The United States Census Bureau projects that between 2000
and 2030 the number of Americans 65 years old or older will
double.1 The aging of our population, combined with many
other factors, will likely contribute to a corresponding increase
in serious illnesses such as cancer. In fact, it is now estimated
that 1 in 2 men and 1 in 3 women will develop cancer in a
lifetime.2 Concurrently, an increasingly high number of individuals
are living beyond their prognosis. In 2007, more than
11.7 million people were living with a history of cancer.3
Cancer continues to put a strain on our healthcare system,
not only in terms of increasing prevalence but also increasing
costs per individual. A recent report published online in the
journal Cancer indicated that the cost to treat cancer has nearly
doubled in the past 20 years.4
Additionally, if we remain on this course, the number of people diagnosed with cancer will soon far outweigh the number of oncologists available to treat them.
Additionally, if we remain on
this course, the number of people diagnosed with cancer will
soon far outweigh the number of oncologists available to treat
them. Data from Erickson and colleagues published in 2007
pointed to a projected shortage of more than 4,000 oncologists
by the year 2020.5 The conclusion based on the data was that “a
multi-faceted strategy will be needed to ensure that Americans
have access to oncology services in 2020. … Among the options
to consider are increasing the number of oncology fellowship
positions, increasing use of non-physician clinicians, increasing
the role of primary care physicians in the care of patients in
remission, and redesigning service delivery.”6
Primary care physicians may be able to fill some of the gaps
now emerging in cancer care. Primary care physicians can help
manage side effects and after effects of conventional treatment,
counsel patients on diet, and provide practical lifestyle advice
that can enhance survivorship and help prevent a recurrence.
As it turns out, the increasing prevalence of cancer as a chronic
disease provides an increasing opportunity for the primary
care physician. This could also be good news for the patient.
For example, preliminary research shows that utilization of
primary care in the early phase of lung cancer treatment reduced
mortality risk.7
The 17th International Symposium on Functional Medicine
was designed to engage the primary care community in
integrative cancer treatment. In his opening presentation,
Jeffrey Bland, PhD, FACN, CNS, who founded the Institute
for Functional Medicine with his wife Susan, asked the question
“How can we deliver better care to our patients?” To a sell-out
crowd of doctors, nurses, and other healthcare professionals,
featuring a large number of primary care providers, Bland and
the other expert presenters attempted to teach how functional
medicine can play a role in cancer care. “We need to look at the
soil in which these oncogenes can grow,” says Bland. “For many
patients, cancer has become a chronic disease that demands
long-term management.”
Symposium Highlights
The four-day event (May 20–23, 2010) provided a wide range
of information to an audience of healthcare professionals from
21 different countries. The large international interest may be
indicative of a growing global interest in functional medicine
and innovative thinking surrounding integrative oncology.
During her presentation, Mary Hardy, MD, medical director
for the Simms/Mann–UCLA Center for Integrative Oncology,
told the audience that patients with cancer visit the doctor
twice as often as other patients. She explained that the primary
care physician (PCP) often takes a step back during cancer
treatment; however, there is a need for PCPs to step forward
and play a more active role with their cancer patients.
Hardy, who was on the development panel for the symposium
said, “Our goal was to empower IFM/IM primary care
physicians to do the things they already know how to do well.
This will give the cancer patient the best blend of conventional
and complementary care leading to the best outcomes and least
toxicity.”8
The focus of the symposium was to view cancer as a chronic
disease and then address issues associated with the care and
healing from this illness. Some key topics included
• oncogenetic expression;
• genetics, epigenetics, and environment;
• antioxidants;
• confusion about vitamin D;
• diet and lifestyle;
• offsetting side effects of conventional treatments; and
• enhancing conventional treatments via an integrative approach.
This is the first time that the Institute for Functional Medicine
tackled the issue of cancer care in one of its symposia. “This
conference really brought together some of the best clinical
practitioners in integrative oncology,” said Tina Kaczor, ND,
FABNO, senior medical editor of the Natural Medicine Journal,
who also attended the symposium.
“I was pleased to see that several of my colleagues who are
Fellows of the American Board of Naturopathic Oncology—
specifically Lise Alschuler, Tim Birdsall, Paul Reilly, and Dan
Rubin—were speakers at this event,” said Kaczor. “I think
naturopathic oncology has a lot to offer in terms of focusing on
the patient and using natural agents that benefit our patients
throughout their course of treatment. Our education makes
us uniquely positioned to understand and integrate various
modalities to improve each patient’s quality of life, as well as
affect their risk of recurrence.”9
Each morning of the symposium Bland provided a synthesis
of the information presented the day before. This snapshot
not only added Bland’s perspective to the various topics, it
also neatly encapsulated points of interest and appeared to be
well received by the audience. “This was the class I wish I had
available to me years ago when I was struggling to learn how to
support cancer patients,” Hardy concluded.10
One of the highlights of the
symposium was the presentation of
the Linus and Eva Helen Pauling
award to Dean Ornish, MD, who was
also a presenter at the symposium.
“Dean Ornish was the first to see that
treating the underlying metabolic and
nutritional causes of disease was more
powerful than conventional medical
and surgical approaches to chronic
disease,” explained Mark Hyman,
MD, who presented Ornish with the
award. “Receiving the 2010 Linus
Pauling Award is recognition of his
seminal contribution to the field of nutritional and functional
medicine.”11
Future of Cancer Care
In some respects, we have more questions than answers when
it comes to the future of integrative cancer treatment. We
don’t yet know the role primary care physicians, naturopathic
doctors, and other healthcare professionals will play in the care
of patients diagnosed with cancer and those who survive beyond
their prognosis. We also don’t know exactly how to create a
seamless integration of practitioners to create a truly effective
patient-centered cancer care system. But symposia such as this
are clearly pointing us in the right direction.
Cancer can be a humbling experience for both patient and
physician. When addressing the future of cancer care on the last
day of the symposium, Dan Rubin, ND, FABNO, explained
that cancer can be viewed as a wound that will not heal. To treat
it, we must look at mechanisms involved in wound healing.
He also eloquently pointed out that the future of cancer care
“lies within our patients.” Rubin, who runs a cancer center
in Arizona, said that following a cancer diagnosis the patient
becomes a “blank slate” with a future that is “unwritten and
undefined.” The physician can help the patient write a new
story that entails deep healing of the body, mind, and spirit.
As one of Bland’s last slides pointed out, “There is so much
more to know … so let the story begin.”
Note:
The Institute For Functional Medicine will be
making the information available from the symposium in
a variety of different formats. For more information visit
http://www.functionalmedicine.org.
