The Rich Roll Podcast

From Death To Life: Dr. Dawn Mussallem On Surviving Cancer Twice, Running A Marathon Post Heart Transplant, & Why Mindset Matters More Than Medicine

February 16, 2026

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  • Human resilience is profoundly shaped by the ability to practice acceptance and seek lessons during moments of uncertainty, rather than fighting against adversity. 
  • A strong belief in something beyond oneself (faith, God, or the universe) is a critical component for navigating extreme hardship, as it allows for the surrender of worry and fear. 
  • Lifestyle factors like nutrition and exercise are incredibly powerful, with exercise during chemotherapy potentially being as important as the treatment itself for improving outcomes and mitigating toxicity. 
  • A whole food plant-based or plant-predominant diet is supported by evidence as the best dietary pattern for cancer patients through survivorship, including for metabolic control, despite popular interest in ketogenic or carnivore diets. 
  • Mindset, love, harmony, and connection are considered more important than food, exercise, or sleep for overall well-being and survival, with optimism shown to improve outcomes by 15%. 
  • Patients should curate their information diet carefully, seeking guidance from integrative medicine specialists or hospital pharmacy experts before taking supplements or alternative therapies, as many unproven treatments can be harmful or financially exploitative. 
  • It is crucial for young women, especially those with family history of cancer, to be aware of their bodies and advocate for thorough medical attention until their concerns are heard. 
  • Adhering to 5 to 6 of the American Institute for Cancer Research guidelines (like healthy eating and movement) can reduce breast cancer risk by 50 to 60 percent, emphasizing that there is no single 'magic bullet' supplement. 
  • It is never too late to adopt healthier habits, as starting at age 60 can add eight healthy years to life expectancy, and immediate benefits like improved mood and energy are realized regardless of age. 

Segments

Dawn’s Life Philosophy
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(00:00:00)
  • Key Takeaway: Acceptance, not fighting, is the path to navigating misery during hardship.
  • Summary: Seven out of ten top chronic diseases are preventable with lifestyle choices, as 75-80% of cancers are due to external causes, not genetics. Dr. Dawn Mussallem learned the gift of acceptance during her patient journey, realizing that fighting adversity only prolongs misery. Her experience as a patient taught her more than her medical education.
Resilience and Unfairness
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(00:06:25)
  • Key Takeaway: Innate optimism and a foundation of love are crucial for overcoming extreme adversity.
  • Summary: Dr. Mussallem harbored an early ambition to be a centenarian, viewing her stage four cancer diagnosis as a test of her wellness knowledge rather than an injustice. This self-belief was innate, stemming from a childhood filled with love and an art of optimism cultivated through early competitive activities. She trusted in a power bigger than herself, handing over worry and fear.
Living with Heart Failure
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(00:10:05)
  • Key Takeaway: Cardiovascular reserve built through lifelong fitness allowed survival with an 8% ejection fraction.
  • Summary: Following cancer treatment, Dr. Mussallem suffered heart failure with an ejection fraction as low as 8%, a state she described as living with shackles and constant uphill resistance. Her lifelong physical fitness provided the necessary cardiovascular reserve for her body to function despite this severe cardiac impairment. Simple tasks like driving became difficult, requiring immense effort and leading to near-fainting spells.
Near-Death Experience and Acceptance
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(00:12:08)
  • Key Takeaway: A four-minute flatline experience provided profound acceptance of the unknowing beyond conscious awareness.
  • Summary: While presenting on her integrative oncology program, Dr. Mussallem experienced clinical death, during which she felt embodied love and ultimate stillness. This experience cemented the lesson of total acceptance regarding the unknown aspects of life beyond physical existence. This encounter removed her fear of death, which she attributes to her ego tethering her to the physical body.
Heart Transplant and Donor Impact
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(00:21:18)
  • Key Takeaway: The donor heart carried a complex history, leading to post-transplant dreams that revealed the donor’s struggle.
  • Summary: Dr. Mussallem’s heart failure was linked to the ‘Titan gene,’ triggered by chemotherapy, radiation, and childbirth, leading to a heart transplant in 2021. She initially struggled to accept the donor, who was an IV drug user with Hepatitis C, fearing personality changes. Post-surgery, intense dreams—one terrifying and one involving grace—suggested the donor’s life involved trafficking, culminating in her naming the heart ‘Grace’.
Patient Care Philosophy
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(00:34:32)
  • Key Takeaway: Healing begins by acknowledging real suffering and meeting patients where they are, avoiding toxic positivity.
  • Summary: When meeting newly diagnosed patients, Dr. Mussallem avoids toxic positivity, instead holding space for their real suffering and fear, asking first, ‘What can I help you with?’ She guides patients away from self-flagellation over lifestyle choices, emphasizing that cancer is often not their fault, and encourages seeking meaning rather than just answers to turbulence. Lifestyle changes should elevate existence, not be a hostage to perfection.
Nutrition and Cancer Prevention
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(00:40:29)
  • Key Takeaway: Fiber intake is critically low in Americans, yet high fiber consumption is linked to significantly reduced mortality risks.
  • Summary: Seven out of ten chronic diseases are preventable with lifestyle, and 75-80% of cancers stem from external causes like environment and nutrition. Cancer patients often lack recommended fruit and vegetable intake, but a simple fix is making half of every meal a fruit or vegetable. An umbrella review showed that higher fiber intake reduced the risk of death from heart disease by up to 28% and lowered cancer mortality.
Cancer-Fighting Foods List
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(00:58:33)
  • Key Takeaway: Soy, cruciferous vegetables, turmeric, and EGCG from green tea are top four immune-boosting dietary components.
  • Summary: Soy is suggested to reduce prostate and lung cancer risk and is excellent for the gut microbiome, which ignites the immune system. Other powerful foods include cruciferous vegetables, turmeric, EGCG from green tea, purple sweet potatoes, and berries. Plant protein, such as beans, split peas, and lentils, is recommended as a favorable swap for some animal protein to reduce cancer risk.
Go Brewing Sponsor Segment
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(01:01:04)
  • Key Takeaway: Go Brewing offers handcrafted, small-batch non-alcoholic beers without added sugars or artificial ingredients.
  • Summary: Go Brewing, founded by Joe Chura, is a rapidly growing non-alcoholic beer brand available in over 5,000 locations across 20 states. Their Salty AF Chilata claimed the top non-alcoholic lager spot in America. Listeners can use the code RICHROLL for 15% off at gobrewing.com.
WHOOP Wearable Benefits
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(01:03:03)
  • Key Takeaway: WHOOP 5.0 Advanced Labs integrates biomarker data with daily health metrics for personalized health plans.
  • Summary: Unlike most wearables that only report what happened, WHOOP provides context on why and what to do next. The new Advanced Labs test over 65 biomarkers, reviewed by a clinician, to offer concrete next steps for improving health markers. Listeners can get one month free at join.whoop.com/slash roll.
Berry and Coffee Cancer Data
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(01:04:17)
  • Key Takeaway: Two servings of frozen berries weekly correlated with a 25% reduced risk of breast cancer-specific survival in observational studies.
  • Summary: Observational data from the Nurses’ Health Study suggests two servings of berries per week can reduce breast cancer risk by 25%. Coffee consumption, specifically three cups post-diagnosis, was linked to a 25% reduced risk of breast cancer-specific mortality. Chlorogenic acid in coffee is favorable, and plant milk is better than dairy for absorption.
Dietary Patterns vs. Keto
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(01:08:16)
  • Key Takeaway: The whole food plant-based diet is scientifically superior to keto or carnivore diets for long-term cancer survivorship and metabolic control.
  • Summary: A review from Memorial Sloan Kettering confirmed the whole food plant-based diet is the best pattern for cancer patients through survivorship. Long-term data is lacking for keto and carnivore diets, which may pose risks due to insufficient fiber. Plant-based diets are consistently linked to a minimum 10-20% reduced mortality from all causes.
Implementing Dietary Swaps
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(01:11:29)
  • Key Takeaway: Successful dietary change involves meeting patients where they are, focusing on appropriate food swaps, and acknowledging the time commitment required.
  • Summary: Dr. Mussallem uses 90-minute appointments to discuss studies and make gradual changes, such as swapping buttered toast for sprouted Ezekiel bread with avocado. Patients are encouraged to make food swaps that maintain similar palate and texture, and AI tools like ChatGPT can assist in finding healthy alternatives. While protein intake is important, plant sources like soy, beans, and hemp seeds make it achievable.
Foods to Avoid Hierarchy
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(01:14:03)
  • Key Takeaway: The top dietary concerns to avoid are ultra-processed foods, added sugar, and industrialized oils found high on ingredient lists.
  • Summary: Ultra-processed foods are defined as those containing ingredients unrecognizable to a great-grandmother. Red meat should be limited, prioritizing plant proteins like edamame, tofu, and beans, aligning with American Cancer Society recommendations. For patients needing animal protein, a small serving of fish or turkey is preferred over excessive red meat.
Dairy and Fermented Foods
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(01:18:25)
  • Key Takeaway: Low-fat dairy in moderation, particularly fermented options like Greek yogurt or kefir, supports healthy aging.
  • Summary: A study on healthy aging showed that ultra-processed foods increase the likelihood of unhealthy aging by 32%, while a healthy dietary pattern increases healthy aging likelihood by 86%. Low-fat dairy in moderation was part of this beneficial pattern, and fermented foods are encouraged, ideally goat or sheep kefir.
Fasting Mimicking Diet Use
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(01:20:12)
  • Key Takeaway: Fasting mimicking diets (FMD) can mitigate toxicities from specific chemotherapies by protecting healthy cells.
  • Summary: FMD, like the Prolon one-day kit used for three days around chemotherapy, helps healthy cells ‘go to sleep’ while cancer cells remain alert, potentially increasing treatment efficacy. This is individualized and only used for certain chemotherapy regimens, not weekly treatments. Circadian rhythm eating, stopping food intake by 7 p.m., is also encouraged for optimal health.
Healthcare System Critique
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(01:27:37)
  • Key Takeaway: The current healthcare system undervalues the time needed for lifestyle medicine conversations, leading to unsustainable practice models.
  • Summary: Dr. Mussallem’s 90-minute initial visits, crucial for deep conversations on diet and lifestyle, were deemed unsustainable by Mayo Clinic due to reimbursement structures. Effective patient education on complex topics like diet requires significant time and engagement, which is often lacking in traditional, shorter appointments.
Democratizing Wellness Mission
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(01:30:25)
  • Key Takeaway: Dr. Mussallem is shifting focus to democratize wellness through advanced diagnostics and policy influence, as current care is often inaccessible to the privileged.
  • Summary: As the new Chief Medical Officer for Fountain Life, the focus is on advanced multimodal testing and early diagnostics, which revealed potentially life-threatening findings in 14.4% of screened individuals. The goal is to use longitudinal data to educate and reduce the $4.1 trillion cost of current healthcare, which currently limits access to preventative wellness.
Curbing Misinformation Risks
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(01:34:28)
  • Key Takeaway: Cancer patients are vulnerable to dangerous, unproven ‘snake oil’ supplements like apricot seeds (B17 laetrile) and must consult medical teams before using any supplement.
  • Summary: Integrative medicine specialists at cancer centers can review supplement safety, as many touted cures lack human evidence and some, like apricot seeds linked to cyanide, can cause harm. Patients foregoing conventional therapy for alternative treatments face a 2.5-fold worse outcome, emphasizing the need to integrate evidence-based care.
Handling Patient Choice Conflicts
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(01:40:24)
  • Key Takeaway: Physicians should present evidence clearly without lecturing or condescension, sharing personal experience to encourage evidence-based treatment alongside lifestyle choices.
  • Summary: When patients choose natural treatments over conventional ones, the physician’s role is to share data showing the improved outcomes from standard care, especially in advanced cancer. Dr. Mussallem shares her own story of using integrative methods during chemotherapy to show that conventional treatment does not preclude lifestyle optimization.
Mindset and Post-Traumatic Growth
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(01:44:08)
  • Key Takeaway: Extreme suffering, when navigated with mindset, introduces individuals to an ’eternal bliss state’ and harnesses post-traumatic growth.
  • Summary: Optimism is shown to improve outcomes by 15%, and lived experience from providers can help patients cultivate their own hope. By feeling trauma rather than running from it, individuals can reach a state of immense beauty and gratitude, which is innate and teachable.
Advice for Young Women’s Health
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(01:54:28)
  • Key Takeaway: Young women must be aware of their bodies and ensure their doctors listen to any health concerns, as cancer is increasingly seen in younger patients.
  • Summary: Dr. Mussallem notes seeing very young cancer patients, with her youngest being 20 years old. Awareness of one’s body is crucial for early detection. Patients must advocate for themselves and seek care where their concerns are heard and validated by medical professionals.
Self-Judgment and Growth Obsession
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(01:53:37)
  • Key Takeaway: Obsession with self-growth and longevity should be balanced by focusing life more on serving others.
  • Summary: People are often too hard on themselves, though some self-check is necessary for success. The current culture has become obsessed with self-growth and longevity. Shifting focus toward serving others can simplify life and make the journey easier.
Advice for Young Women’s Health
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(01:54:14)
  • Key Takeaway: Young women must be aware of their bodies and insist on being heard by doctors regarding any health concerns.
  • Summary: Dr. Dawn Mussallem sees many young cancer patients, emphasizing the need for body awareness starting early. Patients must see another doctor if their initial concerns are not heard. Following the American Institute for Cancer Research guidelines can significantly reduce breast cancer risk.
Cancer Prevention Guidelines
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(01:55:03)
  • Key Takeaway: Breast cancer screening for those with family history should start 10 years younger than the youngest relative’s diagnosis, potentially including MRIs.
  • Summary: Achieving five to six of the AICR guidelines can reduce breast cancer risk by 50 to 60 percent through healthy eating, movement, and avoiding risky substances. No supplement can prevent cancer; focus should be on treating diagnosed nutrient deficiencies like Vitamin D. Individualized screening plans, often starting mammograms earlier than age 40 for high-risk women, are essential.
Meaning and Purpose in Life
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(01:57:03)
  • Key Takeaway: Beyond physical health guidelines, finding meaning, passion, and connection in one’s career and daily life is vital for well-being.
  • Summary: The standard health guidelines often omit the importance of living a life that holds personal meaning. Listeners are encouraged to find passion and purpose in their careers, as this is where much of their time is spent. Connecting with coworkers adds significant value to overall health.
Benefits of Late-Life Health Changes
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(01:57:35)
  • Key Takeaway: Starting healthy lifestyle changes at any age, even 60 or 80, significantly adds healthy years to life expectancy and immediately improves daily quality of life.
  • Summary: Starting healthy eating at age 60 can add eight healthy years to life expectancy, and starting at 80 can add 3.4 healthy years. The most powerful benefit is the immediate improvement in energy, sleep, mood, and joy. It is never too early or too late to begin living a healthier life.
Final Distilled Wisdom
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(01:59:55)
  • Key Takeaway: The ultimate guides are trusting one’s truth, avoiding self-judgment, prioritizing love and connection, and understanding there is no ‘perfect’ diet.
  • Summary: Dr. Mussallem advises listeners to trust their truth and learn to fall in love with themselves again, as this guides one toward loving life. People should do their best regarding diet and movement without striving for perfection. The most important action is to love and connect with others, as life is too short to miss opportunities for meaningful connection.