Today's post is the final article in my series on cancer. It describes the difference between the Integrative and Conventional approaches to medicine and how that comes to play in cancer treatments. I will then discuss the controversy of using supplements alongside conventional cancer treatments. Lastly, I detail specific dietary and supplemental approaches that compliment modern cancer therapies.
(Disclaimer: This is NOT medical advice. It is imperative that you find a knowledgeable medical professional, preferably an Integrative Medicine or Naturopathic Oncologist, to guide you in your personal medical decisions.)
Conventional vs. Integrative Approaches to Cancer
The integrative approach to medicine sees all the body’s systems as interrelated, therefore naturopathic and integrative health professionals treat the patient as whole person, not just as an isolated tumor or mass. In addition, there is an understanding of how diet and lifestyle choices affect overall health. Unfortunately, conventional medical doctors only receive about one week of training on nutrition in medical school, and may not fully understand the importance of the body’s need for nutrition to heal and recover; nor its role in the prevention of disease (Wood, 2014a).
The primary conventional treatments are surgery, chemotherapy, radiation, plus some drug and adjunctive therapies. An integrative approach to cancer takes into effect conventional therapies, plus complimentary therapies and supplements. With an integrative approach, attention is paid to immune function, hormone status, insulin resistance, inflammation, digestion, and detoxification.
In contrast to the integrative approach, the conventional medicine approach to cancer is to look for a “magic bullet”, a pill or drug, to cure cancer, instead of a whole lifestyle approach for cancer prevention. More people are getting cancer than ever before, and treatments to fight the” war on cancer” have not improved significantly since 1971 when it was waged. The guidelines of the American Medical Association state that physicians must legally suggest the paradigm of conventional treatments to their patients, whether they are advantageous to the patient or not. These mandates are also influenced by insurance companies and conventional medical school treatment philosophies. Cancer is also a huge $228 billion per year business in the US, and has monetary backing and is influenced by big businesses (Wood, 2014a).
The Controversy: Use of Supplements alongside Conventional Cancer Treatments
Unlike integrative physicians and naturopaths, even the most well intended conventional medical doctors may not be aware of the complementary and alternative approaches to healthcare, especially nutritional dietary supplements. Any type of medical professional may assume that supplements are completely harmless or that they are very harmful, both of which are false beliefs (Alschuler & Gazella, 2010). Many conventional physicians resist the use of supplements for fear they will interfere with treatments, which may or may not be accurate depending on the supplement, the timing, and combined with which therapy.
Supplements are intended to augment an individual’s diet and stimulate particular naturally occurring bodily processes. Over-the-counter supplements consist of vitamins, minerals, botanical herbal extracts, and other nutrients. They are regulated by federal guidelines and may contain a single nutrient or a combination of several nutrients. Supplements work biochemically and physiologically in the body, much like pharmaceutical drugs. In the case of cancer, tailored supplements programs are designed to assist the health and wellbeing of a patient by supporting his or her physiological systems, such as the immune and endocrine systems. Supplements also have the ability to change specific cellular events and affect tumor growth, angiogenesis, and inflammation. Specific herbs and nutrients have been proven to ease cancer symptoms, manage side effects of conventional treatments, enhance quality of life for the patient, and assist in slowing the progression of the disease, or even cause remission. Herbs and nutrients can be a helpful compliment to modern cancer therapies, but are not meant to be a replacement for conventional anticancer drugs (Alschuler & Gazella, 2010).
Herbal medicine, also known as botanical medicine or phytotherapy, has been used since ancient times to foster health and treat illness. Many pharmaceutical drugs, including conventional cancer therapies, were initially isolated from plants or other natural compounds. Both dietary (vitamin/mineral) supplements and botanical supplements can be safe and effective when used under the guidance of a knowledgeable healthcare professional. Plants can have mild or pronounced effects depending on the specific herbs used, their form, and if they are used in combination with other therapies. Many herbs are not as strong nor as concentrated as prescribed drugs, and therefore can be safer and less toxic. However, natural substances can vary in potency and quality, or negatively react with other botanical and pharmaceutical drugs. Therefore, both patient and physician must strive to be fully informed (Alschuler & Gazella, 2010).
When combining complimentary supplements with conventional cancer therapies, a naturopathic or integrative physician can be an invaluable resource. This is especially true in the case of cancer, because it is such a complicated disease and the treatments are very powerful. If administered incorrectly, some supplements may interact negatively by decreasing the effectiveness of conventional treatments or by increasing the side effects. Some supplements may also be inappropriate for specific cancer types. The safety of supplements must be evaluated based upon the specific health circumstances of each individual, including their age and the stage of cancer (Alschuler & Gazella, 2010).
In conventional medicine, the randomized controlled study is considered the gold standard of medical evaluation. Treatments are not determined to be safe and effective until demonstrated in at least three separate, successful human, clinical trials. Unfortunately, it may not be possible to apply this same standard to integrative approaches. Conventional trials are designed to test specific pharmaceutical ingredients or interventions, while integrative approaches employ a combination of treatments specific to individuals, including herbs, nutrients, diet, and/or lifestyle changes. Therefore, the majority of integrative therapies are not substantiated by definitive human clinical trials. However, high research standards are applied to evaluate integrative research, including in vitro tests, in vivo animal tests, and clinical data. Valid, reasonable evidence can be gathered for the effectiveness of a particular complimentary therapy, its safety, and its use in specific applications (Alschuler & Gazella, 2010).
Specific Supplement Use during Cancer Treatment(s)
Surgery A large number of cancer patients undergo surgery to either biopsy an area or remove cancerous tissue. The body needs support and optimal nutrient status in order to heal wounds, control inflammation, fight infection, minimize the risk of metastasis, rebuild, and repair itself. In general, most supplements can be safely used. However, some supplements can increase bleeding risk and should not be used 1-2 weeks prior and post-surgery. These include vitamin E, and herbs such as garlic, ginkgo, red clover, and Panax ginseng. Dr. Eric Wood, a board certified Naturopathic physician with a special focus in oncology, recommends all supplements be discontinued 24-48 hours before and after surgery. The herbs that interfere with anesthesia include valerian, kava, Echinacea, garlic, silymarin, and St. John’s wort (Alschuler & Gazella, 2010).
In addition to eating nutrient-rich, health-promoting foods, some supplements are particularly helpful when undergoing a biopsy or surgery. These procedures carry a risk of seeding malignant cells into the surrounding healthy tissue. To address this risk, taking modified citrus pectin (MCP) before and after has been shown to be effective in reducing cell adhesion and metastatic spread of the cancer. MCP should not be taken simultaneously with chemotherapy drugs, however. Patients are often placed on antibiotic around surgery to prevent infection. They can also kill the body’s beneficial bacteria, so it’s a smart idea to supplement with probiotics for several weeks after surgery. Arnica Montana, a homeopathic remedy, is effective for inflammation, bruising, and pain if taken before and after surgery. The healing of connective tissues can be supported with dietary and supplemental vitamin C, zinc, bromelain, and flavonoids (Alschuler & Gazella, 2010).
Chemotherapy This treatment involves administering chemical agents that circulate throughout the patient’s body. They are toxic to cells and designed to shrink tumors, halt cell reproduction and growth, and cause cell death. Some chemotherapy drugs create free radicals and oxidation purposefully in order to damage the DNA in cancer cells. Chemotherapy drugs are designed to target rapidly dividing cells, like cancer, and the side effects from the treatment often occur when healthy, rapidly growing cells are affected by the chemotherapy agents. Chemotherapy can also cause nerve and heart damage, digestive issues, inflammation in the body, and toxicity problems (Alschuler & Gazella, 2010).
Powerful antioxidants are natural substances which are quite promising complimentary cancer treatments. They can prevent and reverse oxidative damage done by free radicals and are good for overall health. Eating antioxidant rich foods can help prevent cancer. In the case of cancer, antioxidants in low doses tend to have no effect on cancer cells, yet at high doses, antioxidants stimulate apoptosis (cell death) of cancer cells, but not normal cells. They do this through their ability to change the expression of genes that control apoptosis. Single antioxidant supplements tend to protect cancer cells, so high doses of multi-antioxidant supplements are likely to be most beneficial in conjunction with chemotherapy in the effort to kill cancer (Alschuler & Gazella, 2010).
The use of antioxidant supplements during chemotherapy is given the most resistance by oncologists. In general, antioxidant use is safe to use before and after each dose of chemotherapy. However, it is argued that use of certain antioxidants concurrently with chemotherapy, especially in therapeutic amounts, interferes with the tumor killing effect (Alschuler & Gazella, 2010). Dr. Wood states that while many in-vitro studies raise theoretical concerns about interactions between chemotherapy drugs and antioxidants, the actual in-vivo (human) data supports the use of many antioxidants concurrently with conventional chemotherapy treatment. The antioxidant supplements help patients feel better, recover and heal faster, and potentiate the effects of chemotherapy.
Specific antioxidants, like glutathione, can actually enhance the effects of certain chemotherapy agents. Glutathione is made from the amino acids cysteine, glutamic acid, and glycine. Supplements that also enhance glutathione production include selenium, alpha-lipoic acid, and N-acetylcysteine. However, N-acetylcysteine may interfere more with specific chemotherapy drugs or effect particular tumor types differently. The complexity of this issue is why it is vital to consult a medical professional who can look at each individual patient’s case specifically (Alschuler & Gazella, 2010). It is possible to do individual testing to determine strategic dosing and to determine if certain supplements will be particularly effective for a given cancer type and individual (Wood, 2014b).
Radiation The American Cancer Society reports that about 60 percent of cancer patients receive this therapy. It is a form of ionizing energy delivered from an external beam and targeted to a specific tumor or group of cancer cells. Much like chemotherapy, it makes the cells susceptible to destruction by damaging cellular DNA and creating oxidative damage (Alschuler & Gazella, 2010). Antioxidants are also helpful concurrently with radiation therapy, yet the same arguments against them exist; that they protect cancer from being destroyed. However, when used under the care of a qualified medical specialist, antioxidants can potentiate the killing effect of radiation. They can also shield and support the healthy cells from damage, thereby minimizing side effects (Wood, 2014b).
While the goal of radiation is to target cancer cells and avoid exposing healthy cells to radiation, side effects still can occur; both locally to tissues at the radiation site and systemically, such as fatigue and loss of appetite. Again, advanced testing can be done to determine the best strategies for supplementation along with treatment(s). Some supplement options during radiation may include retinoic acid (a derivative of vitamin A) and flavonoids. Both help radiation therapy by enhancing cell death and inhibiting the repair of radiation damage. Some nutrients that offset the side effects of radiation include vitamin A, L-glutamine, honey, and melatonin. Astragalus helps support the immune system. Calendula officinalis cream and vitamin E cream both help to soothe the skin side effects and assist with healing (Alschuler & Gazella, 2010).
Read the Au Naturale Nutrition series on Cancer:
If you want a fantastic resource with information to help you (and your doctor) understand your choices if dealing with the disease, this is the book for you:
The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing By Lise N. Alschuler and Karolyn A. Gazella.
The book gives an integrative, holistic, whole-body approach to the disease and to strategies to prevent cancer and its recurrence. In addition, it discusses incorporating the conventional cancer treatments with more alternative options. It's also a great resource for supplements.
Alschuler, L., & Gazella, K. A. (2010). The definitive guide to cancer: an integrative approach to prevention, treatment, and healing (3rd ed.). New York: Celestial Arts.
Wood, E. ND (2014a). Do this, Don't do that... or, Wait a Sec... Making Sense of Conflicting Recommendations When it Comes to Cancer Treatment, Supplement Use, Lifestyle, and Diet, Part I. CAN 101. Lecture conducted from Hawthorn University, California.
Wood, E. ND (2014b). Do this, Don't do that... or, Wait a Sec... Making Sense of Conflicting Recommendations When it Comes to Cancer Treatment, Supplement Use, Lifestyle, and Diet, Part II. CAN 101. Lecture conducted from Hawthorn University, California.
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