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COMPLEMENTARY AND ALTERNATIVE MEDICINE and NUTRITION An oncologist’s perspective

COMPLEMENTARY AND ALTERNATIVE MEDICINE and NUTRITION An oncologist’s perspective. Rob Rutledge MD FRCPC. MAIN POINTS. Balance the rationale and intuition Tell your doctor what your doing Don’t forego proven treatments Find peace with your approach. PREVALENCE OF CAM.

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COMPLEMENTARY AND ALTERNATIVE MEDICINE and NUTRITION An oncologist’s perspective

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  1. COMPLEMENTARY AND ALTERNATIVE MEDICINEand NUTRITIONAn oncologist’s perspective Rob Rutledge MD FRCPC

  2. MAIN POINTS • Balance the rationale and intuition • Tell your doctor what your doing • Don’t forego proven treatments • Find peace with your approach

  3. PREVALENCE OF CAM • General population - 46% at some time • Breast cancer patients - 23% • $27 billion annually • Most common - herbals, megavitamins

  4. CONVENTIONAL MEDICINE • Scientific method relies on proof • Clinical trials • Documentation of toxicity • Doctor as therapist / consultant • Risks vs. benefits • Breast cancer - higher cure rates

  5. QUALITY OF EVIDENCE • DOES THE TREATMENT WORK? • Randomized trials • Comparison groups • Case series • Phase 1 - experimental • Case reports • Other

  6. CONVENTIONAL MEDICINE • Time / financial restraints • Lacks a fully holistic approach • Will incorporate proven therapy • Limited understanding

  7. WHAT IS CAM? • Complementary and alternative medicine • Covers many healing philosophies, approaches and therapies • Treatment / practices not taught or used in conventional medicine • Holistic - includes physical, mental, emotional and spiritual • Consistent with physiology?

  8. CLASSIFICATION OF CAM 1) Mind-body - yoga, psychotherapy, imagery, spiritual healing 2) Alternative system - oriental, indigenous, homeopathy, acupuncture 3) Lifestyle and disease prevention 4) Biologicals - herbs, phytotherapy, diets, nutrients, products

  9. CLASSIFICATION OF CAM 5) Manipulative / body-based : chiropractic, massage, breathing 6) Biofield - therapeutic touch 7) Bioelectromagnetics

  10. NATUROPATHIC MEDICINE • Emphasis of strengthening body’s ability to fight off cancer cells • “Cancer” forms as a result of body’s inability to heal itself, ie. strengthen immune system to fight cancer • Eg. toxins and lack of needed rest, exercises and diet • Holistic view - stress, lifestyle, etc • Use herbs, vitamins, etc

  11. HOW TO FIND OUT MORE • Ask your doctor?? • Go to the library • National Institute of Health http://nccam.nih.gov • Network

  12. DISADVANTAGES OF CAM • Expensive • Often unproven / false claims • Toxicities unknown • Beware of your nutrition • Safety / poorly regulated • New DIN number on all packaging • Guilt

  13. ADVANTAGES OF CAM • Practitioner gives more time • Attention to emotional/spiritual • Patient involvement and choice • Touch • Hope

  14. WHAT TO ASK YOUR CAM PRACTITIONER • Credentials of practitioner/school • Evidence of benefits of treatment • (Be wary of the “cure-all”) • Toxicity of treatment - documented? • Benefit vs risks? • What is the total cost?

  15. DOES CAM WORK? • Improves overall well-being, pain, nausea etc. • No proof of increased cures • Shark cartilage - $3000/ 3 months • National Institute of health - research • There is always hope

  16. SUMMARY OF CAM • Research and listen to your heart • Tell your doctor • Find a peaceful approach

  17. THE ROLE OF NUTRITION • Consult a professional nutritionist • Health Canada and recent data

  18. MAIN POINTS • Eating is meant to be pleasurable • Maintain a balanced diet • Decrease the fat to less than 20% of caloric intake • Increase fiber greater than 30g • Exercise and maintain healthy weight • Find a happy balance for you

  19. WHY NUTRITION IS IMPORTANT • Toxins in the diet can help cause cancer or make further changes to cancer cells • Certain nutrients can prevent damage to the cell • Good nutrition fuels the body’s immune system and improves overall health

  20. DOES A POOR DIETCAUSE CANCER? • Multiple factors contribute to developing cancer cells • Lab tests - cancer cells grow faster on fatty diets • High fat, low fruits/vegetables is bad • People with healthy diets also get cancer

  21. THE HEALTHY EATING PLAN • Variety from each food group each day • Choose lower-fat foods more often • Grains (5 servings) - wheat, oats, rye, rice, barley, millet, tapioca and buckwheat • Vegetables/Fruit (5-10 servings)

  22. THE HEALTHY EATING PLAN • Choose more often dark green or orange veggies and orange fruit • Milk products (3 servings) - lower fat • Meat/Alternatives (2-3 servings) • Choose leaner meats, poultry, and fish and dried peas, beans and lentils

  23. YOUR NUTRITIONAL NEEDS • Energy, protein and vitamins/ minerals • Supplements • Fluids - 8 cups per day • Fiber - 30g daily - legumes, fruits, vegetables, whole grains, nuts and seeds • Fat - 20% of food energy = 45-65g total fat

  24. THE FAT ISSUE • Polyunsaturated fats are good • vegetable oils (other than coconut and palm), • seeds and nuts, • fatty fishes such as salmon, trout, mackerel • Omega 3 and 6 fatty acids are poly-unsaturates that our body can’t make • Omega 3 found in flaxseed, canola and soybeans, fatty fish and wheatgerm

  25. HOW TO LOWER FAT INTAKE • Prepare foods in ways that use less fat • Limit the amount of fat put on foods • Choose lower-fat forms of foods • Shop better - read the labels • Choose less saturated fats (<5% of calories) and more monounsaturated fats, ie, vegetable oils (canola, peanut, olive oils), nuts like almonds, hazelnuts and macadamia nuts

  26. THE VEGETARIAN ALTERNATIVE • Lower in fat and higher in fiber • With milk products - watch iron intake • If vegan (no animal products) - watch your intake of protein, calcium, zinc and vitamin B12 • Takes time and planning

  27. GOOD FOOD / BAD FOOD • Oxidants - fat, smoking, lack of exercise ... damage the cell’s control center • Anti-oxidants prevent damage • Phytochemicals (from plants) • apples and onions and red wine • Isoflavones, ie, soy and genestein • Nutrients - vitamin A, C, E, beta carotene, selenium

  28. SUGGESTED ANTIOXIDANTS • Vitamin D 400ug / day • Folic acid • Selenium 200 ug / day • (calcium for everyone)

  29. NUTRITION SUMMARY • Effective way to improve our health • Do your research • Enjoy - let food be a source of joy • Questions

  30. Canada’s physical activity guide – 1888-334-9769 • Olive oil and canola are best as higher monounsaturates • Omega 3 – two to three servings per week. • Supplements – don’t take more than upper limit and watch what’s in your diet as well • Ca++ /vit D for everyone • Quack watch then medline

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