By Robert Zieve, MD
The world of cancer treatment is changing, bringing many benefits—and some questions—to patients with cancer. This kind of diagnosis can be overwhelming: once you or your loved one has been diagnosed with a cancer, what do you do next? You often talk with your physician or oncologist or surgeon. You then may start to surf the internet, looking for a “cure.” There is so much information out there, and so many spurious claims, that you do not know what to do. Your surgeon or oncologist is often advising surgery, chemotherapy, and/or radiation therapy. Many people today are fearful of these approaches, and not uncommonly, this is a rational fear because sometimes these therapies are not used in the best way or at the optimal time in your care. I have often heard patients say that they do not want to be burned (radiation), cut (surgery), or poisoned (chemotherapy). However, it is important not to get stuck in the rigid belief that all modern oncology is bad and harmful; in fact, much of it can be very helpful in the treatment of a patient with a cancer, if done in its right timing and with the right integrative and naturopathic supportive therapies.
Most cancers take years to develop to the point where they can be diagnosed on physical examination or with blood tests or scans. If you have been diagnosed with a cancer, it is best—except in a few uncommon types of cancer—to take a little while to come to terms emotionally with this new reality in your life, think it through, and seek advice from a good practitioner that you trust.
A Multi-Faceted Approach I am thankful to have been able to study with Dwight McKee, M.D., a well-known international integrative Board-Certified oncologist-hematologist, who says this:
“Although medicine is informed by science, it is still fundamentally an art and even more so when combining complementary, alternative and conventional oncology tools in innovative ways. Oncology is the study of tumors and ways to attack them. This is only a part of integrative cancer medicine. The other part is the person who has the malignancy, and the terrain that is the microenvironment in which the tumor cells are living.”
These are the two other areas that need to be focused on—the person and the terrain—if an integrative cancer physician is to help his or her patients who have a diagnosis of cancer. To further quote Dr. McKee:
“Conventional oncology is a military model of attack on tumors. It is very left-brained, very masculine—i.e., logical, linear, evaluated by statistical methods— whereas complementary and alternative cancer medicine, (integrative medicine), is a holistic approach designed to support many body systems with many types of intervention. It is more a product of the right brain—feminine, intuitive, non-linear—and it individualizes rather than systematizes. It’s pretty clear that we can do better if we use both sides of our brain.”
Intelligently Combining Modern Oncology with Integrative Medicine Modern Oncology is a part of integrative cancer medicine, as Dr. McKee has pointed out. It brings to the table a number of good diagnostic approaches, such as MRI’s, PET /CT scans, blood tumor markers, biopsies, and high-quality and therapy-guiding laboratory evaluation of tumor biopsy slides. When we combine these modern oncology diagnostic approaches with functional medicine, we include blood tests that enable the practitioner to more completely evaluate and then support and treat the tumor microenvironment and biological terrain in which the cancer has grown, to make it less friendly to cancer cells. These functional medicine tests, through major national labs like Lab Corp, may provide information that is helpful, such as the presence of inflammation that can feed cancer growth; blood levels of Vitamin D; heavy metal toxicity like copper or iron overload that can enable tumors to make blood vessels and to spread, and tendencies of the blood to clot too easily inside blood vessels, thereby diminishing the oxygenation of tissues. The functional medicine approach also can provide us with valuable information about the overall toxic load that affects the body and immune system of a person with a cancer. When these two approaches are combined, using both intellectual, fact-based data as well as our intuition and experience, the practitioner can sculpt a well-rounded treatment program that can be very effective.
Defining Efficacy By the word “effective” we mean an intelligent approach that leads to the death of cancer cells, prolongs the patient’s life, and enhances the quality of life. Each of these is important in a cancer therapy protocol. Such a protocol may include the “military approach” Dr. McKee mentioned of killing cancer cells, but also but also includes the Integrative Medicine comprehensive evaluation and treatment of the terrain or microenvironment.
Modern Oncology Let’s look a little more deeply at what Dr. McKee called the “military” approach of modern oncology. The idea of being immediately rushed into surgery, chemotherapy, and/or radiation is what many people fear and become nervous about. But this need not be. For example, there are times when chemotherapy is necessary and life-saving, and as you will read below, the side effects of these types of well-chosen drugs can be mitigated, and their effectiveness potentiated, by taking specific foods, herbs and nutritional supplements. There are also times when surgery can be an important step to take after the diagnosis of a cancer. This can include conditions where the patient is at risk of rupturing an organ, when there is an obstruction in the body, or significant life-threatening bleeding. However, there are few types of cancers that dictate immediate surgery, radiation, or chemotherapy; it is often more important to step back, evaluate, gather data, and form an intelligent plan for therapy, get some good testing done, and start on a foundational oral program. Radiation therapy can also be particularly helpful in decreasing pain, especially if a patient has bone pain from metastases. Radiation therapy can play an important role in a particular type of brain cancer called glioblastoma.
Targeted Therapies In addition, in modern oncology there are what are called “targeted therapies.” Targeted cancer therapies are drugs or other substances that block the growth and spread of cancer by interfering with specific molecules (“molecular targets”) that are involved in the growth, progression, and spread of cancer. Targeted cancer therapies are sometimes called “molecularly targeted drugs,” “molecularly targeted therapies,” “precision medicines,” or similar names. This is not uncommonly a helpful therapeutic approach, but unfortunately it is often very expensive. These FDA-approved therapies are most often oral therapies.
Targeted therapies differ from standard chemotherapy in several ways:
• Targeted therapies act on specific molecular targets that are associated with cancer, whereas most standard chemotherapies act on all rapidly dividing normal and cancerous cells, to kill these cancer cells, but with many side effects possible.
• Targeted therapies are deliberately chosen or designed to interact with their target, whereas many standard chemotherapies were identified because they kill cells. And these same chemotherapy drugs, as they are used in modern oncology, can also damage healthy body and immune cells.
• Targeted therapies are often cytostatic (that is, they block tumor cell proliferation), whereas standard chemotherapy agents are cytotoxic (that is, they kill tumor cells).
Targeted therapies are currently the focus of much anticancer drug development. They are a cornerstone of what is called precision medicine, a form of modern oncology medicine that uses information about a cancer’s genes and proteins to treat this disease. This is where the military thinking comes in to play. But remember, it is often not about the genes, but about the terrain and tumor microenvironment imbalances that permit a gene mutation to develop into a cancer. And it is the task of good integrative medicine to treat the terrain and the tumor microenvironment effectively. There are times when the intelligent application of a targeted drug can be life-saving. The side effects of these types of drugs can be mitigated, and their effectiveness be potentiated, by taking specific foods, herbs and nutritional supplements.
Antibody-based therapies These are drugs like Herceptin, which has helped many women with breast cancer, Rituxan, which has helped many people with lymphomas, and also Temodor, used in many brain cancer patients after surgery and radiation therapy.
Immunotherapy You have likely heard of this, perhaps through TV ads for drugs called Opdivo or Keytruda. These can be very effective therapies in many types of cancer and are approved in some cancers as first line treatments. By using integrative cancer therapies along with these immunotherapies, complications and side effects of immunotherapies can be treated.
Integrative Cancer Medicine Treatments The Integrative Medicine treatments that address this terrain include such therapies as:
• Intelligent and targeted use of botanicals, nutrients, and homeopathic remedies, as well as food programs, which have well-published research that documents their effectiveness in cancer treatment
• IV Vitamin C and other IV therapies
• The use of injectable mistletoe therapy (one of the more commonly used integrative cancer treatments worldwide, especially in Europe)
• Oxidative therapies that employ ozonation of the blood, to better oxygenate all tissues in the body
• Mind/body medicine approaches like relaxation exercises, meditation, prayer, guided artistic programs, and psychological consultations
• Medical Cannabis: This therapy, when correctly prescribed, as our physicians at Holos Health are trained to do, has good research and experience behind it, that have demonstrated its capacity to lead to cancer cell death, and also to symptom alleviation if a patient is receiving
In sum, integrative cancer medicine is the intelligent and often intuitive combination of modern oncology with integrative medicine, combined with the principles and practices of naturopathic medicine, to help all patients with cancer to have the opportunity to achieve either remission of their cancer, or if that is not possible, stabilization of the cancer, as well as an optimal quality of life.