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How Much Time Do I Have Before I Have to Do Something?
After a diagnosis of cancer, the conventional treatment 'system' efficiently whisks patients into a well-meaning river of action that requires that you trust, not in yourself, but in the experience of others. For many, this may be your first time having to use conventional medicine. Patients are often paddled along by supportive loved-ones who fear losing them. Many patients, however, especially those who think of themselves as 'natural,' are compelled to swim against the establishment current as fast as they can or at least tread water a while.
I advise you to take your time making your treatment choices. While waiting too long may be a risk, only in dire cases can a recently diagnosed person not wait a few weeks to feel 'right' about their treatment decisions. If you are not sure, ask the surgeon or oncologist, "how many days or weeks do you think I have to safely make an informed decision about your recommendations?" With that in mind, the next step is to organize the decisions that must be made now, and the ones that can wait a while. As the Tao de Jing advises: there are times to move forward, times to pause, and times to retreat.
How do you know how much time you have to pause or retreat and try natural methods? This depends on the type of cancer, stage, location, how aggressive it is, and how successful conventional treatments are at leading to remission or cure. These criteria are also the same ones that may lead you to choose the amount of conventional medicine you find necessary. An oncologist can help you answer these questions and give you some insight into what you are facing. Often the surgeon is the first person you will meet, however. You are encouraged to consider speaking to an oncologist (doctor who specializes in cancer) before deciding on surgery, if there is time to do so. This conversation is especially important these days as new forms of cancer treatment and clinical trials may offer pre-surgical options that were not available even a few years ago. Don't be afraid to ask for a second opinion from a surgeon or oncologist at an unaffiliated hospital too.
To get the most out of your oncology visit, you may want to ask the difficult questions such as:
- How common is this form of cancer?
- Is my situation quite typical of those with this form of cancer or are there factors that make my situation unique?
- How aggressive is this form of cancer?
- Help me understand what stage it is.
- If untreated, will the tumor soon inhibit organ function?
- What are the five- and ten-year survival rates for people who have been studied with this specific type of cancer using your suggested treatment method?
- If I did no conventional treatment at all, how long do you think I'd have to live?
- If I only do part of what you recommend, how does that affect long-term survival outcomes?
- Be honest, if you were me, and you were in my exact shoes, would you do the treatment that you are recommending to me?
- If you were discussing my case with other physicians, what would you describe as my biggest challenge?
Knowing what's next is also dependent on knowing yourself. Are you a person who needs to list all the pro's and con's? Are you one to listen to your gut? Do you usually play it safe and do what doctors recommend? Do you run screaming at the thought of doing anything an allopathic doctor recommends? Think about how you have successfully thought your way through other challenging decisions and start there. Also, be honest with yourself about when your blinders might be on. Don't confuse wishful or magical thinking for truly discerned inner wisdom.
In some cases, having a conventional treatment now, while debating the other decisions, is necessary. A few examples include a) there is a narrow window of time that surgery is an option b) a tumor is invading an essential organ that can't function without its removal c) starting chemotherapy before other treatments is advised to shrink a large tumor d) the cancer is so aggressive and rapidly replicating that no form of natural medicine could possibly outpace it.
For example, if a patient has been told that they have an aggressive cancer (for example small-cell lung cancer) that has been diagnosed after a biopsy, and it is currently operable, my advice would be to have the surgery ASAP and then consider natural options later because they are lucky to have found it at an operable stage. However, if a person was diagnosed with a common small, stage I breast cancer which has good outcomes with conventional treatment, but she is riddled with anxiety having never even taken antibiotics in her life, perhaps she can pause for a week while gathering information.
Lastly, and most challenging, perhaps, is the person told that they have six months to live with metastatic cancer. Some might choose to fight with all forms of medicine, others to pause a while to decide and some to do nothing and enjoy the time they have without enduring side effects of treatment in what is likely their last months of life. In that case, it is more about how you make decisions because whether natural or conventional or a mix, no one can promise a cure, but some find one.
What Are My Choices?
The next step is formulating the right questions, which means knowing your options.
- Should I follow the conventionally advised course of treatment only? (A: Conventional Medical Only Option)
- Should I follow only part of it? (B: Individualized Medical Option)
- Should I follow part or all of it and add natural medicine to it? (C: Conventional and Complementary Medicine Option = Integrative Option)
- Should I do the course of advised medical treatment and then try to prevent recurrence with natural medicine? (D: Conventional Then Natural Medicine Option)
- Should I forgo conventional advice and do only natural medicine? (E: Alternative Medicine Option)
If you choose C, D, or E, then there are even more questions to answer. If I do any natural therapies, which ones do I choose? Do I stay local or travel to a comprehensive integrative cancer clinic or a natural only one in the US or abroad? Do I work with a licensed naturopathic oncologist, licensed ND with cancer treatment experience, a holistic DO/MD, other natural practitioner or create my own treatment plan from my online reading?
As you are likely gathering from this long list of important questions, you could spend years trying to figure these things out. Chances are you are mentally and emotionally doe-eyed by now and are feeling pressured by others and are rightly confused and overwhelmed. While you may have more time than you were led to believe to make treatment decisions, don't let your need to have all the answers right now get in your way of taking one wise action step.
Who Are Reliable Experts in Complementary and Alternative Medicine?
Without a licensed naturopathic physician in most oncology clinics, it is up to the individual to find a well-trained, licensed, natural medicine provider with extensive cancer care experience whose practice philosophy is up your alley. My recommendation is to choose a licensed naturopathic physician/doctor (ND). Unlike unlicensed naturopaths with an online certificate, a licensed ND is trained in four-year graduate level naturopathic medical schools. We are primary care physicians in many states and specialists in others and are not licensed in some. Licensed NDs are uniquely trained in both conventional science-based medicine and the art and science of healing by treating the whole person, using the healing power of nature and avoiding the obstacles to a cure. We all must pass national basic science and clinical licensing exams that include competency in pharmaceutical and naturopathic medicines. In many states, we have DEA licenses and full prescriptive rights like MDs and DOs where even intravenous vitamins and botanicals are administered. In other states the drug formulary is limited or nonexistent. Most are members of the Oncology Association of Naturopathic Physicians (OncAnp.org).
A licensed naturopath who focuses their practice in oncology is not bound by a standard of care like medical oncologists are. There are no protocols that we must follow. This is great for individualized care, but it also puts the onus on patients to discern which ND is the best fit for them.
Just like you might consider getting more than one medical oncologist or surgeon opinion, I recommend that you interview a few licensed NDs before choosing one to guide you. Some of us are more classical in our approach and use 'nature-cure' methods while others use a more science-based approach or both. Many offer a free 15-minute meet-and-greet visit to see if you are compatible. Good questions to ask would be how much of your practice is oncology? How long have you practiced? What forms of natural medicine do you most often use? What are your opinions about complementary vs. alternative medicine? What are your opinions about conventional allopathic treatments? How do you avoid giving things that might negatively interact with conventional therapies?
Some licensed naturopathic physicians have taken a special board exam to become a fellow of the American Board of Naturopathic Oncology (FABNO). They are referred to as naturopathic oncologists. Many have or do work at Cancer Treatment Centers of America where they learn expertise in complementary oncology limited to natural medicines that can be proven with peer-reviewed studies. They are the perfect choice for a person who prefers an evidence-based approach. You can find a list of FABNO's at http://fabno.org/membership.html.
There are osteopathic and medical doctors with training in complementary cancer care who learned from integrative or functional medicine courses. Some have cancer clinics that offer simply relaxation techniques. Others direct comprehensive clinics offering everything from intravenous vitamins to hyperthermia and hyperbaric medicine. To my knowledge, there is no national certification for allopathic doctors in CAM therapies. Many allopathic physicians practicing integrative oncology are members of the Society for Integrative Oncology (SIO at integrativeonc.org.)
Finally, there are cancer clinics that patients travel to for treatment. It is vital to discern sham clinics from those with well-trained oncologists who had to leave the US to provide a combination of conventional and natural treatments without waiting for FDA approval. The only resource that I am aware of when considering foreign clinics is Ralph Moss, PhD's Cancerdecisions.com. Many providers and CAM clinics around the world provide often life-saving methods. Others advertise much more than they deliver at great financial expense to people who are most vulnerable with little time to research whom to trust. So, my next piece of advice is to thoroughly consider who you will work with to guide your CAM plan.
Fourth, What Type of Natural Medicine Is Best for You?
Once you have decided what conventional therapies you will or will not choose to do and you have decided to take a complementary or integrative route and found a practitioner you trust, next you need to decide which natural therapies are best for you. This is often based on your personal situation and the prescribing CAM physician. In most therapeutic settings, you will likely be offered complementary treatment plans that help you avoid side effects and optimize conventional treatments like surgery, chemotherapy, radiation, oral medications, and immunotherapy. In some cases, if the cancer you are working to heal from is aggressive or later stage, you may be adding natural therapies that have independent anti-cancer benefits.
CAM or integrative medicines include so many possibilities that this article cannot cover them all. A new book may shed more light on this subject, however: Outside the Box Cancer Therapies by Stengler and Anderson (Hay House Publishing, 2018).
Some therapies that are reputable include combinations of botanical medicine from various traditions or standardized extracts of single plants such as curcumin, artemisinin, berberine and mushroom extracts. Vitamins, minerals, amino acids, essential fatty acids, homeopathic remedies are often included. There are treatments that holistic practitioners may offer such as acupuncture, mind-body therapies or you may be referred to classes in meditation, yoga, Qi Gong, or invited to join a fitness program for those with cancer such as the YMCA's free Livestrong program. Most practitioners will likely discuss what you eat, drink, your fitness, and stress management regimens. Some with additional training might recommend intravenous vitamins and amino acids, and a few are trained in administering IV botanicals. Low-dose medicinal cannabis may treat side effects while higher dosages, with an aim to treat cancer, need the guidance of an experienced practitioner. In addition, European therapies are coming to the United States such as mistletoe injections, hyperthermia, and hyperbaric.
I encourage you to avoid doing therapies that are recommended online until you have found a practitioner with expertise to help you discriminate the ones that have merit from those that will cost you hundreds of dollars a month and do you no good at all.
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