CHAPTER 39
Complementary Alternative Medicine
Jessica Richards and Mark William Kissin
INTRODUCTION
Over the past 100 years, with the aid of surgery, radio therapy, hormone therapy, chemotherapy and immunotherapy, huge advances have been made in the fight against breast cancer. However, even now, not every patient is cured, and in addition some patients suffer from both the cancer itself and its treatment. Every attendant breast physician will, at some point in their career, come across a patient who has a wish to choose an alternative vision for their treatment. The correct approach, and one that satisfies ‘duty of care’, is for that physician to listen, inform, empathise and support such patients and help guide them along their chosen path. Such an approach may facilitate the combination of conventional therapy alongside the alternative measures.
The use of complementary and alternative medicine (CAM) by cancer patients is becoming more prevalent, with breast cancer patients being the most avid users. As many as 75% of breast cancer patients will be using some kind of CAM therapy. Some will seek CAM alone, with or without medical supervision, while others will want to use CAM in conjunction with biomedical treatments. Age, higher education and higher income are predictive indicators of CAM use. Information is gained via the internet, patient groups, access to online research, charities and private clinics.
Reasons for choosing CAM will include active cop ing behaviour, reducing side effects, increasing efficacy of biomedical treatment, enhancing quality of life and long-term survival, and fear or lack of trust in conventional medical treatments.
Interestingly, few patients will disclose CAM use to their medical team but most will readily discuss their medical treatment with their CAM practitioners and with online groups. Non-disclosure of CAM can be as high as 77%. Reasons for non-disclosure to oncology teams include the team is perceived as being unable to offer any added value to what patient already knows or the information the patient already has access to, initial hospital encounter with a specialist was unnecessarily harsh, uncaring or insensitive, fear or experience of ridicule and disrespect if subject is broached in a medical consultation, and fear or experience of being refused access to hospital if patient wishes to delay conventional treatment and discuss CAM.
Non-disclosure can result in potential damaging treatment interactions and unreliable drug data. With so many breast cancer patients choosing CAM, effective collaboration between doctors and patients is more relevant than ever (see Figure 39.1).
The following chapter lists the most popular CAM treatments, products and practices being used by breast cancer patients.
DIET-RELATED THERAPIES
Gerson Therapy (GT)
This was developed by Dr Max Gerson (1881-1959) with the intention of stimulating the body’s own immune defences while readjusting the balance of intracellular waste products. Once both parts of this equation are rectified, Gerson argued that the diseased body will be restored to full health. Although there is no doubt that this therapy has had some notable anecdotal success, there are no scientific data to support its use. The GT regime includes five coffee enemas per day, with extra castor oil ones on alternate days. The rest of the time is spent making and drinking vegetable juices for up to 2 years to fully cleanse the body. It includes a deliberate excess of minerals, enzymes and vitamins, while avoiding the toxic pesticides and herbicides present in conventional food by using only organic versions. Milk, soya and pulses are excluded. All water used for cooking or rinsing must be distilled or produced from reverse osmosis sources, plastic containers and aluminium foil are avoided, and all juices and vegetables must be consumed within 20 minutes of preparation. This is a quite punishing protocol and requires a single minded devotion by the patient.
Probiotics
The human microbiome, the foundation of the immune system, refers to the community of bacteria
WHO’S WHO
• Max Gerson (1881-1959): German-born American physician
• Johanna Budwig (1908-2003): German biochemist
• William Coley (1862-1936): American orthopaedic surgeon and ‘Father of Cancer Immunotherapy’
DOI: 10.1201/9781315115146-45
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