People facing a cancer diagnosis, particularly a late-stage cancer diagnosis, may feel that their locus of control over life has been removed. They are now patients, relying on their oncologist, surgeon, radiation therapist and nursing staff.
But, consider an integrative cancer approach in which patients feel more empowered by an assortment of options they can choose, such as changing their diet, exercise, incorporating methods for reducing stress, seeing an acupuncturist and engaging in mind-body practices. Proponents of an integrative approach say these complements to conventional treatment (chemotherapy, radiation, surgery) make treatment more effective while reducing side effects.
Many cancer patients, like Jasmine Guha-Castle, are turning to integrative cancer care to enhance quality of life, improve outcomes and possibly beat the odds.
Guha-Castle, 50, of Austin, Texas, wont slow down for a minute in her fight to beat breast cancer, again. She made healthy living and volunteering at animal shelters her lifes mission since she overcame breast cancer 13 years ago.
But she received the unfortunate news that her breast cancer had returned while heading to England two summers ago. This time, it was metastatic, meaning the kind that spreads. And it was triple negative, a more aggressive kind of cancer that will not respond to hormonal therapy medicines. So, she flew right back to Austin.
This place gives me hope, which the other places havent so far.
Early in her treatment, regardless of a chemotherapy day, Guha-Castle could be found swimming in Austins Barton Springs pool, attending a meditation class, visiting a nutritional oncologist or acupuncturist, making carb-free foods, dancing and most often, reading science-based information about triple-negative breast cancer (TNBC).
Where you wouldnt find Guha-Castle was hanging out with other patients just because they share her condition. That isnt my cup of tea, says the expat Brit, who finds it hard to connect with members of the cancer community if they are depressed and not optimistic like she is.
You have to be positive and proactive to change the environment of your cells, notes Guha-Castle.
There are more options if you have the right doctor, she says. Initially, she was only treated with chemotherapy and radiation by oncologists who use conventional treatment methods. She says traditional oncologists did not show an interest in hearing about her anti-cancer literature related to medicinal mushrooms, turmeric pills and other approaches that might improve outcomes and help her feel better. She also wanted more guidance, more personalized care and more hope.
Integrative oncology is not alternative medicine, which usually refers to treatments used instead of traditional ones. It also isnt it only complementary, which refers to the use of single-intervention add-ons to support mainstream treatment. So, what exactly is integrative oncology?
Here is a comprehensive definition from JNCI (Journal of the National Cancer Institute) Monographs: Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products and/or lifestyle modifications alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life and clinical outcomes across the cancer care continuum, and to empower people to prevent cancer and become active participants before, during and beyond cancer treatment.
After reading about cancer programs at different clinics, Guha-Castle decided to fly to the independent Block Center for Integrative Cancer Treatment in Skokie, Ill. She was reinvigorated by the clinic, with all of its physicians and specialists in the same building.
A growing number of leading U.S. cancer care centers claim to have integrative medicine programs.
Guha-Castle found it to be like no clinic she had seen, with a kitchen for nutrition classes, a yoga and exercise area and soothing lighting and music. Exercise equipment was only steps away from the chemotherapy areas.
This place gives me hope, which the other places havent so far, she says.
She was particularly motivated after reading the Block Centers preliminary study of stage IV breast cancer patients who were treated there. The treatment improved survival time for the patients, generally, compared to patients treated at conventional clinics.
Dr. Keith Block is the Block Centers medical and scientific director, and considered to be the father of integrative oncology. He developed a treatment program called Life Over Cancer, which uses a plant-based diet, exercise, nutritional supplements, nutritional infusions (administered intravenously) and mind-body therapies. He also uses innovative methods of chemotherapy and experimental and off-label medications.
No two patients are treated in the same way there. Treatment is based on individualized testing to determine a persons biochemical environment or internal biochemistry. This is the environment surrounding a persons cancer cells that can influence the growth and spread of cancers. It includes levels of inflammation, oxidation and the state of his or her immune system. Block uses blood tests for this assessment, which he calls this terrain testing or taking a blood terrain panel.
At the Block Center, all conventional cancer treatments, physician visits, blood draws and visits with counselors are covered by Medicare and most private insurance plans. Some extras, like dietitians, nutritional supplements and nutritional infusions are out-of-pocket.
Fortunately for Guha-Castle, she can afford to fly to the Block Center every two weeks for treatment. But many people dont have the means to do that, she acknowledges. She is still associated with an oncologist in Austin for blood transfusions and scans, but she says she would rather pay more to get the kind of care she wants at the Block Center.
A growing number of leading U.S. cancer care centers claim to have integrative medicine programs.
Dr. Lorenzo Cohen, professor and director of the Integrative Medicine Center at the University of Texas MD Anderson Cancer Center in Houston, says what distinguishes his clinic from the Block Center is being part of an academic medical system. He says blood testing and prescribing medications, particularly of herbs and supplements, becomes a little more challenging when you are in an academic medical center and must follow strict evidence-based guidelines, such as the National Comprehensive Cancer Network guidelines.
Treatments provided by integrated programs within large cancer centers are led by physicians, who also work with providers to guide patients in services like acupuncture, massage, music therapy, yoga, Tai chi and qi gong (methods of movement, breathing and meditation), physical therapy, nutrition and health psychology throughout treatment and whenever possible.
Like other treatment programs, they take commercial insurance and Medicare for standard procedures. The Centers for Medicare and Medicaid Services now covers acupuncture for Medicare patients with back pain. Cohen says this shows that insurers see that integrative approaches are not only cost effective, but a huge value gained in quality of life.
Dr. Dawn Mussallem specializes in breast care at Mayo Clinics Integrative Medicine and Health program in Jacksonville, Fla. She worked with Cohen on an expert integrative oncology panel that recently endorsed the Society for Integrated Oncology Breast Cancer Guidelines.
In the last couple of years, Mussallem developed and piloted a breast-specific integrative medical program within Mayos Jacoby Center for Breast Health that included acupuncture, massage therapy, cancer nutrition, mindfulness classes, yoga and superfood cooking classes.
Mussallem met with patients about whole-person well-being, discussing aspects like nutrition, exercise, purposeful living and avoidance of toxins like alcohol and tobacco. The programs results showed a favorable patient benefit on quality of life, and these integrative services are now offered to all cancer patients at Mayo Clinic in Jacksonville.
Given the high prevalence of patients using alternative modalities often driven by misinformation available to patients, there is a strong need to guide the use of appropriate integrative oncology care to achieve optimal outcomes for our patients, Mussallem says.
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