COMPLEMENTARY AND ALTERNATIVE MEDICINE and NUTRITION

COMPLEMENTARY AND ALTERNATIVE MEDICINE and NUTRITION An oncologist’s perspective Rob Rutledge MD FRCPC MAIN POINTS • Balance the rationale and intuition • Tell your doctor what your doing • Don’t forego proven treatments • Find peace with your approach PREVALENCE OF CAM • • • • General population - 46% at some time Breast cancer patients - 23% $27 billion annually Most common - herbals, megavitamins CONVENTIONAL MEDICINE • • • • • • Scientific method relies on proof Clinical trials Documentation of toxicity Doctor as therapist / consultant Risks vs. benefits Breast cancer - higher cure rates QUALITY OF EVIDENCE • • • • • • • DOES THE TREATMENT WORK? Randomized trials Comparison groups Case series Phase 1 - experimental Case reports Other CONVENTIONAL MEDICINE • • • • Time / financial restraints Lacks a fully holistic approach Will incorporate proven therapy Limited understanding WHAT IS CAM? • Complementary and alternative medicine • Covers many healing philosophies, approaches and therapies • Treatment / practices not taught or used in conventional medicine • Holistic - includes physical, mental, emotional and spiritual • Consistent with physiology? CLASSIFICATION OF CAM 1) Mind-body - yoga, psychotherapy, imagery, spiritual healing 2) Alternative system - oriental, indigenous, homeopathy, acupuncture 3) Lifestyle and disease prevention 4) Biologicals - herbs, phytotherapy, diets, nutrients, products CLASSIFICATION OF CAM 5) Manipulative / body-based : chiropractic, massage, breathing 6) Biofield - therapeutic touch 7) Bioelectromagnetics NATUROPATHIC MEDICINE • Emphasis of strengthening body’s ability to fight off cancer cells • “Cancer” forms as a result of body’s inability to heal itself, ie. strengthen immune system to fight cancer • Eg. toxins and lack of needed rest, exercises and diet • Holistic view - stress, lifestyle, etc • Use herbs, vitamins, etc HOW TO FIND OUT MORE • Ask your doctor?? • Go to the library • National Institute of Health http://nccam.nih.gov • Network DISADVANTAGES OF CAM • • • • • Expensive Often unproven / false claims Toxicities unknown Beware of your nutrition Safety / poorly regulated – New DIN number on all packaging • Guilt ADVANTAGES OF CAM • • • • • Practitioner gives more time Attention to emotional/spiritual Patient involvement and choice Touch Hope WHAT TO ASK YOUR CAM PRACTITIONER • • • • • • Credentials of practitioner/school Evidence of benefits of treatment (Be wary of the “cure-all”) Toxicity of treatment - documented? Benefit vs risks? What is the total cost? DOES CAM WORK? • Improves overall well-being, pain, nausea etc. • No proof of increased cures • Shark cartilage - $3000/ 3 months • National Institute of health - research • There is always hope SUMMARY OF CAM • Research and listen to your heart • Tell your doctor • Find a peaceful approach THE ROLE OF NUTRITION • Consult a professional nutritionist • Health Canada and recent data MAIN POINTS • Eating is meant to be pleasurable • Maintain a balanced diet • Decrease the fat to less than 20% of caloric intake • Increase fiber greater than 30g • Exercise and maintain healthy weight • Find a happy balance for you WHY NUTRITION IS IMPORTANT • Toxins in the diet can help cause cancer or make further changes to cancer cells • Certain nutrients can prevent damage to the cell • Good nutrition fuels the body’s immune system and improves overall health DOES A POOR DIET CAUSE CANCER? • Multiple factors contribute to developing cancer cells • Lab tests - cancer cells grow faster on fatty diets • High fat, low fruits/vegetables is bad • People with healthy diets also get cancer THE HEALTHY EATING PLAN • Variety from each food group each day • Choose lower-fat foods more often • Grains (5 servings) - wheat, oats, rye, rice, barley, millet, tapioca and buckwheat • Vegetables/Fruit (5-10 servings) THE HEALTHY EATING PLAN • Choose more often dark green or orange veggies and orange fruit • Milk products (3 servings) - lower fat • Meat/Alternatives (2-3 servings) • Choose leaner meats, poultry, and fish and dried peas, beans and lentils YOUR NUTRITIONAL NEEDS • • • • Energy, protein and vitamins/ minerals Supplements Fluids - 8 cups per day Fiber - 30g daily - legumes, fruits, vegetables, whole grains, nuts and seeds • Fat - 20% of food energy = 45-65g total fat THE FAT ISSUE • Polyunsaturated fats are good – vegetable oils (other than coconut and palm), – seeds and nuts, – fatty fishes such as salmon, trout, mackerel • Omega 3 and 6 fatty acids are polyunsaturates that our body can’t make • Omega 3 found in flaxseed, canola and soybeans, fatty fish and wheatgerm HOW TO LOWER FAT INTAKE • • • • • Prepare foods in ways that use less fat Limit the amount of fat put on foods Choose lower-fat forms of foods Shop better - read the labels Choose less saturated fats (<5% of calories) and more monounsaturated fats, ie, vegetable oils (canola, peanut, olive oils), nuts like almonds, hazelnuts and macadamia nuts THE VEGETARIAN ALTERNATIVE • Lower in fat and higher in fiber • With milk products - watch iron intake • If vegan (no animal products) watch your intake of protein, calcium, zinc and vitamin B12 • Takes time and planning GOOD FOOD / BAD FOOD • Oxidants - fat, smoking, lack of exercise ... damage the cell’s control center • Anti-oxidants prevent damage • Phytochemicals (from plants) – apples and onions and red wine • Isoflavones, ie, soy and genestein • Nutrients - vitamin A, C, E, beta carotene, selenium SUGGESTED ANTIOXIDANTS • Vitamin D 400ug / day • Folic acid • Selenium 200 ug / day • (calcium for everyone) NUTRITION SUMMARY • • • • Effective way to improve our health Do your research Enjoy - let food be a source of joy Questions • Canada’s physical activity guide – 1888-3349769 • Olive oil and canola are best as higher monounsaturates • Omega 3 – two to three servings per week. • Supplements – don’t take more than upper limit and watch what’s in your diet as well • Ca++ /vit D for everyone • Quack watch then medline