Ask Dr. Block
Dr. Block, what do you think are the main differences between the “standard of care” approach of conventional medicine and a comprehensive, personalized integrative approach?
Mainstream cancer treatment grows out of a cultural – and global – fixation on seeking out silver bullet treatment strategies. This search, while fruitful in small ways, has missed the bigger gains we may have made had we kept the individual as an important central aspect of the ensuing battle. Instead, it’s been displaced by the search for a powerful “Johnny-one-note” single drug solution. However, matching a single drug to a single target has rarely worked at establishing a cure. This search and thinking is not limited to conventional care, but can be found among those practicing in the alternative and CAM (complementary alternative medicine) camps as well. I believe much of the interest in discovering a single curative treatment grew out of our earlier historical experience with antibiotics. While single use antibiotic treatments appeared to be successful early on, over time we have witnessed enormous antibiotic resistance, which has led to far more aggressive, antibiotic-resistant bacterial strains. In a similar way, resistance has become an even greater problem for cancers and cancer drugs than it has with antibiotics.
Yet, when we do look at the history of cancer, we only rarely find a single drug or a single target intervention that does much more than temporarily slow growth. Even when we do, it is mostly limited to a few months. In spite of a large marketing effort touting “personalized care,” most treatment is about matching one drug to a molecular biomarker, and not comprehensively individualizing treatment based on objective criteria, including nutrition, physical care, biobehavioral, metabolic and molecular profiling. Such profiling provides our center with a means for modifying care to comprehensively formulate a treatment plan that is genuinely individualized at every aspect of treatment and care. The fact is, a single molecular site does not represent the full vulnerability of a cancer, the “Achilles heel” of the cancer. Rather, cancer growth is driven by a group of intersecting critical growth tracts. Thus, for improving one’s odds for attaining genuine success with treatment, we take a different approach. In order to broadly analyze multiple targets and growth tracts of a patient’s cancer, we use several different technologies and with the results, we map out a group of multi-targeted strategies in order to more comprehensively and individually address the complexity associated with cancer growth.
Certainly, there have been considerable gains in recent years with experimental treatment approaches including molecular, angiogenic and immune based therapies. However, though some lip service is given to these, most mainstream treatment approaches exist without a foundation of health. Thus, they lack the fundamentals essential for reversing, slowing or containing tumor growth, improving tolerance, diminishing toxicity and enhancing treatment-sensitivity. In my experience, implementing a tailored regimen in order to build a foundation of optimal health is essential to acquiring a successful outcome.
Also, it is important to note that patients rarely die from cancer, but rather from disease or treatment related complications. With an aggressive lifestyle regimen focused on personalized nutritional-oncology care, a physical rebuilding and maintenance program designed to address where a patient is at clinically, and a biobehavioral regimen tailored to the needs of each patient, it is possible to prevent the onset or counter the impact of these complications, which can include pneumonia, blood clots, emboli, wasting syndromes, and sepsis, among others.
As we compare integrative cancer treatment from conventional options, definitions become more important to understand what is being advised and what is needed.
From my viewpoint, the definition of alternative therapy is treatment offered in lieu of mainstream therapy, and may lack rigorous evidence. I think most CAM (complementary alternative medicine) is really a haphazard set of single intervention “add-ons”. For example, green tea with prostate cancer treatment, or yoga for breast cancer are “add-ons.” They are not systematic approaches to care anymore than most mainstream care is systematic. When it comes to defining integrative treatment, most centers have framed it around the use of mostly generic multiple treatment modalities. Along with CAM, this too often provides complementary – generic, single intervention therapies – doled out without the precision basis of systematized care. This short-changes the patient from a myriad of perspectives.
Core to my philosophy of care, detailed in my book, Life Over Cancer, the treatment of cancer must be a:
“Systematic, comprehensive, multi intervention- whole systems model, with treatment strategies individualized to the patient, based upon objective assessments, provided with life affirming and open communication between patients and practitioners”.
This is how I define true integrative cancer treatment; a model I hope and believe will one day be far more broadly embraced and implemented.