Defeat Cancer (49 page)

It’s important for me to address hormonal imbalances in my patients because, for example, high levels of insulin and estrogen can contribute to tumor cell activity, so any excess of these hormones needs to be treated. Hyperparathyroidism, which leads to excess serum calcium, is a rare condition, but can be exacerbated by cancer and conventional cancer treatments. It can lead to further calcium deregulation, so managing this condition is important, as well. If patients have other imbalances, such as hypothyroidism, I also evaluate and manage those.

Hypothyroidism is a common condition that develops as people age, especially in women. We don’t know all of the causes behind it, but it seems to be somewhat related to declining health. It can also be caused by autoimmune disease. When patients suffer from an uncomplicated case of hypothyroidism related to aging, thyroid hormone supplementation may be appropriate. When it’s related to autoimmune disease or cancer, treating the disease may be a better first step.

Sex hormones, like others, are complex in their biological function and should be respected as such. Many practitioners prescribe their patients estrogen, progesterone, and testosterone replacement therapies, without due regard for the potential long-term effects that these supplemental hormones may have upon the body. This isn’t to say that patients can’t benefit from this type of therapy, but it’s a very complex area of medicine, so I don’t focus much on estrogen or testosterone supplementation in my practice. However, I do test my patients’ estrogen and testosterone levels, using blood and urine tests, whenever I suspect that these hormones might be affecting their cancers, and then balance them with herbs or medications.

Supporting the adrenal glands is also important for healing, although some practitioners believe that adrenal insufficiency doesn’t even exist. The majority of naturopaths and many other doctors, including me, however, suspect that it does, and I believe that many people with cancer suffer from challenges to their overall adrenal function. I try to ensure that my patients have adequate nutrients to support their adrenals, such as Vitamin C and certain minerals. Many adaptogenic herbs are thought to support adrenal function, so I also use these frequently in my practice.

Finally, glucocorticoid steroid drugs, which are prescribed to many cancer patients, change the balance of the body’s internal steroid hormones, especially cortisol. Corticosteroids can be difficult to assess and manage, and imbalances can negatively impact the body, especially with long-term use. Drugs like dexamethasone or prednisone, which are often given to help patients tolerate Taxol chemotherapy, can cause severe insomnia, anxiety, digestive problems, and even nausea and vomiting, so I treat these problems whenever they arise in my patients.

Hormone management is complex and complicated. I take a conservative approach to it, because hormones affect every tissue and organ system of the body. In general, I treat my patients’ hormones
depending upon their level of dysfunction and whether or not they are directly affecting their cancers. If patients have uncontrolled diabetes or other complex hormonal issues, though, they should be under the management of doctor skilled in insulin management, or an endocrinologist, not me. A naturopath in my practice focuses on this area, and I sometimes refer my patients to her, as well as to endocrinologists in Seattle or Olympia, Washington.

Adequate, appropriate nutrition, sleep, physical activity, and effective stress management are foundational for good health, so I address all of these areas in my patients. I may also recommend that they take dietary supplements to correct for any nutritional deficiencies and to support their overall health.

My exercise prescription depends upon my patients’ circumstances, including their co-morbidities, or other health problems. Ideally, I recommend that they be physically active for at least 30-45 minutes per day, 4-5 days per week. The form and intensity of the exercise should be varied and tailored to their needs, and can include a combination of cardiovascular, stretching, and/or muscle strengthening techniques. I always recommend that they limit their physical activity if they experience increased fatigue and/or pain because of the activity. Their goals should be realistic, safe, and achievable.

I also generally recommend that they get seven to eight hours of sleep nightly, but these recommendations can vary widely. If they are taking corticosteroids, for instance, they may not be able to sleep for more than four to five hours at a time, anyway.

To help my patients with their mental health, I assess their stress levels and ability to manage that stress. I look at factors such as whether or not they have sleep disturbances and anxiety, whether they are interested in healthy life activities (work and/or social engagements), and whether they are supported by others in their healing process and lives.

How patients manage their stress doesn’t matter, as long as the strategies that they use are effective for them. There are many ways to relieve stress, including psycho-social techniques such as counseling; physical strategies such as biofeedback, exercise, yoga, tai chi, etc.; social strategies, including support groups; spiritual strategies, such as meditation and religious activities, and, of course, symptom management, which I described earlier in this chapter.

I may also make recommendations for improving certain areas of their lives, in addition to prescribing remedies to alleviate the symptom-related aspects of their stress. For instance, I might encourage them to stop smoking or to avoid excessive alcohol consumption, especially during chemotherapy, and to lose weight if they are overweight or obese. They should consider cancer treatment as a full-time job, schedule other obligations and occupational responsibilities accordingly, and do additional activities only as they are able.

Every patient is unique and requires an individualized treatment plan. I typically start off my patients’ visits by asking them what their goals are in seeing me that day. This ensures that I am able to address the issues that are most important to them. I also learn a tremendous amount about them by doing this, which helps me to serve them beyond their initial goals and in ways that they may not have expected.

When determining a treatment regimen, I take into consideration their specific disease (including histological subtype, grade, stage, etc.), lab test results, and oncology treatment plan. I also consider their nutritional status and habits, their level of physical activity and/or ability to be productive, as well as any relevant physical limitations. Their food sensitivities, digestive problems, toxic environmental exposures and other major and minor health problems, are likewise important. Their finances and motivation to do
treatments also play a role in my treatment recommendations, as do their lifestyle habits, including, for example, whether or not they smoke or drink excessive amounts of alcohol.

I also take into account family issues. It’s common for me to see patients whose families are adamant about the supplements or dietary strategies that they think their loved ones should do. I try to serve as an expert reference for them and diffuse the stress that can arise between patients and spouses or other family members. I have at least one patient whose family member is a sales person for a multi-level or network marketing company that sells supplements, and this has created a difficult situation for the patient when she is trying to make treatment decisions, because the family member inadvertently pressures her into taking stuff that she doesn’t want to take.

Additionally, I coordinate my patients’ care with treatments that they receive from other providers. It’s common for me to see patients on drugs that contraindicate other therapies, or patients who are continuing on prescription medicines that were initiated prior to their cancer diagnoses and which they no longer need. When this happens, I may contact their other doctors to find out whether they really need to be on those medications anymore. Or when they have co-morbid conditions, I may refer them to other practitioners for management of these conditions. For instance, sometimes patients’ blood pressure is affected by chemotherapy, so I may need to refer them back to their family practitioners or to a cardiologist. Others may require the assistance of their primary care physicians or an endocrinologist to help them manage their anti-hyperglycemic or insulin medications. Basically, I work with a variety of other doctors, so my patients end up receiving the best care possible. I also routinely send a copy of their chart notes to their managing oncologists, to make sure that we are all on the same page, and to help them understand what my treatment recommendations are and why.

I try to be as helpful as possible to my patients without overwhelming them, because people with cancer are already overwhelmed as it
is. For many, cancer treatment is a full time job and anything I can do to make those treatments easier and more efficient is usually appreciated. When I make a supplement recommendation, for instance, I tell them which brand and how much of that supplement to take, what time of day to take it, and where they can get it. I typically offer them three to four different options, so that they don’t have to research the products themselves. Similarly, when recommending counselors and acupuncturists, I try to help them find providers who participate in their insurance plans and who have extensive experience in working with people with cancer. It’s nice for patients to not have to do this research. We also help those who don’t have financial resources for treatments to find organizations and/or people that provide this kind of support to those with cancer.

My treatments definitely provide my patients with a better quality of life than what they would have had if they had done conventional treatments alone. They are also effective for mitigating the side effects of chemotherapy and radiation. I would like to think that they extend their lifespan, and ensure them a disease-free life, as well, but this is difficult to ascertain without a prospective controlled study in which I could follow up with them long-term. Data on patient survival as a result of conventional oncology treatments are also lacking. Ultimately, I believe that people live better and survive longer because of my work.

Some people with terminal cancers who do integrative treatments live for years beyond their initial prognoses. But we also witness this in people who have presumably done just conventional treatments (the standard of care). Outcomes vary, based upon the stage and histological subtype of the disease, and patients’ initial overall prognoses (which can be anywhere from a few months to several years or longer). My experience has been that people who utilize integrative treatments do far better than those who rely solely upon conventional treatments.

It’s hard to track statistics for diseases like breast cancer, which is typically diagnosed earlier than other types of cancers. Outcomes for the early stages are favorable, and people tend to have fewer recurrences down the road. Many women who have breast cancer live for ten years without a recurrence, much less die from the disease, so it’s something that takes decades to evaluate, compared to the more aggressive types of cancer.

I left CTCA three years ago and started my own practice here in Washington. Since that time, I have been treating a couple of patients with lung and metastatic pancreatic cancer, and so far, they are still alive. I don’t know if their cases are unusual. We have statistics and data on certain treatments, which are relevant for a population, but not for individual people. This is because data is based on thousands of people that are all pooled together, and there are many individual factors which are not accounted for in these kinds of statistics.

I can make some well-educated guesses, and say that a person with advanced diabetes or who has a history of a stroke won’t likely do as well as the person who doesn’t have these types of health problems, and there is data which suggests that maintaining certain lifestyle habits matters. Studies have shown, for instance, that people with lung cancer who eat vegetables will survive longer than those who don’t. Overweight women with breast cancer have a 30 percent increased likelihood of recurrence than those who are at a healthy body weight. People who don’t drink alcohol do better with their treatments than those that do. People who exercise have fewer recurrences of aggressive breast cancer. We know that some of these individual factors matter, but part of the problem of trying to fit the naturopathic model into clinical research is that in most studies, only one factor is accounted for. And in my practice, I am usually changing ten different factors in my patients’ day-to-day regimens, so it’s hard to compare the absolute effectiveness of a single strategy from one patient to the next, much less do a large scale study with 400 patients where we change eight parameters of treatment, and then do another study where we alter a different set of parameters on 400 different patients, and then look at the data
and say, “this is the outcome.” It would be too expensive, time consuming, and logistically impossible. But taken independently, many of the tools that I utilize to treat my patients have proven to be beneficial, and their safety and effectiveness is supported by research data.

Sometimes, my patients have really aggressive cancers and there’s nothing that I, nor their oncologists, can do for them, so this is obviously a roadblock to healing. Social, financial, or motivational factors can also be roadblocks to healing: for instance, if patients don’t follow a treatment protocol, refuse to change their diets, and/or keep smoking. While a lack of compliance can be a roadblock to healing, I also firmly believe that it’s difficult to be healthy in America. You have to be “counter-culture” to maintain a healthy diet. In cities like Boulder, Colorado where I did my undergraduate work, or Seattle, Washington, where I live now, it’s easier to identify and obtain healthy food and more socially acceptable to eat healthy food. But outside of Seattle, in other parts of Washington, for instance, it’s common for people to misunderstand what organic food is or not have easy access to that food. Also, our society values aggressive, unsustainable work habits, at the unfortunate cost of a person’s health. We have to recognize this and take steps to recreate what it means to be healthy in the United States. I educate my patients on the value of things like a good diet, exercise, and sleep. Balance in all aspects of life is important.