In the Chemo Room: Integrative medicine

I'm in a clinical trial of a drug alphanumerically designated by its maker Genentech Inc. as MEHD7945A, as if it were a star or a galaxy.

The drug  has shown some benefit to me so far. It has reduced my lung tumors slightly, and kept other tumors stable. That, besides some moderate side effects, is the drug's benefit.

But my enrollment in the trial is a result of past chemotherapy treatments losing their effectiveness. Standard treatments no longer control the growth of tumors in my lungs and lymph nodes in my chest cavity; the new drug seems to be doing that.

But even as I take the drug and monitor myself for its effects, I have always been interested in what are called alternative or complimentary treatments for my cancer. They include diet, physical exercise, reduction of stress, spiritual and psychological exercise, dietary supplements and just about anything else someone might suggest to a cancer patient.

The suggestions can be overwhelming and an oncologist often will poo poo them as unscientific and not worth your bother.

But I listened to a 90-minute Colon Cancer Alliance webinar called Integrative Medicine: Wellness Throughout Treatment and Surviorship earlier this month and heard something I have wanted to hear ever since I began my own scattershot research of alternatives to chemotherapy.

Mary Hardy, a doctor and medical director of the Simms/Mann UCLA Center for Integrative Oncology, finally put an end to across-the-board dismissals of alternatives:

"I like to choose interventions from this arena that have scientific evidence where it is available," Hardy cautioned from her own scientific background.

She added, "The evidence base for what kind of diet, for what kind of supplements, for what kind of effects, is much smaller than it is for the chemotherapy medications that you'll be offered. But there is a body of evidence and it is growing, and when people are making recommendations for you in this area, they should be aware of this evidence, aware of these studies, and use them appropriately."

Hardy went on to share what she knew of the most-talked-about alternatives, first saying: "The best wellness plan is one that is tailored to you."

She suggested finding a knowledgeable coach to help you craft your own response to your disease, and she said to inform your oncologist of what you are doing so he or she can respond as well. Some chemotherapy drugs can be rendered less effective by certain dietary supplements.

Her basic components of a plan were simple:

• Optimize your diet.
• Exercise regularly.
• Maintain a healthy weight.
• Practice regular stress management.

Hardy's presentation -- you can listen to the whole show by clicking on the link above and then clicking on "Launch Presentation" -- was actually the second part of the webinar.

Anne Coscarelli, a clinical professor in the Department of Psychology at UCLA, opened the session speaking of the mental and emotional toll a cancer diagnosis takes on a patient, their family and their caregivers, and offering "mindful" techniques for patients to dispel fear and anxiety.

"Colon cancer, like other cancers, comes with a measure of uncertainty," Coscarelli said. "It really can change a person's life both physically, mentally and spiritually." It also can disrupt a patient's physical function, their social network, their sexual and reproductive health, their financial and work status and their spiritual and psychological outlook.

"Stress and anxiety become imprinted on us,' Coscarelli said. "They become imprinted on our brain."

She added that fears of the spread or recurrence of the disease can be spiked by news coverage of the latest medical or research developments, by surfing the Internet for more and more information about your disease, and even by anniversary dates: of surgeries or disease-free scans, or other markers in a patient's fight for life.

The webinar, jointly hosted by the UCLA Center for Integrative Oncology and the Colon Cancer Alliance, is one of a series of "Conversations about Colon Cancer" held on the CCA's website. Check it out for more information about living with the disease.

In the Chemo Room: Colon Cancer Alliance national meetup

I walked three miles today, more than I have been able to exercise since they but a bag on my belly and took a tumor and my rectum out of my bottom in September 2007. It felt good.

I was following some of the primary advice given colorectal cancer survivors -- about 60 of them -- attending the national conference of the Colon Cancer Alliance at the Marriott Denver City Center on Friday. The advice I heard most often was: Keep exercising. It will prolong your life.

Which is what all those survivors are looking to do. Some, like me, still have the cancer and are still fighting it. More than half of the 60 had survived the disease for more than five years, and some had passed the 10-year mark. Most of those looked pretty fit. And many of them walked in the Denver Undy 5000, a 5K and one-mile fun run and walk held this morning in City Park.

It didn't take long to be told on Friday that exercise was one of the best anti-cancer drugs. Dr. Tim Byers, a professor of preventive medicine at the University of Colorado Cancer Center in Aurora, opened the day-long conference with a keynote address packed full of statistics that showed declining death rates for both men and women treated for colorectal cancer.

Why?

"We don't really know," Byers said, striking a tone that held throughout the conference: a forthright realism about everything from ordinary doctors' lackadaisical endorsement of colonoscopy, the most effective preventive for colon cancer, to the lingering effects of "chemo brain," a loss of memory and other cognitive function after prolonged chemotherapy.

Another University of Colorado Cancer Center doc, Stephen Leong, lent credence to cancer survivors' complaints of "chemo brain," and suggested it was one of several persistent side effects doctors need to pay more attention to as increasing number of survivors live cancer free for longer than five years.

Other speakers noted lengthening survival times tend to make the magic five-year mark less meaningful. Cancer changes your life, many speakers agreed; but after-cancer realities are often magnified: money problems from long-term loss of income, relationship problems from a lack of a sex life, reassessment of career goals and capacities, all make surviving cancer a new life challenge.

Byers said at the outset that researchers believe all cancers, including colorectal cancer, like car crashes, are caused by a variety of factors -- genetic and cultural, environmental, behavioral, "What we run into in life" and simple "bad luck" -- that often combine in multiple and unpredictable ways.

Colorectal cancer, however, remains the second leading cause of cancer deaths in the United States after lung cancer, and part of the reason is that it strikes both men and women and most of it occurs sporadically, meaning the victim's cells mutate randomly.

Still risk factors for colorectal cancer are listed as:

•  Age, gender, race/ethnicity
• Family history
• Inflammatory bowel disease
• Diet
• Body weight
• Physical activity.

But an estimated 40 percent of colorectal cancer can be attributed to four specific risks: obesity, lack of physical activity, fruit and vegetable intake, and consumption of red meats.

"For colorectal cancer, brisk walking can take down the risk factor dramatically," Byers said.

So the next morning, I decided instead of standing around at the Undy 5000, where runners and walkers wear underwear over their exercise outfits to designate the geography of the colorectal problem, I would indeed walk the three miles to see if I could do it.

It seemed the best and cheapest therapy available.

I did, and it felt good.