Outside the Box Cancer Therapies

Alternative Therapies That Treat and Prevent Cancer
384 pages

This is the sixth book in our Conquering Cancer series. It’s a great overview of the importance of an integrative oncological approach written by two naturopathic medical doctors with over 40 years of combined clinical experience and a ton of experience researching and teaching these principles to other medical professionals and their patients. It’s almost encyclopedic in its analysis of “outside the box cancer therapies” and the kind of book you wish you could instantly download into your traditional oncologist’s brain for a quick introduction to how a powerful integrative approach works. Big Ideas we explore include defining “integrative oncology,” looking at the root causes of cancer (and integrating conflicting theories), the philosophy of integrative medicine, strategic considerations for your cancer plan and the importance of “secondary prevention.”


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“We consider it critically important to provide you, the reader, with the best that integrative oncology has to offer. Our observation is that only bits and pieces of credible integrative oncology information are available. We have resolved that problem by putting it into one resource.

Outside the Box Cancer Therapies is a comprehensive guidebook designed to help patients and their doctors navigate the most effective nutritional and holistic cancer therapies available today. Conventional medical specialties such as oncology are highly technical and specific in their training and with the therapies that are used. In the modern system, no physician can know everything, but in the world of cancer and integrative care, often the feeling ‘if I didn’t learn it in my residency, it must not be good therapy’ prevails. This can encompass simple things such as nutritional therapies or more complex ones such as the large world of integrative oncology. We aim to provide you and your doctors with the details you need to begin using these lifesaving protocols starting today.”

~ Dr. Mark Stengler and Dr. Paul Anderson from Outside the Box Cancer Therapies

This is the sixth book in our Conquering Cancer series. We started with Anticancer then Tripping over the Truth then The Metabolic Approach to Cancer then Cancer as a Metabolic Disease then Keto for Cancer. And, here we are.

I got an advanced copy of this book directly from Dr. Paul Anderson (thank you, Paul) via our mutual friend Dr. Nasha Winters (thank you, Nasha) whose book The Metabolic Approach to Cancer is my #1 “read this book!” recommendation as it’s such a super-comprehensive yet super-practical handbook to rocking the nuts and bolts.

Here’s Nasha’s take from the back cover: “The well-researched and referenced protocols will be a life raft to thousands of people. Thanks to their collective work, I have had the privilege of applying most of the tools they have taught me into clinical and consulting practice, and it has truly been a game changer for the lives of many people otherwise given no hope.”

That captures it well. This book is a great overview of the importance of an integrative oncological approach written by two naturopathic medical doctors with over 40 years of combined clinical experience and a ton of experience researching and teaching these principles to other medical professionals and their patients.

It’s almost encyclopedic in its analysis of “outside the box cancer therapies” including an analysis of the best ways to mitigate side effects of various chemotherapy treatments and an overview of the scientific efficacy of dozens of nutritional supplements.

It’s the kind of book you wish you could instantly download into your traditional oncologist’s brain for a quick introduction to how a powerful integrative approach works. And, I can see it as an effective training guide for other naturopathic doctors.

It’s also super-helpful for patients as a guidebook on how to go about integrating their approach. (Get a copy of the book here.) And, of course, it’s packed with Big Ideas.

I’m excited to share a handful of my favorites so let’s jump straight in!

Integrative Oncology

“Conventional oncology plays an important role in the diagnosis and treatment of cancer. But we consider conventional oncology by itself as incomplete and less humane without the use of the holistic approaches found in integrative oncology. Integrative oncology has a much more encompassing approach to the prevention of cancer, taking into account the individual as a holistic person.”
Dr. Mark Stengler, N.M.D.

“We use the phrase integrative oncology for our approach, which is designed to take into account all available resources—conventional and holistic—to help prevent cancer and treat the disease when it does strike. We recognize people are individuals and every case is different. Sometimes conventional care needs to be prioritized. However, in almost every case, one or more holistic therapies can be used to augment that conventional care in order to reduce your side effects and optimize your chances of survival.

Let’s look at the case of a woman with metastatic breast cancer. Her conventional care might include chemotherapy, surgery, radiation, and antiestrogen medication. But during treatment, she could benefit from additional holistic therapy such as dietary changes, nutritional supplements, detoxification support, and intravenous nutrient therapy such as cancer-fighting high-dose Vitamin C to help ease some of her worst symptoms and side effects such as nausea, fatigue, anxiety, or insomnia. Once she has finished conventional treatment, integrative oncology and naturopathic approaches could be used to reduce her risk of recurrence. This would include focusing on diet and lifestyle choices and possibly using genetic-specific nutritional recommendations (known as ‘nutrigenomic therapy’). You’ll find several cases throughout the book demonstrating how integrative oncology works in the real world.”

“Integrative oncology.”

I love that phrase.

And, this line brilliantly captures the primary thesis of the book: “While conventional cancer therapy has its place, it also has its limits.”

That’s worth a repeat: Conventional cancer therapy has its place. AND… It has its limits.

As with most wise approaches to life, the wisest approach to cancer isn’t “either/or.”

We need to transcend and include the best of both the conventional and “holistic” worlds. This book does a great job of showing us how to do so.

As we discussed in Conquering Cancer 101, one of the first things I learned from my friend Pilar Gerasimo was to ask if there was an “integrative” physician on the team. Unfortunately, the answer at the hospital was no. And, unfortunately, my brother’s insurance doesn’t have any in-network integrative/functional MDs nor does it cover naturopathic doctors—which is part of a longer discussion.

For now, let’s embrace the idea of “integrative oncology” and remember (one more time!) the fact that “While conventional cancer therapy has its place, it also has its limits.”

The Metabolic Theory

“Many cancer patients have reported to us that their oncologist told them it was fine to consume simple sugar products as they had no effect on their cancer. Is this good science? We don’t think so.”
Dr. Mark Stengler, N.M.D.

“For the past 50 years, cancer researchers have focused on targeting the genetic mutations of cancer. In the 1920s, the Nobel Prize winner, Dr. Otto Warburg proposed that cancer was essentially a disease of deranged cell metabolism. This inspired the idea of cancer as a metabolic disease, or the ‘metabolic theory’ of cancer.

As with all things, as science progresses, the technology allows deeper insights into these theories and the mechanisms they are built upon. One of the many such revelations is that the energy-producing parts of the cell (the mitochondria) are essentially damaged in cancer, which helps drive a different metabolism in a cancer cell versus a normal healthy cell. And while we can now ‘see’ the changes and differences between healthy and cancerous cells, we can also see what Warburg described is essentially still true.

Is there a crossover in the genomic theory of cancer and the metabolic theory? To simplify this very deep discussion (which is the topic of many oncology books and some excellent reviews), we will summarize the crossover. First, the fidelity of the nuclear genome (genetic material allowing an organism to develop and grow) is tightly linked to mitochondrial function, so if the mitochondria ‘go bad,’ they naturally affect the genome. Cancer activation may be a downstream consequence of changes in energy metabolism (via the damaged mitochondria and genetic changes), creating a cancer ‘snowball effect,’ all of which has significant implications for treatment and prevention.

As you can see, there are not really right or wrong ideas but rather multiple ways of examining the existence and persistence of cancer. The only time these ideas get in the way of preventing, treating, or curing cancer is when the approach to treatment relies on only one theory and ignores the others. Our goal is to honor the science and truth in these theories and describe methods of prevention, intervention, and synergy that will help you receive the very best treatment.”

That’s from Chapter 2 on “The Root Causes of Cancer.”

We’ve discussed the two primary theories of cancer in our prior Notes. (Check out Tripping over the Truth and Cancer As a Metabolic Disease for more.)

Stengler and Anderson describe a third theory: The Cancer Stem Cell / Trophoblastic Theory.

For our practical purposes today, let’s focus on this important point: “The only time these ideas get in the way of preventing, treating, or curing cancer is when the approach to treatment relies on only one theory and ignores the others.”

Again, we want to transcend and include and INTEGRATE.

Genetic? Metabolic?

Ultimately, the answer is: Yes.

And, most importantly, we want to make sure our approach accounts for both.

Which, unfortunately, is where our conventional approaches often fall short.

A sign you may need to expand your team’s theoretical and therapeutic perspective to include the metabolic approach? Your oncologist tells you things like, “Eat whatever you want. Nutrition doesn’t matter.” And/or: Your chemotherapy room is stocked with soda and Cheez Its. :0

P.S. For the record, I love the way Nasha addresses the theoretical discussion: “The genetic mutations considered by conventional medicine as the root causes of cancer are, in fact, modifiable by epigenetic factors. Indeed, it is well established that genetics is the cause of only 5-10 percent of cancers and most of these genes encode proteins that impact mitochondrial respiration. It is mitochondrial damage that causes cancer, not the genes. If the inherited cancer gene does not damage mitochondria, cancer will not occur.”

Integrative medicine philosophy

“Diet and nutrition are truly the base upon which all other cancer therapies build. We have seen time and time again that a patient’s good response will fall away because the base of proper diet and nutrition is ignored. In many cases, diet is a difficult thing to change, but our experience has proven that it is critical and worth it. But more important than your diet, your attitude about your cancer treatment is a primary determinant of the success for your cancer treatment.”
Dr. Mark Stengler, N.M.D.

“Since most people are aware of what conventional medicine practices involve, we are going to introduce integrative medicine philosophy. As naturopathic medical doctors, we believe most comprehensive principles for integrative medicine come from the principles of naturopathic medicine. The American Association of Naturopathic Physicians defines them as follows:

  • ‘THE HEALING POWER OF NATURE (VIS MEDICATRIX NATURAE): Naturopathic medicine recognizes an inherent self-healing process in people that is ordered and intelligent. Naturopathic physicians act to identify and remove obstacles to healing and recovery, and to facilitate and augment this inherent self-healing process.
  • IDENTIFY AND TREAT THE CAUSES (TOLLE CAUSAM): The naturopathic physician seeks to identify and remove the underlying causes of illness rather than to merely eliminate or suppress symptoms.
  • FIRST DO NO HARM (PRIMUM NON NOCERE):
  • DOCTOR AS TEACHER (DOCERE): Naturopathic physicians educate their patients and encourage self-responsibility for health. …
  • TREAT THE WHOLE PERSON: Naturopathic physicians treat each patient by taking into account individual physical, mental, emotional, genetic, environmental, social, and other factors. …
  • PREVENTION: Naturopathic physicians emphasize the prevention of disease by assessing risk factors, heredity and susceptibility to disease, and by making appropriate interventions in partnership with their patients to prevent illness.’

Integrative doctors treat the root causes of disease. This is very important for cancer in both terms of treatment and prevention.”

As discussed, when we step “outside the box” and into a more integrative approach to cancer therapies, we enter the world of naturopathic medicine.

Seeing that philosophy drives therapy, it’s important to look at the underlying philosophical principles of an integrative approach. Specifically, the naturopathic approach.

I don’t know about you but a) Even though I’m super open, it’s easy to fall prey to our cultural bias and think an “MD” is somehow “better than” an “ND” and… b) When I read that list above I wish ALL medical doctors adhered to those philosophical principles!!!

Allow the body’s natural healing power to run the show? Sounds smart to remove the obstacles to that ineffably powerful natural life force.

In fact, David Servan-Schreiber, MD, PhD actually kicked off Anticancer with a quote from renowned scientist Rene Dubos (who discovered the first antibiotic in clinical use in 1939): “I have always felt that the only trouble with scientific medicine is that it is not scientific enough. Modern medicine will become really scientific only when physicians and their patients have learned to manage the forces of the body and the mind that operate via vis medicatrix naturae [the healing power of nature].”

Treat the cause rather than just the symptoms. Um, yah. As per our discussion on wise gardeners and Cancer’s Roots and Leaves, modern medicine has some strengths and weaknesses. Going after the symptoms while ignoring the systems is, perhaps, its biggest flaw.

First, do no harm? That sounds like a good idea—in both theory AND practice. Treating the whole person as a biologically and psychologically unique individual? Good idea! And, finally, Amen to the prevention.

Here’s to the rise of the naturopathic medical doctor! (And standard insurance coverage that includes their wise services!)

P.S. Later in the book, the authors share some wisdom from Dan Rubin, one of the founders of the American Board of Naturopathic Oncology. I love how he puts it: “I have maintained the opinion that naturopathic oncology, as a whole, is not very good at killing cancer cells. What we are good at is causing the cancer cells to die. … Therein lies the question posed by naturopathic oncology: what is it about the environment that allows the cancer cells to survive?”

Strategic Variables for your specific cancer care plan

“While people may debate the merits of chemotherapy, radiation, surgery, or other interventions in cancer care, what cannot be debated is that people need to heal from (and often be protected during) such therapies.”
Dr. Mark Stengler, N.M.D.
“Again, if you are following a KD (Ketogenic Diet), especially if you have cancer, make sure you do so under the supervision of a qualified medical professional.”
Dr. Mark Stengler, N.M.D.

“A primary consideration is ‘What are the chances of survival with standard cancer therapies for this type of cancer?’ If there is a very high survival rate, then often it is wise to seriously consider following the standard protocols while adding a well-rounded integrative oncology program. If, on the other hand, the survival chances are low, we often carefully consider the potential for side effects, lower quality of life, and other negative effects in balance with the low potential for remission.

Another consideration beyond the type of cancer and the likelihood of survival is the actual stage of the cancer and your specific survival potential given that stage. A lower stage cancer generally has a much higher survival rate than a higher stage cancer of the same type. We will often highly recommend standard cancer therapies in a ‘high survival’ cancer (with a well-rounded integrative oncology program), even though it may be similar for a low stage cancer. On the other hand, a high-stage cancer where survival is much lower and effects of standard treatment would more likely cause harm than remission, we will often tip the balance in the other direction and focus on an aggressive integrative approach.”

That’s from a chapter called “Common Cancers and Integrative Approaches” in which we learn how to map out our strategic, integrative approach to our specific diagnosis.

Note: Every (!!!) situation is unique. Period. And, of course, ultimately YOU are the CEO of your health care. Period.

And… Stengler and Anderson provide a powerful overview of how to architect your approach. Check out the book for more. For now, here’s the super-quick take.

If conventional approaches have been proven to work really well for your cancer (like testicular or prostate or Hodgkin’s lymphoma or breast cancer) then, they say, it’s often wise to “seriously consider following the standard protocols”—supplementing it with other integrative practices.

If, on the other hand, you are facing an advanced form of a type of cancer that is notoriously hard for conventional approaches to handle, you may want to consider a much more aggressive alternative approach. That’s where we are with my brother.

In fact, yesterday I literally opened the book to page 207 where they have a chart of “Overall Percent Survival at 1, 5, and 10 Years” for 10 different types of cancers. My brother has pancreatic cancer. Unfortunately, that has, by far, the worst survival rates via conventional care. Our approach is, therefore, as aggressive as it can get in following alternative approaches.

(This is also one of the reasons why, after looking at the PET scan 5 weeks after surgery (that resulted in the oncologist and his team saying “If we didn’t know you had cancer, we wouldn’t know you had cancer after looking at these scans.”), our oncologist said that if HE was diagnosed with what my brother has, he’d be following our approach.)

Again, every case is unique. Work with your team. Find the optimal integrative approach for you.

“Secondary Prevention”

“The primary job of integrative oncology is to push the boundaries of care into areas that yield better and better outcomes for people who have cancer. Conventional cancer therapy, while holding a place in cancer care, is not enough.”
Dr. Mark Stengler, N.M.D.

“In addition to cancer frequency, we will describe our process in considering active cancer therapies based on ‘addressing the foundation’ or working with the whole body to oppose the cancer and return health and balance. We will also look at the incredibly important topic of ‘secondary prevention’ or the process of stopping a return of cancer once you have been diagnosed with ‘no evidence of disease.’”

Let’s say you win the first battle with cancer and enter a state of remission in which there is “no evidence of disease.”

First: YES!!! Well done.

Now: Let’s keep you there!! It’s time for “secondary prevention.” We need to do all we can to PREVENT the relapse. This is where an integrative approach is so important. It’s not enough to push the cancer back once. We need to do everything we can to make sure our “terrain” is optimized such that cancer has as little chance as possible of coming back!!!

Stengler and Anderson give us a bunch of ways to approach this. We’ve discussed many in our other Notes. The first and most important therapeutic tool in our tool shed is our MINDS. We’ve gotta maintain that hope and commitment!!

Then we focus on the next biggest lever: Our DIET! Let’s follow the 80/20 stuff we talked about in our Notes on Anticancer plus Conquering Cancer 101, and, if you’re feeling it (and your type of cancer is a good candidate), you may want to go deep with the Keto for Cancer approach we talk about in Conquering Cancer 102.

Then we have stress management, exercise, supplements and IV treatments (super powerful!).

Check out the book for more but know that “stress makes your body more hospitable to cancer” and that “physical activity has the most pronounced effect of all the lifestyle factors on reducing breast cancer recurrence.”

Ultimately, prevention is where it’s at. If we missed the “primary” prevention phase and get hit with cancer, let’s give it all we got and push it into remission. THEN, let’s go ALL IN on a lifetime commitment to secondary prevention. And, in the process, let’s see if we can recreate our health from the ground up and get it so Optimized we’re more radiantly alive than ever before!

Sending love and blessings to you and your family as we think outside the box with our cancer therapies and give life all we’ve got!

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