Comprehensive Cancer Care: Integrating Alternative, Complementary And Conventional Therapiesby James Gordon, Sharon Curtin
"This book represents truly pioneering work. It brings much needed information about the best of new cancer treatments to those who need it most and it does so with compassion and an inspired bedside manner."-Dean Ornish, M.D.Drawing on the studies and critiques of many of the world's most gifted researchers and clinicians, this book scientifically explores the
"This book represents truly pioneering work. It brings much needed information about the best of new cancer treatments to those who need it most and it does so with compassion and an inspired bedside manner."-Dean Ornish, M.D.Drawing on the studies and critiques of many of the world's most gifted researchers and clinicians, this book scientifically explores the most promising complementary and alternative therapies-and sifts through the often frustrating and confusing barrage of information and misinformation about them-to provide readers with the direction and help they need to create an individualized cancer-care strategy. Comprehensive Cancer Care includes reports on the most accepted and researched complementary and alternative practices, empowering advice for patients with clear action steps for speaking to doctors, and critical discussion of cutting-edge interventions.
- Da Capo Press
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- 6.09(w) x 9.28(h) x 0.90(d)
Read an Excerpt
In the Beginning ...
Sarah found a lump in her breast on May 1, 1995. As usual, she was doing several things at once: taking a shower, planning her day, and performing her regular monthly breast self-examination. Naked, slick with soap, she was thinking about how she could manage to shop for groceries, finish her project at work, and get the kids new sneakers all in that one day. Those few moments alone in the shower were the only time she had for herself; privacy and quiet were associated with the sound of running water, the smell of lavender soap, the smoothness of tile, and the pebbled glass door. When her fingers first found the lump, she hesitated, then probed the spot. She felt her body quiver, as if there had been an earthquake. She immediately thought, I don't have time for this.
That moment of discovery was a beginningand an end. It was the end of her peaceful and lavender-scented sanctuary, the end of her unquestioning and thoughtless confidence in her body. Once she felt this new thing in her breast, the shower became a cold tiled place, where the play of morning light in the water cast a shadow across her skin. She saw her hand groping for a towel and turning off the water. Her hand, her arm, her body, her breast, were suddenly unfamiliar and strange. I'm not ready, she thought. I don't want to begin this, not now.
Then came the doctors, the diagnostic tests, the biopsies; the search for information, options, resources, trustworthy experts. Sarah sat silently as her body was scanned by mysterious machines and watched as computers talked and technicians said nothing. She stared at the ceiling, naked to the waist, as white-coated strangers felt her breast and discussed her case. She felt vulnerable, as if every time her breast was bared she was being attacked. She tried not to think, not to feel fear. Don't borrow trouble, she chanted silently. Wait until you know. She smiled, nodded, chatted politely. Inside, she felt herself disappearing, erased and abandoned.
Finally, Sarah sat in her doctor's tasteful office and watched her husband's face turn white with shock as the physician talked about her cancer. She supposed she should comfort her husband, listen carefully to the doctor, ask thoughtful, quiet questions. But all she could think of was how woefully alone and unprepared she was. Panic smothered her, and she sat numb and silent, compelled to hide fear and unable to raise a single issue. It was as if she were only a spectator, standing outside and alone.
Even as she waved away the tissues offered and took her husband's hand, her mind locked on that word. Cancer. He said it was cancer. The word set loose an echo in her head, a wave of sound crashing against her skull. She reminded herself that she was a competent, practical woman. I may want to run screaming from the room, and I may resent that I have to think about other people right now, she thought, but I have to deal with this. Finally, the echo faded and she could hear the doctor's voice again.
The doctor, a surgical oncologist recommended by her family physician, spoke slowly, explaining the standard treatment for her stage of breast cancer. Surgery: a simple mastectomy, the removal of the breast and the lymph nodes in her axilla, or armpit, sparing much of the underlying muscle that is lost in a radical mastectomy. Radiation: local, precise radiation to eliminate any remaining cancer cells. Possibly chemotherapy, now or later, depending on what they found during surgery and on how she responded to radiation. Side effects? Minimal and tolerable. They, the cancer experts, would take care of this for her. This is what they knew, this is what must be done.
What can I do? Sarah asked.
Nothing. Just do what we tell you. Our experience shows really good results, and your particular diagnosis suggests a high likelihood of successful treatment.
Nothing? Sarah felt a gap opening between her and her caregivers. There was their realitya breast, a lump, a biopsy, the careful scientific studies, the surgeon's experienceand then there was Sarah. The disconnection widened and darkened as the oncologist labored to reassure his patient. He was highly skilled, a recognized expert in breast cancer. Everyone said so. She chose him, believed him to be the best available surgical oncologist.
It was tempting, maybe even easier, to adopt the doctor's viewpoint. He would actively perform and coordinate the best interventions medical science could offer. She just had to cooperate, show up, follow the plan, be a good patient. The oncologist spoke in a flat, cheerful voice that reminded her of high school health classes. He sounded censored, as if confined to some sanitized script. The bad news had the ring of truth, but the reassurances fell flat and false.
Sarah didn't speak of her uneasiness with the proposed treatment or with the way her doctor was talking to her. She wondered if her need for more help and information was something peculiar to her alone. The medical care she would receive would be the best, and she suspected that it was her own weakness that now demanded more.
Until now, Sarah had followed all the guidelines: regular physical examinations, mammograms, self-examination of her breasts each month. She knew early detection and treatment were important factors in successful cancer care, and indeed it seemed that she had found her tumor in a timely manner. Sarah tried to focus on the facts, the numbers, the survival rates, the chances of recurrence, the plans for long-term follow-up care. She noticed her husband's color returning and he began to nod sagely, asking a few questions. Everyone but the patient felt confident, she thought.
Sarah was appalled to hear her own voice echo that of her husband's, the quiet and polite response of agreement. They can always count on that, she thought. I respond appropriately, I do the right thing, I defer to the experts, I worry about everyone else and what they think. I want my family unworried, my doctor confident and sure, myself well behaved. This is not a melodrama, not a time for emotional overheating. I am a responsible, stable, intelligent, adult. She smiled and smiled and felt alone.
Sarah saw the doctor glance at his watch, absently moving her chart to the side. Well, she thought. He's finished, but it doesn't make sense. There must be something I should be doing. Even as the three of them stood, smiling and shaking hands like people ending a successful business transaction, she made a stubborn and silent vow: I must shake off the paralyzing numbness I feelI must find out ways to become active in my own care.
The decisions were made, the dates for hospital admission and surgery chosen. Sarah held the information packet in one hand and tried not to cling to her husband with the other. Yes, yes, she said. You may as well go to work. I have things to do. She saw his relief as he turned and moved away with that lanky stride she loved.
Without thinking she moved forward as if to stop him, her empty hand stretching out. As he turned to wave, she clenched her fist into a jaunty gesture, a mocking thumbs-up. I love you, he mouthed. Me too, she whispered.
But I won't stick my head into the sand, Sarah vowed. There has to be a better way to do this, some way I can connect with my body, my feelings, the people around me. I can't survive feeling so disconnected from an event, a moment as important as this. I've just been told I have cancer, and the news has emptied me out. I have to find a way to deal with the aftershock. The doctors can dismiss my concerns, and my family can expect me to cope with this efficiently. But I know I have to find a way to fill this awful emptiness and overcome the helplessness I'm feeling. I can't do nothing.
Sarah began her journey in a dark place, feeling alone and ignorant. Surgery, radiation, and possible chemotherapy seemed drastic and mutilating measures, agents of destruction, however necessary. To the doctor, these were ordinary and common procedures. To Sarah, they seemed to be frightening physical invasions that she was forced to endure.
Sarah wanted her physicians to recognize the threat their routine procedures posed to her body, to her. She wanted someone to give her permission to voice and feel her fears, someone to be there for her. She also wanted to discard the passive role encouraged by her doctors, to do something to help herself to feel better while the surgery, radiation, and chemotherapy attacked her tumor. She was desperate for ways to reconnect herself to her body and to her treatment. She remembered reading a book by Norman Cousins, years before, about his experience with a life-threatening illness. Take charge, he advised, in Anatomy of an Illness. Be involved, be responsible, do research, find out ways to take care of yourself.
That vague memory was the start Sarah needed. She began what she later called "supermarket research." Determined to overcome her own ignorance, she began gathering information like a student cramming for a final exam. She found books written by cancer survivors. She searched the Internet for information. She read magazine articles and struggled to comprehend professional medical journals. She tried to talk to her family physician about what she was finding out, but found her uninterested or uninformed. Just as the oncologist had dismissed her concerns, her own doctor saw no value in Sarah knowing so much about cancer or in the unconventional, alternative therapies Sarah asked her about.
Sarah felt stupid and even more vulnerable when her questions about acupuncture and herbal therapies to increase her immunity, dietary changes, vitamin and mineral supplements, and relaxation techniques were met with amused glances and dismissive shrugs. None of the doctors was interested in the books she read or the studies she found. Go ahead and waste your time and money, if it makes you feel better, they seemed to be saying, but surgery and radiation is the combination that will work. Science, not magic.
Still Sarah persisted with her research, feeling she was being driven underground. The specialists worked above, enlightened by science and technology, focusing solely on eradicating the cancer cells. Sarah was in a tunnel by herself, searching for ways to defend and protect and nurture herself, struggling to survive both the cancer and the cancer treatment.
Stubbornly, she began to incorporate some of the information she had gathered into her life. Even though she was initially unsure of the effects of some of the changes in lifestyle she made, it was clear that actively participating in her own care was importantat least to her. It felt as though she were trying to bring light to the dark shadows cast by her diagnosis and treatment. She employed techniques that seemed to help, quit trying to talk about it, and cooperated more or less cheerfully in the conventional treatment plan.
Sarah had a supportive family, her doctor was competent, and her medical insurance coverage was adequate. Five years after diagnosis, she calls herself a cancer survivor. However, she acknowledges that she still struggles with periods of bleak depression and worries about a recurrence of the cancer.
And she is still angry about being treated with condescension, about not being offered good information, and about not being helped to make use of an integrative treatment plan that would maximize her chances for survival and her own peace of mind.
From the time of her diagnosis, throughout her treatment, and afterwards, Sarah needed a guide, a source of information that would provide her with the basic tools she needed to be a partner, an active participant in her healing. She needed a map of an integrative treatment, one that combined the best of conventional oncology with the most reliable and the safest complementary medical approaches. She needed counseling about how to best mobilize her capacity for self-healing and where exactly to find the practitioners who could help her.
When Sarah finally came to talk to us, four years after her diagnosis, we provided support and guidance. We confirmed her hunch that physical exercise and periods of meditation were helpful to her. We worked with her to make sure her diet was designed to help prevent recurrences. We encouraged her to keep on exploring her feelings about the cancer and its treatment with her husband, to make sure they both stayed engaged with her careand with each other. We referred her to complementary and alternative practitioners who would help and to practices that might make a real difference in how she felt and perhaps, as well, in her chance for long-term survival. Now, in Comprehensive Cancer Care we offer this guidance, and those practices and practitioners, to you.
Coping with Cancer
In her doctor's office, Sarah felt fragile and frustrated, alone and uncertain. She needed far more help than she received. Still, she was soon making use of physical, mental, and emotional resources that would help her through her journey as a cancer patient. She approached her breast cancer as a problem, a natural disaster in her body, that must be understood, directly confronted, and managed. Although it was difficult, she did her best to seek guidance and information that allowed her to develop an integrated, supportive, and active strategy. Of course, not everyone responds to the news of cancer the way Sarah did.
There is, in fact, no "normal" way to respond to the diagnosis of cancer, or for that matter, to any threat or disaster. Numbness, self-pity, bad jokes, physical and emotional collapse, weeping, and outright denial are just some of the immediate defenses that we use. These are responses each of us has developed as protective measures, ways to call "time out" until we are ready to take more direct action. Many of us experience a sort of hyperawareness at such moments: Time seems to slow down or light becomes more intense or we become aware of some small detail with perfect clarity. Sarah, for example, could describe her reaction with total recall four years later. She remembered her tone of voice and even the color of the walls in the room, as she responded to the news of her cancer.
As time goes on our distinctive way of dealing with challenging and threatening situations, of "coping," emerges. Sarah's initial frozen acceptance gave way to determination, her shocked passivity to active engagement in her own care. She overcame her feelings of abandonment and isolation and reached out to her husband and, later, to friends and people who could help her find what she needed. Sarah was prepared, because of her intelligence and personality, to move through shock, assimilate the bad news, and make a personal decision to act. For Sarah, this approach, this way of coping, fueled and energized her search for integrative treatment.
Each of us has a particular way of coping with disaster. All of these responses appear to have certain consequences for our well-being as well as our behavior. And when it comes to cancer, the research suggests that our personal coping styles may have a direct and significant influence on outcome after diagnosis, on how well and how long we live.
Excerpted from Comprehensive Cancer Care by James S. Gordon, M.D. Sharon Curtin. Copyright © 2000 by James S. Gordon, M.D., and Sharon Curtin. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Meet the Author
James S. Gordon, M.D., author of Manifesto for a New Medicine, is the Chairman of the White House Commission on Complementary and Alternative Medicine Policy. A clinical professor of medicine at the Georgetown University School of Medicine, he is also director of the Center for Mind-Body Medicine in Washington, D.C., and creator of the Comprehensive Cancer Care Conference.
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