There is no question that cancer is a growing epidemic in the modern world. According to the Canadian Cancer Society, 2 in every 5 Canadians can expect to develop cancer in their lifetime. One in four of them will die. About 78,000 Canadians will have died of cancer in 2015 (1). Worse yet, cancer is often a very difficult disease to treat, with treatments and therapies that are quite harsh, with side effects that rival the symptoms of the disease itself. In fact, on average, the likelihood of surviving 5 years past a cancer diagnosis is only 63%, compared with other individuals without cancer in comparable demographics (1).
It therefore comes as no surprise that many cancer patients, about 50-60%, seek out integrative, natural, and complementary care therapies, in addition to the more conventional treatment approaches, in order to improve their prognoses, as well as overall quality of life, as they fight this terrible disease. Certainly, there are a great deal of options out there that can serve to help tip the odds in your favor, if you are dealing with a cancer diagnosis, if you are simply interested in long-term prevention, or if you have beaten cancer before and are seeking to reduce the risk of recurrence.
There is a sizable and growing body of scientific evidence supporting natural and nutrition-based therapies that can be safely and effectively combined with the standard medical approach. These tools, strategies, and therapies are there for the taking, but it can sometimes be difficult to determine the best or most effective way to use them. Some may or may not be the best for your particular type of cancer, or they may not be compatible with standard therapies you may already be using, and so must be applied strategically, if at all. But there are means of using them to your advantage.
"Natural" or Integrative oncology is a fairly new and growing field, bringing forth innovations in cancer treatment protocols that can serve to enhance the success rate of cancer therapies. Conventional cancer therapies, including surgery, chemotherapy drugs, and radiation treatments, tend to focus on the act of killing, starving, and destroying the cancer cells themselves. Certainly, this is an important part of the process. But natural therapies involving plant medicines, nutritional supplementation, dietary strategies, detoxification, exercise, and emotional support, when rationally employed, can serve to strengthen the immune system, normalize cell regulation, and encourage "bad" cells to recycle themselves. These two fundamental approaches to cancer support can indeed be rationally and sustainably combined, so as to make use of the best of both worlds, for an overall improved chance of recovery.
The following is Part One of a two-part article. This month, we will be discussing the essentials of cancer itself; some of the key concepts involved in how it starts, persists, and spreads in the body. Having established these concepts, it will clarify the rationale and overall value of natural and nutrition-based therapies in the fight to, not just destroy cancer cells directly with interventionist therapies, but also to cut off cancer's lifelines, inhibit its spread, trigger its self-destruction, and induce remission, by supporting the body's natural capacities for self-healing.
What is Cancer?
The human body is little short of a miracle of biochemical coordination; the product of hundreds of millions of years of evolution. Each one of the trillions of cells that form the synchronized collective of your body is assigned to serve the role of a particular kind of tissue. We have bone cells, skin cells, brain cells, kidney cells, liver cells, etc. This is called differentiation. If a cell is specialized to function in a particular tissue, then it operates within certain functional limitations, and could normally never survive outside of that context.
Cancer cells are cells which have lost much or all of that differentiation. They have lost their distinctive structure and shape that they would normally have, and no longer produce the hormones or other metabolic products they normally would have, to serve their role. The "role" they have adopted no longer involves serving a function for the body, but merely to consume resources and GROW. Unfortunately, this means they have the capacity to grow and spread beyond the context of their original tissue function. Normally, there is a mechanism, called contact inhibition, that signals the cells to STOP growing, once they are in close enough proximity to their neighbors. This signal is lost in cancer cells.
Normal cells are also held in check by what is called the Hayflick limit, which means that no cell line can survive beyond 50 doublings, even if you provide an ideal environment with all the necessary nutrients. Once this threshold is reached, a normal cell line cannot keep going. Cancer cells however, have broken away from that fail-safe limit, and so are essentially immortal. They will keep dividing forever, as long as you keep feeding them.
Thus they grow non-stop into uncoordinated masses of cells, called tumors. As the tumor grows and begins to starve for oxygen and nutrients, the cancer cells send out chemical signals to trigger the formation of new blood vessels, exploiting the nutrient supply of the rest of the body in order to grow even further. This disorganized mass of cells is unstable, and sometimes individual cells will break off and be spread by way of the blood and lymph vessels to new regions of the body. Since the cancer cells no longer identify with any particular normal tissue, they can survive anywhere, and will simply start growing into a new tumor in their new location. This is called metastasis; the spread of cancer beyond its tissue of origin.
Thus, cancer is a home-grown parasite. It can disrupt and destroy the symphonic harmony of the rest of the body's cellular metabolism, deplete the body's resources, destroy organs, and undermine basic life support functions, ultimately resulting in the death of the host, if left unchecked.
Mutation and Oxidative Stress:
The fail-safe mechanisms, such as contact inhibition, which normally prevent the formation and spread of cancer, are coded in our cells' DNA. DNA can be damaged in a number of ways, resulting in mutations/changes to the code that dictates a cell's behavior. When certain key mutations occur, without resulting in the death of the cell, it can permanently adopt the characteristics of a cancer cell (carcinogenesis).
Often times, DNA is damaged by a phenomenon called oxidative stress, which essentially is the same phenomenon as iron developing rust. Just about anything in this world can burn or rust, including our proteins and DNA. Oxygen reacts destructively with the delicate macromolecules that form our bodies, including DNA, and contributes to mutation. We usually have natural defenses, called antioxidants, which serve to quench destructive oxygen molecules. Our bodies make some of our antioxidants, but most of them we need to get from our food, especially fresh fruits and vegetables. Antioxidant molecules which help to protect against oxidative stress, include Vitamin D, Vitamin E, Selenium, and Alpha lipoic acid.
By contrast, stress hormones, chronic inflammation, cancer-causing chemicals (carcinogens), and radiation, are all insults which can increase the impact of oxidative stress in our bodies, and thus increase the risk of developing the mutations that lead to cancer.
One of the most important fail-safe mechanisms is a kind of "spell check" that cells perform to check for DNA damage, as well as repair functions to correct minor mutations. If too many mutations have accumulated, then the cell should be able to recognize its non-viability, and trigger a process of automatic cell death, called apoptosis. Normally, apoptosis functions to protect the body from the accumulation of "bad" cells. Cancer cells have lost this internal "off switch", and so continue to grow out of control. Helping to restore this "off switch" is one of the primary goals of cancer therapy.
Growth factors and Inflammation:
In addition to the underlying mutations, another very important factor in the growth of cancer are cell signal molecules, called growth factors, which bind to receptors on cell surfaces, and stimulate growth. These growth factors have normal functions in healthy bodies, for growth and development, building muscle and fat tissue, or for healing. But in a case of cancer, they are very bad, as cancer cells are already growing too fast! Having elevated growth factors in a case of cancer is like throwing gasoline on a fire.
Most of these growth factors consist of sex hormones, such as estrogen and testosterone, but even more critically, as outside chemicals that mimic sex hormones, called xenohormones, or xenobiotics. The pesticides endosulfan, toxaphane, and dieldrin, for instance, have estrogenic effects on human estrogen-senstive cells, and so exposure to them can increase the risk of breast cancer, or exacerbate an existing case of breast cancer (2). Likewise, we can be inadvertently exposed to growth hormones through our food, where factory farming practices involve using such compounds to maximize meat and dairy production. Therefore, eating a clean organic diet, and detoxification, while not to be considered a primary therapy for cancer, can be very important for prevention, and as an adjunct for the maximum success of other anti-cancer treatments.
Molecules such as insulin-like growth factors (IGF-1 and IGF-2) produced in the liver in response to sugar intake, as well as Cyclooxygenase-2 (COX-2), released during inflammation, are also very important growth factors.
One of the critical things about cancer is that it is perceived by the body as a kind of "wound that won't heal", eliciting a perpetual inflammatory response, triggering the release of growth factors to help with the misguided production of new blood and lymph vessels to support the growing tumor. This is why reducing inflammation is so important to the long-term management of cancer. Sugar in the diet, for instance, not only stimulates the release of insulin-like growth factors, but is also pro-inflammatory to the body. Hence, a diet consisting of low-glycemic foods is essential; More on that later.
Integrating the Natural Approach:
The goals of natural therapies in cancer care are to restore quality of life, slow/stop disease progression, support remission and cure, as well as to increase the effectiveness of medical therapies and reduce their harm. Before beginning any line of therapy, the first step is to get a proper diagnosis, and determine the staging of the disease. That way, you know exactly what you're dealing with. Biopsy and tissue evaluation is the only way to confirm cancer.
Provide your healthcare team with all relevant laboratory tests, scans, and pathology reports. Some natural therapies are not compatible with certain conventional treatments, such as radiation and certain chemotherapy drugs. Therefore, consult with your naturopathic doctor on which natural therapies need to be alternated with conventional treatments. Return for regular follow-ups, so that your treatment regime can be updated and refined according to your response to therapy.
Of course, there will be some conservative thinkers out there who will question the use of natural therapies at all. I would argue that even if a certain natural medicine is not "proven" to the highest possible standard, it is still reasonable to proceed so long as informed consent is in place.
The American Food and Drug Administration (FDA) suggests that "substantial evidence" would be 2 or more randomized controlled trials. This level of evidence is considered more than an iota, but less than a preponderance, and if there is good reason to believe that a given therapy is likely to work, is safe, and if the need of the patient is great, then it can be offered in good faith, with informed consent. High standards of evidence are noble, but if applied too restrictively, we unnecessarily dismiss new, natural, and safe therapies that may make all the difference with the prognosis. As it is, there are now a great many natural medicines available with this level of evidence and more, in their favor.
Healing is about restoring harmony and functional balance to our lives, socially, nutritionally, physically, and emotionally. The idea is to optimize the patient's vitality so as to continue to experience the joys of life and of our relationships. It is not always possible to induce remission of cancer, but achieving significant quality of life, as well as significant life extension, is usually possible.
Biological Strategies in Natural Cancer Care:
- Support normal cell metabolism, primarily by improving nutrition (reducing inflammation, oxidative stress, insulin-like growth factors, and stress hormones)
- Support cell differentiation and programmed cell death (apoptosis).
- Remove promoters, including environmental carcinogens, dietary hazards, as well as mental/emotional factors such as fear, anger, and despair.
- Inhibit metastasis.
- Enhance cell-to-cell communication.
- Support balanced immune function
- Inhibit tumor-induced new blood vessel formation.
- Seek to destroy cancer cells with natural medicines (e.g. IV vitamin C)
- Reduce side effects of conventional treatments.
- Prevention of recurrence after remission.
What response to Natural therapies can we expect?
A majority of patients will experience some degree of response to therapy, and that is good, but it does not guarantee longer survival. Unfortunately, it is not rare to experience a recurrence of cancer, and recurrent cancers are often treatment resistant. Treatments should be applied safely but aggressively to achieve a substantial response, and therapies designed to prevent recurrence should be applied even after apparent remission. Follow up assessments should be done every 3 months for the first year, every 6 months for the second year, and annually after that. The chances of recurrence drop sharply after 5 years of being apparently cancer free, and it is then that a patient is considered "cured". After this hallmark is passed, 20 year survival is about 85%.
Any therapy, natural or conventional, should be applied rationally and promptly. CT scans are the standard tool for measuring the response (reduction in size) of a tumor. Oftentimes, natural therapies may not act as quickly as their harsher pharmaceutical counterparts, but a substantial response must nonetheless be objectively observed by 4 to 6 weeks, or else new options must be explored.
Stay Tuned for Part Two!!!!
And so that is my introduction to the background concepts involved in natural cancer care. I hope you enjoyed it and that this has served to provide some context for the rationale of what I will discuss in the next part of this short article series. Next month, I will outline some of the specific lifestyle, nutritional, herbal, and supplement-based therapies involved in integrative cancer care. While not a replacement for professional advice for anyone's particular case of cancer, what follows will be an informative outline of what natural cancer care entails, and how it can be incorporated into one's overall treatment plan.
As always, feel free to contact us in case you have any questions or concerns, or to book an appointment.
DO NOT ACCEPT ILLNESS!
Yours in health,
Dr. Evan McCarvill, B.Sc., Doctor of Naturopathic Medicine (ND)