Category Archives: Cancer

Summary of my nutrition talk to runners

  • Use weight as a guide to hydration

–I’m ok with 1 lb weight loss after running

  • Hydrate with water and/or fluids with some salt in it like coconut water or apple juice.

–And Yes, you can be on a liquid diet while running, you do not need to eat solids while running

  • Some people are heavy salt sweaters.
  • I’m ok with running on fasted state (empty) but well hydrated for up to 1 hour
  • Everyone is different and nutrition is complex, and talking about nutrition is akin to religion or politics. It’s not always one size fits all, and even as our own personal health changes, our diet needs changes. So it’s not one size fits all at all times.
  • The world of nutrition research is complicated by people with agendas.
  • I choose for my own health, plants and the associated carbohydrates with whole plants: legumes, grains, potatoes, rice, fruits.
  • I choose blender over juicer for fiber. We all need lots of fiber.
  • B12 is made by anaerobic bacteria. We need B12.
  • All plants have protein even rice.
  • Just a fun fact: 1 calorie of broccoli has more protein than 1 calorie of steak.
  • Yes, athletes need more protein, but they also need for calories. By naturally eating more calories, we will naturally make up for it in protein.
  • We were made to eat plants more so than cats. Cats have protein taste receptors on their tongues but they can’t taste carbohydrates.

Nutrition lecture for runners was given 2/11/17 at Doctors Hospital in Manteca, California.

Most doctors don’t get a Nutrition course?

Let me explain why:

But we get courses in the groundwork that explains nutrition: BIOCHEMISTRY

I was in medical school 20 years ago

I got my MD degree about 20 years ago, and we did have a fundamental course in nutrition but it wasn’t a heavy weight course as I remembered it, but important enough for me to feel that at least I could say that I’m one of the few doctors maybe?? that got a nutrition course.

Biochemistry is the mother of Nutrition

I know a lot of nutrition focused doctors around the world frequently quote that most doctors don’t get a nutrition course. That is probably true, however, it’s not the whole truth. Because, all doctors I know get several courses on BIOCHEMISTRY which is the MOTHER of Nutrition. Biochemistry is the groundwork for which helps us understand how our bodies work and how our bodies interact with nutrition. And there’s biochemistry of what happens when things go wrong like CANCER.  If nutrition were a course, it would be bundled into biochemistry. We all studied the biochemistry of humans, animals, bacteria, viruses, and plants. I think back when we were in medical school, I have a feeling that the very smart doctors who were in charge of our medical education probably felt that nutrition was somehow influenced too strongly by businesses and probably felt it wise to just teach us the basics of how to evaluate nutritional claims. Now that’s wiser than cramming down our throats some information that would change from time to time as we search for the truth. I believe that search swings like a pendulum around what is the truth or the “best practice.” So we’ll go from one wild extreme to the other and back and forth sometimes.

Smart doctor colleagues love biochemistry

Many smart doctors I know even have degrees in Biochemistry such as my wife, Dr. Tammy Wu – plastic surgeon, and Dr. Monica Wood – orthopedic hand surgeon.

As doctors and medical professionals, we should all embrace our biochemistry roots and apply it to nutrition

I have had a renewed interest in Nutrition and have had this interest for the past 7-8 years as I decided to transition myself to a vegan diet. But most of that interest comes from our skills in evaluating medical studies – which is a skill I was supposed to learn in medical school, and balancing that with the understanding and reviewing of the subject of biochemistry – which is the chemistry of life. I believe that my other physician colleagues in Modesto and in the world have similar interests especially as we come more and more to the conclusion that some of the best medicines come from nature. Even BOTOX comes from nature.

Superior Vena Cava Syndrome

SVCS – Caused by Obstruction

  • Caused by direct obstruction of the superior vena cava
  • Usually by malignancies of lung tumors, thymomas or mediastinal lymphadenopathies.
  • Most common is Bronchiogenic carcinoma

Signs and Symptoms of Superior Vena Cava Syndrome

  • Facial Edema
  • Venous distention in the neck
  • Arm edema
  • Cough
  • Bluish tint, not to be confused with Tyndall effect from Hyaluronic Dermal Filler injections
  • development of facial flushing, distended neck veins when raising arms above head.


Facial Plastic Surgery – Head, Neck, Facial Cancer Notes


Triangles of the neck – anatomy

Most of this is probably of interest to folks that work with facial anatomy: such as ENT’s – Ear Nose Throat surgeons, facial plastic surgeons, cosmetic surgeons, and those who work around the face all the time such as dermatologists, and cosmetic injectors who perform Botox and dermal fillers.  These are notes that I took for myself while reviewing some head and neck cancer issues.  Keeping up to date and reviewing medical knowledge is important for my – Calvin Lee, MD – surgical practice in Modesto, CA.

Sistrunk Procedure for Thyroid Glossal Duct Cysts with papillary carcinoma

Surgical Review: Sistrunk Procedure (of which I’ve done a few in my career) and some with assistance from my expert Modesto surgeon friend Dr. Suntra (ENT/facial plastic surgeon) is used for the removal of thyroid glossal duct cysts and involves the cyst removal in continuity with the tract, central portion of the hyoid bone, and tissue above the hyoid bone to the base of the tongue. This procedure is usually considered adequate for a finding of a well differentiated papillary carcinoma of the thyroid.

Fine Needle Aspiration for diagnosing neck lymph nodes

Surgical Review: FNA (fine needle aspiration) is considered first line for tissue diagnosis for a solitary neck mass suspicious for metastatic squamous cell carcinoma.

Tonsils – the great sequester of cancer in the head and neck

Surgical Review: Consider tonsils when finding a non-obvious source of metastatic squamous cell carcinoma in the upper neck.

Metachronous and Synchronous – definition

Surgical Review head and neck cancers: Metachronous means occurring at different times, as opposed to synchronous (at the same time).

Lateral Aberrant Thyroid = papillary thyroid carcinoma

My personal Surgical Review: Lateral Aberrant Thyroid is a lymph node metastasis from papillary thyroid carcinoma. Consider the surgery of: total thyroidectomy with a neck dissection ie. central compartment.


Wartin’s Tumor – treat with parotidectomy superficial or total

My personal Surgery Review: Papillary Cystadenoma Lymphomatosum (Warthin’s Tumor) is a benign salivary tumor (like pleomorphic adenoma), which is usually in the Partoid gland. Treatment is excision with superficial (lateral) parotidectomy or total parotidectomy (which preserves the facial nerve) depending on location of the benign tumor. Enucleation is contraindicated due to recurrence.


Facial nerve, parotid gland



Just some personal notes for Calvin Lee, MD Modesto, CA.  No medical advice here.


a kumquat in a cup 4394 with logo

Miewa Kumquat, Picture by Calvin Lee


  • Looks like a mini orange
  • Size of an Olive
  • Kumquat in Chinese means Golden Orange
  • Hardier than Oranges
  • The rind is eat by itself or the whole fruit can be eaten.
  • Symbol of good luck
  • Grows reasonably well in Modesto, CA

Kumquat Health Benefits

  • Antioxidants – protect from cancer, aging, inflammation, degenerative diseases, diabetes.
  • Vitamin A
  • Vitamin C
  • Vitamin E
  • Carotene alpha
  • Cryptoxanthin
  • Lutein-zeaxanthin
  • Minerals
  • Calcium
  • Copper
  • Iron
  • Magnesium
  • Manganese
  • Zinc
  • Omega 3 and Omega 6

Varieties of Kumquat

  • Miewa
  • Nagami
  • Morgani / Marumi
  • Fukushu
  • Jiangsu
  • Hong Kong Wild
  • Others

How is this related to Surgical Artistry

We own a Kumquat tree in our Modesto home’s backyard, and we believe it to be a source of good fortune and good health for us.  It is quite pretty to look at as well.  Our tree is a Miewa tree.  The picture above was taken around the end of January 2013.