Defeat Cancer (48 page)

For fatigue that’s attributable to cardiovascular problems, I may prescribe Coenzyme Q10, which is necessary for energy production at the mitochondrial or cellular level. Many patients with cancer take statin drugs, which are intended to lower their cholesterol levels; however, they also inhibit the body’s production of CoQ10, which is why it may be important to give such people CoQ10.

Nutrient deficiencies and other nutritional problems also contribute to fatigue. Patients with nausea, diarrhea, constipation, taste changes, and other symptoms may have difficulty getting enough calories into their bodies, and/or may struggle to maintain a well-rounded diet. Also, patients who have undergone surgeries that affect the digestive tract may have problems absorbing their nutrients and will often experience fatigue and other symptoms.

Depending upon the circumstances, I may recommend protein supplements to help my patients get adequate nutrition. Other substances that I prescribe for fatigue, depending upon the cause, include B vitamins, Ayurvedic formulas consisting of multiple herbs, and acetyl-L-carnitine. The latter is an amino acid that can cross the blood-brain barrier and also relieve symptoms of “chemo brain” or post-chemotherapy cognitive impairment, problems with memory recall, concentration and mental focus that may occur as a result of chemotherapy. I have found, through research and clinical experience, that higher, more beneficial concentrations of L-carnitine are best achieved when dosed in a powdered formulation.
If patients have diarrhea and fatigue, simply increasing their fluid intake can improve their energy levels. Ultimately, I don’t have a simple algorithm that I use when prescribing therapies. I make recommendations based upon my patients’ specific circumstances, their biochemistry (which is assessed through laboratory tests), and what’s causing their symptoms.

Changing the body’s internal terrain to make it less hospitable or supportive of cancer cells is another one of my treatment goals. Doing this involves addressing all of the following in my patients: poor immune system function, nutrient deficiencies, inflammation, oxidative stress, insulin and glucose balance, hypercoagulation, and stress. Lab test results help to guide my clinical decision making in these areas.

Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are two common markers (tests) that I commonly use to evaluate my patients for systemic inflammation. ESR is generally used to measure inflammation in people who have arthritis and some autoimmune diseases, while CRP is primarily used to measure inflammation that specifically affects the cardiovascular system. Elevated CRP may be suggestive of cardiovascular disease, but not always. These tests are also useful for indicating to what degree people with cancer have systemic inflammation. This is important to know because high levels of inflammation are sometimes associated with poor long-term treatment outcomes. A half-dozen other tests can reveal the presence of inflammation, but I rarely run the full panel of those tests on all of my patients.

I treat inflammation using various anti-inflammatory substances, which range from non-steroidal anti-inflammatory drugs to dietary supplements and herbal medications that are well-known for their anti-inflammatory properties. Such supplements include omega-3 fatty acids, curcumin, boswellia, and bromelain, among others.

Reviewing my patients’ dietary habits can give me an idea of what their nutrient deficiencies are, although I may also order laboratory tests to help determine this. Vitamin D and omega-3 fatty acids are two common deficiencies that I find, so I frequently recommend supplementation with fish oil, flax seed oil, or other foods containing essential fatty acids. However, people with cancer must understand that no amount of a capsule product can make up for a terrible diet. It’s difficult for me to justify prescribing a highly concentrated omega-3 fish oil product to my patients if they have a diet that consists entirely of fast and processed foods. Most patients reap greater benefits from changing their dietary and lifestyle habits than from taking multiple vitamin and mineral supplements.

Some of the tests that I do to determine the body’s levels of oxidative stress and its antioxidant capacity include: a lipid peroxide profile, oxidized LDL (low-density lipids), gamma-glutamyl transferase (a liver enzyme), ferritin, and blood levels of Coenzyme Q10. If my patients’ test results are abnormal, I may prescribe them supplemental antioxidants such as Vitamin E or resveratrol, or work to increase their glutathione activity by providing them with glutathione precursors. There’s much debate and disagreement among practitioners about whether antioxidants are safe to use during chemotherapy, but the answer isn’t as simple as saying that all antioxidants interfere with chemotherapy or that all antioxidants are safe to use in combination with anti-cancer treatments. Neither is entirely correct because the issue is complex, so I evaluate my patients on an individual basis and then treat them accordingly.

I may also test my patients’ fasting glucose, insulin, hemoglobin A1c and insulin-like growth factor levels, as well as others. Whenever any of these are abnormal, I recommend that they eat foods that will prevent them from having frequent blood sugar spikes after
they eat. Unfortunately, blood sugar spikes (in which the body’s blood sugar rapidly rises, causing it to release an excessive amount of insulin) are common in people who follow a standard American diet (SAD). Many of my patients need to change their eating habits, but they are often pleasantly surprised when they learn that I don’t recommend that they follow a strict diet of “twigs and seeds.” I also don’t advocate that they follow any specific fad diet. Rather, I try to get them to maintain a well-balanced, whole-foods based diet that’s mostly comprised of plants and small portions of animal products (primarily meat and eggs).

Many cancers increase the risk of developing blood clots. These need to be prevented and/or aggressively managed because the processes that lead to clotting, as well as some of the results of clotting, such as blood vessel injury, can cause cell signaling within the body that prompts tumor cell growth. I often test my patients’ fibrinogen, homocysteine, D-dimer, and even vascular endothelial growth factor (VEGF) levels to determine whether hypercoagulation is present. Treatments for hypercoagulation include green tea, Nattokinase, and Coenzyme Q10, among others. High VEGF, which promotes new blood vessel growth, is treated with drugs like Avastin (bevacizumab).

Some of the tests that we do to determine our patients’ immune system status include natural killer cell (NK) activity, as well as white blood cell and absolute neutrophil counts. As well, we measure their Vitamin D levels. These are all important indicators of immune function. Interventions range from protein supplementation to the use of short-term, high-dose Vitamin D or medicinal mushroom extracts, such as coriolus, reishi, maitake, and agaricus.

Minimizing the processes that encourage cancer cell survival, growth and division, such as hypoxia (oxygen deprivation), cancer cell signaling and mitochondrial dysfunction, is also an important
component of my treatment plan. Many clinicians and medical scientists are spending an increasing amount of time and financial resources studying each of these areas in a quest to improve cancer treatments and prevention strategies.

Physical therapy can benefit patients in their healing and help them to feel better. Treatments that I often recommend to my patients include simple forms of hydrotherapy, Epsom salt baths for muscle aches and pains, massage, acupuncture, and local cold treatments during chemotherapy infusions to prevent or minimize peripheral neuropathy. I don’t do acupuncture myself, but I have a network of practitioners that I refer my patients to, who have extensive training and experience in working with people with cancer. Acupuncture is useful for alleviating symptoms, but I’m not aware of any data which suggests that it does anything to mitigate the underlying causes of cancer.

My dietary recommendations are based upon a whole foods diet. Although there are many good diets that can help people to improve their eating habits and general health, such as Dr. D’Adamo’s Blood Type diet, the Mediterranean diet and the Paleolithic diet, I try to make good nutrition as simple as possible for my patients. I encourage them to consume whole foods, and to minimize/eliminate processed and fast food. Author Michael Pollan has some great ideas about healthy eating in his books, so I regularly recommend these to my patients.

I often emphasize many of the basic concepts upon which the US Department of Agriculture’s Food Pyramid was founded. The Food Pyramid encourages the consumption of a wide variety of fruits (two to three pieces or cups/day), vegetables (three to four cups/day) and whole grains (two cups of cooked whole grains) per day.

People with cancer should avoid foods that are processed: anything in a box, bag, bottle, jar, or can should be considered as processed unless their ingredients labels show convincing evidence to the contrary. There are some exceptions to this guideline, as frozen fruits and vegetables are often considered ‘whole foods,’ even though they usually come packaged in bags. People with cancer should also minimize their consumption of animal products, including dairy. Meat and dairy should be hormone and antibiotic-free and primarily consumed as ‘condiments.’ It’s also okay for people with cancer to freely consume wild-caught fish but they should avoid farmed fish entirely, because these fish have a higher incidence of disease, are genetically modified and often given antibiotics. Also, they are fed a non-native diet, and have potentially decreased omega-3 fatty acid content and increased contamination from polychlorinated bi-phenyls and other environmental pollutants, among other problems. Tropical fish, such as tuna and swordfish, should only be eaten in moderation. I also recommend high amounts of vegetables and fruits, green drinks, and omega-3 fatty acids (as mentioned above).

In America, it seems as though people have to be “alternative” or “counter-culture” to maintain a healthy lifestyle. Of course, this shouldn’t be an earth-shattering revelation, as many studies have found that the average American is terribly deficient in essential nutrients, due to their consumption of poor quality foods.

I recommend that my patients eliminate as many toxic exposures as possible from their lives. This includes tobacco, alcohol, recreational and unnecessary prescription drugs, as well as toxic chemicals in the workplace and in the home. Such chemicals include solvents, paints, lubricants, petrochemicals, harsh cleaners, and typical antimicrobial agents (including bleach). There are many healthy, nontoxic alternatives out there, but many people don’t take the time to learn about these products and their benefits.

I also recommend that my patients maximize their innate detoxification processes by consuming at least 64 ounces of clean, filtered water daily. Green leafy, cruciferous and root vegetables are also important, as are culinary herbs and spices, lots of garlic and onions, and mild teas that support liver and kidney function.

I don’t advocate aggressive detoxification regimens involving colonic irrigation, fasting, frequent constitutional hydrotherapy and/or sauna therapy, while patients are undergoing active chemotherapy, radiation, and/or immediately before or after surgery. These types of detoxification procedures can deplete the body and are therefore contraindicated during active anti-neoplastic treatments. While they may be effective for removing toxins, they can also remove vital nutrients from the body that patients need in order to get through their oncology treatments. Furthermore, complex detoxification programs may compromise the effectiveness of chemotherapy or radiation.

I do, however, encourage gentle detoxification, because it’s a critical component of healing, and detoxification is also a part of our body’s normal physiological processes. So I try to support its inherent ways of doing that.

Some doctors prescribe heavy metal chelation to their cancer patients, but I find that metals are rarely my patients’ principal concern. I don’t do this type of treatment anyway when they are undergoing chemotherapy, because chelation involves drawing metals out of the tissues, which may increase the amount of metals that circulate throughout the body. This then creates neurological, cardiovascular, and digestive symptoms. I would be doing my patients a great disservice by exposing them to more mercury, because it would create too much of a toxic burden for their bodies.

I generally work with my patients to establish some type of detoxification protocol after they complete their chemotherapy, though as previously mentioned, it’s usually a bad idea to do any type of aggressive detoxification protocol during chemotherapy, not just
because of the excessive toxic burden that it could create for the body, but also because the goal of a detoxification protocol is to decrease some type of toxic substance in the body. Chemotherapy regimens are designed to deliver a certain amount of a toxic drug to the body over a period of time, and ideally, in a controlled environment. Detoxification would potentially decrease the amount of the active drug in the body, thereby limiting its effectiveness.

Therefore, my detoxification protocol during chemotherapy is basically geared towards maximizing the body’s innate detoxification processes. We aren’t “sweeping out the dust,” but rather, helping the body to stimulate the removal of that dust. Fundamentally, I want to ensure that my patients receive adequate nutrition and fluids, and that they are physically active on a regular basis. I may also give them herbs such as milk thistle (in capsule, tea, or liquid form), or antioxidants that support their detoxification organs, especially the liver and kidneys.