Dugald Seely, ND/Rogers Prize, Integrative medicine, Oncology, Canadian healthcare
Dugald Seely and the Rogers Award
Subtitle: Small Country-Big Prize: What’s the story?
Jacob Schor, ND, FABNO
On the evening of September 14th, 2017, out dear friend and colleague Dugald Seely, wearing a tuxedo with a black tie, was awarded the Rogers Prize at an elegant banquet in Vancouver, British Columbia.
There are so many aspects to that single sentence that are amazing that I find myself sitting at my keyboard unable to type further. Attempting to describe this singular event has blown my brain’s circuits, so to speak, making it difficult to even start.
It is so rare for the right person to get chosen for any big prize that this in itself is a starting point. I so often find myself cheering for the runner-up, the honorable mention, the poor sucker who almost won, the loser as it were, that being on the winner’s side is something of a shock. The one thing that makes sense about any of this is that Dugald Seely is unquestionably a true leader, advancing integrative health care in Canada, unarguably deserving of this prize. That part is indisputable.
But let me break this stupefaction down further so our readers comprehend why I am incredulous. Let us start with the prize.
Since 2007 the Rogers Prize has been awarded every second year to a practitioner who has contributed to complementary and alternative medicine in Canada. Catch that last word, Canada.
This prize is only given to people who live in that country to the north of us. It’s certainly a big country, but not many people live up there. Back in 2015 when their total population topped 35 million, Canadians got excited and celebrated. Keep in mind that California alone has as many people. Imagine spreading out all the people in California from Newfoundland to Vancouver Island and as far north as Hudson Bay. People are sparse and far between up there. The US has almost ten times Canada’s population. Yet Canada has the Rogers Prize, well properly known as the “Dr. Rogers Prize for Excellence in Complementary and Alternative Medicine,” and we don’t.
The Rogers Prize isn’t just some somber plaque to hang on your wall. It is a cash prize: a two hundred-and-fifty-thousand-dollar cash prize. Granted that these are Canadian dollars awarded, but California has nothing to compete with this. The entire US of A has nothing to compare.
Our Canadian friends know that Lotte and John Hecht of Vancouver fund the Rogers award; and they all have let me know that these generous benefactors, while not anonymous, don’t want publicity, so they mention this quietly.
The US did have the Bravewell Award of $100,000 for a few years that was last presented in 2013 to Dr. Oz (see Bravewell.org), and though the prize was for leadership in integrative medicine, only MDs ever received the prize. A country one tenth our size sees fit to present an award that is twice the amount of the Bravewell Award and then gives it to a naturopathic doctor. Actually plural, naturopathic doctors: Don Warren, ND, received a “Groundbreaker Award” this year as well. This says something about the relative appreciation of integrative healthcare and naturopathic physicians in our two countries, but exactly what does it say?
“The Dr. Rogers Prize recognizes” according to their website, “those who embody the same level of vision, leadership, and integrity as that of the late Dr. Roger Hayward Rogers. Among the first physicians to provide non-traditional therapies for cancer patients, Dr. Rogers was appointed to the Order of British Columbia in 2001, in recognition of his ground-breaking work.”
Ponder that for a moment. Dr. Roger Rogers. In our country we would ridicule someone whose first and last names were nearly identical. In Canada, Roger Rogers is appointed to the Order of BC. In the US, doctors who encouraged the use of alternative medicine to treat cancer in decades past lost their licenses and were forced to practice in Mexico.
I asked Joe Pizzorno ND, who served as one of the award jurors that chose Seely, about the differences between Canada and the US. He didn’t think actual clinical practice differs appreciably, just that they, the Canadians, were ahead of us when it comes to integration and cooperation: “I don’t see any difference between integrative medicine in the US and Canada. However, a case could be made that historically, Canadian integrative medicine organizationally started before the US. I think that Orthomolecular Medicine was first.”
We might point out that Health Canada adopted the Determinants of Health concepts in the early 1970s.1 To put this into context, recall that JAMA had accepted tobacco advertisements in its journal up until 1954, and the American Medical Association didn’t call for a ban on cigarette advertising until 1985.2 Tobacco advertising has been illegal in Canada since 1988. We’ve been playing catch-up with Canada when it comes to public health for quite a while.
But back to Vancouver, who would have ever imagined Dr. Seely dressed up in a black tie and tuxedo? This is amazing. Dugald has always been and always will be the guy with sleeves rolled up, the guy who is so hard at work that he doesn’t dress up. Suits don’t fit him. Looking at his photo holding the prize, I can’t help but smile in disbelief.
The online bios of Seely call him a “clinician and researcher, the author of numerous scientific reviews on complementary medicine….” Talk about understatements. Plug “Seely, Dugald” into a PubMed.gov search and it spits back 72 citations. Does he have competitors within our profession? Well yes, Heather Greenlee has 87 citations, but she’s a full time academic at Columbia University. Dugald is, as his bio says, a clinician who sees patients for a living.
Reading through his published work, you want to describe it all as ‘research with a purpose.’ Lise Alschuler, ND, is the one who pointed this out to me:
One important attribute of Dr. Seely is his consistent and long-term clinical practice. The reason that his research efforts are so clinically impactful is because he approaches the research as a clinician first and as a researcher second. All of his research answers clinical queries and has immediate translational value to the practice of oncology. The importance of this cannot be overstated. In times when new research is completed at an almost overwhelming rate, research that is informed by clinical needs becomes the fulcrum of change and practice innovation. END QUOTE
If you doubt Dr. Alschuler, read through that Pubmed list and notice the topics Seely’s covered. His clinical trials have examined naturopathic medicine and cardiovascular disease (2013) and whether it is cost effective, whether naturopathic medicine is effective for chronic low back pain (2007), for anxiety (2009), for tendinitis in postal workers (2009 and 2013) and whether vitamin supplements can prevent HIV transmission from mother to child (2005). He has led teams of academic reviewers who have performed systematic reviews and evaluated among other things, black cohosh and breast cancer, selenium and lung cancer, Vitamin D safety in cancer patients, green tea and lung cancer, flax and breast cancer, Vitamin A and lung cancer, melatonin and cancer, ionic footbaths, green tea and breast cancer recurrence, soy and red clover in breast cancer, fish oil in prostate cancer, both in vitro and in vivo and analysis of Essiac, metronomic dosing of chemo in pediatric cancer, EDTA and cardiovascular disease (CVD), African herbs for HIV, ginseng use during pregnancy, cinnamon and diabetes, supplement interactions with chemotherapy in pediatric cancer, niacin for migraines, acupuncture for stroke, thermography for breast cancer screening, supplement interactions with CVD drugs, and black cohosh safety during pregnancy and lactation. He was also a key contributor to the guidelines for integrative therapy use during breast cancer treatment. This list isn’t complete. I got tired of typing. Those of us who practice naturopathic oncology rely on Seely’s work; to say it is invaluable in daily practice would be an understatement.
Dr. Seely is the founder and executive director of the Ottawa Integrative Cancer Centre (OICC), where he and his team of 26 are pioneering a contemporary cancer treatment model based on “scientifically grounded, evidence-informed complementary medicine.” With the 2011 establishment of this first integrative cancer care and research center in Eastern Canada, Dr. Seely’s team provides whole-person care to people living with cancer and addresses research gaps in cancer care.
Dr. Seely completed his M.Sc. in cancer research at the University of Toronto and is a Fellow of the American Board of Naturopathic Oncology (FABNO). He is currently the vice-president of the Oncology Association of Naturopathic Physicians (ONCANP). As a clinician scientist, Dugald has been awarded competitive grant and trainee funding from CIHR, CBCRA, the SickKids Foundation, the Lotte and John Hecht Memorial Foundation, the Ottawa Regional Cancer Foundation, and the Gateway for Cancer Research.
While Dr. Seely has led numerous research projects over the years, his largest and most exciting project is the ongoing Thoracic-POISE study. Just three years ago, in October 2014, Seely announced the $3.85 million-dollar grant that is allowing him to study the addition of naturopathic medicine to conventional care for lung, gastric and esophageal cancers. This is the largest research grant for naturopathic medicine ever awarded. The full title is a mouthful: “Thoracic Peri-Operative Integrative Surgical Care Evaluation” (or Thoracic POISE). The project’s goals are twofold. First, it is pioneering the naturopathic interventions to use before and after cancer surgery. Second, it will fund a randomized controlled trial to evaluate if the integrative care approach reduces adverse events and improves disease-free survival. A multi-center network of Canadian thoracic surgery centers, partnering with naturopathic doctors, will collaborate over an 11-year period in this 300-patient study. [NCT02845479]
Dugald has brought this same pattern of using research to inform clinical practice to the Oncology Association of Naturopathic Physicians where he chairs the research committee. He has been instrumental in pioneering an online database of clinical trials, which our membership uses to inform clinical practice. Known by the acronym KNOW for “Knowledge in Naturopathic Oncology Website,” this is the largest and most expensive project ONCANP has undertaken. Let me confess here that it has been Dr. Seely’s steadfast lobbying of ONCANP’s board of directors, including myself, that has kept KNOW alive and kept me usually voting in favor of the project despite my fears that it could turn into a perpetual and bottomless financial sink hole. When this KNOW site is fully operational and everyone is praising ONCANP’s foresight, much credit should go to Dr. Seely for his prescience.
We are banking on this prescience thing. It was from David Schleich, PhD, that I first heard the term prescience to describe Dr. Seely:
BLOCK
Dugald Seely knows that the Canadian naturopathic profession has had considerable savvy for several decades about the patient-driven need for wide access to natural medicine modalities and protocols. His tireless work enhances the profession’s responsibility to blend the best evidence with the powerful practice traditions of CAM long in place in Canada.
Dugald Seely is a remarkably prescient and skilled research professional who knows what we have to get done now. The Roger’s Prize is a special, strong statement about his gifts and his tenacity. (2017) END QUOTE
Aside from responsibilities already mentioned, Dr. Seely serves as the director of research and clinical epidemiology at the Canadian College of Naturopathic Medicine and is an affiliate investigator for the Ottawa Hospital Research Institute. Dr. Seely is also a section editor for integrative oncology in the journal Current Oncology and a past board member for the Society of Integrative Oncology (SIO). Dr. Seely was also appointed to Health Canada’s Expert Advisory Panel for the Vigilance of Health Products on which he served three years.
Iva Lloyd pointed out to me via email that, “Under Dugald’s leadership, as director of naturopathic research at the CCCM for over ten years, he has created the largest naturopathic research department in North America and one that continues to be recognized on the international research stage.” In fact, no end of prominent people in the naturopathic profession have pointed out to me that Dr. Seely seems to be everywhere in Canada and has no shortage of associations with various entities that have long names that are capitalized and often turned into acronyms. We may have to add a glossary at the end of this article
What is hard to convey by listing all these hats Dr. Seely wears during his workday and by listing his steady published study output is that he is a nice guy. Again, Dr. Alschuler:
With a 25-page curriculum vitae, one might suppose Dr. Seely to be either entirely reclusive or a braggart. However, nothing could be farther from the truth. Despite his herculean worth ethic and staggering accomplishments, Dr. Seely is one of the most kind, respectful, engaging and delightful people that I know. He builds consensus, cares about the ideas of others, is passionate about the future and, above all, is fundamentally dedicated to the betterment of the human community…..
I am so thrilled for Dugald – literally smiling ear to ear! Dr. Seely has led the charge for the validation of the practice of naturopathic oncology in Canada and North America.
Of course, there is an elephant trampling around in the background, one of those big obvious things that I have so far failed to mention. There is a fundamental difference in Canadian healthcare compared to healthcare in the US that cannot help but impact complementary and alternative practice in their country. Basic healthcare is afforded to every Canadian resident. Healthcare is considered a basic right of citizenship. Try to explain that to a US citizen. It is hard for us to comprehend. Try to explain monthly insurance premiums, co-pays and the need to meet a deductible before care is reimbursed to a Canadian; this is impossible for them to comprehend. If they nod their heads yes, pretending to understand, take it a step further: explain the increasing frequency of elective procedures late in the year after people have met insurance deductibles. Most of us speak English, but the fundamental realities that separate our countries couldn’t be wider. So yes, integrative healthcare is more evolved and better appreciated in Canada. The Rogers Prize is amazing but so is Health Canada; healthcare itself is a basic human right in Canada. Here in the US, this simple idea is still open for debate.
So, congratulations, Dr. Seely, and well done, Canada, for having the prescience to appreciate him.
Side Bar 1:
The Family: A Seely of Doctors
By Jacob Schor, ND, FABNO
There are specific names for collectives of various types of animals. You have seen the lists: a “pride” of lions, a “shrewdness” of apes, a “parliament” of owls, a “cauldron” of bats, a “troop” of monkeys, and so on. Reading about Dugald Seely’s family background, I want to propose a new collective grouping, a “Seely” of doctors. They are all doctors, generations of doctors. Seely’s great-grandfather Dr. Dugald Christie, established the first Western-style medical clinic, then hospital, and finally medical school in Shenyang, China, in the late 1800s. His grandfather Dr. Ronald Christie worked with Fleming to develop penicillin and was Dean of Medicine at McGill University. There’s still an award, the Christie Award, named after Ronald, which is presented by the Canadian Association of Professors of Medicine to an outstanding member each year. Our Dugald’s grandmother Phoebe Seely was one of the founders of Meals on Wheels. Dugald’s late father, Dr. John F. Seely, was an internationally recognized clinician; he passed away from cancer in 2009. John Seely was Dean of the Faculty of Medicine at the University of Ottawa and developed the palliative care program for The Ottawa Hospital.
Dugald’s mother, Dr. Janet Christie-Seely, is a family therapist, teaches family medicine at the University of Ottawa, and practices family therapy. Janet focuses on “systems theory” in her practice, looking at family interactions or the family as a whole and how these correlate with illness.
Dugald Seely is one of four siblings that all practice medicine. His older sister Jean is head of breast imaging at the Ottawa Hospital. Dugald’s brother, Dr. Andrew Seely, is an intensivist and thoracic surgeon at the Ottawa Hospital. This is how Ottawa Life Magazine described Andrew’s specialization: “Andrew is an international leader in the bedside application of complexity science using mathematical analysis of patterns of variation of vital signs.”3 I guess I can be forgiven when I don’t always follow what Dugald is talking about. Look where he comes from!
Dugald’s sister Allison is a veterinarian who has specialized in providing chiropractic care to animals of all sizes, from cats to horses. Dugald is the youngest of the family and continues a long tradition of clinical practice that is dedicated to supporting patients. The fact that he has embraced naturopathic medicine has not dimmed an appreciation of conventional medicine or rigorous science. Living with his family, he has had to learn the value of integrating alternative medical practices with conventional medicine. No, that isn’t right. Heidi Vincent who works with both OICC and ONCANP corrects me: “He didn’t ‘have’ to learn to come around to integrative medicine…he had an openness of bringing the two modes of care together from the beginning, which he instinctively learned, given that he was part of a conventional medical care family.”
Keeping with the familial theme, Sarah Young, Dugald’s wife, has also been a major contributor in the creation of the Ottawa Integrative Cancer Centre. Following a two-year feasibility study they conducted after moving to Ottawa in 2009, the OICC was opened in the fall of 2011. Currently the center sees over 700 patient visits monthly, caring for nearly 500 unique new patients and their families annually.
Dugald Seely has inherited a family model of dedicating one’s life to closely caring for individual people while at the same time stepping back far enough that he can examine the practice of medicine in a larger perspective so as to ponder how to advance the field as a whole. See why I’m only half joking about this collective term; it’s easy to say that Dugald comes from a Seely of doctors. Or perhaps we could turn it the other way around and instead say, an “integration” of Seelys in order to describe a family reunion.
[Barb, he would like this quotation to stand out, perhaps shade/box and treat as a box quote?
A quotation to make stand out:
“My father was greatly supportive of the vision for the OICC and joined the board of governors of the Canadian College of Naturopathic Medicine before his diagnosis. He fully believed in and exemplified whole-person, patient-centered care. A medical doctor like many in my family, my father was wholly supportive of integrative medicine and an approach to care that benefits the patient the most.” – Dr. Dugald Seely, ND]
SIDEBAR 2
The Thoracic-POISE Study:
By Jacob Schor, ND, FABNO
Dugald Seely, ND, and his brother Andrew Seely, MD, are the co-principal investigators in this first of its kind research trial to determine if naturopathic therapies can help thoracic cancer patients to improve long-term survival and adverse events associated with surgery. Lung, esophageal and gastric cancer patients are all included in the trial. Ottawa, home of the Seely’s is the primary site. The trial protocols have been developed from previously published work.
In a recently completed randomized clinical trial, another study co-led by the Seely brothers, 710 participants were enrolled in collaboration with the Canadian Association of Thoracic Surgeons in eight hospitals across Canada. This earlier study called AMPLCaRe, explores the effect of melatonin for lung cancer recurrence and survival results of which are expected to be ready and published within the next 6 to 12 months. According to Ottawa Life Magazine, “If trial results reflect what has been shown in other studies, there is real potential for reducing lung cancer recurrence after lung cancer resection, and thus improving quality and efficiency of care to the health care system through the use of this low cost non-patentable natural health product.”3 This study and the new TPOISE trial are compelling examples of the pioneering complementary cancer care research efforts led by Dugald.
KNOWoncology.org
By Heather Wright, ND, FABNO
For the past several years, the Oncology Association of Naturopathic Physicians (ONCANP) has funded an initiative to assemble human level data on natural therapies in cancer care to help our members better access, understand, and refer to the evidence basis of our medicine.
The goal was to provide members ready access to curated data to allow for meaningful discussions with patients and other providers. This project is led by KNOW project research directors Jen Green, ND, FABNO, Heather Wright, ND, FABNO, and Dugald Seely, ND, FABNO, and is supported by research assistants Anne Thiel, ND, Julia Dean, ND, and Sarah Soles, ND, in addition to others as well as volunteers.
Becky Skidmore, BA, MLS, a research librarian, helped design both the PubMed CAM search filter as well as an expanded and more detailed CAM search filter with input from naturopathic doctors in oncology specifically for KNOW to help find increased numbers of relevant studies vs. the standard PubMed search.
The initial KNOW literature search looked at clinical trials using natural therapies related to ‘breast cancer’ in PubMed and Embase (the European equivalent) and yielded over 54,000 citations. Reviewers screened these articles using a program called Abstrakr, selecting ones that met inclusion criteria and excluding others. Selected articles are uploaded to the website using a reference manager software called Mendeley. Full text articles are pulled for these studies and reviewed by a team of research assistants who summarize and tag them.
Thus, for breast cancer, the original 54,061 papers were winnowed down to just 451 papers. For neuropathy, the 1500 initial papers were reduced to 40 and for curcumin, the initial 1200 were reduced to 18. This process occurs to select papers that are clinically meaningful and that meet criteria specific to integrative oncology.
After those four initial topics, (breast, neuropathy, curcumin and thanks to Dugald Seely’s interests, lung cancer) were included in a beta version of KNOW, the search methodology was shifted to make the process more efficient and improvements continue. KNOW was presented at the conference for the Society of Integrative Oncology in Miami in 2016, and at the Oncology Association of Naturopathic Physicians conference in 2017, and supplied both oral and poster presentations to each. To date, KNOW holds about 750 human clinical trial summaries, and these are searchable in the database. KNOW website also has an ‘unsummarized’ section that contains articles that are waiting to be summarized and tagged.
The KNOW project team plans to continue to search PubMed and Embase each year using their specialized filters to get relevant articles on integrative oncology human studies for that year. Currently, KNOW searches include data from 2010-2016. Summarizing articles is a rigorous process. The KNOW team of five research assistants working five hours a week completed about 275 summaries over the summer.
KNOW also contains files of support literature, which includes a range of handouts, protocols, and other work authored by naturopathic doctors. Submissions are always welcome. These allow the expert group of physicians to share with those starting out, and this dialogue is supportive to raising the bar of the profession.
At this point in time, use of KNOW is limited to OnCANP members who can cut and paste citations or whole summary charts into emails or word documents for best communication and collaboration on treatment plans or with providers. In the future, KNOW project hopes to be able to license copies to other organizations so that their members will have access. KNOW also looks to develop collaborations that will add new data to the site and support in-kind work. One goal in the future is to cover data on topics that have been excluded from KNOW to keep the numbers manageable. Topics such as mind-body therapies and acupuncture are yet to be added, and the KNOW project looks to forge partnerships with other research groups to help add these segments of research to widen the holdings that are of interest to clinicians in cancer care. The KNOW project’s newly formed advisory board, made of leaders in integrative oncology, is helping the project improve and grow.
References
. Glouberman S, Millar J. Evolution of the Determinants of Health, Health Policy, and Health Information Systems in Canada. Am J Public Health. 2003 March;93(3):388–392.↩︎
. Bayer R. Tobacco, Commercial Speech, and Libertarian Values: The End of the Line for Restrictions on Advertising? Am J Public Health. 2002 March;92(3):356–359.
3. The Seely’s – A Family of Medical Pioneers. Ottawa Life Magazine. November 2013. http://www.oicc.ca/uploads/ottawa-life-seely-family-article.pdf↩︎
Authors
0 Comments