The British Society for Integrative Oncology
Juliet Hayward - Jul 2012
The British Society for Integrative Oncology held their first cancer conference for healthcare professionals on the 26th May 2012. Here, nutritionist Juliet Hayward reports on her experience attending.
TUCKED AWAY IN A HOTEL in a side street off Euston station, a conference was held on 26th May 2012 which aimed to introduce a new era of integrated oncology. It was the brain child of Robin Daly, the founder of the charity, 'Yes to Life', which educates, supports and helps fund those seeking to adopt an integrated approach to managing their cancer. Robin announced its aim was to increase 'strength, resources, skills and co-operation'.
The conference attracted a diverse group, including nutritional therapists, nutritionally-minded oncologists, naturopaths, researchers, writers and doctors committed to the integrated approach, who shared a similar vision. Attendees included: Xandria Williams, Dr Callebout, Dr Damien Downing, Patricia Peat from Cancer Options, the oncologist Ashraf Patel from St Margaret's hospital in Epping and Dr Rob Verkerk from The Alliance for Natural Health. Various organizations were represented including The Haven, the Gerson Institute, The Penny Brohn Centre and the British Naturopathic Association.
The keynote speaker was Dr Gary Deng, who was President of the US Society for Integrative Oncology in 2011. He is currently an integrative physician at Memorial Sloane Kettering Cancer Centre in New York. Gary explained the structure and the functioning of the SIO and his experience and insights should help to form a blue print for the newly formed BSIO.
Gary stated the cost of cancer drugs in America was 40% of healthcare spending, and that only 4% was spent on prevention. The 'SIO' sought to tackle all the factors that were involved in tumour formation. Formerly there was a gaping hole in cancer support due to allopathic medicine merely focusing on the tumour itself. The SIO aimed to rectify this by looking at environment, society, family, mind, body and spirit. Up to 70% of cancer sufferers use CAM in the United States, usually due to poor prognosis and limited treatment options. The 'SIO' is able to structure the application of CAM with research and professional guidance.
Dr Rob Verkerk highlighted the difficulties posed by the 1939 Cancer Act, which was originally brought in to protect the newly acquired cancer treatment - radiotherapy. It prohibits any publication that offers to treat people with cancer or prescribe any remedy or give any advice in connection with the treatment of cancer. Many CAM practitioners are comfortable with not using the word treat, as most probably see their role as bolstering immunity so the body is better able to augment its own defences more effectively against the tumour, altering the terrain that grew the tumour in the first place and reducing the side effects of drug therapy. However many practitioners are fearful of giving advice that could be considered to be in connection with the treatment even if there is good amounts of reliable research to support their approach.
It was also agreed that the allopathic insistence on double blind placebo trials as being the only credible way to prove the efficacy of an approach is too limited, leading us into an unpromising cul-de- sac rather than improving recovery rates. Double blind placebo trials cannot cope with the complexity of a truly holistic approach that involves counselling, dietary changes, supplement regimes tailored to the individual and lifestyle changes including exercise regimes. These multifactoral approaches can not be 'blind'. A double blind placebo trial is far more relevant to the administration of a single drug.
Marie Polley, Senior Researcher and lecturer at Westminister University is critiquing and evaluating the CAM approach to cancer and feels the evidence to support it is much stronger than it was 5 years ago and points to an increased survival rate and a reduction in reoccurrence.
Professor Robert Thomas from Bedford and Addenbrooke's Hospital, was awarded Oncologist of the Year in 2007. He specializes in breast, bowel and urological cancers. He is an advocate for healthy eating and exercise as part of a cancer management regime. He is currently conducting a double blind randomised placebo controlled trial of 201 men diagnosed with prostate cancer who are currently on active surveillance. They are each being administered a whole-food supplement called Pomi-T, which contains extracts of broccoli, turmeric, green tea and pomegranates; foods that have published papers proving their effectiveness in cancer management.
He pointed out the need to avoid carcinogenic foods such as hydrocarbons derived from burnt and smoked food and acrylamides from veggie chips. He also cited foods that have high ORAC rating such as alfalfa, blueberries, green tea, pomegranate, goji berries and raisins. He also stressed the importance of broccoli in the light of new research that has emerged from Britain's Institute of Food Research. The study involved 24 men with pre-cancerous lesions in their prostates. They all agreed to eat 4 extra portions of broccoli and peas a week for a year. When tissue samples were taken from the patients it was found that broccoli influences 400 to 500 different gene changes in a positive way.
Dr Henry Manning from the Cancer Centre, Star Throwers in Norfolk talked about how he was administering Coley's Toxins to cancer patients. Coley's toxins were discovered in the 1890s by William Coley, a surgical oncologist. It is a by-product of 2 detrimental bacteria; streptococcus pyogenes and serratia marascens. It is given intravenously and after 30 minutes it usually induces back pain, nausea, fever, under-arm pain and shaking. It basically initiates a type of heat therapy, boosting macrophage and lymphocyte activity and increasing the production of Tumour Necrosis Factor. There are now thousands of case studies demonstrating how cancer patients have gone on to survive for a further 5 years when Coley's toxins have been administered.
Dr Steven Hickey, author of 'Tarnished Gold: The Sickness of Evidence Based Medicine', questioned the usefulness of basing the treatment of an individual patient, on the evidence produced from huge medical trials. This approach is considered the gold standard for medical decision making. He argues that marginally effective treatments, based on population averages rather than the needs of the individual are used when evidence based medicine is applied. This approach dissuades the doctor to draw on his or her experience and consider the multiple causes of their patient's ill health, reducing the clinician to a statistician, and he criticised mega trials, which are incapable of finding causes of diseases for wasting research budgets and exposing patients to unnecessary health risks.
Dr. Hicky likened the impersonal nature of this approach to a survey of the shoe sizes of the inhabitants of New York. Once all the shoe sizes are collected, an average size could be worked out based on the data and an average shoe could be made for everyone. The result of the exercise would mean that the majority of people would have ill fitting shoes. An increase in the trial size does not mean that the results become more significant even though the effects may be tiny and unimportant; highly significant in statistical terms does not mean it is important when it comes to practical application and the effects could be so small that it is clinically irrelevant. He also insisted that group statistics cannot predict an individual's response to treatment, and that meta-analysis unfortunately rejects the vast majority of data, which may lead to results that are more subjective than they might initially first appear.
Stating the importance of doctor-patient collaboration, Dr. Hicky concluded that evidence-based medicine does not provide enough data and it is necessary to consider all the data and unfortunately the trials needed to provide evidence based medicine are not repeatable as they are far too expensive. Instead he favoured whole system research looking at a combination of drugs or integrated medicine rather than the application of a single drug.
As the BSIO takes it first infant steps into a world which has been beleaguered by restrictive European Legislation it is important it is well supported, so it continues to exist for the cancer patients it seeks to serve. The more collective data that is amassed by CAM practitioners for the BSIO the more it will be a credible force within the world of oncology.