Dr. Paisley seeks to enhance survival and quality of life for those living with cancer through integrative naturopathic oncology care.
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Naturopathic oncology, as defined by the Oncology Association of Naturopathic Oncology, is the application of the art and science of naturopathic medicine in the field of cancer care and treatment. Naturopathic oncology is a vital component of a comprehensive, whole-person approach to cancer care that spans from prevention through treatment and into survivorship.
The Role of Naturopathic Medicine in Oncology Services
An integrative approach to cancer care is at the leading edge of what is happening in care delivery as consumers drive a trend to integrate natural therapies. With the NIH reporting complementary and alternative medicine (CAM) use by oncology patients at 80% with less than 50% reporting to their physician, it is essential that we find a way to offer safe, evidence-based, cost effective, natural medicine to our patients. Pediatric Oncology use of CAM has been reported at 59%.
One of the major concerns about CAM use is the lack of data substantiating it’s benefit to patients, but current literature is reflecting a trend towards good safety profiles and efficacy of complementary management, particularly in the area of side effect management. Pre-clinical is very strong and clinical data is gaining traction in a conventional setting, for example, presentation at ASCO 2010 on the use of calcium and magnesium with platinum administration to attenuate dose-limiting neuropathy.
Of great interest in the field is a growing cache of data demonstrating the potential to optimize outcomes and reduce recurrence with integrative treatment, particularly in the areas of breast, prostate and pancreatic cancers.
In cancer care, the naturopathic medicine core principles are adapted to co-management. For this reason, symptom management is a priority in this setting and does not support natural therapy as first-line intervention.
My goal in an oncology setting are multi-fold. As a naturopathic physician, In partnership with medical oncology, radiation and surgery, I aim to:
- Address unsupervised use of herbs and supplements
- Redress concerns about source, quality, contamination and standardization of ingredients
- Educate providers and patients on herb-drug-therapeutic interaction
- Identify and redress occult use of natural therapy in conjunction with conventional management.
- Discourage the use of natural therapy as primary first-line intervention
- Help treat dose-limiting side effects of conventional treatment and preserve quality of life.
- Help prevent long-term side effects of conventional treatments
The clinical intention is to work with and for the patients and their oncology providers, to ensure that they co-manage with natural therapies that are safe, evidenced-based and cost effective.
Leading edge features of integrative oncology are the potential to enhance care delivery with the co-management of dose-limiting side effects such as cardiotoxicity, CINV and CIPN from conventional management. Work to optimize surgical outcomes and potentially reduce infection rates post op with appropriate pre-loading and post-surgical immunonutrition. Use a holistic approach to levy broader syndromes like fatigue, anemia, anorexia and depression, recruiting multiple modalities: nutrition, counseling, botanicals, community resources, physical therapy, mind body medicine.
The literature suggests that an integrated approach to cancer care offers:
- Improve patient satisfaction
- Reduce post procedure complications
- Reduce dose-limiting side effects
- Improve patient tolerance
- Improve patient compliance
Survivorship
Continue to follow patients into survivorship. Here, the naturopathic physician works to harness the individual’s desire to be empowered and engaged in their health. In this setting I may use naturopathic modalities including behavioral health counseling and functional medicine testing to address co-morbid chronic health issues such as metabolic syndrome, immune dysregulation, digestive issues, cardiovascular disease and nutritional deficiency.
Probably most importantly, co-management does not necessarily mean recommending copious supplements. Given the availability of over-the-counter supplements and the purported “expertise” of multiple media sources in appropriate recommendation and dosing, naturopathic physicians, critically advise patients to discontinue supplements that can potentially interact with chemotherapy and radiation. And most times, to steer patients towards products that are:
- Well-evidenced
- Well-sourced
- Safe in the context of conventional treatment
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