Integrative Cancer Care
by Dr. Joe Schnurr
The integrative, whole person approach to cancer treatment recognizes the growing evidence that individuals themselves play a fundamental role in their own healing.
Two in five Canadians will develop cancer in their lifetimes1. There has been a substantial increase in the number of people living with or beyond a cancer diagnosis2 with the need for providing physical, emotional, and spiritual support for cancer survivors and their loved ones.
The standard or conventional approach to cancer treatment has been the “tumour-oriented model” where the focus is on eradication of the tumour through surgery, chemotherapy, and/or radiation. This treatment approach does not address the broader concepts of health and illness, or the underlying factors that can predispose to, or assist in reducing the risk of, cancer occurrence, and/or progression.
Little support is provided to assist patients in exploring the beneficial roles that healthful nutrition, exercise, emotional, spiritual, and immune system support play in overall healing, even though their importance is now being acknowledged in the oncology literature3.
The emerging science of epigenetics provides clear evidence that the pattern of gene expression of cells in the tumour stroma or microenvironment (in other words, the activity of the genes in the cells surrounding the tumour) is more highly correlated with prognosis than the tumour grade or whether the tumour has spread to the lymph nodes4. The mechanisms of dysfunction influencing gene expression and playing a major role in most every chronic illness, including cancer, are oxidative stress, inflammation, insulin resistance associated with elevated blood sugar levels, the hormones, and other molecules associated with the chronic stress response, and environmental toxins. These upstream drivers of chronic disease often go unrecognized and untreated in the conventional health-care system. It is alarming that a mere 5 per cent of cancer survivors are meeting the bare minimum standards of:
1) Eating at least five servings of vegetable and fruits per day;
2) At least 150 minutes of exercise per week; and
3) Not smoking5.
If one were to include stress management practices, this number would fall to less than 1 per cent.
Cancer survivors are not getting the information and support they need to engage in and maintain healthy lifestyle and behavioural changes. Frequently, they are also not receiving adequate emotional support.
The integrative, whole person approach to cancer treatment recognizes the growing evidence that individuals themselves play a fundamental role in their own healing. While the standard treatments of surgery, chemotherapy, and radiation play a very important role in cancer treatment, it is the person who is the focus of care and their health—body, mind, and spirit—is optimally supported.
There is a growing body of research that confirms the anti-cancer benefits of good nutrition6 7, regular exercise8 9, adequate sleep10, stress reduction11 12, emotional and spiritual support13, and the judicious use of supplements14 15. Furthermore, they are interrelated and each contributes to the benefit provided by the others in a synergistic way16 17. They are positive epigenetic modifiers, meaning they activate genes that are health promoting and deactivate genes that are disease promoting18 19, and they address the underlying mechanisms of dysfunction20. By supporting the whole person approach to cancer treatment (and/or that of any chronic illness), solid foundations are created to optimize healing.
1 Canadian Cancer Society’s Advisory Committee on Cancer Statistics. Canadian Cancer Statistics 2013. Toronto, ON: Canadian Cancer Society; 2013
3 Ligibel, J. J Clin Oncol, 2012.
4 Finak, G et al Nat Med. 2008.
5 Blanchard, M. J Clin Oncol, 2008; 26(13): 2198-2204.
6 Meyerhardt, J et al JAMA, 2007.
7 Chlebowski, R et al J Natl Cancer Inst, 2006.
8 Holmes, M et al JAMA, 2005.
9 Kenfield et al J Clin Oncol, 2011.
10 Blask D Sleep Med Rev, 2009.
11 Kang et al Oncol Nursing Forum, 2011
12 Antoni, M. et al Nat Rev Cancer, 2006; 6(3): 240-248.
13 Anderson, B et al Cancer, 2008.
14 Zhang, M et al Int J Cancer, 2004.
15 Lissoni, P et al Euro J Cancer 1999.
16 Pierce, J et al J Clin Oncol, 2007.
17 Knoops, K et al JAMA, 2004.
18 Ornish, D et al Proceeding of the National Academy of Science USA, 2008.
19 Huang, J. et al Current Drug Targets, 2011;12 (11).
20 Traka, M et al PLoS ONE, 2008.
Dr. Joseph Schnurr, MD, MA, practices integrative and functional medicine in Saskatoon. Functional medicine is a science-based, personalized medicine that deals with primary prevention and addressing the underlying causes of chronic illness. He recently spent two years leading the Kelowna branch of InspireHealth, an integrative cancer care centre in British Columbia. He is a co-founder of the Centre of Integrative Medicine in the College of Medicine at the University of Saskatchewan. His clinic address is 1814 Lorne Avenue, phone 306-955-2633.