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Natural And Integrative Cancer Care
Cancer is one of the top killers in North America. The world health organization predicts that cancer rates will double by 2050. Many people are turning to alternative medicine to support their conventional treatment. There are many natural "anti-cancer" therapies that you may have heard about from friends or read about on the Internet but how can you be sure this is right for you? You may be asking do they work and are they safe? Cancer is frightening enough as it is and going outside your conventional care to seek out alternative and natural therapies can be scary and overwhelming if you don't know what to expect or who to trust.
This article will address the emerging role of natural and integrative cancer treatment. The goal is to create a clearer understanding of the role of integrative cancer care, exploring benefits and safety and understanding whether it can it be combined with conventional treatments. The information will be presented in an easy to understand question and answer format much like the same way you would ask your doctor. Ultimately, the reader should be empowered and informed about the evidence based, natural options available to them to combat cancer.
What Is Integrative Cancer Care?
The term integrative cancer care is really becoming a buzz phase in medicine. Still many people (and doctors) don’t really fully understand the true depth and application of the term “integrative,” especially how it pertains to cancer treatment. The modern use of the term originated from cancer treatment centers in the United States that started to combine the best of standard, conventional treatments and natural and complementary therapies. While this has been the standard of care in other countries around the world (i.e. Germany), this was a new concept to North America. In the last 15-20 years a number of centers throughout the United States have begun to set the standard of integrative cancer care. The Cancer Treatment Centers of America and The Block Centre (www.cancercenter.com, www.blockmd.com) are 2 of the most well known examples. In Canada, there still are not any large scale government funded centers, so the majority of integrative cancer care is being provided by Naturopathic physicians (NDs) who work with local oncologists and other allied healthcare practitioners to address all aspects of a cancer patient. There are still some limitations in Canada since most oncologists and NDs do not work under the same roof but the hope is in the future we will be able to find a way to follow the model developed in America.
The idea behind an integrative approach is that since cancer is a multifactorial disease, affecting every aspect of a person, you need a multi-faceted treatment plan. The research now clearly shows that cancer patients have improved outcomes and reduced mortality when they use complementary techniques (such as fitness therapy, diet counseling, yoga, meditation etc.). Integrative cancer care combines the best of conventional treatments (i.e. new chemotherapy agents, surgical techniques etc.) supportive natural approaches (vitamins and nutrients) and mind-body-spirit practices.
What Is the Goal Of Naturopathic, Natural And Integrative Cancer Care?
One of the key goals of integrative cancer care is to find the treatment approach(s) that provide the best chance for the patient to destroy cancer cells during active treatment, achieve long term remission and have the highest quality of life. This may include choosing the conventional treatment, which has the best outcomes, compared to potential side effects and risks. There is also a strong focus on making sure that the basic needs and well being of each patient is being met. This includes general nutrition, weight management, and reduction of side effects from conventional treatments. Once treatment options have been selected and a person’s basics needs are met, the focus can shift to changing the environment that led to the development of cancer and employing specific therapies that promote cancer cell destruction and prevent growth and spread.
The following is a list of ways that natural and complementary treatments can achieve the above goals.
• Directly cause cancer cells to self-destruct and die during active treatments
• Boost the overall immune system so that it is able to destroy cancer cells
• Reduce or prevent the toxicity and side effects caused by chemotherapy drugs and radiation therapy
• Improve nutrition and restore any deficiencies in order to improve cellular function
• Integrate the mind, body and spirit to promote healing at the deepest levels
Is Cancer Preventable?
One of the most common questions people ask is whether cancer is preventable and what causes cancer? There is a commonly held belief that most diseases, including cancer are genetically caused. While there are some cancers that have strong genetic links (i.e. BRCA1/2+ breast cancer) there are number of environmental factors that have been linked with cancer development. As of 2007, the International Agency for Research on Cancer identified 415 known or suspected carcinogens (cancer causing agents) (Clapp 2007). The world cancer research fund estimates that 30-40% of all cancers are preventable if food, nutrition and physical activity were improved. Another 20% can be attributed to infectious causes and an additional 10% to workplace exposures (American Cancer Society 2013, World cancer research fund 2007). This puts the cumulative risk at over 80% without considering other environmental and lifestyle factors. Other factors such as tobacco smoke (10-15%), alcohol abuse and other environmental pollutants raise the preventable percentage to well over 90%. While it is difficult to pinpoint the exact percentage attributable to each factor, there is no denying that nutritional, lifestyle and environmental factors play a key role is cancer prevention while genetics play a much smaller role (Irigaray et al 2007). The same factors that caused the cancer also need to be addressed in the treatment and resolution. This should provide hope and motivation to cancer patients to change the environment that most likely led to the development of cancer.
Are Natural And Integrative Cancer Therapies Compatible With Conventional Treatment Options?
Our society is conditioned to think in shades of black and white, especially when it comes to medicine. Many people assume that having “natural” or “naturopathic” cancer treatment means that you automatically cannot also have standard cancer care. There is a large assumption by the public and medical profession that natural and conventional treatments are incompatible. The reality is that the research shows us nothing is further from the truth. Numerous studies have shown that natural agents actually improve the treatment outcomes and reduce the side effects of chemotherapy and radiation. An excellent review highlighting the safety of antioxidants with chemotherapy was published in 2008. Its showed that not only were antioxidant nutrients safe and did not negatively impact the effectiveness of chemotherapy treatments, they actually improved effectiveness and reduced side effects (Block et al. 2008). These findings where directly opposite to the commonly held belief that antioxidants counteract the oxidative mechanism of chemotherapy and radiation. Recent findings show that chemo and radiation actually don’t directly kill the cancer cell immediately but rather fatally damage it before it undergoes natural apoptosis (cell death). Antioxidants and natural plant compounds, such as curcumin, actually help promote apoptosis of cancer cells thus having a complementary effect to chemo and radiation.
One of the most common concerns patients have is that they were told by their oncologist to stop all natural supplements when on chemo or radiation. This contributes to uncertainty and confusion about using natural supplements and treatments. As discussed above, there is a growing body of evidence to suggest they are safe, reduce side effects and may even have a synergist effect. However, this does not confirm that all natural substances are safe to take along side conventional treatments. There are exceptions depending on the type of chemotherapy and other factors. There still needs to be more research done to confirm these findings. To be safe, please follow the advice of your primary physician unless you are also under the care of a certified Naturopathic physician. NDs are trained to guide patients to safely choose which natural therapies are safe with each conventional treatment.
What are the top natural cancer treatment options?
There are many different natural therapies that have been studied in cancer treatment. Most of this evidence has been done in test tube and animal studies. Fewer therapies have been studied in human trials, which is the gold standard of evidence. The following is a very brief description of my top natural and complementary therapies. I did not cover every single possible therapy such as diet and nutrition, curcumin, green tea or mushroom extracts but they also are very therapeutically important.
Fitness therapy and exercise
Physical activity may be considered one of the most powerful natural therapies for cancer prevention and treatment. Unfortunately, most patients are told to rest and relax in conventional settings. There are a number of vital changes (i.e. improvement in insulin function, mitochondrial growth) that occur within the body during exercise that improve cellular function and decrease cancer. Some integrative treatment centers have even begun to conduct chemotherapy treatments while exercising in order to take advantage of the positive effects that occur during physical activity. Studies have shown exercise has been shown to improve fatigue, sleep disorders, and depression, which can limit quality of life in cancer patients. Breast cancer patients that had higher levels of physical activity had decreased breast cancer risk (Steindorf et al. 2013). The protective effects were found after just 30 – 60 minutes of moderate to vigorous exercise per day.
Melatonin is a neurohormone and potent antioxidant secreted from the pineal in the brain. It is best known to help with sleep and regulating circadian rhythms but it also been studied in with a number of cancers including lung and colon. It has been shown to extended survival time, reduce progression and improve chemotherapy treatment (Srinivasan et al 2008). However, the dose for melatonin in cancer is 10-20mg which is much higher than for insomnia.
Vitamin C is one of the most well-known and widely used antioxidants. There is some confusion when it comes to vitamin C and cancer treatment. Oral and dietary supplementation has been showed to have beneficial effects on immune cells and to improve cancer prevention. However, oral doses are limited by absorption in the digestive tract. To achieve higher, anti-cancer doses, intravenous administration is needed. A key point about vitamin C is that at lower doses (below 15g) it acts primarily as an anti-oxidant but doses above 15g have a “pro-oxidant” effect. The pro-oxidant effect is essential into order to generate hydrogen peroxide, which selectively destroys cancer cells (Chen et al 2007). Cancer cells have an impaired ability to deal with hydrogen peroxide and die when exposed to high dose vitamin C (25-50g). Vitamin C needs to be administered for a number of months to have a substantial beneficial effect on tumor size and mortality. Vitamin C has also been shown to be safe with the majority of chemotherapeutic agents and it improves quality of life by preventing damaging to healthy cells, therefore reducing unwanted side effects (Verrax and Calderon 2008). It is also important to note that vitamin C therapy may not work for everyone and for every type of cancer. Consult your Naturopathic doctor to see if it is right for you.
Conclusion: How Do I Apply Natural And Integrative Cancer Care?
There is no doubt that people are looking for alternative and complementary ways to help treat and prevent cancer. There are a number of integrative cancer care options.
• Patients can choose to undergo conventional care and with the help of a trained physician or ND they can use natural therapies to support their treatment and reduce side effects.
• Patients that have already gone through chemo or radiation can use natural approaches to reduce and eliminate any lasting side effects, improve quality life and prevent reoccurrence.
• Some people choose to take steps to prevent cancer by changing their diet, activity level and lifestyle habits.
• There are even a number of patients that refuse standard treatments and use natural therapies as their primary treatment plan.
There are many ways to effectively and safely incorporate integrative and natural medicine into your cancer care plan. Through discussions with a trained ND you can find treatments and protocols that can be tailored to fit your needs. I encourage you to do your research and be open to changing your life. Cancer can be a very frightening disease but many patients talk about it being a very transformative process. Embrace your healing journey and find a treatment approach that addresses every aspect of your being.
Clapp RW, Jacobs MM, Loechler EL. Environmental and occupational causes of cancer: new evidence 2005-2007. Rev Environ Health. 2008 Jan-Mar;23(1):1-37.
Food, Nutrition and the Prevention of Cancer: A Global Perspective”, World Cancer Research Fund 2007.
American Cancer Society. Cancer Facts & Figures 2013. Atlanta: American Cancer Society; 2013.
Irigaray et al. Lifestyle-related factors and environmental agents causing cancer: an overview. Biomed Pharmacother. 2007 Dec;61(10):640-58. Epub 2007 Nov 20.
Block et al. Impact of antioxidant supplementation on chemotherapeutic toxicity: a systematic review of the evidence from randomized controlled trials. Int J Cancer. 2008 Sep 15;123(6):1227-39.
Steindorf et al. Physical activity and risk of breast cancer overall and by hormone receptor status: The European prospective investigation into cancer and nutrition. Int J Cancer. 2013 Apr 1;132(7):1667-78.
Srinivasan et al. Therapeutic actions of melatonin in cancer: possible mechanisms. Integr Cancer Ther. 2008 Sep;7(3):189-203.
Chen Q, Espey MG, Sun AY, Lee JH, Krishna MC, Shacter E, Choyke PL, Pooput C, Kirk KL, Buettner GR, Levine M. Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo. Proc Natl Acad Sci U S A. 2007 May 22;104(21):8749-54. Epub 2007 May 14.
Verrax J, Calderon PB. The controversial place of vitamin C in cancer treatment. Biochem Pharmacol. 2008 Dec 15;76(12):1644-52.