In recognition of Pediatric Cancer Awareness Month, here are latest statistics to come out of the American Cancer Institute [1]:
- Childhood cancer is the leading cause of disease-related death among children and adolescents (ages 1 to 19 years) in the United States, although cancer among children is rare.
- Survival rates for most childhood cancers vary widely across cancer types. Survival rates for some cancers have improved in recent years, and, overall, more than 80 percent of children and adolescents who are diagnosed with cancer live at least 5 years after their diagnosis. However, for some childhood cancer types, survival rates remain low.
- Children and adolescents who have been treated for cancer need regular follow-up care for the rest of their lives because they are at risk of late side effects that can occur many years later, including second cancers.
- The most common types of cancer diagnosed in children and adolescents are leukemia, brain and central nervous system, lymphoma, rhabdomyosarcoma, neuroblastoma, Wilms tumor, bone cancer, and germ cell tumors.
Recently, I spoke at a Pediatric Hematology and Oncology Conference on the implementation of Complementary and Alternative Medicine (CAM) in Children with Cancer. In preparation for the lecture I re-evaluated the literature on both the demand for and the evidence to support the use of CAM in this population. The rising trend towards use continues, with up to 90% families looking beyond conventional medicine in the care of their children with cancer. [2] Only about 50% of them inform or disclose their use to their health care providers. [3] The majority of these patients are utilizing CAM therapies without the guidance of a trained professional. Unfortunately, while many of these therapies are safe standing alone, pharmacological medicines in conjunction with certain natural biological substances poses a potential risk for an interaction that could lead to toxicity and/or decreased efficacy of proven therapies. Now more than ever, it is vital that we create integrative health communities that communicate openly. Dialogue among practitioners creates an opportunity to learn and grow from one another’s others area of expertise as well as protect and empower our patients.
Why are patients using CAM?
According to current literature, patients turn to CAM to reduce side effects of the disease, reduce treatment related side effects, management of co morbidities, improve quality of life, improve immune system, and receive compassionate and holistic approach to their care. According to a recent publication, Asking the Experts: CAM and Cancer, “the field of oncology is often perceived as insufficient, particularly when it comes to what we call bed side manners, the way patients are dealt with, lack of empathy, lack of time and so forth—and alternative providers give all of that in high measure to our patients…” [4] Increasingly accepted, is the idea that CAM is a viable option for families looking beyond the limitations of conventional cancer care to optimize health and wellness.
Great strides have been made in pediatric oncology; currently there is upwards of an 80% 5-year survival rate for children with cancer. [1] However, many types of cancer such as gliomas are still very difficult to treat. In addition, cancer treatments pose significant risk for both short and long term side effects. The need for therapies that support these children, while increasing tolerance and efficacy of conventional therapies is undeniable. In naturopathic medicine, we may have the ability to do just that. It is well known that cancer survivors are at a significant risk for chronic diseases. In fact, a study found that almost half of childhood cancer survivors experience a serious or life-threatening condition or death between 5 and 30 years after diagnosis and that almost three-quarters develop at least one chronic condition. [5] Another study of adult survivors of childhood cancers found that by age 45, 96 percent of them had developed a chronic health condition and 81 percent had a severe or life-threatening condition. [6] The risk of developing a health condition increased over time. The preventative model rooted in naturopathic medicine is ideal for families looking to improve the quality of life and reduce the long-term risk for these children.
Speaking the Same Language
Currently, CAM is the commonly used term when it comes to implementing many of the tools that naturopathic physicians recommend. A preferred term by many oncologists and naturopathic physicians that specialize in oncology is that of integrative oncology. [7] Integrative oncology is an evidence-based approach to reducing symptoms and improving quality of life with non-pharmacologic therapies in conjunction with conventional cancer care. There is substantial value is this approach to childhood cancers. It can help patients complete treatments in a timely manor and maintain some health through their treatments. Naturopaths can support children with vitamins, herbs, hydrotherapy, homeopathy, and even IV therapies. Naturopathic medicine can also be helpful with choosing which foods to focus on during treatment, whether the child is having taste changes, nausea, or decreased appetite.
What is Naturopathic Oncology?
Naturopathic Physicians are medically trained physicians, offering many modalities focused on the prevention and treatment of disease. We have a four year post doctorate degree and are licensed to practice primary care in the state of Oregon. (licensure varies by state and exsists in 16 states). When a child is diagnosed with cancer, naturopathic physicians can help support their bodies, making them better able to cope with the mental, emotion and physical stress of both disease and treatment. Many of the modalities used can reduce side effects, support the immune system, reduce weight loss, and reduce fatigue. Naturopathic physicians can address neuropathy (numbness and tingling), hearing changes, mouth sores, xerostomia, weight loss, and radiation burns – currently conventional medicine has little to nothing [4] (as with cardio toxicity, ottotoxity and xerostomia) to offer in these situations.
Upon completion of treatment, during survivorship, naturopathic medicine can support the body in returning to optimal function. A naturopathic physician that specializes in oncology can help reduce the long-term side effects from treatment. Some of the long-term side effects can include immune deficiency, metabolic disease as with diabetes, heart and lung damage, thyroid dysfunction, and low red and white blood cell counts. For example, consider this staggering statistic: at diagnosis, 21% of children were overweight or obese. At the end of treatment and 5 years post-treatment, approximately 40% were overweight or obese. [8] This is an area where naturopathic oncology really shines, education and behavioral modification tools rooted in natural medicine can significantly reduce obesity and empower patients to live long, active, healthy lives.
Modalities:
- Diet/Exercise •Nutritional Supplementation •Botanical Medicine
- Homeopathy •Counseling •Hydrotherapy
- Physical Medicine •Oriental/Ayurvedic Medicine •Pharmacology
While many of these modalities have been in practice for 100s to 1000s of years, more recent discoveries about cellular metabolism, epigenetics, phamacognacy and the like have led to new clinical applications. For example, with a greater understanding of the specific cellular demands of cancer cells, we are better able to explore possible nutritional approaches to reduce cancer cell viability. Years of research by Dr. Seyfried, of Boston College, has produced an increased interest in the use of a Ketogenic Diet for certain cancers and data is surfacing that supports a therapeutic potential in the treatment of cancer. Another area of interest is that of genetic SNIPs, or single nucleotide poly morphisims. The understanding of how genetic mutations effect human physiology have led physicians to explore how well a medicine will work, the potential for toxicity as well as the risk for development of cancer. In a recent article, the authors found that with the MTHFR mutation, patients with the 677T genotype had an approximately six-fold greater risk of developing hematological toxicity compared with wild-type carriers and have reduced disease-free survival compared with wild-type patients (67% vs. 100%). [9] What’s exciting is that the MTHFR mutation can be easily addressed with vitamin supplementation, lowering the risks associated with this SNIP.
The Future of Integrative Cancer Care in Children
We currently have a developing body of research to support and guide practitioners in the reasonable and safe use of integrative medicine in the setting of cancer. According to a recent article, clinicians should consider the role of CAM in the adoption of healthy lifestyles. [9] It is exciting to consider that – whether we are trying to reduce inflammation, lower IGF, or enhance naturally killer cells – children, with their epic vitality and resilience respond beautifully to naturopathic medicine. We have a growing body of evidence demonstrating safety with several non-pharmacological therapies. More research is, of course, needed to and as always, this begins by working from what we know from existing science and emerging studies in pediatric and adult populations, and extending that knowledge base into clinical practice.
Given the number of children and families that are affected by cancer, it is likely that you or someone you know is struggling with the myriad of challenges that come with a cancer diagnosis. If you are interested in finding a naturopath that can support a child with cancer, please call Dr. Rose.
- National Cancer Institute, 2014
- Bishop FL, et al, 2010 Apr;125(4)
- Davis EL, et al, The Oncologist. 2012, 17:1475-1481
- Miller, G et al Asking the experts: CAM and Cancer, Medscape, Sep, 02, 2014
- Oeffinger KC, et al, Chronic health conditions in adult survivors of childhood cancer. New England Journal of Medicine. 2006;355(15)
- Hudson MM, et al Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA. 2013;309(22):2371–2381
- Mythbusters: complementary and Alternative Treatments in Cancer, Sep 02, 2014
- Zhang FF, et al, Predictor of being overweight or Obese in Survivors of ALL, Pedatric Blood cancers. 2014;6
- D’angelo V, et al, Influence of methylenetetrahydrofolate reductase gene polymorphisms on the outcome of pediatric patients with non-Hodgkin lymphoma treated with high-dose methotrexate. Leuk lymph. 2013 Dec, 54 (12)
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