This section compiles information from several books and recent research articles on integrative cancer treatment.
A comprehensive list of sources can be found at the bottom of the page.
Integrative cancer treatment strives to improve cancer treatment by considering all dimensions of care: the physiological, the psychologically spiritual and the social aspects.
Characteristics of an integrative approach to cancer
Lifestyle
Four lifestyle measures are critical in reducing risk of cancer: not smoking, BMI below 30, 3-5 hours a week of exercise or more and eating a healthy diet. Having all four lifestyle factors reduced the risk of cancer by 36% in a European cancer study (Ford, 2009). Block (2009) found that at their integrative cancer center with attention to nutrition, nutraceuticals, exercise, and psychological interventions, metastatic breast cancer patients had a survival rate twice that of comparison groups in the literature. Median survival in their center was 38 months, compared with 12 to 24 months reported in similar populations.
Exercise
Exercise has a role in cancer prevention through weight control, muscle strength, and improved immunity and mood control. During and after cancer treatment, exercise can benefit mood, strength, weight control, energy levels, immunity, overall health and well-being, survival, prevention of recurrence, and quality of life. Schwartz describes in his book ”Cancer Fitness” (2004) that exercise allows patients to go through their cancer treatments with increased strength, less fatigue and muscle weakness, better balance, and fewer falls. Yoga and higher intensity, frequent exercise have significant beneficial effects on the mood of the cancer patient (Saeed, 2010).
Nutrition
Diets high in vegetables, fish, fresh foods, fruits and olive oil (the Mediterranean diet) reduce the risk of many cancers (Schwingshackl, 2016). Food intake high in fiber can reduce the risk of cancer. In the Malmö Diet and Cancer cohort, intake of high-fiber bread reduced the risk of breast cancer.
Controversy exists about the role of alcohol and risk of cancer. In primary prevention (before you the diagnosis of cancer), alcohol intake and lower folate levels are associated with increased risk (Kushi, 2012). In secondary prevention (after the cancer diagnosis), low to moderate alcohol intake does not seem to be associated with increased risk of recurrence or increased mortality. Alcohol in moderation might even be beneficial, but this is a highly individual concept. Alcohol has
both risks and benefits.
High sugar intake increases insulin levels, which can have deleterious metabolic effects contributing to cancer cell growth. Sugar also contains a lot of extra energy (sometimes excluding more nutritious food) and in this way it contributes to weight gain. High sugar intake in the form of products with high-fructose corn syrup, sugar, honey, and molasses is not recommended. A healthy choice is the ketogenic diet (Allen, 2014 ; Branco, 2016).
Polyunsaturated fatty acids include omega-3 and omega-6 fatty acids. In large quantities and especially if hydrogenated for extended shelf life, sunflower, safflower, soy, sesame, and corn oils can be proinflammatory in the body. Omega-3 fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) are anti-inflammatory and are contained in fish oil, flaxseed oil, and the oil in walnuts. Omega-3 fatty acids are present in fatty fish (such as salmon, sardines, and mackerel), walnuts, green leafy vegetables, and flaxseed meal. The VITAL study demonstrated that fish oil reduced the risk of ductal but not lobular breast cancers. Biondo (2008) found that omega-3 fatty acids may enhance the effects of chemotherapy. Stop fish oil immediately if any bleeding occurs or you are heading for a surgery, because its action on decreasing adhesiveness of platelets in clotting has been widely reported. Use with caution if any other anticoagulants are taken.
Monounsaturated Fatty Acids such as oleic acid (omega-9 fatty acid) is found in olive oil, avocados,
hazelnuts, and cashew nuts. It can help with suppression of growth of some tumor cells. Eating nuts and using olive oil in cooking and as a salad dressing are recommended.
Green tea is a polyphenol that is a natural aromatase inhibitor (important in breast cancer). Green tea consumption of more than three cups per day reduced the risk of breast cancer recurrence by 27%, but no consistent effect could be found on other forms of cancer incidence (Ogunleye, 2010).
Flax, usually consumed as flaxseed meal or oil, is a rich source of phytoestrogens containing alpha-linoleic acid. It has protective effects by decreasing inflammation in the body and thus occasionally decreases cancer cell growth.
Diets high in fruits and vegetables are high in antioxidants and can lower risk of cancer. Carotenoids in fruits and vegetables consumed in large amounts have been found to reduce the risk of invasive breast cancer in premenopausal women. Antioxidants in foods are safer and preferable to high-dose supplement forms, given their bioavailability, synergistic effects, and better absorption.
Medicinal mushrooms that have an anti-inflammatory and immune-enhancing effect include maitake (Grifola frondosa), shiitake (Lentinus edodes), reishi (Ganoderma lucidum), and turkey tail (Trametes versicolor). Lindequist (2005) showed that mushrooms also have a number of other properties, including antifungal, antibacterial, antiviral, and tumor attenuating.
Botanicals and supplements can be useful in promoting health. Some have an anticancer effect or immunity-enhancing effect, and some are useful in attenuating the side effects of conventional cancer therapies. It is important to consider the interactions of some botanicals and supplements with chemotherapy and radiation therapy that might decrease the effectiveness of these modalities and in some cases increase toxicity. Antioxidants taken in high-dose supplement form can theoretically interfere with radiation therapy and chemotherapy by neutralizing free radical formation key to the effectiveness of these agents.
Vitamin D deficiency is common, especially in patients chronically or acutely ill and in northern climates. Vitamin D is important in immunity and has an anticancer effect. Vitamin D is preferably ingested as vitamin D3 (cholecalciferol). Vitamin D3 is also formed in the skin when 7-dehydrocholesterol, the skin precursor, is exposed to ultraviolet B light. Calcidiol is converted in the kidney to 1,25-dihydroxyvitamin D (calcitriol), the active metabolite. Calcitriol significantly inhibits cancer cell growth, especially in breast, colon, prostate, and ovarian tissue (Meyer, 2004).
Thoughts on modern cancer research
Modern research has shown that tumours not only grow and become malignant through genetic alterations in the cancer cells themselves, but also due to the fact that the micro-environment of the body is advantageous to their existence. This includes the cancer cells’ ability to efficiently absorb nutrition and give rise to blood vessels (angiogenesis) and inflammation as well as their ability to suppress cell specific immunity.
The tumours’ micro-environments to a large degree determine whether the cancer cells will grow or not. The body has a number of defence mechanisms (the immune system for example) that can prevent cancer growth. These defence mechanisms are strengthened if we commit to a healthy lifestyle which includes, among other things, an appropriate diet, physical activity, stress treatment and good social networks, and if we successfully avoid environmental contaminants, such as tobacco, alcohol, etc.
Cancer research strives to map out the processes that benefit the existence of cancer cells. Once these processes are known, medicines that block them can be developed and thus cancer cells can be killed or reverted back to a healthy condition. An effective cancer treatment devitalises the environment of the cancer cells by fortifying the body’s own defence mechanisms. Research shows that changes in lifestyle and behaviour can strengthen those defence mechanisms and so impact the results of cancer treatment. This health consciousness means that we not only combat the illness but also promote and stimulate health. Thus people get the chance to impact their health themselves.
A radical alteration of previous lifestyle habits in terms of nutrition, exercise, your emotional life and living environment and retaining an unshakeable thirst for life both supports the treatments and can be the determining factor between life and death. The combined forces are very strong.
You can affect the progress of cancer!
The keys to your recovery or to a higher quality of life for the time remaining to you, together with a likely lengthening of that time, can actually be in your own hands! You need not feel powerless in the face of your situation. You can affect it! New knowledge shows that you can effectively attack the cancer’s greatest weaknesses with means only you yourself control better than anyone else. These means are part of your daily life and have to do with nutrition, exercise, your emotional life and your attitude to life – an everyday existence free from stress in the form of feelings of powerlessness, in a living environment that is as free from environmental toxins as possible.
A necessary prerequisite for the success of this battle is that you have knowledge of the nature of cancer and the reasons why we get cancer. Only through knowledge and awareness can you create the insight you need to go on the offensive, through strengthening your body’s natural defence mechanisms and through the changes you have before you.
Sources
Books
– Loo May. Integrative medicine for children. Saunders, 2009
– Micozzi Marc S. Complementary and integrative medicine in cancer care and prevention : foundations and evidence-based interventions. Springer Publishing Company, 2007
– Rakel David. Integrative Medicine. Elsevier, 2017
– Servan-Schreiber David. Anticancer : a new way of life. Penguin Books Ltd., 2008
– Schwartz AL. Cancer Fitness: Exercise Programs for Patients and Survivors. Simon and Schuster; 2004
– Wisneski Leonard A & Anderson Lucy. The Scientific Basis of Integrative Medicine. CRC Press, 2009
Research Papers
– Allen BG, Bhatia SK, Anderson CM, Eichenberger-Gilmore JM, Sibenaller ZA, Mapuskar KA, Schoenfeld JD, Buatti JM, Spitz DR, Fath MA. Ketogenic diets as an adjuvant cancer therapy: History and potential mechanism. Redox Biol. 2014;2:963-70. doi: 10.1016/j.redox.2014.08.002. Epub 2014 Aug 7.
– Ben-Arye E, Doweck I, Schiff E, Samuels N. Exploring an Integrative Patient-Tailored Complementary Medicine Approach for Chemotherapy-Induced Taste Disorders. Explore (NY). 2018 Apr 22. pii: S1550-8307(17)30249-5. doi: 10.1016/j.explore.2017.09.012. [Epub ahead of print]
– Biondo PD, Brindley DN, Sawyer MB, Field CJ. The potential for treatment with dietary long-chain polyunsaturated n-3 fatty acids during chemotherapy. J Nutr Biochem. 2008;19:787–796.
– Block K, Gyllenhaal C, Tripathy D, Freels S, Mead MN, Block PB, Steinmann WC, Newman RA, Shoham J. Survival impact of integrative cancer care in advanced metastatic breast cancer. Breast J. 2009;15:357–366.
– Brasky TM, Lampe JW, Potter JD, Patterson RE, White E. Specialty supplements and breast cancer risk in the VITamins And Lifestyle (VITAL) cohort. Cancer Epidemiol Biomarkers Prev. 2010;19:1696–1708. 2009:9216
– Ford ES, Bergmann MM, Kröger J, Schienkiewitz A, Weikert C, Boeing H. Healthy living is the best revenge: findings from the European Prospective Investigation into Cancer and Nutrition–Potsdam Study. Arch Intern Med. 2009;169:1355–1362.
– Frenkel M, Sapire K. Complementary and Integrative Medicine in Hematologic Malignancies: Questions and Challenges. Curr Oncol Rep. 2017 Oct 14;19(12):79. doi: 10.1007/s11912-017-0635-0.
– Hack CC, Antoniadis S, Hackl J, Langemann H, Schwitulla J, Fasching PA, Beckmann MW, Theuser AK. Breast cancer patients’ satisfaction with individual therapy goals and treatment in a standardized integrative medicine consultancy service. Arch Gynecol Obstet. 2018 Jul;298(1):147-156. doi: 10.1007/s00404-018-4779-4. Epub 2018 Apr 27.
– Hunter J, Ussher J, Parton C, Kellett A, Smith C, Delaney G, Oyston E. Australian integrative oncology services: a mixed-method study exploring the views of cancer survivors. BMC Complement Altern Med. 2018 May 9;18(1):153. doi: 10.1186/s12906-018-2209-6.
– Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T; American Cancer Society 2010 Nutrition and Physical Activity Guidelines Advisory Committee. American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012 Jan-Feb;62(1):30-67. doi: 10.3322/caac.20140.
– Lindequist U, Niedermeyer TH, Jülich WD. The pharmacological potential of mushrooms. Evid Based Complement Alternat Med. 2005;2:285–299.
– Ling CQ, Fan J, Lin HS, Shen F, Xu ZY, Lin LZ, Qin SK, Zhou WP, Zhai XF, Li B, Zhou QH; Chinese Integrative Therapy of Primary Liver Cancer Working Group. Clinical practice guidelines for the treatment of primary liver cancer with integrative traditional Chinese and Western medicine. J Integr Med. 2018 May 17. pii: S2095-4964(18)30060-8. doi: 10.1016/j.joim.2018.05.002. [Epub ahead of print]
– Lyman GH, Greenlee H, Bohlke K, Bao T, DeMichele AM, Deng GE, Fouladbakhsh JM, Gil B, Hershman DL, Mansfield S, Mussallem DM, Mustian KM, Price E, Rafte S, Cohen L. Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline. J Clin Oncol. 2018 Jun 11:JCO2018792721. doi: 10.1200/JCO.2018.79.2721. [Epub ahead of print]
– Meyer C. Scientists probe role of vitamin D. JAMA. 2004;292:1416–1418.
– Ogunleye AA, Xue F, Michels KB. Green tea consumption and breast cancer risk or recurrence: a meta-analysis. Breast Cancer Res Treat. 2010;119:477–484.
– Rossi P, Difrancia R, Quagliariello V, Savino E, Tralongo P, Randazzo CL, Berretta M. B-glucans from Grifola frondosa and Ganoderma lucidum in breast cancer: an example of complementary and integrative medicine. Oncotarget. 2018 May 15;9(37):24837-24856. doi: 10.18632/oncotarget.24984. eCollection 2018 May 15.
– Saeed SA, Antonacci DJ, Bloch RM. Exercise, yoga and meditation for depressive and anxiety disorders. Am Fam Physician. 2010;81:981–986.
– Schwingshackl L, Hoffmann G. Does a Mediterranean-Type Diet Reduce Cancer Risk? Curr Nutr Rep. 2016;5:9-17. Epub 2015 Sep 23.
– Sonestedt E, Borgquist S, Ericson U, Gullberg B, Landberg G, Olsson H, Wirfält E. Plant foods and oestrogen receptor alpha and beta-defined breast cancer: observations from the Malmö Diet and Cancer cohort. Carcinogenesis. 2008;29: 2203–2209.
Online Materials
Anti-Cancer Strategies & Healthy Living for All
How do you build your very own personal Integrative cancer treatment programme?
12 foods to fight cancer
CANCER: Increasing Your Odds for Survival
MD Anderson Cancer Center
Osher Center for Integrative Medicine
VIDEO: Natural Defenses in Preventing and Treating Cancer
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