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Joseph Nowinski, Ph.D.

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Alternative and Complementary Treatments for Cancer

Posted: 04/17/11 12:37 PM ET

The National Cancer Institute (NCI) maintains and regularly updates library that provides information on the effectiveness of "alternative and complementary treatments," or ACT's. Versions for professionals and the general public are available on line. For those who have been diagnosed with cancer, as well as those who are in treatment that includes chemotherapy, this information is definitely worth a look. Depending on where you live these complementary treatments may be readily available; alternatively, you may need to be assertive in order to find and access them.

What has become known as the new grief refers to an increasingly lengthy process that has been made possible by medical advances in diagnosis and treatment. These advances have literally transformed the nature of death and dying over the past 40 years, and we must assume that they will continue to do so. The stages that patients and their families can expect to go through, beginning when a diagnosis is rendered, are described in "Saying Goodbye: How Families Can Find Renewal through Loss." Beginning with the first stage of the new grief--Crisis--we advocate that families try as best they can to rally resources. As soon as the initial shock is absorbed (at least enough so that family members are not paralyzed) it is extremely helpful if someone in the family can step up and help to create a team.

Some family members, for example, can be asked to help out by attending doctors' appointments (with the consent of the patient) and taking notes. This is critical because we've found that patients forget much of what was said in such meetings soon afterward. Other family members may pitch in with chores and other responsibilities that the patient may have to relinquish, at least temporarily. And some may take on the responsibility for researching the particular disease that the patient has been diagnosed with, along with treatment options. This is where checking out ACT's comes in.

While oncologists, surgeons, and radiologists are expert in their respective areas, health care in the United States today remains fragmented. You should not, for example, expect the various medical specialists who treat you to communicate well with one another. That's another area where family can help: by pressing for more communication with respect to treatment planning. Similarly, do not expect doctors who are expert in a particular area (chemotherapy, surgery), to be able to educate you or make recommendations when it comes to ACT's.

Acupuncture is one ACT (others will be explored in future posts) that has been the subject of research. Not all of this research passes muster to qualify as definitive, but some of it does. Virtually all of it thus far has focused on patients diagnosed with some form of cancer. Typically, acupuncture treatments are given concurrently with other treatments such as chemotherapy. Standard acupuncture treatment involves one or more sessions per week, in which sterile needles are inserted in one or more points along what are thought to be meridians of energy that course through the body. The idea is to free up these meridians when they become blocked, thus relieving various symptoms.

According to the NCI there is no substantial evidence that acupuncture cures cancer itself. However, let's take a look at the results of studies that looked at acupuncture with respect to various symptoms.

Pain

The most common acupuncture treatment for pain involves embedding short acupuncture needles at various places on the ear. One study compared 20 cancer patients who received such acupuncture in addition to pain medication to a group that received only the medication. All 20 in the former group reported significantly less pain. A second study of 183 patients reported that 52% were significantly helped. They required multiple treatments at intervals ranging from 1 to 4 weeks to achieve this effect.
While promising, studies of the effectiveness of acupuncture for pain are limited in what can be said definitively because they do not include a comparison group, in other words, a group that received some other treatment, either real or placebo. That said, looking into acupuncture for relief of chronic pain may be worthwhile.

Nausea and Vomiting

It is with respect to these common side effects of chemotherapy that we have the best evidence of the effectiveness of acupuncture. Here the NCI has reported on the results of several "randomized clinical trials," which are generally considered to be the gold standard for evaluating the effectiveness of treatments. A number of studies have found that acupuncture treatment than runs concurrently with chemotherapy significantly reduces nausea and vomiting. For example, researchers studied the effects of acupuncture treatments that were delivered weekly for three months on women who were taking tamoxifen as part of their treatment for breast cancer and found that this group, as compared to a group who did not receive the acupuncture, reported not only less nausea but less anxiety and depression. In short, there is evidence that acupuncture enhances the control of these symptoms.

Fatigue

In one study cancer patients were randomly assigned to one of three treatment groups: standard acupuncture using needles; acupressure; and "sham acupressure" meaning applying pressure to random places on the body. The results showed the regular acupuncture to be superior to the other treatments with respect to increasing the patients' overall energy levels.

The term "terminal illness" does not mean what it once did. A generation or two ago a "terminal" diagnosis usually meant that death was imminent. Today, "terminal" is relative. Those who are diagnosed as having Stage 4 (metastatic) cancer know that the threat to them is very real. Yet they too can work with their doctors to contain or slow the progress of cancer, as Elizabeth Edwards did for several years. If more research dollars were to be devoted to studying means of containing (if not curing) these patients their life expectancy could increase dramatically.

For those who are diagnosed early with forms of cancer for which we have effective treatments (prostate cancer, early stage breast cancer) "terminal" is increasingly an almost abstract concept. This is good. Regardless of the degree of threat, we recommend that families approach a cancer diagnosis as a team. In fact, we have found that in many cases such a diagnosis, as threatening as it may be, can also set the stage for families to resolve longstanding grievances and come together as a more cohesive, resilient unit. In that way they can look collectively at treatment options and evaluate them, including alternative and complementary treatments such as acupuncture.

In response to my inquiry, David Rosenthal, M.D., former President of the American Cancer Society and Medical Director of Harvard University, wrote that many cancer patients receive concurrent acupuncture at the Dana-Farber Cancer Institute as well as at Massachusetts General Hospital. In addition, patients who reside (for free) at the Hope Lodge in Boston while they undergo cancer treatment are offered massage therapy and Reiki, two additional complementary therapies that we will look at later on.

To join the conversation visit www.newgrief.com

 
 
 

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The National Cancer Institute (NCI) maintains and regularly updates library that provides information on the effectiveness of "alternative and complementary treatments," or ACT's. Versions for profess...
The National Cancer Institute (NCI) maintains and regularly updates library that provides information on the effectiveness of "alternative and complementary treatments," or ACT's. Versions for profess...
 
 
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08:30 PM on 04/21/2011
It puzzles me sometimes as to why some people insist on seeing modern medicine and complementary/alternative medicine (CAM) as mutually exclusive--or worse, incompatible. This series is about how we can and should look into using them in an integrated way to relieve symptoms, prolong life, and improve our quality of life. Stay tuned. Joe Nowinski, PhD
02:28 PM on 04/22/2011
Why waste time and precious healthcare resources on CAM modalities that repeatedly have not and ultimately will not ever be proven to be efficacious beyond a placebo effect when measured by a legitimate controlled scientific method of analysis? Pseudomedical psychobabble offering false hope to patients in dire straits does not belong in healthcare!
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Dyson
debunking pseudoscience, one fallacy at a time.
07:15 PM on 04/22/2011
Joseph, the problem is that the definition of the moniker "alternative/complementary/integrative" medicine has been deliberately blurred by many of those who promote it.
There are some modalities that have some reasonable scientific basis that come under the CAM umbrella, and no-one should have issues about having orthodox medicine utilize these. However, when it comes to remedies with zero evidence base such as homeopathy, reiki, therapeutic touch, crystal therapy, reflexology, quantum dowsing, flower remedies etc then the conclusion should be to whack them out of the park.
As soon as CAM eliminates these elements of utter quackery from its portfolio, it would be better respected by the medical profession and taken more seriously.
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luvU2
the band not u
04:20 PM on 04/19/2011
My mother has colorectal cancer, she is currently NED. The only treatment she has received so far is surgery. After doing months of research she/we have decided no chemo/radiation.

She has decided to build her immune system, juicing etc. If and when the time comes she will most likely use alternative therapies.

Thanks for the story, look forward too the next one.
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Dyson
debunking pseudoscience, one fallacy at a time.
05:48 PM on 04/19/2011
Your oncologist has not just spent "months" doing research of dodgy internet websites - he/she has spent many years studying his specialist field.
Why not trust his opinion? - it will be based upon real knowledge and real experience.
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luvU2
the band not u
05:57 PM on 04/19/2011
Do you have cancer ?
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luvU2
the band not u
06:19 PM on 04/19/2011
I suggest you spend some time on these websites, so you can get an up close and personal view/idea of with it is like to have cancer.

http://csn.cancer.org/forum

http://www.cancercompass.com/message-board/cancers/1,0,119.htm

On these boards you will hear many stories of people using all sorts of treatments. It is a very personal choice. You should not be so judgmental. There is no “sure thing” when
treating cancer.

BTW If you would have read my post you would know that my mother has cancer, not me.
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Dyson
debunking pseudoscience, one fallacy at a time.
01:18 PM on 04/20/2011
Seems like the surgery alone may have been curative if she is NED.
I hope things work out for her.
04:11 PM on 04/19/2011
You have to find a good oncologist who personally sees you throughout your treatment (not hands you off to a nurse practitioner), who acts as your 'traffic cop" coordinating with all your other doctors (specialized and general surgeons, pain managers, etc.) and who has an office staff that handles your insurance problems for you. You should never have to fight your own insurance battles - you should be fighting for your life. You may say these doctors don't exist but I have one who does all these things and more. Because cancer can be considered a chronic illness that you may be in treatment for a long time, you have to be comfortable with a doctor's personality you are willing to deal with possibly for years. Alternative treatments should be part of a system that includes standard treatment and you should never take supplements without telling your oncologist as many alternative treatments can interfere with the way chemotherapy agents work. And as for trials - toss out any doctor who immediately asks you to enter a trial unless you have definitively been told no standard treatment will help, unless it is a last resort or it isn't offered as a parallel to standard treatment. They don't call them trials for nothing.
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Sayer Ji
The World's Largest, Open Access, Natural Medicin
11:27 AM on 04/19/2011
There are actually thousands of peer reviewed studies on natural substances, some of which show the superiority of "alternative" phytocompounds to chemo-agents. Here are 60 such studies http://www.greenmedinfo.com/disease/cancers-multi-drug-resistant
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Nalini Chilkov
09:57 AM on 04/19/2011
Great article touching upon issues cancer patients face. See my HuffPo article from last year which discusses the value of acupuncture for cancer patients. It is important to understand the immense value of improving the quality of life of cancer patients, giving patients a sense of agency and control over their experience. Critics cry out..but it doesn't cure cancer...that is not what we are talking about....We are talking about support. Can Acupuncture Help Cancer Patients http://www.huffingtonpost.com/nalini-chilkov/can-acupuncture-treatment_b_577686.html
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Mirabai305
Are you Jeff Vader?
02:17 AM on 04/19/2011
I am uncomfortable with the idea of using exclusively Chinese medicine or some other 'alternative' to treat patients with cancer. That said, I find enormous benefit in using acupuncture and Chinese herbs to ameliorate the effects of western cancer treatment. No one should be misled; chemotherapies are harsh and do dreadful things to the body. Even as they help they do great harm. I find that patients who use acupuncture and carefully coordinated Chinese herbs tolerate the unpleasantries of chemotherapy much better than patients who don't.

I do not work with practitioners who promise cures and I always make sure my patients and their families have reasonable expectations, but I really like the practice of integrative medicine and I hope that we see more and more of it in the future.
11:28 PM on 04/18/2011
Here is a fact-There are no recognized effective homeopathic 'cures' or treatment of cancer. A person who contends to the contrary could be intentionally or unintentionally misleading patients and providing a conduit of unrealistic expectations.

Modern medicine is structured around scientific validation of all remedies. Otherwise, too many individual with varying degrees of sincerity and trustworthiness can come forward and offer unique nostrums that he or she could contend are as strong as other therapies. There has to be validation of the efficacy of treatments. This is unfortunately where a lot of alternative medicine fails.
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luvU2
the band not u
05:10 PM on 04/19/2011
You really have no clue what you are talking about. My family has used alternative medicine/therapy to treat depression/anxiety, high blood pressure, hypothyroidism, inflammation of joints, coughs/asthma, antibiotics just to mane a few.

Most prescription drugs are poison and can ki// you.

If you think that the chemo is a safe and effective drug, I suggest that you do some research.

There is no guarantee for ANY cancer treatment, traditional or otherwise.
06:38 PM on 04/19/2011
As someone who's using alternative therapies to successfully treat bipolar and psychosis, I really appreciate your line of commentary here! My grandmother also recovered from a brain tumor prior to the chemo and surgery doctors claimed was "absolutely necessary"...all with alternative treatments.

Unfortunately, there are still so many folks out there who blast the idea that anything other than western medicine is capable of curing...they're missing the point that western medicine is rarely preventive or healing, but rather reactionary and invasive. And that yes, indeed, no treatment is a guarantee!

Natalie Guerrier
Mental Health Advocate
www.rockpapershutup.com
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Dyson
debunking pseudoscience, one fallacy at a time.
07:19 PM on 04/22/2011
You are right, there is no guarantee of cure for any cancer treatment.
But with conventional therapies, there are cure rates of 70% for lymphoma, 90% for testicular cancer, 80% for leukemia, and good success rates for a range of otherwise lethal cancers (breast, prostate, stomach, bowel, lung)

One thing I can guarantee - with alternative remedies, the cure rate for cancer is 0% (after one has excluded the very tiny minority of recognized spontaneously remitting tumors).
07:31 PM on 04/19/2011
lots a western medicine too and when you have cancer you will try anything
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Bettaman
Former Republican - now sane
10:18 PM on 04/18/2011
Trying this again. I'm going in for another round of chemo in the morning. That last thing I can image wanting are yet more needles being stuck into me. I've heard just about every theory - some crackpot, most well meaning and all unwelcomed. I'm sorry to be blunt, and I've talked with many others in my cancer survivors group and trust me - I am NOT alone in feeling this way. We know you mean it with love and concern, and we love you right back for it, but please STOP with the advice of how we should treat our disease already! Sure, some things will help some people. Is that through the power ofthe mind or some actual scientific benefit? Who knows and it really doesn't matter so long as it does help some people. But I get nervous when alternative treatments are propped up as some kind of panacea for those of us dealing with cancer on a day in and day out basis. It never isn't a part of our lives already, but if we were to try all the things people suggest, from green algae to bee stings to macro whassits what's left of our lives would be spent trying them - Please, if it works for you, great. But until you are living it day in and day out, just offer a smile and a friendly conversation and leave us to decide what treatments are right for us.
MommyMD
MD, Professor, Mom
03:32 AM on 04/19/2011
Fanned. Good luck tomorrow.
04:31 PM on 04/19/2011
Good luck to you my chemo buddy! Good points and as someone who has been in chemo non-stop for 4 years, I want to add that I don't appreciate people telling me my doctor is keeping me in chemo to make money. You tell someone your tumor marker went down and you had one good scan and they want to know why you're still in treatment. They accuse your doc of wanting to keep "poisoning" you to pay for "his yacht" or they accuse you of not having enough faith in God and good food and "things that the Chinese have been using for years". I hate to sound cynical or unappreciative, I'm not, but like you said, people need to let us make our own decisions and if that includes alternative medicine or not, ultimatelty it's our life. Maybe one of the doctors here can explain to the masses the difference between 'in vivo' and 'in vitro' and how these things may be a whole lot less promising than you think.
MommyMD
MD, Professor, Mom
04:51 PM on 04/19/2011
Happy to: You seem like a lovely person. "In vitro" means: in a petri dish. "In vivo" means in a live being (rat, mouse or human). Unfortunately, the human body is MUCH more complicated than a petri dish, and often works quite differently than an animal models. Drugs and "natural remedies" that work "in vitro" and even "in vivo" need to be tested in live patients WITH the disease as a final step in research. Journals vary hugely in quality...some of the journals I see referred to here are laughable....they just show a few non-reproducable results without regard to actual statistics (a science in itself). A reputable journal will will be peer-reviewed with discussion that mention "this is simply in vitro data...we don't know if we would see the same results in our patients." A reputable journal will also have statisticians working on the project to assure that the results did not simply occur by chance. Hope this helps. And good luck to all the cancer patients commenting here. Courageous people.
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Mirabai305
Are you Jeff Vader?
05:39 PM on 04/19/2011
"things that the Chinese have been using for years".

In China, medical facilities are not using exclusively Traditional Chinese Medicine (TCM) to treat patients with cancer. They are using a fully integrative protocol that definitely includes surgeries, chemo, and radiation alongside acupuncture, nutrition therapy, and herbal prescriptions. It's a gross inaccuracy to suggest that TCM can do it alone and even the Chinese know that.

You are so right. it's your life. No one should be pressuring you to do or not do any treatment. You need good education from sources you trust and then you need to make your own decision. I'm sorry things have been difficult these past 4 years. Good luck to you.
05:23 PM on 04/18/2011
Great conversation! Thanks to all. Things are indeed changing. In fact, modern medicine is literally transforming death and dying before our very eyes. I can remember when the word "terminal" meant "soon." Today for many it is almost an abstract concept, meaning "sooner or later." That is what motivated us to write our book about these transformative changes--what families can expect, and what they can do. Because "terminal" no longer necessarily means "soon" it is all the more important that we look at treatment holistically and open ourselves to complementary treatments that can provide effective palliative care, if not a cure. Effective palliative care is no small matter. It should properly begin with a diagnosis and continue from there. It is true that a lot of research on complementary treatments may lack scientific rigor, but that is no reason to dismiss them out of hand. Hopefully we will be able to learn more about treatments such as acupuncture: what it works for, and who it works for. I invite readers to share their stories on www.newgrief.com.
01:03 AM on 04/19/2011
While homeopathy doesn't cure diseases, it does allows an individual­'s body to re-balance itself. Here are some indication­s for remedies that con help with nausea from Chemo. There are a number of remedies for nausea that can be researched and tried, but of course you need to be sure your symptoms match what the remedy has been known to cure in the past. I will mention a few here- homeopathi­c (not the regular Ipecac but the homeopathi­c) Ipecac (also known as ipecacuanh­a) 30c. This remedy covers intense nausea that doesn't let up. Along with that nausea one has a clean tongue with no coating or discolorat­ion.Vomiti­ng sometimes immediatel­y after eating. Salivation­.
Another common remedy for nausea is Nux Vomica 30c potency. The person will feel violently nauseous and want to throw up but very little will come up if at all. Symptoms are often worse 3AM- 5Am. Often with headache, cramps in legs and feet, anxiety, and trembling of limbs. Other homeopathi­c remedies available from a large health food store include Veratrum album and Arsenicum Album. Check the internet to research the symptoms that would indicate their use. These remedies can be extremely effective; if they are only partially effective a stronger (higher) potency may be needed than can be found at the health food store, or another remedy may be more indicated. Someone certified in classical homeopath (CCH) will be able to help.
Until 1900 Homeopathy was well establishe­d in the US curing Cholera and Typhoid epidemics.
ThinkCreeps
Seriously, it's time.
06:48 PM on 04/19/2011
Absolute nonsense (apart from the first clause).

Homeopathy can indeed be the basis of an effective treatment for cholera, with some modification. Just get a very large dose of the homeopathic remedy, made up using clean water, add appropriate electrolytes and drink.
04:53 PM on 04/18/2011
The argument of the effectiveness of conventional western medicine vs. "alternative medicine" is so incredible complex, it cannot be debated in a blog. It involves culture, cosmology and perception. I've written a 360 page book about Chinese medicine that just begins to scratch the surface of this subject. Science is not a static entity unto itself. It is a cultural segment with its own rules of engagement and survival. The existance of outside forces (such as "alternative medicine") is a threat to conventional science. I'm not speaking so much of an economic threat, I'm speaking of a threat to a way of believing, a threat to a cultural lifestyle. This argument is much deeper than mere effectiveness of treatment. It involves our very belief systems.
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onionboy
Blessed are the Cheese Makers
07:06 PM on 04/18/2011
History would say the opposite. The belief systems are the ones that have been threatened by the scientists , not the other way around.

I have no problem with people's belief systems, but we let's call them what they are, as you just have. If people feel better getting acupuncture during the chemo, that's great for them. But until someone can show there's something stronger than they're belief providing that benefit, I would not like to contribute to paying for it...anymore than I would contribute money to a TV preacher to pray for my friend's recovery.
11:02 PM on 04/18/2011
Actually a close examination of history says just the opposite. Take a look at Thomas Kuhn's book, The Structure of Scientific Revolutions. The "advancement of science" is not a smooth addition of new knowledge upon old knowledge. It is often a complete rejection of old knowledge and a new beginning in a different direction. And I'm not speaking of hundreds of years ago. This is happening today.
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Dyson
debunking pseudoscience, one fallacy at a time.
12:15 PM on 04/19/2011
Jerry,
If it is still happening today in the field of medical science, where a totally new revolutionary concept replaces virtually all previous conventional dogma, then I'd be grateful if you cited some examples.

I think you will find that most progress is incremental and leaps forward are effectively small progressive steps along the same path.

And anyhow, the fact that in the 19th century many major developments were made that overthrew the prevailing paradigm does NOT mean that every kooky alternative medical theory that people come up with must be right.
08:25 AM on 04/19/2011
Thank you! Few people have said it better. I wrote a book, Embrace,Release,Heal: An Empowering Guide to Talking About, Thinking About and Treating Cancer, that is chock full of interviews with cutting edge docs--both allopathic and alternative--who know that there's more to healing than what western medicine recognizes. Many of the docs acknowledge that permitting more of these "alternative" treatments not only insults the dictates of Big Pharma, but puts a crack in the very bedrock of how medical science operates. Even if we can't scientifically prove certain therapies (yet) they are worthy of investigation. Just as chemo and radiation don't work for everyone, alternatives don't either. But if they work for some, they have merit. Millions of people are ready for such alternatives as the brutality of many--especially cancer--treatments are not healthy in and of themselves.
11:49 AM on 04/19/2011
It is very possible that we will never prove how some "alternative" methods work. As I discuss in my book, East Meets West: A Collision of Medicines, there is far more going on in this universe than we are aware of. We may never have the capabilities to mechanically measure or even detect these life energies that are manipulated in energy therapies, but that does not negate their existence. Intelligent doctors know this to be true, and they use this knowledge to help their patients even though it flys in the face of conventional medical theory.
04:30 PM on 04/18/2011
It's heartening to read this from a psychologist who knows the importance of integrative medicine and emotional support. I endured three cancer diagnosis and did both allopathic and complementary treatments for all three. That included massage, reiki, healing touch, acupuncture, yoga and counseling. The last diagnosis led me more to the alternative path where I learned a great deal about the role of diet, how our thoughts and emotions impact our cells, and the how a holistic approach can offer healing on many levels. My own fears--and need to give meaning to the experience--inspired me to write a book about my journey. It literally helped save me and enlightened me to the need to broaden our conversations about what cancer is and what it means to heal. Go to embracehealingcancer.com to learn more. Things are changing, and it's time.
02:21 PM on 04/18/2011
A few months ago I read in Findrxonline that massages are a good alternative to reduce chronic pain and that a study shows that 3 people from each 10 improve notablmente. Although also mentions that although it reduces the pain unchecked it as prescription drugs - vicodin, oxycodone or lortab - but if it helps to have greater resistance to medication.
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Halsey
"There is a price to pay for speaking the truth. T
12:06 PM on 04/18/2011
Those patients who can get acupunture to help them are quite fortunate. I went through treatment at a very famous hospital in Santa Monica. No such service was even mentioned and my insurance wouldn't have coverned it anyway. I am still paying off radiation treatment from 2 years ago. The Elizabeth Edwards of this world are amazing; she had much to survive for.
My choice (should C return) will be not to treat it. Sad as it is, no point to being healthy if I'm homeless. Life got a LOT scarier in the past 6 years, and not because of cancer.
I fear more and more YOUNG will come down with aggressive cancers; so much more exposure to chemicals,hormones, etc, that our parents ever were exposed to.
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Aquest
No one here is exactly what they appear.
05:59 PM on 04/18/2011
There is an acupuncture school in Santa Monica. Its on Wilshire, down the street from USM. I've forgotten the name. They have a clinic that is very cheap. I had a great experience. Its a teaching clinic and the teacher was with the student the entire time of my treatments.
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Mirabai305
Are you Jeff Vader?
02:04 AM on 04/19/2011
I think you're talking about Emperor's College. People should definitely look into college clinics for access to low cost acupuncture led by highly qualified supervisors. i recommend calling ahead and asking for an appointment during the time a cancer specialist is in the clinic with the students.
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Dyson
debunking pseudoscience, one fallacy at a time.
11:23 AM on 04/18/2011
Acupuncture revisited.
http://www.sciencebasedmedicine.org/?p=11765

Worth the read.
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luvs2eat
What fresh hell is this?
09:08 AM on 04/18/2011
Acupuncture is available to my daughter, who's fighting stage 4 breast cancer. A member of her support group had an acupuncture treatment the day before and the day after her chemo treatments and experienced NONE of the nausea and vomiting that had crippled her in earlier treatments.
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MamacitaOfLove
Micro-bio curious
09:27 AM on 04/18/2011
All my best to you and your daughter. I am glad she experienced good results with acupuncture. I know chemo can be hell.
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Dyson
debunking pseudoscience, one fallacy at a time.
11:14 AM on 04/18/2011
My sympathies - I hope she pulls through it all.