BY Oyetokunbo Ibidapo-Obe, M.D., Assistant Professor of Family Medicine, Women’s Specialist, UTMB-Health
Integrative medicine approaches health in multiple ways, including mainstream-conventional medicine and several complementary and alternative approaches to positively impact well-being. Several types of complementary modalities are used in cancer care. This article will focus on breast cancer survivorship and the integrated approach to breast cancer care.
Breast cancer, like any other cancer, is a life-changing diagnosis with an impact on every aspect of a person’s life. In the same way, breast cancer care should target all aspects of a cancer diagnosis. Rather than treating breast cancer, alternative therapies help with dealing with side effects of cancer treatment such as nausea and fatigue.
Integrative approaches include diet, herbal and nutritional supplements, mind-body modalities- yoga, and acupuncture.
Diet- A dietary shift to include low fat, high fiber – fruits and vegetables have shown promise in some studies; however, the mechanism lacks clear understanding, and results were not consistent.
Several herbs have been found to help with the way breast cancer develops, however, use is limited due to side effects and interaction with other medications. These herbs can stimulate protective enzymes or inhibit tumor growth. Research is ongoing.
There are several plants that are used in breast cancer most of them work to destroy abnormal cells, inhibit the progression of cancer cells, and minimize side effects from cancer therapy.
Green tea also has been of interest due to its cancer-preventing potential in laboratory testing.
Garlic possesses the ability to delay the production of cancer cells and kills cancer cells, prevent the spread of cancer, and reduces the adverse effects of chemo and radiotherapy.
Turmeric has been found to possess anticancer properties. The spread of cancers of the breast, skin, lung, and stomach can be limited by turmeric.
Burdock- has been found to reduce cancer pain, cause tumor shrinkage, and thereby enhance the survival phase.
Other helpful herbs that have been used in breast cancer care include ginseng, black cohosh, flaxseed, vitamin D, ginkgo, saw palmetto, Aloe vera, black cohosh, goldenseal, ragweed, echinacea, and snakeroot.
Hot flashes, vaginal dryness, and other menopausal symptoms can be minimized with the use of acupuncture and phytoestrogens, especially in post-menopausal women in whom estrogens cannot be used.
Soy, red clover, bean sprouts, and some seeds and nuts possess phytoestrogens. Theoretically, phytoestrogens can bind to the estrogen receptor and reduce the risk or recurrence of breast cancer. Several small studies have shown a reduction in recurrence risk, but this effect is not seen in larger studies.
Vitamin D is a fat-soluble vitamin that can be produced under the skin with exposure to UV light and can also be gotten from certain foods. This vitamin is responsible for calcium homeostasis, skeletal metabolism, and immune, cardiovascular, and reproductive systems’ functions and has been of interest in cancer care.
Vitamin D deficiency has been linked to diabetes, rheumatic arthritis, Parkinson’s, Alzheimer’s disease, osteomalacia, osteoporosis, fractures in adults, and cancers such as breast, colorectal, kidney, lung, and pancreatic cancers.
Several studies have implied a reduction in breast cancer risk and recurrence with high-normal vitamin D levels (27ng-45ng) in meta-analysis. However, one study implied that higher than normal vitamin D levels might increase breast cancer risk. The difference in results can be attributed to the study selection criteria of patients and location (USA vs Europe), among other factors. The overall conclusion of the relationship between vitamin D and breast cancer supports that low vitamin D levels increase breast cancer risk and high levels reduce risk.
Exercise
Evidence that exercise and maintaining physical activity help with the prevention of colon cancer suggests that the same may be true for recurrence of postmenopausal breast and endometrial cancers. Exercise has been found to improve breast cancer survivorship at 10 years and reduce the risk of developing breast cancer.
Acupuncture
Acupuncture affects immune function in ways that are still unclear. The research recognized by the National Institute of Health has found acupuncture as beneficial to reduce cancer pain, fatigue, depression, anxiety, nausea, and improving quality of life.
Mind-Body therapies
These approaches target mental health and employ modalities such as yoga, behavioral therapy, meditation, sensory therapy, support groups, art therapy, and others. Although studies do not find an increase in survival rates, they have shown a positive impact in reducing anxiety, insomnia, cancer-related pain, overall quality of life, and depression, among other parameters.
Overall, breast cancer care should be a team approach with the patient, primary physician, oncologist, psychologist, social worker, and family. Patients should be given information on complementary and alternative medicine approaches that are beneficial to breast cancer care and survivorship as early in the diagnosis as possible.
It is imperative that the patient understands that better outcomes occur with early detection and effective conventional therapies, including chemotherapy, surgery, radiation, and hormonal management. Integrative therapies are best used as adjuncts and play an important supporting role in improving quality of life, reducing side effects of treatment, and addressing survivorship needs holistically, mind, body, and spirit.
REFERENCES
Abrams D, Weil A. Integrative Oncology. Oxford University Press, 2014; 21: 589-605