mean is there any kind of salami or bruschetta or any of that stuff? Like if you get it from your local farmer, are we okay? Or is it just big buying it behind the deli counter situation?

DR. DAWN MUSSALLEM: You know, let’s have an honest conversation. So what I share with people is how much of this are you going to consume? And you’re in a social gathering, you may have a piece, what, once or twice a month. That’s just not enough to hurt you. The body is resilient. But if someone’s having it every day, that’s when it adds up.

You’ve got to live. And if you love having some of that charcuterie, and we certainly know in the Mediterranean countries, and I think a Mediterranean diet can be very healthy if that’s what you do. Just because I don’t do it doesn’t mean that I think that it’s going to kill you. But what I’m here to say is, yes, processed food is considered a carcinogenic. So are cigarettes.

If you smoked one cigarette four times a year, that’s also probably not going to cause cancer. But that would sound ridiculous as a doctor, if I said, yes, go and have a cigarette once in a while. But why do we frown down so much if I say, yeah, you should avoid processed meat? People get very protective around the discussion of food.

So I’m just here to kind of talk some sense into what that really means. I share this with my patients. Like speeding on the highway. You know, when you get in your car, put on your seatbelt. Let’s keep yourself safe. Speed is posted. 65, you’re going 67, 68. You’re not going to get a ticket, especially if you’re doing everything else right. You know, stay in your lane. Get your vegetables and fruits. Get your fiber. Get what you need. Don’t throw the whole meal away. If you have the charcuterie, lean in on some avocado and get some whole grain crackers. Enjoy yourself. I love you.

MEL ROBBINS: You’re my new doctor. That’s all I’m saying.

DR. DAWN MUSSALLEM: You’re my new doctor. I won’t be eating the charcuterie, by the way.

MEL ROBBINS: That’s fine. You know what? Let them. I’m happy to have a couple pieces of salami. Yes. With some avocado and some olives.

DR. DAWN MUSSALLEM: But no one enjoys me when I’m at a party because everyone behaves, you know, and it’s all the people behind me that are doing all this stuff. Everyone in front of me is doing. And they go to the back and do it.

The Healing Power of Exercise

MEL ROBBINS: I think I would enjoy you anywhere. So don’t worry about that. Let them think what they’re going to think. So you talked about exercise. Let’s talk about how exercise, particularly when you have a cancer diagnosis or you are battling some other illness. Talk to me about the healing properties in exercise.

DR. DAWN MUSSALLEM: You know, there’s this really cool mechanism that takes place that we’re still doing research on. It appears that exercise during that period of chemotherapy improves cancer outcomes. We see this with metastatic breast cancer, too. So it’s extremely exciting.

And the one hard thing with cancer treatment is oftentimes people lose muscle, you know, and that’s the metabolic tissue. So if you can try to do your cardiovascular work to try to really keep that cardiorespiratory, meaning the heart and lungs, as fit as possible, but also even trying to lift some weights during your cancer treatment, it can really help to maintain that muscle, which is going to make your survivorship easier.

Like I shared the statistics with breast cancer is you exercise as a breast cancer survivor can improve outcomes by 50%.

MEL ROBBINS: Meaning the cancer doesn’t come back.

DR. DAWN MUSSALLEM: Yeah, it improves survival from all causes from breast cancer by up to 50%. It’s a really powerful number. You know, if someone cornered me and said, what is the most important thing a cancer patient should do? I wouldn’t really answer one. I would refuse to answer one, because there’s like, three things at the top of the list.

The Top Three Things Every Cancer Patient Should Do

MEL ROBBINS: What are the top three things a cancer patient should be doing, Dr. Mussallem?

DR. DAWN MUSSALLEM: Well, I would start. Number one is love. Love self. Love others. It starts there. It’s that simple. Because if you don’t love yourself enough to show up for yourself, to exercise, exercise, move your body, and take time to find healthy food, you’re not going to do it. So we got to start there. Love self and then love others. Just open that heart and be kind. It feels so good.

Like, I love you. I love all you. I love you, too. It just feels good. You say that and you elevate the energy of the room. And if you do that, you’re going to be more energized. You’re going to have more pep in your stuff, even during that chemo to go walk.

And, you know, it’s kind of a responsibility even to help others. We feel good, so we should be kind of good stewards in the world to share that energy with people that aren’t doing as good today to help them. So starts with love. Show it for yourself. Move your body. You don’t need to be running marathons. Just go for a little walk and say, hey, five minutes counts, even if you’re walking around your kitchen. Hey, do a few dance moves. I don’t have to dance with your husband. It doesn’t matter. Just move. You don’t need to go to a gym.

MEL ROBBINS: Love.

DR. DAWN MUSSALLEM: Move.

MEL ROBBINS: And what’s the third thing every cancer patient should be doing?

DR. DAWN MUSSALLEM: Yeah, hey, it’s the food. And, you know, that’s my favorite. Like, food is love. Because it’s really like it’s going to give you the energy, nourish your body, help you with regeneration. Actually turn, turn off those tumor promoter genes, turn on those tumor suppressor genes and it’s just going to optimize everything from your mood to your sleep even. Which we’ll talk to in a little bit here to that gut microbiome and beyond. So the food is fun. Let’s do it.

The Critical Role of Sleep in Cancer Prevention

MEL ROBBINS: Absolutely love this. Let’s talk about sleep. Does sleep help you prevent cancer?

DR. DAWN MUSSALLEM: No, sleep is rough, man. I live a pretty healthy lifestyle, but I sleep like a baby. But I just can’t find time for sleep these days. I would just rather be to able activated and alive. But listen, that sounds funny, right? That’s not actually a funny thing. We need sleep. Sleep is when our brain gets its bath.

MEL ROBBINS: Talk to me. What do you mean your brain gets a bath?

DR. DAWN MUSSALLEM: Seven to nine hours is what it takes for the brain to kind of get its little washing to get rid of all those toxins. You need to. I just joke. My patients, like, yeah, no stinky brains. Get your sleep. I just did talk to the Mayo Clinic staff. I said that they kind of, all these very brilliant, like the smartest people in the world are kind of like, okay, patients love that stuff. Academics, they don’t always find it cute, but this is the truth. Wash your brain.

You know, sleep hygiene, we call it sleep hygiene for a reason, because your brain needs its bath. But there’s things we can do to improve the quality of our sleep. And really what’s so important is that when you wake up, you get that first morning sunlight. Getting that first morning sunlight resets that circadian rhythm.

And then, man, we need to be careful with the screen exposures because all that blue light that’s emitted, especially if you don’t wear the blue blockers on your glasses, it just drops and drops and drops your natural melatonin. So when you go to bed at night, you either can’t fall asleep or if you do, you can’t stay asleep. And it’s because of all of that blue light, especially after sundown.

So aim for those seven to nine hours of sleep. And we know that’s when your body’s regenerating. There are studies that actually show us in people who do shift work, that there’s increased risk of cancers. And listen, these people can’t help it. That is what they.

MEL ROBBINS: What is this connection between not getting good sleep and cancer risk?

DR. DAWN MUSSALLEM: There may be a lot of things contributing to that, you know, is part of it that if you’re not sleeping, are you just not as energized to do as much exercise? This is where it’s hard to control for confounding variables. So what is it that’s driving that? But we know that one of the main mechanisms is you’re getting that restorative period in your body that is very, very critical in terms of optimal health from all health conditions.

MEL ROBBINS: So when you talk about the fact that if you get seven to eight hours of good sleep, right, and you prioritize that, that it’s also when your brain is getting a bath and it’s clearing out the toxins, why does that matter when it comes to preventing cancer or diseases or curing yourself of the different health things that you’re dealing with?

DR. DAWN MUSSALLEM: You know what I think, Mel? The biggest reason why individuals who don’t get enough sleep aren’t as healthy as they should be, that goes right in line with that cancer discussion, is because it really disarms metabolic health.

So moving beyond that brain health, into what else is happening in the body, we know in people that aren’t getting adequate amount of sleep or good quality sleep, that it really is interfering with optimal metabolic health or control of blood sugar during the day.

MEL ROBBINS: So when you say metabolic health, what should I, as somebody who’s not a medical doctor, with all your experience and expertise, what should I hear in plain language?

DR. DAWN MUSSALLEM: It’s tricky, right? And again, we chatted about how 93% of Americans fall in this bucket of not being metabolically healthy. I really would love if doctors checked something called a hemoglobin A1C in their patients. This is an average blood sugar level over a three month period of time.

MEL ROBBINS: Hemoglobin A1C.

DR. DAWN MUSSALLEM: A1C. It’s a simple blood test. You know, it’s tricky though, because oftentimes Medicare doesn’t like covering it. And doctors just need to code properly and really try to get that test checked.

And at the end of the day, if your doctor doesn’t check it, just do the things that we’re talking about because we know those are the things that will move you forward with being more metabolically healthy. Get the seven to nine hours of sleep. We know if you get less than that, generally we see a little bit of an insult to that metabolic optimization. During the day, the blood sugar control just isn’t as optimal.

The Connection Between Sleep and Disease Prevention

MEL ROBBINS: Well, it kind of makes sense because if you really, if I really think about both the jaw dropping research that you’re talking about, but then the common sense side of this, which is in order to prevent disease, in order to prevent cancer, in order to actually cure yourself of chronic diseases or of cancer and make yourself healthier, you have to boost your immune system, you have to manage stress, you have to put your body in the best place it can be in order to do the job of helping you get healthy alongside what the medical interventions are.

If you are getting good sleep, it means that you’re putting yourself in the best position to do that. And if you’re getting lousy sleep and you’re not prioritizing it, then you’re already waking up and you’re at a major disadvantage because your insulin’s all over the place, your hormones are all over the place, you’re stressed out because you haven’t slept, which impacts your immune system, which of course just common sense tells you that would impact your ability to truly show up for yourself and fight the thing that you’re dealing with or prevent anything worse from happening.

So could you explain just why you keep referring to muscle being really important for your patients and muscle being something that’s important for preventing cancer? What, medically speaking, is the reason why muscle is so important when it comes to preventing cancer or curing it?

Why Muscle Matters in Cancer Prevention

DR. DAWN MUSSALLEM: I love that. And it’s such a perfect segue because we’re talking about metabolic health. The muscle is what takes up the blood sugar. So when you exercise, if you eat a meal and you go for a five or ten minute walk, those muscles are going to take up some of that blood sugar. That’s a great thing to do.

And so muscle is what’s so critical. The fat just sits there, it doesn’t do anything metabolically, but the muscle requires some maintenance. It needs energy. And so that’s where the blood sugar is going to go. And your body takes it up. And that’s what is so important and so awesome.

And strength. You need strength to be functional so you don’t fall as we get older. And so muscle is critical. And I think muscle also partners so importantly with bone health. You know, that’s a big thing that I see in my breast cancer patients, especially in those on those anti estrogen medications.

I was a hospital physician for the first 10 years of my career at Mayo Clinic. And it was nothing that broke my heart more than a breast cancer survivor that was cured of her breast cancer, 78 years old, falls and breaks her hip because she has massive osteoporosis from all those anti estrogens she took.

So, you know, we’ve got to think about muscle. So you don’t fall. Keep you strong. When you strengthen your muscle by doing the resistance training, you keep those bones strong too. So you get all kinds of benefits by doing those strengthening exercises to keep the muscle strong.

When You Do Everything Right and Still Get Sick

MEL ROBBINS: Now, we’ve just talked about the magical ability to prevent cancer and cure cancer based on the fact that food is medicine. We’ve talked about things that you should avoid because they activate very bad things in your body that can cause cancer.

But isn’t it true that someone can be doing everything right? You can have a really healthy lifestyle, you can be working hard to manage your stress, you can be eating a whole food diet or even vegan. You could be reading all the labels, you can be getting your exercise and you still get cancer, you still get some sort of disease. I would love to have you talk to us about how important it is when that happens to not blame yourself.

DR. DAWN MUSSALLEM: It’s so important. And you know, there’s really amazing research that shows in individuals who took really good care of themselves their whole life and they get this cancer diagnosis, I’m that example. Right. There are studies that show that they improve their cancer outcomes and they get credit for all that good year of taking care of themselves that they did over their life expectancy.

MEL ROBBINS: Hold on. I want to make sure that the person listening and watching just got that. You’re basically saying if you have been taking really good care of yourself and all of a sudden you get this diagnosis that everything that you’ve done that was positive before the diagnosis counts.

And the research shows that you are in a better position because of all that positive work that you’ve done and the good choices that you made and focusing on your health. You’re literally based on the research in a better position to beat this disease and to have a more positive outcome.

DR. DAWN MUSSALLEM: That’s exactly what I’m saying.

MEL ROBBINS: Oh, I love that.

DR. DAWN MUSSALLEM: It’s so beautiful. But there’s a really beautiful message here. There was a nurse’s health study that did a nice job with this, with nutrition, and it showed that individuals that did more of a healthy diet, not a perfect diet, but just eating a little healthier, a little more vegetables and fruits, little lower in fat, a little less red meat, don’t do the sugar sweetened beverages, that yes, if you were living a healthy lifestyle and you continued on that trajectory, you had a much better breast cancer outcome.

But guess what? This study also showed if you learned that, oh my gosh, I’ve been given this cancer and there’s such a lesson here for me to start living healthier. Now I’m going to start maybe with having a few breakfasts better each week. It doesn’t need to be perfect right out of the starting bat.

But what they found is that those individuals who all of a sudden pivoted and became more healthy, that they also had that improved risk after the breast cancer diagnosis. So it’s never too late, regardless of what your adversity is, to try to just make yourself a little bit healthier, you’ll feel better, have more vitality, and can help those cancer outcomes.

The Importance of Both Traditional and Lifestyle Medicine

MEL ROBBINS: Well, what I love about your approach as both a physician and the fact that you are also a cancer survivor is that you are very clear in your personal story and with all of the patients that you see in your own clinical practice, all of the research that you’re doing, you know, at Mayo, that it’s both.

That when you get that cancer diagnosis, first of all react however you’re going to react, process whatever emotions you’re going to process. But by God, you want them to double down on vitality. You want them to double down on healthy choices right now. Because the research really proves that it increases your health outcomes in a super positive way. Whether you started healthy or not. You’ve got to double down on that right now.

But in your clinical practice and as a medical doctor, you do prescribe chemotherapy, radiation, you do recommend surgery, you do lean on all of the incredible medical interventions that are available to people now, along with exercise, love yourself, really focus on the foods I’m telling you to eat. Why, Dr. Mussallem, do you have your patients do both?

DR. DAWN MUSSALLEM: It’s critical. There are studies that show this. You know, I would say my biggest success story is when I have a young woman come in and she is refusing chemotherapy and treatment. And she comes to see me because her hope is that I’ll give her a natural remedy to get rid of her cancer.

And what I really hope is that we can meet her where she’s at, but yet give her the evidence to show the support of these conventional therapies and the need that they have in the place of an aggressive cancer. And so what the studies have shown is that patients that refuse a traditional cancer treatment instead only go the alternative route, that they have a two and a half fold increased risk of dying.

MEL ROBBINS: Hold on. I want to make sure everybody hears it because obviously your decisions about your own body are your choice. However, it is critical with all the misinformation being spread right now, that you understand the facts and the research from a medical doctor and a researcher who’s been doing this for decades.

So I want to be clear that you just said that somebody that refuses the traditional medical interventions like chemotherapy and tries only all natural, that you have a two and a half times. You’re two and a half times more likely to die. Is that right?

DR. DAWN MUSSALLEM: That’s right. And if you look at all the studies, the average. This is really scary. And this isn’t meaning to scare people because everyone has their own reason for doing what they do. But as a doctor who’s sitting in that room and look in the eyes of a 35 year old that’s telling me she doesn’t want to do chemo. These studies help me to convey that message. Not that I’m trying to evoke fear, but I just wanted to understand the reality of what she’s actually committing to.

Having the Hard Conversations

MEL ROBBINS: What do you say to somebody in that? Put us at the scene. We’re in a consultation with you. I realize you’re not my doctor.

DR. DAWN MUSSALLEM: Sure.

MEL ROBBINS: And this is hypothetical, but if you have somebody that’s just like, no, no, no. I just really think that I can, you know, I understand the power of food, which is true. But what do you tell that person about the facts in that moment that they should consider?

DR. DAWN MUSSALLEM: Yeah, you know, so I share the broad range and what the range shows is between 30% and 470% increased risk of dying.

MEL ROBBINS: 30 to 470%.

The Importance of Treatment and Finding the Right Oncology Team

DR. DAWN MUSSALLEM: There’s a 30 to 470% risk of dying for not doing treatment. And this is especially really witnessed in these cancers. We do a good job with curing colon cancer, breast cancer, even lung cancer.

And so this is what I see. I have women, I have a woman, right, she does not want to do treatment and that’s okay. This is her life. I’m just here to give it up. I don’t take a person. I’ve told my colleagues, listen, it is not your job, my job, any of your jobs to browbeat or to convince people to do chemo.

It’s our job to give them the information, to give them the support that we have all these natural therapies that can help you feel fine during treatment. And I share with them my journey, how I did this, that we can have, you still have your normal life pretty close to that.

There’s some treatments that are much harder and there’s some women that really, I’m just going to suffer. But that’s the rare. I don’t have as many women in that bucket that are really struggling with chemo. I have more that are attaining their vitality by doing some of these holistic measures.

But there’s always some people that really do have a hard time. And there’s just some chemotherapy regimens out there that people require that are very, very harsh on the system. And it’s not because they’re doing anything wrong. They’re doing, quite frankly, everything right, but by not doing the traditional therapy to go after that cancer.

And what’s interesting is most of these individuals, many of them coming in, were already living the healthy lifestyle. So think about that. I’m like, whoa, the cancer became one with your body while you were living this good lifestyle. I have nowhere to pivot and turn. There’s nowhere really to take you. And there certainly is no magic bullet.

And I know that within the naturopathic community, the thought is, well, a lot of traditional chemotherapies come from natural substances, but they’re not regulated. We don’t know the dose. We don’t have the science to drive that forward.

So this is all personal preference. This is why I went to traditional medical school, because I really wanted to be able to support my patients through the lens of holistic, but also be able to rely on the conventional treatments that cured my cancer personally. And I just really stand behind that.

And so that’s what I would suggest for individuals is please find the oncology team that hears you, hears your concerns, acknowledges your vulnerability and your fears. And let’s hear your fears. Why are you scared?

And Mel, I just see women really find a different connection with their life during cancer treatment. I mean, my days, it’s just, I have the best job in the world. It’s the most beautiful thing to be at that intersection of love and life and kind of death.

Every breath we take, we’re dying. It’s just all of us are dying. But when you’re given a cancer diagnosis, it’s a little harder. I mean, it’s right in your face. And it’s so hard for these women, these moms, these wives, these daughters. And oftentimes, they’re the one that takes care of everyone. And now this is the first time who’s going to take care of them. So I love being able to be there for them in a space.

The Biggest Mistake People Make After a Cancer Diagnosis

MEL ROBBINS: Dr. Mussallem, what do you think the biggest mistake people tend to make when they get a cancer diagnosis?

DR. DAWN MUSSALLEM: I think the biggest mistake is they fight it, meaning they’re given the diagnosis and they all of a sudden, it’s very natural to do this, but they have this almost prolonged state of resistance. And for me and in my patients that seem to be able to regain their vitality a little quicker, because at first, yes, the carpet’s pulled out from underneath you, you have this floor.

Don’t ever place judgment on what you’re doing. This is not a time for self judgment because just trust your emotions, trust your feelings, have some reflection, maybe even think of journaling and writing down what that means. Sometimes we can make more sense of it.

But what I would say is that the acceptance of the diagnosis gets you out of that place of just resistance so much faster. It’s not going to change. It’s there. And resisting it isn’t going to make it better. It’s actually going to make you worse.

And so if you can just try, and some people will confuse this with positive psychology, and it’s not because this is hard. I sobbed. Yes, I was scared. I was scared of dying. Even though I’m comfortable with my mortality, actually, I was still scared of dying. Not because I was going to miss out on life, but because my family, they would be sad. Our friends. There’s so much that you process during this time.

But if you can accept the diagnosis, figure out what treatment strategy works for you and move forward, all while taking better care of yourself, it seems it’s just an easier path.

In addition to that acceptance, I find reframing it, again, is taking that cancer word and flipping it around to something that will be meaningful to you, that will give you a little bit of maybe almost meaning behind it.

MEL ROBBINS: Can you give me an example?

DR. DAWN MUSSALLEM: Yeah. I mean, for me, it was, what could I learn from this cancer diagnosis to one day be able to elevate humanity through the lessons that I was given? I just feel so blessed that I was able to get through my cancer treatment actually easy.

Losing a Husband While Raising a Young Daughter

MEL ROBBINS: Well, I want to go back to that moment in your life, because at the time of your cancer diagnosis, you’re in medical school, you’re 26. Right around that time, you also lost your husband. It was just you and your young daughter. Can you talk to the person listening about what it was like to be raising your daughter when you were also mourning the loss of your husband? What was that like? I’d love to have you talk to the person who’s listening right now.

DR. DAWN MUSSALLEM: Yeah. So this is when I learned that there’s nothing harder in life than when something happens outside of you. So I feel I was given this gift of just innate resilience, innate joy. I was just born a very happy person when my husband passed away.

And so it was very interesting. I actually had finished my cancer treatment, and we were given a gift of growing our family. I was not supposed to be able to have children. That was the other thing they came in, is you’re never going to be able to have children.

MEL ROBBINS: Oh, my gosh. So they’re like, you have three months to live, no children, she’s pregnant. What on earth do we do with this? Right?

DR. DAWN MUSSALLEM: And so delivered this very healthy little girl. Her name’s Sophia. Amazing. One of the first individuals ever to be able to do this after a bone marrow transplant.

MEL ROBBINS: Wait, hold on a second. You had a bone marrow transplant, and then all of a sudden you’re pregnant and you deliver your daughter Sophia, and you were one of the first people ever to have a successful pregnancy and deliver your daughter after bone marrow? You’re one of the first.

A Miracle Pregnancy and Heart Failure

DR. DAWN MUSSALLEM: Yes. Because women, usually the ovaries would shut down. And so from all the chemo they gave and they didn’t have time to do fertility preservation. I mean, they had to start chemo immediately when I was diagnosed because I was so sick, and that cardiogenic shock, so they didn’t have a chance.

And I was okay with that. And I just said, trust, one day I’ll adopt. That was kind of my solution. I always look for solutions. Whenever someone threw an obstacle, I was quick to say, okay, what direction do I go? Where is my survival skill? This is natural. We look for survival.

And so that was how my brain registered, okay, this threat. Okay, I’ll pivot here. And that was my happy place. I just always seek the happy place. Like a chess match, or a maze, if you may.

So this is what was really interesting, though, is after my daughter was born, because I had had that high dose chemo, radiation, I had to do several months of radiation. It was right to my heart. It was a few weeks after my daughter was born. I wasn’t feeling well again, and I thought the cancer was back.

But this time that whole narrative flipped. Now I’m a mom, I’m a wife. I don’t want anyone to know. So I just was quiet. I was terrified. But it started getting worse and worse. Went to the emergency room. I was again in a cardiogenic shock.

They did an ultrasound on my heart, and my ejection fraction was 8%, single digit. How much blood my heart pumped forward, it’s called an ejection fraction, was 8%. I was in advanced heart failure. Yeah. So that was really difficult.

MEL ROBBINS: How old were you at that time?

DR. DAWN MUSSALLEM: I was 29.

MEL ROBBINS: And how old was your daughter?

DR. DAWN MUSSALLEM: She was just born. She was a newborn. So after I had delivered her, this is just a few months later. So it was really, really difficult.

And so, fortunately, this is when Mayo Clinic became my place for healthcare. I became a physician there. I was doing my medical training there, and they filled my heart with hope. They said, we’ll do medications. When the medications don’t work, we’ll have to do procedures. And the procedures don’t work. Someday you may need a heart transplant. Let’s start with the medicines.

I got better. I was able to go back to residency, but I was only better for about two years. And then in 2007, I took a nosedive. I had to take time off of work. And it was just a short time later that my husband died unexpectedly.

MEL ROBBINS: So it’s awful.

The Morning Everything Changed

DR. DAWN MUSSALLEM: I mean, Mel, there’s nothing worse than that. And this, that joy, that elation, I remember that morning so vividly. And we always wake up at 4am. He was just like me, very high energy, just the most beautiful human to ever walk the planet.

And he wasn’t feeling good the night before, so he said, go sleep with Sophia, honey. So I did that. Woke up, figured he was still sleeping. She wakes up, mom, where’s dad? He’s sleeping, honey.

8 o’clock rolls around, something’s wrong. All of a sudden I knew. I mean, I knew. And I walked into the bedroom and he had died in his sleep.

And I remember it so like it was yesterday. I just remember hitting him. Don’t do this to me. And it was just that joy. It was like that Disney ride that everything just free falls.

And I just remember I didn’t become depressed, but I remember I could handle no stimulation for a full year after he died. I couldn’t listen to music. I didn’t want any noise. I didn’t want anything. I just wanted to be still, still so that I could be present for my daughter, give her the love she needed, and kind of just figure out, where do I go now?

And there was this, oh, my gosh, I don’t know what to do. And I just kept asking that question.

MEL ROBBINS: I was always.

The Power of Faith Through Loss

DR. DAWN MUSSALLEM: I was raised Catholic, and I always believed in God, but I was never faithful. Like, I was like, oh, you go to church on Sundays, whatever. You know, during time in church, I think about a thousand other things. I don’t know, like, who’s a cute boy in high school? Really, like crazy.

But you get cancer and you become much closer to God. Like, that kind of gives you more spirituality in your life. But still, I was young and kind of careless with that whole thing.

When my husband died, I became one with my faith and belief in something bigger than myself. For me, that’s Jesus, that’s God. But whatever it is for you, it doesn’t matter. You have to believe in something bigger than yourself.

And so for me, that strategy of being able to hand over any problem to God, to Jesus, is what worked for me. And the concept of heaven is how I knew my husband was okay.

So I got stronger, you know, after he died. It took about a year for me to get stronger, but there was no handbook. And you still grieve.

You know, I was just in California doing some work out there. And on the countertop in the hotel I was in, in the marble, there was a heart. I have it on my Instagram. A beautiful, perfect heart. I just started sobbing.

And I’m not kidding you, that night I went to bed, I swear I felt a hand on my shoulder. Like, there’s all these messages still, just these loving embraces.

And, you know, so loss, grief, suffering, it’s our opportunity to really transcend that hurt, that pain, that suffering, and just arise this place in awakening in a different capacity and a different appreciation for life where it’s just so precious and it doesn’t—you never lose that person that died.

It’s really this acknowledgement of the persistence of love. And how blessed am I to have the best love story in the world where some people will never experience that.

It was very hard, though. And that’s why when I look in the eyes of the caregivers of the patients I’m helping, or when I occasionally have a patient who dies, which is actually very rare, I don’t see women dying as much nowadays.

But recently I’ve actually had two very close patients of mine die. And it’s so hard to see their children and their spouses, you know, and my heart just goes out to them.

What I would say is these women that die, die in grace.

Living with Heart Failure While Healing Others

And if I fast forward through my heart failure, you know, I got stronger. I went back to work. I even did a hospital fellowship, became a hospitalist at Mayo, and the heart started getting weak again.

And so this is when I transitioned to the outpatient setting and I started the Integrative Breast Oncology program at Mayo Clinic. It was actually an opportunity for me to get out of the hospital so I could try to function as a doctor with advanced heart failure. And this was a good seven years after my husband had passed away.

MEL ROBBINS: So you’re living and practicing medicine and running this clinic at the Mayo Clinic, treating patients with cancer while you’re managing heart failure.

DR. DAWN MUSSALLEM: Yeah, it was hard. No one really knew. Now when I look back, life was so hard, but I had to work. You have to work, you have to do what you do. Life circumstances are what they are.

And for me, work isn’t work. It’s purpose and meaning. It’s being able to touch the lives of others through that lens of love. I mean, it really is.

And so I think what kept me alive was my daughter, my mom and my dad, you know, that love that I have for my family. But my patients, they elevated that purpose and reason that I was alive. And I had this mission to try to figure out this program.

And so, thank you. Fast forward, I would list a heart transplant. I was on the transplant list for over 12 months with not one matching heart.

There’s 103,000 people on the transplant list. 103,000. Every day, 17 people die for heart transplant. It’s a smaller number. About 3,900 people are on the heart transplant list. And every day one person dies that doesn’t get a heart.

That could have been me. They couldn’t find a matching heart because of my body size, my blood type. There’s a lot that goes into that. And I was dying. I was actively dying. And this was in 2020.

And then in 2021, New Year’s Eve rolled around and I was starting to compensate. They admitted me to the hospital for supportive care. And after a few weeks, they found a matching heart.

So here I am, alive and more youthful because of this, because I received a 29-year-old woman’s heart. That is the biggest gift in the world.

Receiving the Gift of a New Heart

MEL ROBBINS: What is it like to have somebody else’s heart in your body?

DR. DAWN MUSSALLEM: There’s so many lessons. So it was interesting. So a few weeks before my heart transplant, a good friend of mine who’s a psychiatrist said, “Dawn, do you even want this transplant?”

The crazy things we say to people, by the way, and especially the doctor, what you say really matters.

I’m like, “I need one. But why do you say this? Please inform me of your wisdom, do share.”

Because, you know, they say that you acquire the personality of your donor. But like, oh, great. Well, I actually love my personality, so this is a wonderful thing.

So guess what? So my colleague, who’s also a dear friend, sits at the head of my bed. “We have a matching heart.”

You would think I’d be elated, but I’m not. I’m actually like, “Whoa, what do you mean you have a matching heart?” I’ve been waiting 18 years for a heart. You think I’d be beaming, thank you.

MEL ROBBINS: You have a heart.

DR. DAWN MUSSALLEM: But all of a sudden, the reality hits. I’m like, “Okay, what does this mean? Like, is it a spiritual heart? Is it an emotional heart? Is it just a physical heart? Like, what is the heart, by the way? You know, is there this other element, this other entity of the heart that is powerful?”

And I started thinking, “I’m going to lose that.” My good friend told me that, “Wow, your personality is going to change.” And all this stuff starts flooding my brain.

And then he goes on to tell me, “Your donor is an IV drug user with hepatitis C.” Yeah.

MEL ROBBINS: Did you stop and think, “Maybe I don’t want this heart?”

The Lesson of Judgment

DR. DAWN MUSSALLEM: Yeah, that’s exactly what I did. I judged. So this is the biggest lesson I learned with my transplant is judgment.

So within a few hours after I learned this, I said, “Okay, I need to think about this,” because what’s going through my mind now is, “Okay, am I going to lose this heart? That is amazing. Family history, you know, childhood that was bliss and beauty. My daughter being born, my husband passing away. Am I going to lose all this? And I’m going to take on an IV drug—what does that mean?”

You know? But then after a few hours, I’m like, “Wait a minute. This is a woman that decided to donate her heart.”

And all of a sudden, I had this knowing that this was the right heart for me. I feel receiving her heart, I don’t know what her circumstances were. You write a letter to the donor family at six months, and they never responded back to me. And that’s okay, because I don’t know what the circumstances are.

But I feel she may not have come from the beautiful life that I did. And she enters this body, and we dance to the harmony of life together. It is so cool.

So if you are not an organ donor and you would like your heart one day to dance in harmony, I am one representative of all those transplant patients out there. They’re just like me. They are unapologetically alive and living lives of meaning and purpose.

And this is a shout out. If you’re not an organ donor, please be one. Because, you know, why succumb to the finality of death when you can allow your organ to kind of arise this place of deep meaning and purpose with that next person’s life? They’re there for their family and humanity at large.

So it’s just incredible. So here I am.

A Message for Those Facing Diagnosis

MEL ROBBINS: What a beautiful, beautiful story and message and call to action. Thank you for sharing that.

You know, there is somebody right now who’s listening and watching and spending time together with us and they’ve gotten a diagnosis that is terrifying. And they may be feeling grief or fear or they’re heartbroken or they’re devastated.

You have been there. You are with people when they get these diagnoses. I know that people are going to be sharing this all over the world, this conversation with you and all the tools and hope that you are infusing us.

But I would love to have you speak directly to the person that has received that life-changing medical diagnosis. And what do you want to say to them right now and what do you want them to know?

DR. DAWN MUSSALLEM: Yeah, you know, what I would say is without these life experiences, I never would have understood how to unpack vulnerability in a way that you can trust it and to move you beyond this hope, which kind of to me has this connotation of questions, to this place of true knowing that you too can experience what I did and find those lessons.

It’s not evident up front. And don’t judge yourself for having moments of blame, for maybe having fear, because it is scary regardless if you have faith or not. It is still scary if we think we’re going to die.

But what I found is that when I trusted that there was something far greater than me, outside of me that was kind of managing all this and I surrendered that to them, that I could show up for myself in a way that mattered, so that I could be the best version of myself.

And that starts with loving ourself. From there, I felt like I got stronger. I was able to acquire such deep wisdom that now I’m able to find such meaning in my life so I can share that meaning with you. And that’s really, truly the purpose of life.

The Good News About Cancer Treatment Today

MEL ROBBINS: And you’ve talked a lot today about hope. I found it really encouraging and inspiring and awesome that as a medical doctor treating cancer patients for over two decades at Mayo, that you also said, “Oh, not as like, my patients are doing dynamite.”

You know, back in years ago, people died a lot, but not today. And I would imagine that’s because of the major advances in medical technology, medical treatment, and also when you combine it with the things that you spoke about today, loving yourself, exercising, and really eating in a way where your food is your medicine, you triple your positive outcome.

So if the person that is listening right now got a breast cancer diagnosis, what do you want them to know? What’s the good news here about where we are in the world today?

DR. DAWN MUSSALLEM: Yeah, we are doing so amazing with curing breast cancer. I have so many amazing success stories.

And you know, we used to say that we can only cure early stage breast cancer. That’s stage zero to stage three. Stage three is early stage breast cancer. We cure that all day long.

But metastatic breast cancer, we say we can’t cure you. You know, it’s a chronic disease. You’re going to take a medicine the rest of your life.

Well, I have so many success stories of women, they still are on medicines. Some of those medicines can really interfere with some of their elements of quality of life. So that’s where the healthy living and some integrative modalities rooted in science can help to support them.

But I have one woman in particular, her name’s Michelle. I share her story all the time because it’s crazy cool. It makes mine look boring.

She had metastatic cancer to her brain. She was a former fitness competitor, exercises every day of her cancer treatment. Guess what? That tumor in her brain, have you ever heard of breast cancer that’s metastasized to the brain going away? It’s gone.

She travels the world talking about her incredibly inspirational story and she never misses a workout. She’s in the gym and talk about, I mean, you know, the one medicine she was on caused this peeling of her hands. And she would lift weights and they would bleed sometimes and she would just push through.

She’s like, “It’s okay.” She’s like, “I don’t feel it.” She’s like, “I take my mind someplace else.”

And it’s just these magic—you know, I don’t have all my women exercising at that capacity. But the ones that I would say that do the best are the ones that accept that diagnosis. They really use their mind in a way that’s creative. They seek that sense of awe, that sense of wonder, that curiosity of how can I rise above this?

That’s what they do. They do what works for them. Maybe it’s meditation, maybe it’s yoga. Whatever it is, maybe it’s cooking a beautiful dinner for their family. But just doing what’s special for you. Be fully alive during this time. Trust the medicines you’re doing and take really good care of yourself.

The Most Important Action to Take

MEL ROBBINS: It’s important. If the person listening takes just one action today, just one from everything that you have poured into us, taught us, shared with us, explained to us today. What do you think the most important thing to do is?

The Power of Love and Self-Worth

DR. DAWN MUSSALLEM: Love. It is. Life is too short. If I have someone coming in to see me and they’re turbulent, the idea of changing their diet is too much. The idea of exercising is too much. Let’s just talk about love. Love.

What’s important to you when you wake up in the morning? What makes you excited? What tickles you? Why do you want to be alive? And let’s just start there and let’s rediscover why we love ourselves because so many people struggle with that and it may be rooted from childhood traumas.

And I feel like my journey was easy because I never had that, but many people have. And I’ve looked in the eyes of these people and I can understand why it’s hard for them to think about eating healthy because they just have no reason to do it because they don’t love themselves. So you have to first learn to love yourself again and allow yourself that because you’re worth it. That’s what I would say.

MEL ROBBINS: Dr. Mussallem, what are your parting words?

An Invitation to Experience Your Aliveness

DR. DAWN MUSSALLEM: You know, I’m always here for folks and I would love to invite your listeners. The fourth Monday of each month at noon, I do this little introduction to lifestyle medicine for cancer patients. And I love this. And this is on Eastern time because it allows me to get into the science, but I don’t really have the heart.

Today we were able to talk a little bit about the heart behind what we do. And that is kind of my parting message is, yes, we’re here to continue to drive the science forward. But at the end of the day, whether you’ve been given a diagnosis that’s cancer or of a chronic disease, whatever it may be, this is an invitation.

I invite you to experience your aliveness. It’s so important. Look for what’s special in your life. Give gratitude. You know, if life is hard for you, gratitude, finding one little thing that you’re thankful for each day will start to take you from that place of deficit and move you closer to this place of abundance. I just think it’s so important.

So I really think my parting message is just lean into your aliveness. Whatever is authentic to you in that word, aliveness. That’s where I want you to start because it’s different for each person. And then once you’ve kind of figured that out, start to really continue to show up for yourself. Start eating better so you can energize yourself to move your body, focus on getting enough sleep. That would be it. It’s actually pretty simple.

Taking Better Care of Yourself Is How You Love Yourself

MEL ROBBINS: It’s also how you love yourself. You start taking better care of yourself. Well, I just have to tell you, I love you. And if there is a human being on this planet that embodies aliveness, it is you.

Dr. Mussallem, thank you. Thank you. Thank you for the extraordinary work that you do every day. Thank you for the work that you’re doing in your clinical practice. Thank you for not only showing up here and making us smarter and tripling down on the research and the science and the facts of what works and what doesn’t work.

And thank you for giving us a really simple roadmap that based on the research will help us be healthier and happier and take better care of ourselves. I love you and I love everything that you’re doing and that you stand for.

DR. DAWN MUSSALLEM: Thank you, Mel. Thank you so much for the opportunity to be here, for being so real, for all of us who listen to you, for inspiring me during some of my hard days to keep going. So thank you and thank you all for listening and thank you.

MEL ROBBINS: Thank you for choosing to listen to something that is going to help you take better care of yourself. It’s going to help you love yourself a little bit more. And I also want to thank you for sharing the magic of Dr. Mussallem with everybody that you care about. I mean, I think everybody wants her as their doctor, don’t you? I mean, I know I do. I want to jump on a plane and go to Florida every month when I need to go see my doctor or I don’t see my doctor that much. And if I’m following the advice, we don’t have to.

DR. DAWN MUSSALLEM: There you go.

MEL ROBBINS: And in case no one else tells you today, I wanted to be sure to tell you as your friend that I love you and I believe in you and your ability to create a better life and taking better care of yourself is 100% how you’re going to do it. Leaning into your aliveness is also how you do it.

Alrighty. I can’t wait to hear what you get out of this episode. Can’t wait to hear what your friends and family get out of this episode. And I will be waiting for you in the very next episode. I’ll welcome you in the moment you hit play. I’ll see you there.

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