AANP's Written Testimony to Senate HELP Committee Hearing on Cancer
CANCER: Challenges and Opportunities in the 21st Century
Written Testimony Presented to the Senate Committee on Health, Education, Labor and Pensions
May 8, 2008
Presented by, Lise Alschuler, ND, President, American Association of Naturopathic Physicians
My name is Dr. Lise Alschuler. I am a naturopathic physician with board certification in naturopathic oncology, currently practicing in the state of Arizona. Prior to opening my Arizona practice, I was the director of the naturopathic medicine department and naturopathic oncology residency program at Cancer Treatment Centers of America - Midwestern Regional Medical Center, a JCAHO-accredited hospital located north of Chicago. I am also the President of the American Association of Naturopathic Physicians.
I would like to thank the Committee for this opportunity to submit testimony for the record on how naturopathic medicine can support the challenges we face in preventing and treating cancer now, and in the future. The American Association of Naturopathic Physicians is the national professional association for naturopathic physicians in the United States, and is committed to transforming our health care system from one with an infrastructure designed to treat disease to one that is rooted in prevention and wellness. Naturopathic physicians are experts in the scientific application of natural healing. They graduate from 4-year naturopathic medical programs recognized by the U.S. Department of Education. Naturopathic physicians use scientifically based principles to guide their diagnosis and treatment, and provide individual and family health care, emphasizing the use of natural therapies. By using protocols that minimize the risk of harm, naturopathic physicians help facilitate the body's inherent ability to restore and maintain optimal health. We believe that it is the physician's role to identify and remove barriers to good health by helping to create a healing internal and external environment.
As the Committee has clearly noted, this country is facing the Perfect Storm for further explosion of cancer-related illness due to the aging of our population, increase in life expectancy, the numerous toxins in our environment and the lack of systemic intention to transform unhealthy behaviors of both the young and old. Naturopathic medicine, with its emphasis on empowering the individual and identifying the underlying causes of symptoms that result in chronic health conditions, including cancer, can and should be a major component of any new approach to redefining The War on Cancer.
The most effective way to control cancer is to prevent cancer. While diagnostic screening for many cancers is often an effective tool, naturopathic physicians serve our patients and the public by educating them on the impact of lifestyle factors on the prevention and treatment of cancer. We support comprehensive measures to protect the environment, including strict compliance with industrial, agricultural and occupational regulations, as well as full disclosure labeling of consumer products and foods. We encourage the Committee to support more research on the effect of carcinogens.
We offer our patients the highly effective strategies of diet, specific nutrients and exercise for the prevention of cancer. These influence the cancer process by stimulating the immune system, neutralizing potential carcinogens, enhancing cell maturation and generally creating a healthy environment which is not conducive to cancer growth. In addition, studies indicate that many non-toxic therapies including botanical medicine, homeopathy, positive visualization and nutrition holds promise for the treatment of cancer. Naturopathic physicians also play a key role in providing emotional support to patients with cancer. We are well trained in communication skills and statistically spend more time talking with our patients. This need is currently not being met by many conventional oncologists.
My expertise as a practicing clinician of 14 years is in integrative oncology, the responsible blending of complementary natural approaches and therapies with conventional strategies and treatments for cancer. This integrated system examines all health promoting treatments and then uses those that are most beneficial for the patient. The goal of integrative oncology is to enhance the quality of life and to promote deep healing to the mind, body and spirit for those patients. Thus the cornerstone of integrative oncology is the combination of evidence based tools and approaches with an enhanced patient-doctor relationship. Integrative oncology includes a woman with breast cancer who, while receiving chemotherapy, utilizes natural supplements to minimize the adverse toxicity of the chemotherapy agents. Integrative oncology also includes a man with prostate cancer, who while being monitored in a ‘watchful waiting’ manner by his conventional physician, seeks naturopathic care to receive dietary, nutritional supplement, herbal and other lifestyle recommendations to prevent and delay cancerous growth. Many patients are demanding integrative treatment. Recent estimates suggest that between 69% and 88% of all patients diagnosed with cancer will utilize both conventional and complementary natural therapies.1 2 3
Cancer is the result of many contributing interdependent factors collaborating over a typically long period of time. We cannot identify a single cause of cancer but we can identify cancer-causing agents (carcinogens) and cancer promoting activities that work together to encourage the development and spread of cancer. The majority of the causes of cancer is considered modifiable and includes:4
- 35% due to lifestyle: diet, physical activity and obesity
- 30% due to smoking
- 25% due to exposure to environmental and occupational pollutants
- 10% due to genetic factors
The typical western diet promotes obesity and contributes to the development of cancer. Recent studies have confirmed that obesity is responsible for one in six cancer deaths in the United States.5 Excess weight contributes to the development of cancer. The more liquor consumed, the higher the risk of developing cancers of the mouth, larynx, esophagus, liver, colon and breast.6 The lack of regular physical activity is another risk factor for cancer development.7 Conversely, implementation of a regular exercise program reduces the risk of cancer development and cancer recurrence.8 Every cancer prevention and treatment initiative in this country should include guidelines on healthy eating, physical activity and weight control.
Cigarette smoke is a risk factor for cancers of the lung, bladder, breast and leukemia. Lead exposure even at low levels is linked to an increase risk of childhood cancers. The water we drink contains carcinogens such as trihalomethanes (THMSs). Soft drinks contain the potent carcinogen benzene linked to leukemia and other cancers, sometimes at levels up to 10 or 20 parts per billion. This is four times the acceptable limit in drinking water. A number of other organic pollutants found in pesticides, insecticides and as a by-product of incinerated waste also are prevalent in our food, water and air.9. A successful cancer prevention and treatment program should include public health and education programs as well as revised and enhanced environmental pollution regulations.
People who have been diagnosed with cancer deserve access to all safe and effective therapies both conventional and complementary. An integrative treatment plan should be endorsed by their health care practitioners and healthcare institutions. This plan might include standard conventional therapies such as surgery, radiation, biologic and molecular agents and also dietary supplements, herbal therapies, massage, acupuncture, naturopathic medicine and psychological support. The National Center for Complementary and Alternative Medicine within the NIH defines complementary and alternative medicine domains as:10
- Biologically based practices (focused on the use of herbs, dietary supplements, and foods)
- Mind-body medicine (including support groups, prayer, and meditation)
- Manipulative and body-based approaches (massage, chiropractic and other manual therapies)
- Energy medicine (therapies such as qigong and Reiki)
- Alternative medical systems (Traditional Chinese medicine/acupuncture, Ayurvedic medicine, Naturopathic medicine and Homeopathy)
Incorporation of Complementary and Alternative medicine into cancer care complements conventional cancer treatment, offsets adverse toxicities of conventional medicine, and strengthens the body's natural healing ability. A growing body of evidence in support of integrative oncology treatments indicates that incorporation of complementary treatment is both safe and effective. Additionally, a vast majority of people diagnosed with cancer want to use integrative treatments. A patient's bill of rights regarding their cancer treatment should support the accessibility of qualified integrative practitioners and evidence-based natural and complementary therapies.
Collaboration is becoming the new cornerstone of cancer care. Cancer prevention and treatment will then encompass the best of conventional and complementary medicine to support the proactive efforts of the patient to make healthy lifestyle choices. This is integrative oncology; this is an integral part of any and all strategies for the future of cancer care for generations to come.
Dr. Alschuler has been a practicing naturopathic physician for 14 years. She received her doctorate in naturopathic medicine from Bastyr University in Seattle WA, where she also completed a post-graduate residency. Her undergraduate degree is from Brown University in Providence R.I. where she received a B.S. in Medical Anthropology with Honors. In September 2000, she was named by Seattle Magazine as one of Seattle’s Top Doctors. She was formerly the clinic medical director and associate professor at Bastyr University Center for Natural Health in Seattle, WA. She has also authored many articles in professional and popular press publications and has co-authored Definitive Guide to Cancer: An Integrative Approach to Prevention, Treatment and Healing (Celestial Arts, 2007). Dr. Alschuler is also on the Board of Medical Examiners for the American Board of Naturopathic Oncology and was a founding Board member of the Oncology Association of Naturopathic Physicians from 2004-2007. Dr. Alschuler is licensed as a naturopathic physician in Arizona and Washington states.
1. Barnes, P et al. Complementary and alternative medicine use among adults: United States, 2002. Advance Data, 2004;343:1-19.
2. Fred Hutchinson Cancer Research Center. 2002. More than 70 percent of adults with cancer use alternative therapies: Nearly all report improved sense of well-being. Fred Hutchinson Cancer Research Center home page, September 4, 2002. www.fhcrc.org/about/ne/news/2002/09/04/alternative.html (accessed November 15, 2006).
3. Richardson, MA et al. Complementary/alternative medicine use ina comprehensive cancer center and the implications for oncology. Journal of Clinical Oncology, 2000;18(13):2505-14.
4. Lee B, Park K. Beneficial and adverse effects of chemopreventive agents. Mutat Res. 2003;523-524:265-78.
5. Calle E. et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. New England Journal of Medicine. 2003;348(17):1625-38.
6. Boffetta P, Hashibe M. Alcohol and cancer. Lancet Oncology. 2006; 7(2):149-52.
7. Michaud D, et al. Physical activity, obesity, height and the risk of pancreatic cancer. Journal of the American Medical Association, 2001;286(8):967-68.
8. Holmes M, et al. Physical activity and survival after breast cancer diagnosis. Journal of the American Medical Association, 2005;293(20):279-86.
9. American Cancer Society. Special section: Environmental pollutants and cancer. In Cancer Facts and Figures 2006, 2006;22-31.
10. National Center for Complementary and Alternative Medicine. What is complementary and alternative medicine. 2006. http://nccam.nih.gov/health/whatiscam/#4 (accessed November 17, 2006).