Alternative Cancer Therapy (Part 2)Dr. Paul Hrkal ND December 1, 2014
Cancer rates are increasing throughout the developed world and current treatment approaches are not effectively changing this trend. More and more people are now looking for alternatives to conventional therapies. But with so much misinformation available on the internet it is difficult to know if natural and alternative therapies are effective and safe.
In Part I of this article series (Oct/2014), I discussed the most common questions about natural and integrative cancer care: Is it safe in conjunction with chemo and radiation?; What makes up an anti-cancer diet?; and more. In the world of the internet and “Dr. Google,” a person can read about natural treatments from around the world that are claiming to cure cancer – but are these claims to good to be true?
Other countries offer integrative and holistic approaches to treating cancer with natural therapies used alongside chemotherapy, radiation and surgery – but some of these therapies still are not available in Canada. This article will highlight the most cutting edge natural therapies from around the world that are available here. This information will help a person consider the evidence for each therapy and make an informed choice if it could be appropriate for them. This does not replace medical advice and these options should be discussed with your oncology-focused naturopathic doctor and/or oncologist before starting.
High Dose IV Vitamin C
Vitamin C is one of the most well known and widely used natural cancer therapies. Integrative practitioners have used vitamin C to successfully to improve quality of life and survival times in cancer patients for over 40 years. A large number of research studies have confirmed that vitamin C is safe in conjunction with the majority of chemotherapy drugs and radiation.(2,3) Its improves quality of life and reduces side effects by preventing damage to healthy cells.(3,4)
Years of research have found that vitamin C has two distinct modes action when it comes to combating cancer. At low doses (under 2 grams), vitamin C has an antioxidant effect that protects 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 directly 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.(5,6) Researchers think that cancer cells are particularly vulnerable to hydrogen peroxide because they don’t have the enzyme catalase to break it down while healthy cells do. This effect is only achievable by intravenous (IV) infusion since oral vitamin C above 2 to 5 grams causes loose stools and only a small amount is actually absorbed.
Most people achieve the anti-cancer concentration of vitamin C at 25-75 grams given by IV. In addition to this effect, high doses of vitamin C have been shown to regulate cell division, improve immune response and reduce inflammation.(6,7)
The main benefit of vitamin C is definitely a direct anti-cancer effect when used in high doses, and it has other benefits that are very helpful against cancer. The following list is a summary of those effects:
1. Low doses (from diet or supplements) act as an antioxidant and prevent cancer formation;
2. High doses (from intravenous therapy) form hydrogen peroxide to kill cancer cells directly;
3. Improves immune function and reduces chance of infection;
4. Reduces inflammation, a key marker linked to cancer growth;
5. Promotes collagen formation around cells which slows cancer cell spread;
6. Improves outcomes and reduces side effects of chemotherapy.
Bottom Line: Vitamin C stands as one of the best and safest natural treatment options for cancer. A recent survey of integrative healthcare practitioners using IV vitamin C found no substantial adverse effects over two years of use in almost 10,000 patients.(8) The research trials all concluded that IV vitamin C is a very safe and well tolerated therapy. Nevertheless, a trained naturopathic doctor will have to assess each patient to insure that they are able to tolerate IV therapy. Since vitamin C is non-toxic, the dose and protocol can be tailored to almost any person, even those in very poor health. In terms of treatment frequency, vitamin C levels peak in the bloodstream after only a few hours so multiple infusions per week have been shown as most effective in active treatment cases. One IV session per week is usually considered a maintenance protocol.
Mistletoe (viscum album L.) is a parasitic plant that grows on various woody hosts such as apple, lime, and poplar trees. The refined extract of mistletoe, sometimes known as Iscador, is the most commonly used oncological drug in Germany. It is estimated that over 75% of cancer patients in Germany and Austria use it as part of their cancer treatment. Mistletoe contains specific active compounds called lectins and viscotoxins. These molecules have the ability to directly kill cancer cells and also activate immune cells.(9) They can stimulate natural killer cells, T-cells, macrophages and other immune components to destroy cancer cells.(9,10)
An important benefit of mistletoe extract is that it also protects the organs and immune system from damage during chemotherapy and radiation. Numerous studies have shown that mistletoe therapy can improve survival times and quality of life at the same time as reducing the side effects of radiation and chemotherapy.(11,12,13,14)
In summary, research has shown that mistletoe extract has the following benefits:
1. Direct anti-cancer effect (killing cancer cells);
2. Stops tumour growth and spread;
3. Protects the DNA of healthy cells, decreasing side effects of chemotherapy and radiation without altering the effectiveness of the chemo;
4. Improves well-being and the quality of life of cancer patients;
5. Immune stimulation/stabilization;
6. Improves overall survival by up to 40% in some studies.(13)
Mistletoe starts stimulating the immune system immediately but it usually takes one to two months to work up to the highest doses. One of the effects that patients will see right after an injection is ‘flu-like symptoms and an increase in body temperature, which is a sign that immune cells are being activated (like in a fever).
Bottom Line: The mistletoe extract itself comes directly from Europe and is grown and refined according to the highest standards. Different types of extracts (i.e. Helixor, Iscador) vary according to how the original plant was grown and processed. A Naturopathic doctor can select the safest and most effective type of mistletoe for each patient, depending on the type of cancer and state of health. It cannot be taken orally as a supplement, so it is most commonly administerd by injection every three days. The doses start very low and are gradually increased, stimulating the immune system at each dosage level.
Mistletoe is intended for long-term use and some benefits really start to show after use for more than three months. Once on the maintenance dose, studies show that the most effective results are seen when treatment is continued for one to three years. After being taught the proper technique, most people find the best and most convenient method is to inject themselves at home. Their ND show will them how to do it properly and safely, and once learned it actually is a very simple procedure. Overall, the impressive, broad, and evidence-based benefits associated with mistletoe injections make it one of the leading and safest natural therapies available in Canada.
Heat Therapy / Hyperthermia
Heat therapies have been used for thousands of years for various medical conditions. Many cultures use heat from saunas to stimulate sweating to promote detoxification and elimination. It is also known that a fever is the body’s way to purposely increase core temperature to kill bacteria and stimulate immune cells, which occurs at 40-42 degrees Celsius. By making immune cells more effective, heat produces an indirect anti-cancer effect. As mentioned above, mistletoe therapy also causes an increase in body temperature as one of its indirect anti-cancer effects.
Recent evidence has shown that cells begin to die at temperatures between 42 and 44 degrees Celsius in an environment with low oxygen levels and low pH.(15) These conditions are found specifically within and around cancer tumours because of excessive lactic acid production and poor blood flow. Unfortunately, healthy cells can also be damaged at these temperatures so full body hyperthermia above 42 degrees C is not recommended (regular sauna therapy stays below 42 degrees celsius).
New radiowave technology allows local temperatures to reach 46-48 degrees Celsius in a targeted area, which has been shown to directly kill cancer cells without affecting the whole body.(16) The emerging research on this is promising and evidence suggests that it can even be done along with chemo and radiation.(15) This method is more commonly used in Europe and is called local oncothermia. A few clinics in Canada have also started to offer this therapy.
Bottom Line: Heat therapy is an excellent and safe addition to most cancer protocols. Heat can combat cancer in three unique ways: by increasing detoxification of stored wastes and toxins; stimulating immune cell function; and directly destroying cancer cells. Oncothermia is a very specialized and innovative therapy that may make conventional therapies like radiation more effective.
Not everyone has access to an oncothermia machine, but I recommend that everyone incorporate regular sauna (wet or dry) sessions for 20-30 minutes, three to four times per week, into his or her cancer treatment plan. While it is generally safe, some people with pacemakers, cardiovascular disease, and poor health should not use sauna therapy. If you do, remember to drink water before, during, and after your time in the sauna, and take extra electrolytes and minerals before and after to replenish stores that are lost by sweating.
Fermented Wheat Germ Extract (FWGE)
FWGE is one of the most promising natural agents in fighting cancer. Specific compounds are extracted from the most nutrient-rich part of a wheat seed (called the germ) and then fermented. This extract has been the subject of numerous scientific studies and publications. The results where so impressive that it is now listed in the supplement database of the Sloan-Kettering Cancer Center.(17,18) Research has shown that FWGE is beneficial in the following ways:
• Improves the overall survival, metastases-free survival, and progression-free survival of certain cancer patients;
• Enhances the quality of life and physical condition of early and late stage cancer patients (less fatigue, less pain and increased appetite);
• Stimulates cancer cell apoptosis (programmed cell death);
• Modifies the glucose metabolism of cancer cells by decreasing sugar uptake and shifting it away from DNA synthesis and the production of more cancer cells;
• Stimulates the cancer killing cells of the immune system. It specifically enhances the ability of natural killer cells to identify and kill cancerous cells.
One of the most promising things about FWGE is that all the studies conducted did not find any interactions with chemotherapy or radiation.(17,18) In fact, FWGE improved the effectiveness and reduced side effects of conventional care. One study found that it decreased the damaging effects of surgery, radiation, and chemotherapy on the immune system.(18) It also was very well tolerated, with no serious side effects documented other than mild digestive disturbance.
Bottom Line: FWGE is an excellent cancer-fighting supplement, which is gaining traction even in conventional medical circles. It really shines in its ability to reduce the negative effects of conventional treatment, especially in breast and colon cancer cases. The extract comes in sachets that can be mixed with water or juice.
Mushrooms and fungi have been used in medicine for thousands of years. They have been used traditionally to treat and prevent infections and offset the negative effects of stress. There are many different varieties of mushrooms that have demonstrated beneficial effects against cancer cells, boosting the immune system and reducing chemo side effects. Mushrooms contain specific compounds called alpha and beta glucans that are responsible for the anti-cancer and immune stimulating actions. The most well studied types of mushrooms are Coriolus versicolor, Agaricus blazi, Grifolia frondosa (aka Maitake), and ganoderma lucidum (aka Reishi).
Coriolus versicolor: This mushroom extract, commonly known as turkey tail, has the strongest human evidence supporting its use in cancer. Two specific extracts called PSP and PSK have been isolated from coriolus and studied in human subjects while they were taking chemotherapy. Thousands of patients have been studied using these extracts and they actually are part of the conventional treatment protocol in Japan.(19,20) Numerous studies have shown it improves survival rates for gastric, breast, and colon cancer.(20) A recent review found that coriolus extracts in combination with chemo reduced the five year mortality rate by 9%, with fewer side effects.(20)
Grifolia frondosa (Maitake): Compelling evidence suggests that it increases immune function, specifically activating macrophages, which further turn on lymphocytes – the part of our immune system that directly targets cancers. While a large number of clinical trials are still limited, Maitake extracts have been studied extensively in Japan on cancer patients with promising results.
Reishi mushroom: has consistently shown the ability to kill cancer cells in pre-clinical studies. A recent review concluded that while there is not enough evidence to recommend it yet as a first line cancer therapy, its immune boosting and anti-tumour effects make it a good option for supportive therapy.(21) The added bonus with reishi (and most other mushrooms) is that they are generally really well tolerated and have little interactions with standard therapies.
AHCC: A more refined mushroom extract called Active Hexose Correlated Compound (AHCC) comes from the shiitake mushroom family. This extract is a blend of mushrooms that are grown and fermented together before the active components are extracted. AHCC is used alongside chemotherapy treatments in many Japanese hospitals for its immune supportive effects.(22) The majority of studies on AHCC have shown reduced side effects, increased quality of life, and improved survival rates.(23,24,25) The primary mechanism through which AHCC delivers its beneficial effect is by stimulating and balancing the immune system. Research has shown that this mushroom extract works to increase immune cells such as macrophages, T-cells, dendritic cells and natural killer cells, which in turn target and destroy cancer cells.(23,24,25) This broad spectrum of action is very important to recreate immune balance so that blood cells are able to recognize and attack cancer cells.
The immune effects of AHCC are not limited only to cancer – they have been applied to microbial infections as well. One interesting note: AHCC supplementation improved immune response to vaccinations, which is very applicable to the elderly who sometimes have difficulty mounting an adequate immune response to vaccines.(26)
The good news is that you don’t always need to eat fancy medicine mushrooms to get the benefits. One study found that plain white button mushrooms (only five daily) could have an anti-breast cancer effect since they suppress aromatase activity and estrogen formation.(27)
Or a strong tea can be made out of the medicinal chaga mushroom, a powerful alkalinizing plant medicine which grows on birch trees in Canada; it can be found in health food stores in its ground and dried form. And for an added immune boosting punch, add shiitake and king oyster mushrooms to your winter soups and stews.
Bottom Line: Mushrooms have potent immune stimulating and balancing properties. There are many different extracts with unique benefits but the common action they all share is that they stimulate the immune system. A good prevention strategy would be to eat various kinds of mushrooms as part of your diet. Specific extracts such as AHCC or coriolus at the doses of 2 to 6 grams can be used in cases of active infections and cancer. Clinical experience suggests that the body gets used to one specific extract after about three months, so alternating the mushroom types, or taking a combination formula, will maximize effectiveness. Look for a hot water extract to get the maximal benefit from mushroom supplements (or in the case of chaga, buy the dried chunks and place in a glass mason jar with boiled water to create your own infusion or tea).
Pancreatic enzymes are secreted in the digestive tract to break down protein and fat. The use of pancreatic enzymes as a cancer therapy originated with Dr. John Beard, an embryologist from Scotland. Dr. Beard observed that cancers have the opposite charge (negative) to enzymes (positive), and enzymes attract and digest cancer cells while healthy cells are unaffected.(28) A dentist named Dr. William Kelly found Dr. Beard’s research from the early 1900’s, and applied the theory that enzymes can digest the wall of the tumour cell to treat his own cancer. He succeeded in curing himself and went on to create an innovative cancer protocol centered around massive doses of pancreatic enzymes for which he became well known.(28)
A common outcome of Dr. Kelly’s protocol was that patients became ill with ‘flu like symptoms, which was due to the tumour breaking down and releasing waste products (also known as tumour lysis syndrome). This highlighted the additional need for detoxification to eliminate the cellular debris. Today, Dr. Nicholas Gonzalez continues to treat cancer patients using Dr. Kelly’s enzyme-based protocol, with considerable success. The current protocol (used at the Gonzalez clinic in New York) is comprised of very large doses of pancreatic enzymes (up to 150 a day), along with individualized diets, enemas for detoxification, and glandular supplements.(28)
In 1999, the Gonzalez protocol was studied in late stage pancreatic cancer cases showing an improved survival time.(29) When asked, Dr Gonzalez himself is not 100% sure of exactly why the enzymes destroy cancer cells, but he thinks specific enzymes called trypsin and chymotrypsin break down the protein in the cancer cell wall ultimately causing apoptosis.(28) The protocol gained enough attention from the conventional medical establishment that Dr Gonzalez’s complete protocol was compared to standard chemotherapy in pancreatic cancer patients (considered the toughest of all cancers to treat). The results showed that the chemo group had better survival times and quality of life – but the study may have contained some biases, which altered the results.(30,31)
Bottom Line: A diet high in animal protein and processed foods requires high amounts of pancreatic enzymes for complete digestion. Fresh fruits and vegetables actually contain their own enzymes and require less enzymes to be broken down, leaving more for other functions. You can conserve your digestive enzymes and pancreatic function by eating a plant-based diet. Regular digestive enzymes are not quite the same as the ones used by Kelly and Gonzalez (they use specifically formulated and stabilized enzymes high in trypsin and chymotrypsin from New Zealand). Similar enzymes are available in Canada but recently have had some trouble getting approval by Health Canada. While the research is unclear, there is still much benefit to be derived from taking digestive enzymes, either with meals to facilitate complete digestion of food, or between meals on an empty stomach for digestion of clots, tumours, and other debris in the body. I recommend them to cancer patients as a complementary therapy to protect organs from damage (i.e. kidneys), reduce inflammation, and support digestion.
Amygdalin (AKA Laetrile, Vitamin B17)
Amygdalin (also called vitamin B17) is a compound naturally found in fruits, almonds, and grains – with the highest amounts to be found in the pits of apricots, plums and peaches. It was isolated from apricot pits in the 1920’s by a father and son team, Dr.’s Ernest Krebs and Krebs, Jr.(32) Amygdalin is made up of three sugar molecules: glucose, benzaldahyde, cyanide. Although cyanide is toxic to all cells, it is thought that the cyanide compound is more toxic to cancer cells. At low amounts, healthy cells have the ability to eliminate cyanide compounds. Cancer cells have higher levels of an enzyme called beta glucoronidase which liberates the cyanide, killing the cancer cell while leaving healthy cells alone.(32,33)
Laetrile is the patented drug made from the natural compound Amygdalin. In the 1970’s, Laetrile became popular as a natural cancer therapy and some estimates suggest that up to 70,000 Americans were using it, despite it being banned in 1963.(33) Patients had to travel to clinics in Mexico and bring it back across the border themselves in order to use it. Today Mexican clinics still use an IV form of B17 as part of their cancer protocols. Due to great public interest, the prestigious Sloan-Kettering cancer centre commissioned Dr Kanematsu Suguira to research Amygdalin. The initial results from animal studies showed that Amygdalin appeared to slow lung cancer cell growth and spread.(33) Dr. Suguira concluded it should be studied further since the results were so promising. Unfortunately, the news headlines published by Sloan-Kettering officials about the results delivered a very negative message and claimed there were no beneficial effects. Some researchers, including Dr. Suguira and Dr. Ralph Moss who were involved in the study, were outraged and felt that the board of directors and government officials suppressed the truth for the sake of protecting pharmaceutical interests.(33)
From that point on, Amygdalin was considered toxic and ineffective by conventional medicine and the American Cancer Society. A current review of case reports and existing studies showed Amygdalin to be ineffective and possibly toxic, however it continues to be used intravenously in Mexico and some American clinics.(34,35)
Bottom Line: While Amygdalin / B17 is illegal in Canada, patients are still able to source this oral supplement from online retailers. The lack of easily accessible scientific evidence has made it difficult for licensed medical practitioners (including my-self) to assess its safety and effectiveness for cancer patients. Different extracts (Mexican vs European) and routes of administration (IV vs oral) further confuse the situation.
Nevertheless, it is an intriguing therapy that may slow the growth of cancer but it still needs to be studied further before it can be confidently recommended. I would caution against using B17 (or any supplement) without the guidance of a trained integrative physician. The reported cyanide toxicity, especially when taken orally, is very concerning and more evidence is needed to assess its safety.(35) For information about the B17 / laetrile controversy, I recommend watching the 2014 documentary featuring Dr. Ralph Moss called Second Opinion: Laetrile and Sloan-Kettering.(33)
In recent years, there is increasing interest in marijuana medical applications. Most people are familiar with marijuana use for chronic pain, and more recently to reduce seizures in children, but now it is also being studied for cancer applications. It is important to point out that the marijuana smoked as a drug or used in pain relief is different from that being used to directly address cancer.
The body has a class of receptor molecules that are called cannabinoids, which are responsible for a number of essential cellular functions. The hemp/marijuana plant contains up to 70 different cannabinoids that influence these receptors.(36) The best known is delta-9-tetrahydrocannabinol (THC), which is responsible for the psychoactive properties (the “high”), but the lesser-known cannabidiol molecule is now being studied in cancer applications.(36,37) Test tube and animal studies are showing that cannabinoids regulate key cell signaling pathways that are involved in cell survival, invasion, new blood vessel growth, and cancer spread.(37) Other effects include reducing inflammation, stimulating appetite, reducing pain and side effects of chemotherapy.(36)
Bottom Line: The cannabinoids found in industrial hemp (higher in cannabidiols) and medical marijuana have very promising effects against cancer. More studies are needed to fully understand the complex nature of these molecules and signaling system. Some clinicians are already prescribing hemp and marijuana extracts in the form of oil that is concentrated to have high levels of cannabidiols and can be safely vaporized. I am intrigued by what this therapy has to offer. But at this point there is not enough evidence to support consuming or inhaling hemp vapour to directly fight cancer, although the research is promising. I do not recommend smoking marijuana (unless used in pain management) as it can have a number of negative long-term effects.
Lipoic Acid and the Mitochondria
Every cell in our body contains numerous mitochondria that use sugar and fats in combination with oxygen to produce energy in the form of adenosine triphosphate (ATP). This process is essential for human life and function. Mitochondria are also responsible for the self-destruct trigger known as apoptosis.(38,39)
As we age, and through exposure to toxins, heavy metals and free radicals, our mitochondria lose the ability to function and produce energy. In addition, as cancer cells grow they choke out blood flow and nutrient exchange, which lowers the amount of oxygen concentration around the tumour. Cancer cells survive in this environment by switching to a less efficient energy production called anaerobic respiration, which doesn’t need oxygen or the mitochondria. This puts the mitochondria to sleep and the cancer cell ‘kill switch’ (AKA apoptosis) along with it. When in this mode, cancer cells are very resistant to death even from chemo and radiation.(38)
A new theory has emerged which suggests that restoring the ability of mitochondria can turn the ability of the cancer cell to self-destruct back on.(38,39) An old drug called dichloroacetate or DCA was able to re-start mitochondrial function in an animal study done at the University of Alberta, reversing breast cancer in mice.(40) However, DCA can also be very toxic to nerves, especially if used orally, so only a few medical doctors use it along with natural substances to offset the side effects.
Fortunately, other natural substances can “re-start” the mitochondria as well. One of the best known is called alpha lipoic acid. Lipoic acid has multiple actions in the body and is considered a key “network antioxidant” since it recharges other antioxidants (like vitamin C) to do their job. The better known effects of lipoic acid are balancing blood sugar, improving liver function, and healing nerve damage. Its also activates an enzyme called pyruvate dehydrogenase which pumps fuel back into the mitochondria and restarts its action.(41,42,43) Its also reduces lactic acid production which stimulates more mitochondrial function. Many integrative physicians use poly-MVA, which is lipoic acid combined with the metal palladium and vitamin B12, administered intravenously. However it is difficult to source and is very expensive.
Bottom Line: The mitochondria are essential for healthy cellular function but they are poorly functioning in almost every chronic disease. Stimulating mitochondrial activity is an innovative approach to restoring the cancer cell death signal. Lipoic acid is available as an oral supplement or can be given intravenously for rapid delivery. It is important to ensure that the oral supplement is the bioactive “R-form” instead of a 50/50 mixture that is found in some alpha lipoic acid supplements. Restoring mitochondrial function also requires multiple nutrients because of the complexity and intricacy of its function.
B-vitamins, coenzyme Q10, glutathione and acetyl L-carnitine all are key mitochondrial stimulators and protectors. In my experience, mitochondrial rehabilitation is a key foundational pillar to every chronic disease treatment plan. More research is needed to further understand its effects specifically in cancer but the mechanism of action is promising.
There are many more therapies that have anti-cancer effects. I have discussed therapies that are available in Canada, have been studied in some way for cancer, and that I think people should know about. I want to be clear that I am not recommending each therapy for every patient. In fact, in the case of Amygdalin, I recommend that people avoid it until more safety research is done. Each one of the therapies I discussed needs to be implemented as part of an integrative cancer treatment plan. As I mentioned in Part I of this article series, some cases require chemotherapy, radiation, and surgery in order to rapidly reverse the cancer process, along with natural therapies to complement their effects and reduce toxicity.
Diet, lifestyle, exercise and foundational supplements should be put in place first before these therapies are considered. An oncology-focused Naturopathic doctor will help make sure that all of the therapies (conventional and natural) can be used safely together. They will also help decide which ones are best for your situation, conventional treatment protocol, and type of cancer. It is encouraging that some of the natural therapies from around the world are finally being studied and are becoming available here in Canada. While there still is resistance from the conventional medical system, the evidence is becoming too compelling to ignore.
Patients who use natural therapies along with their chemo, radiation, or surgery almost always have fewer side effects and better outcomes. I hope you have found the information in Part I and II of this article helpful in your cancer journey. Information is power and it is my belief that people should know about natural options so they can confidently include them as part of their cancer care plan.
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- Video: The Truth About Cancer, 2014 – Interview with Dr Nicholas Gonzalez
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Dr. Paul Hrkal is a board-certified Naturopathic doctor with a clinical practice in the Toronto area at 2 multidisciplinary clinics. He has a special interest in neurological health, chronic pain and brain injuries, writing and lecturing extensively on these topics which includes over 100 webinar, podcast and live presentations to medical professionals, researchers, and public audiences. He is a member of the scientific advisory board of Complete Concussion Management, an international leader in research-based concussion management education and is the co-founder of the Concussion Fix program. He also has extensive experience in the natural health industry where he has been a scientific advisor and medical director for nearly a decade educating clinicians and formulating science-based products including a number of best-selling formulations. Follow Dr Hrkal: Instagram @DrPaulHrkal 7000+ followers Clinical practices: pureBalance Wellness Centre - Cancer Care 219 Lakeshore Road East, Mississauga, Ontario, L5G 1G5 P. (905) 891.3865 <a href="https://www.mypurebalance.ca/">www.mypurebalance.ca</a> The Pain and Wellness Centre 2301 Major Mackenzie Dr. West Unit 101 Maple, ON L6A 3Z3 P. 1 (800) 597-5733 Watch the following short video to learn more about Dr Hrkal’s practice: <a href="https://thepwc.ca/directory/dr-paul-hrkal-naturopathic-doctor/">thepwc.ca</a> The Concussion Fix Program <a href="https://concussiondoc.io/offer/the-concussion-fix/">concussiondoc.io</a> Complete Concussion Management <a href="https://completeconcussions.com/about-us/medical-advisory-board/">completeconcussions.com</a>