Complementary and Integrative Therapies

 Laurl at ONS 

Welcome to the ONS Hot Topic Chats! Today’s expert is Dr, Heidi Lucas , who will be talking with us about Complimentary and Integrative Therapies. Welcome Heidi!

 heidilucas 

Hello everyone thank you for having me, all ready to discuss...

 heidilucas 

Any burning questions?

 Laurl at ONS 

Heidi, to get us going, are there any botanical remedies for GI symptoms resulting from chemo?

 leahma 

Would love to hear about the use of Chinese herbs and chemotherapy.

 heidilucas 

GI symptoms: for diarrhea I use a lot of L-glutamine, slippery elm bark and fish oils (epecially with CPT-11).

 heidilucas 

Chinese herbs can be a great adjunct to treatment, the ones I use most commonly are Astragalus root (immune support) and Scutellaria (anti-inflammatory).

 heidilucas 

There is a lot of research on Chinese herbs so they have quite a history of using them with chemotherapy.

 leahma 

Any great reference suggestions?

 heidilucas 

As far as research in general PubMed, in terms of books I like "Jade Remedies". I can add some more to the transcript; I will ask the acupuncturist in my office.

 Laurl at ONS 

Where does one typically obtain these herbs? Are there over the counter preparations of these particular ones?

 heidilucas 

Yes you can get them from an herb or health food store, but the quality is not regulated, so I recommend getting them from a practitioner who knows the source.

 heidilucas 

Especially with Chinese herbs there are some serious concerns about heavy metal toxicity. There are some companies that test every batch.

 steph199 

What about contraindications with prescribed medications and chemo meds

 steph199 

Who is best to inform the pt as to what to take and what to avoid?

 heidilucas 

I use Vital Nutrients, Thorne, Health Concerns and Honso brands.

 heidilucas 

I always ask the patient to say everything they are taking; there are contraindications with some herbs so I recommend that they see a practitioner familiar with oncology.

 leahma 

What are your suggestions for nausea?

 heidilucas 

Who best to inform pt: that may be an Traditional Chinese medicine doctor, Naturopathic oncologist, Medical herbalist, Holistic MD or Nutritionist specializing in integrated oncology.

 heidilucas 

For nausea, ginger is really the first I try; strong tea with 1/2 tsp honey -sip throughout the day. I also use fennel tea, homeopathic nux vomica and sea bands.

 heidilucas 

Sea bands are small bracelets that stimulate the acupuncture point pericardium 6 which is the anti-nausea point.

 oncnurse 

Sea bands worked great for me during a very difficult pregnancy where I was nauseated the entire 9 months.

 heidilucas 

In terms of nutrition I make sure the patient is getting enough protein in the diet; this helps to balance blood sugar which stabilizes digestive tract and nervous system.

 leahma 

Anyone using music therapy or biofeedback in their practice?

 heidilucas 

Yes I use music, especially for brain cancer patients or high anxiety patients. I do a form of biofeeback with simple yogic breathing

 leahma 

Are you self-learned so to speak...where do I start?

 heidilucas 

It is always amazing to me how in the fear state of cancer we forget deep breathing, which is crucial for cognitive function, pain relief and immune support.

 heidilucas 

I am a yoga teacher I have a certification in hatha yoga so that is a start; the music therapy was inspired by Oliver Sachs book "Musicophilia".

 heidilucas 

I would start with basic yoga or whatever mind body modality you are attracted to, and read up on some of the psychoneuroimmunology.

 Laurl at ONS 

What would you recommend for pain relief?

 heidilucas 

First I start with abdominal breathing; nutritionally, I use calcium and magnesium, as these are often depleted by pain medications.

 leahma 

Would you recommend the use of pressure points?

 heidilucas 

For pain, there are some good herbs, like white willow, boswellia, jamaican dogwood, fenel seed, california poppy...

 heidilucas 

Leahma, do you mean massage on those points?

 leahma 

Yes

 heidilucas 

I would check in with the patient; if there is a lot of pain and sensitivity I would not go too deeply. I would use more subtle therapy like cranio-sacral.

 heidilucas 

Sometimes when those points are inflammed I use a topical with light massage like traumeel, St. John’s wort oil or arnica oil.

 heidilucas 

Traumeel is a homeopathic preparation used a lot in Germany.

 heidilucas 

It (traumeel) is great for after surgery and really any area of pain, inflammatory or nerve related. It comes in a cream, gel and oral preparations.

 Laurl at ONS 

What is reiki therapy best used for?

 heidilucas 

Anything, anytime, anywhere... I think of this with other energy healing modalities; we could all use them. There is research on them too and patients usually feel a difference.

 leahma 

Thanks for some great info but I gotta go--no overtime in my institution!

 Laurl at ONS 

Glad you could come!

 heidilucas 

Thank you much healing to you.

 oncnurse 

Heidi, what would you do for ascites/edema?

 heidilucas 

Ascites, I confirm if albumin is low in the labs and start the patient on egg white protein. For general edema I use diuretic herbs like nettle leaf tea, chamomile and green tea.

 heidilucas 

I use some physical medicine, massage to increase circulation, some stretching and simple yoga poses to move fluid, decrease stress on the heart.

 oncnurse 

Are there any herbs that particularly should be avoided when on chemo? And why?

 heidilucas 

One of the main herbs that I use a lot in practice is turmeric (curcumin), but there are some cautions when you are on certain treatments. Do not use it with cytoxan, irinotecan or any anthracycline.

 heidilucas 

Why: there have been in vitro studies that show it interferes with efficacy (I know in vitro not the best indicator but until we get better studies I take a conservative approach).

 heidilucas 

Another combo I avoid is Quercetin (a bioflavonoid) with any of the taxanes, again some in vitro work that showed interference with chemo efficacy.

 heidilucas 

In these cases if a human study comes out that clears the supplement or herb for use,  then I feel more comfortable using it.

 Laurl at ONS 

Do you think it’s a fair statement to say that most of what you prescribe is research-based?

 heidilucas 

Yes, although I use clinical experience as well. Our clinic has been around for 10+ years and we do use herbs if they make sense in the traditional herbal medicine context.

 heidilucas 

I also use food as medicine- for example having patients eat more cruciferous veggies or adding simple protein powder, simple herbal teas like cinnamon for diarrhea because we know it’s an astringent... there are no studies on these but it makes sense and patients do well.

 Laurl at ONS 

Have you heard of raspberry tea also for nausea?

 heidilucas 

I think of raspberry leaf for uterine support so no haven't used it for nausea, just women’s health.

 Laurl at ONS 

It’s a few minutes before the end of our chat- please don’t stop asking questions! However, when you can, please take a moment after the chat to cut and paste this URL into a browser window and take our very brief survey –we’d love to hear what you think of these chats! The URL is http://research.zarca.com/k/RsTUTRsTPPsXYURUsPsP.

 Laurl at ONS 

Well, if we have no more questions, we'll call it a day! Thank you Heidi, for your great new suggestions today - please be sure to check out the previous transcripts, as well as this one, which will be posted tomorrow.

 Laurl at ONS 

The last chat in this series is this Monday at 11am Eastern- please join us!

 heidilucas 

Thank you, lots of healing to you.

 Laurl at ONS 

Good afternoon!