Beyond the norms of cancer treatment

Health: These days, oncologists are more accepting of unorthodox approaches to treatment.

January 06, 2002|By Shari Roan | Shari Roan,SPECIAL TO THE SUN

Doctors had hoped to operate on the cancer in Rhio Weir's lungs that January morning almost two years ago. But when Weir, a 63-year-old underwriter for a title company, awoke, he was told the tumors were in the lining of his lungs and couldn't be removed.

"The doctor told me the news was very bad, that the only thing I could do was radiation and chemotherapy," the Los Angeles man recalls.

But there was something else Weir could do - and did. He stepped outside the circle of conventional cancer therapy for aspects of his treatment. And he found that conventional medicine bowed to his wishes.

In addition to chemotherapy and radiation, Weir received acupuncture and took Chinese herbs, adopted an Eastern-style diet, attended a support group and saw a spiritual healer - all with varying degrees of acceptance from his doctors.

His primary doctor was "very open" to alternative medicine; his oncologist was tolerant of it. And though one surgeon objected to Weir's request to listen to soothing music on a headset during surgery, an anesthesiologist in the room intervened, saying the music "was a good idea."

"If conventional doctors are secure in what they do, then they shouldn't feel threatened by alternative medicine," Weir says. "No one really said `no' to me."

What was unthinkable 10 years ago - that cancer doctors would sanctify their patients' sojourns into alternative medicine - is today a reality in many clinics nationwide. While steadfast in their belief that science-based therapies offer people the best chance of getting well, more doctors acknowledge the gaps in their rigidly fact-based model. They concede that some cancer patients in need of emotional support, relief from unrelenting nausea, even hope, are finding it outside of traditional medicine.

"Five years ago, most conventional oncologists weren't even thinking about these therapies," says Dr. James Gordon, an expert in complementary medicine at the Georgetown University School of Medicine in Washington. "The interest now is certainly not universal. But young oncologists, in particular, are coming up against the limitations of what they can do. They are looking for approaches to help their patients deal with the experience of cancer."

Training `cancer guides'

Last summer, Gordon offered a program to train health care professionals to become a "cancer guide," defined as a professional who helps patients deal with all aspects of cancer care: physical, psychological, emotional and spiritual. Expecting mostly nurses and therapists, Gordon was surprised when two dozen doctors showed up for the class.

"Oncologists are recognizing that this is not an either-or phenomenon or a cultural war. It's about: How do we create the most effective care for our patients?" says Gordon, author of the book Comprehensive Cancer Care: Integrating Alternative, Complementary, and Conventional Therapies."

Although many doctors still disapprove of the use of any scientifically untested therapy, signs of oncology's acceptance of nontraditional forms of medicine are apparent. The federal government's cancer unit, the National Cancer Institute, established its own office of complementary and alternative medicine and increased its budget from $36.6 million in 1999 to $47 million this year. Owing to such funding, studies on alternative medicine have become regular features in scientific cancer journals.

Many hospitals are hiring alternative-medicine experts or are launching departments devoted to non-Western research and treatments. Some doctors are even learning to perform alternative treatments, particularly acupuncture.

Although trained to possess a laserlike focus on cure, cancer doctors are beginning to value therapies that, while not able to halt the disease, improve a patient's life.

"Cancer patients have specific side effects: fatigue, lymphedema [swelling], nausea and other long-term problems that, very often, their conventional medical doctors are not addressing. Or they are addressing in a way that - from the patient's perspective - is over-medicalized," says Judith Jacobson, an assistant professor of clinical epidemiology at Columbia University. "Patients are looking for a more gentle, easier way to deal with things."

After struggling with advanced colon cancer, Dr. R. Scott Hitt says he has altered the way he treats his own patients. Hitt specializes in treating people with HIV.

"Now, when someone is diagnosed with HIV, the first thing I do is order a T-cell blood count and tell them to get some help in the mental area," says Hitt. "I think that should be done in oncology."

Facing a recurrence of colon cancer that had spread to his liver, Hitt last spring turned to hypnosis to alleviate the side effects of chemotherapy and a support group to help him cope with his emotions.

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