This year, an estimated 196,900 Canadians will be diagnosed with cancer—the disease that’s responsible for approximately 30 per cent of all deaths in Canada, according to the Canadian Cancer Society’s Advisory Committee on Cancer Statistics, Canadian Cancer Statistics 2015. Due to the nature of cancer and its potential for quick progression, urgent care is needed and it usually starts with conventional medicine. Using an integrative approach, which combines both conventional and naturopathic therapies, may provide real benefit to patients; however this needs further evaluation. Researchers hope to determine what impact naturopathic medicine has on survival and quality of life in cancer patients.
The Ottawa Integrative Cancer Centre (OICC), an arm of the Canadian College of Naturopathic Medicine (CCNM) in Toronto and the first integrative care and research centre in central and eastern Canada, has recently become a participant of the largest-ever North American observational study on the effectiveness of advanced integrative oncology (AIO) for people with late-stage cancer. A three-million dollar grant, provided by an anonymous private Canadian foundation, will fund the Canadian/US Integrative Oncology Study (CUSIOS)—an observational study aimed at evaluating and documenting patients’ diagnoses and the treatment they are receiving both from conventional and naturopathic medicine.
The six-year-long study will recruit a total of 400 patients from seven clinics across North America, four of which are in Canada (Ottawa Integrative Cancer Centre, Integrated Health Clinic in Fort Langley, B.C., the Marsden Centre of Naturopathic Excellence in Markham, Ont. and Vital Victoria Naturopathic Clinic in Victoria, B.C.).
“From the CUSIOS study, we will have a very good description for the range of the best naturopathic therapies currently available,” says Dr. Dugald Seely, a naturopathic doctor, director of research for the CCNM and executive director of the OICC. “We will also have some evidence on the naturopathic oncology approach and the impact it has on survival for advanced cancer patients.”
Dr. Seely hopes this information will potentially be used to support regulatory changes and expand the scope of the practice.
Last year, Ottawa researchers received $3.85 million, which is the largest-ever North American grant to study the effectiveness of naturopathic medicine used in combination with conventional medicine for patients with esophageal, gastric and lung cancer who will undergo surgery. The Thoracic Peri-Operative Integrative Surgical Care Evaluation (Thoracic POISE) will bring together Canadian thoracic centres and naturopathic doctors over the next 11 years.
“The Thoracic POISE study is a pragmatic randomized trial that is truly integrative. We are having discussions with and working with surgeons and oncologists as to what we incorporate and how we incorporate the naturopathic care,” says Dr. Seely.
The study will recruit 350 patients with different stages of cancer from three Canadian hospitals—in Ottawa, Hamilton and Kelowna. According to Dr. Seely, 11 years will give the researchers enough time to recruit the patients effectively and evaluate outcomes.
“The Thoracic POISE trial will evaluate if naturopathic medicine in conjunction with surgery and standard oncological care impacts surgical outcomes and long term survival. This study will also test the impact of naturopathy on cost effectiveness, immune function, and quality of life in patients with lung, gastric or esophageal cancer.”
Dr. Seely says neither of the two studies look at naturopathic medicine in isolation as both evaluate the impact of naturopathic medicine in addition to the conventional care that patients are receiving. Though there are studies that focus exclusively on naturopathic treatments, the research we need more today is based on an integrative approach with results associated with both short- and long-term outcomes of additional care.
“The conventional approach is focused on the pathology of the disease and looks at eradicating the tumour—either through a surgery or by using chemotherapy, or radiation, which is toxic to rapidly dividing cells,” says Dr. Seely.
While conventional therapies typically focus on killing cancer cells, the naturopathic approach aims to support the immune system, reduce inflammation and inhibit cancer cell metabolism.
“Other components we use include natural-health products and more aggressive intravenous therapies to inhibit cancer progression,” says Dr. Seely. “There are a variety of different options to use, such as curcumin, green tea extract, melatonin, mushroom extracts and other herbal therapies. We might use intravenous vitamin C in certain cases and even the application of intravenous or subcutaneously injected mistletoe.”
Acupuncture, diet and symptom control are only some of the ways naturopathic medicine can work in sync with conventional treatments in fighting a tumour. Though both naturopathic and conventional medicine utilize evidence-based medicine, there is a difference in approach. Dr. Seely says naturopathic medicine evaluates a combination of therapies and the impact they have on patient outcome rather than “isolating one particular constituent and researching that in a drug trial.” He believes methodology around the whole practice needs to be better developed to help evaluate the impact that naturopathic medicine has.
“Research methodology has to expand beyond where it has been in the past, which is based on the pharmaceutical model of care,” Dr. Seely says. “We have been looking for a magic bullet, and for cancer, there is no magic bullet.”
The Canadian Institute of Health Research is the only government-supported body providing funds for both conventional and naturopathic medicine research, unlike in the US, where the National Center for Complementary and Integrative Health offers funding opportunities exclusively for integrative research. Dr. Seely hopes that one day there will be a similar institute in Canada.
Conventional medicine practitioners are now more willing to explore naturopathic medicine, mainly due to high patient demand and the limits of what conventional oncology practice has to offer, says Dr. Seely. Another reason why naturopathic medicine is becoming more accepted within the conventional medicine community is the Naturopathy Act, 2007, which has just reached proclamation in Ontario, joining provinces like Alberta and British Columbia who have strong provincial regulations for naturopathic medicine.
