Cancer patients may try alternative remedies
Help your patients by being fully informed
Cancer is perhaps one of the most frightening and disempowering diseases known to humankind. A diagnosis of cancer seems like a death sentence to most patients, no matter how much time health care professionals spend talking about options and about hope.
Patients frequently feel helpless and angry until they enter the stage of fighting back, usually characterized by a regimen of voracious reading to learn more about their disease. And it isn’t long after that the patient discovers the jungle of information about alternative therapies for cancer.
What your patient does with that information, however, is a product of the trust you’ve built. Whether he discusses alternative therapies with you or whether he goes off on his own and tries several approaches about which you may never know, studies show up to 60% of all cancer patients will avail themselves of at least one form of alternative therapy during the course of their disease.1
Making your patient a partner
And, experts say, your patients can become partners in the care by helping with the research necessary to make an informed decision about the potential usefulness of specific alternative therapies.
"A number of alternative agents seem to be extremely helpful," says James Gordon, MD, founder and director of the Center for Mind-Body Medicine in Washington, DC. "The consideration of a wide range of alternative therapies should be part of a comprehensive cancer care program for everyone."
Alternative therapies can have many effects among them. They can unleash the possibilities for self-healing in patients with cancer, says Gordon, who also serves as chairman of the White House Commission on Complementary and Alternative Medicine Policy and is a clinical professor of psychiatry and family medicine at Georgetown University in Washington, DC.
"[Those therapies] nourish the body’s reparative processes, increase its ability to destroy cancer cells, and decrease the tumor burdens. They enhance the quality of life and help people with cancer see their illness as more of a challenge and less of a misfortune," he says. Gordon is author of the recently released Comprehensive Cancer Care: Integrating Alternative, Complementary and Conventional Thera-pies, compiled from information presented at the annual conference of the same name as the book.
Gordon recommends an integrated approach to cancer care that is tailored to each patient’s needs.
"Doctors and members of the health care team should be proactive in helping people put together their care program, particularly in helping patients cope with the psychological impact of a diagnosis of cancer," he says.
It is inherent on the physician and his team to be up to date and well-informed about complementary therapies, ranging from herbs and natural supplements to chemical compounds to traditional Chinese medicine, meditation, yoga, tai chi, acupuncture, and more.
"Patients are becoming very disturbed by oncologists who make pronouncements about what works or not based on no knowledge at all," says Gordon.
He recommends the following therapies for cancer patients, based on his own research:
• Green tea with its polyphenols act as a powerful antioxidant, "as close to a perfect phytonutrient as we’ve seen. It should be part of a cancer treatment plan."
• Shark cartilage inhibits the signals for capillary growth to the tumor. "Large doses appear to be effective for some cancer patients in controlling cancer growth and even causing regression of tumors."
• Maitake mushroom extract has the "ability to kill tumors by activating the immune system," particularly for breast, lung, liver, prostate, and brain cancers, especially in conjunction with chemotherapy.
• Coenzyme Q10 can reduce chemotherapy-induced heart damage and has an antioxidant agent that may affect tumor growth. "For anyone with breast cancer, CoQ10 is essential," says Gordon.
Clearly, some alternative therapies have better evidence behind them than others, so that simply gives health care professionals a stronger incentive to communicate effectively and clearly with their patients about their use, says Jeffrey White, MD. White is the director of the National Cancer Institute’s Office of Complementary and Alternative Medicine in Bethesda, MD.
"Work with your patients," says White. "Don’t create a situation in which patients are afraid to tell their doctors what they are taking. Have an open dialogue with them about their expectations and help them realistically understand what’s going on and what their options are."
He says some therapies are helpful and effective; his particular favorites are garlic and saw palmetto for prostate cancer patients and grapeseed extract and milk thistle for a wide range of other cancers. White also is willing to concede that the placebo effect may be responsible for some of the results that have been published for these and other remedies. "It doesn’t matter. We don’t want to offhandedly dismiss these sorts of things."
The National Institutes of Health’s National Center for Complementary and Alternative Medicine (NCCAM), also in Bethesda, MD, is working to "get a handle on the complicated questions associated with alternative cancer therapies," says Mary Ann Richardson, DrPH, program officer for NCCAM.
Richardson encourages physicians and clinicians to "open the dialogue," to share information and case studies of these ancient remedies that are being rediscovered in the context of modern medicine."
"We need to collect reliable information and then undertake a systematic review of the evidence," she says. "It’s a new day; the world of medicine is just waking up to the possibilities of complementary medicine."
Reference
1. Oneschuk D, Fennell L, Hanson J. The use of complementary medications by cancer patients attending an outpatient pain and symptom clinic. J Palliat Care 1998; 14:21-26.
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