Dr. Brian Lawenda

02/28/2026

I wrote The Cancer Tightrope to help patients and their loved ones through one of the most difficult times of their lives,

Cancer doesn’t just affect your body, it upends everything. Your breath. Your identity. Your relationships. Your sense of safety. Whether you’ve been diagnosed, are caring for someone you love, or navigating life after treatment, it can feel like walking a wire with no net. The Cancer Tightrope is a steady, compassionate guide through that instability. Written by Dr. Brian Lawenda, a Harvard-trained radiation oncologist and nationally recognized expert in integrative and functional medicine, this book offers short, practical chapters to help you stay grounded. At its core is “The Four Pillars of Stability,” a whole-person framework to support your mind, body, and relationships through every stage of the cancer journey. You’ll find tools for managing scanxiety, fear, and emotional overwhelm; strategies to restore sleep, energy, and recovery; support for caregivers and life after treatment; and language for hard conversations with loved ones and doctors.

Available in print and ebook: https://a.co/d/0fL313W7

Listen to the audiobook on Eleven Labs: https://elevenreader.io/audiobooks/the-cancer-tightrope-audiobook/pj:5AtenPaZB5OQVWh11qtu

Cancer doesn’t just affect your body—it upends everything. Your breath. Your identity. Your relationships. Your sense of safety. ...

02/16/2026

Tired of conflicting information on anti-cancer supplements and off-label drugs? OncoIntegrate offers a unique lens, focusing on preclinical evidence to help you understand underlying mechanisms, not proven clinical outcomes. We empower researchers and patients to see the full evidence landscape. Explore the evidence: https://oncointegrate.com

02/14/2026

Many of our patients use this drug to fight cancer. It’s great to see the NCI funding research to investigate this inexpensive generic medicine. We need data not anecdotes.
https://kffhealthnews.org/news/article/ivermectin-cancer-treatment-nih-study-dewormer-offlabel-drug/

02/12/2026

Why do I keep posting about something called VeloNote?
Most of you have known me for years through health education, research updates, and my books. So I understand why this might feel like a shift.
Here’s why it isn’t.
When you see a physician for something serious, you assume we have carefully reviewed your entire story. Every scan. Every biopsy. Every prior note. Every treatment recommendation.
That’s what you deserve.
But medical records today are often scattered across different systems. Notes don’t always agree with each other. Dates can conflict. Important details can be buried in 30 or 40 pages of documentation.
Before a complex visit, I used to spend 30 to 45 minutes reading and organizing everything so I could walk into the room fully prepared. I did that because I believe patients should never feel like their doctor is figuring out the case while they’re talking.
But that level of preparation is time-intensive.
So I worked with a healthcare software development team to build something that helps me synthesize records quickly and systematically. Now I can upload the relevant documents and generate a structured draft note and draft plan in minutes. It organizes the timeline and can even flag inconsistencies across records so I can address them before the visit.
The result is simple.
When I sit down with a patient, I already understand their case.
The conversation is about decisions and goals, not reconstructing history.
That is why I talk about this.
It’s not a tech project. It’s a workflow that helps me stay prepared and focused on the person in front of me.
If you’re curious, I wrote more about it in my latest Substack article:
https://brianlawenda.substack.com/p/seven-minutes-to-prepare-a-complex
Prepared care is better care.

02/09/2026

☕🧠 Coffee, Caffeine, and Dementia Risk

A large new JAMA study (Feb 2026) reports that caffeinated coffee ☕️ (but NOT DECAF) is associated with a 19% lower risk of dementia and better long-term cognitive outcomes compared to non-drinkers. The strongest association was seen at 2–4 cups per day, with benefits flattening at higher intakes.

This likely isn’t about coffee as a beverage. It’s about caffeine and underlying brain biology.

Caffeine blocks adenosine (2A) receptors. Adenosine signaling increases with aging and neurodegeneration and is linked to synaptic dysfunction, neuroinflammation, and amyloid/tau pathology. Chronic A2A antagonism appears to preserve synaptic plasticity and cognitive resilience over time.

Caffeine also improves neurovascular function. Dementia is not purely a neurodegenerative disease; it is also a vascular one. Better cerebral blood flow and neurovascular coupling may help protect white matter integrity and cognitive reserve.

There is also evidence for long-term anti-inflammatory effects. Regular caffeine intake is associated with lower systemic inflammatory markers and may modulate microglial activation toward a less harmful phenotype.

Metabolic signaling likely plays a role as well. Insulin resistance is a major risk factor for cognitive decline, and moderate caffeine intake improves insulin sensitivity, lipid metabolism, and mitochondrial efficiency.

The fact that decaffeinated coffee did not show the same association strongly implicates caffeine itself rather than polyphenols or coffee rituals. Similar protective signals seen with tea further support this.

The nonlinear curve makes biological sense. At higher intakes, caffeine can impair sleep, increase cortisol, and raise sympathetic tone, all of which work against long-term cognitive health.

Bottom line:
This is observational data, not proof of causation, and coffee is not a dementia therapy. But taken together, moderate caffeine intake appears to act as a slow neurovascular and neurometabolic protective signal over decades, layered on top of the fundamentals that still matter most: sleep, exercise, metabolic health, and vascular risk control.

For people who tolerate it well, 2–4 cups of caffeinated coffee per day may be a small but meaningful contributor to long-term brain health.

https://jamanetwork.com/journals/jama/fullarticle/2844764

02/07/2026

Chart prep shouldn't be a second shift. I built VeloNote to do the heavy lifting for you.
✅ 90% of your note done before the encounter.
✅ 3X productivity increase (proven in my own clinic).
✅ HIPAA & SOC 2 Type II secure.
✅ No IT integration required.
Turn disorganized records into billing-ready notes in minutes. Built by a clinician, for clinicians. 🚀
Try it free for 7 days: https://velonote.base44.app

02/06/2026

Stop spending your evenings in the EHR. 🩺

I am beyond excited to finally launch VeloNote! As a clinician, I built this to solve a problem we all face: the soul-crushing hours spent on manual chart prep.

Since I started using VeloNote in my own clinic, my chart prep productivity has increased by 2-3X in the same amount of time. This hasn't just saved me hours; it has allowed me to focus more on my patients instead of my screen.

I'm Brian Lawenda, MD, and I designed VeloNote to turn a stack of disorganized patient records into structured, billing-ready consultation, follow-up, and re-evaluation notes in minutes.

90% of your note is done before the encounter even begins.
Comprehensive Coverage: Seamlessly generate consultation, follow-up, and re-evaluation notes from your latest clinical data.

No IT integration needed: It works via simple screenshots from any EHR.

HIPAA Compliant and SOC 2 Type II Secure.

Reclaim your time and get back to why you started practicing medicine. 🚀

Start your 7-day free trial today: https://velonote.base44.app

02/03/2026

Proud to work with these brilliant radiation oncologists 🙌🏻

Today, we honor the outstanding women physicians at Advocate Radiation Oncology!

🌟 Dr. Amy Fox
🌟 Dr. Graciela Garton
🌟 Dr. Mary Koshy
🌟 Dr. Ariel Po***ck
🌟 Dr. Sonal Sura
🌟 Dr. My-Lien Truong

The compassion and leadership of these remarkable women help guide our team and support our patients every day. Their commitment to delivering thoughtful, personalized care makes a meaningful difference, and we are truly grateful to have them as part of the Advocate family. 👩‍⚕️✨

02/02/2026

A major new study in Nature Medicine looked at patients with advanced lung cancer getting immunotherapy + chemo. The only thing they compared was what time of day the infusion started.

They split patients into two groups:
• Early treatment: before 3:00 PM
• Late treatment: 3:00 PM or later

💥 The results were striking:
• Median survival was 28 months if treatment started before 3 PM
• Median survival was 16.8 months if treatment started after 3 PM
• That’s about an 11-month difference
• The risk of death was 58% lower in the early-day group

This wasn’t a small or borderline finding, it was highly statistically significant.

🧠 Why might this happen?
Our immune system follows a circadian rhythm. Immune cells are more active, responsive, and coordinated earlier in the day. Since immunotherapy depends on your immune system doing the work, when you give it may matter, not just what you give.

⚠️ Important caveats
This doesn’t prove cause-and-effect yet, and it doesn’t mean late-day treatment is “bad.” But it strongly suggests that timing is a real biological variable, not just a scheduling detail.

📌 Bottom line:
If future studies confirm this, something as simple as scheduling cancer treatment earlier in the day could meaningfully improve outcomes with zero added cost, drugs, or side effects.

https://www.nature.com/articles/s41591-025-04181-w

02/01/2026

Lost respect for Peter Attia, MD.

I have followed Attia’s work for years. His podcast, Outlive, and the Medicine 3.0 focus on prevention have influenced a lot of people, myself included.

The newly released DOJ Epstein files from January 2026 are deeply troubling.

Multiple outlets report extensive email correspondence, ranging from dozens to more than 1,700 messages, between Attia and Jeffrey Epstein. This communication continued for years after Epstein’s 2008 conviction for procuring a minor. The emails reference Epstein’s “outrageous” lifestyle, ongoing contact kept secret, interest in visiting properties like Little St. James, and medical discussions.

To be clear, there is no direct evidence in the released files that Attia participated in Epstein’s criminal acts. That distinction matters and should not be blurred.

But physicians are held to a higher standard. Maintaining a close, private relationship with a convicted s*x offender long after the facts were public raises serious questions about judgment, boundaries, and credibility, especially for someone positioned as a leading voice in health, longevity, and preventative medicine.

Disappointing and disillusioning.
Integrity matters more than protocols or biomarkers.

**see comments for the list of companies he is financially involved in

01/30/2026

It won’t be much longer until AI is so good that it will be able to outperform ALL doctors in diagnosing any disease.

Hundreds of millions of people are turning to chatbots to help figure out what's wrong with them. Doctors say that's not always a bad thing. In fact, many are using it themselves.

01/19/2026

These drugs help your kidneys excrete up to 100 grams of sugar per day. Fascinating to see them have this impact on prostate cancer treatment.

Among men with undergoing hormone therapy, inhibitor use was associated with lower risk of treatment failure and delayed progression compared with nonuse, supporting potential adjunctive benefit.

https://ja.ma/4qvhJ2t