THE PLACE OF CHEMOTHERAPY IN AN INTEGRATIVE CANCER TREATMENT PROGRAM- Dr. Raoul Goldberg md
Many cancer patients and their loved ones frequently have to face the agonizing decision as to whether to include chemotherapy in their treatment programme. Main stream western orientated medicine regards chemotherapy as a mainstay of cancer treatments alongside surgery, radiotherapy, hormone therapy and immunotherapy. These therapies are given credibility by an evidence based medical science that relies on proving the effectiveness of the treatment. This is done by randomized double blind studies whereby neither patient nor clinician know what the patient is receiving so that as far as possible the effects of the chemo drug itself can be evaluated without the influence of other factors such as the placebo effect. The oncologist is trained in the use of these drugs and should be well versed in the most current evidence so as to be in the best position to assess both the benefits and risks of these chemotherapeutic agents
The cancer patient who faces the reality of his or her illness, will have to consider various options, and unless the tumour is localized and non invasive, chemotherapy will be one of these options, because the prevailing main stream conviction is that this is the most effective treatment. For some this will be accepted without question, for others it will create a great deal of uncertainty and confusion.
The attitude and response of cancer patients in current times has changed rapidly. People today are so much more informed than ever before and are therefore in better positions to make self determining informed decisions, especially when it comes to such critical decisions as to their choice of treatment for the cancer. Such patients will question the recommendations of their doctors and oncologists and will often be searching for other safe and effective therapy options. They are aware of the potential toxic side effects of chemotherapy, or have been emotionally or intellectually challenged by their negative experiences of chemotherapy. Perhaps a loved one has gone through a brutal chemotherapeutic experience or they have read of overall poor long term cancer survival using chemotherapy or they recognize that cytotoxic drugs are toxic to the very system that should be preventing and controlling cancer, the immune system. Not only negative past experiences will determine one’s response, but also one’s temperament and personality will play a part. Thus patients who feel self empowered and self motivated may choose to participate actively in the treatment of the cancer and will search for a health practitioner who will partner them in an integrative approach. On the other hand, cancer patients who are terrified of the cancer threat to their life, who have never questioned traditional attitudes or who believe in the conventional medical system, will want to trust completely the treating physician to help cure them without question.
A growing number of patients are realizing that the combination approach is the best option. My experience over the past thirty five years convinces me that chemotherapy in specific cases is an integral and necessary part of the integrative cancer treatment programme. When the patient’s natural defences are weakened and there is insufficient time to build them up again, chemotherapy may be an inevitable option to reduce the tumour mass and provide time and space for an integrative therapy to rehabilate the whole system.
A recent experience with a patient leaves no doubt that chemotherapy used judiciously can not only be life saving but also long term curative in selected patients.
DL came to see me several years ago with a recurrence of Hodgkin’s Lymphoma that had been treated at Stanford University Cancer Centre, USA with first line chemotherapy and radiotherapy, but did not achieve complete cure. This is a cancer of certain white blood cells called lymphocytes that develop from blood stem cells that are located in the bone marrow. Although this cancer has an excellent cure rate with chemotherapy, she was left with an indolent growth of lymphoid tissue in her neck that was slowly progressive. She was offered at this time stem cell transplant therapy as a curative treatment. This involves destroying all white blood cells in the body, some of which are cancerous, as well as the bone marrow stem cells that produce them and then replacing them with healthy bone marrow cells that were harvested prior to ablating the bone marrow with the most powerful chemotherapeutic agents available. At that time DL was not willing to undergo a chemotherapeutic programme that was far more intense and damaging than the treatment she had just undergone in 2009, and opted for an integrative treatment approach. She received an integrative cancer treatment in our cancer clinic which contained the growth of the tumour for several years. Then several months ago a combination of extreme stress, poor diet, lack of sleep and not being actively treated, seemed to activate the tumour to start growing rapidly, and in the confined space of her neck, began to impinge on vital structures. Nerve pressure in the region started causing pain and numbness, the windpipe and esophagus were displaced and blood vessels were being compromised. It was clear to all that to prevent more serious complications and to save her life, the growth had to be controlled.
DL returned to Stanford to undergo the stem cell transplant programme and I had the rare opportunity to witness part of this treatment programme first hand as I happened to be teaching in California at the time.
Firstly, an inductive chemotherapy was used to reduce the neck mass. After two cycles of treatments over a four week period, she was in complete remission. Further chemotherapy was used to control microscopic invasion and suppress the bone marrow. After her healthy bone marrow stem cells had been harvested, she was admitted into an isolation unit where the ablation therapy would be carried out over three weeks. Without white blood cells she would be at high risk of infection, damage to red blood cells would cause anaemia and platelet reduction would result in bleeding tendencies. She therefore had to be protected and supported with intensive nursing care following the ablative chemotherapy and the subsequent re-introduction of healthy white blood stem cells into her system. She experienced the most brutal side effects from the chemotherapy where she was unable to speak, eat or drink for many days because of the intense ulceration throughout her digestive tract. Chemo burning of the skin caused extreme burning, itch and peeling. She received continuous blood transfusions, had to be fed intravenously and was on multiple antibiotics, antiviral and antifungal drugs.
The outcome following this intense assault on her body was directly visible: the mass had shrunk from 14 cm to 3 cm, and the tissue that remained was regarded as scar tissue. She was given an excellent prognosis with very good chances of life long cure.
DL will require an intense recovery and supportive treatment over the next few months to both detox and build up her organ and tissue vitality. This will include Vitamin C infusions, Ozone Therapy, Lymph compression massage, Mistletoe injections, a variety of oral supplements as well as dietary, lifestyle and psychotherapeutic management. She will need to be conscious of her characterological predispositions and to be vigilant in avoiding and removing environmental and lifestyle factors that could internally trigger tumour cell growth and/or hinder active immune system surveillance.
Chemotherapeutic agents are designed to disrupt, damage and destroy cancer cells and will do this effectively when the cancer tissue is sensitive to these drugs. However, they will inevitably also damage actively growing healthy body cells that include the white blood cells that constitute the body’s defense system. Therefore the benefits, both short and long term, must outweigh the potential for harmful side effects. On the other hand, the many known natural substances that enhance the immune system, are for the most part non toxic to other body cells. These substances can therefore be used to support the healthy immune response to cancer cells and to offset the toxic side effects of chemotherapy. Many also have natural anti cancer properties. One would therefore expect a combination of these modalities to have the best results.
A rational integrative cancer therapy should address the four primary elements that lead to the development of cancers:
-the background predispositions, genetic and personality, can be managed through treating the miasm or bodily disposition through homeopathic or herbal medications on the one hand, on the other through understanding and managing the psychological patterning that creates the predisposing congestive blocks that can lead to cancer formation.
-the lifestyle or environmental trigger factors that can activate latent dispositions such as mould, house dust mites, — chemicals in the home, in body products, in food, drink and medication, — electromagnetic radiation via cell phones, radiation damage through air flight, diagnostic radiation and many others potential carcinogenic triggers.
- the compromised immune regulative systems have to be strengthened to reinstate the natural surveillance systems that keep cancer under control
- the natural proliferative tendency of cells to mutate and to degenerate into cancer cells have to be contained, controlled and eliminated.
The effective control of cancerous cells is the domain in integrative cancer care where chemotherapy has an important role to play and is frequently an integral part of an integrative cancer treatment programme. When used wisely and carefully together with the other three principles of such a program, it may be an essential or necessary modality in the struggle to contain one of the most powerful and common disease processes of our times.
In advanced cancer, the decision to use chemotherapy becomes more critical since the immune system is usually weakened and the body has often become tolerant to the chemotherapeutic drugs already used. This means more aggressive cytotoxic drugs have to be used so that their toxic effects may irreversibly damage and overwhelm the bodies normal organ functions. However, body systems can be supported at all stages with integrative care to limit these side effects.
Within the framework of a treatment programme which encompasses the whole person and where the cancer patient, integrative health practitioner, oncologist and therapist, are working together as a therapeutic team, one can undoubtedly anticipate the best outcomes.
[This article is specifically directed to those who are averse or uncertain to using chemotherapy in a treatment programme as well as to those who regard conventional cancer therapy as the only effective way of treating cancer. ]
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