Naturopathic Oncology-- An Integrative Approach
By Tina Kaczor, ND, FABNO
Contrary to popular belief, some natural medicines are safe to use with conventional therapies. However, I recommend proceeding with caution as there can be supplements that have unknown interactions with conventional medicine. Knowledge of the mechanism of action of natural agents as well as conventional treatments can help determine if they are likely to interact. For example, you may have heard that antioxidants should not be taken while receiving chemotherapy. The blanket statement, "absolutely no antioxidants" may be over-simplistic, as many agents that are antioxidant also have other cellular actions.
Ultimately, the balance between cell survival pathways and cell death pathways determines whether a cell will live or die. Chemo and radiation effectively injure a cell to such a degree that the cell "decides" to kill itself. (This too is an oversimplification, but for purposes of understanding the goal of integrating natural agents with chemo/radiation, it is helpful.)
The goal is always to tip the balance toward cellular death of the cancer cells and away from survival pathways. This is an area of ongoing research and each natural agent must be studied as an independent entity against each class of chemotherapy to gauge whether it is encouraging survival or death of cells.
Further complicating this is that "cancer" is an umbrella term encompassing thousands of differing molecular processes of growth and spread of cells. From a cellular level, cancers arising from the same organ/ tissue have hundreds of variations. So, any blanket statements- about natural or conventional treatments- begin to break down when the complexity of what we call "cancer' is unraveled. This is the true complexity behind the question of antioxidants with chemotherapies. Unless there is proof an anti-oxidant is safe (and yes, some have been proven safe with specific chemotherapies), it is presumed to interfere. That seems reasonable.
So what is safe? What may help? To be honest, the research is coming out so fast the data is a moving target. I spend many hours each week reading medical literature and reviewing what is best to use with my patients. Given the complexity of possible interactions, and the amount of information that must be looked at objectively, it is prudent to pursue natural medicine with someone who is versed in both conventional and natural medicines. (If you are not in my geographical area, check to see if there is naturopathic physician in your area who can help you at www.oncanp.org. If no one is near you to see you in person, I will be happy to help as much as I can from a distance with a phone consultation.)
Why use natural medicines if I'm receiving conventional treatment?
It has been my experience that patients receiving natural therapies fare better throughout their conventional treatment. The goals of naturopathic support are:
· Maintain muscle mass and maintain hydration.
· Boost the effectiveness of chemotherapy, radiation or other treatment.
· Decrease side effects of conventional treatment.
· Address organ damage induced by conventional treatments (i.e., liver, kidney, nerve, etc.)
· Address nutritional deficiencies known to be induced by the conventional treatment.
· Address any concurrent health conditions and medications being taken.
In the case of chemotherapy, it may be dosed every day, once weekly, once every three weeks, etc. There are many cycling regimes, but most have some time off between treatments in which to recover from the toxicity. During the interim between treatments, you can bolster your immune system, aid in repair of damaged tissue (including your liver and gastrointestinal tract), and clear the chemotherapy from your system so you can tolerate your next treatment better. Most chemotherapeutic agents have no therapeutic effect two days after the infusion (there are some that last much longer). Some of the "toxic feeling" from chemo is from the process of clearing out the cellular debris from die off of cells in the body. As cells die, cancer or normal, their contents are spilled and must be cleared (eliminated through feces, urine) or recycled for repair of tissue. These processes of elimination and repair can be helped with natural agents. Every person and every treatment is different, but generally everyone tolerates the treatment better when they undergo a "rejuvenation program" between treatment. The idea is to keep you as healthy as possible to keep you feeling good day to day, and to keep you on schedule and at the dose intended for the chemotherapy.
There are many schools of thought about the timing of natural medicines in conjunction with conventional treatment. In general, if there is any concern about taking any natural agent alongside chemotherapy, I recommend taking a supplement vacation on the days of chemotherapy infusion. Since regimes differ greatly, and some chemotherapies are given daily, this is not always a feasible option. Again, working with someone knowledgeable in the mechanisms of both the natural and conventional medicines, you can tailor a plan that works to ensure you do not interfere with the effectiveness of the chemo/radiation, but do everything you can to make sure you stay as healthy as possible throughout.
This is a question whose answer encompasses the science and art of medicine. The science is knowing the way in which the herbs or nutrients interact with the cells of the body (cellular mechanisms). The art is in observation by the practitioner-what has worked in the past, what type of patient is best suited to a given medicine-as well as in knowing the patient well enough to predict what may happen.
There is a large and growing pool of research regarding nutrients, herbs and other natural agents in conjunction with conventional treatments. Some of this research is done by the very companies that make a given product. Such studies must be reviewed with skepticism, but not thrown out completely. When a given medicine, natural or pharmaceutical, needs to be proven effective through clinical trials, it is the maker of such medicines that initiate the trials. While this may seem to be a conflict of interest, it is the current system in place for all medications. Public funding and grants are used to gather further data, but funds for such studies on natural medicines is currently limited. Therefore, a healthy dose of skepticism should be the norm when reading any studies of new medications, be they natural or pharmaceutical. (Also, most natural medicines are not patented, therefore no party has a financial gain in proving its worth to society. With no financial incentive, many natural treatments go unproven.)