Comprehensive Cancer Care: An Integrative Care Clinic Perspective -
Effectively Targeting Cancer beyond the Treatment Phase
By Colleen Tetzlaff, DNP, FNP-C, AOCNP
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ntegrative cancer care brings together the best ideas and evidence from both conventional and comple- mentary and alternative medicine or so-called CAM. It is a more innovative and holistic approach to cancer which could prove critical to maximizing both quality and quantity of life. In applying the approach as an integrative practice, we like to break it down into phases of treatment because each phase represents a shift in how we might apply or utilize certain modalities or strategies.
Phases One and Two - Initial Diagnosis and Treatments for Cancer
As an integrative care practice, the earlier we see our patients the better; getting them stronger and healthier, sleeping better, and coping better with a multidisciplinary approach when needed. A great example of the influence of sleep on drug effectiveness was recently reported in Cancer Research showing that the popular drug Tamoxi- fen, utilized mainly in the post- treatment phase for breast cancer, worked much better when women slept soundly 7-8 hours in a very dark room and when the drug was taken at night instead of in the morning. Fascinating, and makes sense given that we are circadian creatures and need to be in proper rhythm to be in balance. This is why seeing patients as soon as possible after a diagnosis of cancer can be very helpful to shifting the body into anti- cancer mode so to speak, while addressing the founda-
tional pillars of the approach: diet/nutrition, stress man- agement, physical activity, and sleep patterns. During the conventional treatment phase for cancer
(i.e. surgery, chemotherapy, radiation) we are interested in maximizing outcomes through the utilization of modalities which take into consideration the biology of cancer in or- der to synergistically target the multiple aspects of cancer behavior and thereby effectively complement the medi- cal treatments. Modalities may include nutrition, targeted herbals and nutritional supplements, body work such as massage, energy work such as Reiki, acupuncture, and physical activity, along with assessment of and treatment for sleep problems and problematic coping patterns. These modalities must be expertly applied to be used in a syn- ergistic manner during the treatment phase to work well with whatever intervention is being utilized, again wheth- er that is surgery, chemotherapy or radiation therapies. At our practice, we utilize a team to guide these interventions and strategies. Personalized chemotherapy is something we often dis- cuss with patients. This approach, particularly in the set- ting of a cancer recurrence or more rare forms of cancer, offers a more effective approach to utilizing good cancer drugs, but personally applied to your cancer through what is called cytometric profiling, which measures apoptosis or programmed cellular death. This involves taking a sample of tumor, blood or bone marrow (depending on the type of cancer) and utilizing
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