"The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated." -- Plato
Plato succinctly expresses a crucial aspect of medicine that is all too often forgotten. For cancer patients, this idea that physicians need to tend to the soul and the body is especially true. One of the most significant aspects of a therapeutic alliance between a physician and a cancer patient is the creation of a relationship that helps the patient to build and strengthen mental and physical fortitude.
There are no cookie-cutter regimens on how to accomplish this. The key component to achieving this for a patient is to listen and empathize. From that comes true healing for the patient and allows the physician to plan a patient-specific healing regimen that will resonate with that specific patient. It is in this journey of finding a therapeutic regimen that resonates with the patient that physicians are able to achieve optimal healing outcome.
Allow me to take you on such a journey of healing, where the healing occurred not just for the patient but also for me, as I watched the patient's inner strength overcome the limitations of her physicality. As a privileged spectator of such tremendous spiritual fortitude aided by integrative medicine therapy, she has given me the optimism and hope to help other patients push through doubt and fear in their frequently overwhelming journey of healing.
One of my patients is woman in her early 50s and was diagnosed with stage I breast cancer. She came to see me after she's had her lumpectomy and lymph node dissection that showed negative nodes. Her breast cancer is estrogen receptor positive, and her breast tumor was a little less than 1cm in measurement. Her mother also had breast cancer in her 50s. She came to see me for acupuncture treatment and medical guidance on cancer recurrence prevention. She is also very concerned about her younger sister getting breast cancer and wanted to know about dietary, lifestyle, and supplemental methods for primary cancer prevention.
We began her treatment with a discussion on the impact of this on her life and her family. She reports that she was stressed when she found out about the diagnosis, but through her church group and her family, she's been able to get through it. She feels more generally fatigued since the diagnosis, but she says she is coping "as well as can be expected." We discussed how the stress and impact of battling cancer could lead to adrenal fatigue and she was very interested in implementing mind-body techniques to lessen daily stress, adrenal tonic supplements, and acupuncture to help re-build her Jing and strengthen her Spleen function.
For a few weeks, she came regularly to learn self-hypnosis and other mind-body techniques such as breath work and heart rate variability biofeedback. Concomitantly, she came regularly for ongoing acupuncture treatments and lifestyle/nutritional counseling. Through a gluten elimination trial, we found that she was mild-to-moderately sensitive to gluten based on her fatigue level and feeling of sluggishness when she consumed gluten vs. when she was off gluten. After discussions, she also decided to change her diet to a mostly vegan/vegetarian diet to avoid hormones in animal meats and in cow's milk. She switched to almond or rice milk and stayed away from the foods high in phytoestrogen. She tried to consume foods high in indole-3-carbinol and flavonoids. She began drinking organic Japanese green tea and found time for twice daily mind-body relaxation times at home.
She began taking vitamin D3 and turmeric with black pepper and eating an organic well-balanced high in fiber and phytonutrient diet that is anti-inflammatory by nature. We had a discussion about whether she should take a multivitamin or not. Due to her incredible self discipline and ability to eat what she needed to for nutritional intake, we agreed that it would be safer for her to obtain all her vitamins from her foods since she was eating well and regularly without labs showing any indications of significant nutritional deficiencies. Her other significant lab findings included a salivary cortisol test prior to treatment coming back as mildly abnormal. However, after six months of this treatment, her repeat salivary cortisol test returned significantly improved.
While she opted not to take any other supplements for now, because she is a firm believer in getting her nutrients from the whole plant in its purest form via food, she has opted to take tamoxifen based on her own research of available online clinical data. She has been doing well with the combination of conventional and complementary therapies such that she feels "like myself again." Since then, she has helped her sister down the path of living, what she terms, "a well-balanced life." She has also worked as a volunteer at several non-profit cancer communities and support groups. By finding her own "balance," she is now helping others find there's. Above all else, she has tremendous hope for herself and her sister, and this is a hope she tries to bring to all others she encounters, even the other patients in my waiting room.
As I have had the tremendous pleasure and privilege to witness this patient's transformation from the fatigued and doubtful patient at the onset of our therapeutic alliance to her current state of vitality and optimism, I can't help but want to share her optimism with other patients who are coming into my clinic as she had first presented. By listening and empathizing with her concerns and creating a treatment regimen that resonated with her desire to utilize food, acupuncture, and mind-body techniques over an abundance of supplements, I was able to provide her with the tools so that she could build the foundation of her current fortress of health and hopefulness.
As a testament of the importance of how mental fortitude can lead to physical fortitude, the turning point for her transformation really began when she started the daily mind-body regimen at home and regular visits for acupuncture. She was able to find her "balance" enough to do the gluten elimination trial and to eat in a self-disciplined way such that her foods became her medicine.
Above and beyond her physical appearance of vitality, the normalization of her salivary cortisol test as well as her other lab parameters provided further evidence that strengthening of both her mind as well as her body allowed her to reach this place. As she continues to share her bright light of hope, having gone through battle herself, she has been an inspirational example of the beauty that emerges from treating both the body and the soul.
Educational References Regarding Nutrition and Cancer:
1. American Institute for Cancer Research, Nutrition and the Cancer Survivor, special population series, 2003.
2. American Institute for Cancer Research, Dietary Options for Cancer Survivors, 2002.
3. Brown J, Byers T, Thompson K, Eldridge B, Doyle C and Williams AM. 2001. Nutrition during and after cancer treatment: A guide for informed choices by cancer survivors, American Cancer Society Workgroup on Nutrition and Physical Activity for Cancer Survivors, CA Cancer J Clin, 51:153-187.
4. Byers T, Nestle M, McTiernan A, Doyle C, Currie-Williams A, Gansler T, Thun M and the American Cancer Society. 2002. Nutrition and Physical Activity Guidelines Advisory Committee. American Cancer Society guidelines on nutrition and physical activity for cancer prevention: Reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin, 52:92-119
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