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(c) 2014 Northwest Natural Health A
Specialty Care Clinic
Dan Labriola ND
Kathleen Pratt ND
Lisa Price ND
Carrie Dennett MPH RD
Complementary and Alternative
Medicine for Cancer Survivors
Moving Beyond Cancer to Wellness
Fred Hutchinson Cancer Research Center
Northwest Natural Health®
A Specialty Care Clinic
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 2
Objectives
• What is new with natural medicine and cancer
• What works
• What doesn’t work
• How natural medicine can affect your conventional cancer treatment
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 3
Objectives
Combine the best of conventional and
natural medicine strategies for the
very best cancer outcome
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 4
Most Common CAM Therapies in
the US
• Acupuncture*
• Ayurveda*
• Biofeedback*
• Chelation therapy*
• Chiropractic or osteopathic manipulation*
• Deep breathing exercises
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 5
Most Common CAM Therapies in
the US
• Diet-based therapies
– Atkins diet
– Macrobiotic diet
– Ornish diet
– Pritikin diet
– South Beach diet
– Vegetarian diet
– Zone diet
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 6
Most Common CAM Therapies in
the US
• Energy healing therapy/Reiki*
• Guided imagery
• Homeopathic treatment
• Hypnosis*
• Massage*
• Meditation
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 7
Most Common CAM Therapies in
the US
• Movement therapies – Alexander technique
– Feldenkreis
– Pilates
– Trager psychophysical integration
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 8
Most Common CAM Therapies in
the US
• Natural products (nonvitamin and
nonmineral, such as herbs and other
products from plants, enzymes, etc.)
• Naturopathic Medicine*
• Progressive relaxation
• Qi gong
• Tai chi
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 9
Most Common CAM Therapies in
the US
• Traditional healers* – Botanica
– Curandero
– Espiritista
– Hierbero or Yerbera
– Native American healer/Medicine man
– Shaman
– Sobador
• Yoga
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 10
CAM Use by US Adults and
Children - NIH
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 11
CAM Use by Age
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 12
CAM Use by Children increases with
a Specific Diagnosis
• Epilepsy 62%
• Cancer 59%
• Cerebral Palsy 56%
• Asthma 51%
• Sickle Cell Disease 47%
• Ped Neurology overall 44%
• General Pediatrics 36%
Sources:
University of Minnesota General and Specialty Medical Clinics
U Michigan Medical Center
U Alberta Canada
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 13
Adult CAM use by Race/Ethnicity
2007
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 14
Acupuncture
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 15
Massage
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 16
Botanical Medicine
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 17
Botanical Medicine
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 18
Reiki practitioner with a patient.
Reiki is an energy medicine
practice that originated in Japan
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 19
A community group practices Tai
Chi, a mind-body practice that
originated in China as a martial art.
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 20
Participants in a yoga class
Lotus Pose
Lunge Pose
Yoga Tree Pose
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 21
Where Patients Get their Information
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 22
What’s Really Important?
• Stay strong and healthy
• Avoid interactions with treatment
– Respect the “Protected Zone”
• Prevention for the future
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 23
A Plan that works
• Maintain quality of life before, during and after treatment in every way
– Overall Health
– Cancer specific issues
• Take back control of your life. Do most or all that you could do prior to being diagnosed
• Control adverse effects from treatment
• Manage Co-morbidities
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 24
A Plan that works
• Exercise
– Cardio
– Weight training
• Spirituality
• Mind-body connection
• Social support
• Visualization and imagery
• Technology at the right time
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 25
Exercise
• Exercise improves
– Quality of life
– Cancer Related Fatigue
– Muscle Mass
– Mood
– Immunity
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 26
Cancer, Spirituality and the
Mind-Body Connection
• Self-forgiveness improves QOL
• Visualization and Imagery improve QOL
• PsychoOncology strategies improve
Quality of Life
• Outcomes!?
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 27
More great Strategies
• Social support = 21.8% improvement in
quality of life
• New exercises reduce lymphedema
• Hyperbaric oxygen improves healing
without affecting safety (Pilot study)
• Weight training improves quality of life
• IVF does not increase risk
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 28
Survivorship Strategies
Avoid Possible interactions
with cancer treatment
• Chemotherapy
• Radiation
• Surgery
• Targeted Therapies
Evidence Overview:
Antioxidants during treatment
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 29
Placebo
Antioxidants
Cancer-free Survival Ref: Bairati et al “A Randomized trial of
Antioxidant Vitamins to Prevent Second
Primary Cancers in Head and Neck Cancer
Patients” Int J Cancer 2006 Nov 1:119(9):2221-4
Years
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 30
Prevention is always
important
• Avoid cancer
– Primary Prevention
– Secondary Prevention
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 31
Primary Prevention
Reduce Risk
• Reduce alcohol consumption
• Exercise
• Weight gain since age 18 and 30
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 32
Primary Prevention
Reduce Risk
• Control blood sugar – Insulin resistance, diabetes and cancer
association
• Address metabolic syndrome
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 33
Primary Prevention
Reduce Risk
• Reduce workplace exposures to agents
associated with increased cancer
incidence
– Organic solvents
– Sterilizing agents (ethylene oxide)
– Some pesticides
– Circadian Dysrhythmia
– Tobacco smoke
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 34
Primary Prevention
Diet and Nutrition
• Vitamin B12
• Folate
• Vitamin D
• Fiber
• Fruits and vegetables
• Fish
• Some antioxidants
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 35
More Nutritional Treatments
• Vitamin E
• Selenium
• Calcium, vitamin D, phosphorus
• Zinc
• Beta carotene
• Antioxidants in general
• Consider IV delivery
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 36
Primary Prevention
Mediterranean Diet and Olive Oil
Reduce Cancer Risk
• Reduced risk for cancer, heart disease
• Early studies
– Suppress overexpression of Her2NEU in test tubes
– Support the activity of Herceptin
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 37
After Diagnosis and Treatment
• More Secondary Prevention
– Hormones
– Diet and nutrition?
– Botanicals?
– Lifestyle
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(c) 2014 Northwest Natural Health A
Specialty Care Clinic
Frequent Questions
Combining Complementary and
Alternative Medicine with
Conventional Therapy
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 39
Phytoestrogens
Including
Soy Isoflavones
? Safe Replacement for Hormone Therapy?
Answer: Probably the same risk as HRT
Ask for Patient Briefing Paper
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 40
Menopause and Hot Flashes
• Estrogen replacement ??
• Effexor etc.
• Phytoestrogens ??
• Diet
• Sleep
• Exercise
• Weight Control
• Avoiding alcohol and sugar
• Nutrition and non-estrogen herbs
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 41
Strategies that work
• Maintain quality of life before, during and
after treatment
– Cancer and treatment specific issues that can be
helped even if they existed prior to treatment
• Fatigue
• Hot flashes and other menopausal symptoms
• Gas (belching, flatulence)
• Bloating
• Stomach upset
• Constipation
• Diarrhea and bowel urgency
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 42
Strategies that work
(Continued)
• Maintain quality of life before, during and
after treatment
– Cancer and treatment specific issues that can be
helped
• Urination urgency
• Joint and muscle aches (including fibromyalgia)
• Headaches
• Sleep quality
• Pain
• Weight gain or loss
• Headaches
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 43
Strategies that work
(Continued)
• Maintain quality of life before, during and
after treatment
– Cancer and treatment specific issues that can be
helped:
• Treatment side effects
• Neuropathy
• Muscle cramps
• Restless leg syndrome
• Skin rashes
• Blood sugar metabolism
(c) 2014 Northwest Natural Health A
Specialty Care Clinic 44
Questions?
Comments?
Dan Labriola ND
Kathleen Pratt ND
Lisa Price ND
Carrie Dennett RD, MPH
Northwest Natural Health, A Specialty Care Clinic
7 convenient locations
206-784-9111
nwnaturalhealth.com
