Defeat Cancer (47 page)

Because of my training, I have both a deeper understanding of and greater appreciation for the conventional medical approach to cancer care than if I had been a non-residency trained naturopathic doctor. During my two years of post-graduate training, not only did
I use my naturopathic tools of care to support patients, but day in and day out, I worked alongside numerous physicians: medical, radiation, and naturopathic oncologists; gastroenterologists and surgeons, and witnessed their work firsthand. Occasionally, I assisted with major surgical procedures, radiation planning, chemotherapy infusions and managing complex, sometimes emergency medical situations. In my first year of residency alone, I had the opportunity to meet, track, interact, and have case discussions about more than 2,000 cancer patients, so my training has been greatly augmented by my direct clinical experience with these patients.

I am grateful for this experience, and believe that I have a higher level of competency in treating patients because of my training and experience. I’m able to complement my patients’ conventional treatments more effectively because I understand and appreciate them. I’m also able to better assess the compatibility between my treatments and those of the oncologist, and ensure that potential adverse interactions between them are minimized. In fact, combining oncology treatments with naturopathic treatments can be inappropriate at times, because there may be potential interactions between, for example, herbs or nutrients, and chemotherapy. Because of my understanding of oncology treatments, in certain situations, I am more conservative with treatments than some of my colleagues who aren’t residency-trained. Conversely, in other situations, I am more aggressive with certain treatments than my colleagues who aren’t Board Certified (FABNO) or residency-trained.

Unfortunately, not all naturopathic physicians have the opportunity to do post-graduate residency training, nor do most state licensing boards require naturopathic doctors to undergo this type of training. Although I suspected it was valuable, I now believe that it’s crucial for naturopathic doctors to have extensive, advanced training in an oncology environment if they wish to competently support their cancer patients while they are undergoing conventional treatments.

There is evidence that conventional medicine helps many people with cancer, which is why I collaborate with oncologists in my work. But we (medical professionals) also know that other types of therapies such as nutrition, physical activity, sleep and stress management; herbal medicines, and vitamin and mineral therapies, can help patients. I use treatments that have the best track record for effectiveness, based on the following: clinical evidence, the known mechanisms of action behind the treatment, the patient’s biochemistry, and my past experience of treating patients. While some of my decision-making is based upon the results of placebo-controlled clinical trials, this type of evidence isn’t available for all of the treatment interventions I might consider. Furthermore, these trials don’t allow me to effectively evaluate the entire body and all of its systems, which is what we do in naturopathic medicine.

In summary, as a physician of integrative medicine, my goal is to support my patients’ health as they go through chemotherapy and radiation, while providing them with additional therapies that may have anti-cancer benefits. As well, I try to provide treatments that will prevent their cancers from recurring and which will increase their long-term survival.

I tell my patients that cancer occurs when a person’s cells no longer perform optimally, and stop following the directions provided by the body’s DNA instruction manual. Of course, this is an over-simplification of the process because the body is a complex organism. Cancer-causing processes are occurring all the time in everyone as a result of numerous factors. These include: DNA damage from radiation (both natural and man-made), pollution (or other toxic environmental substances, such as industrial solvents), normal oxidative stress, and ordinary mistakes in DNA replication during cell division (typically corrected by normal cellular processes). These factors sometimes allow or even cause cells to thrive unchecked, and to continue to grow and divide inappropriately.

Local and systemic inflammation, infection, and an excess of insulin or estrogen may also stimulate ongoing and unwarranted cell growth and division, which can then initiate other processes that may cause mutations of the DNA code. For example, in a healthy person, estrogen stimulates breast tissue growth, which is one of estrogen’s normal functions. But when a person has breast tissue cells that have been injured and transformed into diseased or pre-cancerous cells, both naturally-occurring and foreign sources of estrogen can cause excessive cell growth and division, further damage cells, and lead to increased DNA mutations and eventually, tumor cell activity.

A healthy body is typically able to correct many of these processes through its own DNA repair and pre-programmed cell death (apoptosis) processes and the immune system’s surveillance strategies, which allow it to identify and destroy abnormal cells, but the body has a limited ability to sustain ongoing injury. When the immune system is under stress from any of the aforementioned factors (e.g., excessive insulin or estrogen, inflammation, and infections) it may not be able to prevent the development of cancer.

Environmental factors such as exposure to industrial carcinogens, radiation from the sun, environmental pollutants, contaminated foods, and changing lifestyle patterns are thought to cause as many as 90 percent of all cancers. The foods that we eat and our daily activities have changed significantly over the past 100 years. For example, as a society, we consume less natural food than our ancestors and are also more sedentary. Both of these factors have increased our risk for developing cancer, among other chronic diseases, including heart disease, diabetes, and autoimmune conditions.

As previously mentioned, infections also play a role in cancer development. For example, the human papilloma virus (HPV) is known to increase the risk for developing squamous cell tissue cancers, especially of the uterine cervix, but it’s not a straightforward relationship, because not everyone who has this virus will get
cervical cancer, nor does everyone with cervical cancer have the HPV virus. Similar correlations have been found among other types of cancer and infections.

My overall treatment approach is to provide optimal integrative cancer care that supports the whole person through a customized and dynamic treatment program.

As mentioned in my biography, I typically work with patients that are either currently undergoing conventional treatment, or who have received it in the past. Many of my patients, as well as their referring physicians, view me as the physician team member who uses natural therapies to support patients while they are being treated and/or monitored for cancer by their oncologists. However, my services are more than just “complementary”; they are an integral part of each patient’s care. I don’t provide “alternative” cancer care. My experience is that people diagnosed with cancer are best served by utilizing every tool available to treat not only their cancers, but also their overall health.

I also work with patients who have been told by their medical doctors that they have cancer but don’t need active treatment yet. They are instead undergoing active surveillance; a process sometimes referred to as “watchful waiting” to see how their cancers develop. This includes patients who have slow-growing cancers, such as early-stage prostate cancer, or indolent follicular lymphoma. My goal for such people is to provide health-promoting and disease-preventing techniques that will keep their cancers from progressing.

I categorize my treatment goals into four broad categories, which include: safely preventing and minimizing the adverse effects of anti-neoplastic therapies, managing symptoms, improving the body’s terrain, and supporting patients’ overall health. While the conventional approach to medicine essentially focuses on treating the organ or system where the disease is located, the naturopathic
approach takes into account the entire body. In the following sections, I describe some of the therapies that I use to accomplish these goals.

How many and what types of adverse reactions or side effects patients suffer from depends upon their specific treatments. It’s important for me to know every patient’s oncology treatment plan in advance so that I know what to expect in each case, because, for example, the side effects of adjuvant radiation to the breast are much different than the effects of radiation to the brain. Radiation to the breast in a typical adjuvant setting (in which a tangential beam is targeted specifically at the residual breast tissue) avoids exposing internal organs to the potentially damaging effects of radiation. On the other hand, whole brain radiation is targeted at the central nervous system, and often more adversely affects the patient’s quality of life. Women who undergo breast radiation treatments may experience short-term changes to their quality of life, including minor fatigue and mild skin changes, whereas patients who receive brain radiation can suffer from balance, memory, cognitive and central nervous system problems; profound fatigue and hearing loss. Of course, this doesn’t always happen, and some people seem to tolerate brain radiation well. Nonetheless, it’s important that doctors understand the potential side effects of different treatments so that they know how to best prevent and/or treat them.

Also, there are multiple types of therapeutic radiation methods, and each has different effects—and side effects—upon the body. For instance, proton therapy is different from electron therapy, and the effects of both differ from the more commonly used photon-based radiation. Radiation seed implant is a type of radiation that is frequently used for prostate cancer, which has its own unique side effects. Systemic radioisotope therapies, which are given for thyroid cancer or certain lymphomas, present an additional level of complexity when choosing the right treatments to minimize adverse
effects. Since many of my patients are also treated by radiation oncologists, I must understand the differences among all types of radiation therapy, in order to provide them with safe and effective treatments.

We see a similar, often more complex scenario, with multi-drug chemotherapy regimens, especially because drugs can interact with herbs and nutrients. Interpreting the symptoms that result from treatments can be complex and complicated, given that there are hundreds of different chemotherapy agents and supportive medications, and patients all have different needs.

It would take days to mention all of the treatments that I use to treat the different side effects of chemotherapy and radiation. Over the course of three years, including during my clinical residency program, I created a clinical handbook which describes many of these treatments. This handbook is now being used in all of the residency programs for this specialty at the many Cancer Treatment Centers of America.

Many people with cancer, whether or not they are undergoing treatment, have difficulty sleeping—for many reasons. I typically treat this symptom by first addressing my patients’ sleep hygiene, because many simply don’t spend a sufficient amount of time in bed to get the recommended seven to nine hours of sleep. Also, many don’t sleep in a cool, dark, quiet environment, without dogs, cats and other disruptive factors. No amount of sleep medication will help patients to sleep better if they don’t address these underlying sleep hygiene issues, which is why I start by teaching them about sleep management. Then I might prescribe them a sleep remedy to address the specific nature of their insomnia, which may be due to anxiety, pain, Restless Leg Syndrome, frequent nighttime urination, or using steroid drugs (such as dexamethasone or prednisone, which are often given to patients to help them tolerate chemotherapy
drugs). One remedy that I often recommend is chamomile tea, but it must be covered and steeped for five to ten minutes; otherwise, its sedative properties evaporate up and out of the drink. Other remedies that I recommend include: magnesium, valerian, melatonin, or glycine. If the cause of insomnia is complex, I may refer my patients to an expert in sleep medicine, who can do a sleep study on them and recommend additional treatments.

Peripheral neuropathy, which is typically caused by damage to nerves of the peripheral nervous system, is a common side effect of chemotherapy and sometimes, radiation. Taxol and Taxotere are chemotherapy drugs that commonly cause tingling, pain, or numbness in the hands and feet, and it’s difficult to make these symptoms go away; more difficult than to prevent in the first place.

For this condition, I often prescribe my patients ten grams of L-glutamine, three times daily, which is typically a safe and effective remedy. Although the medical literature indicates that L-glutamine is only moderately effective for treating neuropathy, I find that it works very well for many people.

Local cold therapy is also helpful for preventing neuropathy caused by taxane-based drugs. It’s common for women who are going through adjuvant chemotherapy for breast cancer to undergo a twelve-week course of Taxol treatment. During their chemotherapy infusions, which typically last 60-90 minutes, I give them a stainless steel water bottle filled with cold water and a couple of ice cubes to hold in their hands. This cools their hands and reduces the blood flow to their fingers, thereby decreasing the leakage of chemotherapy into their peripheral tissues, where it has no benefit and damages nerve cells. Local cold therapy is remarkable for preventing peripheral neuropathy in both the hands and feet, and it’s a free, simple, and effective treatment. As with many treatment interventions, however, local cold therapy isn’t appropriate for everyone. For example, another chemotherapy drug called oxaliplatin, which is frequently used to treat colorectal and sometimes
pancreatic or gastric cancers, causes neuropathy but also cold sensitivity, so I wouldn’t recommend local cold therapy to patients who are receiving this drug. Other substances that I commonly use to treat peripheral neuropathy include Vitamin E and alpha-lipoic acid, which I prescribe at moderate to high doses, except during active chemotherapy or radiation, due to the potential for these substances to interact with the medications. Vitamin B-6 can also be helpful, and there are other substances that I use, as well.