23. An Oncologist’s Approach to Functional Medicine: (Assessing Contributors of Immune Function)

A healthy immune system is critically important in ensuring its ability to identify and destroy cancer cells.

I encourage my patients to get a functional medicine assessment of key physiological factors that influence their immune system. These assessments are very helpful in the development of a customized integrative oncology management plan for each individual. Learn more about functional medicine testing as used in my online (www.IOEprogram.com) and in-clinic practice (Northwest Cancer Clinic, Kennewick, WA).

I offer remote video integrative oncology, radiation oncology or functional medicine consultations. Learn more here.

The tests I recommend:

  1. Micronutrient:
    • SpectraCell Micronutrient (includes Immunidex Immune Response Score) or
    • Genova NutrEval
  2. Insulin resistance:
  3. GI health (inflammation, leaky gut, digestive enzymes, blood and dysbiosis):
  4. Systemic inflammation:
    • hsCRP (included in the Basic Functional Labs) and
    • Fibrinogen and
    • IL-6
  5. Hypothalamic Pituitary Adrenal Axis (cortisol, epi/noriepinephrine, sex hormone metabolites, methylation, melatonin):
    • DUTCH or
    • Genova Adrenal
  6. Immune status:
    1. NK cell assay and
    2. CBC with differential and
    3. Immunidex Immune Response Score (included in the SpectraCell Micronutrient)
  7. Epigenetic Age Test

We can get most of these tests shipped directly to you.**Spectracell, Genova Adrenal, and Genova Stool not available to order through IOE Program

In ideal circumstances, your immune system detects cancer cells, produces antibodies that target them and deploys cancer killing cells throughout the body to destroy them. This complex process is happening all the time, which is critical as all of us have cancer cells in our body. The mere fact that not everyone gets diagnosed with cancer in their lifetime is a testament in large part to their immune system. It is also well-established that patients who have been diagnosed with cancer and have impaired immunity, compared with those who have intact immunity, experience significantly worse progression, recurrence and survival outcomes.

Dr. Brian Lawenda explains how immune function is impacted by a variety of measurable physiological variables that can be assessed with functional medicine assay testing (i.e. micronutrient assay, NK cell activity, Immunidex/WBC activity, oral glucose tolerance test with insulin, inflammatory markers, gut DNA microbiome test, hypothalamic adrenal axis assay, etc.)


These are the basic tests I recommend everyone with a cancer diagnosis, including survivors, consider having done.

#1) Get A Micronutrient Test

Genova NutrEval Micronutrient Test


#2) Check For Insulin Resistance


Optimal levels:

  • HgBA1c: <5.1%
  • Fasting glucose: < 90 mg/dl
  • Fasting insulin: < 6 mIU/dl
  • 1 hour glucose after glucose drink: < 130 mg/dl
  • 2 hour glucose after glucose drink: < 100 mg/dl
  • 1 hour insulin after glucose drink: < 30 mIU/dl
  • 2 hour insulin after glucose drink: < 20 mIU/dl

#3) Assess Your Gut Microbiome, Inflammation and Leaky Gut Status


#4) Test For Systemic Inflammation

Optimal levels:

Fibrinogen

  • Optimal: < 370 mg/dL
  • Borderline: 370-470 mg/dL
  • Increased risk: >470 mg/dL

High sensitivity C-reactive protein (hsCRP)

  • Optimal: < 1 mg/L
  • Borderline: 1-3 mg/L
  • Increased risk: >3 mg/L

Interleukin-6 (IL-6)

  • Optimal: < 5 pg/mL
  • Increased risk: >5 pg/mL

#5) Test Your HPA Axis

Melatonin has both anti-inflammatory and immune support effects


#6) Test Your Immune Function

NK (Natural Killer) Cell Test:

Complete Blood Count (CBC) with Differential Assay:

#7) Epigenetic Age Test

myDNAge Test:

As we age, our immune system function declines. Studies show that your immune system’s biological age correlates more accurately with your epigenetic age than simply your chronological age.

  • Epigenetic modifications are biological processes that affect how genes are expressed and change with age and lifestyle. The myDNAge®test measures over 1,000 epigenetic biomarkers to provide the most accurate biological age.
  • The reversible, dynamic nature of DNA methylation modifications (in contrast to genetic changes) make the DNAge® clock an ideal test to directly monitor lifestyle interventions.
  • To monitor your DNAge®changes, it is recommended to repeat testing 6-12 months after your original test.