Complementary Medicine

I require a very complete set of medical records for my new patients. I review these carefully. If I am unfamiliar with any aspect of their cancer or treatment, I research by reading my oncology text books, reading published studies and consulting with my naturopathic and oncologist colleagues. My first visits with new patients are typically 90 minutes so that I can learn as much as I can about each person as an individual (after all they are people with cancer, not just cancer diagnoses). I then several more hours developing my recommendations, which stem from my experience and additional research. I then provide my consultation note and my recommendations to the patient and to their other healthcare providers. I typically follow-up with patients in accordance with their treatment and disease experience on a repeated basis.

EmbodiWorks provides an educational website with integrative cancer care resources about whole person health and healing in five areas–body, mind, spirit, social, and environmental. We also have a Resources section to help cancer patients and caregivers navigate their cancer journey. Our goals are to reduce cancer risk and improve cancer-related survival, quality of life, and whole person health care.

Please visit our site at www.embodiworks.org.

Meditation has been shown to reduce stress, improve mood, and affect immune function, but studies have not yet established whether it prevents cancer recurrence. However, just because a study hasn’t been done yet to prove meditation prevents recurrence, does not mean it won’t be helpful. Stress and depression are often associated with higher morbidity and mortality rates among people with chronic disease in general, so anything you can do to manage your stress will be good for your health. In terms of the type of meditation, I suggest selecting the one you like the best and feels the most right to you. People vary a lot in their response to various forms of meditation and stress reduction. If you are in or around Massachusetts, for classes I highly recommend the UMass Center for Mindfulness http://www.umassmed.edu/Content.aspx?id=41252 originally founded by Jon Kabat-Zinn.

The most basic would be a metabolic panel (sometimes called a chem 7 or basic chemistry). It basically is a picture of the electrolyte balance in your body and kidney function. With this test the bicarbonate level will give your doctor an idea of any acid-base problems. The other way to directly measure blood pH is an arterial blood gas. Here blood is taken directly from the artery (usually the radial artery in the wrist) and information about the level of oxygen and carbon dioxide in your blood helps direct your care—usually ventilator settings (yep, this is the “in the intensive care unit” scenario).

No, please save your money. For a more detailed answer please see (http://talkabouthealth.com/how-are-ph-and-the-acid-alkaline-balance-related-to-cancer).

Make sure you understand tests that actually measure acid-base balance. It must be a blood test. Salivary or urinary tests will not completely measure acid-base balance in your blood.

This is one of the more common questions I get since there are folks out there selling alkaline water supposedly to combat acid problems related to cancer. Basically there are many half-truths out there on the internet. The half-truth behind alkaline water is that tumors exist in an acidic environment. The problem is that it is an acidic environment created by the tumor. Acid in the body is largely created by cellular metabolism and tumor cells are metabolizing at an accelerated rate. They produce more acid than the body can clear away and therefore live in an acidic environment. They outgrow their blood supply and hence their oxygen supply which also contributes to the acidity. So acid is not a cause of the tumor, it is a byproduct. Secondly there is no amount of alkaline water that you can drink that will change your body's pH. Your body has thousands of chemical reactions and mechanisms to keep your body's pH at 7.4. If you stray too far from that number then you end up in the Intensive Care Unit. Your kidneys and lungs are well equipped to help your body with acid/base balance. Drinking alkaline water will alkalinize your urine (because it is getting rid of excess base). It will do nothing for your cancer.

Inflammation is heat or fire in the body. This includes a distinction between acute and chronic inflammation. Think about when you've had a cut or wound. Your skin is red, flamed, and perhaps uncomfortable. That's acute inflammation. But in chronic inflammation, the "flare" does not stop. It continues on and on for months and years where the body acts with immune and other processes to heal a "wound" and yet there isn't one. The chronic inflammation then begins to support health conditions such as cancer.

To reduce inflammation, eat organic vegetables, some fruits, spices such as turmeric, and consider specific supplements. Inflammation levels can also be tested. The most common blood test is called c-reactive protein (CRP) high sensitivity available through mainstream blood laboratories. A healthy level is below 1.0 mg/L.

You can learn more about inflammation and cancer, including a more in depth explanation about inflammation and how to reduce it, in an article on the EmbodiWorks integrative cancer care resources website at http://www.embodiworks.org/cancertreatments/bodymindspirit/inflammation/.

There is a lot you can do….and most of it does not require a prescription of any kind. Regular exercise reduces chronic inflammation. Perhaps this is why exercise has been helpful in controlling things like high blood pressure and heart disease and has been associated with better survival in cancer patients. Eating a Mediterranean diet also decreases inflammation (in fact another name for this diet is the anti-inflammatory diet). Omega-3 fatty acids (fish oil) are anti-inflammatory. Getting enough sleep, meditation, fiber, red wine (in moderation), aspirin and other non-steroidal anti-inflammatory drugs, and prescription cholesterol lowering drugs called statins all lower measures of chronic inflammation.

Elevated levels of markers of chronic inflammation are associated with an increased risk of cancer (for more details: http://talkabouthealth.com/what-is-meant-by-the-term-inflammation-in-the-context-of-cancer-and-integrative-medicine). There is a difference between association and causation. While chronic inflammation and many diseases occur together, the exact mechanisms as to how inflammation might cause illness have not yet been worked out—but what an exciting area of research!

Most commonly this is done with a high sensitivity c-reactive protein (hs CRP in medspeak), IL-6 (usually limited to research studies), and serum amyloid A was measured in the study by Pierce, et al. (noted here: http://talkabouthealth.com/what-is-meant-by-the-term-inflammation-in-the-context-of-cancer-and-integrative-medicine) but I’m not as familiar with it. Most likely your insurance won’t cover a hs CRP unless you have heart disease.

Let me start by saying there are some components of citrus fruits that have anti-tumor activity in pre-clinical studies (those done in test tubes and mice). In particular d-limonene which is a monoterpene found in orange and lemon peels may be active against some tumors and is being investigated in phase I/II trials. Keep in mind this is a concentrated chemical extracted from citrus fruit and given in intravenous form—sound familiar? Yep, this is how chemotherapy got its start. In one trial I read, nausea and vomiting were “dose-limiting toxicities” (one goal of phase I trials is to see how much drug can be tolerated). Side effects like nausea and vomiting occur because of the effect of the drug on normal cells. Now with that said, there is no evidence that lemon juice is effective in the least for treating cancer. As for impact on “normal” cells—have you ever tried drinking much lemon juice? I think you’ll find there is an effect on normal cells.

The standard treatment for lymphedema is lymphatic massage and compression under the guidance of a physical therapist specifically trained in lymphedema management. There is no question that is the most effective treatment. In addition, there is one trial that was conducted in France and published in 1996 which demonstrates some efficacy using an extract of Ruscus (Butcher’s Broom) and Hesperidin Methyl Chalcone ( a citrus flavonoid) called CYCLO 3 FORT. In that trial all 57 patients received manual lymphatic drainage (lymphatic massage) and the patients that received CYCLO 3 FORT had less edema at the end of 3 months. Butcher’s Broom can cause diarrhea.

Tai Chi is sometimes called "moving meditation." It was absolutely one of my favorite things to learn when I studied Chinese medicine but it is something that takes years to master. It is a Qi building exercise that many Chinese participate in on a daily basis. The focus is on slow, intentional movements that based on martial arts moves. The slower the better. There have been a couple of interesting studies involving Tai Chi that come to mind. One looked at improving balance in elderly patients (which it did). A randomized trial reported in the New England Journal of Medicine in 2010 showed that it improved the symptoms of fibromyalgia compared to a control group. A researcher at the Univ of Missouri found in a small trial that it may also improve cognitive function (chemo-brain anyone?) Finally, another study published in Archives of Internal Medicine in 2011 showed that Tai Chi may improve quality of life, mood, and exercise self-efficacy in patients with heart failure.

Thasnks for that question. Traditional Chinese Medicine is an entire system. It has been used in China and other Asian countries for literally thousands of years. I think their first herbal book is 6000 years old. But at the same time, it is a growing and changing system, added to as health challenges change.

The Chinese herbalist who provided herbs to me was trained by his grandfather in Asia. He also came to the US and got a PhD from Harvard, in Biostatistics. So he was, I felt, a trustworthy source. He has spent many years studying breast cancer specifically (although he tells me he treats Asian people with any ailment), and with what he learned, he began creating herbal formulas.
Chinese formulas are combinations of herbs -thus they do not, generally, cause the adverse effects that are all too common in cancer treatments. (That said I have been dizzy or disliked the taste of smell sometimes of the herbal combos).
The basic formula is probably the same for all folks who get it, but then some herbs are added that are specific for each person. So the formula I got would not be totally duplicated for anyone else. I did not ask which herbs I was getting, after the first time, because the list of either Chinese characters or Chinese herbal names, really had not much meaning to me.

The herbs affect the body and its systems, acting like any other medication. They cause changes to the cells, affect pathways, etc. I had an MRI before I started the herbal treatment, and an MRI afterwards.

Dr. George Wong has spoken at SHARE in NYC, and at my organization Annie Appleseed Project's conferences. He has also offered consults while there. A summary of one of his talks can be found on our website www.annieappleseedproject.org - just SEARCH on his name.

I have worked with a Chinese herbalist - NYC-based who strongly supports the idea of using Chinese herbs to reduce the unwanted toxicities/adverse effects of the radiation to the non-cancer cells.

Have you ever looked into this? I think it would be GREAT to see what Chinese medicine has to offer. It is after all, a 4-6,000 year old system that has been adapting to modern ailments and health challenges.

I founded www.annieappleseedproject.org to provide this type of information.

The short answer is: Yes, under proper supervision. Unfortunately, in the past, some less-trained herbalists have prescribed herbs to cancer patients in such a way that both the chemotherapy and the herbs are processed by the same organ (e.g., the liver), and therefore the liver gets over-taxed, and the patient ends up in the hospital for a few days. This has led to many oncologists putting down a blanket rule that cancer patients should take no herbs or vitamin supplements during chemotherapy. We wholeheartedly disagree with this blanket rule, especially given the fact that there are numerous, published clinical trials that show the efficacy of herbal supplements for alleviating the side effects of chemotherapy.

In Traditional Chinese Medicine, unlike Western Medicine, each person is seen as wholly unique - even if they present with the same illness. Therefore, the herbs we suggest for one breast cancer patient will not necessarily be the same as what we suggest for another breast cancer patient. Take diabetes - you may have diabetes solely because of your diet. In that case, we would suggest certain herbs to help with your appetite. Or, you may have diabetes due to a congenital problem with your pancreas - in that case, we would suggest different herbs.

So, it is impossible to say exactly which herbs are safe to take during chemotherapy, because we would recommend different herbs depending on each person's unique situation. However, the important thing to remember is that the herbalist should know precisely through which organs that person's chemotherapy is being processed (e.g., the liver, or the kidneys), and then to choose herbs that are not processed by that same organ. If they are, then the herbs should be taken no earlier than 5-7 days after the chemotherapy infusion, so as not to over-burden that organ.

Hope that helps,
Kelly Turner, PhD and Aaron Teich, LAc
www.ShuniyaHealing.com
Twitter @ShuniyaHealing

Hi, Kelly:
Those are great suggestions. They are things that I typically do - but I have gotten away from walking regularly due to school (and living in South Florida summer heat!). Maybe the key for me is to get more oxygen into my body on a consistent basis.

EmbodiWorks at http://www.embodiworks.org/ provides reliable integrative cancer care resources. Addressing whole person health and healing in five areas, topics include body, mind, and spirit, including social and environmental health. The Resources section helps cancer patients and caregivers navigate their cancer journey as well. Various ways to create an integrative cancer care program, questions for evaluating cancer treatments and providers, help in evaluating cancer research and treatments, integrative providers and clinics, retreats, books, financial assistance, and other trustworthy resources empowers people with, through, and beyond cancer. Articles also inform cancer care providers with some practitioners serving as authors. Scientific references are incorporated throughout their site. For EmbodiWorks educational resources to help reduce cancer risk and improve cancer-related survival, quality of life, and whole person health care, visit www.embodiworks.org.

I agree with Gwen.I believe in fighting and healing (not the same as curing)cancer from within. The power of the mind is enormous and can be used:
To find the inner strength
Stimulate your immune system
Alleviate physical and, most importantly, emotional pain
Learn to cope with fear, anxiety and stress
Learn how to fix energy drains and create energy
Learn how to create happiness and fulfillment

In summary,cancer survivors can build the life they want. It takes learning the tools that work, implementing them in your life and having support to make it a "new" way of life.

Naturopathic medicine uses natural & supportive therapies to enhance the individual's immune system. The goal is to create an optimal internal & external environment.

Every form of healing is necessary when someone is diagnosed with cancer. There are times when surgery, radiation, chemotherapy are needed to reduce/eradicate tumors/cancer cells. The focus of naturopathic medicine is to take a "whole-person" approach and use scientifically based natural methods to strengthen the body.

By using clinical nutrition, IV therapy, botanical (herbal) medicine, asian medicine (includes acupuncture & asian herbs) the goal is to:
- decrease side effects of cancer treatment
- improve energy & overall quality of life
- support and improve the body's immune system
- support the mind/body/spirit during the healing process
- provide strategies for cancer prevention and health maintenance.

In clinical practice, the patients that have the best "outcomes" are those who incorporate both conventional and naturopathic medicine into their health regime when faced with a diagnosis of cancer.