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Cambridge Location

2500 Massachusetts Avenue
Cambridge, MA 02140

ph 617.661.6225
fax 617.492.2002

Wellesley Location

372 Washington Street
Wellesley, MA 02481

ph 781.235.5200
fax 781.235.1103

An Integrated Approach to Treatment and Healing of Cancer

by Deb Brothers-Klezmer, BSN, RN-BC, CRRN, NCTMB and Wendy Midgley, MEd, RD, LDN, CDE

“Know then, whatever cheerful and serene supports the mind…..supports the body, too.”  John Armstrong

In the most recent Annual Report to the Nation on the Status of Cancer, (compiled by leading cancer organizations, updated 3/28/12), findings indicate: overall new diagnoses for cancer—for both men and women-- have decreased an average of less than 1% per year from 1998-2006.   Rates of death for men, women and children have continued to slowly decline (2004-2008 studies). 

Although these statistics are headed in the right direction, there is a need for much better numbers!  

A diagnosis of cancer can trigger a strong reaction of fear, anxiety and worry in the individual affected---as well as within family members and friends.   What is important to know is:  there are proactive steps a person can take towards his/her own health and healing, as well as steps one can take in being a strong support person for someone with the diagnosis.

Many cancers can be caught early or managed well —utilizing the variety of early detection, diagnostic and treatment methodologies available.  When you combine these conventional approaches with complementary therapies such as acupuncture, massage and stress reduction in an integrative approach, you can become empowered to manage your disease.   

What are the best Treatment Methods? 
There are many types and levels of cancers.  Each person has his or her own unique health blueprint and complexity of factors to consider.  And so, there is “no one-treatment-fits-all” answer to this question.   Treatment programs need to be individualized.

Traditional state-of-the-art cancer treatment centers, like Dana Farber, Mayo Clinic, and Sloan Kettering, offer excellent diagnostic and treatment options as well as emotional, mental and spiritual support. (see Society for Integrative Oncology Practices under REFERENCES). Major mainstream treatment centers, including those associated with well-known teaching hospitals, offer a wide variety of integrative services.  In Boston, The Leonard P. Zakim Center for Integrated Therapies is part of the internationally known Dana Farber Cancer Institute, associated with the Brigham and Women’s Hospital and Harvard Medical School.

At the Marino Center, we support an integrative approach to the treatment of cancer. Conventional medical and surgical treatment options—together with complementary modalities—can enhance and speed up the healing process.

Some examples of complementary care treatments include: nutrition; relaxation, mindfulness and meditation practices; visualization; spiritual and religious practices; exercise; music therapy; laughter and humor; body work therapies such as:  physical therapy, acupuncture, chiropractic, massage, and lymphatic drainage--to name a few; energy healing such as Reiki;  yoga and Tai Chi;  and emotional support therapies. For this article we will focus on: nutrition therapy, mindfulness, chiropractic, manual lymphatic drainage. acupuncture, massage, exercise and physical activity, Reiki (energy healing); emotional support; and laughter/humor and creativity.

Nutrition Therapy  
It is important to eat a wide variety of healthy, whole foods on a daily basis.  A good, “clean diet” can nourish and rebuild cells, enhance the immune system and the healing process, and provide more overall energy.  The typical American diet--containing a high percentage of acid-forming foods--- operates against healing.  High acid-forming foods include:  sugar/syrups, refined grains, chemicals and preservatives in foods, and an excess of acid-producing items like coffee and alcohol.

It is important to eat more alkaline-forming foods such as a diet rich in green vegetables. Also include: some fruits, healthy fats from nuts, seeds, avocado, olive oil; high fiber beans and legumes, and high omega-3 fatty acid fish such as wild salmon.  Grains should be whole grains (high in fiber), not refined.  Vegetables and fruits offer a variety of vitamins and healthy phytochemicals, as well as fiber. Animal proteins should be steroid-free.  It is advised that-- if buying beef—buy grass fed.  For eggs, buy those from free-range chickens, raised in healthful conditions. Home cooked foods can be more appealing, as well as more healthful: for example: soups, stews and home-made shakes.  (See Cookbooks under REFERENCES).

Adequate fluid is important for overall workings in the body and to “flush” the system from toxic breakdown products.  Gastro-intestinal health is a key ingredient for good nutrition and healing.   A healthy gut will ensure more optimum absorption of key nutrients and increased release of toxic waste materials.   Probiotics can be helpful for intestinal balance.   Digestive enzymes and healing shakes may be helpful for others.  If there are food intolerances, allergies, or sensitivities—these should be addressed.

Supplements
There is controversy regarding the proper amounts and types of nutrient supplements during cancer treatments.  The best advice comes from experts in this field including your oncologist and nutritionist with a specialty in cancer treatments.
Detox programs/Cleanses:  There are a number of positive testimonies regarding natural healing -- through detoxification programs and cleanses.   One should not attempt such programs alone; and it is advised that such programs be discussed with your integrative health care provider.

MIindfullness Practice
Mindfulness, and other meditative practices, can be of great support during cancer treatment/recovery----and in one’s life in general.  According to Jon Kabat-Zinn, meditation/stress reduction guru, mindfulness can be defined as  “Awareness, cultivated by paying attention in a sustained way, on purpose, in the present moment, and non-judgmentally.”  Kabat-Zinn teaches that practice in mindfulness can bring ‘profound healing and transformation into one’s life’.  Susan Bauer-Wu, PhD, RN states that mindfulness meditation practices “have been shown to positively affect the quality of life and biological outcomes in many populations including cancer patients and in healthcare professionals”.  http://www.cancernetwork.com/nurses/content/article/10165/1698208  “Mindfulness Meditation”, S.Bauer-Wu, Integrative Oncology 10-19-2010

Being in treatment for cancer can be an emotional, high anxiety, high stress time.  A practice of mindfulness  and present moment living can ease stress and result in decreased levels of the stress hormone cortisol---thus strengthening one’s immune system, and enhancing the healing process. Practicing mindfulness can also result in a greater level of expanded awareness, thus adding more meaning and hope in one’s life.  NOTE: The positive aspects of mindfulness practice are true for care providers and support people-- as well as for patients.

Suggestions for Staying Mindful

•Pay attention to your breathing, in and out
•Let thoughts just pass through the mind---without judging or grabbing onto them
•BE PRESENT in each moment: whether sitting, standing, walking, eating, or taking a shower
•Let each unfolding moment be OK (even if not your favorite moment).
•Be KIND to yourself.  Be SOFT with yourself

Chiropractic
Chiropractic treatment can relieve pain and stiffness in your bones, muscles, joints, tendons, and ligaments caused or intensified by surgery, chemotherapy, or radiation therapy.  Chiropractic treatment can help alleviate a variety of symptoms including: back pain, neck pain, headaches, sciatic nerve pain, painful walking, postural changes, and nausea. Chiropractic care in collaboration with conventional cancer care can reduce stress, increase mobility, flexibility, strength, and function, as well as help promote quality of life and overall well-being.  While Chiropractic can be beneficial to patients undergoing treatment, there are some precautions necessary to ensure safe delivery of care.  A chiropractor should review recent x-rays, bone and CAT scans to ensure there is no metastasis, or cord compression.  Also, platelet counts need to be monitored.  Some cancer treatments can lower your platelet count which puts you at higher risk for bleeding.

Manual Lymphatic Drainage (used to treat Lymphedema)
Lymphedema is an accumulation of lymphatic fluids that produce abnormal swelling in the body.  This condition can appear in some people who are undergoing, or have been through, cancer treatment.  When lymphatic drainage is blocked, protein-rich fluids gradually build up and stagnate in the soft tissues where bacterial growth can develop, possibly leading to infection.  To help prevent or control lymphedema, carefully observe changes in your body, learn how to plan in personal hygiene, and develop an exercise program. Lymphedema can occur as late as 15 years after surgery. Manual lymphatic drainage can also help. In addition, ask your clinician, if the at-home pump would be beneficial to you. For further information contact: National Lymphedema network @ 800-541-3259 or go to http://lymphnet.org or Information services of the National Cancer Institute:  800-4-CANCER Y-ME hotline: 800-221-2141, or go to www.y-me.org.

Acupuncture
Acupuncture is very effective for managing pain related to surgery, tumors, chemotherapy, radiation and inflammation. Cancer can be a very painful disease, and the treatments can sometimes cause pain, inflammation, and swelling. Other symptoms may include constipation, nausea, difficult urinating and respiratory depression.  Acupuncture can help with symptom reduction. Many cancers and cancer treatments cause a suppression of the bone marrow, the source of blood cells that are the army for the immune system.  Acupuncture increases blood cell production and enhances Natural killer Cells and Lymphocytes--which leads to increased immune response and decreased risk of infection. By managing the side effects of surgery, chemotherapy, radiation, reducing pain and inflammation, improving sleep, supporting normal digestive function and minimizing stress—the quality of life of cancer patients is improved with acupuncture treatments.  Eugene Mak, MD a board certified oncologist states that acupuncture “can also add to the patients’ sense of well being and decrease the malaise associated with any chronic disease, especially cancer…and imparts a sense of well being and accelerates patients’ recovery.”

Massage Therapy
Massage therapy is a touch therapy where techniques such as kneading, rubbing, stroking, and tapping are performed on the soft tissues of the body. Controlled research has shown that massage in cancer patients reduces anxiety, eases pain, helps control nausea, helps decrease medical costs of managing nausea and vomiting, improves sleep, and eases fatigue.  Massage is contraindicated with burns, open wounds, fever, and cancer that has spread to the bone or spine.  Massage is not only recommended for cancer patients, but also for their loved ones and caretakers.

Reiki
Reiki uses specific techniques to balance the natural life force energy in the body. It reduces stress to increase relaxation and avoid energy depletion. Reiki has been proven to raise the comfort and well-being of patients, post-chemotherapy treatments.  It is a method of healing developed in Japan in 1922.  Through this technique, practitioners channel healing energy through their hands.  It is not a religious practice.  One of the best Reiki options is to find a practitioner or training that teaches you how to do this on yourself or a loved one.  Reiki or any other healing energy modality should always be used in collaboration with conventional treatments.

Exercise
According to the National Comprehensive Cancer Network, one of the recommended nonpharmacological approaches to cancer-related fatigue and muscle weakness is increased physical activity.  There have been several random controlled trials on the topic. Overall, a combination of stretching, resistance, circuit weight training for all major muscles of upper and lower extremities,  aerobics and walking have aided cancer patients with fatigue, aerobic capacity, muscle strength, anxiety, depression, self-esteem, and quality of life.  Cancer and cancer treatment can be exhausting, and it doesn’t go away with sleep.  To begin your exercise regimen, see a physical therapist, personal trainer in a reputable fitness center, or check with your cancer treatment center for exercise groups or trials that you may attend. If none of these work for you, commit yourself to walk as often as possible.  (Reference: Cancer Epidemiol Biomarkers Prev 2007 16 (12) December 2007)

Emotional Support 
Emotional support is an important aspect of healing.  Emotional support comes in many forms, starting with trusted family and friends.  Although friends and family may offer the closest support, it is also important to seek additional sources----as primary support people also need time to restore their energies.  Options include: individual psychotherapy, a personal spiritual guide, coaching, and various support groups. There are numerous blogs to read, Chat Rooms to join, and online communities such as What Next, Circle of Sharing and Cancer Survivors Network.  Books and inspirational tapes can also offer great emotional support.  

Causes and fund-raising events can be inspirational: e.g. being involved in (or supportive of) a 5 mile run to raise money for breast cancer research. Many programs are offered at the cancer treatment centers themselves (for example, The Leonard P. Zakim Center for Integrated Therapies at Dana Farber) or for example: through cancer support groups and stress reduction programs at UMASS Memorial Medical Center in Worcester (cancer support:  http://www.umassmemorial.org/our-care/cancer-center-of-excellence/cancer-support-groups/cancer-support-groups;  stress reduction at the UMASS Medical Stress Reduction Program:  http://www.umassmed.edu/cfm/stress/index.aspx.  For more information re:  What Next, Circle of Sharing, Cancer Survivors Network and other Support groups and Services in your area, go to: http://www.cancer.org/Treatment/SupportProgramsServices/index

Laughter/Humor and Creativity  
Laughter and humor are an important part of coping and healing.  An American Cancer Society article states that humor therapy offers five main benefits: 1. Relief from Tension and Stress (release of “feel good hormones”), 2.  An aerobic and internal work-out, 3. Stimulation to the immune system, 4.Expansion of one’s perspective—resulting in increased coping skills and 5. EMPOWERMENT and enhanced quality of life.   http://www.joyfulaging.com/HumorTherapy.htm   
One can boost “feel good hormones” by watching favorite funny movies or TV comedy reruns, or by hanging out with funny, uplifting friends.   Also, check out writers and speakers like Loretta LaRoche who have made a career out of humor therapy!  See her website at: http://www.LorettaLaRoche.com   for books, DVDs, CDs.  NOTE: find humor and laughter in everyday events, even amidst the serious moments—whenever possible.   

Creativity 
It can be soothing and healing to engage one’s creative side with activities such as music or art, creative writing, or in the design of a special garden.  When we use ‘the right side of the brain’—we take our thoughts away from the usual “mind and worry tapes."  We can become lost (in a good way) in musical notes, the poetry of words, colors of paintings, or in the scents of nature.  Each person has a creative side---which offers many healing aspects in the journey to health and well-being.  Find the activities that call to you.  For Art Healing ideas, go to: http://www.curetoday.com   (SEARCH:  ART HEALING)

Choose those complementary modalities that call to YOU!    The following support therapies are available at the Marino Center:   Nutrition, Chiropractic, Physical Therapy, Massage, Lymphatic Drainage, Acupuncture, and Reiki energy healing (in Cambridge only).  

“What we do for ourselves dies with us.  What we do for others and the world remains, and is immortal.”     -by Albert Pine-

REFERENCES
BOOKS

  • Anti-Cancer:  A New Way of Life by David Servan-Schrieber, MD, PhD
  • Crazy Sexy Cancer Survivor:  More Rebellion and Fire for Your Healing Journey by Kris Carr
  • Crazy Sexy Diet:  Eat Your Veggies, Ignite Your Spark and Live Your Life Like You Mean It by Kris Carr
  • Eating Well, Staying Well: During and After Cancer (American Cancer Society book)
  • Foods that Fight Cancer by R. Beliveau, PhD and D. Gingras, PhD
  • Fresh Choices:  More Than 100 Easy Recipes for Pure Foods Choices When You Can’t Buy 100% Organic by D. Joachim and R. Davis
  • Full Catastrophe Living: Using the Wisdom of your Body to Face Stress, Pain and Illness a classic by Jon Kabat-Zinn.  (also by Kabat-Zinn: his NEW Book:   Mindfulness for Beginners: Reclaiming the Present Moment in Your Life and his other classic:  Wherever You Go, There You Are.
  • Happy Talk: Fun Ways to Talk to Yourself (133 pp) by Loretta Laroche
  • Healing Gourmet.  Eat to Fight Cancer by S. Liu, MD; K.McManus, RD, and J Carlino, CEC
  • Integrative Nutrition Therapies for Cancer by N.B. Kumar, PhD, RD
  • Mindfulness-Based Cancer Recovery by Linda Carlson
  • Mindful Eating by Jan Bays, MD
  • Nourishing Wisdom: A Mind-Body Approach to Nutrition and Well Being by Marc David. (inspirational)
  • One Bite at a Time: Nourishing Recipes for Cancer Survivors and Their Friends by Rebecca Katz
  • SuperFOODs Rx:  Foods That will Change Your Life by S. Pratt, MD
  • The Anti-Cancer Cookbook by Julia Greer
  • The Cancer Fighting Kitchen by Rebecca Kitchen (5 Star Amazon rating!)

WEBSITES