2015 Northwest Natural Health A Specialty Care Clinic

2015 Northwest Natural Health A Specialty Care Clinic

Complementary and Alternative
Medicine for Cancer Survivors
Moving Beyond Cancer to Wellness
Fred Hutchinson Cancer Research Center
Dan Labriola ND
Lisa Price ND
Tara Stacker ND
Carrie Dennett MPH RD
Northwest Natural Health®
A Specialty Care Clinic
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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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) 2015 Northwest Natural Health A
Specialty Care Clinic
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Objectives
Combine the best of conventional and
natural medicine strategies for the
very best cancer outcome
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Most Common CAM Therapies in
the US
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Acupuncture*
Ayurveda*
Biofeedback*
Chelation therapy*
Chiropractic or osteopathic
manipulation*
• Deep breathing exercises
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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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) 2015 Northwest Natural Health A
Specialty Care Clinic
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Most Common CAM Therapies in
the US
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Energy healing therapy/Reiki*
Guided imagery
Homeopathic treatment
Hypnosis*
Massage*
Meditation
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Most Common CAM Therapies in
the US
• Movement therapies
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Alexander technique
Feldenkreis
Pilates
Trager psychophysical integration
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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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) 2015 Northwest Natural Health A
Specialty Care Clinic
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Most Common CAM Therapies in
the US
• Traditional healers*
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Botanica
Curandero
Espiritista
Hierbero or Yerbera
Native American healer/Medicine man
Shaman
– Sobador
• Yoga
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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CAM Use by US Adults and
Children - NIH
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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CAM Use by Age
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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CAM Use by Children increases with
a Specific Diagnosis
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Epilepsy
Cancer
Cerebral Palsy
Asthma
Sickle Cell Disease
Ped Neurology overall
General Pediatrics
62%
59%
56%
51%
47%
44%
36%
Sources:
University of Minnesota General and Specialty Medical Clinics
U Michigan Medical Center
U Alberta Canada
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Adult CAM use by Race/Ethnicity
2007
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Acupuncture
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Massage
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Botanical Medicine
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Botanical Medicine
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Reiki practitioner with a patient.
Reiki is an energy medicine
practice that originated in Japan
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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A community group practices Tai
Chi, a mind-body practice that
originated in China as a martial art.
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Participants in a yoga class
Lunge Pose
Lotus Pose
Yoga Tree Pose
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Where Patients Get their
Information
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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What’s Really Important?
• Stay strong and healthy
• Avoid interactions with treatment
– Respect the “Protected Zone”
• Prevention for the future
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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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) 2015 Northwest Natural Health A
Specialty Care Clinic
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A Plan that works
• Exercise
– Cardio
– Weight training
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Spirituality
Mind-body connection
Social support
Visualization and imagery
Technology at the right time
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Exercise
• Exercise improves
– Quality of life
– Cancer Related Fatigue
– Muscle Mass
– Mood
– Immunity
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Cancer, Spirituality and the
Mind-Body Connection
• Self-forgiveness improves QOL
• Visualization and Imagery improve QOL
• PsychoOncology strategies improve
Quality of Life
• Outcomes!?
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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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) 2015 Northwest Natural Health A
Specialty Care Clinic
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Survivorship Strategies
Avoid Possible interactions
with cancer treatment
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Chemotherapy
Radiation
Surgery
Targeted Therapies
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Evidence Overview:
Antioxidants during treatment
Placebo
Antioxidants
Years
Cancer-free Survival
Ref: Bairati et al “A Randomized trial of
Antioxidant Vitamins to Prevent Second
Primary Cancers in Head and Neck Cancer
(c) 2015 Northwest Natural Health A
Patients” Int J Cancer 2006 Nov 1:119(9):2221-4
Specialty Care Clinic
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Prevention is always
important
• Avoid cancer
– Primary Prevention
– Secondary Prevention
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Primary Prevention
Reduce Risk
• Reduce alcohol consumption
• Exercise
• Weight gain since age 18 and 30
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Primary Prevention
Reduce Risk
• Control blood sugar
– Insulin resistance, diabetes and cancer
association
• Address metabolic syndrome
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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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) 2015 Northwest Natural Health A
Specialty Care Clinic
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Primary Prevention
Diet and Nutrition
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Vitamin B12
Folate
Vitamin D
Fiber
Fruits and vegetables
Fish
Some antioxidants
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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More Nutritional Treatments
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Vitamin E
Selenium
Calcium, vitamin D, phosphorus
Zinc
Beta carotene
Antioxidants in general
Consider IV delivery
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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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) 2015 Northwest Natural Health A
Specialty Care Clinic
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After Diagnosis and Treatment
• More Secondary Prevention
– Hormones
– Diet and nutrition?
– Botanicals?
– Lifestyle
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Frequent Questions
Combining Complementary and
Alternative Medicine with
Conventional Therapy
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Phytoestrogens
Including
Soy Isoflavones
?
Safe Replacement for Hormone Therapy?
Answer: Probably the same risk as HRT
Ask for Patient Briefing Paper
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Menopause and Hot Flashes
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Estrogen replacement ??
Effexor etc.
Phytoestrogens ??
Diet
Sleep
Exercise
Weight Control
Avoiding alcohol and sugar
Nutrition and non-estrogen herbs
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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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
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Fatigue
Hot flashes and other menopausal symptoms
Gas (belching, flatulence)
Bloating
Stomach upset
Constipation
Diarrhea and bowel urgency
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Strategies that work
(Continued)
• Maintain quality of life before, during and
after treatment
– Cancer and treatment specific issues that can be
helped
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Urination urgency
Joint and muscle aches (including fibromyalgia)
Headaches
Sleep quality
Pain
Weight gain or loss
Headaches
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Strategies that work
(Continued)
• Maintain quality of life before, during and
after treatment
– Cancer and treatment specific issues that can be
helped:
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Treatment side effects
Neuropathy
Muscle cramps
Restless leg syndrome
Skin rashes
Blood sugar metabolism
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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Questions?
Comments?
Dan Labriola ND
Lisa Price ND
Tara Stacker ND
Carrie Dennett RD, MPH
Northwest Natural Health, A Specialty Care Clinic
7 convenient locations
206-784-9111
nwnaturalhealth.com
(c) 2015 Northwest Natural Health A
Specialty Care Clinic
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