The whole person approach to cancer care

by Professor Avni Sali

Living Well Magazine Autumn 2015

Cancer doesn’t just happen to a site in the body, it happens to the whole person. One in two people will be affected by cancer by 85 years of age, so we may all be touched by cancer, either directly or with a loved one, in our lifetime. 

The most common cancers in males (not including skin cancer) are prostrate, colorectal, lung, lymphoma and bladder. In females they are breast, colorectal, lung, lymphoma and uterine. Melanoma is the third commonest cancer. Cancer-related deaths are increasing.

Research has been slowly uncovering the risk factors for cancer. We now know there is not one particular factor that is responsible for the cause of cancer. Genetic influences, family history and age appear to be background factors, possibly for all cancers; however, lifestyle and dietary factors play a major role  in the cause.

Lifestyle factors include behavioural factors, poor diet, lack of exercise, sleep patterns, lack of sunlight, smoking and environmental causes. Research indicates that more than 30%  of all cancers are contributed to  by a poor diet and a depleted nutritional status.

Integrative Medicine always begins with an enquiry into the lifestyle factors that may be contributing to ill-health. This is a critical, but often overlooked, element in cancer diagnosis when ‘treating the cancer’ becomes the first priority. It is not enough to just diagnose cancer – we need to understand why the cancer has developed.

There is a role for evidence-based complementary care options to be incorporated into any cancer care plan and an integrative practitioner can support patients in navigating the complex world of treatment decisions and planning, a task that can be challenging when patients are already feeling unwell. Conventional cancer treatment is orientated around removing the cancer with surgery, chemotherapy and radiotherapy, often with less emphasis on the ‘person’ who has the cancer.

An integrative model is inclusive of all the options available to a patient including surgery, chemotherapy and radiotherapy, but it extends beyond conventional treatments to include a range of evidence-based complementary therapies that treat the whole person – biologically, physically, mentally, emotionally and spiritually.

Research indicates that more than 70% of cancer patients use at least one form of complementary medicine during their illness, this mirrors complementary therapy use in all forms of health care.

An informed and empowered patient is able to make treatment choices that best suit their individual disease profile and philosophies of healing. Integrative cancer care can:

  • provide therapeutic support in addition to conventional treatments
  • assist in improving the efficacy of conventional treatments
  • provide treatment options in their own right
  • alleviate symptoms of conventional treatments
  • support the preparation for, and recovery from, surgery and other treatments
  • provide a preventative approach to reoccurrence of cancers
  • support a lifestyle that is preventative for cancer
  • encourage the patient to be an active participant in their healing process
  • aim to make the patient as healthy as possible, as a ‘healthy’ cancer patient will have a better prognosis.

At the core of an integrative approach to cancer care are the lifestyle therapies such as mind-body Medicine, diet and nutritional medicine, exercise, adequate sunlight exposure, sleep, meditation and stress management, and  social support.

Mind-body Medicine is an area of medicine that looks at how the mind influences the body through psychoneuroimmunology and pychoneuroendocrinology. These terms refer to the mind-body connections between the psyche, the nervous system, the immune system and endocrine systems. The relevance to illness has been proven in a body of research that establishes a direct link between the role of the mind and the cause of disease. Stress, depression, fear and tension are all understood to compromise  immunity and influence hormones, especially growth stimulating hormones, and thus are precursors to illnesses such as cancer.

The integrative approach deals with behavioural factors that lead to the immunological and hormonal disturbances involved in the cause of cancer. Mental relaxation techniques, group therapy and even chatting with a confidant have all been shown to help positively influence prognosis relating to cancer.

Nutritional influences are important. Not only is diet a risk factor in the cause of cancer, but there is increasing evidence it can influence the course of cancer.

Nutritional and herbal supplements can help improve body function especially in those with malnourishment. Adequate vitamins and minerals are important for normal immune function. Your health professional will be able to guide you with supplementation (beyond natural food sources) that may be helpful.

Acupuncture, although not a treatment for cancer, has been shown in research to be effective in supporting patients manage the side-effects of chemotherapy such as fatigue, nausea and vomiting.

Hyperthermia treatment is a progressive treatment in which cancers are exposed to high temperatures to make them more sensitive to the effects of radiation and anti-cancer drugs. Hyperthermia also influences cancer in other ways. This treatment is endorsed by the American Cancer Society and is widely used in Europe and Asia.

The National Institute of Integrative Medicine in Melbourne has introduced Hyperthermia treatment in Australia.

An Integrative Medicine practitioner is an important ally providing the level of patient care, ongoing support and referrals to other specialists that are essential for a patient navigating a cancer diagnosis.

Research into integrative and complementary treatment options has shown an improved quality of life for patients, and the potential to extend survival times, in some cancers.

Integrative cancer care, with its whole person approach, can bring together many therapies to develop a thorough treatment plan that is the best that all medicine has to offer.

Sources:
Kotsirilos, Vitetta, Sali. 2011 A guide to evidence-based integrative and complementary medicine, Elsevier, Sydney.

Prof. Avni Sali
(MBBS, PhD, FRACS, FACS, FACNEM)

Prof. Sali is often referred to as the father of Integrative Medicine in Australia. In 1996 he was the Founding Head of the Graduate School of Integrative Medicine at the Swinburne University in Melbourne. In 2009 he established the not-for-profit, charitable National Institute of Integrative Medicine (NIIM), and became its founding Director. His lifelong work has been the tireless promotion of bringing evidence-based Integrative Medicine into the mainstream medical model – to become the medical paradigm of healthcare.  Professor Avni Sali is a long standing board member of The Gawler Cancer Foundation.