Transcription:
Integrative Approaches to Cancer Treatment

Melanie Cole (Host):  Cancer Treatment Centers of America® (CTCA) uses leading technology to aggressively treat cancer, at the same time supporting patients with nutrition and other therapies, because we know that managing the side effects of cancer treatment is half the battle. My guest today is Carolyn Lammersfeld. She’s the Vice-President of Integrative Medicine at Cancer Treatment Centers of America. Welcome to  the show, Carolyn. Tell us what that means—“integrative medicine.”

Carolyn Lammersfeld (Guest):  Sure. Integrative medicine is a field that can actually be used to manage many diseases. In oncology, we kind of refer to it as “integrative oncology,” and it’s an approach that combines treatments from standard medical care for cancer--chemotherapy, radiation therapy,  surgical interventions-with complementary therapies like nutrition, physical therapy, acupuncture, psychosocial or mind-body support, spiritual support. So, combining them to help improve quality of life, for example, for people that are being treated for cancer.

Melanie:  These things are so important. Tell us how you work as this team approach, bringing in nutrition  therapy and chiropractic and mind-body medicine. How do you bring them all together for the person, the patient?

Carolyn:  Absolutely. It’s interesting. Most of the literature shows us integrative oncology—integrative  medicine—is very commonly used by people during cancer treatment. So, the literature shows us  anywhere from 40percent, even up to 83 percent of people being treated for cancer are using these methods.  Sometimes, they’re actually seeking them out on their own and may or may not even be  communicating that to their oncologist, for example. So, this raises all kinds of concerns with safety, interactions and efficacy. So, knowing that patients are seeking that out and, many times, doing it separately from where they’re getting their oncology care, we actually have tried to make it easy for patients to access all of that at the same time they have their oncology care under one roof. So, we put a team around patients. We call it our “Patient-Empowered Care® team”- where every oncologist has a team of these individuals that work with them. They actually see patients together and every time patients come in to the clinic for care. So, all of these individuals will  assess, in their particular area of expertise, what's going on with the patient. Of course, the patient is kind of the coach of the team. Then, they put together a plan of care as a team to address not only, for example, the chemotherapy, radiotherapy or surgery that patient is having, but all of their other needs. The nice thing is, because they are working together, seeing patients together and meeting together, everyone among the team knows what the patient's plan is. They're adding things to support that plan and to deal with, for example, side effects that the patient might be at risk for because of the treatment they are having or to deal with the emotional issues that come with adjusting to the desease like cancer and treatments that are involved.

Melanie:  What role does the nutritional therapy play in dealing with some of those side effects during cancer treatment?

Carolyn:  Sure. It's interesting because one of the biggest areas that nutrition is involved in is really weight management issues, and it goes from one end of the spectrum to the other. So, we will sometimes see the patient that has lost significant amount of weight—what we call “involuntary weight loss” or “unintended weight loss.” Some patients may even develop something called “cancer cachexia,” which is a wasting condition that can be caused by very complex compounds  that are produced from the disease. And then, again, sometimes, the side effects can make it difficult to eat as well. So, a lot what we are doing is dealing with that. So, many of our patients come to us already malnourished. They’ve lost significant amounts of weight and muscles and so we are trying to develop a plan with diet and supplements. Actually, this is where the integrative approach is very helpful, too, because sometimes the patient may also be having difficulties eating because of depression, so we’ll deal with that. The dietitian will put a plan together from a diet supplement standpoint to try and help with weight gain and then our physical therapist will be working with patients to help them do activity to build muscles back, so they are gaining back important tissue and not necessarily adding back fat tissue or adipose tissue. So, that's one role, and again, we will be making different diet modifications using different food or other supplements to help with some of what we call "nutrition impact symptoms":  loss of appetite, nausea, taste changes, maybe even bowel changes. So, that's one and then, it kind of goes across the other spectrum. Another role our nutritionists and our registered dietitians, and, really, the integrative care team, work on to help patients who maybe have extra weight. Many times, we are first trying to make sure that they don't gain weight during treatment and then working using behavior modification and trying to establish different eating and activity behaviors to help them achive and maintain a healthy weight after treament to reduce the risk of  a recurrence or another chronic disease.

Melanie:  Tell us about the mind-body medicine and what does that have to do with helping that patient deal with some of those side effects?

Carolyn:  As you can imagine, a diagnosis of cancer is life-changing. Our mind-body team is working with patients from Day One also. So, I mentioned, even in the context of weight issues or depression, our mind-body therapists are there to establish a relationship with patients to help them work through some of the adjustment of having a disease like cancer and the treatments that are involved. With weight issues, that even goes into if somebody is trying to achieve and maintain a healthy body weight or just a healthy lifestyle in general, working with them to identify what their motivation is and any barriers that can may be making it difficult for them to eat healthy or be active, for example. They also work with families, so children whose parents are being treated for cancer. There's also a whole range of services that are designed to help with stress management, for example, and managing some of the side effects. So, we have Reiki Therapy, for example; laughter therapy; animal therapy; yoga; tai chi — anything that can really help patients manage stress and, hopefully, help with fatigue and quality of life during care. So, those are all available to patients every time they come in for treatment.

Melanie:  It really is so important to treat that whole person, and in just few last minutes, Carolyn, what should people be thinking about when considering integrative approaches to cancer treatment?

Carolyn:  Well, I think one of the things is, obviously, get as much information as you can. Always get a second opinion, particularly if you are looking for an integrative approach and not getting it. Our website at cancercenter.com may be helpful. The Society for Integrative Oncology is another great resource to get information. And then, there are different models for integrative oncology. Primarily, make sure whatever you're doing, you communicate with your attending oncologist and there is communication between those providers and the attending oncologist. There can be interactions, if you are taking supplements, for example, or chiropractic care and you want to make sure your chiropractor knows whether it's safe to do an adjustment based on what type of cancer you may have or are being treated for. Ideally, if you can find a place where it's being provided under one roof and the providers are communicating one with another, I think that's critical for safety.

Melanie:  Thank you so much. You are listening to Managing Cancer with Cancer Treatment Centers of America. For more information, you can go to cancercenter.com. This is Melanie Cole. Thank you for listening.