Alternative Cancer TherapyDr. Paul Hrkal ND October 1, 2014
How Integrative Medicine is Improving Patient Outcomes
I am naturopathic doctor (ND) with a clinical focus on natural and integrative cancer care. At every presentation I do, or conference I attend, people are very interested in natural alternatives to chemotherapy, radiation, and surgery. Many turn to the internet where they find hundreds of websites, articles, and personal stories that promote various ‘cures’ of questionable integrity.
What you really need are straight answers to direct questions by someone who has looked at the research and is applying it to real life situations. The goal of this article is to do just that. Here, I will share my answers to the most common questions about natural cancer care. This article is written in a direct question and answer format to give you the evidence and information you need in order to make the best possible choice in your cancer care.
Question: I have heard about integrative cancer care. What does an integrative cancer plan look like?
Answer: The integrative medical concept combines the best of conventional treatments with natural and complementary therapies. The idea behind an integrative approach is that since cancer is a multifactoral disease affecting every aspect of a person, you need a multi-faceted treatment plan. The research now clearly shows that cancer patients have improved outcomes and reduced mortality when they use natural and complementary techniques such as fitness therapy, diet counseling, yoga, meditation etc.(1,2,3,4)
Integrative cancer care combines the best of conventional treatments (i.e. new chemotherapy agents, surgical techniques etc.), supportive natural approaches (vitamins and nutrients), and mind-body-spirit practices. This includes making sure that all the approaches work together without interfering with the primary therapy (i.e. chemotherapy). In my practice I focus on helping the patient get the best combination of treatments available at any point in their cancer healing process. No matter where the patient is in their treatment, I support them with the best integrative and natural therapies that safely fit with their current treatment plan.
Q: Are natural and integrative cancer therapies compatible with conventional treatment options?
A: There is a big assumption by the public and medical profession that natural and conventional treatments are incompatible. But the research shows us that nothing is further from the truth. Some of the most cutting edge and progressive cancer treatment centres all over the world are now using natural and integrative treatments right along with conventional therapies. Numerous studies have shown that natural agents actually improve the treatment outcomes and reduce the side effects of chemotherapy and radiation. An excellent review highlighting the safety of antioxidants with chemotherapy was published in 2008. It showed that not only were antioxidant nutrients safe and compatible with chemotherapy treatments, they actually improved effectiveness and reduced side effects.(2)
Another review found that vitamin C, one of the most commonly used natural therapies, is proven safe in conjunction with the majority of chemotherapy drugs, and it improves quality of life and reduces side effects by preventing damage to healthy cells.(5,6)
Q: If natural therapies are safe with chemo and radiation, why do most oncologists still recommend avoidance of nutrients, herbs, and antioxidants?
A: The studies cited above came to conclusions that directly oppose the commonly held belief that antioxidants counteract chemotherapy and radiation. Unfortunately, many oncologists are still holding on to the outdated concept that chemo and radiation have a ‘PRO-oxidant’ effect, which would be undermined by the consumption of ‘ANTI-oxidants’.
The mechanisms of chemotherapy and radiation are actually poorly understood, but recent evidence shows that they may not directly kill the cancer cells immediately, but rather fatally damage them before they undergo natural apoptosis (cell death).(7) Antioxidants and natural plant compounds such as curcumin (derived from the herb turmeric) may actually help finish the job and promote the death of cancer cells, thus having a complementary effect on chemo and radiation, instead of working against it.(8)
However, it is very important to point out that not all natural substances are safe to take alongside conventional treatments. There are exceptions depending on the type of chemotherapy or radiation, type of cancer, and the condition of each patient. NDs are trained to guide patients to choose which natural therapies are safe with each conventional treatment.
Q: My oncologist is very much against any natural treatments but I want to include natural therapies as part of my treatment plan. I feel like I am between a rock and a hard place. What can I do?
A: While the number of open-minded oncologists is growing, there are still many who are totally against taking any natural therapies while on chemo or radiation. The process of cancer diagnosis and treatment is frightening and often starts quickly, with very little time for the patient to think about the options presented to them. Some patients feel they are given little choice by an oncologist who is pushing to start treatment quickly while, at the same time, being against any natural therapies. Here are a few suggestions that other people have found helpful:
– First, don’t rush into a decision. You may feel like you have no choice, but you always do. Unless it’s a medical emergency, waiting a few days, or even weeks, to make the right decision won’t impact the success of your therapy.
– Second, ask lots of questions. If you don’t like what the oncologist has to say, don’t be afraid to ask direct questions and maybe even seek a second opinion. If you are wondering about natural alternatives, then ask a trained ND. Many NDs offer free consultations with prospective patients so they can ask questions and find out whether natural therapies are right for them. This is a good way to make sure you are on the same page, without any cost or commitment. Ultimately, this is a difficult question to answer since it’s really about what you, as a patient, are comfortable with, but don’t feel like a doctor should make your decision for you.
Q: Are you totally against chemo and radiation?
A: I am not totally against chemo, radiation, or surgery. I believe that the current Canadian medical system is an excellent system for handling acute or emergency healthcare. Unfortunately, it is not set up to successfully prevent and treat chronic diseases such as cancer. While chemo and radiation are extremely toxic therapies, they definitely do have a place in the treatment of some cancers. For example, leukemia, lymphoma, and testicular cancer respond well to chemotherapy. However, the success rate is much lower for solid tumours such as colon or breast cancer. Some new targeted chemotherapies have had promising results in stopping cancer growth and managing the disease, but eventually the cancer cells become resistant to these drugs as well. I look at chemotherapy, radiation, and surgery as ways to buy the patient some time. These therapies can shrink tumours and stop cancer growth temporarily so the patient doesn’t die from those complications (like a tumour pressing on an organ), but they can never eliminate all cancer cells.
The fundamental problem is that none of these therapies address the root cause of cancer. While there are many potential cancer triggers, established evidence tells us that substances that damage our cellular DNA and promote abnormal cell growth (i.e. electromagnetic radiation, smoking, synthetic hormones, etc.) can lead to cancer development.
Unfortunately chemo and radiation do nothing to change these factors, and actually strongly contribute to them. Chemotherapy and radiation all have short and long term side effects, which severely impair the body’s ability to heal. Over and above the specific acute side effects (nausea, mouth sores, skin burns, organ damage etc.), they also impair the immune system, which is responsible for killing the remaining cancer cells once the chemo or radiation is done. The long term side effects of both chemotherapy and radiation are secondary cancers since these treatments cause damage to healthy cells, which can lead to metastatic changes.(9) This is where an integrative approach is so beneficial. When natural therapies are used during, and after, chemo and radiation they can be very effective at reducing both the short and long term side effects.
Q: My understanding is that surgery is the closest thing to “curing” cancer. Is this true?
A: I think surgery is the closest thing we have to achieving a cure in our conventional playbook. Many people look at surgery as the holy grail of therapies since we all want to “get the cancer out” of our bodies, as if it was a foreign invader. Unfortunately, surgery is not a perfect therapy. A surgical procedure with general anesthetic suppresses the immune system, sometimes even for weeks after, and it does nothing to change the reasons the cancer started in the first place.(15) Recently, some new evidence is showing that surgery to remove cancer can actually spread cancer cells to other areas of the body.(16) And removing the primary tumour may increase the growth of smaller secondary tumours.
The primary tumour actually suppresses the growth of any other tumours in the body since it wants to keep all the nutrients and fuel for itself. Removing that primary tumour also removes the brakes on the other tumours’ increasing growth. So clearly, surgery is far from a perfect solution even though it’s still the best option to buy time in the hopes the person can change the reasons that caused the cancer in the first place.
Q: Do you believe that cancer can be “cured”?
A: Cure is a difficult word. I never make any promises for treatment outcomes. What we do know is that we all have cancer cells in our bodies. Healthy immune and detoxification systems prevent them from growing out of control. I think we can definitely reduce the risk of cancer cells forming, and support the body’s ability to keep cancer cells in check.
If a person already has a cancer diagnosis and the tumour growth ‘runaway train’ has started, I think the best hope is to return to a point where the body regains control and is keeping the cancer cells in check again. This is a definite possibility, but it requires that a patient is committed to a whole body approach. The plan has to include changes to diet, stress levels, sleep, waste elimination, emotions, and spirituality. It’s difficult to predict which person will be able to regain control because every person and every cancer is different. But I can say that the people who accept their cancer journey, and fully embrace the changes they have to make in their lifestyle, have the most success.
Q: There are so many anti-cancer diets promoted on the internet. Which one is the best?
A: To fully answer this question I would have to write an entire book. The most popular cancer diets include the Gerson diet, the Budwig diet, the raw-vegan diet, the ketogenic/paleo diet, and the Mediterranean diet. With all these therapeutic approaches there is a large variation in how each person responds. Each person’s condition is also very unique, making some diets inappropriate for them. For example, a person with weak digestion will not do well on a raw food diet (because raw food diets require a lot of ‘digestive fire’ to metabolize the food). Also, many of these diets are time consuming to prepare, so some people can’t maintain the effort for very long. For this reason, I don’t support any one of the strict diets mentioned above; rather I tailor my approach for each patient into manageable steps. While each diet is unique, almost all of them follow a few principles that I believe are essential to any anti-cancer diet:
1) No processed food – Make your own food so you know exactly what’s in it. For example, that means you make your own salad dressing instead of buying it.
2) Eat more veggies and less meat – Most meat contains unhealthy fats and toxins which promote inflammation. Replace that meat with colourful veggies.
3) Eat more raw veggies – I don’t support a 100% raw diet but most people need to eat more raw vegetables. They contain enzymes and nutrients that have a potent anti-cancer effect; these enzymes are destroyed during cooking.
4) Juicing veggies is a great way to get ultra high doses of antioxidants condensed into one serving. It would also take longer to eat that same amount of veggies without compressing them into a juice.
5) No sugar or refined carbohydrates – It is well known that sugar drives inflammation and is the primary fuel for cancer cells. Carbs like bread and pasta also are rapidly converted to sugar, which promotes the growth of cancer.
Q: What is the Gerson therapy and why is it so popular? Does it really work?
A: Dr. Gerson was a medical doctor who successfully treated end stage cancer patients with a strict vegan diet, vegetable juices, potassium iodide, calf liver, and coffee enemas. While he claimed to have excellent results with this approach, he was prosecuted by the FDA and labeled a quack. His approach lives on through his daughter, Charlotte, and a few other doctors who have set up clinics in Mexico to continue the Gerson Therapy. Many patients claim to have experienced regression of their advanced cancers after intensive diet and detoxification at these clinics. Some of these patients also say that the Gerson approach is very time consuming and difficult to maintain when returning back home.
Aspects of the approach are valuable but I don’t support the complete protocol due to its intensive and restrictive nature.
Q: There are many natural supplements that claim to have an anti-cancer effect. Which ones work and which don’t?
A: There are many supplements that have demonstrated a beneficial effect against cancer cells. I can’t address them all here, due to space limitations, but I will briefly share my approach to supplements in general, without getting into specifics. I think there are five unique actions of natural supplements (nutrients, vitamins, and herbs). Each action has a distinct benefit when supporting a cancer patient, depending on the stage of their treatment:
1) Directly anti-cancer – Very few natural substances are effective at directly killing cancer cells but concentrations of vitamin C – only achievable through an intravenous (IV) infusion – can have this direct cancer killing effect.(10) Mistletoe extract is another example of a substance that has a direct cancer killing effect, in addition to protecting healthy cells from the effects of chemo/radiation.(11)
2) Supporting cell function – This is the reason so many natural substances reduce the side effects and improve the action of chemotherapy. If a healthy cell is able to protect itself and produce energy it can resist cancerous changes. Not only is this essential for cancer prevention, it also allows our immune system to identify and kill cancer cells. Fish oil and vitamin D are examples of nutrients that support healthy cell function.
3) Detoxification – This process is done by every cell and tissue all the time because our body produces, and is exposed to, wastes and toxins daily. If the amount of toxins surpasses the ability of our body to remove them, the changes that promote disease start to occur. This is often at the root cause of why cancer occurred in the first place, so it has to be addressed in order to change the cellular environment. Milk thistle and broccoli extracts are good examples of natural substances that promote healthy detoxification and elimination.
4) Blocks cancer growth and spread – This unique action is important in controlling cancer spread, while allowing chemo/radiation, or the immune system, to kill cancer cells. Natural substances can block new blood vessels from growing to feed tumours and prevent the spread of cancer cells to new areas of the body. Green tea and modified citrus pectin are two good examples of substances that prevent the growth of tumours and the spread of cancer cells.
5) Activate the immune system – The immune system is responsible for identifying and eliminating cancer cells. However, there are many things that weaken our immune system to the point where it can no longer keep up its defensive responsibilities. Also, cancer cells are smart ,and often hide from immune cells to prevent them from being targeted and destroyed. There is an important role for natural substances that wake up the immune system to get it started on targeting cancer cells. Mushroom extracts are powerful immune activators and also have an anti-inflammatory, and anti-cancer, effect.(12)
Q: I have heard that intravenous (IV) vitamin C is being used as a natural cancer therapy. Why can’t I just take it orally through food, or as a supplement?
A: Research has found that vitamin C has two distinct modes of action when it comes to combating cancer. At low doses (under 2 grams), vitamin C has an antioxidant effect that protects key cells against cancer-causing compounds. Vitamin C intake through diet or oral supplementation will have this effect.
The second mechanism of action is actually a pro-oxidant or anti-cancer effect. Doses above 15 grams are shown to have a ‘pro-oxidant’ effect by generating hydrogen peroxide, which in turn selectively destroys cancer cells.(10,13) Researchers think that cancer cells are particularly vulnerable to hydrogen peroxide as they don’t have the enzyme ‘catalase’ to break down the hyrogen peroxide, while healthy cells do. This effect is only achievable by IV infusion since oral vitamin C causes loose stools above dosages of 2 to 5 grams, and only a small amount is actually absorbed. Most people achieve the anti-cancer concentration of vitamin C at 25 to 75 grams. In addition to this effect, high doses of vitamin C have been shown to regulate cell division, improve immune response, and reduce inflammation.(13,14) Oral vitamin C is still important to take since it maintains blood vitamin C levels between IV infusions. And even without IVs, doses of 2 to 10 grams of vitamin C twice a day (until stools become loose) have a potent anti-bacterial effect.
Q: What three supplements are you most excited about when it comes to supporting cancer patients?
A: 1) Medicinal mushrooms: There are many different varieties of fungi that have demonstrated beneficial effects against cancer cells; they also support the immune system and reduce chemo side effects. One of my favourites is the chaga mushroom, which grows on birch trees around the world, from Russia to Canada. Packages of chaga, harvested from Ontario birch trees, then dried and ground, are available in health food stores. This mushroom (which is actually a fungus) is rich in betulinic acid which has anti-cancer effects, and the mineral, cesium, which is very alkalizing.(17) Chaga can be enjoyed as a tea, or boiled as a strong decoction. (Editor’s note: For more information on chaga’s many benefits, read The Cure Is In the Forest by Cass Ingram, available at The Healthy Planet across the GTA.)
A more refined mushroom extract called Active Hexose Correlated Compound (AHCC) comes from Japan. It is used along side chemotherapy treatments in many Japanese hospitals for its immune supportive effects. A number of human studies have shown that AHCC increases natural killer cells, which combat cancer cells.(18) There are also cancer- preventive effects in ordinary mushrooms. One study found that plain white button mushrooms (only 5 daily) could have an anti-breast-cancer effect since they suppress aromatase activity and estrogen formation.(19)
2) Fermented wheat germ extract (FWGE): FWGE has been the subject of over 100 scientific studies and 33 PubMed reports. FWGE is also included in the database of the Memorial Sloan-Kettering Cancer Center. It is one of the most promising natural agents in fighting cancer. Studies show that it enhances the quality of life for early and late stage cancer patients, boosts white blood cells, and improves overall survival. One of the most promising things about FWGE is that the studies did not find any interactions with chemotherapy or radiation. In fact, FWGE improved the effectiveness, and reduced side effects of conventional care.(20,21)
3) Lactoferrin is a key immune boosting molecule that is secreted primarily in breast milk, boosting the baby’s immune system at the same time as delivering iron. In adults, it is secreted in certain body fluids (such as saliva or lung mucous) as a first line of defence. Studies have found that lactoferrin’s multifunctional role encompasses antibacterial, antiviral, antifungal, antioxidant and immune-balancing activities.(22) Since lactoferrin has so many beneficial actions on the immune system and inflammation, it has been successfully studied as an adjunct to chemotherapy to improve the immunity of cancer patients undergoing treatment, and to reduce the side effects of the chemotherapy.(22,23,24) In human trials, Lactoferrin was found to be particularly active against lung cancer in doses up to 5 grams.(25)
Q: Natural therapies are not covered under OHIP, so I have to pay out of pocket. Why doesn’t the government support their use and pay for them?
A: Unfortunately, the answer comes down to money. The typical response from any government or medical official is that there is not enough evidence supporting the use of natural therapies for cancer. But this excuse is quickly becoming invalid as the body of research supporting natural therapies rapidly grows. Nevertheless, the measuring stick used by the medical profession to judge therapies is the typical large scale, randomized, placebo-controlled trial. These trials take millions of dollars to run, which is almost always paid for by pharmaceutical companies that are hoping to profit from the results.
Vitamin C and curcumin are natural substances that you can’t patent and sell as drugs, leaving very little incentive for them to be studied on a large scale. If a substance is deemed to have little evidence supporting its use, then the conventional medical profession won’t accept it and, in turn, the government won’t fund it.
The good news is that medical systems in other countries (Germany, Japan, and parts of the U.S.) are starting to recognize the merits of natural substances when used alongside chemo and radiation. Hopefully Canada will soon follow.
Q: What is unique about your approach to cancer as a Naturopathic doctor?
A: The great thing about the naturopathic approach is that it has something to offer every patient at any stage of his, or her, cancer care journey. A naturopathic visit is not limited by time in the same way as a medical doctor’s, so there is a chance to personalize a treatment plan to meet the specific needs of each person. This may mean doing IV vitamin C to prepare for a session of chemotherapy, or it could mean doing acupuncture for hot flashes experienced by a breast cancer patient.
It could also involve teaching a person how to prepare an anti-cancer diet to help prevent the re-occurrence of cancer, or using mistletoe injections to counteract the side effects of radiation. The naturopathic approach offers a broad range of evidence-based therapies to not only address the needs of people at different cancer stages, but to also create a plan that impacts the body, mind, and spirit. This type of approach is the most effective at bringing about deep, and lasting, healing.
Q: What would be the top three recommendations you would give to someone who is looking to incorporate natural and integrative therapies into their cancer care?
A: 1) Collect information; don’t rush – you may feel like you have no time but take a few extra days to research the approach you want to take. This includes chemo, radiation, surgery, or natural therapies. Taking this approach will give you a greater sense of control and peace about your treatment plan.
2) Get a naturopathic doctor who is trained in integrative cancer care as part of your team – there is lots of information on the internet, but you need someone who knows the latest research, and has experience with natural therapies, to guide you.
3) Look at cancer as a health journey – survey your life so far and take an honest look at how you have treated yourself and others around you. Many cancer survivors will tell you that their cancer diagnosis actually saved their life, despite it being one of the most difficult things they had to go through. It forced them to re-evaluate their priorities and how they should be living life and treating others. Consider your stress levels, how you eat, how you think, and your lifestyle. Changing these things will change the internal environment that contributes to cancer growth. On the journey of becoming healthy and reversing the cancer process, many people rediscover what it means to be fully alive.
In conclusion, it is important to note that the answers to many of the questions in this article contain a combination of my opinion, and my perspective, on the existing research. It should not be taken as medical advice and you should always follow the instructions of your healthcare practitioner.
I hope you found the information I shared in this article easy to understand and straight to the point. If you are wondering if natural cancer care is right for you, include a Naturopathic Doctor with a cancer focus as part of your healthcare team. I wish you the best of luck and many blessings on your journey to better health.
(Editor’s note: Look for Part II of this series – ‘Cutting Edge Cancer Therapies From Around The World’ – in the December 2014/January 2015 issue of Vitality magazine.)
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Dr. Paul Hrkal is a Naturopathic physician with a special clinical focus in brain health, neurological disorders, cancer, chronic pain and sports medicine. He is an expert in nutrition and supplemental treatments, and has additional training and certification in intravenous and injection therapy. He is currently a senior medical advisor for Advanced Orthomolecular Research and maintains a clinical practice at: pureBalance Wellness Centre in Mississauga, ON (Tel: (905) 891-3865), and also at the Pain and Wellness Centre, an integrative medical practice in Vaughan, ON (Telephone: 1-800-597-5733). For more information, visit www.paulhrkalnd.com