Reports

COMPREHENSIVE CANCER CARE CONFERENCE SPONSORED BY CENTER FOR MIND BODY MEDICINE, WASHINGTON HILTON, WASHINGTON D.C. APRIL 9-13, 2003

by Helen Moss

"Integrating Complementary and Alternative Therapies with Mainstream Care

Scholarship recipients: Dr. Jane Hart, YMCA; Kathleen McCue, the Gathering Place; Carol Adrine, Trustee; and Dr. Elizabeth McKinley, who paid her own tuition but has attended the "Food as Medicine" training at CMBM.

April 9

"Ayurvedic Strategies for Prevention and Management of Cancer"
Speaker: Hari Sharma, M.D., Moderator: Stephen Sagar, MD

The audience for this topic was composed mostly of PhDs and medical caregivers besides MD's. Approximately 750 people attended the conference. At the last conference only 25% were MD's which I felt meant that it will be more difficult to develop programs of integrative medicine and that integrative medicine would be taken less seriously. I venture to guess that the percentage is the same this conference.

Having been to India and heard many ayurvedic doctors as well as Deepak Chopra, this was a "nuts and bolts" introduction to the ayurvedic practice, very fundamental and practical. If I had heard this talk before I attended the Conference in India, I would have been better prepared. So, I got it backwards.

Dr. Chopra speaks with a broad philosophical brush showing how allopathic and ayurvedic medicine can work together. Even though I knew nothing about ayurvedic medicine at that time, Dr. Chopra conveyed the differences so that by the end of his lecture, I was able to understand the comparison. Dr. Sharma only spoke of ayurvedic practice, which is very similar to Chinese Medical Treatment or CMT. He did very little comparing. He did not attempt to integrate in a significant manner allopathic and ayurvedic.

Both ayurvedic and Chinese medicine stress energy, digestion, diet, and lifestyle in the prevention of disease, rather than attacking the disease after it has occurred as allopathic medicine does. They also believe that if one organ is affected, other organs are affected as well. They believe that the cause of the disease is lifestyle including diet and stress. A disease indicates a lifestyle change is in order.

I am bringing back the tape and Dr. Sharma's book on the topic as a reference. I have briefly reviewed his book which is a good basic text on ayurvedic medicine. Dr. Chopra's by comparison is very elegant.

April 10

Morning Session: "Effective Strategies for Integrative Cancer Care: - The Cancer Guides Model

CMBM sponsors an annual "Cancer Guide" training for medical professionals and even laymen to work between the medical oncologists and physicians on one side and the patients on the other. They work to empower the patient in working with the medical doctors in presenting options they may not have considered. Again this is all a matter of degree with each patient, depending upon the uniqueness of the individual.

Each cancer guide works with the cancer patient individually helping the patient gain empowerment over their treatment in being a partner with their physician as well as dealing with the existential reality of facing cancer and the possibility of death. Cancer guides work with the patient after the disease has struck. Yet, they advise the patient on "lifestyle" change in order to defeat the disease and to strengthen the immune system after treatment. Unlike palliative care, Cancer Guides operate with hope, if not for cure, then for more quality-time life. In metastasis, they work with the patient to treat their disease as a chronic illness, which may end up with a cure.

A very interesting point was brought up; i.e., that a physician is to not only cure but to alleviate pain and suffering. Sometimes physicians are so intent on "curing" that the alleviation of pain and suffering which includes mental torment is not considered as helping to cure, much less their duty to alleviate the depression and mental suffering. The mental suffering is also caused by the physical pain of many cancer treatments. The allopathic doctor when confronted with depression recommends pharmacology in the form of anxiety relieving drugs. He or she if familiar with CAM could refer the patient to acupuncture or a "cancer guide." Social workers were mentioned, but unless the social worker is trained as a "cancer guide," their effectiveness would fall short.

I talked to the representative of the Komen Foundation, who is considering sponsoring the "Cancer Guide" program. I think that our Foundation could work with them in granting scholarships for people to be trained in this program. I will explore this with them in the near future.

"Afternoon Session: THE DANA-FARBER CANCER INSTITUTE EXPERIENCE

This is the story of how the institute was structured within the very conservative institutional environment and bureaucracy of allopathic medicine at Dana Farber. One very influential man who had cancer pushed the institution to begin the program. Without funding, but with dedication and enthusiasm, the institute was begun. When the first flyers were posted regarding a CAM educational lecture in 1998, the posters were ripped off the walls. However, it has since been integrated into the established institution because of some very astute strategy.

I have the 3-hour presentation taped with power-point presentations by six of the staff. I talked to the Director and indicated that we would be interested in looking over his institution. He said that we would be welcome. We would work through Dr. Susan Bauer-Wu.

They are doing research in CAM primarily in acupuncture. Their focus is on acupuncture, message, and diet integrating this regimen with the mainstream doctor. The patients must be Dana Farber patients, and each physician gets a letter that his patient is working with the Zakim Center, which forces the mainstream physician to work with the Zakim Center staff in consultation over the patient. That procedure itself has been important to introducing CAM to the mainstream doctor so that he learns about CAM and its value to his patient.

It is a model for an institutional environment. I believe that it will become better as the concept of "Cancer Guides," i.e., the individual patient receiving counseling unique to him or her, be added to the program. It still does not treat the patient as a whole person, but at this point, supplements the work of the allopathic doctor in attacking the disease, rather than using preventive medicine in preventing disease.

It will improve if they can stress "preventive medicine" within the institution. One drawback is that they do not accept new patients unless they are being treated by one of the Dana Farber allopathic physicians.

They have two acupuncturists who are doing research on acupuncture increasing the white blood cells and in alleviating pain and stress during chemotherapy. However, in the meantime, acupuncture is used to treat these conditions, even though the studies are not complete. Many of the medical doctors are showing interest and referring patients. They have continuing education in introducing CAM to the staff. One of the staff of the Zakim Center was sent to China to investigate the integrative medicine. She spoke at the Conference and said that she was very impressed.

April 11

Plenary Session - Komen Foundation and Cancer Centers of America, Sponsors

At the Conference Opening two speakers stood out who may help us provide services in Cleveland: Dwight Randle of the Komen Foundation who gives away 21 million dollars a year in grants and Steve Bonner, President of the Cancer Treatment Centers of America.

Carol Adrine and I spoke with Mr. Randle, who indicated that he would be interested in helping sponsor Deepak Chopra if there were a breast cancer component.

Mr. Bonner also indicated an interest in Cleveland and invited us to come to Chicago to see one of his centers. I had seen their ads in TV at 4 a.m. in the morning and Richard (my husband) and I thought they were quite good. They have a booklet which I am bringing back which explains 'integrative" medicine.

Dr. Mitchell Gaynor spoke about the environment and the increased incidences of cancer in America. He said that we must stress "preventative" medicine through the environment and through diet and lifestyle. Good speaker. I have the tape.

Burzynski - Antineoplastons

Carol Adrine and I attended the Stanislaw Burzynski presentation of "The State of Antineoplaston Research. There is little doubt that he has been having some successes, especially in brain cancer in children. I have the tape.

The Cleveland Plain Dealer Sunday Magazine had an article about a man who had been treated at Dr. Burzynski's Clinic after everyone else had given up on him. Five years later, he is still living.

As an alternative medicine doctor, he gets patients who are very sick and not much chance for cure with allopathic medicine. Many are debilitated not only from the disease but with repeated bouts of chemotherapy and radiation. He is not allowed by the FDA to treat people at the beginning stages of their disease.

Critique of Dana Farber - Zakim Center - healing center

So far, I find that the information we are getting that will help us most in Cleveland is the possibility of integrative cancer centers affiliated with allopathic cancer centers like Dana-Farber. The "stand-alone" integrative cancer centers, such as Cancer Centers of America in Chicago, are able to afford treating their patients with integrative medicine because the allopathic part of the treatment is paid for by insurance. They can afford to treat with acupuncture and "Cancer Guides" because of the profits of the mainstream treatments. Inner Harmony in Pennsylvania, where mainstream doctors can refer patients, has to be subsidized. They have on their staff acupuncturists and other integrative methods of treatment, including preventive medicine. The Gathering Place in Cleveland councils cancer patients and their families and must be subsidized. They council patients and are a resource for information on diet, exercise (yoga), and music therapy. The idea situation would be a closer relationship between the integrative caregivers and the allopathic physicians.

I attended the open house given by the Cancer Centers of America and met Dr. Birdsell, who is a doctor on nutrition and we exchanged cards. We must go to Chicago. I have also mentioned to our board that we must go to Pa. to Inner Harmony.

The Dana Farber model has two drawbacks - one is that you must be a patient at Dana Farber and its affiliates and must work with the allopathic doctor which means that the public cannot choose to use the clinic directly. The second is that they do not have the humanistic or comprehensive patient work-up which includes mind, spirit, and body. They address these factors, but not in a systematic way. The Komen Foundation is working with CMBM to educate more people as "cancer guides," the program which I believe would certainly make the Dana Farber experience more complete. I believe that Dana Farber has only six full-time staff members. The Gathering Place has 5 full-time staff.

Furthermore, Dana Farber has one Chinese acupuncturist who has earned the respect of the allopathic doctors and is doing research in acupuncture. Thus, it is too strongly centered on the acupuncturist himself, who overshadows the other aspects of integrative medicine and the other services, such as yoga, strengthening the immune system by diet and vitamin supplements, and music therapy. The center does refer patients to Chinese treatments by request, especially in regard to Chinese herbs. They also offer yoga and acupressure, music therapy, and "food as medicine." As I stated earlier, one of the staff traveled to China with the Chinese connections of their acupuncturist and was very much impressed the way China is ahead of us in incorporating alternative practices into the mainstream in a seamless fashion.

I think that it is very important that a qualified person in Cleveland should visit China (Dana Farber will refer them), and to India to an ayurvedic spa like Soukya just outside of Bangalore. I also think that it is important that our allopathic physicians be familiar with at least the other two theories of medicine, Ayurvedic and Chinese which is energy based. They would feel more comfortable in incorporating some of these foreign practices into the mainstream by referring patients if they were aware of their philosophies and treatments.

Science-based research will naturally develop with these new programs as it is beginning to do at Dana Farber.

Block Treatment Center

This afternoon I heard Dr. Block of the Block Treatment Center which is a clinic that emphasizes chemotherapy but includes a full service of integrative treatments. It is unusual for a stand-alone clinic to be so traditional in its approach to chemotherapy. In some ways, it is similar to the Cancer Centers of America.

Working Dinner with the scholarship recipients.

Dinner at an organic restaurant with Kathleen McCue of the Gathering Place, Carol Adrine, Trustee, Dr. Jane Hart, of the YMCA and Dr. Elizabeth McKinley.

We discussed the breakout sessions of the day. Most of the women will write reports and along with mine, we will have a record of what we think is important for Cleveland to bring back to our friends in Cleveland.

We discussed the two alternatives we have in Cleveland - developing a treatment center of preventative and integrative medicine on the order of Dana Farber or bringing in a center as in a partnership such as Inner Harmony who hire the professionals and to whom the hospitals in Cleveland can refer patients.

As far as the YMCA is concerned, we could train "Cancer Guides" to council cancer patients throughout the YMCA system.

Health Clinics - Preventative Medicine for Cancer and other Diseases

When we are looking at preventative medicine where lifestyle changes would be advised, something like losing weight could be partnered with Weight Watchers. We can also give people information about the Atkins diet or the Cornish diet. Jenny Craig sells frozen foods to their clients to lose weight. Similarly, we can recommend a diet limited in calories by having the people we service buy "Lean Cuisine" for some of their meals. We could even incorporate Slim Fast into the diets and sell it at the clinics. I bet Sam's Club would help us get good prices on these two items as they are sold there very cheaply. Obesity is a problem, we all know that. There were comments at the conference that losing weight during chemotherapy is not necessarily a bad thing and if a patient puts on weight during treatment, it is bad. It has something to do with the idea that if cancer metastasizes, it will grow faster if weight is put on. By losing some weight during chemotherapy treatment, the patients are ridding themselves of more cancer cells. Interesting.

Yoga/exercise - healing and prevention

According to Dana-Farber, the most requested service is Yoga, which is an exercise that is healthy both physically and mentally. All people can do it, even sick people. It can be as strenuous or not depending upon the health and age of the practitioner. The theory is to strengthen the body which calms the mind. It is the reverse theory of "no pain, no gain."

Partnership with Independent Clinic for Prevention of Cancer and other illnesses as well as helping people regain their health after an illness

As I mentioned before, rather than starting from scratch and hiring and training personnel ourselves, the institutions could partner with experienced people or companies who have stand alone centers. Another idea we talked about is compiling a list of all acupuncturists, but my feeling is that we have no criteria or standard for putting professionals on the list. That's why I like the idea of partnering with an independent health center. The interesting thing about the Health Centers of America, people can spend a week there in improving their health as I did in going the a Chinese master healer in Boston to regain my health. Probably this is reaching a bit in thinking of something other than an outpatient clinic, but it is okay to think "outside" the box as J. Krishnamurti said 50 years ago. I found that with working, it was easier for me to take off for one week to go to "boot" camp to learn and regain my strength at a Chinese Medical Treatment Center with a Master Healer, than to visit Dr. Frackelton in Lakewood every 90 days for one hour who does a good job in counseling on diet and preventative medicine.

Random comments

Dana-Farber centers on a highly qualified acupuncturist who also teaches at the acupuncture school in Boston. The Gathering Place refers people to a list.

Difficult to find a good dietitian - healing and prevention

Kathleen McCue of The Gathering Place said that it is difficult to find a really good dietitian who understands "Food as Medicine." Dr. McKinley just returned from training in this subject. She is going to give us a report on the course. I said that after my cancer treatment, a dietitian visited me while I was at University Hospitals, and although I knew almost nothing, I knew more than she did. Her strong point was recommending the canned energy drinks.

Cooking classes for good nutrition - YMCA system or at a preventative medicine clinic

Wild Oats has been giving cooking classes in healthy foods at the Gathering Place. At a preventative medicine clinic, they could give cooking lessons in promoting a healthy diet at various clinics, even the YMCA or in conjunction with Weight Watchers working with us. On TV recently "60 Minutes", they had a contest as to which of four individuals lost weight faster, each on a different program: hypnotism, Dr. Atkins diet, Weight Watchers, and Super Exercise. The most successful were Dr. Atkins diet and hypnotism followed by Weight Watchers with the person who ran 10 miles every day coming in last.

Chopra & Komen Foundation

I mentioned to our group about Deepak Chopra's coming to Cleveland in one year and that I would talk to his promoter about having a breast cancer component to his talk or a cancer component with breast cancer being a major part of that talk to interest the Komen Foundation. Carol and I got to know the man who gives out the grants. I spoke to him again this afternoon. If he is interested in helping us with Chopra, then I think he might help us give counseling to breast cancer patients through a clinic. They are going to sponsor the "Cancer Guide" program at CMBM. Perhaps they would give scholarships to our clinic personnel to attend this training.

April 12

Ralph Moss, PhD - Plenary Session

Dr. Moss spoke of the depressing statistics of the increase of cancer around the world and the many billions of dollars spent on this disease. I will get his slide presentation.

MD Anderson

This program is led by Ph.D. Lorenzo Cohen the integrative cancer center at MD Anderson. In effect, there was little program and little enthusiasm. They are doing some studies on two kinds of Yoga, which was very promising. They have much in the way of written information and brochures, but nothing on acupuncture. They said that if there is no scientific evidence, it is bad medicine. They have a much different attitude than Dana Farber with no enthusiasm or energy. Very lackluster. Little money is budgeted for the program. Dr. Cohen said that they have a lot to learn from China, which is what Dana Farber said. He also said that they have gotten much resistance from the faculty and staff. He said that patients are requesting CAM, but they are not getting much. Only 1,700 feet is dedicated to space.

Cancer Centers of America

What a presentation! There are about three hospitals they run with allopathic medicine completely integrated with CAM.

There are no charges for the CAM portion as they attract patients to the core allopathic practice because the integration of mind, spirit, and body and because the patient and their family is the focal point and director of the treatments. The patient interacts with every one of their disciplines. The medical professionals meet three times a week for an hour to discuss every patient. The slides were very impressive regarding their setup and system. I have seen their ads on TV which are quite good. Their booklet is as well. They have the new radiation machines which a cancer patient's protocol lasts only 7 days instead of 6 weeks. The rays do not impact as much on the ribs and internal organs and can be focused primarily on the tumor areas.

It would not work to partner with them in Cleveland as their money is made on mainstream treatments which subsidize CAM. However, this could be the hook that would awaken Cleveland Hospitals - the full integration of CAM with mainstream medicine, emphasizing patient's needs. Cancer Centers of America attract patients from all over the country because they advertise "integration."

Summary

It is clear that Dana Farber is far ahead of MD Anderson with enthusiasm and the backing of its trustees. They seem to have bridged some of the objections of their staff, while M.D. Anderson is not so far along.

The ideal relationship is exemplified by the Cancer Centers of America.

The last plenary session featured Dr. Ben Case, Chief of neurosurgery at Johns Hopkins. He was a fabulous speaker, altogether different from Deepak Chopra, yet very riveting. This doctor has had cancer twice and drinks Noni juice. I had heard of Noni Juice before, but shrugged it off. It is a concentrate of a fruit grown in Hawaii and Tahiti which is supposed to strengthen the immune system to fight and ward of many diseases. I was really surprised Right now there are trials going on regarding this drink. Now, my mother, my husband, and I are each drinking one ounce a day. Nothing to lose.

I met and talked to Dr. Moss of the Moss reports and told him that every time I come to one of these Conferences, I am mistaken for his wife. We exchanged cards, and I will contact him. I have admired his reports and have read a couple of his books. I especially liked "Questioning Chemotherapy" I told him as much and he said that the book was written before the internet where there is so much information available today. It was very difficult when he wrote the book to get information. He is writing a new book on radiation and its effectiveness. He is another man I would like to see in Cleveland.

On a final note, I want to quote from the Moss Reports, Dr. Moss' comments regarding this Conference: