“You have cancer.” Three of the most dreaded and frightening words one can ever hear. And as the process of becoming “a patient” begins, a new fear often begins to take over: the fear of chemotherapy. In fact, we frequently hear from patients that their fear of treatment is greater than the fear of the disease itself.
Back in February, 2023, Dr. Block participated in an extended version of Robin Daly’s Yes To Life (yestolife.org) radio show on UK Health Radio. Titled “Pioneers in Integrative Oncology,” Dr. Block was selected to participate as one of 6 panelists who “have made a hugely significant contribution to the evolution of cancer care, paving the way for much of what is now accepted as good integrative practice.” In today’s blog, we’ll take a look at a question he was asked during this radio show, one that comes up routinely with our patients:
Robin Daly: “As our knowledge of epigenetics and nutrigenomics expands, it becomes increasingly clear that the DNA damage inflicted by some conventional treatments has the potential to significantly accelerate growth and repair pathways in ways that may be undesirable in people with active cancer. While my practice currently focuses on helping clients make the most of integrative care, I find myself wondering if our evolving understanding of cancer behavior has arrived at a point where chemotherapy in particular may be considered to harm more people than it helps. Can we honestly justify its continued use?”
Dr Keith Block – It’s actually a fabulous question. It’s also a very complex question, because more often than not, chemotherapy is utilized as a single tool to treat what we’ve come to understand is a complex, multi-faceted disease. It’s hard for me to believe – and science continues to tell us – that any one or two or even three bullets would be enough to hit the 50 or 500 bullseyes that make up the biology that’s driving malignancy. For way too long, our medical model has been fixated specifically on this idea that we’re going to find a magic bullet, a silver bullet – a single drug – that’s going to knock down just the right bullseye, and everything else is going to follow.
The only exception to what I’m talking about is immunotherapy and some of the newer drugs and newer approaches to immune treatments. Even though these treatments might be given as a single drug, they’re working with multiple arms of the immune system and, therefore, can have a multi-targeted, rather profound impact. And while we are seeing some impressive results, the problem is that we’re seeing this effectiveness with only a very small number of patients.
I would argue that this lack of more widespread effectiveness speaks even more loudly to the importance of integrative care. As an example, a number of randomized controlled trials (gold standard research) suggest that if we get the microbiome diverse, if we get those bacteria having dozens and dozens and dozens of cousins, that diversity will markedly drive up the effectiveness of immunotherapy. But there are times when, for example, someone is facing a life-threatening health challenge – sepsis or pneumonia or an infection – that has to be treated with an antibiotic. And we know that antibiotics, as well as probiotics (not prebiotics), can narrow diversity. This is where our clinicians will intervene. Because fermented foods, high fiber diets, healthy diets, cashews, Jerusalem artichokes, all of these, for reasons that we don’t currently fully understand, drive up favorable diversity. Which boosts the effectiveness of immunotherapies.
Additionally, and maybe from my perspective much more importantly, the real question about chemotherapy may be solely the way it’s currently given. Not only as a single tool, as I previously mentioned, but without the addition of meaningful, complementary therapies that can help reduce treatment side effects. Science demonstrates that incomplete chemotherapy reduces survival. Yet if a patient experiences significant side effects, the standard thing doctors do is drop dosing or delay treatment or widen the interval between treatments, all of which diminishes outcome and shrinks survival. This is well documented in multiple studies. For example, there’s a breast cancer study that was done several years ago with almost 500 patients with early-stage breast cancer. The patients who received 25% to 30% fewer treatments because of quality of life and toxicity from adverse effects, the patients who were unable to complete their treatments or delayed their treatments … those patients had shorter survival. It was rather pronounced, and I would argue that there is no question: incomplete chemotherapy reduces survival.
We know that integrative treatment approaches improve quality of life. They also reduce treatment toxicity. Very significantly, they allow patients to complete full courses of treatment. The data speaks for itself that they improve outcome and survival.
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In Part 2, Dr. Block will explain how the timing of the administration of chemotherapy drugs (chronomodulated chemotherapy) can improve treatment tolerance, have a profound impact on patients’ response to treatment, enhance clinical results, and boost overall survival.