Letter from the Publisher
Aug/Sept 2017
National University of Natural Medicine Commencement and Honorary
Doctor of Letters
In May and June, I was preparing to give the 2017 commencement address at the National University of Natural Medicine (NUNM) in Portland, Oregon. I had been informed in April that I was to be conferred an honorary degree and with that honor came the privilege of addressing the graduating class. Not being much of a public speaker, I faced this responsibility with a mixture of pride and terror. Of course, I knew that thousands of public figures give commencement addresses, not the least of which was our President who spoke at two institutions this Spring, although his talks seemed more like campaign addresses. When I watched on TV and saw a government administrator address the University of Washington in Seattle at a filled Husky Stadium, I turned grey experiencing typical stage fright. But I have been practicing breathing exercises and sharing stories in a support group during the past year, so I was not nearly as frightened as I might have been. The folks at NUNM were also very encouraging and supportive and were, after all, a group after my own heart, practicing naturopathic and functional medicine, holistic healing, and nutrition. They very much subscribe to the medicine I practice as well as the writings published in the Townsend Letter. So what was there really to worry about? Basically, I just needed to share my story and be myself.
Beyond telling the story of why I decided to practice integrative medicine and touching on milestones in my life, I wanted to share some common visions that I had with the graduates. From my speech (viewable online at NUNM Commencement 2017), I had these insights to offer each of the Masters and Doctorate graduates of Naturopathic Medicine, Chinese Medicine & Acupuncture, Nutrition, Global Health, and Integrative Medicine Research:
I share your vision that if at all possible, the ill patient should be treated with herbal and natural supports, not pharmaceuticals. I share your wisdom that food should be our medicine and that nutrition is not limited to dieting and detoxing. I share your clarity that when I approach the patient I want to understand everything about that patient—not limit my diagnosis and treatment to a body system or part that should be examined in seven minutes. I share your courage to provide the patient the best possible diagnosis and treatment even if it lies outside the scope of conventional medicine, even if it does not abide by medicine’s standard of care, when I know that the treatment I am providing will help, when other treatments have failed, and when I know that the treatment will not harm the patient. I share your knowledge that there are no patients who suffer long-term pain and fatigue for which there is no diagnosis or treatment, and who should be sent to a psychiatrist for an anti-depressant. I share your moral integrity to counter the wrong-headed messages that the conventional medical community may make about naturopathic, nutritional, and integrative care—that we offer the best type of care that is a roadmap to true healing, not a Band-Aid that only temporarily helps but fails to get to the root of the patient’s problem. And most of all, I share your philosophy that behind all of our work we work from a basis of “love” rather than “fear,” that our patient is engaged with us in the process of getting better, and that we will find healing from deep within ourselves, not by waging war against or suppressing the disease. END QUOTE
Following my speech, I made an effort to return to my seat on the stage with the NUNM faculty when President David Schleich called me back to receive my honorary Litt. D. degree, Doctor of Letters. If you are like me, you are wondering what is a Doctor of Letters degree. According to Wikipedia this is a high academic degree, considered by some to be beyond a PhD degree, that is conferred when extensive post-fellowship graduate work is done at an academic institution. The honorary Litt. D. is conferred by universities for exemplary work done outside the academic setting. The example Wikipedia offered for an honorary Litt. D. degree was when Oxford University in the UK conferred it to Samuel Clemens, author of Huckleberry Finn, in 1907. I have to admit that I experienced a certain level of hubris being in such rarified company as Clemens. The degree had been conferred to me for the work accomplished in publishing the Townsend Letter for nearly 35 years.
Attending my graduation speech and degree ceremony were my wife, Deborah, daughter Affinity, son-in-law, Jeffrey, and seven-month-old granddaughter Jacqueline, who managed to suffer through my talk with no melt-downs.
Cancer Treatment Hype Gives False Hope
The April 28th, 2017, edition of USA Today had a front page story titled, “Cancer Treatment Hype Gives False Hope.” In the 1970s President Nixon announced major funding at the National Institute of Health would enable researchers to win the war on cancer. In 1998, Nobel laureate James Watson predicted that a cure for cancer was imminent. In 2003, the director of the National Cancer Institute, Andrew von Eschenbach, announced that research and clinical efforts would end suffering from cancer by 2015.
But patients with advanced cancers not only are not winning the war with cancer, they are suffering both from the disease and the treatments. Gilda Radner described the brutal experience a cancer patient undergoes in her book, It’s Always Something. Radner had been suffering from metastatic ovarian cancer, and her treatment was primarily chemotherapy. Radner put on a brave face tolerating the constant nausea and vomiting and overall malaise that she bore while being given recurrent rounds of chemotherapy in the late 1980s. Except for certain childhood cancers, chemotherapy rarely extends life for older patients with metastatic tumors.
In the first decade of the 2000s, biotech firms began rolling out new biologic agents that held the promise of being able to arrest cancer without the horrible adverse effects of chemotherapy. In fact, not a few of these drug agents that function by shutting down key enzyme pathways that cancer cells require to survive offered increased survival and quality of life for lymphoma, leukemia, and other blood cancers. However, these drugs are extremely expensive, and patients need to be qualified before insurance companies agreed to reimburse their use. Still, for most advanced solid cancers including breast, prostate, colon, lung, pancreas, brain, ovarian, and more, these drugs are not effective and also are outrageously expensive. Some are priced at $1 million per year for a single patient’s use.
And yet, the advertising to the public for the new cancer drug often shows an older individual enjoying hiking, boating, golfing, and playing with the grandchildren, as though the cancer has been successfully put into remission. In fact, it is not unusual for these drugs to only offer additional months or a few years at most for survival, and not necessarily with a high quality of life. Not only has the advertising for these cancer drugs dramatically increased in the past decade, but cancer institutes, such as MD Anderson, that have built palatial facilities tout that cancer is being licked when no such thing is occurring. Patients are being misled to believe that their metastatic disease will be arrested by using the new biologics and immunotherapy, when survival is not dramatically increased; and there is real risk that complications will include major autoimmune disease and more.
Why am I carrying on about the cancer treatment hype giving false hope?
Because there are practitioners who are offering alternative cancer treatments, integrative medical therapies, naturopathic treatment, acupuncture, Chinese medicine, nutrition, and these treatments are being studied under IRB, investigational review boards. In a word, naturopathic and integrative therapies, acupuncture, Chinese medicine, and nutrition are achieving improved survival, quality of life, reduction of adverse effects, and regression of tumors when used as complementary therapies to conventional cancer treatment. However, we are seeing case reports of advanced cancers responding to naturopathic therapies and nutrition as stand-alone therapies long after conventional therapies have been completed and failed.
It is unfortunately true that conventional medicine does not yet sufficiently employ naturopathic physicians and nutrition scientists to manage advanced cancer care. Naturopathic physicians are now being educated for oncology work training in post-graduate programs to serve as naturopathic oncologists. Integrative medicine researchers are engaging with universities to assess integrative and naturopathic care for advanced cancer care. While routine oncology tends to ignore nutrition, research is being conducted to assess nutrition’s role in cancer care. Beyond supporting the cachectic patient’s malnourished state, nutrition plays a vital role in its own right in treating cancer. Research over the past few years has demonstrated that a high-fat, low carbohydrate “ketogenic diet” has been pivotal in surviving certain malignancies, especially brain cancer. Furthermore, Seyfried’s research has described cancer as a metabolic disease especially dependent on glucose and glutamine. If the tumor can be deprived of sugar, Seyfried’s research has shown a reduction in tumor growth and improved survival. If Seyfried’s thesis is correct, nutrition researchers will be busy developing new strategies to disengage the cancer metabolic process.
Surviving metastatic cancer will require symptomatic support from naturopathic doctors, acupuncturists, Oriental medicine practitioners, and integrative medicine clinicians. When we transform the treatment of cancer from palliative care for a killer disease to managing a chronic disease like diabetes with naturopathic and nutritional care, not only will patients get their lives back and be able to enjoy activities with grandchildren, but experiencing barbaric cancer treatment will end. While medicine largely does not recognize the integration of conventional and naturopathic care, such integration will become mainstay in the future. Similarly, while medicine largely ignores the role of nutrition except in recommending patients lower their fat intake to prevent heart disease and diabetes, nutritional treatment will become mainstay as well.
With patients being availed naturopathic and Oriental medicine as well as nutrition counseling, it will no longer be a case of false hope. Patients and their families will have reason to believe that their cancer will be addressed with a good quality of life.
The Healing Platform
I had the pleasure of meeting Annie Brandt at the Best Answer to Cancer Conference in San Diego this April. (Mary Budinger reports on the meeting in this issue.) Annie is the president of this organization and the physician group, International Organization of Integrative Cancer Physicians. Annie’s background is in the computer software business, and she was very successful in network sales and consultant work as well as being an entrepreneur. However, in the early 1990s she became overwhelmingly ill with what would be later diagnosed as chronic fatigue immune dysfunction syndrome (CFIDS) or myalgic encephalomyelitis (ME). The symptoms were so severe and disabling that she was largely confined to bed rest 20 or more hours per day for two years. Her symptoms worsened, and she was then given a diagnosis of progressive multiple sclerosis. Of course, she was laid off and her husband, not able to cope with her illness, divorced her, causing her major stress, a factor known to play a contributing role to developing cancer. Despite the fact that Annie would revise her life, eating much better nutritionally, exercising, engaged in meditation and prayer, involved in mindfulness activities, using immune supplements and supports, she developed breast cancer about one decade that showed early metastasis. Although she was ordered by her physicians to immediately have surgery and then do radiation treatment, she opted to consider her alternatives and became very involved in detoxing and cleaning up her life psychologically. The cancer spread, however, and she was led to work with James Forsythe, MD, HMD, who administered insulin-potentiated, low-dose chemotherapy (IPT) as a first step in her cancer recovery. Annie is now a fifteen-year survivor of metastatic breast cancer. She has shared her story with thousands of patients, and those patients have inquired of Annie what they should do to initiate their recovery.
The book The Healing Platform: Discover What Thousands Have Done to Conquer Cancer is a guidebook for patients to design by themselves the best healing approach.
One of the nice aspects of Annie’s book are pages that are set up following each chapter with questions and blank space for the reader to journal their answers. Annie is very concerned with the cancer patient’s psychological, emotional, and spiritual background. She insists that there are deep emotional issues that generally precede the cancer diagnosis and most patients do not examine those traumatic events, nor the underlying anger, resentment, and sadness that are concealed and denied. Annie thinks that without addressing the emotional and mental issues, the cancer patient cannot fully heal. Of course, most cancer patients eat the Standard American Diet and use minimal to no supplements and take a few or many pharmaceuticals. She argues that patients need to become informed about cancer treatments and options and not be coerced into undertaking surgery and chemotherapy until they understand their options.
The Healing Platform describes appropriate lifestyle changes, nutrition, supplementation, detoxification, and energy supports but asserts that each individual needs to assess those options and choose what works best for oneself. Her chapter on integrative cancer modalities is a great synopsis of what integrative cancer care offers diagnostically and treatment-wise.
One point that Annie makes is that cancer cells, particularly cancer stem cells, are highly resistant to curative treatments and develop resistance rapidly to such therapies. She recommends that natural therapies be employed for certain time periods and then stopped; they may be resumed at a later point, but the patient should avoid long-term continuous treatment as this encourages resistance. Annie also advises vigilance in determining what works and what doesn’t—the latter should be eliminated from treatment protocols.
The Cancer Revolution
Leigh Erin Conneally, MD, is a physician in southern California who, at one time, practiced primarily urology but found herself more concerned with holistic medicine. Her clinic in Irvine brings together nearly a dozen practitioners providing a breadth of services that may be integrative medicine’s answer to what the Mayo Clinic offers. While Mayo focuses on CT scans and MRIs, basic lab panels, and conventional medicine diagnoses, Conneally reaches for benchmarks that look for disease before a major diagnosis can be confirmed. Alternatively, she prefers to follow markers that assess whether the treatment is definitely making headway or just spinning wheels.
Many of her patients either have cancer or are worried about developing cancer. In her new book: The Cancer Revolution: A Groundbreaking Program to Reverse and Prevent Cancer, Conneally spells out exactly what those markers are that enable one to diagnose cancer early as well as follow treatment progress. Not surprisingly, none of these benchmarks are generally part of the typical annual physical, and most are not part of the oncology exam for either the early or the advanced cancer patient. Yet, such testing is surprisingly simple, not so expensive, and very informative. With all the hubris that the pharmaceutical industry makes about the very expensive immunotherapy drugs, one would think that oncology would seek other means to follow the cancer patient’s progress beyond doing CT and PET scans. Unfortunately, that is not the case, so patient and doctor are deprived of an easy means of following cancer progress as well as the means to assess the effectiveness of proposed chemical, biologic, and natural therapies.
Conneally is a major advocate of making nutrition a cornerstone of cancer treatment. She fiercely calls for patient adherence to dietary lifestyle changes and frets that a laissez-faire standard American diet will nullify much of the benefit of supportive cancer treatment. Conneally is judicious about her use of supplementation but champions high doses of nutrients, herbals, essential fatty acids, amino acids and more. Conneally reviews intensive treatments that are important in cancer care including the use of IVs, hyperbaric oxygen, IPT, and detoxification strategies. She will call for a daily coffee enema, juicing, and mindful meditation and breathing exercise. Detoxification does not mean sickening Herxheimer reactions need to be the order of the day.
Perhaps the best part of Conneally’s writing is the synopsis she provides with each chapter describing the strategy in one column and its benefits in the second column. The trouble for most new cancer patients is the overwhelming information patients need to digest and assimilate. While a patient may not wish to follow all of her suggestions at least the strategy is laid out in a very organized manner, tactics to employ are spelled out, and resources are provided in one very easy to read text. I will be directing the patient to use this book first.
The Molecular Basis of Prostate Cancer and Targeting Therapies
Prof. Serge Jurasunas is an integrative naturopathic physician in Lisbon, Portugal, who has developed successful oncology protocols for managing cancer. Townsend Letter readers may be familiar with his work as he has published many papers here in the past 15 years. While Jurasunas employs naturopathic approaches to reversing cancer, he has become dependent on studying and evaluating tumor and molecular markers in assessing cancer status. With prostate cancer he is very interested in understanding the molecular functioning of genes involved in apoptosis.
The paper he has written for this issue examines how defects in the gene P53 network leads to tumor promotion, decreased apoptosis, angiogenesis, and metastases. In fact, Jurasunas considers reversing the mutation of the P53 gene to the normal “wild type” gene functioning a key to managing and remitting advanced cancer. An important molecular factor in encouraging metastasis is BCL-2 while a related factor, BAX, encourages apoptosis. Hence, high BCL-2 and low BAX activity would encourage tumor progression. Jurasunas explores how to reverse the over-activity of BCL-2. Similarly, the recently studied anti-apoptotic protein survivin causes more aggressive prostate cancer activity.
Among the many treatment strategies that Jurasunas employs is the use of soy extract, Tegaran, that he hypothesizes inhibits the activity of BCL-2 and survivin. Soy extract increases the efficacy of chemotherapy, an important consideration in considering synergistic (adjunctive) treatment. Jurasunas is very encouraged with other supplement supports such as curcumin and propolis.
Jonathan Collin, MD
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