Breast Cancer: Beyond Convention: The World's Foremost Authorities on Complementary and Alternative Medicine Offer Advice on Healingby Isaac Cohen
Breast Cancer: Beyond Convention is the only single resource that lays out all of the traditional and alternative approaches available today. Assembling a "dream team" of breast cancer experts, the editors/i>/b>
Today, more breast cancer treatment options are available than ever before. But how can you determine the course of action that is right for YOU?
Breast Cancer: Beyond Convention is the only single resource that lays out all of the traditional and alternative approaches available today. Assembling a "dream team" of breast cancer experts, the editors of this truly groundbreaking guide encourage readers to work with their practitioners as they consider a variety of approaches, all explained in clear, nontechnical language. Readers will discover
- how to find the right caregiver and how to best complement conventional medical treatment with alternative medicine
- how to be "healed" without necessarily being "cured"
- how to incorporate traditional Chinese medicine -- including herbs, qigong, and acupuncture
- the right diet to choose, no matter the form of treatment; the importance of soy products; plus fifteen delicious recipes to sample
- the best vitamins, minerals, and natural foods, and the specific benefits -- and possible dangers -- of each
- the merits of spiritual treatments, from meditation and directed prayer to the powerful mystery of the "will to live."
The guide features an encyclopedic appendix of websites, and lists of national support organizations, care centers, recommended audiotapes, CDs, and books -- making this the single source to help patients take control of their treatment, assuage their fears, and get them on the road to healing.
A portion of the proceeds from the sale of this book will be donated to the Carol Franc Buck Breast Care Center Complementary and Alternative Medicine Program at the University of California, San Francisco
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Read an Excerpt
I am delighted to write a foreword for this pioneering book on breast cancer. These wonderful essays span the entire range of options from conventional to alternative. Each author has made profound contributions to the medical community, and the expertise and experience they share in this book may help provide you with new hope and new choices.
They address not only the physical but also the psychological, emotional, and spiritual dimensions of curing and healing, suffering and transformation. Indeed, this book embodies an integrative approach that is both wise and far-reaching. Each contributor offers a different voice and point of view. Not all may be useful to you, and not all may ultimately be proved correct, but I hope you find them to be as interesting as I have.
Anyone who is faced with a life-threatening illness such as breast cancer has a natural tendency to want to get as much information and to do everything possible to get better. It is becoming increasingly apparent that while traditional Western, allopathic medicine (primarily chemotherapy, radiation, and surgery) offers much value and hope to people with breast cancer, many other options are also available. All systems of healing have limitations.
The problem is making sense of these myriad choices, which can feel especially overwhelming when a person is ill and in emotional and spiritual turmoil. Reading this book is like having a wise friend by your side.
I am a scientist as well as a clinician because I believe in the power of science to help sort out conflicting claims and to distinguish fact from fancy, what sounds plausible from what is real, what works and what doesn't, for whom, and under what circumstances.
Indeed, that is the whole point of science. As Tom Cruise playing Jerry Maguire might say if he were a scientist, "Show me the data!" The peer-reviewed scientific process is about people challenging each other to demonstrate scientific evidence, not just their opinions or beliefs, to support their positions. Dr. Denis Burkit once wrote, "Not everything that counts can be counted" and not everything meaningful is measurable, but much is.
The question is not "Should Americans seek out alternative medicine practitioners?" because so many already are. Although there is relatively little hard scientific evidence proving the value of most alternative medicine approaches, several studies have revealed that as much money is spent out of pocket for complementary or alternative medicine as for traditional physicians' services. In most cases, these decisions are being made with inadequate scientific information to make informed and intelligent choices.
The editors of The New England Journal of Medicine stated, "There cannot be two kinds of medicine conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted."
But this presumes that funding is available to rigorously test complementary medicine. Also, conventional approaches such as drugs and surgery are not always held to the same scientific standards. Although research in alternative and mind-body medicine is important, it is often very difficult to obtain funding to do these studies. In my experience, it is often a catch-22: many funding agencies presume that these approaches have little value, so they are reluctant to fund studies to determine their effectiveness; yet, one cannot assess their effectiveness without funding to do the research. The National Center for Complementary and Alternative Medicine at the National Institutes of Health (NIH) is a good start, but it still provides only a fraction of the overall NIH budget.
Thus, just because data are not available does not mean an alternative treatment is ineffective, only that we don't yet know. The presumption that unstudied approaches have no value is itself unscientific until these approaches are scientifically studied and tested. At the same time, just because someone believes in the efficacy of their treatment doesn't mean it really works.
The medicine of the twenty-first century should integrate the best of traditional allopathic medicine and of complementary or alternative medicine. Our research has demonstrated that an integrated approach can be both medically effective and cost effective.
We tend to think of an advance in medicine as a new drug, a new surgical technique, a laser something high-tech and expensive. We often have a hard time believing that the simple choices we make each day in our lives for example, what we eat, how we respond to stress, whether or not we smoke, how much exercise we get, and the quality of our social and spiritual relationships can make such a powerful difference in our health and well-being, even our survival. But they often do.
When we treat these underlying issues, we find that the body often has a remarkable capacity to begin healing itself and much more quickly than had once been thought possible. But not always. On the other hand, if we just bypass the problem, literally with surgery or figuratively with drugs, without also addressing these underlying causes, then the same problem may recur or new problems may emerge. Often it can feel like mopping up the floor around an overflowing sink without also turning off the faucet.
For the past twenty-four years, my colleagues and I at the nonprofit Preventive Medicine Research Institute have conducted a series of scientific studies and randomized clinical trials demonstrating that the progression of even severe coronary heart disease can often be reversed by making comprehensive changes in diet and lifestyle, without coronary bypass surgery, angioplasty, or a lifetime of cholesterol-lowering drugs. These lifestyle changes include a very low-fat, plant-based, whole-foods diet; stress management techniques; moderate exercise; smoking cessation; and psychosocial support. We have published our findings in peer-reviewed medical and scientific journals.
Our work is a model of a scientifically based approach that may be helpful to others in building bridges between the alternative and conventional medical communities. The idea that heart disease might be reversible was a radical concept when we began our first study; now, it has become mainstream and is generally accepted as true by most cardiologists and scientists. In our research, we use the latest high-tech, expensive, state-of-the-art medical techniques such as computer-analyzed quantitative coronary arteriography and cardiac position emission tomography to prove the power of ancient, low-tech, and inexpensive alternative and mind-body interventions.
I think we may be at a similar place with respect to the evidence linking diet and lifestyle with breast cancer, prostate cancer, and colon cancer to where we were in 1977 when we began studying coronary heart disease. There are data from animal studies, epidemiological surveys, and anecdotal case reports in humans suggesting that diet and lifestyle choices may play a role in the development of these illnesses. For example, the incidence of clinically significant prostate, breast, and colon cancers is much lower in parts of the world that eat a predominantly low-fat, whole-foods, plant-based diet. Subgroups of people in the United States who eat this diet also have much lower rates of these cancers than those who eat a typical American diet. However, randomized controlled trials have not yet been completed to see whether altering the diet may influence the progression of cancer. Many of these trials are currently under way.
Diet is only part of the story. For example, a randomized controlled trial of women with metastatic breast cancer has shown that women who received group support lived twice as long as those in the control group. Other studies have shown that people who feel lonely, depressed, and isolated are many times more likely to get sick and die prematurely than those who have a strong sense of connection, community, and intimacy.
In 1997, we began a randomized controlled trial in collaboration with Dr. Peter Carroll at the University of California, San Francisco, and Dr. William Fair at Memorial Sloan-Kettering Cancer Center to determine whether prostate cancer can be affected by comprehensive changes in diet and lifestyle, without surgery, radiation, or drug (hormonal) treatments. Men with biopsy-proven prostate cancer who have elected not to be treated conventionally ("watchful waiting") were randomly assigned to an experimental group that was asked to make comprehensive lifestyle changes or to a control group that was not.
We have the opportunity to determine the effects of diet and comprehensive lifestyle changes on prostate cancer without confounding variables a study that would not be ethically possible in breast cancer, colon cancer, or related illnesses. Whatever we show, the data may be of wide interest.
While it would be premature and unwise to draw any definitive conclusions from a study that is still in progress, our preliminary data are encouraging. An increasing number of scientists believe that what affects prostate cancer will likely affect breast cancer as well, so research in one area has direct implications for the other.
The authors of this book describe numerous innovative research strategies that will begin the process of illuminating the scientific and clinical basis of many alternative modalities that have been used for centuries or, in some cases, formulated more recently on the basis of theory and the observations of seasoned clinicians. It will require tenacity and imagination to adapt the investigative process to the individualized nature of alternative medicine while maintaining scientific validity.
Clearly, more good science is needed. What to do in the meantime?
In choosing any therapy, one considers what is called the risk/benefit ratio. In other words, if the risk is small and the potential benefit is great, then it is probably a choice worth making.
I suspect that the optimal treatment for breast cancer and prostate cancer will integrate the best of conventional and complementary therapies. For example, there is a significant risk of recurrence after the surgical removal of breast cancer or prostate cancer, even if it seems that the tumor was localized at the time of surgery, because of microscopic metastases. In this context, even though the data are not conclusive that changes in diet and lifestyle affect the progression of breast cancer or prostate cancer, there is enough evidence to suggest that they might.
Since the only side effects of eating a low-fat, whole-foods, plant-based diet (along with exercise, meditation, and support groups) are beneficial, one can make a persuasive case that it would be prudent to do all of these practices in addition to conventional treatments when these are chosen. Some alternative interventions do have risks, so one needs to exercise caution in these areas as well. Clearly, more scientific research is needed. This book can help you to find the right balance in making difficult choices.
Dean Ornish, M.D.
Founder and President, Preventive Medicine Research Institute
Clinical Professor of Medicine,
University of California, San Francisco
Copyright © 2002 by Mary Tagliaferri, M.D., L.Ac., Debu Tripathy, M.D., and Isaac Cohen, O.M.D., L.Ac.
Meet the Author
Mary Tagliaferri, M.D., L.Ac. (center), is one of the founders of the Complementary and Alternative Medicine Program at the University of California, San Francisco's Carol Franc Buck Breast Care Center. She opened the first traditional Chinese medicine clinic at UCSF and has lectured extensively on alternative therapies for treating breast cancer. She is also a breast cancer survivor.
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