Some, including St. John’s wort, which is used to ease depression, interfere with the liver’s ability to metabolize medications. Others, such as ginkgo, are anticoagulants that can lead to uncontrolled bleeding in patients undergoing surgery. That’s why one key role integrative programs play is warning patients away from things that might harm them—no easy task given the proliferation of unsubstantiated claims on the Internet and the ready availability of many supplements.
“We spend half of our time working against quackery,” says Cassileth. “It’s really a bad situation. What patients see on the Internet is extremely seductive.” To counter the wave of unsubstantiated claims, both M.D. Anderson and Memorial Sloan-Kettering maintain websites that offer the latest research findings on hundreds of purported cancer therapies.
Search for evidence
For most therapies, definitive evidence is hard to come by. Researchers are keenly interested in curcumin, for example, a botanical that has been used for a long time in Ayurvedic medicine, a healing system of India. “We know it’s extremely safe even at high doses. What we don’t know yet is whether it’s effective,” says Cohen. Researchers at M.D. Anderson are currently studying its use for multiple myelomas and rectal cancer.
Researchers are also interested in medicinal mushrooms from traditional Chinese medicine. Widely used in China for centuries, they appear to be safe, and laboratory evidence suggests that they may act against cancer cells. But proof that they fight the disease in patients will take time—something many cancer patients don’t have. “My approach is, if something is safe and there’s a chance that it may help, why not encourage patients who are interested to give it a try?” says Donald Abrams, M.D., who directs research at the Osher Center for Integrative Medicine at the University of California, San Francisco.
Indeed, doing something, anything, may have healing powers of its own. “Cancer patients feel helpless. Their bodies are turning on them,” says psychiatrist David Spiegel, M.D., who directs the Stanford University Center for Integrative Medicine. “To the extent that we can give them a sense of power, of control, we can improve their quality of life and, I think, perhaps even affect the course of the disease.”
Reducing levels of stress hormones in the body, some experts believe, may also reduce inflammation and promote healing. “We’re more and more aware that inflammation is damaging in many ways,” says Abrams. “By decreasing it, we think we may be able to boost the body’s fight against cancer. I don’t think stress is a major cause of cancer. But I think stress hormones may make cancer more aggressive. So anything we can do to reduce stress may help.”
Therapies offer hope
One of Abrams’ patients, a 76-year-old retired associate professor of medicine at Mount Sinai School of Medicine in New York, has metastatic kidney cancer. Along with a strict diet that eliminates meat, dairy products, and refined sugars, he goes in once a week for reiki therapy, which proponents claim can focus healing energies within the body. “I say to myself, unless these are going to hurt me, I don’t see what I have to lose,” says the doctor, who asked that his name not be used. “I’m sitting here waiting with this metastatic cancer. It makes me feel better to be doing something. Do I hope it will help slow the disease? Of course I do.”
And hope, integrative oncologists say, may be potent medicine.
“The concept of hope and a fighting spirit, how powerful can that be in fighting cancer? We don’t know,” says Gary Elkins, director of the Mind Body Medicine Research Laboratory at Baylor University in Waco, Texas. “But we do know that there’s a very strong placebo effect in medicine. If a patient believes something will work, it often does. Researchers try to rule out the placebo effect in studies of drugs. But if you’re in the business of caring for patients, if something works, we should use it.”