Note to the Reader: This article on cancer and cancer treatment with an integration of Complementary Medicine to your protocol, is comprehensive and extensive, as is appropriate for such a complex subject. Unlike most web articles, this one is not presenting a short pseudo-advertisement on an alleged miracle cure or treatment (there is no known cure for cancers). To utilize the article, you may just skip ahead to the section of interest that pertains to a particular type of cancer or therapy, or you may first read the research concerning the new approaches to cancer treatment protocol, which is undergoing quite the change in recent years, reflecting a new patient-centered and holistic metabolic approach to both acute treatment and prevention of recurrence, as well as a better pro-active approach preceding a diagnosis of cancer to decrease the risk of occurrence. I apologize for the length and complexity of the article, but not for all the hard work that went into it. There are also extensive links to sound research at the end of the article, where specific questions may be answered.
In 2014, the U.S. National Cancer Institute emphasized that cancer incidence and mortality alone do not define the burden of these diseases. Cancer is now associated with severe emotional distress, overall reduction in quality of life, and has been observed to be a severe financial stressor, with cancer patients 2.6 times more likely to file for bankruptcy due to the expense of our treatment strategy, and the debility it brings. Some new strategies in cancer care that were announced by the National Cancer Institute included altering the metabolism of carcinogens in the body, becoming better educated to healthy changes in diet and lifestyle, preventing the metabolic activation of both alleles of the numerous genes associated with cancerous mechanisms, focusing on the tissues that accomodate cancer mutation and spread, rather than just the cells, and realizing that the risk factors and clinical characteristics of malignant cancer exhibit considerable variation by anatomic site and even by different tumor types within that same anatomic site. In other words, we desperately need a broader and more holistic approach to cancer care that involves less expensive therapies and integrates more supportive care. Standard medicine has failed to integrate Complementary Medicine and the specialties of Traditional Chinese Medicine and Naturopathy for decades despite overwhelming scientific proof of its effectiveness in a broad array of mechanisms. Instead, standard medicine has described Complementary Medicine as a dangerous attitude of 'alternative' treatment, despite the fact that physicians in these specialties have always emphasized their goals of supporting standard care, and overall patient quality of life, not supplanting it. This attitude of discouraging Integrative Medicine involving a wide array of supportive and inexpensive therapies has engendered a huge burden on our patients diagnosed with the widely varied family of diseases that we call cancer. An increasing patient demand is changing that.
Defining a New More Individualized and Comprehensive Cancer Treatment Protocol That Does Not Take a One Size Fits All Approach With the Harshest Treatment Possible for Everyone, and Which Includes a Restorative and Healthy Preventive Protocol After Destruction of Cancer Cells and Tumors
The American Cancer Society defines cancer as a group of diseases characterized by uncontrolled growth and spread of abnormal cells, not a single disease. Today, to promote more treatment of cancer and improve the statistics of success, the term cancer in situ, an oxymoron, is used. "In situ" literally means not growing and spreading, and reflects the attitude toward cancer care in standard medicine, where improving statistical results by any means is more important that actual changes in care to improve results for the patients. Instead of recognizing potentially precancerous tissue with a need to restore the healthy tissue environment, integrating Complementary Medicine to achieve this goal, instead these unhealthy tissue lesions are described as cancer themselves, unnecessarily frightening the patient and engendering types of radical treatments that are unnecessary, expensive and often come with debilitating adverse effects. For example, a comprehensive long-term study of breast cancer and mastectomy in 2014, conducted by Stanford University and the Cancer Prevention Institute of California, once again definitively proved that double mastectomy provides no survival benefits over lumpectomy and targeted radiation, yet has increased between 1978 and 2011 from just 2 percent of patients diagnosed to about 33 percent of patients under 40 diagnosed with breast cancer or cancer in situ, which is not actually a real cancer. Patients must take a proactive approach and demand an individualized assessment when cancer is diagnosed, thoroughly discussing the type of cancer cell and actual individualized prognosis and choice of treatments rather than being rushed into harsh treatments without a real understanding of the level of threat. While this is challenging and scary, it insures better choices and better outcomes.
Often, the initial threat of cancer is overstated, generating great anxiety and fear, and then the success of treatment is overstated as well. A study in 2010, at the Tehran University of Medical Sciences, published in the World Journal of Surgical Oncology, found that "despite the use of adjuvant therapies during the study, we found a LRR (locoregional recurrence of cancer) rate after mastectomy of 20.2%." The adjuvant therapy in this study was radiation therapy, and the follow-up for these patients was between 2 and 140 months (Kheradmand et al WJ of SO 2010; 8:30). Such studies of cancer recurrence even with double mastectomy are not performed or published in the United States or Europe. Cancer experts, such as Dr. Steven Katz of the University of Michigan, have noted that a number of studies have shown that the rate of cancer recurrence in areas of the body beyond the breasts after double mastectomy is as high as 13%. With many women opting for mastectomy when diagnosed with "cancer in situ", where more than 90 percent are not expected to develop into life threatening cancer, a large percentage of women receiving double mastectomy would have been expected to have no future cancer even without therapy, thus affecting the statistical outcomes. A large emphasis purely on statistical results, rather than a more complete cancer prevention protocol is not sensible. Obviously, a better treatment protocol is needed as well, and while radical mastectomy may be needed in certain cases, it is not the promised answer for many patients. An elaborate system has been developed to increase the treatments that are the most profitable despite this elaborate and unquestioned proof that such decisions are not being made based on facts, and we are still not supporting integrative cancer care despite an overwhelming proof of efficacy. The approach to cancer treatment and prevention is slowly changing and evolving based on such scientific proof, but this change is not helping patients diagnosed with cancer and potential precancerous lesions fast enough. Real professional treatment and preventive medicine with CIM/TCM is still discouraged.
Each year more and more scientific evidence emerges that supports an integration of Complementary Medicine and TCM into cancer care and prevention, to alleviated adverse effects of standard treatment, cancer symptoms, to help prevent occurrence or recurrence, and to improve the outcomes of standard cancer treatment. Understanding this new integrative approach to cancer is vitally important. Standard medicine has spent the last 50 years learning how to attack cancer cells and largely ignored the question of how to correct the environment that governs this abnormal cellular growth and spread, despite the recognition of the basis of metastatic cancer theory in the work of Dr. Stephen Paget in 1889, and his warning that we must address the "soil" as well as the "seed" of cancerous growth, or in other words, the cellular tissue environment that allows these mutated cells to spread. Finally, in recent years, cancer is being once again seen as more of a metabolic set of diseases than a genetic one, and like one of the pioneers of cancer theory, Stephen Paget, described, the microenvironment where metastatic cancer cells proliferate needs to be corrected. Now we need to promote less fear and more reassurance that an integrated comprehensive approach to cancer care and prevention will provide the greatest assurance of remission and prevention.
The allopathic approach in medicine dictates the focus on destruction of cancerous cells, while the realm of Complementary and Integrative Medicine (CIM) focuses on restoring the holistic physiological environment that allows cell mutations and spread of cancer only when it is out of balance. These two strategies need to be integrated. Many sensible cancer experts now do agree that integration of these strategies is the key to further progress in treatment and prevention of cancers. To exert control over cancer you need to restore the natural homeostatic defenses against it by restoring the cellular tissue environment. When our body functions normally, we have the inherent defenses to protect us from excessive cell mutation and unregulated growth, and to fight cancer we need to restore that balance and drive cancer back into remission. A new biologic focus in cancer therapy is finally adopting this strategy, utilizing the body's own immune system to destroy cancer cells, and finding even greater success as allopathic medicine integrates with Complementary Medicine to provide an array of integrative benefits, especially utilizing TCM (Traditional Chinese Medicine). In addition, as cancer is broken down and cleared in the body, a struggle to clear the toxic metabolites occurs, and an array of therapies are needed to restore health after radiation and chemotherapy, as well as new Biologic treatments. Complementary and Integrative Medicine (CIM) provides a holistic package of care to aid these processes, with diet, nutritional medicine, herbal chemistry, physiotherapy and acupuncture, as well as cognitive and energetic therapies. A more proactive, holistic and healthier approach by cancer patients is achieving a better overall outcome, and needs to be encouraged, turning cancer victims into productive and positive individuals who are not being defeated by their disease. Quality of life is a huge consideration that has been downplayed in standard medicine, and Complementary Medicine can help achieve a high quality of life with cancer.
Biologic approaches in cancer treatment promise the potential that we could achieve the goals of holistic and restorative medicine by utilizing the body's own anticancer responses, especially the immune system. While the new technology of altering the body's own immune cells to do what we tell them to do seems like a more promising way to treat cancer, and is hailed as the current miracle cancer cure, the reality of this technology of course presents serious risk of harm to the health. For instance, in 2016, the leading pharmaceutical company with this technology, Juno Therapeutics, halted its human clinical trials of a new, much touted biologic to cure acute lymphoblastic leukemia with CAR-T immunotherapy (chimeric antigen receptors on bioengineered T-cells), and JCAR015, after 3 of 20 patients enrolled died of excess fluid and swelling in the brain, or cerebral edema. This trial had tried to enroll 90 patients, but only found 20 willing to take the risk, despite the poor outcomes with acute lymphoblastic leukemia. The strategy used a chemotherapy drug to first wipe out the normal T-cell population so that more engineered T-cells could be used to target the cancer cells. Of course this comes with much risk to unwanted immune responses as well as neurological risks, and common adverse CNS effects have been seen, such as confusion and and seizures, although the experts creating this technology for the last 20 years still are unsure of how this technology adversely affects the central nervous system. The response to a wide array of very threatening adverse health effects, even death, is a shrug. 'Managing unique side effects' is the response, and a number of strategies are suggested, such as polypharmacy with chemotherapy and immune suppressant drugs. While the use of medications with very harsh side effects is suggested with no apparent concern, intelligent patients will be able to see that this is not an optimal strategy to present a new cancer treatment that avoids the harsh effects of past cancer therapies. Polypharmacy with harsh medications is the standard answer to these 'side effect' problems, but not an answer that most cancer patients want to hear. While we are still hopeful that more of these engineered immune cell therapies will work, the verdict is out, and like so many new cancer drugs in the past, the small initial successes are highly touted, but the long-term and general risks ignored. With CIM/TCM therapies, the immune system is enhanced in a holistic protocol, both with specific mechanisms and with a general aid to function. This is completely safe, and as stated, could be a valuable adjunct approach. Integrating specific CIM/TCM protocols into this new biologic medicine to counter adverse health effects is also promising, and could avoid much harm to the health if integrated, and decrease the need for harsh polypharmacy and additive adverse side effects.
A comprehensive set of articles on cancer treatment in the May 15, 2016 New York Times Sunday Magazine, entitled The New Anatomy of Cancer, again tries to shed positive light on the intrinsic and systemic failures of the approach to cancer care and spin these failures into hope that we now are on the verge of complete success. The articles note that we now realize that there is no actual set of 'oncogenes' where cancer mutations occur, but that the number of genetic mutations seen in cancer becomes larger every time we look, implying that we may be able to individualize the cancer analysis to individualize therapy, if this were not prohibitively expensive. The articles also note that "resistant" cases, or "non-responders", which make up the majority of patients no matter what is tried, now have better access to experimental drugs, but that unfortunately the percentage of new cancer drugs which actually succeed through the 3-stage human clinical trials is now less than 7 percent, falling from 10 percent in 2010, and from 20 percent in 1990, and that almost all of these approved new cancer treatments show only the ability to extend survival for a brief period. The touted belief and hope in experimental cancer drugs is not based in objective evidence. There is still no proven cure for the many types of cancer, although a small number of individuals with a severe type of cancer have experienced a complete remission of their cancer. Often, the reason for this remission remains unknown, and we can assume that the intrinsic homeostatic mechanisms in the body did their job. What is obviously overlooked in this scenario for new technology is the fact that we need to discover just how the human organism routinely corrects these infinite number of genetic mutations that lie at the heart of cancer in healthy surviving humans, not how to catalogue and block them all. Now that we are able to actually map the whole gene code, we have sometimes found thousands of mutations that could relate to cancer, as well as thousands more that could be involved in a sequence of genetic triggers. There is no harm in continuing to discover new ways to block cell mutations, but to take a completely binary attitude and not see the importance of restoring the homeostatic capacity of the body to continuously correct cell mutations, as was suggested by the pioneers of cancer research such as Steven Paget a century ago, is just blind and foolish. Often, it is the restoration of normal cell metabolism that stops cancer growth, not the correction of the genetic mutation. The cost of holistic and restorative medicine is relatively miniscule, while the cost of new technology has been increasingly enormous, leading to a future where only the rich may be able to afford it, or the cost increasing the budget for medicine to an unworkable state. The approaches with programming viral RNA to alter immune cells or to splice parts of the genetic code needed for specific cancer replication has been initially successful, but the chances that the organism will adapt to these tricks, or that altering the genetic code will have unforeseen negative consequences are great. We cannot overlook all of these foibles.
In 2011 there are nearly 12 million cancer survivors living in the United States, many of them finding a path in life that prevents spread (metastasis) or recurrence, and keeps them in what we call remission. Many of them, like the New York Times bestselling author of Crazy Sexy Cancer Survivor, Kris Carr, did not receive radiation or chemotherapy, but instead found ways to utilize the body's natural defenses with diet, herbal and nutrient medicine, and an array of naturopathic cancer treatment techniques, including acupuncture and physiotherapies such as Tui na (massage, acupressure, and deep tissue, or soft tissue mobilization). There are more and more examples of people famous for not just surviving, but doing the right things to maintain their health. People are finding out that they don't need to view themselves as victims or cancer zombies, but as smart people that educated themselves, sought help and understanding, and used adversity to find a more positive quality of life. The TCM physician, or Licensed Acupuncturist and herbalist, can be an integral part of the team of support that turns around this sometimes threatening diagnosis and works with an oncologist that takes a more positive and open minded integrative approach to individualized cancer therapy. As you can see from the numerous scientific studies cited and linked below in Additional Information, much of even the standard treatment in Traditional Chinese Medicine (TCM), with common herbs in formula, nutrient medicines, and even acupuncture, are now proven to prevent or fight cancer and its recurrence. Standard treatment in TCM, as well as the dietary and lifestyle recommendations common to the practice, may be one of the best tools in cancer prevention that we have. If we support the medical specialties of TCM and Naturopathy in CIM and adjunct cancer care, these professions will continue to utilize evolving scientific study to provide more proven and directed therapies for the many types of diseases we call cancer.
While we might assume that once cancer remission is achieved, that the task is accomplished, we are learning that this is not the case. The harsh therapies and enormous stress of cancer survival has left many millions of patients with much to be accomplished after remission is achieved. For instance, Suleika Jaquad, a wellness writer for the New York Times describes how after completing cancer therapy and achieving remission she then found herself dealing with induced menopause at age 27, infertility, chronic fatigue, a thyroid pathology and a weakened immune system that resulted in easy infections and trips to the emergency room. Added to this was the effect on mood, with an anxious depressed mood imbalance persisting. More and more stories of the travails of cancer survivors show the need for integration of Complementary Medicine and other specialties to deal with these burdens of cancer as well. Restoration of health often takes a concerted effort and there are many types of physicians that can assist the return to a whole and healthy state. The National Cancer Society provides a book entitled Facing Forward for the 14 million cancer survivors who now face this array of health problems after chemotherapy, radiation and biologics, and recommends Complementary and Integrative Medicine (CIM), although the knowledge of CIM in standard medicine is still behind the times, and while it is good to integrate this with your Medical Doctors, there is still almost no study of this type of medicine in standard medical schools, so advice has been largely negative, avoiding most of this therapy "because we don't know how it works or if there is any adverse effects". Hopefully, this is changing.
Complementary and Integrative Medicine (CIM/TCM) brings a needed holistic approach to cancer care. Cancer experts are now realizing that the primary assumptions of the last 50 years, that an allopathic focus on a relatively small number of oncogenes, was indeed a mistake, and are looking for a broader, more holistic protocol of cancer treatment and prevention. The experts that wrote the landmark paper, The Hallmarks of Cancer, Douglas Hanahan and Robert A. Weinberg, have now published a follow-up article admitting that the focus on random mutations of just 2 percent of the human genome as the root of cancers was wrong. Cancerous mutations are a complex array of both human and biotic cell dysfunctions that involve a breakdown of the whole cycle of feedback protections that our organisms have evolved. Restoration of healthy homeostatic controls is needed to prevent and reverse these mechanisms of excess cell growth that we call cancer, as well as support the health of the organ tissues where these cells may seed and grow. Cancer is a widely variable group of metabolic diseases that involve complex genetic, epigenetic, molecular and environmental interactions. An integrated holistic approach is needed to fully achieve remission and restoration, as well as prevention of cancerous cell mutation and spread that is threatening. While cancerous mutations are occurring in all humans at all times, and circulating in our bodies, the focus in medicine should be those cancers that may grow and spread unchecked, threatening healthy tissues in the body. The variety of types of threatening cancers is a challenge for the patient and physicians, and a greater variety of approaches to treatment and prevention is needed to address this subject.
A new approach to treatment and prevention of cancer finally utilizes a wealth of scientific research and a more holistic approach, getting past the notion that those with cancer were just suffering a fate programmed by a small number of oncogenes
How does cancer occur and how do our bodies get rid of it? Our cells multiply and grow in a highly controlled fashion evolved over millions of years. Our genes encode proteins that regulate cell division and growth, and these genes often experience mutation. Our immune system constantly repairs these genetic mutations, but sometimes this mechanism of repair is overwhelmed. By focusing on the promise of finding a small set of inherited oncogenes, or genes that cause cancer, our research has overlooked the bigger picture of genetic repair and maintenance. The definition of oncogenes has also changed, now encompassing the huge set of genes in our DNA that contribute to cancer metabolism, but do not cause it. Genetic contributions to cancer now include the epigene, and the DNA of the mitochondria, and hence the term oncogene has almost lost all meaning. The search for the magic oncogenes has not produced a cure for cancer, and the focus on inherited genetic mutations has not produced successful therapy. In addition, the advice of the researcher that framed the pathophysiology of cancerous metastasis, Dr. Stephen Paget, to focus on the unhealthy tissues where cancer cells are seeded and grow has been largely ignored. Research in the past has overlooked such important topics as fat cells that play a key role in preventing cancerous cell mutation, because they are important producers of hormones and cytokines, and the importance of the energy metabolism in the cells, with a focus on mitochondria and the oxygen metabolism (Warburg effect). Standard medicine is not adapting to evidence supporting a new approach to cancer therapy quickly enough. Integration of a broader and more holistic strategy is needed as we finally admit that the pioneers of cancer theory were correct in their findings that cancer is indeed a complex metabolic set of diseases that need a holistic approach in treatment and prevention.
The Hallmarks of Cancer have indeed changed. As stated, Hanahan and Weinberg, the authors of the famed Hallmarks of Cancer have admitted that the focus on inherited oncogenes in just 2 percent of the human genome were wrong, and have revised these hallmarks of cancer. What does this mean? As mapping of the whole human genome was accomplished, we found that pioneers in early cancer theory, who were derided despite their stature as Nobel Prize winning scientists, Dr. Otto Warburg, Dr. Max Gershon, Dr. Joseph Issels, and Dr. Stephen Paget, were indeed correct in their assumptions that the pathophysiology of cancer was much broader than a handful of inherited mutations in a small number of our genes. Until recently, their research was religiously denied as heresy and excluded from textbooks, and the reasons involved the enormous sums of money in cancer research and drug development, not concern for the patient, or for the truth.
A revision of the hallmarks of cancer has led us to assumptions that the physiology of the tissue surrounding the cancer cells is more important to the survival and spread of cancer than the cells themselves. The new hallmarks include a lack of homeostatic controls of angiogenesis (formation of new blood vessels), cell replication and apoptosis (programmed cell life cycle and death), neurohormonal growth signals, and the whole tissue environment around the cancerous cells, as well as the tissues where they "seed". A new emphasis outlines how carcinogenesis is driven by defects in tissue organization, with all cells in the body inherently in a potentially cancerous state. The model of cancer outlined by Vogelstein and Kinzler emphasizes that cancer is a disease of poor repair of damaged DNA, and that while individuals may inherent a variety of propensities for these pathological genetic mutations, including epigenetic traits of a more metabolic nature, all individuals apparently may experience these same mutations, with strictly inherited genetic predispositions leading to cancers diagnosed early in life, while those diagnosed later probably related more to environmental factors, and the inability of the system to efficiently correct these varied genetic mutations. We have found nothing to correct these inherited "germline" genetic propensities, especially as they are so varied and numerous, but we now have a lot of tools at our disposal to correct the mechanisms of poor genetic repair, unhealthy tissue environment, and the metabolic problems that contribute to cancerous growth and spread. While such holistic medicine is not as dramatic in the short term as surgery, chemotherapy and radiation, it may be much more important to overall quality of life and maintenance of cancer remission. Since there is no cure for cancer, maintaining a healthy and productive state after a diagnosis of metastatic cancer is perhaps the most important goal.
Of course, cancer prevention is the most important goal for the population as a whole. A variety of cancers are linked to the rising epidemic of obesity and overweight conditions. Our fat cells produce most of our local steroid lipid-based hormones, as well as many of the immune modulators, or cytokines, that regulate the local inflammatory processes. Healthy fat cells maintain a delicate balance between localized hormone and immune regulation. What is a healthy fat cell? Healthy adipose cells are not overwhelmed by reactive oxidants and chronic inflammation, maintain renewal of healthy lipoprotein cell membranes, and respond to hormonal triggers to store and release triglycerides and free fatty acids in a healthy manner. Healthy fat cells also produce and release important regulatory hormones, immune cytokines, and growth factors. Unhealthy fat cells fail to provide us with these vital services, and instead create dysfunction that allows the seeding of cancerous cells in circulation. As Dr. KN Frayn of the University of Oxford Centre for Diabetes and Endocrinology stated in 2003: "Adipose tissue is now recognized as a highly active metabolic and endocrine organ." (Intl J of Obes 27:875-888). Dr. Frayn pointed out that adipose cells, as a whole organ, possesses the ability to regulate differentiation of new adipocytes as well as production of new blood vessel growth (angiogenesis), issues that are extremely important to oncology and cancer treatment today. In 2009, experts at the University Medical Center Utrecht, The Netherlands, noted in the journal Cancer Epidemiological Biomarkers that "insulin resistance, increased levels of leptin, plasminogen activator inhibitor-1, and endogenous sex steroids, decreased levels of adiponectin, and chronic inflammation are involved in carcinogenesis and cancer progression", and are the hallmarks of an unhealthy adipose system seen in overweight conditions and obesity (PMID: 19755644). Alterations in the energy metabolism in cancer cells lies at the heart of abnormal growth, and Metabolic Syndrome and increased levels of insulin in states of insulin resistance may play a significant role. All of these issues may be addressed with Complementary and Integrative Medicine (CIM).
Dysfunction of the oxygen metabolism of our cells also both creates excess oxidative stress and fails to provide the energy for our cells to regulate the cell life cycle (apoptosis) and detoxification. Past research by the nobel laureate Dr. Otto Heinrich Warburg (The Warburg Effect) has proven that the mitochondria in the cell, rather than the genetic nucleus, is primarily associated with cancer growth, due to the heightened metabolism of oxidative phosphorylation for cellular energy when the mitochondrial utilization of the oxygen pathway is affected. More recent follow-up on this research has also revealed that the mitochondria in our cells have a separate and symbiotic genetic code whose mutations may be more responsible for cancerous growth than the actual cell nucleus. Correcting mitochondrial dysfunction may be the most important aspect of both cancer prevention and treatment. A strong renewed interest in the theories of Dr. Otto Warburg, Dr. Joseph Issels and Dr. Max Gershon may be finally changing the way we treat and prevent cancer, and finally bringing an integration of naturopathic holistic Complementary Medicine into the arena of standard cancer care. While technology such as programmed viral RNA used to alter the human genetic code has received more attention, the greatest advances in cancer treatment relate to a renewed interest in cell metabolism. It is unfortunate that a strong societal division between holistic and allopathic medicine continues, and the practices promoted as 'The Gershon Therapy' today, promoted by Dr. Gershon's daughter and her institute, are a clear distortion of his research and theories, which should be intelligently integrated in a comprehensive protocol, not touted as an 'alternative' with radical approaches with extreme diets, unrealistic regimens of 'detox', and extreme use of enemas, rather than an intelligent integration of Dr. Gershon's findings, which were meant to aid an actual metabolic approach in standard medical care.
Cancer cells intrinsically have a prolonged life, and the degree to which they avoid natural cell cycle death, or apoptosis, generally determines the ability to metastasize, or spread and grow as tumors. Steroid hormones regulate programmed cell death, or apoptosis, and work with many different protein receptors to guarantee that cells are replaced before they form dangerous cancer cells due to excess mutations in aging cells. Hormones operate in a feedback system, and a delicate balance of natural hormones in the whole body is necessary to guarantee proper regulation of apoptosis. Some hormones, such as adrenaline (epinephrine), also function as neurotransmitters. We now know that a balance of neurotransmitters, some of which also effect hormone responses, and immune cytokines, which often act on hormone receptors as well, are important in a holistic manner to insure proper homeostatic regulation of cell apoptosis and protect us from excess cellular mutations that drive cancerous growth. The only answer to reversal of cancer in our bodies is not to just destroy cancerous tumors, but to also holistically restore the natural balance that protects us every day of our existence, especially the homeostatic balance of the endocrine, autonomic and immune systems. This is the primary goal of Complementary Medicine and Traditional Chinese Medicine. As the science of neurohormonal immunology progresses, this field will overtake simple oncology as the best hope for cancer prevention, treatment and, hopefully one day, a cure.
A New Paradigm for Genetics and Mutation
An article in the August 16, 2011 New York Times Science Times entitled Cancer's Secrets Come Into Sharper Focus outlines how the realm of cancer research is finally realizing that the overly simplistic genetic theories of cancerous cell mutation that we took as dogma were indeed wrong, and how research in the last few years has demonstrated that broad holistic or quantum aspects of genetic control are indeed involved in the overall environment that allows cell growth to create tumors and the malignant spread of cancer cells.
A broad environment of pseudogenes, normally noncoding, from the human genome may play a significant role in cancerous cell mutations. More importantly, researchers are coming to grips with the truth that about 90 percent of the genes in our bodies that encode regulatory proteins are microbial, and that the symbiotic bacterial and viral microbiota in our bodies create most of the RNA that alters the normal cell programming determining cell life and death (apoptosis) and growth regulation. In addition, normal healthy cells are conscripted into cancerous growth to promote blood vessel growth and build the tissue structure, or fascia. Dr. Jeremy K Nicholson, a professor at Imperial College, London, and the Head of the Department of Surgery and Cancer, is quoted: "The signals that these microbes do is dramatically complex. They send metabolic signals to each other - and they are sending chemicals out constantly that are stimulating our biological processes. It's astonishing, really. There they are, sitting around and doing stuff, and most of it we don't really know or understand." Indeed, the complex nature of evolved cell biology, constantly changing and adapting to our environment, make even the subject of genetic control of cancerous cell growth too complicated to be corrected with present narrow allopathic protocols.
For instance, in the March 29, 2015 New York Times, a renowned cancer specialist and director of the leukemia program at the Cleveland Clinic, Dr. Mikkael A. Sekeres, wrote in an article entitled Trying to Fool Cancer that studies last year mapping the genetic code for thousands of patients with specific cancers, one involving 600 patients at the Cleveland Clinic with acute myeloid leukemia and myelodysplastic syndrome, showed that an average of 10 distinct related mutations in different genes may be causing the cancerous growth or dysfunction, identifiable before the diagnosis, but attacking just one of these gene mutations with a biologic drug would have a small chance of preventing the cancer. In addition, as Dr. Sekeres points out, many of these "founder" mutations occur in the normal human genome, called "germline", and are present in both cancerous and noncancerous cells, meaning that targeting these mutations would create devastating consequences for normal cell functions. Complicating matters further, Dr. Sekeres points out that these germline mutations may have caused mutations in secondary genes that are actually more threatening than the founder mutations, and targeting the germline genes may not affect the cancer at all. These studies have also revealed that inheritable germline mutations discovered for specific cancers are often seen only in a small percentage of patients with this cancer. In one study that found such a mutation in twins, only 2.4 percent of another 1000 patients with the same cancer had this inheritable germline mutation. While he found a biologic that actually helped the symptoms of these twins in the short term remarkably well, both patients still died in the near term, one from an infection months later related to the therapy, which targeted the germline marrow cells that produce important immune cells and cytokines. He notes that as we do more genetic testing that many patients are being found with these germline mutations related to specific cancers but that we still are not sure that they will ever get these cancers, only that their statistical risk is higher. Basing cancer treatment on genetic testing presents the patient with a high degree of risk of overtreatment with harsh and expensive therapies that still will not stop cancer, perhaps not even the cancer that the genetic profile reveals as a significant risk. The business of medicine is depending on the complexity of this subject to sell a lot of unnecessary and harmful cancer therapy to patients that do not yet have cancer. Who will be able to tell if it really worked, or was indeed useless?
Dr. Sekeres wrote: "There are many genetic mutations associated with cancer that won't actually cause it in a majority of people, probably because they don't lead to secondary mutations that are a requisite in developing the disease. Telling people with those mutations that they have the potential for cancer would surely introduce unnecessary lifelong anxiety. Some might even receive targeted chemotherapy (or other treatment) for a cancer that doesn't exist. Even for patients who have a genetic mutation and a clearly defined cancer, that mutation might have nothing to do with causing the cancer. Targeting it with a drug could just damage cells that might be innocent bystanders." In other words, while there are patients whose life is saved or prolonged by these new biologics, and with past chemotherapies, "we shouldn't delude ourselves, or our patients" that this success is now curative, dependable, or even effective for a majority of patients. More needs to be added to this protocol to achieve better results. Helping the whole organism, both animal and microbial cells (biotic), to regain the evolved programming that keeps us healthy, seems the only way to reverse cancer for most patients, no matter whether we use targeted therapies or not. Restoration of functional homeostasis is the key to this greater success, and this has always been the focus in Complementary and Integrative Medicine (CIM) and TCM (Traditional Chinese Medicine). Continuing to discourage this integrative care is not helping the patients, only the pharmaceutical and medical corporations. At this point in time, even most TCM physicians are now convinced that they should avoid the most direct and effective therapies to help their patients with cancer, or to prevent it, and this is not helping patients at all.
While inherited genetic mutations continue to be a prime focus in standard medicine, more than 50 years of intense research in this field has failed to find many practical applications in oncology that benefit more than a small percentage of patients. One of the most well-known genetic mutations associated with cancer is the BRCA gene mutations associated with aggressive breast cancers. The discovery of this genetic mutation led to a now well-known U.S. Supreme Court decision that disallowed the patenting of such genetic discovery and its application in therapy. Despite the publicity surrounding this single genetic cancer association, the prevalence and application of BRCA mutations are not well known, though. A study at the Institute of Cancer Research, Surrey, United Kingdom, in 1999, published in the medical journal Journal of the National Cancer Institute, showed that the incidence of mutations in women with breast cancers diagnosed before age 36 was only 5.9 percent. The study estimated that the percentage of women with breast cancer with these BRCA1 or 2 mutations are about 3 percent for each type of mutation, and only 0.11 percent in the general population. To repeat: The Institute of Cancer Research in the UK noted that only about one-tenth of one percent of women in the population have this BRCA1 or BRCA2 mutation, and a relatively small percent of these women are at risk, yet the publicity surrounding this inherited genetic cancer propensity is huge, especially now that Angelina Jolie has become the face of this complicated cancer marker.
The National Cancer Institute of the United States states as well that not all mutations of the BRCA1 and BRCA2 genes are harmful, and some may even be beneficial. Harmful BRCA1 and BRCA2 mutations are associated with more than breast cancer risk, and are linked in both men and women to breast, pancreatic and colon cancers, as well as melanomas, pancreatic cancer, stomach cancer and gallbladder cancer, and so radical mastectomies to prevent cancer will not eliminate the risk in women with these genetic abnormalities. In the case of Angelina Jolie, studies also revealed the potential for ovarian cancer, and ovarectomy was performed, inducing early menopause and the need for hormone replacement therapy, but was this proven necessary, and did it eliminate cancer risk in these tissues? Prostate cancers are also linked to BRCA2 harmful mutations in men, yet no push to surgically remove prostate glands are recommended. Risk assessment for those with these BRCA abnormalities is not simple. Not all BRCA mutations are harmful, but those with known harmful mutations in BRCA1 or BRCA2 have an estimated 60 percent chance of eventually being diagnosed with breast cancer, although most breast cancers are not malignant, and most of these eventual malignancies will occur in old age. The assessment of benefit versus risk in treatment when a BRCA mutation is detected is not simple, yet the publicity surrounding this issue has implied that it is.
The National Cancer Institute states that it is possible that a large number of these cancer cases with inherited harmful mutations of BRCA1 and BRCA2 involve cancer risks due in part to other genetic, epigenetic, or environmental factors as well, skewing the reports of an estimated 60 percent of women with harmful types of BRCA1 and BRCA2 mutations eventually acquiring some form of benign or aggressive cancer, many of which will not be breast cancer. In addition, the Institute notes that no data is available from long-term studies of the general population comparing cancer risk in women with these mutations compared to women without these mutations. We will not know the full story of risk for another decade. As genetic analysis becomes more common, the patients must pay attention to what the test findings actually mean, and not succumb to alarm to rush into hasty decisions concerning more radical therapy. The findings of mutations of the BRCA1 and BRCA2 genes do not doom the woman, or man, to cancer, and a realistic assessment of risk is needed. Even if radical prevention is chosen, such as a radical mastectomy, the risk of other cancers is still higher in persons with these mutations, and a more holistic look at cancer prevention should be adopted.
The pharmacological therapy for these BRCA-related cancers is an inhibitor of DNA repair, called a PARP inhibitor (PARPi), not an aid to better DNA repair. PARP refers to a polymerase enzyme important in the constant process of DNA repair, and the BRCA genes express these protein enzymes. Inhibition of these enzymes decreases the activity of the mutated BRCA genes, which are deficient in their job as DNA repair technicians. This approach has been questioned because the manufacturers state that theoretically they shouldn't affect other repair genes, especially the healthy BRCA genes that we need to repair our DNA and prevent cancers. The long-term adverse effects, once again, may not be apparent for years. An important consideration when you are among the one tenth of one percent of the general population with BRCA1 or 2 type genetic mutations is to also look into cancer prevention with Complementary Medicine, a very safe, conservative and proven form of thorough holistic therapy that integrates well with any approach that the patient chooses. A double radical mastectomy is not the only option, and it does not eliminate the mutations of the BRCA1 and BRCA in other tissues.
Research in recent years is changing the entire focus in cancer pathophysiology
As research progresses, the complexity of the genetic and epigenetic contributions to unregulated cell growth, or metastatic cancer, is becoming ever more complicated. In 2011, researchers at Virginia Commonwealth University Massey Cancer Center discovered that all cells in the human organism have two distinct genomes, one in the nucleus of the cell, and the other in the mitochondrion. Mitochondria appear to be an evolved organ in our cells introduced originally by symbiotic bacteria. These mitochondria produce most of the energy of our cells, and still retain their own separate genetic code. These mitochondrial genes act as a sort of epigene in our cells, and act as genetic on/off switches utilizing DNA methylation, and with mitochondrial dysfunction, these epigenetic switches allow genetic expression in the nuclei of the cells to allow uncontrolled growth. The head researcher in this study, Shirley M. Taylor Ph.D., believes that this mitochondrial dysfunction could explain a host of disease mechanisms, in cancerous growth, Parkinson's disease, and cardiovascular disease. While allopathic medicine uses this research to design biologics to alter enzyme expression to reverse this mechanism, Complementary Medicine continues to research to find ways to restore the homeostatic function of cellular mitochondria, as well as to reduce oxidative stress, regulate inflammatory mechanisms, and restore neurohormonal balance. These goals are both important, and are integrative.
Complementary and Integrative Medicine (CIM/TCM) plays a key role in the treatment and prevention of cancer. While standard allopathic medicine refines many ways to remove or kill our cancerous cells, it does not address the underlying cellular environment that drives cancerous growth and prevents our natural homeostatic mechanisms from reversing and correcting this abnormal growth when it is unhealthy and dysfunctional. More and more experts in standard treatment and prevention of cancer are accepting Integrative and Complementary Medicine as an important part of the treatment protocol. Restoration of our natural homeostatic mechanisms is absolutely necessary to achieve cancer remission. Acupuncture and herbal/nutrient medicine, and professional guidance with targeted healthy diet and lifestyle choices and stress reduction, as well as physiotherapies that reduce tissue inflammation and physiological stress, provides a comprehensive approach to achieve the goal of restoration of a healthy cellular environment, optimum homeostatic mechanisms, and cancer remission. It's a big job, get to it and take a proactive approach.
Is there a clear cure for cancer? The answer is no. Neither standard allopathic medicine or holistic Complementary Medicine offers a clear cure, only a means to help the body to achieve cancer remission and protect it against future cancerous mutation and growth. An integrative and holistic approach is sorely needed to provide better care and outcomes, especially concerning the quality of life and functional health of patients while undergoing standard therapies. While this Integrative care is being administered, Quality of Life considerations are most important, and we need expanded Complementary and Integrative Medicine (CIM) to provide therapies that increase the Quality of Life and healthy function of the patient. Discouragement of Complementary and Integrative Medicine in the field of cancer care, or oncology, has not been justified, as the numerous anecdotal warnings or harm and contraindication have not materialized clinically, and now our leading cancer centers are utilizing CIM more and more.
Simply cutting away cancerous growth or damaging it with toxic chemotherapy or radiation does not prevent cancerous cell mutations from continuing to occur and cancerous cells to spread. No competent physician in any specialty suggests that patients abandon these standard therapies when they are needed, but there is a strong need to more fully integrate Complementary Medicine into this standard protocol. The myth of so-called alternative medicine has been fostered by the standard medical industry to create an illusion that the cancer patient must choose between standard care or the alternative. This is not only untrue, but adds much stress for the patients as they choose an array of therapies to prevent dangerous cancer growth. The cancer patient is faced with a very complicated and risky course of treatment no matter where they turn, but restoration of a healthy homeostasis must be included in the treatment protocol. The stress from this decision process, coupled with the stress from the disease and the therapies, is an enormous challenge, and standard oncology has not been helpful in this regard. Many patients today do utilize Complementary Medicine to help them deal with this overwhelming feat of survival, not only to better cope with the physical and psychological stress inherent in cancer treatment and recovery, but also to insure that their total protocol of treatment and prevention is optimized by restoration of the body's natural defenses against cancer. Patients today see real life remarkable recoveries, such as Lance Armstrong's defeat of metastatic cancer and return to win another Tour de France, and find that these patients have utilized a comprehensive Complementary and Integrative medical protocol to achieve almost miraculous success. Did Lance Armstrong cheat in bicycle racing? That may be a matter of opinion, but he did cheat cancer, and largely by integrating Complementary Medicine. The key to a complete treatment protocol is in the integration of allopathic and holistic medicines.
Do we advocate so-called Alternative Medicine over standard therapy? The answer should be no, we use the tools at our disposal and integrate them. There is no such thing as alternative medicine, only more medical protocols to integrate with standard practice to achieve better outcomes. The decisions in choices of treatment options are complex and should be left completely to the individual patient.
There is no alternative to the treatment options that the patient decides are the correct course to save their life. There are a host of complementary and integrative treatment options, though, that improve chances of healthy outcome, decrease risk of harsh therapies, and provide help in maintaining optimal physical and emotional health during the difficult course of therapy. Modern research is also revealing more and more herbal and nutrient chemicals that perform similar tasks in your body that the latest pharmaceuticals perform, as well as revealing more and more natural homeostatic ways that reverse cancer that the pharmaceutical industry is trying to copy with a new class of "biologic" drugs. Medical doctors and researchers throughout the world are busy utilizing the wealth of pharmaceutical research data to find safer and more benign effects that may accomplish the same goals as synthetic pharmaceuticals with herbal extracts and nutrient chemicals to reduce the alarming side effects of comprehensive cancer therapy.
Herbal and nutrient medicine can be quite exacting in its treatment strategies, as there is a wealth of natural chemicals in herbal medicines. Oncologists around the world that specialize in herbal medicine have long utilized research that links specific cancer biomarkers and cytology data to specific herbal chemicals. Just a small portion of this body of research is available at the end of this article with links to research summaries. In addition, the science of nutrient medicines is becoming increasingly complex and producing new data and medicines at an accelerated rate each year. More and more patients and doctors are utilizing this wealth of new research to form a more effective overall treatment plan. Acupuncture works synergistically with these herbal and nutrient therapies to help our bodies better utilize these natural therapies. The combination of acupuncture and herbal/nutrient medicine is more effective than just one of these modalities alone. A knowledgeable Licensed Acupuncturist is able to deliver a superior treatment protocol with much less expense than the allopathic cancer clinic. Integrating such a practice with your standard care may be a life saver.
A patient centered approach in modern integrative cancer therapy
Effective cancer screening and patient education is the first step in a patient centered approach that is increasingly utilized throughout the world. You can go to the article entitled Cancer Screening and the need for better approaches on this website to better understand cancer screening the United States. Of course, as science continues to expand and explore cancer screening and assessment, each year we develop more tools and information to help the patient and the cancer specialist to work together to choose the most appropriate course of therapy. If the cancer is fast growing and life threatening, aggressive allopathic treatments need to be performed, but if the cancer is slow growing, the patient has time to try a more complex and thorough approach with Complementary Medicine and integrate this with less invasive and harmful approaches in standard medicine. Screening should provide the patient and doctor with the information to proceed to the next levels of assessment, such as ultrasound and MRI, physical exam, extensive laboratory analysis, and then tissue biopsy. The biopsy should result in an extensive cytology assessment, explained so that the patient understands the cell type, where it comes from, what drives the cancer mutation, and what specific therapies can be utilized for this particular cell line. Rushing into quick decisions and being treated with a one-size-fits-all protocol instead of an individualized patient-centered approach is not what most patients want, although the fear generated by the realm of cancer leads to many patients avoiding such research and understanding. A very large percentage of cases of cancer do not present the grave risk and mortality that we associate with the word cancer, and in most cases, taking the time to actually understand your individual cancer case will alleviate such fear. In the small percentage that are very threatening, taking a more comprehensive approach to care will insure a much better quality of life.
The approach of a one-size-fits-all treatment to cancers is finally coming to an end. Extensive genetic research has not uncovered specific cancer genes, or oncogenes, and instead has uncovered a large number of genetic abnormalities that could potentially link to each type of cancer. The number of individual genetic abnormalities in just one of these genes is often high as well. Adding to the complexity is the discovery that other genes may play significant roles in triggering and modulating gene expression, with most studied genes showing the ability to express multiple proteins and RNA. To modulate this complex control of cancer metabolism, a holistic approach is needed.
The discovery of the importance of the epigene, or the molecular pool of chemicals that surrounds our genes, and its ability to also alter and modulate genetic expression, and in fact pass on inheritable epigenetic traits that are reversible with improvement in the health and environment, also adds to the complexity. Newer research is revealing how environmental chemicals may alter the epigenes over time, increasing the risk that carcinogenic chemicals may cause or contribute to cancerous mutation over time. The study of genetic biomarkers has not yielded the clear path to chemical therapy that was hoped for. Drugs that block a specific genetic expression to suppress cancer, such as those that target the B-RAF genetic expression in specific breast cancers, have been found to be ineffective against cancers with the B-RAF biomarker in other areas of the body. The genetic environment is just too complicated to rely solely on specific allopathic drugs. Cancers that spread, such as breast cancer that may spread to the liver, often have shown that these metastatic cancer cells now differ from the original tumor in the genetic biomarkers. While some cancer drugs that target cells with specific genetic biomarkers are effective, they do not cover all of the genetic drivers of the cell mutations, and may not be effective for a percentage of patients when the cancer cells spread and change. Current research has elucidated the numerous mechanisms by which acupuncture stimulation, herbal and nutrient medicine may help the body to counter the metabolic pathways of cancer, and effects via the epigenome are key to this homeostatic aid. Integration of a more comprehensive treatment protocol with Complementary Medicine provides us with the ability to address these complex concerns.
A new approach is emerging in cancer therapy, and this is a more comprehensive and individualized approach to each patient. While neither the patient or physician likes the complexity of treatment, this is emerging as the only effective approach to many cancers. Comprehensive and individualized testing is now being applied to cancer care. Europe is far ahead of the United States in such testing, but leading genetic scientists from Harvard and M.I.T. have started a company called Foundation Medicine that is developing comprehensive individualized tumor profiling to help guide therapy, and many of the leading cancer treatment centers, such as Sloan-Kettering are now using comprehensive analysis of genetic biomarkers with individualized results that help guide the therapy. To expand such an individualized approach the cancer specialists also need to integrate Complementary Medicine into the protocol. Pharmaceutical medicine will never be able to develop the number of drugs needed to provide such an individualized and comprehensive protocol. A specific patient might need twenty different drugs to target the array of individualized genetic drivers of a particular cancer. Even if this many drugs are developed in the future, the side effects from this therapy would be overwhelming. Complementary Medicine offers an array of scientifically proven herbal and nutrient chemicals that are largely without side effects, as well as an array of treatments to decrease the side effects of standard therapy. These natural chemicals may be enhanced by stimulating homeostatic mechanisms with acupuncture. Integrative and Complementary Medicine is thus an important part of the future individualized approach to cancer therapy.
Many cancer treatment centers are including aspects of Complementary and Integrative Medicine (CIM/TCM) into their treatment protocol, but are they offering the best available treatment in this realm? Depending on standard allopathic medicine to provide the best Complementary and Integrative care may not be a sensible approach. There is a long history of economic competition and a sense of rivalry between standard medicine and Complementary Medicine. To assume that this does not play a role in the designing of modern integrative protocols is naive. The medical industry still sees Complementary Medicine as a low cost care that eats into overall profits. Just because these therapies are now being demanded by the public does not mean that the medical industry is looking to provide the best and most efficient, low cost care in this realm. The best Complementary Medicine physicians are still in private practice, where they control their own treatment protocols and decisions. They do not take low paying jobs with standard industry clinics and hospitals. The thoughtful patient realizes this, and also realizes that each Licensed Acupuncturist and herbalist is not providing the same expertise and care. By carefully choosing the Complementary and Integrative Medicine physician, such as a Licensed Acupuncturist, the patient insures that they are receiving the highest quality integrative care at the most reasonable cost.