An Integrative Plan

When Dominic Balestra, 59, was diagnosed with prostate cancer six years ago, he did everything his oncologist told him to do. He had surgery followed by radiation, and for nearly five years his cancer stayed in remission. When Balestra’s PSA count started creeping up in April 2006 and accelerated to 44 by that summer, his oncologist began treating him with hormone therapy, and Balestra decided to also try integrative medicine.

Integrative medicine includes practices and products not part of conventional medicine, but which may be used in conjunction with standard care to relieve treatment side effects and improve quality of life. These add-ons include a vast array of approaches, such as meditation, Tai chi, yoga, herbs, acupuncture and nutrition.

Balestra flew from his home in New York to consult with Donald Abrams, MD, at the UCSF Osher Center for Integrative Medicine about how he might benefit from integrative therapy. “When I met with Dr. Abrams, he asked me about my eating habits and lifestyle and explained that Western medicine has an analytical approach to attack the disease through medicine, surgery or radiation, and that Eastern medicine says you can do those things and at the same time enhance the body’s ability to heal,” says Balestra, who integrated a diet and exercise plan into his hormone therapy regimen after discussion with Dr. Abrams and his oncologist in New York.

Within a month of starting hormone therapy, his PSA count was down to 0.77. Balestra says the exercise helped him combat fatigue, a side effect of the hormone therapy, and what’s more, his blood pressure and cholesterol levels are lower since he’s been on the diet and exercise regimen.

Definitive results about the benefits of integrative medicine may be on their way. The National Center for Complementary and Alternative Medicine has a number of clinical trials studying the effects of integrative approaches used in conjunction with standard cancer treatment. Some current studies include acupuncture to relieve pain following surgery for head and neck cancer, massage to treat cancer pain and the herb ginger to combat nausea and vomiting caused by chemotherapy.

Ginseng is another herb showing promise in helping cancer patients. An epidemiological study, known as the Shanghai Breast Cancer Study, involved almost 1,500 breast cancer patients who received at least one type of conventional cancer treatment to test whether ginseng could improve survival and quality of life.

“We found that patients who used ginseng prior to diagnosis had a better survival than those who never used ginseng,” says Xiao-Ou Shu, MD, PhD, professor of medicine at Vanderbilt-Ingram and the study’s lead investigator. When Dr. Shu and his team looked at ginseng use after cancer diagnosis and correlated that with quality of life, they found patients who used ginseng had a slightly higher quality of life. A larger study of 5,000 breast cancer patients looking at the effects of ginseng is now under way.

Other studies are also looking at the efficacy, safety and toxicity of combining botanicals, such as mistletoe, with conventional chemotherapy. “Mistletoe has been used for centuries in Europe,” says Patrick Mansky, MD, research oncologist and staff clinician at the NCCAM. “We’ve developed a phase I study, which combines mistletoe plant extract with the chemotherapy drug Gemzar. We’re trying to establish what would be a safe dose and a safe regimen for giving those two agents together.” Trial participants include patients with advanced breast, non-small cell lung, colorectal and pancreatic cancers.

Dr. Abrams says an extra benefit of integrative care is it gives cancer patients a sense of control. “[Integrative medicine] helps patients harness the energy of their mind to fight cancer, and these are the things that are empowering.”