An expert discusses ways to complement cancer treatment and potentially improve outcomes.
Integrative medicine could be extremely beneficial in cancer care. However, it is important that patients understand the difference between integrative and alternative treatment, according to Shelly Latte-Naor, M.D., director of Mind-Body Medicine at Memorial Sloan Kettering Cancer Center.
“In integrative medicine, we take care of the whole garden. Cancer is the weed. We optimize the water and the soil to do everything we can to make the garden as inhospitable to cancer as possible,” Latte-Naor said during a presentation at the 2018 Ovarian Cancer National Conference held in Washington, DC.
Integrative or Alternative: What’s the Difference?
To potentially improve cancer outcomes, integrative treatment tackles health aspects such as nutrition, exercise and sleep habits — affordable practices that have a solid safety record and are evidence-based. Importantly, integrative treatment is meant to work alongside conventional cancer treatments to potentially improve outcomes and make patients feel better throughout the process.
On the contrary, alternative medicine could be riskier. This type of treatment, which will often market a magic herb or natural supplement to improve or cure their cancer could cost patients a pretty penny — or their life.
“Alternative medicine is sometimes touted as being curative, and it’s not backed by robust studies,” Latte-Naor said. Claims behind alternative medicine are often based in anecdotes, and have no supporting safety data, she added.
Not to mention, when someone explored an alternative medicine regimen, they may be encouraged to go off their prescribed cancer therapy, according to Latte-Naor. “That’s also a red flag to me. That’s a very serious responsibility to take on,” she said.
Latte-Naor explained that integrative therapy is a much safer approach that is growing across all National Comprehensive Cancer Network-designated cancer centers throughout the United States.
“The general population is demanding more information on integrative medicine,” Latte-Naor said. “Science is picking up on that.”
One of the “central targets” for integrative therapy is managing stress, as that can trickle down to other healthy activities. High stress and anxiety levels can cause sleep disruptions, a lack of motivation to exercise, poor food choices and less engagement with a social support system.
Although stress has not definitively been linked to be cancer-causing, it can weaken the immune system. And in mouse models, mice with ovarian cancer who were constantly stressed had more cancer growth than their counterparts who also had the disease but lived a normal life. “Stress response depends on our perception, and our perception can change very quickly,” Latte-Naor said. “We can learn and train ourselves to change our reaction in the face of stress, and one of these tools is called meditation.”
Meditation can come in multiple forms, such as sitting comfortably and doing a scan of how your body feels, guided imagery or being still with your thoughts.
Sleep is also crucial in decreasing stress (and decreased stress might lead to improved sleep). This is another key area in integrative medicine for cancer care, as 25 to 59 percent of patients with cancer experience sleep disturbances, according to Latte-Naor.
“It really impacts quality of life,” she said.
Latte-Naor said that while getting enough sleep is crucial, naps actually “are one of the reasons why patients develop a circadian rhythm disruption.”
Instead, she recommends having good sleep hygiene, which includes limiting screen time before bed, going to sleep and waking up at the same time each day and having regular eating and exercise habits.
Diet and Exercise
The exercise portion of integrative therapy is easier to discuss. Any safe form of movement that a person will do on a regular basis is likely to be beneficial. Nutrition, on the other hand, is a touchier subject.
“What’s touted as a ‘cancer diet’ ranges from a vegan to a ketogenic diet — which are opposites — and everything in between,” Latte-Naor said.
Currently, there is no one diet that has proven to have an effect on cancer outcomes. And if one is developed down the line, it likely won’t be one diet at all, but a number of different components analyzed to craft the best nutrition regimen for each individual, according to Latte-Naor.
For now, Latte-Naor recommends a whole food, plant-based diet that is rich in fiber.
“I usually advise my patients against running around with a list of things they should avoid. I would like them to focus on things that they can eat more of,” she said, noting that everyone should eat five to seven servings of vegetables a day. “Everything else might have to be modified based on your situation.”
Overall, be it with sleep, diet or exercise, Latte-Naor said that it is important that individuals figure out what kind of integrative medicine and care works best for them. For instance, if someone is agonizing over a certain diet or meditating correctly, perhaps they should move on and find something that better suits them so that they can keep up with the intervention.
“When stress reduction becomes stressful, we have a problem,” she said. “Set realistic goals that serve you best and that you’ll make a habit of doing.”