The Role of Naturopathic Doctors in Integrative Oncology
Cancer causes more deaths each year in the U.S. than any other diagnosis besides heart disease (cancer.org). In Maine and for women and men aged 45-64, it’s the leading cause of death each year. Approximately 38% of the U.S. population will be diagnosed with cancer at some time in their lifetime. Cancer affects us all, in one way or another.
What is Integrative Oncology?
Per Stephen Sagar, MD in 2006, “Integrative oncology combines the discipline of modern science with the wisdom of traditional healing. It is an evolving evidence-based specialty that uses complementary therapies in concert with medical treatment to enhance its efficacy, improve symptom control, alleviate patient distress, and reduce suffering.” In my opinion, integrative oncology incorporates CAM (complementary and alternative medicine) with conventional treatments, utilizing evidence-based therapies, in a safe and effective manner.
Conventional cancer treatment falls short when it comes to addressing a patient’s quality of life throughout aggressive treatments. Medical management of treatment side effects and nutritional guidance and support is lacking. The treatments recommended to address side effects often come with additional side effects or intolerances. Patients increasingly seek out alternative and complementary medicine options to help manage their cancer diagnosis and treatment.
Most conventional medical providers lack the time and/or training required to effectively guide curious patients seeking complementary therapies. Although natural therapies are generally low-risk or safe, interactions with cancer treatment may occur. Indiscriminate and unguided use of natural therapies may result in unintended consequences or harm.
Naturopathic Doctors to the Rescue
Licensed naturopathic doctors (ND) receive training in both modern science and natural medicine from accredited naturopathic medical schools. They emerge well-versed in the use of botanical medicine, homeopathy, diet/nutrition, nutraceuticals/supplements, psycho-immunology and other complementary and alternative medical therapies and techniques. NDs specializing in naturopathic oncology understand standard cancer treatments employed by medical oncologists and how best to work with them in an integrative model of care. They provide guidance on the safe and effective use of natural therapies.
Since 2006, the American Board of Naturopathic Oncology has conferred board-certification in naturopathic oncology to licensed naturopathic doctors. FABNO (Fellow of the American Board of Naturopathic Oncology) certification requires additional training and experience in integrative oncology as well as successful completion of a written exam. Eligible candidates must have at least five years of experience practicing as a naturopathic doctor or have completed a two-year oncology residency. Since 2006, 100 NDs have attained FABNO status in the U.S. and Canada, demonstrating experience and specialization in integrative oncology.
| NUNM* | Yale Med | |
|---|---|---|
| Basic and Clinical Sciences | 1548 Hrs | 1420 Hrs |
| Clerkships and Allopathic Therapeutics | 2244 Hrs | 2891 + thesis |
| ND Therapeutics | 588 | 0 |
| Therapeutic Nutrition | 144 | 0 |
| Counseling | 144 | Psychiatry (incl above) |
ADAPTED FROM NATUROPATHIC.ORG
*NUNM: NATIONAL UNIVERSITY OF NATURAL MEDICINE
NDs/FABNOs combine nutritional and dietary counseling with the use of high-quality herbs, pharmaceutical grade nutritional supplements, and homeopathy to achieve desired health goals. The addition of lifestyle and mind/body support provides a comprehensive and holistic approach. Despite statements to the contrary, a large body of research exists supporting the safe and effective use of natural agents in the setting of cancer. FABNOs are well-versed in this data and evidence and rely on it for their recommendations. NDs provide individualized recommendations taking into account the specific diagnosis and personal health history, social and environmental factors, and the mental/emotional/spiritual realms for each person.
The Role of NDs in Integrative Oncology
Naturopathic doctors provide support in three broad spheres of influence:
Prevention
Naturopathic medicine is uniquely positioned to provide true preventative care. Generally, preventative medicine, as practiced in conventional care, screens for the presence of disease through early detection and then the preemptive use of medications. In naturopathic medicine, the active avoidance of disease development defines prevention.
Everyone carries a unique set of circumstances influencing their risk for developing cancer. NDs assess family history, hormone status, environmental exposures, lifestyle and behavioral risks, and genetic predisposition to provide targeted recommendations for cancer prevention. Recommendations may include diet, lifestyle, stress management, and supplements.
Active treatment
NDs specializing in integrative oncology provide effective therapies to support individuals undergoing cancer treatment. The recommendations are researched to ensure no interaction with a specific treatment or cancer type. Common treatment side effects that may be improved or prevented include:
- Mouth sores, Taste Changes
- Nausea
- Indigestion
- Bowel changes
- Neuropathy
- Fatigue
- Radiation Burn
- Insomnia
- “Chemo-brain”
Other recommendations may enhance the cancer-fighting potential of conventional treatments as shown in research studies. Much of this data remains preliminary, but some small human trials have demonstrated benefit when natural therapies are combined with chemotherapy, radiation treatment, and hormone therapy. In addition, naturopathic doctors offer support to ensure the highest quality of life, as defined by each person. Support often includes nutritional guidance, relaxation/stress management techniques, and mind/body support with supplements.
Finally, NDs support individuals undergoing surgery as part of their treatment plan. Specific natural therapies have been shown to reduce complications and improve recovery from surgery. It is important to ensure safe timing of the supplements as some may be contraindicated if taken too close to the time of the surgery.
Post-treatment
After conventional treatment, patients seek the guidance of experienced NDs to address post-treatment health issues, support gentle/appropriate detoxification, establish optimal health, and for the prevention of recurrence. Ideally, everyone beginning chemotherapy would be under the care of an oncology-experienced ND for targeted support. However, that is often not the case. Individuals experiencing lingering adverse effects from treatment including; lymphedema, neuropathy, and “chemo-brain” would benefit significantly from naturopathic medicine. In addition, for some a gentle detox program following treatment may be beneficial. Ensuring that the detox is gentle and doesn’t result in malnutrition which may already be present after chemotherapy is of critical importance. Seeking a provider well-versed in the nuances of post-cancer treatment results in the best outcome.
NDs/FABNOs guide patients on effective cancer prevention strategies. These may include dietary changes, behavioral changes, specific nutraceutical recommendations, and addressing factors contributing to the original cancer diagnosis, if known. Again, working with an evidence-based ND/FABNO is crucial to avoid the avalanche of mis-information bombarding us daily and to find the needles in the haystack to benefit each individual and their specific situation.
NDs for Education and Safety
A key role for FABNOs/NDs is education. The internet, while in many ways a great tool, is also full of misinformation, misguided “experts”, and sometimes outright fraudulent scams. In the setting of cancer, these aspects of the internet move from annoying to potentially life-threatening. When mis-information results in treatment delay or avoidance, people suffer. FABNOs investigate internet claims to determine if they’re based on research, if they make biological sense, and to guide individuals to make educated decisions about treatment. In addition, the risks and benefits of all treatment options are discussed with each person to facilitate a truly educated decision. My goal as an expert in integrative oncology is to ensure that each person receives the most effective and safe, treatment plan possible, to beat their cancer and to do so with the highest quality of life possible.
Renée Lang, ND, FABNO, MPH is licensed as a naturopathic doctor in the state of Maine and is board certified in naturopathic oncology (FABNO). She received her naturopathic doctorate from National College of Natural Medicine in 2003 and holds a B.S. in Conservation and Resource Studies from the University of California at Berkeley. As a Reiki Master and Shamanic practitioner, Dr. Lang has been incorporating these healing techniques in her since 2002. Dr. Lang currently sees patients at her office in the Parkview Office Building in Brunswick, ME. From 2009-2013 she worked as a naturopathic oncology consultant at the Cancer Treatment Centers of America (CTCA) in Philadelphia. While at CTCA, Dr. Lang provided integrative naturopathic care to thousands of individuals with cancer. Visit: www.reneelangnd.com or email: info@reneelangnd.com for more information or to schedule an appointment.
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