I have been treating women with breast cancer for over ten years, and I believe naturopathic medicine can help counter the growing incidence of this disease. It can also help women with breast cancer undergoing conventional chemo- or radiation therapy. A comprehensive naturopathic treatment program can make a significant difference in patients' ability to tolerate conventional therapy with a minimum of side effects, and may also improve survival.
Last year, I began documenting my patients' outcomes with the aim of collecting preliminary data that would draw attention to the value of this integrated approach. This pilot study is not sufficiently powered to test the biological activity of specific naturopathic therapies. But it does document the efficacy of an integrated treatment program in a realistic setting, reflecting how blended medicine is actually practiced in both a hospital-based, outpatient chemotherapy department (North Hawaii Community Hospital, Kamuela, Hawaii) and a freestanding naturopathic clinic (Lokahi Health Center, Kailua Kona, Hawaii).
Naturopathic treatment for breast cancer is not standardized. However, Dr. Leanna Standish and associates at the Bastyr University Research Institute published a paper last year outlining how NDs approach this disease (Standish L. Altern Ther Health Med 2002; 8(4):74–78). They reported that "to develop naturopathic treatment plans, naturopathic physicians most often considered the stage of cancer, the patient's emotional constitution, and the conventional therapies used. The most common therapies used were dietary counseling (94%), botanical medicines (88%), antioxidants (84%), and supplemental nutrition (84%). The most common specific treatments were vitamin C (39%) and coenzyme Q10 (34%)."
The treatment plans I provided for my patients had a high degree of consistency. Standish identified eleven naturopathic principles for treatment of breast cancer, which emerge from the basic naturopathic philosophy of treating the whole person, individualizing therapy, and taking into account physical, mental, emotional, genetic, environmental, social, and spiritual factors.
Following each principle is the specific naturopathic treatment for addressing it. Collectively, these form the basis of the interventions used in this pilot study. The principles are: 1) prevent metastases (modified citrus pectin); 2) block cancer cell cycle, induce apoptosis, and reduce tumor cell division (coenzyme Q10, garlic, quercetin); 3) prevent mutation (antioxidants, including vitamins A, C, E, beta carotene and melatonin); 4) inhibit tumor angiogenesis (soy isoflavones, docosahexaenoic acid, selenium); 5) enhance general immune function (melatonin, medicinal mushrooms, aerobic exercise); 6) enhance specific immune recognition and cytotoxic activity (inositol hexaphosphate, medicinal mushrooms); 7) decrease estrogen effects (calcium glucarate, diindolyl methane); 8) remove initiators and promoters of malignancy (deep tissue cleansing, treat hypothyroidism); 9) provide nutritional support (vitamins A, C, E, beta carotene, omega-3s, soy isoflavones, flax seed lignans); 10) access the "healer within" (psychotherapy, group therapy, imagery, meditation, prayer); 11) minimize side effects of conventional treatment (modified citrus pectin, antioxidants, B vitamins, coenzyme Q10, glutamine, deglycyrrhizinated licorice, Black Cohosh).
The women in my study were given two questionnaires. One was adapted from the University of Washington Quality of Life Questionnaire (UW-QOL) originally used for patients undergoing conventional treatment for head and neck cancer. I modified it to address common adverse effects of chemotherapy and radiation for breast cancer. It includes twelve questions regarding mouth sores, nausea/vomiting, activity, recreation, hot flashes, infection, hair loss, diarrhea, neuropathy, mood, and anxiety. Patients completed this survey weekly following chemotherapy. The second questionnaire was the SF-12v2 Health Survey, a short version (twelve questions) of the well-known SF-36 quality of life survey. Patients completed this survey for the month following each treatment.
At present, I have data from three women completing standard "AC" chemotherapy (doxorubicin [Adriamycin] and cyclophosphamide [Cytoxan]), given every three weeks for a total of four treatments. Three other patients are currently undergoing treatment. The patients ranged in age from 45 to 60 years. Naturopathic treatment began prior to initiation of chemotherapy and continued after radiation was completed. The two written surveys gave the following results:
- Mouth sores (aphthae): 1 of 3 patients had post-treatment aphthae.
Nausea/vomiting: All experienced some nausea (2 had mild to moderate nausea and 1 had severe vomiting after their 1st treatments).
Activity: 1 patient had slight decrease in level of activity, 2 had mild to moderate decreases.
Recreation: 3 patients had no limitations after 2 treatments and moderate limitations after the second 2 treatments.
Hot flashes: 2 patients had mild hot flashes; 1 had none.
Infection: None experienced infections.
Hair loss: All 3 patients lost all their hair.
Diarrhea: 2 of 3 patients had mild diarrhea after their 1st treatment only.
Neuropathy: None experienced this side effect.
Mood changes: 1 patient rated her mood as excellent and unaffected throughout treatment; 1 rated her mood as excellent following 2 treatments, and only occasionally affected after the other 2; the third patient was somewhat depressed after her first 3 treatments, but felt generally good after the 4th.
Anxiety: 1 patient had none; 2 were mildly to moderately anxious through most of their treatments.
The SF-12v2 results corresponded closely with the above. In general, one patient rated her health as excellent throughout treatment, one said it was very good, and one said it was good.
Few conclusions can reliably be drawn from these preliminary data, other than to say they are favorable. The pilot study will be published when the remainder of the data is collected and compared to a matched control group of patients receiving conventional care alone, without any naturopathic adjunctive therapy.
Michael Traub, ND, is currently president of the American Association of Naturopathic Physicians. He practices in Kailua-Kona, Hawaii, and is on staff at North Hawaii Community Hospital.