Terry Thompson’s Blog

Last year, a government task force proclaimed that women didn’t need mammograms until they were past forty.  Then the American College of Obstetricians and Gynecologists announced that women in their 20’s no longer need annual pap smears.  They said once every two years was enough.  Now, the American Cancer Society has just urged doctors to help men understand the limitations of prostate screening and that they could cause more harm than good. Is cancer screening going the way of polio vaccination? 

The ACS message is that both the PSA blood test and the digital exam for signs of prostate cancer can give false indications.  According to them, the PSA can show high numbers that indicate possible cancer when there is another problem causing the indication.  Further, the digital exam can produce the appearance of cancer when the patient doesn’t actually have cancer.  The thought is that treatment and its side effects resulting from a false diagnosis for prostate cancer is of greater concern in some cases than occasionally missing a diagnosis. 

I don’t really have a valid answer for why institutionalized medicine is trending away from their previously adamant position of more is better when it comes to screening.  My skeptical mind wonders whether the growing pressure to lower medical costs universally has somewhat influenced the reduced testing recommendations.  I can imaging doctors and researchers thinking that, since they are under scrutiny for cutting costs, all these tests may not be necessary.  I agree wholly that medical costs need to be cut in many areas.  I’m just not sure that screening for any type of cancer is the best place to look for cost savings.  The insurance industry has tremendous lobbying power and may be influencing this movement, also.

I do know this.  Cancer is one of the worst health enemies we face today.  It kills over 1500 people in America each and every day.  Each of us needs to try to avoid it at all costs.  Therefore, I want to be tested for potential prostate cancer at every opportunity taking advantage of every method.  And, I want my wife to have mammograms and pap smears as often as possible.  The same goes for all of my kids, family members, and close friends.  We are probably at a point where we will have to insist that our doctors test us for these and other cancers to the maximum extent within reason.  Likewise, if we are diagnosed with cancer, we should insist that our oncologist provide complementary treatments to the maximum extent within reason.  Or, we should find an oncologist who will. 

The loss of my wife of 33 years to cancer in 2001 was the heart-rending catalyst for my book project, A New Strategy for the War on Cancer.  The next major incentive that keeps me in aggressive pursuit of publishing the book and advocating the subject is the never-ending series of friends and family that are diagnosed with the disease month after month.  Just last week, another close friend, a gentle, loving lady whom I have known for years, was told she has stage 4 cancer.  Her husband, one of my best friends and weekly breakfast prayer partner, has had many conversations with me in times past about complementary cancer therapies.   We have discussed my upcoming book numerous times. 

Upon sharing the bad news with me, he mentioned that he had already checked on options for connecting with an integrative oncologist.  He already understood the scarcity of integrative oncology practitioners and clinics, but was discouraged to learn just how difficult it would be to obtain such care.  He learned first hand that the closest medical center that specialized in natural therapies complementary to his wife’s conventional therapies would require a drive of over 250 miles each way.   He was also told that he would probably have to spend tens of thousands of dollars out of pocket for the complementary therapies that insurance companies would not cover.  He was somewhat aware of the challenges he would face in attempting to incorporate complementary therapies into his wife’s treatment regimen, but was not expecting it to be almost an impossibility.  I knew what he would be facing, but I still agonize over loved ones who understand the benefits of complementary therapies, but are unable to obtain them.

Awareness of and access to integrative oncologists will not improve until there is wide-spread demand from patients and potential patients for many more doctors and medical institutions to practice complementary therapies.  As always, I urge my readers to support the movement of integrative oncology.  Support the research for better complementary therapies.  Give to integrative oncology research foundations.  Ask conventional treatment doctors about it.  Make it a long-term educational journey.  We must pursue a new strategy for the war on cancer. 

Homeopathy has been practiced for centuries as a curative process for all kinds of diseases.  Today, it is widely used in other countries, but has been only on the periphery of acceptability in the U. S.  The National Cancer Institute defines homeopathy as: A method of treating disease with small amounts of remedies that, in large amounts in healthy people, produce symptoms similar to those being treated. Homeopathy seeks to stimulate the body’s defense mechanisms and processes so as to prevent or treat illness.  In other words, homeopathic practitioners infuse harmless amounts of various compounds into the patient that will make the body react in ways it reacts to the disease, but more aggressively.  This stimulates the immune system to produce more and stronger antibodies to fight the original disease. 

In recent years, most medical scientists have denounced homeopathy as quackery.  Having hardly any opportunities for development within mainstream medicine, research and practice has been relegated to kitchen laboratories and back offices of natural food stores.  However, increasing evidence of the efficacy of the practice is beginning to stir renewed interest in unexpected places.

According to Ralph Moss’ latest Cancer Decisions newsletter, The February 2010 issue of the International Journal of Oncology reported that the M. D. Anderson Cancer Center has found that four homeopathic remedies can induce cancer cell death in breast cancer tumors.  This news came out of the Integrative Medicine Program, the Department of Molecular Pathology, and the Department of Melanoma Medical Oncology at the Center.  The effects of two of the remedies appear similar to the activity of Taxol, the most commonly used chemotherapy drug for breast cancer.  The four remedies are typically used in India to treat breast cancer.

The biggest problem with relying solely on conventional medical science’s drug testing for an answer to cancer is that this testing always assumes certain parameters of dogmatic “facts” that prejudge the possible outcomes.  If any theory doesn’t fit within preconceived outcomes, it doesn’t get a seat at the table of modern medical science.  Homeopathy has not had that advantage of legitimacy, and has more or less been sidelined from consideration for cancer therapy possibilities.  Now that M. D. Anderson, the top cancer center in America, has come out with a study that gives credence to the age-old practice, conventional cancer treatment researchers and practitioners have some re-thinking to do.

Just one study, even from such a prestigious institution, is not going to change conventional medicine overnight, but it is exciting to see more and more of these revelation bringing legitimacy to a new strategy for the war on cancer.

During my wife’s treatment for breast cancer in 2000, we asked our oncologist several times about what and how she should be eating.  Each time, we were told not to worry about diet and to eat whatever she desired.  The oncologist’s rationale was that, since the treatment reduced appetite significantly, any food tolerable would be advantageous to consume.  Unfortunately, that continues to be the nutritional philosophy of many conventional oncologists.

Even the National Cancer Institute has reported that 20% to 40% of cancer patients die from causes related to malnutrition rather than from the cancer itself.  Insufficient nutrients can lead to a condition called “cachexia” which negates the benefits of nutrients and compromises immunity.  Cachexia causes weakness along with loss of weight, fat, and muscle.  Have you known of cancer patients under treatment who gained weight and became stronger?  Of course not.  They always look gaunt and hardly have the strength to function normally.

Dr. Keith Block of the Block Center for Integrative Cancer Treatment in Evanston, Illinois, explains that malignancy generates the production of low-grade inflammatory molecules that break down lean muscles and disrupt immune functions.  The typical American diet of fats, refined flours, and sugar increases this inflammation and contributes to lack of appetite, more debilitating weight loss, and actually promotes the very disease the patient is trying to fight. 

Dr. David Katz, director of the Yale Prevention Research Center, says that cancer may kill in part by causing starvation and that conventional therapies may actually exacerbate this aspect of the disease.  It is critical that the conventional assault on cancer be combined with effective nurturing and nourishing of the body.  Dr. Katz is adamant that optimizing nutrition during and following cancer therapy is a vital element in overcoming the disease. 

Drs. Block and Katz offer the following suggestions for the cancer patient’s diet.

1. Eat lots of phytonutrients found in fresh fruits and vegetables

2. Eat omega 3 fats, monounsaturated fats such as olive oil, complex carbohydrates, and proteins.

3. Eat energy dense foods such as avocados, nut butters, and soy.

4. Avoid “bad” fats such as saturated fats in milk, cheese, butter, red meat, pork, and poultry.

5. Eliminate unnatural fats, or trans fats, found in margarine, hydrogenated oils and many baked goods and convenience foods.

6. Reduce or eliminate high-glycemic, simple carbohydrates such as sugar, honey, high fructose corn syrup, concentrated sweeteners, sugary beverages, cookies, cakes, pastries, white bread, crackers, and white-flour baked goods.

Nutritional counseling and management are key parts of complementary therapies offered by integrative oncologists.  They are essential to the new strategy for the war on cancer.                                                                      

My last post highlighted how impersonal most cancer treatment was regarding the specific drugs used in the chemotherapy.  There are standard drug combinations for almost all conventional treatment patients based on the average need for the average patient with a particular type of cancer.  Very few oncologists take advantage of a technology that has been available for several years which involves the lab testing of a cancer tissue sample for resistance and vulnerability to different drugs or drug combinations.  This is a common practice for integrative oncologists who are interested in personalizing treatment in every way possible.

Another aspect of personalized cancer treatment is the doctor’s practice of involving the patient in both the strategy and details of the treatment.  Most integrative oncologists discuss the patient’s desire for treatment as the first step.  They explain the options thoroughly and ask many questions about what the patient’s objectives are for responding to the disease.  It may surprise you to learn that many patients do not place their personal priority on living as long as absolutely possible.  Many prefer to maintain a comfortable quality of life without the rigors of aggressive therapies.  In such cases, the doctor-patient relationship is key to providing the cancer victim exactly what they desire in treatment as they spend sufficient time in determining what their treatment will consist of.  Perhaps a milder form of chemotherapy accompanied by various natural complementary therapies is in order.  Other patients may elect to receive only pain relief therapy with no chemotherapy of radiation.  This is in sharp contrast to the typical conventional treatment that is offered by most oncologists as the only option.

The majority of oncologists today will, in the initial meeting with the patient, discuss aggressive chemotherapy and/or radiation as the only options.  Even when a patient is diagnosed with metastasized, terminal cancer, the oncologist will usually recommend strong chemotherapy to extend life as long as possible.  Seldom is the patient even asked about their desires or priorities.  Seldom does the patient ever consider that he or she has options.  Part of the new strategy for the war on cancer is to move the cancer patients into a position of control over their own destiny.  Patient education and advocacy will create freedoms for the cancer victim that can lead to much improved quality of life, and in some cases, longer life or healing. 

Much is being written and talked about today regarding “personalized” cancer treatment.  What a novel idea.  What if we treat each cancer patient’s tumor or blood cell cancer as the unique problem that it is?  For several years, medical technology has provided the capability to test specific cancer cells in the laboratory for their vulnerability and response to particular drug combinations.   Surprisingly, it has only been practiced by a few oncologists.

Almost all cancer is being treated by chemotherapy regimens for the “average” or “typical” patient.  Researchers study a particular type of cancer and design a concoction of cytotoxic drugs that they determine best meets the criteria for killing the particular category of cells.  Levels of aggressiveness and progression are taken into consideration, but therapies are standardized within a spreadsheet layout of the options.  Standard references are used by oncologists to prescribe the treatment.  This allows for the convenient production of the drugs, a convenient system of categorizing and cataloging the drugs, and a convenient method for doctors to prescribe the drugs.  The conventional cancer treatment community–scientists, oncologists, pharmaceutical companies, and funding agencies–have all maintained a comfort level with this treatment protocol.

The problem is that each cancer patient’s cancer cells have unique characteristics.  They have different levels of resistance and varying vulnerabilities.  Some cancer cells may be virtually immune to their prescribed standard chemotherapy, but possibly defenseless to just a small tweak in the formula.  Many integrative oncologists make it a common practice to extract cancer cells from the tumor or blood and conduct resistance and efficacy tests using various combinations and strength levels of drugs.  Once they have determined the most effective combination, they prescribe the chemotherapy accordingly.  This seems like such a no-brainer.  However, it is still a rare practice among oncologists.  The main argument for not bothering with the procedure is that it is an extra burden, expensive, and not necessary.  The burden and expense would likely be offset by the avoidance of treatments with ineffective drugs.  Nevertheless, most oncologists profess the virtues of the standard process.  Well, one only has to look at the abysmal record of progress in cancer treatment for the last 40 years to see that some kind of meaningful change might be worth considering.  We desperately need a new strategy for the war on cancer.

We’ve been discussing clinical trials for new cancer treatment possibilities.  We’ve alluded to the high costs for these trials.  So, who pays for this research?  The major source for cancer research financing is the National Cancer Institute (NCI).  The NCI is a government agency, and the providers of almost all of their funds are this nation’s tax payers–you and I.  This year’s federal budget includes $5.15 billion for NCI.  Of that, only $122 million is earmarked for complementary and alternative medicine (CAM).  That is about 2% of all NCI research allocated to CAM. 

The next largest supplier of cancer research funds is the American Cancer Society (ACS).  Their receipts are almost completely from donations from fundraising projects such as Relay for Life and corporate or philanthropic grants.  Their annual budget is hovering around a billion dollars now with less than 1% going toward anything CAM related.

A third significant player in the funding of cancer research is the Komen Foundation.  Concentrating exclusively on breast cancer, Komen is raising about $60 million each year for fighting the disease.  Their Race for the Cure grows more popular every year.  This year, they have only four projects for CAM-oriented research with a cost of about a million dollars.  That is less than 2% of their annual research budget.

It is difficult to analyze the contributions of these and a host of other agencies that contribute to cancer research.  But, I believe I can safely say that the sum of all research efforts involving natural complementary cancer treatments only amount to between one and two percent of the total cancer research efforts of our nation.  I strongly advocate giving to cancer research.  Run the races, participate in the walk-a-thons, buy the pink products, drop your extra change in the fast food containers, and send your checks to your favorite agency.  However, do it with the understanding that only one or two percent will finance research other than the quest for more drugs and conventional modalities.  If you desire to earmark your donations to help the one or two percent effort toward promising complementary therapies, you only have a few options.  One is the Connie Thompson Foundation.  Another is the Helen Moss Foundation. 

The new strategy for the war on cancer hopes to increase the allocations of major funding agencies to research in the genre of non-toxic, non-intrusive complementary therapies.  The strategy also encourages the establishment of more fund-raising foundations to support research into these therapies.   

Clinical trials for prospective medicines and methodologies are absolutely necessary.  They help to protect us from ineffectiveness, harmful side effects, and dangerous dosages.  They are not, however, without down sides.  They are painfully long in duration, extremely expensive, and not always conclusive.  Unfortunately, most conventional medicine professionals revere them as the mecca of modern medical science.

Clinical trials have been both the friend and foe of complementary and alternative medicine.  Thankfully, they have bestowed the stamp of legitimacy to such practices as adding nutrition and dietary supplements to certain prescribed protocols as well as hyperthermia therapy to chemotherapy and radiation treatments.  On the other hand, clinical trials have rejected many potentially helpful natural medicines and methods as a result of inadequate processes or misinterpreted data. 

The hyperthermia therapy trials that I wrote about in my last blog post were successful only after many years of research and previous trials.  Dr. Ralph Moss, in his latest weekly newsletter, Cancer Decisions, noted that, in the mid-eighties, a large randomized controlled study failed to show any benefit of hyperthermia therapy as a complement to conventional cancer treatment.  So, this tremendously enhancing procedure was put on the shelf for several years.  Later, researchers who “studied the study” judged it as have glaring issues of quality control.  Even The Journal of the National Cancer Institute reported that almost one-third of the tumors that were treated were never tested for an internal temperature.  The JNCI also concluded that there were problems with the equipment and technique during the course of the trial.  Unfortunately, the initial official reportings of the trial had already had their effect on the cancer treatment community, and few practitioners wanted to associate themselves with what was considered a bad field of practice.  Not until the very recent new trials, has hyperthermia redeemed itself in the scientific world as a therapy of choice.

The lesson from the hyperthermia trials and many other medical science research projects is that it often takes more than one trial to accept or reject a new medicine or method.  Numerous chemotherapy drugs used routinely today were “proven” ineffective in early trials.  Seemingly, toxic chemicals developed by major medical research labs continue to survive multiple trials until they are legitimized.  Meanwhile, natural candidate medicines and methods such as chelation, laetrile, vitamin C, etc, are doomed after one trial with questionable quality control and technique.

The difference is mostly about financial investment.  Costly toxic drugs can recoup the investment of multiple clinical trials once they are proven safe and effective.  Who is going to finance multiple trials for even a potentially highly beneficial therapy that can be purchased from an aisle in the grocery store?  There lies the biggest dilemma in the world of cancer treatment.  We must pursue a new strategy for the war on cancer.

Quite some time ago, I wrote about hyperthermia as a complementary therapy for cancer treatment.  Since then, it has become of even greater interest to the oncologist community.  Dr. Josef Issels, a 20th century German physician improved a concept he called “sweat therapy” or induced hyperthermia.  Used for centuries in Europe to treat chronic diseases, it causes a pronounced increase in white blood cell count.  The white blood cells are the core of the disease fighting antibodies of the body.  Dr. Issels administered monthly “fever shots” to patients which induced a high fever for up to five hours.  In 1984, the FDA approved this practice as a valid cancer treatment.  Five years later, the National Cancer Institute stated that heat therapy increases the effectiveness of other treatments by 25 to 35 percent.

A recent Boston Globe article observed that traditional therapies offer little to help shrink cancerous tumors.  The article went on to say that, according to clinical studies, when tumors are treated with radiation therapy and hyperthermia in combination, they tend to shrink, sometimes dramatically.

Last month, a breaking news article in the Journal of the National Cancer Institute again drew attention to hyperthermia.  The article reported that a randomized trial in Europe showed that patients given chemotherapy plus hyperthermia had a median disease-free survival period of almost twice that of those who got chemotherapy alone.  Elizabeth Repasky, Ph.D., of Roswelll Park Cancer Institute, Buffalo, N.Y., commented on the trial results, “We are on a verge, I think, of a major new adjuvant cancer therapy that will not replace chemotherapy or radiation, but will make them work a lot better.”

That is what complementary therapies prescribed by integrative oncologists are all about–making conventional treatments work a lot better.  Of course, there is always hope that some of these evidence-based therapies will become breakthroughs that lead to beating the disease altogether.  The heartbreaker is that relatively few oncologists today practice any of the complementary therapies including hyperthermia.  They rely exclusively on toxic drugs and radiation.  The new strategy for the war on cancer hopes to change that.

From the beginning of my book project for A New Strategy for the War on Cancer, I planned for an Appendix that would list where cancer victims could go for integrative treatment.  As I searched for clinics, centers, and institutions that offered natural complementary therapies managed by certified oncologists, I was disappointed to learn just how few there were.  Although these complementary therapies are becoming more prevalent each year, they are still far from being readily accessible to the general population.

Plenty of small clinics offer various natural alternative therapies, but most are administered by naturopaths or other non-physician practitioners.  I am not critical of that or deny their right to do that.  However, my focus is on certified oncologists who realize the benefit of natural therapies and prescribe them as necessary complements to conventional treatment.  I believe that is the future of cancer treatment that works.

 As I searched for integrative oncologists, I found them relatively accessible to potential patients on the east and west coasts.  They were especially available in major medical school clinics like those of Harvard, Yale, Duke, UCLA, UCSF, etc.  Of course, Cancer Treatment Centers of America that you see advertised on TV have hospitals in the north central and northwest areas of the country.  A few are found in Arizona and Nevada where the state agencies are receptive of them.  Outside of M.D. Anderson in Houston, which has a relative small presence of integrative oncologists, very little is available in the south and south east.  Regardless of where one might live, it is very seldom that such capability is available within a short, convenient drive.

A principal part of the new strategy is to encourage cancer patients to request complementary treatements from their oncologists.  Until that happens, integrative oncologists will not be inclined to expand their practices, and conventional oncologists will not have incentive to broaden their practice into complementary therapies.  In our free market economy reliance on supply and demand prinicples, we must make all oncologists feel the demand for complementary therapy options.  That is done through education and information.  We all need to become involved in spreading the word.  That will be the thrust of my book.