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Integrative Care, Mind-Body Methods Aid Cancer Patients
When
you're coping with cancer you need healthcare providers
you trust, and you need a little help from your friends.
"It's been demonstrated that people who have strong social networks
weather the stress of cancer and cancer treatment much better than people who
are isolated," says Barry Boyd, MD. In fact, he thinks social support
for people with cancer is so important that he joined his current church because
it offers a deep sense of fellowship to his cancer patients. "There's
such a sense of connection and nurturing, and that's what any religion
should provide," he says.
Boyd is a medical oncologist, and the founder and director of the integrative
medicine program at Greenwich Hospital, in Greenwich, Connecticut. Maintaining
hope is critical when dealing with cancer, he says. "You need support.
It can come from a friend, a relative, your children, or nurses at the practice
where you're getting your care. It can be anyone that you feel safe
and comfortable with."
In addition to social support, cancer patients benefit from using mind-body
methods to deal with cancer. Boyd offers his patients the book Prepare
for Surgery, Heal Faster: A Guide of Mind-Body Techniques,
by Peggy Huddleston, plus its companion relaxation tape. While the book title
refers specifically
to surgery, these methods are just as useful when preparing for chemotherapy
or coping with emotional and personal issues related to cancer, Boyd says. "Guided
imagery techniques are important in re-framing patients' anticipation
of traumatic events such as surgical procedures and chemotherapy. A program
like this can significantly reduce anticipatory anxiety and help many patients
better tolerate cancer treatment."
Beverly Pierce, MLS, MHD, RN, CHTP, agrees. "With a diagnosis of cancer,
you're dealing with anxiety, thoughts that won't stop, all the 'what
ifs'," she says. "Mind-body methods can help with coping,
decision-making, and communication." The methods can be as simple as
deep breathing, to slow down mind and body. Or they can include more complex
forms of guided imagery. "The imagery can be very flexible, according
to the needs of the individual," Pierce says. "A person can choose
an image that has meaning and resonance for them."
Pierce is the Cancer Program Manager at the Center for Mind-Body Medicine,
in Washington, DC. For five years, the center has pulled together an annual
conference on integrating complementary and alternative therapies with mainstream
cancer care, attended by both patients and providers. In the future, Pierce
pictures smaller regional conferences. The center also offers training programs
for healthcare professionals, including a program for integrative cancer care
counselors, called Cancer Guides, who are knowledgeable about CAM modalities
that can be helpful when dealing with cancer.
Pierce has referred cancer patients to Huddleston's book and tape, as
well as guided imagery tapes developed by Belleruth Naparstek. This series
includes several titles designed to help patients and their families deal with
various aspects of cancer, including:
- Fight Cancer
- Help with Chemotherapy
- Help with Radiation Therapy
- Bone Marrow & Stem Cell Transplantation
- Relaxed & Awake
During Medical Procedures
- Successful Surgery
- Ease Pain
- Healthful Sleep
- Peaceful Dying
- Relaxation & Wellness
- Relieve Stress
- Ease Grief
- Healing Trauma
In addition to using these guided imagery books and tapes, patients
with cancer may benefit from private meetings with local
counselors who are trained in
mind-body methods. Several organizations offer training for healthcare
professionals; contact them to locate a practitioner in your
city. (See
resource list.)
Integrative Care for Cancer
People who are coping with cancer need the best possible conventional treatment.
According to Pierce, today many conventional cancer treatment centers do
offer some alternative modalities, but programs vary. "Wherever you're
getting your conventional treatment, ask what additional services they offer," she
says. "If you don't get a satisfactory answer, ask someone
else. Keep asking. There may be a very lively integrative program, but people
aren't always told about it. It depends on who you ask."
Then there are a few cancer treatment centers that do make a point of offering
comprehensive integrative care. The Block Center for Integrative Cancer Care,
in Evanston, Illinois, combines conventional treatment with mind-body methods,
a semi-vegetarian diet rich in phytochemicals, nutritional supplements, and
other CAM modalities.
Cancer Treatment Centers of America offers care at two hospitals (in Zion,
Illinois and Tulsa, Oklahoma) plus an outpatient care center in Seattle, Washington. "We
specialize in combining conventional care with complementary and alternative
medicine," says Christine Girard, ND, Director of Naturopathic Medicine
for Cancer Treatment Centers of America at Southwestern Regional Medical Center. "Here
in Tulsa we offer mind-body methods, naturopathic medicine, nutrition, pastoral
or spiritual care, psychoneuroimmunology, massage, pain management, and rehabilitation."
Many of these services can be billed through the patient's insurance. "However,
it's hard to bill for certain things," explains Girard, "We
as an institution just include them in our package of services at no additional
charge. For example, for patients who are under active treatment or active
follow-up, there is no charge for a visit with a naturopathic doctor." Patients
are responsible for nutritional supplements, which can be a substantial, though
tax-deductible, expense.
At this hospital, naturopathic physicians see both inpatients and outpatients,
and provide care concurrently with conventional modalities. This means CTCA
patients generally are able to stay on nutritional supplements while going
through chemotherapy or radiation, since the organization has developed specialized
expertise in this area.
CTCA prides itself on its cutting-edge conventional care. The CTCA hospital
in Tulsa uses fluorescence bronchoscopy to identify abnormal lung tissue and
pre-cancerous areas; it is the only hospital in a four-state area to offer
this form of diagnostic imaging, which can identify lung cancer in its earliest,
most treatable stages.
At the same time, CTCA invests a remarkable amount of time and energy in smoothing
communications between clinicians. The treatment team meets regularly throughout
the week to discuss specific patient cases, and usually includes a medical
oncologist, a specialist in hospital medicine (called a hospitalist), plus
staffers from pain management, rehabilitation, and naturopathic medicine. "This
is how we can understand what each department or each practitioner is doing," says
Girard. "By communicating with one another we can provide more cohesive
care." Usually the discussion is just a quick overview, but in complicated
or difficult cases, the team may spend more time focused on a single patient.
It would be wonderful if every person dealing with cancer could rely on such
an integrated, dedicated team of care providers. In most cities, that's
not the reality, yet. But there are nuggets of integrative care gleaming within
the conventional care system.
Resources
Mind-Body Methods:
Center for Mind-Body Medicine
5225 Connecticut Avenue NW, Suite 414
Washington, DC 20015
202-966-7338; www.cmbm.org
Training for Cancer Guides and consultations with a Cancer Guide:
http://www.cmbm.org/clinicalservices/CancerGuides.htm
Information on
previous cancer conferences, including speakers and topics, is posted
at
http://www.cmbm.org/conferences/conferencehome.htm
Peggy Huddleston
Book, tape, training for healthcare providers
http://www.healfaster.com/
Belleruth Naparstek
Many books, tapes and CDs, plus training for healthcare providers
Searchable catalog: http://www.healthjourneys.com/product_catalog.asp
Academy for Guided Imagery
Training programs for healthcare providers, self-care products and
programs
www.interactiveimagery.com/
(Note: Sept. 2004, new site is at http://www.academyforguidedimagery.com)
Integrative Cancer Care
Cancer Treatment Centers of America
800-367-4357 or 800-FOR-HELP
http://www.cancercenter.com/
http://www.mycancercompass.com/
(Note: Sept. 2004, new site is at http://www.cancercompass.com)
Block Center for Integrative Cancer Care
1800 Sherman Avenue Suite 515
Evanston, IL 60201
847-492-3040
http://www.blockmd.com/
Cancer Treatments
http://www.cancerhelper.com
Cancer information including treatment options, symptoms and more.
Elaine Zablocki is the editor of CHRF
News Files, a bimonthly emailed
newsletter about the emerging integrative medicine industry, published
by the Collaboration for Healthcare Renewal Foundation.
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