From nutritional therapy to off-label drugs, holistic approaches help patients heal
In this age of one-size-fits-all medicine, doctors who practice integrative therapies tailor their treatments to their patients. When it comes to cancer, integrative approaches can encompass everything from nutrition to vitamin infusions to different ways of delivering treatments.
“Since the early ’80s, I have believed in my patients having a foundation in good nutrition to heal serious diseases such as cancer,” says Keith Block, MD, medical and scientific director of the Block Center for Integrative Cancer Treatment and Wellness in Skokie.
Integrative cancer care goes where traditional doctors don’t, says Block, who has been called “the father of integrative oncology.”
The Block Center provides mainstream oncology treatment as well as individualized nutritional therapy, biobehavioral techniques (which include mind-body approaches) and tailored supplement regimens to diminish toxicity and to potentially enhance the effectiveness of treatments.
Some large academic medical centers, like Rush University Medical Center, provide integrative therapies to reduce the mental and physical stress that accompany chemotherapy and radiation. Individual and group therapy, acupuncture, massage therapy and nutritional counseling can help manage the pain, anxiety and some of the side effects of cancer treatment.
Often, the first stop is nutrition—revising a patient’s diet and adding protective vitamins, herbs, botanicals and supplements. A diet that is low in saturated fat and avoids most animal products, with the exception of cold water fish, is the healthiest diet for cancer patients, Block says.
Block recommends eating whole foods—fresh vegetables, complex carbohydrates and foods high in omega-3 fatty acids. Those foods include brown rice, oats, quinoa, other whole grains, legumes, tempeh, tofu, seeds, nuts, fruits and many fish options, including salmon, halibut, cod and sea bass.
Specific supplements, he says, can counteract the toxic effects of chemotherapy drugs, protecting against neuropathy or countering fatigue. Selenium, magnesium and potassium can protect the kidneys, he says. And the Chinese herb astragalus has been shown to boost the immune system.
Infusions are often used as well. Vitamin C infusions help restore the soft tissues that are harmed by chemotherapy and radiation treatments, Block says. Detoxification can help reduce the buildup of toxic metabolites that can increase treatment resistance, he adds.
Amberlea Childs, who was a patient at the Block Center in 2010, recovered from stage 3 breast cancer. She chose to undergo treatment at the Block Center because of its emphasis on nutrition. “The Block Center married two philosophies of healing for me: Eastern and Western. Coming there every day was like going to a spa. I felt better every day,” she says.
A similar nutritional approach is supplied at Rush University Medical Center’s Cancer Integrative Medicine Program, where specialists understand that integrative treatment can improve outcomes for cancer patients. Dietitians work with patients to improve their strength during chemotherapy. They recommend a low-fat, plant-based diet that is high in fruits and vegetables as well as omega-3 fatty acids. Patients are told to avoid eating processed foods. If a test shows they are deficient in a vitamin like vitamin B or D, they can receive intravenous infusions to improve their vitality.
“Our dietitians educate our patients,” says Sarah Thilges, PhD, a clinical psychologist at Rush. “Chemotherapy can cause unwanted weight gain or loss as well as nausea. [We help them] find the type of food that makes them feel as well as possible.”
Approaches to medications
At Rush, a team of doctors comes together from many specialties to create integrative treatments for each patient. The hematologist or oncologist might recommend supplements that won’t increase an immune response. Instead of having a bone marrow transplant for blood cancers, patients often receive stem cell transplants. And if radiation is needed, only the tumor cells are targeted, leaving the other healthy cells alone.
“We use evidence-based treatments,” Thilges says. “Our doctors are willing to research the randomized clinical trials to find the most effective treatments for their patients.” This includes traditional approaches as well as referring patients to Eastern approaches like traditional Chinese medicine.
Block and his staff have designed off-label cocktails that help patients fight cancer. “It can take many years and billions of dollars for the FDA to approve a drug,” Block says. “So we often include the use of off-label drugs for their effectiveness against cancer.” For instance, metformin is approved as a diabetes drug, but in an off-label use it may affect cancer cell growth and proliferation.
Using an understanding of circadian rhythms, the staff coordinates infusion of drugs with the optimal time that will minimize toxicity and maximize effectiveness. “Since some patients suffer from sleep disruption, rest can improve drug activity while aiding recovery. Harmonizing rest as well as the timing of treatment can improve the patient’s healing and wellbeing,” Block says.
Help for the spirit
The patient’s psychological needs are important, Thilges says. “Often our patients come to us suffering from depression and anxiety. We help our patients realize that the diagnosis isn’t their identity.”
Integrative medicine is based on an understanding that the body’s systems are interconnected, says Penny Block, PhD, co-founder and executive director of the Block Center. Sleep, health and psychological wellbeing are critical components of each patient’s recovery.
Stress and distress have unwanted consequences, she says. Studies have shown that if too much adrenaline is coursing through the body, then cancer cells can become more resistant to chemotherapy and apoptosis (programmed cell death), allowing the tumor to grow.
“These factors can make the existing cancer into a more aggressive disease, so we explain that and provide each person with approaches that can effectively counteract such problems,” she says.
Approaches to produce the relaxation response, practiced daily, can halt the rampage of adrenaline, Penny Block says. “Achieving a state of deep ease changes the biological and emotional consequences of stressors. Making the relaxation process a daily routine for 20 minutes is a health essential,” she says.
“I bang this drum loudly—every medical clinic should strongly advise their patients to incorporate the relaxation response into their full integrative program as a fundamental way to enhance health.”
Integrative therapies like massage and acupuncture support patients as they are going through traditional cancer treatment, says Angela Johnson, MSTOM, a practitioner of Chinese medicine at Rush. Many patients come to Johnson for help addressing treatment side effects such as hot flashes, nausea and pain. The acupuncture treatments she gives them help relieve the severity of their symptoms.
Oncology massage can help patients recover from rigorous treatments. The massage therapist uses soothing Swedish relaxation massage techniques that help release relaxation endorphins.
“There are so many studies that show the positive results of integrative medicine for the patient,” Johnson says. “My patients will often tell me, ‘I feel like I have my life back.’”
“The impact that integrative medicine provides is truly amazing,” she adds. “There are so many research studies that show the positive effects of integrative treatments when they’re combined with mainstream medicine. The outcomes for patients are superior.”
Originally published in the Spring 2017 print edition