Alternative Medicine 5—It’s Cancer! Now What?

“I presume, Curmudge, that we are just going to play copy-cat and pass along what we have learned in our reading.”

“Right as usual, Julie.  Despite having read good stuff, what might sound like advice is really our perceptions.  So let’s begin.  For most people, a diagnosis of cancer hits like a whack with a wet towel in a locker room.  Their immediate emotion is, ‘Do something!  I want it out!’ “

“Whoa-up there, Partner.  If our patient’s diagnosis is based on a biopsy, she’ll want a second opinion from another pathologist.  Cancer is serious business, and nobody wants an incorrect diagnosis.  She should also read our Evidence-Based Medicine postings back in September and October of 2010.”

 

“Here are some of the things that I have learned that pertain to many cancers.  If they don’t require immediate action, there is time for the patient to learn about the various modes of treatment and to select among them.  When one consults oncologists, the surgeons will want to cut, the clinical oncologists will favor chemotherapy, and the radiation oncologists will propose radiation therapy.  By their very nature, specialists in many fields are parochial in their diagnosis and plan of care.  And irrespective of the initial approach, the cancer may return, its further growth need to be arrested, and it might become something the patient must learn to live with.”

“Hey, that’s more scary than I realized.  To most people, ‘removed’ or ‘in remission’ means ‘goodbye.’ “ 

“Lots of people don’t realize that, Julie, and they also aren’t aware that alternative medicine might play an important role in their plan of care.  So before plunging ahead with surgery, chemotherapy, or radiation, our patient should—if possible—consult with someone who practices integrative or alternate medicine.  Our readings have told us about complementary medicine techniques that can strengthen the patient prior to conventional procedures, mitigate the procedures’ side effects, and hasten the patient’s recovery.  Furthermore, there may be opportunities to skip the conventional procedures altogether.”

“Wow, Curmudge!  I’ll bet those ‘opportunities’ enliven the debate between the allopathic and alternative docs.  Fortunately, if the cancer is growing slowly enough, there might be time to test the alternative meds to see if they shrink the tumor or arrest its growth.”

“Nevertheless, Julie, an alternative med zealot should not bet all of her chips on some herbal concoction without carefully evaluating the oncologist’s proposed conventional plan of care.”

“That’s for sure, Old Guy, but from my search of the Web, it’s not going to be very easy for our cancer patient to find an alternative medicine doc with the training she needs for consultation.  A person with cancer or malfunctioning innards such as liver, lungs, intestines, or whatever needs an herbalist with experience with her particular ailment.”

“That seems to be the case.  Recall the two main categories of alternative medicine mentioned in our first posting on this topic, ‘Alternative medicine includes use of natural products (herbs, vitamins, minerals, and probiotics) as well as mind and body practices (acupuncture, meditation, relaxation techniques, and movement therapies).’  If one specializes in just one or a few of the mind and body practices, less training is needed than for treatment with natural products.”

“I’ve even seen some of the mind and body practice clinics advertising their ‘antiaging’ services, whatever that is.”

“I’m puzzled too, Julie.  To me, antiaging is opposition to growing old, i.e. dying young.  I think we’ll just skip that aspect of alternative medicine.”

“So, Curmudge, back to our patient’s search for a natural products practitioner who can provide the help that she needs.”

“That may require reading the publications of Yance and Blaylock that we mentioned in our posting on nutrition.  The Blaylock Report Archives is a collection of his monthly newsletters on a variety of illnesses.  Another book that discusses a host of conditions has the intimidating title, Miracles from the Vault: Anthology of Underground Cures by Jenny Thompson of the Institute of Health Sciences (see Quackwatch).  She is an excellent writer, but some of her ‘cures’ sound too good to be true (and they may be).”

“Hey, Professor, let’s not forget Suzanne Somers, an actress also cited in Quackwatch.  She has been criticized mostly for promoting bioidentical hormones.  However, she has also written Knockout (1), a book comprised of interviews with ‘doctors who are curing cancer,’ including one whose treatments include coffee enemas (!).    Our cancer patient might wish to follow up with some of her more conventional interviewees, which might require long-distance travel.  But as you and I have said many times, we don’t make recommendations.  Recall also our suggesting that cancer patients may be willing to take somewhat greater—but hopefully intelligent—risks.”

“And that, Curmudge, is about as risky as this posting is going to get.  In future postings, do you intend to discuss any of the so-called mind and body aspects of alternative medicine?”

“I’ll try, Julie, and if we’re lucky we may get some help from a guest author.”

Kaizen Curmudgeon

(1) Somers, Suzanne  Knockout (2009, Random House)

Link to posting from blog archives: Patient Safety—Your Lifestyle 2/26/09

http://kaizencurmudgeon.blogspot.com/2009/02/patient-safety-your-lifestyle.html

Alternative Medicine 4—Illness and Risk

“Julie, do you recall the ‘Tylenol murders’ in 1982?  Seven people died after taking Tylenol capsules laced with potassium cyanide.  As a result, over-the-counter meds now come in tamper-proof bottles.”

“That was before my time, Curmudge, but now when I open a bottle of Bayer aspirin from Walgreen’s I can be confident that each tablet contains 81 mg of 2-acetoxybenzoic acid plus an enteric coating.  However, I would be assuming a bit more risk if I were opening a package of a multi-component mixture of exotic Chinese herbs from an unfamiliar vendor.”

“That’s the point, Julie.  There is the possibility of contamination or adulteration at each step in the product’s chain-of-custody—from picking the herbs to drying, grinding, compounding, bottling, labeling, and selling to the consumer.  These are minimally regulated dietary supplements, and the consumers’ main protection is to buy from trustworthy vendors who, in turn, buy from trustworthy suppliers.  Problems like contamination and mislabeling are apt to get past the cautions that we mentioned in Alternative Medicine 2.”

“In Alternative Medicine 3 we promised to talk about the use of alternative meds by people with a disease or who are likely to contract a disease.  Here is how I see that our discussion above relates to the use of alternative meds and their inherent risks: As the risk of one’s contracting a disease goes up, so does one’s willingness to accept greater risk in avoiding the disease.  Consider these examples: If a woman’s mother died of breast cancer, the woman may regard herself to be at risk.  If a man’s father has prostate cancer, the younger man may consider himself at a higher-than-normal risk of prostate cancer.  In both examples, the younger persons might consider the prophylactic use—and attendant risks—of alternative medications.”

“Wow, Julie!  How perceptive!  That’s our story, so let’s develop it.  The best way to ward off disease, including cancer, is proper diet and a healthy lifestyle including adequate rest and exercise and no tobacco.  Of these, a healthy diet may be the most difficult to achieve unilaterally.  Consider these obstacles: living with a spouse who is an intractable meat-and-potatoes person, living at home with Mom whose cooking is irresistible, or living alone and unwilling to devote more than seven minutes to preparing dinner.  The last example leaves one with a diet high in all the bad stuff in processed food.”

“Other than divorce to solve the intractable spouse problem, dietary supplements may need to be considered for filling the nutrition gaps in one’s current régime.  One could take the supplements when Mom isn’t looking.  Based on your well-known lack of expertise, Curmudge, how would you recommend that one proceed in selecting dietary supplements?”

“You seem to have forgotten, Dear Colleague, that the making of recommendations is above our salary grade (which is zero) as well as our knowledge grade.  My perception, however, is that one should simply compare his diet with those we have referenced, take out the bad stuff if Mom will allow it, and fill in the blanks with over–the-counter multivitamin and multimineral supplements.  Add fruit and fiber at breakfast and raw vegetables and more fruit at lunch.  Up to this point, we have stayed with safe and reliable products from the neighborhood pharmacy and food market and avoided exotic herbal concoctions.”

“Next, Old Guy, what about the person who is fearful that his ancestors have left him with the propensity for contracting a horrible disease?  We assume that this person is already following the dietary program noted above.”

“If this person is really serious, his best move is to find a health care provider with knowledge of integrative, alternative, or holistic medicine or herbalism.  However, those people are pretty scarce, so Plan B is to ask around and read the right literature.  ow per eptIn addition to reading the books on nutrition that we have already cited, become an ‘information hound’ on the issue or ailment of your concern.  If you wonder about something, Google it and you will be amazed at the response (sometimes mostly ads).  If the person’s fear is hereditary cancer, Yance and Blaylock (references in preceding posting) discuss the biochemical pathways involved in carcinogenesis; learn from them what substances have been found to derail those processes.  Some of these substances may have strange-sounding names and come from strange-sounding places.  With these, the risk of adulteration or contamination goes up, especially with multi-component mixtures.  So if one is self-medicating, keep it simple and conservative.”

“That sounds like good advice, Curmudge, especially coming from someone who doesn’t give advice.  I presume that you also have some non-advice for someone who already has cancer?”

“Jaded Julie, the literature on alternative medicine and cancer is metastasizing.  Come back next week and we’ll learn more.”

Kaizen Curmudgeon

Link to posting from blog archives: Patient Safety—Human Factors 2/19/09

http://kaizencurmudgeon.blogspot.com/2009/02/patient-safety-human-factors.html 

Alternative Medicine 3--Nutrition

“In our last posting, Curmudge, you suggested that we had learned a few things about alternative medicine worth sharing.  How do you propose that we proceed?”

“This may be a bit presumptuous, Julie, but we are going to provide a blog’s worth of guidance for a selection of people with various degrees of health.  We’ll start at the healthy end of the spectrum—with young people who are healthy and want to stay that way.  Their simplest path forward is good nutrition.”

“Nutrition!  Here we go again, discussing something about which we know absolutely nothing.”

“As of a few weeks ago, I knew at least a little bit.  Here are my rules of thumb:

(a)  Everything that tastes really good is probably bad for you.

(b)  An apple a day would have kept the doctor away many years ago when doctors made house calls.

(c)  If you are healthy and happy with your diet, don’t change it.

‘If it ain’t broke don’t fix it.’  Of course, you might die tomorrow.

(d)  If you are 79 years old, you must have been eating some of the right foods for the past 79 years.  But don’t make big plans for ten years from now.

(e)  If you are obese and don’t want to stay that way, change your diet and lifestyle.  There are a million sources of advice out there.  If you decide to remain obese, move to Mississippi, the fattest state in the nation.  You’ll have lots of company down there.”

“Curmudge, some of your rules sound rather unkind, but it’s hard to argue against them.  And you suggested that you have learned more about nutrition in the past few weeks.  You must have been reading the right books; it can’t be from your exemplary eating habits.”

“I grew up as a meat-and-potatoes kid.  During the Second World War the meat was sometimes Spam®, and we raised potatoes in our victory garden.  Nationally, every week we celebrated ‘Meatless Tuesday.’  The objective of a meal was to get over the feeling of hunger, and that has continued until recently.  If we look around, we see most people still eating that way; and in the U.S. they eat too much.  Regrettably, in some parts of the world people never get over feeling hungry.”

“In the past many years since your youth, Professor, scientists have learned that the real purpose of eating is to nourish the biochemical systems that run one’s body.  Paraphrasing Blaylock’s comment about nutrition and cancer, ‘New techniques for measuring biochemical events on a molecular level have allowed us to map out the many ways the components of (a proper diet including) fruits and vegetables inhibit cancer formation.’ (1) “

“You’ve got it right as usual, Julie.  That’s the link between the natural products side of alternative medicine and nutrition.  One’s good health can be largely dependent on the specific natural products in the foods that he eats.  That’s why we could say a moment ago that good nutrition is the best path forward for a healthy person who wants to stay healthy.”

“Shall we provide some specific suggestions for that up-to-now healthy person?”

“Sure.  Most people in the U.S. have been eating too much sugar, refined carbohydrates, and the wrong kind of fat.  Instead, they need more fruits and vegetables, especially the cruciferous ones like broccoli, cauliflower, and Brussels sprouts.  There was even an article in the August 2013 National Geographic about how we eat too much sugar, much of it invisible as high-fructose corn syrup.  The average American eats 22.7 teaspoons of sugar per day without touching the sugar bowl.  Among the worst sources are sugar-coated breakfast cereals and carbonated drinks (soda).  We have acquired a taste for poor nutrition.  For example, a can of soup wouldn’t taste right if were not crammed full of salt.”

“Curmudge, I believe everyone knows what you just said, but they seem unwilling to put it into practice.  But suppose our ‘healthy person’ really wants to get serious about his/her diet.  Assuming she has a computer and is willing to learn, what resources should she turn to?”

“I first recommend a change in syntax.  Use the French word régime instead of diet.  Diet connotes ‘fat’ and an effort that is often short, unpleasant, and unsuccessful.  Second, recognize that many of the experts in nutrition are those who have used diet as the foundation for their approach to diseases via alternate medicine.  And finally, you’ll see that many of those diseases are senior citizens’ afflictions that have been the most resistant to conventional medicine, such as cancer.”               

“I suspect that the first nutrition ‘guru’ that you will recommend is Andrew Weil, MD.”

“For him, ‘guru’ is he right term, Julie, and he can certainly provide more authoritative advice than we can.  It‘s spelled out in his anti-inflammatory diet and food pyramid.  Most of the authorities whose books I have read are fairly consistent in their dietary recommendations.  Russell Blaylock MD and Donald Yance, a nutritionist and herbalist (2), describe in detail why certain foods are good or bad for you.  And locally (Green Bay), Terry Lemerond includes diet advice in his Terry’s Traditional Diet.  For the dedicated meat eater, Al Sears MD provides advice on protein. (3)”

“A new find for us, Old Guy, but seemingly not for a lot of other people, is William Davis’s book, Wheat Belly.  I even found a summary of the book on the web, so the price is right for a tightwad like you.  Dr. Davis makes a pretty strong case for a wheat-free diet, although some of his assertions have recently been contested.  Davis’s diet has a lot in common with the well-known Paleo diet.”

“Davis’s results sound impressive, Julie, but adhering to a wheat-free diet would be difficult.  I would have to make toast from rye bread and give up frosted cupcakes and weissbier (beer made from wheat).”  

“But Curmudge, all of these diets are demanding, and it’s hard to get enthusiastic about eating a bunch of vegetables.”

“Try juicing or blenderizing them, Julie.  I haven’t tried that yet, but Doc Mack has.  The first step is to buy a blender, and it’s critical to find one that is easy to clean. (1, p. 28)”

“We can’t leave nutrition without considering smart shopping.  Look for a store that uses the NuVal system for evaluating food nutrition. The system considers 30-plus nutrients and nutrition factors – the good (protein, calcium, vitamins) and the not-so-good (sugar, sodium, cholesterol).  And then it boils it down into an algorithm that gives a score from 1 (bad) to 100 (good) for each food item.  These numbers should be visible for each item in a store that has adopted this fairly new system.  I’ve seen some of these numbers in the local Festival Foods.  So, Professor, we’re at the end of another class.  Do we have a final observation for our readers?”

“When I’m in a restaurant or in the hospital where I volunteer, there seem to be lots of obese people.  But in my apartment complex, where most of the residents are over 80 years old, very few people are obese.  I think I know why.  Bon appétit, Julie.”      

Kaizen Curmudgeon

(1)  Blaylock, Russell L., MD  Natural Strategies for Cancer Patients (2003, Kensington)

(2)  Yance, Donald R.  Herbal Medicine, Healing & Cancer (1999, McGraw-Hill)

(3)  Sears, Al, MD  P.A.C.E. (2010, Wellness Research and Consulting)

Link to posting from blog archives: Patient Safety—Communications 1/22/09

http://kaizencurmudgeon.blogspot.com/2009/01/patient-safety-communications.html

Alternative Medicine 2—Words of Wisdom and Caution

“As I recall, Curmudge, you had an unfortunate brush with alternative medicine 20 years ago.”

“I had almost forgotten, Julie.  I had tendonitis in my arm, and a colleague gave me some capsules containing the Chinese herb, ma huang (ephedra).  Assuming that a billion Chinese can’t be wrong (they were), I took a couple.  My head felt like it was going to blow off; my blood pressure must have gone through the roof.  The effects soon subsided, but not before I trashed the rest of the capsules.  I have since learned that although ephedra is presumably banned in the U.S. due to serious side effects, it is still available for weight loss under appetizing names like ‘Green Stinger’ and ‘Yellow Bullet.’ “

“And more recently, Old Guy, you saw an article on page 1 of the 7/25/13 issue of USA Today telling about the dangers to bodybuilders of questionable supplements…stuff with names like ‘Craze’ and ‘Superdrol’ “

“Believe it or not, Julie, the vendor set up his business from his jail cell.” 

“Now that we have our readers’ attention, Curmudge, what resources are available to guide consumers away from supplements that might be ineffective or dangerous and assist them in finding alternative medicines of potential value?”

“There are a number of databases that are quite comprehensive.  Listed below are some with hyperlinks:

Natural Medicines Comprehensive Database (Professional Version [by subscription]) http://naturaldatabase.therapeuticresearch.com/home.aspx?s=ND&cs=&referer=none&logout=1&logoutcomplete=1

Kaiser Permanente Consumer Information  and Education (Same database as above in which searches are free.)

Kaiser Permanente Database (vitamins, herb, and supplements)

Office of Dietary Supplements  (Nat’l. Institute of Health.  Making Decisions.)

Dietary Supplements: What you need to know to stay safe and avoid fraud.  (From Human Performance Resource Center,  Department of Defense)

Kaiser Permanente  Which websites are reliable?

National Center for Complementary and Alternative Medicine (NCCAM): Herbs at a Glance. How Safe Is This Product or Practice?  These are lists of items that can be searched.”

“You know, Old Guy, there are also extensive lists of questionable associations, institutes, and presumed educational and research organizations in Quackwatch.  The name of the site speaks for itself.  Quackwatch also has a list of doctors that they call Promoters of Questionable Methods or Advice.  Another Quackwatch database is A Message to Cancer Patients Seeking Alternative Treatments.  Of special interest are the treatments and information sources that are absent from their nonrecommended lists.”

“Julie, I wish that I were confident that Quackwatch is accurate and up to date.  A few people and organizations appear to be listed because they were on the wrong side of conventional wisdom.  Examples include Dr. Russell Blaylock, Dr. Mehmet Oz (TV), Suzanne Somers (actress), and NCCAM (database above).  Sometimes I wonder who is watching Quackwatch.”

 

“In any case, Curmudge, after looking at these databases I can see why you are impressed.  If one searches on a substance, the database answers questions like: ‘What is it?’ ‘Is it effective?’ ‘How does it work?’ ‘Are there safety concerns?’ ‘Are there any interactions with herbs and supplements?’ ‘What other names is the product known by?’ “

“Also, Julie, the report from the Department of Defense lists some alerts on product labels.  There are notes of what should be there as well as statements to look out for such as claiming to cure a wide range of diseases.  I was interested in their list of problematic ingredients that included my nemesis, ephedra.”

“Common advice also is, ‘Talk with your health care provider.’ “

“That’s great advice, Julie, but after studying these documents you might know more about the product of interest than the doc does.  To make the conversation more productive, you might give him or her the appropriate documents ahead of time.  Incidentally, this problem has not gone unnoticed by physicians.”

“If we end our Alternative Medicine series right here, Curmudge, we will be leaving our readers pretty much up to their own devices.  You have read quite a bit about alternative medicine.  Despite your total lack of formal qualifications, is there more information on this topic that we can share?”

“I believe the info presented in this posting is a pretty big gulp for our readers, so let’s ring the chapel bell to end the lecture.  But next week we’ll share our further perceptions on Alternative Medicine.”

Kaizen Curmudgeon

Link to posting from blog archives: Patient Safety—Medications 2 1/14/09

http://kaizencurmudgeon.blogspot.com/2009/01/patient-safety-medications-2.html