Show Notes
When it comes to cancer treatment and care, most of us think of chemotherapy, radiation and surgery. But there’ s another level of care that can be offered right along with traditional medicine. It’s called integrative medicine. Dr. Russell Greenfield of Novant Health walks us through it. To sign up for an upcoming conference on integrative medicine and cancer that's coming to Charlotte,
click here.
Transcript:
Roland Wilkerson
0:06 When it comes to cancer treatment and care, most of us think of chemotherapy, radiation and surgery. But there's another level of care that can be offered right along with traditional medicine. It's called integrative medicine, and it focuses on treating the entire mind and body. I'm Roland Wilkerson, and in this episode of Novant Health Healthy Headlines, you'll hear Dr. Russell Greenfield explain how integrative medicine, working in tandem with your oncologist and other providers can help with your recovery. And for our Charlotte, North Carolina area listeners stick around at the end to learn about a conference on the integrative medicine cancer that's coming to Charlotte on October 26.
So what is integrative medicine and what does it have to do with treating cancer patients?
Dr. Russell Greenfield
0:58 Thank you for asking integrative medicine. My peers and I defined as healing oriented care that takes account of the whole person. So certainly its body, but it's also mind its spirit, family, community environment, it's all of that. So we are indivisible systems and conventional medicine parses us out, you know, our physical body over here we take care of our spirit over here. in integrative medicine, we say we have to look at the totality of a person, we have to look at the whole person before us in order to help optimize health and well being and bring forth that gift that they have within that innate capacity to heal, to respond as well as possible to treatment and to fend off disease. That's our goal to bring that forth wherever we can. Now, we're not saying that this is alternative medicine, alternative pretty much implies we're not going to use conventional medicine. So we're not saying to folks, Hey, you know what, don't do surgery, don't do radiation or chemotherapy. Just take this herb. We're not saying that we're saying that we have a trust and a belief in good excellent conventional medical treatment. But together with that, there are things that people can do on their own to enhance their health and well being, maybe even enhance the successful outcome of treatment and help minimize side effects and stay well for the long haul. But that's where we come in, because there's so much information out there internet books, health, food stores, etc. Where are you going to go for credible information, we would like to believe that you can come to us, because otherwise, you're going to sources that may not be quite so credible. And then oftentimes, patients are uncomfortable going back to their doctor and asking questions about these types of things. Because they feel like they're going to be judged, or just flat out told, don't take any of that stuff. But there's so much pressure out there on the internet or in the media, or amongst our friends or other practitioners saying, well, you got to take this and you don't even have to tell your doctor about it. The problem with that is that some of these things we might take might actually counteract the conventional medical treatment we're using to try and beat that cancer in the first place.
What's an example, Dr. Greenfield. an integrative medical practice when it comes to cancer that wasn't done a generation or two ago. And how's that going?
Dr. Russell Greenfield
3:09 In the United States has actually been quite a growth in integrative medicine practice, starting with education that has been going on oh, I would say since the late 1990s. But remembering that even folks who have not gone through, let's say, formal fellowship, education, there are a lot of people in this country and beyond who said, you know, what, just focusing on prescription medication, there's got to be more to help. And so there are folks who were very brave and very forthright and saying, I'm going to learn more, and I'm going to work towards transforming our healthcare system to really make it be about health. So there are lots of brave individuals out there who saw that there was something better who explore things like acupuncture, explore things like Mind Body therapies, who took a look and discern between what might be promising what might be harmful and dangerous. And so there's a lot A lot of different things going on. And so now within the cancer space, there are societies like the Society for Integrative Oncology, which has many, many members. There are institutions like our own Novartis health, but also MD Anderson, Sloan Kettering, etc, that are all offering aspects of integrative oncology. In fact, National Cancer Institute certified comprehensive care centers, the vast majority of them offer some form of integrative oncology. Why? Because number one, our patients are asking about it. Number two, we have to help keep folks safe in the midst of all this. And number three, we want to give them ideas about things that might actually help them. So to that end, one of the things that's different these days, acupuncture is being used widely. Why? Well, in theory from a Chinese medicine perspective, part of what acupuncture does is it balances the chi, the life force energy of a person, and in part what that does theoretically is it helps the medication go exactly where it needs to go, while limiting side effects, how beautiful and what a almost poetic way to move forward and help to take care of oneself or other people. So you asked about what area might be a little bit different. Acupuncture is being offered widely in association with chemotherapy or immunotherapy. And certainly afterwards in case people have any side effects related to treatment, that is certainly a sea change compared to what was going on 20-30 years ago.
So I can see a lot of old school folks out there going acupuncture and chi, that sounds like a flaky hippie thing. It's so so so here's your chance to tell them why they might want to rethink that attitude.
Dr. Russell Greenfield
5:43 So I was one of those people you should know. So back in the late 1990s, I went off and did a two year fellowship at the University of Arizona College of Medicine, integrative medicine, in part because I wanted to see where are their data, if there are data at all? Is there an evidence basis to this kind of thing. And I learned something very, very important that I share with my peers all the time. There's a big difference between there not being any evidence, and my simply not being aware of the existing evidence. So as an example, you know, where my peers, and are all struggling to stay up to date in our own fields, let alone figure out what's going on with acupuncture. You know, we're trying to figure out what's the newest medication, the newest procedure, the newest study, whatever the case may be, but sometimes we're so busy, we just flipped past that acupuncture article, when there are evidence points around this. So the evidence perhaps best for acupuncture around nausea and vomiting, pain, insomnia, things of that nature, but there are some really good data points, some really good evidence here. And so we're not saying it's a panacea that it excuse me covers everything. But for specific maladies acupuncture may be very helpful. An example some people develop something called neuropathy when they get treated with chemotherapy and it can be very uncomfortable. It's a burning tingling sensation, and the hands and feet that is really hard to treat. We have certain prescriptions that we give people like Gabba, Penton, or lyric or things like that to try and help with it. But it's really hit and miss as to whether it actually does anything. But from an integrated perspective, there are other things we can use acupuncture being one of them, and people will know within four or five sessions, whether acupuncture is going to help or not. And if it's not helping, we tell people stop. It's like saying do another 10 to 15. See if you can get somewhere you should know relatively quickly if it can help. And there's very good evidence suggesting that the majority of folks have developed neuropathy and associated with their treatment, acupuncture might help.
Let's talk about the role of diet and integrative medicine when it comes to cancer care.
Dr. Russell Greenfield
7:46 It's actually a central component of health and well being actually for anybody. When you think about it, diet is one of the few things with regards to our health and well being that we actually have a real significant amount of control over. Now when we talk about diet with people, we actually really don't like the term diet or dieting, because that implies something we're gonna go on and off of, we really like to talk about a pattern of healthy eating that we can all hold to. That latter part is really important because it means that the very first thing that a healthy diet has to be as satisfying, otherwise, we're not going to stick to it. So we want food to be a source of joy for people, not a source of fear. And there's too much fear mongering on the internet with all these different kinds of diets that are promoted out there. The way we look at eating well is that we want people to enjoy their food, to eat in the company of others that they love. And to know that they are nourishing themselves, not just body, but mind and spirit and family, community and even environment as well. So it's all of those things, we promote what's termed an anti inflammatory pattern of eating. Why?...under ordinary circumstances, inflammation is considered a very important part of a properly functioning immune system. But when inflammation sets up shop where it doesn't need to be or perhaps lasts longer than is necessary. Theoretically, it may end up injuring otherwise healthy cells. And there's some experts who believe that untoward inflammation is actually one of the root sources of cancer. So what are the ways that we can help to control untoward inflammation? One of the best ways is by eating a relatively healthy diet. The reason why I say relatively healthy is yes, we want you to trend more towards eating well. But the occasional splurge is not really okay, we recommend it again, food should be a source of joy. So if tonight's the night for pizza and ice cream, have a blast, say hey, we had a really good time, and I'm going to help you over the next few days. That's a good course. Now, if you're doing pizza and ice cream every day, that's not splurging, that's more like unhealthy eating. So what we actually ask people to do is use some combination of Mediterranean and Asian style fare. So it's really more vegetables and fruit, whole grains, healthy fats, like extra virgin olive oil, perhaps more fish than red meat, you don't have to go vegetarian vegan in order to be healthy, you just want to make some prudent choices. That's all.
And where does that come in in terms of your cancer recovery?
Dr. Russell Greenfield
10:11 Well, first thing is we want to use diet, first and foremost, to help prevent cancer, which actually there are some significant data showing that we can have an impact that regard. So eating a healthy diet actually reduces the risk for certain forms of cancer. If somebody is diagnosed with cancer during treatment, we want to make certain that they're getting adequate protein and adequate caloric intake in order to respond well to treatment. And then after treatment is completed, we want people to be able to eat in a way that can actually again, give them some sense of control that maybe through diet and exercise and stress management and the best of conventional medical care, and even some compliments to that care. Maybe I can keep this thing at bay. And there's adequate evidence to suggest that's true.
So let's talk about the role of mental outlook, stress those factors when it comes to cancer care, integrative medicine.
Dr. Russell Greenfield
11:02 Stress is ubiquitous in our society, everybody has stress. The problem is that very few people possess adequate means to manage it. Now, many years ago, now, actually, not that many, maybe 20-25 years ago, medical students were still primarily taught that mind and body are separate, you know. So if you have an emotional issue, you go see this person, you get a physical issue, you go see your doctor, you're a spiritualist, you go see your, your cat, Pastor, or rabbi, Minister, whatever, we've now come to understand something that that was a misplaced judgment, which is that mind body spirit, all of that is part of the whole person, you can't separate that out and still take care of the entirety of the person. So when somebody receives a challenging diagnosis, like cancer, certainly there is stress, there's anxiety, there's fear, there may be depression, there are all manner of truly human emotions that people can go through. So there has to be honored. It also has to be attended to.
And so what are a few things, key ways in which you help reduce stress, or give patients a feeling like they, they do have some control?
Dr. Russell Greenfield
12:10 We have conversations with folks to find out what's important to them, you know, again, what's their value system? Are they religious? Are they somebody who likes to be home by themselves? Is it somebody who really, it's more gregarious and likes to be out amongst people? Do they enjoy laughter? Do they enjoy human touch, like massage, we try and find out again, about the unique individual and what has worked for them in the past, what they might be open to exploring, it can be as simple as learning a new breathing exercise, because there's actually research about that it might be massage, or acupuncture, it might be meditation. In some instances, it might be literally just going outdoors, you know, it might be attending services. I'm a big, big fan of actually meeting with counselors, you know, these are trained experts, who have witnessed people being in various in those circumstances before, and can help kind of hold a mirror up for us to take a look and see what's going on for us and how to make sense of it all and find some peace, oftentimes, in the midst of a new diagnosis or a challenging diagnosis, we can't see the forest for the trees and having a counselor or therapist, social workers, someone who is really expert in this space can be invaluable. I'm a big fan of that as well. remember some of these techniques that can be done one on one, but many of them can be done in groups too, because healing takes place in community.
And what happens potentially, what added complications or problems do patients face when they ignore the mind or the mental side of their, of their cancer treatment and recovery? Well, first, I would say it's just us not being as kind with ourselves as we could be, you know, any diagnosis can be challenging, but the diagnosis of cancer for many people is just truly frightening. And so finding a way that we can let people know, hey, we hear you, we understand what you're telling us, we're doing our best to understand where you're coming from. And now we want to do our best to try and help you find peace as you move forward with treatment. Because we think that can help want people to know that they're receiving the best of medical care, and again, to return some sense of control so that they're not completely out of control. So it's not so much that people are at risk, if they don't take care of their stress. It's just that we think that we can help people to experience this treatment phase. And then beyond that, once they've completed treatment to thrive again, in a different way that creates balance that supports overall health and well being and can hopefully help manage fear to the extent possible, because that will help people to live their best lives.
And I guess it only makes sense, you know, in in just very simplistic terms, healthy outlook is just going to help you take on whatever life throws at you.
Dr. Russell Greenfield
15:05 It's true. So folks who have, you know, certain coping skills, again, whether it be community or laughter, or just the way they're made up, or their family members, you know, there's some data suggesting that they seem to do better, but for the folks who may not have that, we want to be there for you will be there for everybody. So whether you have the skills, we're going to congratulate you and support you and just let you know, hey, we'll be here in case you need us. For those who really need us. We're going to be here.
So if you're intrigued by what you've just heard, and want to learn more, Novant Health is sponsoring a conference on the benefits of integrative medicine as part of your cancer treatment plan. The conference will be Saturday, October 26th in Charlotte. It runs from 7:30am to 5pm. The fee is $99 and includes breakfast and lunch along with an appearance from keynote speaker, Dr. Andrew Weil, he's known for more or less popularizing the idea of integrative medicine. So whether you're a cancer patient, a cancer survivor, or a family member, a friend of someone who's been diagnosed, come learn about healthy ways to eat, vitamins and supplements that may be appropriate and mind and body practices that can promote healing. We've got a link to the conference in the show notes or search integrative medicine symposium Novant Health. One extra note, there's a Friday, October 25 conference for physicians. don't enroll in that one by accident. Make sure you choose the October 26 event. Thanks for listening.