COMPLEMENTARY AND ALTERNATIVE MEDICINE and NUTRITION An oncologist

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COMPLEMENTARY AND ALTERNATIVE MEDICINEand
NUTRITIONAn oncologists perspective

• Rob Rutledge MD FRCPC

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MAIN POINTS

• Balance the rationale and intuition
• Tell your doctor what your doing
• Dont forego proven treatments
• Find peace with your approach

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PREVALENCE OF CAM

• General population - 46 at some time
• Breast cancer patients - 23
• 27 billion annually
• Most common - herbals, megavitamins

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CONVENTIONAL MEDICINE

• Scientific method relies on proof
• Clinical trials
• Documentation of toxicity
• Doctor as therapist / consultant
• Risks vs. benefits
• Breast cancer - higher cure rates

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QUALITY OF EVIDENCE

• DOES THE TREATMENT WORK?
• Randomized trials
• Comparison groups
• Case series
• Phase 1 - experimental
• Case reports
• Other

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CONVENTIONAL MEDICINE

• Time / financial restraints
• Lacks a fully holistic approach
• Will incorporate proven therapy
• Limited understanding

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WHAT IS CAM?

• Complementary and alternative medicine
• Covers many healing philosophies, approaches and
  therapies
• Treatment / practices not taught or used in
  conventional medicine
• Holistic - includes physical, mental, emotional
  and spiritual
• Consistent with physiology?

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CLASSIFICATION OF CAM

• 1) Mind-body - yoga, psychotherapy, imagery,
  spiritual healing
• 2) Alternative system - oriental, indigenous,
  homeopathy, acupuncture
• 3) Lifestyle and disease prevention
• 4) Biologicals - herbs, phytotherapy, diets,
  nutrients, products

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CLASSIFICATION OF CAM

• 5) Manipulative / body-based chiropractic,
  massage, breathing
• 6) Biofield - therapeutic touch
• 7) Bioelectromagnetics

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NATUROPATHIC MEDICINE

• Emphasis of strengthening bodys ability to fight
  off cancer cells
• Cancer forms as a result of bodys inability to
  heal itself, ie. strengthen immune system to
  fight cancer
• Eg. toxins and lack of needed rest, exercises and
  diet
• Holistic view - stress, lifestyle, etc
• Use herbs, vitamins, etc

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HOW TO FIND OUT MORE

• Ask your doctor??
• Go to the library
• National Institute of Health
• http//nccam.nih.gov
• Network

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DISADVANTAGES OF CAM

• Expensive
• Often unproven / false claims
• Toxicities unknown
• Beware of your nutrition
• Safety / poorly regulated
• New DIN number on all packaging
• Guilt

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ADVANTAGES OF CAM

• Practitioner gives more time
• Attention to emotional/spiritual
• Patient involvement and choice
• Touch
• Hope

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WHAT TO ASK YOUR CAM PRACTITIONER

• Credentials of practitioner/school
• Evidence of benefits of treatment
• (Be wary of the cure-all)
• Toxicity of treatment - documented?
• Benefit vs risks?
• What is the total cost?

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DOES CAM WORK?

• Improves overall well-being, pain, nausea etc.
• No proof of increased cures
• Shark cartilage - 3000/ 3 months
• National Institute of health - research
• There is always hope

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SUMMARY OF CAM

• Research and listen to your heart
• Tell your doctor
• Find a peaceful approach

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THE ROLE OF NUTRITION

• Consult a professional nutritionist
• Health Canada and recent data

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MAIN POINTS

• Eating is meant to be pleasurable
• Maintain a balanced diet
• Decrease the fat to less than 20 of caloric
  intake
• Increase fiber greater than 30g
• Exercise and maintain healthy weight
• Find a happy balance for you

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WHY NUTRITION IS IMPORTANT

• Toxins in the diet can help cause cancer or make
  further changes to cancer cells
• Certain nutrients can prevent damage to the cell
• Good nutrition fuels the bodys immune system and
  improves overall health

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DOES A POOR DIETCAUSE CANCER?

• Multiple factors contribute to developing cancer
  cells
• Lab tests - cancer cells grow faster on fatty
  diets
• High fat, low fruits/vegetables is bad
• People with healthy diets also get cancer

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THE HEALTHY EATING PLAN

• Variety from each food group each day
• Choose lower-fat foods more often
• Grains (5 servings) - wheat, oats, rye, rice,
  barley, millet, tapioca and buckwheat
• Vegetables/Fruit (5-10 servings)

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THE HEALTHY EATING PLAN

• Choose more often dark green or orange veggies
  and orange fruit
• Milk products (3 servings) - lower fat
• Meat/Alternatives (2-3 servings)
• Choose leaner meats, poultry, and fish and dried
  peas, beans and lentils

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YOUR NUTRITIONAL NEEDS

• Energy, protein and vitamins/ minerals
• Supplements
• Fluids - 8 cups per day
• Fiber - 30g daily - legumes, fruits, vegetables,
  whole grains, nuts and seeds
• Fat - 20 of food energy 45-65g total fat

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THE FAT ISSUE

• Polyunsaturated fats are good
• vegetable oils (other than coconut and palm),
• seeds and nuts,
• fatty fishes such as salmon, trout, mackerel
• Omega 3 and 6 fatty acids are poly-unsaturates
  that our body cant make
• Omega 3 found in flaxseed, canola and soybeans,
  fatty fish and wheatgerm

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HOW TO LOWER FAT INTAKE

• Prepare foods in ways that use less fat
• Limit the amount of fat put on foods
• Choose lower-fat forms of foods
• Shop better - read the labels
• Choose less saturated fats (lt5 of calories) and
  more monounsaturated fats, ie, vegetable oils
  (canola, peanut, olive oils), nuts like almonds,
  hazelnuts and macadamia nuts

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THE VEGETARIAN ALTERNATIVE

• Lower in fat and higher in fiber
• With milk products - watch iron intake
• If vegan (no animal products) - watch
  your intake of protein, calcium, zinc and vitamin
  B12
• Takes time and planning

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GOOD FOOD / BAD FOOD

• Oxidants - fat, smoking, lack of exercise ...
  damage the cells control center
• Anti-oxidants prevent damage
• Phytochemicals (from plants)
• apples and onions and red wine
• Isoflavones, ie, soy and genestein
• Nutrients - vitamin A, C, E, beta carotene,
  selenium

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SUGGESTED ANTIOXIDANTS

• Vitamin D 400ug / day
• Folic acid
• Selenium 200 ug / day
• (calcium for everyone)

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NUTRITION SUMMARY

• Effective way to improve our health
• Do your research
• Enjoy - let food be a source of joy
• Questions

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• Canadas physical activity guide 1888-334-9769
• Olive oil and canola are best as higher
  monounsaturates
• Omega 3 two to three servings per week.
• Supplements dont take more than upper limit
  and watch whats in your diet as well
• Ca /vit D for everyone
• Quack watch then medline