Treatment Options for Cancer Patients
by Patricia Peat(more info)
listed in cancer, originally published in issue 79 - August 2002
Over the last ten years, the world of cancer treatments has changed. Our understanding of the disease has improved, and our expectations of our doctors and treatments have increased. Cancer has lost some of its stigma and become widely discussed. People are more aware and ready to be more active and questioning in pursuing the treatment that is right for them. Finding the right path is often where the difficulty lies.
While we are blessed with an increasing abundance of accessible information, both formal and informal, it can frequently be as confusing as it is informing. So, where does one start once having received that diagnosis of cancer? It will undoubtedly be received via an orthodox doctor. After the initial shock, there is often an understandable urge to spring into immediate action, to begin to eradicate the disease.
It is at this point that it is sometimes useful to stand back and take stock of the situation, though I recognize the difficulty at an emotionally turbulent time.
Firstly one needs to assess the urgency of the situation – your doctor should be able to guide you on this. Cancer is essentially a chronic state. The process of cells in the body becoming malignant has, for most people, taken quite some time, followed by their development to the point that the tumours make themselves known. In most cases, you may find that a few weeks elapse while further investigations are carried out. At this point begins a steep learning curve about cancer.
For the majority of people, the option that will be offered first will usually be surgery to take away as much of the tumour as possible. This may be followed at this point, or some time in the future, by drug-related treatment with chemotherapy, hormone therapy, immunotherapy or some of the newer approaches, many of which may still be undergoing clinical trials. Radiotherapy may be offered as a treatment in its own right, or to accompany some of the others.
A good approach at this stage is to ask for as much information as possible from your doctor concerning the treatments. Take it away and study it carefully before you make any decisions.
Information to Acquire
• What new developments are taking place for your particular type of cancer?
• With the treatment offered, what results did the research show about its effectiveness?
• What exactly can you expect in terms of side effects and debility?
• Are there any new treatments in development that are looking promising
• Is it worth your considering going on a clinical trial? Ask yourself, whether you would be prepared to travel to other areas in order to access different treatments or try new ones. Bear in mind, over a long-term treatment, this can prove expensive and tiring – are you prepared for that?
• What type of clinical trial is it? Orthodox clinical trials can be random double blind, which means that you may receive a placebo rather than the new treatment, and may not know. You need to be prepared for this.
"Thanks But Hold on a Minute"
As you find yourself being offered these treatments, it is difficult to tell your doctor, "Thank you, but I want to look at all the options before I make a decision". I know many people who have done this, and none without a large amount of trepidation and bravery.
You can expect many different reactions, depending on the individual attitudes and opinions of your doctor. If there is reason to spring into urgent, immediate action, that advice should not be ignored, but, if there are a few weeks' grace, you could put your time to good use by acquiring the knowledge and information necessary to making an informed decision.
Having to deal with people who are very well informed is a challenging development for doctors. They then proceed to their oncologists armed with so much information that I have heard some complain that the patients often know more about all the different treatments than they do.
Hopefully your doctor will be receptive and support you. I have known instances where this unfortunately does not happen and the person has felt they were being ridiculed for considering other options. It pays to stand firm in this situation. Many more people are using alternatives to the orthodox either to support their treatments, or by devising their own treatment programmes, involving a change of lifestyle, both dietary and holistically.
At this point, try to acquire as clear a picture as possible about cancer as a disease, and about your individual cancer. From here, the way forward is to decide how you want to approach it.
Many people, further down the road with their cancer, look back at this time, and are surprised that some of the nutritional and what are considered alternative treatments are never mentioned. Don't be! It is unusual, though not unique, to find a doctor who takes a broader view on approaches to treating cancer. This is not a criticism of orthodox doctors; they have been trained to view disease through a medical model of attacking the tumours and dealing with arising symptoms.
The tools that are available to them are generally toxic and very powerful. All of these treatments have been through strict clinical trials and are known to have measurable benefits in suppressing the disease and shrinking the tumours. Most are successful in achieving that, though it is widely recognized that few achieve total eradication of the disease.
The downside can be the side effects and the long-term immunosuppression that is caused. If you are considering these treatments, it is useful to know what to expect. Also, if you are likely to become nutritionally compromised and suffer a lot of weight loss, you may wish to take measures to minimize the damage.
A longstanding problem with orthodox treatments is that insufficient attention is paid to correcting the nutritional problems that may have played a part in the development of cancer, or will become a problem due to treatment. This is invariably down to a lack of resources, and some planning and work on your own part may prove useful in preventing too many problems.
Should I Consider Other Approaches?
The main difference between orthodox and alternative treatments lies in how the causes and philosophy of treatment are viewed.
Both agree that it is a complex immune system disorder that allows uncontrolled spread of mutated cells, but orthodox treatment tends to focus on eradicating it with strong treatments, whereas the alternatives, particularly nutritionally based treatments, prefer to speculate on individual reasons for developing the disease, and alter the cellular environment in which it first started.
Another view is that if you do manage to eradicate most of the cancer cells that are in the body at present, there was originally some genetic deficit or antigen that allowed the disease to develop in the first place. Therefore, what is there to stop that deficit allowing other tumours to develop? This is a good question and one that should underlie many people's approaches to how they deal with their illness.
What Avenues are Open to Me?
The three main approaches are:
• Orthodox therapies;
• Orthodox therapies with alternatives to support them and help the body to cope;
• Only alternative treatments.
Orthodox Treatment Options
Orthodox treatments have traditionally focused on eradicating the disease from the body by surgery and then blasting the cells with either radiation or cytotoxic drugs. A problem with this in the past has been achieving the right balance between causing damage and side effects to non-cancerous cells and providing a sufficient dosage to eradicate the disease. However, over recent years improvements have been made in managing the side effects and immunosuppression, so treatments can be given longer, thereby lengthening survival rates. Unfortunately, in the case of chemotherapy, the cells can mutate and become resistant to the chemotherapy, which often is the reason for treatment having to stop.
Orthodox treatments are known to be effective in shrinking tumours and controlling disease. This is well researched and measured. However, one of the long-term problems, and the focal point for many people in deciding whether to use alternative approaches, is the suppression caused to the immune system. An alternative approach may propose that rather than suppressing the immune system, as that may well be the reason for the problem developing, a sounder argument would be to look to repair and strengthen the immune system, so the body can heal itself. The people who have found success with this approach have achieved long-lasting benefits.
There is a change taking place, with new orthodox treatments coming through. New methods of drug delivery, the development of cancer vaccines and the focus now on treatments that utilize the immune system are making future treatments look far less toxic and hopefully more effective. Examples are as follows:
• Immunotherapy is showing some progress from the early days of Interferon. A lot of research is being done into utilizing the immune system, which is where the major evidence suggests that our system flaws, which lead to malignant disease, begin. The paradox that this approach has been largely criticized when used by alternative practitioners over the years is not lost on a lot of people;
• Photo dynamic therapy is a useful addition to systemic treatments. After treatment with photosensitive drugs, areas are treated with lasers to eradicate malignant cells;
• Tumour ablation, used by inserting a probe directly into the tumour and destroying it with radio- or microwaves, has had success in other countries and is becoming available in the UK. Liver primary and metastases have been treated, and work is in the early stages of treating breast cancers without the need for mutilating surgery;
• Cancer vaccines provide a more individualistic approach that may also bring some viable benefits without the problems associated with other treatments.
Overall, the future is looking more promising. How long it will be before we actually see any results is difficult to say. Whether new treatments make it past being only available in the private sector, as are some currently more effective treatments, is another issue.
Most oncology centres in your hospital will have information about available treatments. Cancer Bacup and Cancer UK are both excellent resources for information about current and upcoming treatments. Available both online and via the telephone, they also provide booklets explaining about the different types of cancer.
Supportive Complementary Treatments for Chemotherapy or Radiotherapy
There are many treatments that are beneficial in helping the body to cope with the massive increase in toxicity that these orthodox treatments entail. Chemotherapy in particular is known to deplete the body's cells of many vital vitamins and minerals. Without support, it can take the body a long time to re-regain equilibrium.
I had a client recently who had undergone long periods of treatment for leukaemia. After a failed bone-marrow transplant, he had stem-cell treatment, which was struggling to take due to a lack of response from his immune system. He used high-dose intravenous vitamin C, Ukrain, and nutritional, dietary and enzyme therapy to boost the immune system and benefit from the non-toxic chemotherapeutic effects. This was carried out with the full blessing of his haematology team.
Nutritional Approaches
Your first consideration should be for nutritional support. A good homeopath, naturopath or nutritionists can help you to make a plan for maintaining cellular function. There are many recorded cases of partial and complete remission being obtained by exclusively using nutritional approaches. However, if you decide to use them to complement your orthodox treatment, an element of caution should be applied. Some nutritional supplements can interfere with the effectiveness of orthodox drugs. Always check out anything that has been suggested to you with your oncologist or, better still, encourage your oncologist and nutritionist to work together!
You should also check that the person you choose is fully qualified and registered with an appropriate governing body. Registers of practitioners are available from the British Homeopathic Society, the Faculty of Homeopathy, BANT (British Association of Nutritional Therapists) and The Nutritional Cancer Trust.
Acupuncture and Acupressure
Acupuncture is extremely useful in helping the body to detoxify. By keeping the energy channels clear, it can help the body to release a lot of the heat that is stored in the tissues following radiotherapy.
Both acupuncture and acupressure have shown very positive effects when used with chemotherapy. In a new pilot study recently published in the journal Oncology Nursing Forum,[1] scientists examined the use of finger acupressure in relieving the symptoms of nausea in breast cancer patients undergoing chemotherapy. Although the study group was small, those receiving acupressure reported "significant differences" in nausea intensity and duration compared with those who did not.
Reiki Massage and Healing
Reiki massage and healing are both widely used more in hospices than in general oncology centres. Reiki has evolved as an energy medicine, which can be understood through advanced physics principles. Reiki actively promotes the healing process in many other ways. It acts not only on physical levels, but also addresses mental, emotional and energetic imbalances. Reiki has a similar effect on the body/mind to meditation. It promotes personal and spiritual growth, expands consciousness and stimulates intuitive, spiritual and creative awareness. I know people who have used it and have found it to be a good tool for grounding and rediscovering themselves amidst the turmoil of cancer treatments.
Aromatherapy and Massage
Aromatherapy is nowadays a very popular therapy for many things. The physical effects of the massage alone are known to change levels of endorphins, our natural painkillers. Hormone levels have been shown to change. The blood is diluted because of the lymphatic drainage effect. Muscles respond to the physical effects of the massage, and muscle spasms are prevented or removed. Poor peripheral circulation is improved. Touch sensors in the skin are affected and these pass messages to the brain. Body energy flow may be stimulated by massage in a similar manner to acupuncture. Therefore massage alone has enormous and clinically proven benefits. A word of caution, though: while helpful, a lot of doctors are uneasy about the use of aromatherapy massage during treatments, and there are also potential problems from some essential oils. As with nutrition, discuss your plans with your doctors first.
Reflexology can be useful. Many people with cancer who have had reflexology say that they find that it helps to ease nausea, vomiting and pain and increases their general feeling of well-being. There are studies to support this, and over the last few years some cancer departments in hospitals have started to offer reflexology as part of their NHS service, but the majority of treatments are still done on a private basis.
While all of the previously named treatments can prove effective as part of a treatment menu from which to choose, the most powerful evidence from alternative treatments in achieving long-term results against cancer lies with nutritional therapy. Changing of poor dietary habits and analysing and correcting the nutritional disorders in the individual have achieved impressive results, as illustrated in many of the books on the subject. (Please see Bibliography.)
There are several very famous treatment regimes, including the Gerson diet and the Issell's treatment regime, which combine detoxification with a rigorous transformation of the nutritional state of the body. While they involve a major change in dietary approaches and a lot of self-discipline, there are many recorded instances of effectiveness. There are clinics in Europe that specialize in these, but, if you do not wish to travel so far afield, most of the practitioners in this country base their practice on the principles of these approaches.
Finding out which is the right approach for you and having confidence that you are not following the wrong course are the elements that people generally find the most daunting. What works for one individual may not be the correct course of treatment for another. Some people do choose to follow a method of treatment that has been described as successful for other people, but I would generally advise them first to see a qualified homeopathic/integrative doctor, medical herbalist or nutritionist.
Much can be gained from some individual analysis, which can be achieved through various methods of testing, e.g. electro dermal testing and blood tests. Although this may be expensive initially, it is a much surer way of knowing that you are receiving advice and treatment to suit your particular circumstances.
There are many excellent doctors, most of whom have worked in orthodox medicine, now practising integrative medicine. They offer intensive courses of intravenous therapies.
There is an expanding repertoire of effective treatments which, while natural, are based on scientific study and have many parallels with the new developments taking place in orthodox cancer research, such as:
• Biochemistry to analyse immune function;
• Ukrain, a natural chemotherapy;
• Cancer vaccines;
• Ozone therapy;
• Mistletoe (the subject of Mary Martin's column in Issue 80).
The majority of these are undertaken in combination with other complementary approaches. Most clinics do an intensive three- to four-week course of treatment, usually as an outpatient.
These sorts of treatments are unfortunately fairly expensive, but have shown good results in helping to get the cancer under control, so the more ongoing nutritional approaches have more chance of being successful.
When choosing complementary approaches and practitioners, it is worth running through the following questions:
1. Has research been done on this therapy, or is there other evidence that it works?
2. Is it potentially harmful?
3. What are the side effects?
4. Do I know anyone who has used it, and what did they think about it?
5. Does my doctor have any views?
6. Could it interfere with my current medical treatment?
7. Can I trust the alternative/complementary practitioner?
8. Will they communicate with my orthodox doctor to ensure that the treatments do complement each other?
9. What information is available?
10. Is the practitioner I am considering a member in good standing of a national organization?
11. Is the practitioner insured?
12. What will it cost?
13. I am considering visiting a clinic abroad, but is there one nearer that offers the same treatments, or follows similar principles of practice?
One of the main problems I find people come across is acquiring clear, concise information about a treatment's effects and effectiveness. Though we have access to more information systems than ever, this abundance sometimes serves to confuse as much it informs.
It is rare to obtain good information about both orthodox and alternative treatments from the same place. If you find yourself blessed with a doctor who has some knowledge of the alternatives, and is happy to offer you a rational discussion of the pros and cons, you should take full advantage of them. Unfortunately, while we still are reticent in this country to consider anything that does not have a scientific background, finding an unbiased appraisal of treatments will remain a problem.
When you are coping with a diagnosis of cancer, it must be unhelpful to find yourself being put in a situation of having to adopt an absolutist approach to one side or the other. The approach of integrative medicine is gathering strength and many more practitioners are coming into it, finding that it gives them a more satisfactory way of working with their patients.
It is often a big learning curve for clients to broaden their focus from chemotherapy and radiotherapy towards understanding the concepts behind homeopathic and complementary treatments. I find that they frequently feel that, as their oncologists do not mention other treatments, these may not be worthwhile.
A feeling of betraying their oncologists and a fear of what their reaction is going to be are also common. Worries are frequently expressed that their oncologists may stop treating them, or they are concerned that attitudes towards them may change if they look elsewhere. In the worst scenarios I have dealt with, it can turn into a battlefield, where one side is accusing the other of complete ignorance about the disease and the best way to treat the individual.
Most people I have dealt with can see that there are sensible cases to be put on both sides, and wish to choose their options without the feeling that they are making a statement of criticism about treatments they may choose not to have.
I am sure that the majority of doctors would agree that we do not have an overwhelming argument for the success of orthodox treatments, so to consider all plausible avenues is a reasonable course of action.
A widely held view amongst patients that come to me to find out about other treatments is that both their dietary status and general well-being are given insufficient attention by oncologists. Focus is solely upon the disease and the shrinkage of tumours. Any deterioration in their immune system and its role in fighting cancer are not sufficiently acknowledged.
Research is the Stumbling Block
The methods of research carried out do represent a stumbling block for the integration of treatments.
Alternative treatments may not be able to provide the scientifically measured data from multi-centre trials that will satisfy the scientific community that their treatments have an effect. Holistic treatment involves more than one approach, and this does not always lend itself to individual treatments being singled out for study.
For many of the treatments I have mentioned there is supporting evidence, either from clinical trials or observational studies; others just have circumstantial or anecdotal evidence to support them. The questions to be asked then are: If they lack clinical trials, does that necessarily make them a poor treatment? Does unproven mean unworthy? These are difficult questions to answer, and ones that the individual needs to consider when all the information is available to them. A person with cancer has, to some extent, to understand the concepts behind the individual approaches in order to make an informed decision.
The Importance of Making the Right Choice
If it looks like eradication of the disease may not be possible for an individual, that makes treatment choices all the more important. Many a patient has endured great suffering in the belief that a cure, or a decent long remission, is the reward, only to find that their life has been extended by little, and a lot of it has been spent suffering from the side effects of the treatments.
Cancer can give an overwhelming sense of helplessness. 'Receiving' treatment is a very passive state; the depersonalization that can occur, where you lose your sense of energy, power and purpose, may prove to be a very negative factor. If an element of empowering and enabling takes place, choosing treatments that suit you as a person and having a sense of choice and purpose may be important factors in how your body manages its battle with the disease.
I have seen clients who have benefited tremendously during orthodox treatments from nutritional and vitamin supplementation. A recently published visit to a Chinese oncology ward recorded surprise at how well patients who were receiving Chinese herbs looked during their chemotherapy treatments. My involvement with some of the top integrative doctors in this country has given me the privilege of seeing people benefit enormously in their health and vitality from some of the holistic approaches used. For people who have had radiotherapy, particularly for pain control, I have often suggested acupuncture as a powerful method of releasing the stored energy and slowing down the nerve stimulation caused by chronic pain.
Getting as wide a choice of options, from as wide a variety of approaches, as possible, may well be the key to giving yourself the best chance of the best possible outcome.
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Links to cancer sites: www.positivehealth.com/Links/links.htm
Integrative Clinics
• Dr R Sharma, The Hale Clinic, 7 Park Crescent, London W1B 1PF; Tel: 01202 744747
• The Dove Clinic, Hockley Mill Stables, Church Lane, Twyford, Hampshire; Tel: 01962 718000; www.doveclinic.com
• Park Atwood Clinic, Trimpley, Bewdley, Worcestershire DY12 1RE; Tel: 01299 861444; www.parkattwood.com
• Dr Etienne Callebout, 10 Harley St, London W1N 1AA; Tel: 0171 467 8300
• Dr Fritz Schellander, Liongate Clinic, 8 Chilston Road, Tunbridge Wells, Kent TN4 9LT; Tel: 01892 543535
• Dr Patrick Kingsley, Main Street, Osgathorp, Leicestershire LE12 9TA; Tel: 01530 223622
About Patricia Peat
Patricia Peat RGN Dip Pall C Dip UTR is a Cancer Nurse Specialist. She worked for 15 years in many areas with orthodox cancer treatments and specializing in symptom control. After several years' interest and research into alternative forms of dealing with the disease, she founded Cancer Options. Cancer Options is an independent, private consultancy. Individualized consultation is followed by a report with information about all the treatment options available, in this country and abroad. Discussion about cancer and the ways to deal with it is provided from the unique position of having seen both sides of the treatment spectrum. She may be contacted via Cancer Options on Tel: 0114 360 8188; https://canceroptions.co.uk/patricia-peat/
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