Intergrated Medicine - who needs it?

The subject of Integrated Medicine is a hot topic in the UK. It shouldn’t be. We should have adopted it, in principle and practice, twenty or more years ago. Integrated is also referred to as Holistic Medicine in the UK, and Integrative Medicine in America.

Sadly, I find myself as one of the leading UK experts on Integrated Medicine, especially as it relates to cancer. I say ’sadly’ because in other Western Countries it is widely adopted, but in the UK possibly due to the dominance of the drug companies, or the innate conservatism of the old school in the BMA, or the insane restrictions of a 1939 cancer advertising act which predates TV, all modern drugs and research on vitamins or exercise, or the misplaced zeal of certain skeptic quacks who, for example, can hound the BBC into removing all mention of complementary and alternative treatments from the health section of their web site we have simply fallen behind.

In America, 37 per cent of hospitals have a phrase about treating ’Mind, body and soul’ in their mission statement. If you want to become an Integrated Doctor, rather than limit yourself to just orthodox medicine, you can learn your trade at UCLA or a number of other medical schools. MD Anderson has people like John Boik, trained in Chinese medicine and nutrition at the very top of the tree. He has even written a tome called Natural Compounds in the Treatment of Cancer’ and cited 4,000 research studies. The National Cancer Institute in America has 36 pages on its web site just on the subject of ’Energy Therapies’, from chakras to acupuncture. Even the traditional Memorial Sloan-Kettering covers herbs and vitamins on its web site. You can find an Integrated Clinic, with Doctors, nutritionists, counsellors etc in just about any town. In May 2012 the American Cancer Society published a report stating that there was ’overwhelming’ research since 2006 that exercise, diet and weight control should be built in to the treatment programmes of people who have had cancer. 

Let’s not confine ourselves to America? In France my Doctor is both a Medical Doctor and Homeopath he is not forced to choose which he wants to practice nor how he should treat a patient as in Britain. In Germany some Doctors are fully qualified herbalists. In Britain, herbalism is a mess. In Australia 68 per cent of people with a back problem go first to an expert osteopath. In Britain 96 per cent go to their GP and in 95 per cent of these cases he sends them home with pain killers to rest.

With cancer in the UK we ’officially’ confine ourselves to the Holy Grail of surgery, radiotherapy and chemotherapy, yet our record in cancer survival is poor. Eurocare 4, after 7 years of the new National Cancer plan, saw us more than 10 women per hundred behind the best country for 5-year survival in breast cancer, 30 men per hundred behind the best for prostate and at half the survival rates of the best for lung cancer. Overall we were worse than Latvia and Bulgaria. Do you really think that Latvia and Bulgaria have better drugs, radiotherapy and surgeons than the UK? Do we really think that that is what modern cancer treatment should be all about?

Every year Cancer Research talks about how we are ’beating cancer’, choosing its statistics carefully but pointing out that from now on its all going to get worse because of an ageing population. They claim better diagnosis and better drugs are the reasons for success. Do they not understand that 60 per cent of cancer patients ’empower’ themselves by going on the Worldwide Web in search of information? Patients now read more, they visit complementary centres like the Haven, Maggie’s or Penny Brohn; nowadays most large cancer hospitals have some sort of complementary centre. Any successes in survival over the last ten years might well have little to do with drugs (98 per cent of the which have not changed in the last decade) and diagnosis and far more to do with people venturing to try some self-help. Half of our readers change their diet, two thirds take supplements; almost 80 per cent use a complementary therapy including some form of exercise.

CANCERactive, icon magazine and research

This magazine, icon, stands for Integrated Cancer and Oncology News. The magazine is currently given out free to patients in over 600 hospitals, cancer centres and health sections of libraries. It has been available for about 8 years. Every article in the magazine becomes an article on the CANCERactive web site which now has over 3200 pages, probably the biggest cancer web site in the UK. Between 2500 and 5,000 people visit the web site every day; nurses and Doctors ring the offices asking to be sent the magazine, and we have not had a bad review by a patient, nurse or Doctor in five years. Over 40 different professors and many Doctors and expert practitioners have been interviewed or written for us. The website covers 94 drugs, the latest in radiotherapy (for example, Varian, the world’s number 1 company, have recently written about the future of radiotherapy), we cover surgery extensively and include articles from experts like top prostate surgeon Christopher Eden. It’s a magazine on the web. And it is loved!


 

But, yes, we also have 500 pages on cancer prevention because what caused your cancer might still be driving it today. Your UK oncologist doesn’t think to try cutting out possible drivers unless you are an oestrogen-positive breast cancer patient. Then he has a drug called tamoxifen and others called Aromatase Inhibitors. An Integrated American Doctor would start his treatment by cutting out possible causes; (for example, what you eat can significantly alter your oestrogen levels too). Blood and lymph cancers are largely the product of toxins American cancer web sites talk of pesticides, heavy metals and even pain-killers as causes. These can be gradually removed from the body in a variety of ’Integrative’ ways. Geoff Boycott’s tongue cancer was greatly relieved by two months of anti-parasite treatment. He didn’t get that treatment from his oncologist; but Geoff has no doubt that the integrated treatment he did use saved him from having a surgically broken jaw, the removal of the tumour and chemotherapy. Plus he is back on TV with no ill effects.

And, yes, we have an extensive section on herbs, vitamins and complementary therapies. We tell which American Hospitals are using the spice Turmeric to fight cancer, we tell people about how fish oil omega 3 in clinical trials from Leeds prevents polyps and recurrence of colon cancer. Professor Robert Thomas of Addenbrook’s tells how newly diagnosed prostate patients can delay the need for treatment significantly if they eat broccoli and tomatoes and do daily exercise. We cover a report on 54 worldwide research studies on exercise from Bristol University and others like Philadelphia and Seattle Medical School which show that regular exercise prevents cancer and light daily exercise can increase cancer survival times by up to 50 per cent in women with breast cancer. We cover Clinical Trials on Meditation and how it reduces blood loss during surgery by 40 per cent; or three studies from Oxford that show how just 75 mgs of aspirin a day can stop metastases and greatly increase cancer survival times. They are asking NICE, right now, to approve this ’complementary therapy’. Shouldn’t it be considered for every cancer patient as part of their Integrated Programme? Then there’s vitamin D which certain US Medical Schools like Harvard think should be given to every cancer patient if they can’t get a daily dose of sunshine, or even drinking alkaline-producing sodium bicarbonate in water, which eleven scientists from three cancer centres in Florida in 2009 showed stopped new metastases in cancer patients depending upon dosage.

Did you know that, unlike the UK where there is denial in most quarters that stress causes cancer, in the USA there is not only the evidence that it does from several research sources but Clinical Trials showing that those patients who use stress management techniques (from counselling to yoga) as a part of their Integrated Programmes survive up to 50 per cent longer?  Surely this is important?

And, yes, we do cover alternative therapies, although I prefer to call these Tomorrow’s therapies. Apart from Professor Robert Thomas on diet and prostate, we recently covered Professor Dan Burke and Professor Gerry Potter on how all new cancer patients were nutritionally deficient and how they had identified certain natural compounds like resveratrol which they call ’pro-drugs’.  All cancers express a certain enzyme, CYP1B1. It is widely regarded as a universal cancer marker. Resveratrol, along with a number of natural compounds in common fruits and vegetables, is turned by this enzyme into a toxic substance, piceatannol, that brings about cell death. Healthy cells do not have the enzyme. (Br J Cancer, 2002; 86: 774-778). For your information, Potter also worked as part of a Royal Marsden/Institute of Cancer Research team that came up with ’wonder drug’ abiraterone that blocks another enzyme, this time for prostate cancer.

Meanwhile Bart’s Hospital is using/testing Swiss Professor Pfeifer’s nutritional prostate treatment (on which he has Swiss Clinical Trials) and in New York, Dr Nicholas Gonzales, monitored by the FDA, treats cancers nutritionally using supplements and pancreatic enzymes with some notable success.

But open the last couple of icon magazines and you can read all about our ’alternative therapies’. You will find we are trying to help the Royal Marsden recruit patients for Clinical Trials on a complementary treatment call Hyperbaric Oxygen Therapy, which greatly reduces damage from radiotherapy to healthy tissues, according to US and German research. Then there is UK Cancer Tsar Professor Mike Richards talking about prioritising some National funding for non-invasive Photodynamic Therapy, Professor Mike Brada of the Royal Marsden talking about Virotherapy and Dendritic Cell Therapy, Professor Mark Emberton talking about localised hyperthermia or HIFU as an alternative to surgery for prostate cancer. Only recently we covered three clinical trials from the Karolinska Institute in Sweden for localised hyperthermia and breast cancer. The heat treatment melts away the cancer. No need for surgery; they were claiming 100 per cent success and talking about women having the treatment in their lunch break. Where are we with this alternative/complementary/integrated therapy in the UK? Or don’t we believe the data from the three Clinical Trials?

Why the debate?

And this brings us full circle, because you can use diet, hyperbaric oxygen therapy, hyperthermia, PDT and so on as part of your Integrated Treatment package. They are as much complementary therapies as alternative ones.

The sad fact is that you could have gone for HIFU anytime in the last dozen or so years in 61 clinics around Europe - predominantly in Germany and Switzerland - it melts a prostate tumour away; no need for surgeons or expensive drugs. But in the UK, we tread slowly. Mark Emberton at UCL has shown it works and how it can save NHS money. But now we need National Clinical Trials. How many people in the UK have to die while we wait?

In Germany and America, Hyperbaric Oxygen is already used to treat cancer, not just to relieve damage from radiotherapy. Research at MD Anderson already shows that the Chinese herb astragalus makes radiotherapy more effective. Meanwhile St Thomas’ have research showing that selenium and isoflavones make radiotherapy work better but they can’t use it or tell anybody because we haven’t done clinical trials in the UK. When we did a centrefold on ways to improve your radiotherapy, one hospital threw icon magazine out their head oncologist said these compounds were contra-indicated. Five times we wrote and asked for the oncologist’s research. Of course, there is none. His response was subjective nonsense. Only the patients suffer.

I could go on about research and Clinical Trials overseas. If you have cancer why would you not use the anti-histamine Cimetidine, the spice turmeric and resveratrol when you had surgery to reduce any chance of cancer spread? There’s clear research on each; 12 studies on Cimetidine. Why would you not use astragalus, selenium and isoflavones to make your radiotherapy work better? Why would you not take a little daily aspirin, or strengthen your immune system by taking grape seed extract, vitamin K and Vitamin D, or herbs like astragalus, cat’s claw and echinacea when there is, frankly, overwhelming volumes of research and usage in other countries already. Or you could try the wonder drug called ’light daily exercise’. Why would you not want to increase your personal odds of 5-year survival from the low rates of the UK, when clearly real life, not just research, shows it is possible?

Why are we still in denial? Why are we even having these debates?

Get real - Integrated treatment is needed more than ever

Be very clear about one thing: The Pharmaceutical companies are no longer trying to ’cure’ cancer. No press releases or CEOs interviewed on Bloomberg talk about cure anymore.  The new catch phrases are ’Cancer Management’ and ’Sequential Treatment’. You will receive drug A for 5 years, then drug B for 3, by which time there will probably be a new one, drug C, which will keep you going for another 2. Since the majority of cancers occur in people over the age of 65 then this route gets people to average life expectancy of 77. Job done. Already Doctors in the UK have bought this argument. Some talk of ’managing’ cancer as we do now with diabetes.

MD Anderson has a couple of pages on its web site devoted to Sequential Management. However, it does warn that your body has to be able to withstand the rigours of the side-effects.

They could have added that the argument is essentially false. Cancer is not a chronic disease like diabetes. In diabetes, one thing has gone wrong you have stopped producing insulin and this can be corrected by providing the missing insulin. In prostate cancer recent research has shown that over 5,000 genes have ’gone wrong’. One new biologic drug can only affect one protein, one enzyme, one gene. What of the other 4,999? Secondly, cancer is becoming an ever-younger disease. Cases of prostate cancer in 40-something men have grown 6-fold in the last ten years. 40 per cent of breast cancer cases now occur in the under 60 age group.

Sequential treatment for ten years is a no-win scenario for someone who develops cancer at the age of 32. They have to turn to Complementary and Alternative therapies for possible solutions. Integrative medicine is going to be demanded more and more in cancer,  not least of all as cancer becomes an ever-younger disease and drugs an ever less affordable luxury. Luxury? Read Sikora’s report (along with 30 other UK oncologists) in The Lancet; the conclusion was that new biologics most usually were expensive and did not give good value for money in terms of added survival times. There was only one group that would not contribute to this important review: The drugs companies refused to take part.

Integrative treatment doesn’t just help, it can cut costs too. MD Anderson did research on how several vitamins like C and K ’improved’ the action of several drugs. Vitamin E (the ’total’ one containing all 8 natural forms not synthetic alpha-tocopherol found in UK high streets) improves the effect of Tamoxifen. What the research also concluded was that, if you took vitamin E, you could use 25 per cent less Tamoxifen. That could represent a big saving to the National Health budget, and great news for patients who risk side-effects, although it’s not such good news for drug company profits, of course.

2 million people have cancer today in Britain. Next year 320,000 will develop it; 200,000 may well die from it. And that is the same number of people who died in the Tsunami in 2004. If the American Cancer Society believe that since 2006 there has been ’overwhelming research’ showing diet, exercise and weight control can prevent cancer returning, just imagine the benefits of incorporating these therapies into Integrated Treatment programmes; in terms of lives and NHS budget!

We have a Tsunami in cancer every year and we still debate Integrated approaches and whether complementary and alternative therapies might help? Get real.

Enlightened Medicine

My daughter, Catherine, developed a glioma, grade 4 brain tumour, when she was 22. She was given 6 months maximum to live. She had a chemistry degree, I had a Biochemistry degree and had spent a year of my course at Oxford specialising in cancer, but it was a long time ago! The Internet and her oncologist said the drugs didn’t cure; there was no hope. We did the only thing available. We looked for alternatives, anything that could prolong Catherine’s life, even by a few years. And we found them. In fact we found so much research out there in other countries, via the Internet and books, articles and magazines, we could hardly believe it. And, yes, from certain alternative practitioners there is a lot of rubbish talked; but these ’over-claims’ extend also to the Pharmaceutical Companies and even to respectable cancer centres and hospitals in other countries. Frankly, you need a biochemistry degree to sort the wheat from the chaff.

But above all, what made Catherine positively angry, was the denial. The needless ’not invented here’ of UK oncologists, ’We’ve done research, but we don’t tell anybody because we haven’t done clinical trials’, ’Yes, it’s interesting, but the Clinical Trials from Sweden/Germany/America/Japan would have to be redone in the UK before we used a treatment such as that’. Blah, blah, blah. Oh, come on . This girl is dying, for goodness sake. What works, now, today?

If there is research on a treatment in another country and a UK cancer patient doesn’t know it, then the patient is not so much dying of cancer but of ignorance. And that is terrible.

But worse, if there is research in another country on a treatment that could help patients like Catherine, but people actively try to prevent her knowing about it by restricting the flow of that information, this is disgraceful. They come between patients and possible survival these people are quacks, Black Quacks at that.

Sometimes, the ’restriction’ is less deliberate and just born out of ignorance or an accumulation of mythology that has developed in conservative British Medical circles. Whatever, there is an astonishing lack of enlightenment on Integrative treatments used in other countries. And this greatly hinders patients and their personal survival plans.

For example, I had interviewed Dr Francisco Contreras of the Integrated Hospital ’The Oasis of Hope’ in Mexico. The hospital is in Mexico because it was founded by his father who is Mexican, as is Francisco. The Oasis of Hope uses drugs, surgery and complementary and alternative therapies from counselling to diet and prayer. It advertises in America and is thriving. Contreras told Catherine he had nothing that could help her, possibly ozone therapy might give her a few more months. She told her oncologist in London that she was thinking of going to Mexico for ozone therapy. His response? ’Well you do know some people go to Mexico for treatment and never come back, don’t you?’

Women phone the CANCERactive offices asking for help and information on complementary cancer therapies. They tell us that their doctor has told them he can not even discuss these treatments or he will be stuck off! We had two women in the same week being treated at Christie’s, Manchester saying the same thing. This is the reality of Integrated Medicine in the UK. America moves forwards; the UK moves backwards.

At the time of Catherine’s illness, no one brought information to the UK on Integrated Therapies which worked abroad. Now you have CANCERactive; only CANCERactive. And there are mischievous elves in the UK who would have us shut down tomorrow.

At the same time that Catherine developed her glioma, so too did Amy. Amy was an air-hostess in America.

Catherine was treated at St Thomas’ with radiotherapy and after 3 years with Temozolomide, which did not work, then a combination of three drugs, PCV, which destroyed all her white cells  - her Natural Killer cells never returned so she was defenceless.  The whole family is convinced the drugs killed Catherine but that’s another subject. For your information, Clinical Research on PCV shows that while 75 per cent of people experience a short-term positive effect (usually less than a month in duration), 91 per cent of patients are damaged by this combination of drugs.

Meanwhile, Amy was treated by the world’s number 1 brain cancer expert, Dr Henry Friedman at Dukes in Carolina. He gave her the new and ’unproven’ Dendritic Cell Therapy. She took about 20 or so supplements (everyone of which I can personally asure you has quality research to support it) and exercised daily. Amy, ten years later, has two children and is ’in remission’ from a cancer that doesn’t allow remission. Friedman says that he his happy for the patient to build their own Integrative programme. He says his view stems from his Hippocratic Oath first, do no harm. As long as taking the supplements does no harm, he is happy for his patients to build the treatment programme they want. He actively encourages it - he calls it Enlightened Medicine.

We live in a country that allows a few ’skeptics’  - who are often not even scientists and are sometimes directly or indirectly supported by the drug companies - to ’slag off’ at whim both complementary and alternative therapies (and anyone who dares to suggest they might benefit patients) with not a drop of objective factual evidence. America, long ago, banned this subjective nonsense and drove these people underground. Court action has also curtailed their libellous comments. Many had their vested interests and connections with drug companies outed.

We live in a country where small vitamin and supplement suppliers simply cannot afford to research the benefits of a herb with cancer. A UK Professor seeking to conduct Clinical Trials on the benefits of two foods with cancer patients was told by UK authorities that he had to get the foods dried and made up in tablet form, thus making them drugs, and no drugs company would do it. In the mid-nineties, America the Government set up and funded the National Institute of Complementary Medicine, which researches and also provides funds to research treatments that could be strong components in Integrated Medicine. Already the herb feverfew has beaten the top leaukaemia drug in Clinical Trials; funded and next up could be dandelion root, which has already been shown to kill cancer cells in animals.

We live in a country where a friend went to a top ’old school’ oncologist in London. My friend asked about options to treat his prostate cancer. He asked about HIFU. Back came the one word reply ’No’. When my friend’s wife said, ’We would simply like to know the benefits and problems with HIFU, and if my husband should consider it as a treatment’, the oncologist replied, ’I have given you my answer, No’.

We live in a country that has a 1939 Cancer Advertising Act. In America, a Doctor’s clinic can do research on Turmeric, then tell patients about it, and even sell it to the patient along with their drugs in the clinic’s dispensary. In Britain that Doctor would go to gaol. The UK Doctor cannot even tell people through advertising, leaflets or the Internet that he treats cancer, even if he has thirty years experience and employs nutritionists, complementary experts and counsellors with success at the clinic.

The fact is, we are twenty years or more behind the times and getting worse and it is obvious why.

 It is high time we took the breaks off Complementary and Alternative therapies and read and took note of the research and clinical trials that already exist in other countries. The concept of ’Not invented here’ must go. No one in the UK quibbles over US research for drugs why do we so brazenly ignore their research on complementary therapies?


 We need our own Institute of Complementary Medicine which must not have the usual suspects in charge, and certainly must in no way be influenced by drugs companies or people directly or indirectly on their payroll.


 We need to scrap the 1939 Cancer Advertising Act. We already have in place the ASA which can monitor health claims for accuracy in the same way it currently does any advertising claim. The 1939 Act is blatantly holding back the fundamental health freedoms of the patient to get involved in their treatment options, and Integrated Medicine.


 Then we need to train all oncologists to join the enlightened few starting in medical school. (A recent graduate I talked to had spent just one morning in a seven year course learning about diet, and that was to  prevent heart disease).

 
 Finally, we  need to stop the subjective negativity and actively encourage patients to use complementary and alternative therapies and build their own Integrated Treatment Programmes using the best of the best the core being the oncologists medicine, but wrapped in therapies that can help increase the patients personal odds of survival.

It’s high time we started supporting, encouraging and practicing Enlightened Medicine in the UK, before we fall further behind.

Sadly we have too many ’Catherine’s. And not enough ’Amy’s.

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