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Complete Remission Is Where The Real Work Begins with Dr.Robert Hoffman
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“Complete remission” is the phrase everyone hopes to hear, and I just did. But once the celebration settles, the real question shows up fast: how do you keep cancer away when you know recurrence can happen years later and come back tougher than before? Dr. Robert Hoffman joins me to talk through the moment a clean Met-PET scan and a liquid biopsy finally bring real relief, and why that relief has to turn into a long-term plan.
We dig into the language medicine uses to measure success, including overall survival (OS) and progression-free survival (PFS). Those numbers can be helpful, but they can also hide what it feels like to live through toxicity, side effects, and “tolerable” harm that never makes the headline. We also talk about why my outcome does not fit the standard box, what that means for decision-making, and why follow-up should be proactive instead of passive.
From there we get practical about cancer survivorship and monitoring: how often to test, what trends matter, and how to think about PET scans without spiraling over radiation exposure. We cover stacking low-risk, high-upside habits and adjunct strategies like methionine restriction, methioninase support, ivermectin, ozone approaches, exercise, and sleep, plus staying on standard therapies when appropriate. If you have ever been told you are in remission and wondered what comes next, this is the roadmap we are using in real time.
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Remission News And Relief
SPEAKER_00Well, hello, and welcome to the Healthy Living Podcast. I'm your host, Joe Grumbine, and today we have back with us Dr. Robert Hoffman. Robert, welcome back to the show. How are you doing today? Always glad to be on your show. Well, especially today, right? And it's a good day today.
SPEAKER_01It's a good day. It's a good day. Every day since you got your MetPet is a good day.
SPEAKER_00So true, so true. I I'm sorry, Scott wasn't on the call last weekend. I wanted to make sure he knew, but hopefully he knows. He'll be on. Yeah, yeah, yeah. I'll be on this week. So, anyways, you know, we left off with a great conversation. I had just gotten back from well, actually, our last episode was from Japan. I had just got back from the clinic. I just got the results. You know, they're their fancy word for you don't have cancer anymore is complete remission. And you know, that's just like when I got the other what do they call it? A CR. Yeah, yeah, yeah, exactly. Or they'll call something, you know, like they said my tumor was resolved when they were reviewing the this pet CT scan from before is NED. Okay, there you go.
SPEAKER_01Valuable disease. Yeah, even MatPet has a limit of detection. Yes. So well, and that's what I kind of want to talk about, you know. But from the from the best we can do, from the most sensitive imaging in the world, you're you're cancer free.
SPEAKER_00Exactly, exactly. And not only that, but remember, I just got that liquid biopsy test too. You know, from now until forever. Well, and and you know, technology's always changing, they're coming up with new and better ways to detect things, and you know, who knows? But for now, I think what we have with this technology out of Japan, I feel very confident, as confident as I could at my current status, and that's what it was all about. You know, I I had pretty good confirmation from the the ENT, from the previous PET CT scan, from the MRI, you know, all these different scans I've had indicated that I'm probably clear. But there's all this sort of, well, but there's this other thing going on. We don't know what it is. Maybe it's just your immune system, maybe it's pneumonia, maybe it's your knee is acting up, you know, maybe it's cancer. We just don't know entirely. And so this told me that it was not cancer. And I just, you know, it's it took a load off of me. Like I always carried felt like I was carrying around a backpack full of rocks, even though, you know, I I felt like I got it. I my heart said, I think we got it. I don't feel like I was fighting anything anymore, but without any level of certainty that, you know, that as Dr. Exame would say, you know, the the highest level of evidence, you know, that says this is what the truth is.
SPEAKER_01Exactly, exactly. And I that that we can get in 2006, uh 26. Exactly.
Met-PET Confidence And Limits
SPEAKER_00And I felt like that backpack of rocks got taken off of me, you know, when we when he told me that news, and I saw the scan, and I saw that little arrow of where it used to be, and there was just nothing there, zero, zero activity, and you know, really just people nomathine accumulation. Yeah, and people can't understand, you know. I I you know, of course, everybody's happy for me, everybody says how great I look, and all of this wonderful stuff. But unless you've been through it, unless you've experienced it, you just don't know what it feels like to have that thing that if you don't take care of it, it's gonna take you out, be not there anymore. Like it's it's just like it's a feeling that I couldn't describe other than just joy and elation and gratitude and all that stuff wrapped up into a box. But what I want to talk about today is this is where the journey begins. So the last chapter is over, and now I'm gonna start writing a new chapter, and that new chapter is gonna be keep it away. And there's a lot of layers to that, and there's no one answer for everybody, just like the solution to making it go away. There's no one answer for everybody. But I want to talk to you, you've got so many years of working with cancer patients, dealing with cancer yourself. When you talk about standard of care and the big box health institutes, they talk about a survival rate, and it makes you feel like, oh, you know, they say that's a good survival rate, but what are they actually talking about?
Overall Survival Versus Real Life
SPEAKER_01Well, these clinical trials often have hundreds of patients, and so then they'll calculate how many patients began the trial and how many patients are still alive at the time of whenever they stop their evaluation and say we've done the trial, which is arbitrary, and and that's a survival rate, and they call that OS. Okay. Okay. But you may be surviving and not want to be surviving, right? So there's another this one with three initials PFS. Okay. Progression free survival. Okay. So at the end of the trial, whenever they decide it's the end of the trial, they evaluate people. They'll take a scan. Here's the scan now, we compare with the scan at the beginning. And if you didn't get bigger, or if it if it regressed, then that amount of time, a year or two years, whatever it is, is your progression free survival. Got it. Remember, in these trials, all the numbers are just averages. Right. What does it mean? Right. I'm a data point. Wow, look at me. So that's what they are. And they get all excited if there's a few months increase, right? If in the in either the OS or the PFS. Oh, look how great we're doing. Yeah. And especially in diseases like pancreatic cancer, you get you add a few extra months, and oh boy, you're the hero. So now there's a new drug for pancreatic cancer. It targets the so-called RAS gene. And I don't know, that either the survival or the I guess the survival went from six point something months to thirteen point something months, and they go, Oh, this is the tipping point, and we've tipped all kinds of you know all scatological stuff like that. So that's where they are. They can't in all the metastatic disease they can't, you know, just a few months here or there is a big victory. You've had a victory that they can't imagine. Yeah. I just don't fit in boxes very well. So anyway, I don't really care much. I I really you know, those clinical trials are the they're the gold standard, they're the uh whatever. I don't put much weight into them. I mean I'm glad okay, the drug has been through that. That tells you something. Uh this drug this new pancreatic cancer drug that increases survival in six months, and everybody's going crazy. They interviewed the former senator, whatever his name is, who has pancreatic cancer, and he got it. Okay. And what they don't tell you in the trial, and this was just an interview, he says, I'm bleeding all over my body. Oh no. Bleeding rash all over his body. Wow. They don't tell you that. Oh, it's toxicity is tolerable. I don't know. We did a study on the same drug, we haven't published it yet, and we show that that new drug, like me almost everything we've tried, is synergistic with methioninase on the cancer cells, but not the normal cells. So that's a good thing. But anyway, you got through all you got through. You had serious side effects because you were receiving very high doses of standard first line chemo. But where we stand now mostly is no pain, no gain.
SPEAKER_00No, absolutely. I'd do it all again if I had to, knowing what I know now. What's surprised?
SPEAKER_01I think Dr. Sato was very surprised. He kind of believed what you told him and all that stuff. Right, right. His own Met Pet negative. Yeah.
SPEAKER_00That that blew him away. Exactly, exactly. And he knows I didn't get the radiation. I didn't follow their cookie cutter. I didn't get the surgery, I didn't get the radiation, and it's gone. It's not, you know.
SPEAKER_01Just think of how many million patients who have gotten head and neck splamer cell carcinoma and have been radiated and surgicalized into something worse than their disease. Yeah. So we're writing a new case report about you with you as a new paradigm. I love it. Well, we talked about that from the beginning, though. We did, but now that's all in the past, Joe. Exactly. And I I don't have the answer. What I do know is that you have to get very frequent. I mean, I would get I would try to get another glucose standard pet within six months, if not earlier, even three months.
SPEAKER_00And what do you know about okay? So this is one thing I talk about get back there for the Met Pet. Yeah, no, absolutely. I'm planning on going back to Japan in a year. My question to you is this it seems to me that aside from methionase and maybe some of the oxygen therapies, everything seems to be a double-edged sword. Meaning yes and no. I think ivermectin is pretty harmless. I agree, I agree. That's another one.
SPEAKER_01Like it may be working. Yeah. I think uh I would continue on it along with your methine low methionine diet, methionase. I would surely continue on the ivermectin. Okay, all right. On the you're taking the ozone, is that what you're taking?
Toxicity Gaps In Drug Hype
SPEAKER_00Yeah, yeah. I make ozone ozonated glycerin. I take that. Yeah, there's but there's no side effects from that, other than a feeling of well-being. I would surely do it. The uh, you know, the exercise. I I I I exercise vigorously. Exercise. We gotta I sleep, you know, my good seven seven to eight hours a day. I'm I'm not like the old days when you had that grapefruit on you. Yeah, exactly. Exactly. And that was one of the actually the the biggest differences was I couldn't sleep. And I I think you know, it it seriously impaired my body's ability to do anything about it. Absolutely. And I I think that's another thing, you know. I it's something that I I'm looking at as all of the pieces, like I'm I'm going over my whole life right now, kind of writing a new vision board, a new, you know, I'm re-evaluating everything and going, where am I gonna put my time now that I have some time to put? I'm not spending my whole day concentrated on getting rid of the cancer. Now I can spend a lot less time keeping it gone, but I've still got to spend a certain amount of time making sure I follow a regimen. I know Dr. Exame talked about some low-hanging fruit like the sodium bicarbonate. With the yeah, with the type of cancer that I had, and if it was to return, it would likely be similar. A solid tumor mass. It seems that the take the pH down. Yeah, and again, no negative side effects unless you know you overdo any of these things.
SPEAKER_01Yeah, I I would I would surely do that, Joe. All these well, what are we gonna call them? Maybe complementary therapies, right? Adjunct therapy, whatever you want to call it, yeah. They're not hurting you. I mean, I would keep doing them. I mean, yeah, and they they there's a you know, everyone you take has some finite chance of helping, and so you know, each one is adding one to the other, to the other, I would do it.
SPEAKER_00I kind of look at it like this it's like when you're stacking something together, I evaluate it. Is there something it could do to cause me harm? Like even some of the supplements, you take too much of them, and and you know, it can get in the way of things, things like antioxidants. And I mean, we're only gonna go. Hi, hang on one second. Yeah, yeah. Thank you. Sorry, Joe. Okay, I'm back. Yeah, no worries. I I paused it for a sec. So um I mean, I I look at there's a there's a an equation, and uh the variables are the amount of energy I can put at remembering to do a thing, you know, it it's just like everything. Like when when my life depended on it, I put off a lot of other things so that I could focus just on this. And my life still depends on it, but not in the same acute, immediate way. Was before. Exactly. So now I look at it and go, okay, what can I manage, you know, as as a regimen? Like, you know, I could do 20 things, or I could do 30 things, or I could do five things, or you know, I'm trying to, I'm trying to come up with a a regimen that I can follow without having to, you know, literally, I was having to write stuff down and you know, uh all the different things to remember. Oh, yeah, don't forget that, don't forget that, don't forget that. And I don't want to live my life, you know, in a in a state of that. So I'm trying to come up with something that I can just, you know, get in the habit of and stay with it. I think those things we're talking about are good, and that's one level, one layer of you know, the prevention. The other one is still dealing with some element of standard of care. You've talked about it before. Like Shahiro's worked with a maintenance chemo, an oral chemo that she takes. There's hormone therapies. Mine's not hormone driven, so that's not really a thing.
SPEAKER_01In that vein, I would stay with the K Truda as long as Dr. Song will give it to you.
SPEAKER_00Yeah, I agree. And and the way that it tends to keep giving it to you. Well, we'll find out on uh this coming Monday. Pick me up, right? I am absolutely yeah, yeah. We'll go see Dr. Song together.
SPEAKER_01Talk with him uh with you along with you.
SPEAKER_00Absolutely, absolutely, and I'm I I'm I want you to be able to see his reaction when we share this with him because I know he's already probably seen the liquid biopsy report, so he's already got that indicator, but this is just a whole nother level that I I know he's going to appreciate when he sees it because he's also gonna be looking at the glucose pet right alongside of it, so it's not I want him to see that you you've lit up in your prostate, right?
A Sustainable Plan To Stay Clear
SPEAKER_01And we're gonna look at that, yeah. On there, yeah, it's gonna monitor. Yep, but that's kind of a miracle of metpet that it can pick up something like that, that glucose didn't even give one iota on it, yeah.
SPEAKER_00Didn't catch it at all, and that's another thing I wanted to talk to you about. So, you know, when we talk about cancer and we talk about survival, and we talk about, you know, they talk about a three-year survival, a five-year survival, they don't really talk about much past that. Like they don't even really consider you're gonna, nobody's gonna live five years past this treatment, but we do. And the other part of it is the progression side of things. So just because somebody has cancer, like I've seen many cases of prostate cancer where you know they still have it, but it hasn't progressed. It's it it remains, I don't know if I call it benign, but certainly not malignant. It's not spreading, it's not metastasizing, it's not mutating, it's just sort of sitting there, maybe trying to grow a little bit, but it's not it's not doing what the squamous cell tumor was doing.
SPEAKER_01That's right. But prostate cancer is boy, it's ugly. It can get ugly pretty quick though. Well, it can be it can be indolent for a long time. Right. Just completely attack you and kill you. Right. It becomes resistant to hormone therapy and starts metastasizing in all your bones, giving you pain that's unbearable, you'd rather die. It it you know, it can be kind of friendly for decades maybe, and then once it progresses to that certain step, it's it's a horrible disease. So the folks, you know, like Dave and Gene and you know, they they they've kind of kept it under control even though it might have progressed a little, but they have to be very diligent too. You know, it's it it it it's prostate cancer can be kind of benign like for a long time, and then when it switches it's horrible.
SPEAKER_00So with prostate cancer, there are some blood tests that are not very expensive that are pretty good indicators, it's not an absolute, but it gives you the trend, right?
SPEAKER_01That's what you do, and you can on your own, you can go to life extension or whatever for a very nominal cost. Yeah, Dr. Song may sign off sign off on it for you, but at some point may not, and you you need to do that, you need to given that medPet result, you gotta keep on it.
SPEAKER_00Oh, yeah, absolutely. And you know, this things like the blood work to me are really no big deal because there's not like any negative side effects, like you take the chemo. And the chemo is going to hurt you. And some people can't handle it. Some people stop because they just can't do it anymore. Radiation, you know, can leave you with dehabilitating, disfiguring effects that end up being worse than the cancer might have been. Not always, but it can certainly. I don't know much about hormone therapy. I've heard some immunotherapy, possible side effects that could be pretty horrible, attacking your vital organs and things like that. So everything has kind of a potential problem. One of the things that concerns me, and I know you've generally kept me feeling like it's not a big deal, but there's some level that says, well, it it's kind of accumulative to some degree, is getting these PET scans is, you know, how often are you able to get them without feeling like, you know, is it is there an accumulative radiation exposure?
Monitoring PSA Scans And Radiation
SPEAKER_01Because the half-life is so short. Okay. You know, you go up, you you you probably got more flying to Japan up there in the stratosphere than you did from the pet. Got it. And there's a lot to say that a little bit of radiation may be immunostimulatory, it's possible. Oh, okay. Interesting. I wouldn't worry about it now. I wouldn't get a pet every month, but you need to know what's going on. Agreed. Agreed.
SPEAKER_00And that's where I'm kind of like, I just want to take the risk. Yeah, I want to do the best possible thing and the least possible harm. That's that's yeah, you're gonna need.
SPEAKER_01I I think let's watch the PSA for a while, right? Eddie Eddie, good. If it starts going up, you'll need a PSMA pet before you go to Japan to show Dr. Sado. Right. And we go from there. Hopefully, and he believes it's still benign, not cancer, and that's that's probably the case. If it's cancer, it's extremely at the beginning.
SPEAKER_00Right.
SPEAKER_01So, but we gotta keep an eye. I I'm I'm kind of curious. Extremely lucky that the med pet picked that up.
SPEAKER_00Oh, absolutely. I couldn't agree more. Well, that's one of the reasons that we wanted to do the full body scan. If there's anything going on, I want to know about it.
SPEAKER_01Yeah, uh, yeah, it's that's you really needed that whole body scan. I mean all the way over there why you shouldn't get it.
SPEAKER_00Yeah, I wonder with the chemo that I took, I I I believe, and I don't know that it to be true, I don't know that that those three drugs I took would kill every cancer. But my thinking was that because of the doses that I took and the length of time that I took and the amount of courses that I took, if I had any other cancers developing, I think it might have knocked them out too. What do you think? Very well could have.
SPEAKER_01And probably you didn't have other cancers. What what's going on in the prostates is probably kind of a pre-malignant thing. Okay. Anyway, getting all that chemo, it's a systemic therapy. Right. It goes everywhere. It's not surgery, it goes over the body.
SPEAKER_00Yeah. And that was part of the that was part of why I was so opposed to the radiation, because what they were trying to do was treat an area that was already treated. And their reasoning was, well, it just gives us better results. And I even told them, I go, if I've got a problem, it's not gonna be right there anymore. It's gonna be floating around looking for a place to land, and your radiation's not gonna touch it. Guidelines says do what they do it.
SPEAKER_01Yeah, there's no need to think about it. Yeah, exactly. Well, I feel that's the way it is. Yeah, that's a big downside of going to these big institutions which must follow the guidelines, as opposed to small private practices like Dr. Castro or Dr. Song. I wonder, does Dr. Castro know about this?
SPEAKER_00Have you talked to him? I think I have, but I'll make sure. Yeah, yeah, as I have it. Last time he saw me, it was that it's worst.
SPEAKER_01Okay, then why Joe, why don't you you you send it to him? Okay, I will. Send them your your your two pet scans you just had in Japan. So be sure you do that.
SPEAKER_00I will. I I'll I'll send that over to him today. So for other people that are listening that have been told that they're in remission, whether it's complete remission or you know, no longer progressing, whatever they they call it, what would your best advice be to, you know, and without knowing the specifics about anybody? Just you had cancer, they say that it's been treated, it's you you you don't have an active malignant disease right now. What's what's the next move?
SPEAKER_01Be extremely diligent. Blood tests, take them frequently, get another scan in a few months. Take, I mean, go on methionine restriction, go on ivermectin, go on all these things that are no-brainers because the chance of it coming back pretty good.
SPEAKER_00Exactly.
SPEAKER_01You don't want that, because when these cancers come back after a long time, they're pretty deadly.
Diligence After Remission And Community
SPEAKER_00That's the part that I was most concerned about. It seems to me that when anybody has had a remission, and whether it's a week, a month, a year, six years later down the road, if it comes back, it usually comes back with a ferocity and a resistance to whatever they were doing before. So you can't like just go back and do the thing you did because somehow it figured it out, you know, how to avoid it.
SPEAKER_01Read this story of Babe Ruth someday. Okay. He was one of the first patients ever treated with chemo in late 40s. Dr. Farber and he was in remission for a little while. I don't know if he had nasal pharyngeal cancer or another kind of head and neck cancer. But nobody who has had cancer can go around saying it ain't ever gonna come back. You cannot say that.
SPEAKER_00Well, I couldn't agree more, and that's part of what this show's about. You know, I've made a a pledge that I'm gonna help people for the rest of my life, best as I can. And so sharing my journey, I think helps in a lot of ways because it shows people what's possible. If you put your mind to it and you do the right things, it can happen. You can get a crazy, unheard of result if you just do all the right things the right way. But most importantly, I'm gonna show along the way, and we're gonna come back and look at this in six months and a year and five years and ten years, and we're gonna keep talking about it in real time because I think that is equally as important. And I just want to make sure that you know, if there's something I can do to cause a person to think or to inquire or to maybe take an action that will cause them to have a better quality of life and a longer lifespan, I just want to make sure that we're doing it. Absolutely, Joe. Diligence is the word. Agreed, agreed. Well, Robert, this has been insightful, and I'm I'm always grateful to have this these conversations. You've got such a wealth of experience with these things that we're talking about, and you know, it's it's it's something that you just can't go on to AI and and and get an answer that you can count on the way that I can having these conversations.
SPEAKER_01Joe, it's my pleasure every time to be on your podcast. Anytime I'm yours, we're talking about something that is of immense importance to the world. So we're we're learning every day, and your case is a great learning case for everybody. And let's you know, let's see how we do.
SPEAKER_00Let's we'll keep on going, keep on going, keep on doing, and and you know, like always, I want to remind everybody every Sunday at 4 p.m. Pacific time, we have a Zoom call. The link is in the show notes of this podcast. I'm on virtually every week. With there's usually at least 15 people on, sometimes there's 40 people on, you just never know. These are people from around the world that are all either battling cancer, have overcome cancer, have a loved one that's going through it, and we're talking about what we're doing to resolve it, what we're doing to keep it gone. And this is stuff that is ahead of the curve. This is stuff that you know, scientists only wish they had access to this kind of data points. This is real life, real time results, and we're sharing them in you know, every single week. So please, if you're even interested in learning about these things we're talking about, hop on. You can be anonymous, you can share your story, you can be quiet and listen. You can come on once, you can come on every week. We're very tolerant. We love, you know, we're it we're all here just to help whoever can come in and and take the time to be there. Absolutely. Awesome, Robert. Well, thank you so much once again for being here. And I look forward to seeing you on Sunday and picking you up on Monday. Big congratulations. Oh, thank you so much. Well, this has been another episode of the Healthy Living Podcast. I'm your host, Joe Grumbine, and I want to thank all of our listeners for making the show possible, and we will see you next time.
