Doreen DeStefano, Doctor of Nursing Practice and owner of Root Causes Holistic Health & Medicine in Fort Myers, approaches health by looking beyond symptoms to the biological factors that may influence resilience, healing and the body’s response to illness.

For more than two decades, DeStefano has worked in integrative and functional medicine, metabolic health and personalized care. At the center of her philosophy is a question that has shaped both her career and her practice: What is happening beneath the symptoms?

Her approach can be summed up in two words: “Terrain First, Disease Second”.

Rather than viewing disease as an isolated problem, DeStefano considers the body’s internal environment—the biological “terrain”—and the factors that may influence how a person responds to illness and treatment. Her practice combines conventional medical care with advanced diagnostics, metabolic medicine, nutrition and selected integrative therapies. This strategy earned her a segment on AmericasBestDoctorsTv.com.

The philosophy grew from a deeply personal experience: her father’s cancer diagnosis.

A Personal Catalyst

“My dad was patient zero,” DeStefano has said of the experience that prompted her to investigate cancer more deeply.

Her father’s diagnosis led her into an intensive period of research, during which she began exploring cancer not simply as a tumor requiring treatment, but as a complex disease involving metabolism, immune function and the body’s overall environment.

According to biographical material provided by DeStefano, her father is now more than seven years beyond his diagnosis with no evidence of disease. She credits an integrative strategy with helping him navigate his illness.

The experience ultimately changed the trajectory of her professional life. For more than 20 years, DeStefano has worked with people dealing with cancer, chronic illness and autoimmune conditions, bringing together conventional clinical training with education in natural health, exercise physiology, metabolic medicine and integrative approaches.

Her work has also led to professional recognition and teaching roles, including certification in the Metabolic Approach to Cancer and instruction for the American Academy of Anti-Aging Medicine (A4M).

Looking at the Whole Picture

For DeStefano, the biological “terrain” encompasses many of the factors that contribute to overall health: nutritional status, metabolic health, inflammation, hormone balance, emotional stress, environmental exposures and immune function.

Nutrition is one part of that picture. Pointing to changes in modern agriculture, food production and environmental exposures, she believes greater attention should be paid to the nutritional foundation of health.

“Today’s food supply does not necessarily provide the same nutrient density available to previous generations,” says DeStefano. “I believe that nutritional status should be considered as part of a broader health strategy.”

Her goal is not to suggest that a single factor explains disease. Instead, she seeks to understand the individual patterns and circumstances that may contribute to a patient’s health and to use that information when developing a personalized care strategy.

Depending on the individual and the circumstances, her practice incorporates approaches such as hyperbaric oxygen, local regional hyperthermia, metabolic optimization, IV nutrient therapy and other integrative therapies.

“There is no one-size-fits-all,” DeStefano says.

That emphasis on personalization is central to how she approaches patients: first understanding the individual, then considering which strategies may be appropriate.

Reimagining the Conversation Around Cancer

Cancer is one area where DeStefano’s terrain-first philosophy is particularly evident. She encourages patients to become informed participants in their care and to explore factors that may affect treatment response, resilience and recovery while working with qualified medical professionals.

Her forthcoming book, Biohacking Cancer: A Clear, Strategic Guide to Helping Your Body Heal, expands on this philosophy. The book examines cancer through the lens of metabolic and immune function and discusses topics including inflammation, hormone imbalance, toxins, metabolic dysfunction and emotional stress.

The approach does not advocate simply abandoning conventional cancer treatment. Instead, it presents an integrative framework intended to consider both the disease and the body’s ability to withstand and respond to treatment.

That distinction is important. Nutrition, exercise, metabolic health, stress management and other supportive measures are increasingly being studied for their potential role alongside conventional cancer care. At the same time, many integrative cancer therapies remain under investigation, and patients should distinguish emerging research from established clinical evidence.

For DeStefano, that balance comes back to patient empowerment: understanding the available information, asking questions and taking an active role in healthcare decisions.

Exploring Emerging Medicine

DeStefano’s interest also extends to emerging areas of biomedical research.

She has followed research involving extracellular vesicles, commonly known as exosomes, which play a role in cell-to-cell communication and are being investigated for potential applications involving inflammation, tissue repair and regenerative medicine.

She is also interested in advances in cancer immunotherapy, including personalized approaches designed to help the immune system recognize and respond to cancer cells.

For DeStefano, these areas represent an evolving understanding of the complex biological systems involved in disease. She emphasizes that research in these fields is still developing and that many applications remain experimental.

That willingness to investigate emerging science while considering the evidence is part of what has defined her approach throughout her career.

From Reactive to Proactive

At the heart of DeStefano’s philosophy is the belief that health should not begin with a diagnosis.

Nutrition, physical activity, sleep, stress management and metabolic health can all play a role in a proactive approach to well-being. When illness does occur, she believes that understanding the individual biological terrain can provide additional information for developing a personalized care strategy.

Her journey began with a personal experience that prompted her to ask different questions about disease. Today, that same curiosity informs her work with patients and her interest in emerging areas of medicine.

For DeStefano, the goal is not necessarily to choose between conventional and integrative medicine, but to thoughtfully consider the best available evidence while continuing to explore new possibilities.

Sometimes, she believes, looking beyond the person who has the disorder.

Root Causes Holistic Health &Medicine is located at 12734 Kenwood Ln., Ste. 56, in Fort Myers. For more information, call 239-347-9234.