Complementing Cancer — lynnette hoffman

Skeptics have long scoffed at the role of complementary therapy in treating cancer, but evidence is taking off

If you’d have asked Scott Stephens’ mates a bit over half a decade ago, it’s doubtful anyone would have envisioned the then cabinet maker as a new age sort of bloke.

At 23 Stephens was a juicy-steak-loving carnivore who enjoyed a cold stubby after a hard day’s work.

But a diagnosis of advanced melanoma followed by multiple surgeries, bouts of immunotherapy and chemotherapy and three relapses has changed a few things.

Two years ago Stephens began learning the basics of meditation and changing his lifestyle, but it wasn’t until about six months later, when the cancer re-emerged in his chest and spread to his pelvis and bowel, that he decided to really get serious.

Today his diet is strictly vegan, all organic, nothing genetically modified, no alcohol. He meditates for a couple hours a day, exercises daily and practices chi kung, a form of exercise similar to tai chi. He also attends a support group run by the Gawler Foundation, a not for profit organisation that teaches complementary and alternative self help techniques to cancer patients.

He says the difference has been profound—his outlook has gone from depressed and overly negative to happy and fulfilled.

“There is hope, no matter what your doctors say. Having no hope can kill you just as much as cancer can,” he says.

As for the cancer itself, the tumors have not grown in more than 12 months.

Would it have stabilized on its own? There’s no way to know.

But a growing segment of the medical community says the evidence supporting such complementary therapies is too important to ignore.

“There is potential for great benefit in complementary therapies,” says Dr Tracey O’Brien, an oncologist and head of Cord & Marrow Transplant Program at Sydney Children's Hospital, Randwick. “We use music, imagination and relaxation as powerful tools to help children and adolescent patients though their cancer journey.”

Studies confirm that practicing meditation or being involved in a support group, for example, can improve quality of life for cancer patients. Other studies have shown improved benefits for patients who incorporate exercise, as well as other lifestyle changes such as stress management, into their treatment.

Last June a senate inquiry into services and treatment options for people with cancer recommended funding for complementary self help programs and activities including “Medicare deductibility for cancer patients accessing these services.” It also recommended increased awareness of additional complementary support services available, as well as funding for research into complementary medicine. As yet the government has not yet made a decision on whether or not it will implement any of the recommendations.

Integrative medicine in cancer treatment has gained significant support overseas—nearly every university medical faculty has an integrative component, while in Australia none do—something many of those who made submissions to the senate inquiry say needs to change.

Even with all the advances in medicine, cancer is still deadly and conventional treatments such as chemotherapy often only have limited effect for many cancers. That’s why advocates of increased government support for complementary therapy say it’s imperative that people have access to as much reliable information and as many resources as possible.

“There are complementary and holistic approaches and lifestyle changes cancer patients could be making that they’re not being informed about or encouraged to take up,” says Dr Craig Hassed, a senior lecturer of general practice at Monash University who specializes in mind body medicine.

“Studies show that massage, music therapy and meditation can help with pain, anxiety and depression and cancer patients need to know about that. Other areas are not as well researched, but the contentions are that these things can help with survival too,” Hassed says. “As medical practitioners we need to stop thinking that it’s some kind of war we’re waging with alternative practices. We need to consider what’s going to be best for the patients without creating artificial barriers.”

At the most basic level the healthier a person is, the better their chances of beating cancer are, according to professor Avni Sali, head of the Graduate School of Integrative Medicine at Swinburne University of Technology and a board member of the Gawler Foundation.

“The very least one should do is make the patient as healthy as possible—they have to be very healthy just to cope with the treatment. It’s not benign treatment, so the fitter you are the better you can cope with cancer because your defenses are going to be working better,” Sali says.

So far a number of studies have shown promising results.

Last year a study published in the Journal of the American Medical Association (2005: 293(20):2479-86) that tracked almost 3000 women who had been diagnosed with breast cancer found that those who walked three to five hours a week cut their risk of dying by 50 per cent.

In September the Journal of Urology published a study of 93 men who had chosen not to undergo conventional treatment for their prostate cancer (2005;174(3):1065-9). Half underwent an intensive lifestyle program that involved a strict vegan diet, antioxidant supplements, moderate aerobic exercise and stress management techniques, while the other half weren’t given any treatment. When researchers measured prostate specific antigen (PSA), an indicator of abnormality in the prostate gland, for the men who had been given the lifestyle intervention, they found it had dropped by an average of 4 per cent. Meanwhile the PSA of the men who were untreated increased by an average of 6 per cent.

Several studies have found benefits to using stress management techniques including meditation and relaxation therapy.

A critical review of nine research articles and five conference abstracts on mindfulness meditation in oncology patients (published in Integrative Cancer Therapies 2006: 5(2):98-108) found consistent benefits including improved psychological functioning, reduced stress symptoms and enhanced coping and well-being.

When a person is chronically depressed or anxious, changes occur that may actually trigger relapse or interfere with treatment. These include an increase in the number of genetic mutations, as well an increase in inflammatory chemicals that make it easier for cancer cells to replicate and spread. But meditation has been shown to decrease those inflammatory chemicals, Hassed says.

“Studies on malignant melanoma patients also showed that stress reduction improved immune response which was associated with reduced recurrence and death rates over six years,” he says.

But while all this might sound like a miracle cure, experts say much more research needs to be done to understand the full effects of such therapies.

“Scientific validation of complementary and alternative medicine is needed, however as every therapy has the potential for harm and unexpected interaction,” O’Brien says. To that end she says clinical trials by the cancer research organisation Children’s Oncology Group are looking at potential benefits of homeopathic remedies to treat some symptoms of certain cancers, as well as to ease some of the side effects associated with chemotherapy.

Hassed agrees that without clinical trials to provide solid evidence, caution needs to be exercised.

“Lack of information can be dangerous because some therapies—such as shark cartilages or mistletoe—have only early circumstantial evidence but there’s not evidence to show long-term survival rates will improve,” he says. “There are legitimate concerns that patients will be given false hope and that therapies that are not supported by evidence will make people potentially vulnerable.”

What’s more, Hassed says it’s essential that patients view these therapies as complementary, rather than as alternatives to conventional medicine.

“The best outcomes use all the available therapies that are appropriate,” he says.

In June a senate inquiry service and treatment options for cancer patients recommended:

· Dedicated funding for complementary medicine research
· Information on complementary medicine to be provided to patients and health professionals
· Enhanced referral network