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Cancer - Alternative and Complementary Treatment Options
Dr. Nimit Sudan discusses alternative and complementary therapies for cancer patients.
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Learn more about Nimit Sudan, MD
Nimit Sudan, MD
Dr. Nimit Sudan is a hematologist oncologist who practices in Encino and Santa Clarita. He is board certified in internal medicine, hematology and medical oncology, and is an assistant clinical professor in the David Geffen School of Medicine at UCLA.Learn more about Nimit Sudan, MD
Transcription:
Melanie Cole (Host): If you’ve been told you have cancer, it’s devastating, and you want to make informed choices about your care with your doctor, and one question that you might have is about complementary and alternative medicine. My guest today is Dr. Nimit Sudan. He’s a physician with UCLA Health who’s on the medical staff at Henry Mayo Newhall Hospital. Dr. Sudan, what a pleasure to have you with us today, and this is such a great topic. So many people that are facing cancer treatments have questions about these different types of therapies that they read about. So, first let’s start talking about what are some of the challenges that cancer patients face that alternative and complementary medicines can help with?
Nimit Sudan MD (Guest): Everyday patients come to my office, and you know, they want treatment for their cancer, but they want to know what they can do. So, part of it is being in control and then the other part is making sure everything that’s possible can be done. Now, Western medicine, we have surgery. We have chemotherapy, radiation therapy, and other interventions, but there is a lot of other things that patients can look into to help. So, one of the things that complementary and alternative medicine can really help with is symptoms. So, things like fatigue, anxiety, pain, depression, insomnia—some of—very common symptoms that patients experience. So, there are a lot of modalities available, and it’s really nice to be in Southern California and Los Angeles where these are available. If you go to the Midwest or East Coast sometimes, it’s very hard to find, you know, acupuncturists or Ayurvedic medicine practitioners in the area, but we’re very fortunate to be in Southern California where these practitioners are, you know, readily available for patients.
Host: So, one of the things, you know, when somebody gets that devastating diagnosis, their life is affected. Their quality of life is really affected whether it’s psychosocial or physical; anger of “Why me?” “Why did this happen to me?” Speak to us a little bit about how that is affected, you know. What they can look to—what are some of the treatment therapies that you like to recommend?
Dr. Sudan: So, obviously, you know, getting a devastating diagnosis such as cancer really does affect a person in so many ways—not only the person, but their family as well. You know, I say that most people will go through the usual stages of grief as, you know, described by different psychologists that people go through when, you know, their loved ones die; so, you know, there’s anger, denial, etc.—eventually acceptance and then moving forward. So, you know, I think things like yoga, things like meditation, massage therapy, and other therapies like music therapy, art therapy, and acupuncture are very helpful in helping patients with anxiety. The other thing, for example, at UCLA and I know at Henry Mayo, as well, there are practitioners available that help in mindfulness. So, we actually have a course in mindfulness where patients—it’s a six-week course—where patients come in and learn how to be better in touch, recognize their anxieties and their fears so they can better deal with it down the road. So, there’s a lot of modalities available to help patients from day one of their diagnosis, and let’s not forget, support groups and other support modalities that are available, and again, Henry Mayo Hospital has a lot of these available, you know, on campus, on site.
Host: Doctor, it’s so important that patients feel that they’re doing something more to help their own care, and I thank you for that last answer, but for the listeners, can you tell us the difference between complementary medicine, alternative medicine, naturopathic medicine because people don’t know really what those all are, and how they fit into, now that we’re combining Western medicine and Eastern medicine, and they’re all kind of coming together for a more holistic care, aren’t they?
Dr. Sudan: Yes, they are, and there’s a lot of words that fly around like complementary medicine, alternative medicine, Eastern medicine, Western medicine. So, so it’s good. Let’s talk about some definitions. So, your standard Western medicine is again, like I mentioned, things like chemo, surgery. The medication that you get when you go to the doctor, okay? Complementary means just that—complements Western medicine. So, anything you use that adds on possibly to Western medicine. Alternative is just that—it’s an alternate to Western medicine, so a lot of people will decline chemo and surgery and seek other treatments for their cancers. Now, you know, that leads us to another issue, another challenge that unfortunately, there are a lot of—how should I put it—false information out there that entice patients to decline standard medicine and pursue alternative medicine. For most alternative medicine modalities, I counsel patients very intensely against, you know, especially if I think they’re making a mistake, definitely, you know, I’ll counsel against, because I think the best approach is complementary medicine, which is use the best of both worlds, you know. Use the Western medicine and if you’d like, add on Eastern medicine, like Ayurvedic medicine or acupuncture to help and augment the standard treatments that they’re receiving, and that is the best-case scenario for any patient to really pursue both complementary and standard medicine.
Host: Well, as an exercise physiologist, I certainly hear that, Dr. Sudan. I, you know, I know that exercise can be such a good complement and help really when you’re going through some of these treatments. It can be difficult and limiting, but it can also really help you to feel better. Now, some of the things that we’ve been discussing are not always indicated. Natural doesn’t always mean safe, correct? Tell us a little bit about some of the considerations you would like patients to think about that they might really want to discuss with their doctor that might have interactions with what they are doing.
Dr. Sudan: So, that is a big issue—the word interaction. So, you know, you’re right, natural does not mean safe. If you really think about it, we have a lot of medications we use, you know, your doctor might prescribe, that are from natural sources, such as even I use them: Taxol, you know, it’s a type of chemotherapy, and there’s other chemotherapies that were initially derived from plants or natural sources and look what chemotherapy does to you, right? Nausea, hair loss, neuropathy, etc., etc. So natural does not always mean safe. That is a very important statement, and not only that, a lot of herbs and natural medications can interact with regular medication. So, you know, medications like ginseng has been shown to interact with a lot of different chemotherapies and other medications you might take, so you have to be very careful with the herbal supplements that you take. There are resources online. There are databases online where you can look to see if your herbal supplements interacts with some of the medications that you’re on, but the reality is—we don’t know a lot of the interactions because they just have not been studied. The other thing is anything you take at a high dose, will have and can have significant side effects. So, for example, if you take a certain vitamin, okay, let’s say Vitamin D. Let’s say your Vitamin D is low. You take Vitamin D. It’s great. Your bones, you know, Vitamin D is suggested for stronger bones, but if you take high doses for a long time, it can cause problems like high calcium which can lead to kidney stones and other issues. So, just because something is good at a normal standard dose doesn’t mean it’s a lot better at a much higher dose. It can be harmful. So, there’s things like interactions to worry about. Anything you put in your mouth can have side effects. So, herbal supplements can also have side effects. I’ve had people who come in with nausea, you know, altered kidney function, altered liver function because of supplements they’ve taken. So, you have interactions; you have side effects. So, you do have to be very careful with what you take. The best thing to do is to be open whenever dialogue with your healthcare providers and talk to them about it. Say, you know, “I am taking this, you know, do you have any known interactions to the medications you’re prescribing, and do you have any suggestions?” You know, most physicians will be very open to talking to you about, you know, the complementary and herbal supplements that you might be on.
Host: Certainly true. Great information. As we wrap up, Dr. Sudan, tell the listeners what you’d like them to know—the take home message from this really important and very interesting segment about the complementary and alternative approaches, things they can look to as adjuvant therapies to go along with their cancer treatment, and why they should really discuss these with their physician.
Dr. Sudan: We’ve talked about the harmful side of things. Let’s talk about the positive side of things. So, you’ve actually mentioned you’re an exercise therapist. So, if you actually look at studies—if you look at data that’s out there, exercise has been shown to reduce relapse of cancers, has been shown to help the standard treatments such as chemotherapy and radiation therapy have a better outcome with exercise. So, if you really look at studies, things like your weight, your exercise, your diet—more plant based—so you don’t have to be vegetarian or vegan but add more fruits and vegetables to your diet. Those interventions actually have studies. Some studies have shown 20, 30% improvement in cancer outcomes with exercise and following a good diet.
Finally, one of the very important things is controlling your blood sugars if you’re a diabetic, okay. If you’re a diabetic, and your sugars are out of control, not only is there increased risk of cancer per studies that have been done, but there’s also decreased or worse outcomes with people getting treatment for cancers or people who are survivors. There’s a worse outcome with relapse rates. So, if you’re overweight; lose some weight. If you’re a diabetic, make sure your sugars are under control. Make sure you eat a well-rounded diet and make sure you exercise. Now exercise, you don’t have to run a marathon, but be active, 20, 30 minutes, mild to moderate exercise—20, 30 minutes; four, five days a week. Those are interventions that have definitely shown to be a benefit that anybody can do. You don’t have to go buy exercise, right? You can go out for a walk every day. So, there are a lot of interventions that are very helpful in your outcomes and will make you feel better. A lot of studies are being done. For example, CBD is really in the news these days and there’s a lot of studies—national studies—that are being done on CBD and other alternative medicine. I am certified in acupuncture, although I don’t practice it currently. Acupuncture has been shown to help with many, many symptoms during and after treatment of cancer. So, seek out a good acupuncturist in your area. Meditation, massage therapy, those are all modalities that have been shown with studies to help actually. There is actually currently standard guidelines out there for treatment of breast cancer and what alternative and complementary medicines work and what kind of data, what kind of studies that have been done on it. So, I would advise you to look these up. Just put in, you know, just search online for guidelines for alternative and complementary medicine for breast cancer. It’s really eye-opening, but there are things out there that work that you can work with your physician or your or healthcare provider as complementary to your standard treatment.
Host: Wow, what a great segment and so important for people to hear, and I love that you listed them out at the end. You mentioned music therapy and yoga and relaxation, meditation. These are all wonderful ways to help with cancer treatments. Thank you so much, doctor, for joining us today, and that wraps up another episode of It’s Your Health Radio with Henry Mayo Newhall Hospital. Head on over to our website at henrymayo.com for more information and to get connected with one of our providers. If you found this podcast as interesting as I did, please share. I’m sure you know somebody going through cancer treatments and for them to hear from the experts that they can try some of these therapies will really be uplifting and such a big help, and be sure not to miss all the other interesting podcasts in our library. Until next time, I’m Melanie Cole.
Melanie Cole (Host): If you’ve been told you have cancer, it’s devastating, and you want to make informed choices about your care with your doctor, and one question that you might have is about complementary and alternative medicine. My guest today is Dr. Nimit Sudan. He’s a physician with UCLA Health who’s on the medical staff at Henry Mayo Newhall Hospital. Dr. Sudan, what a pleasure to have you with us today, and this is such a great topic. So many people that are facing cancer treatments have questions about these different types of therapies that they read about. So, first let’s start talking about what are some of the challenges that cancer patients face that alternative and complementary medicines can help with?
Nimit Sudan MD (Guest): Everyday patients come to my office, and you know, they want treatment for their cancer, but they want to know what they can do. So, part of it is being in control and then the other part is making sure everything that’s possible can be done. Now, Western medicine, we have surgery. We have chemotherapy, radiation therapy, and other interventions, but there is a lot of other things that patients can look into to help. So, one of the things that complementary and alternative medicine can really help with is symptoms. So, things like fatigue, anxiety, pain, depression, insomnia—some of—very common symptoms that patients experience. So, there are a lot of modalities available, and it’s really nice to be in Southern California and Los Angeles where these are available. If you go to the Midwest or East Coast sometimes, it’s very hard to find, you know, acupuncturists or Ayurvedic medicine practitioners in the area, but we’re very fortunate to be in Southern California where these practitioners are, you know, readily available for patients.
Host: So, one of the things, you know, when somebody gets that devastating diagnosis, their life is affected. Their quality of life is really affected whether it’s psychosocial or physical; anger of “Why me?” “Why did this happen to me?” Speak to us a little bit about how that is affected, you know. What they can look to—what are some of the treatment therapies that you like to recommend?
Dr. Sudan: So, obviously, you know, getting a devastating diagnosis such as cancer really does affect a person in so many ways—not only the person, but their family as well. You know, I say that most people will go through the usual stages of grief as, you know, described by different psychologists that people go through when, you know, their loved ones die; so, you know, there’s anger, denial, etc.—eventually acceptance and then moving forward. So, you know, I think things like yoga, things like meditation, massage therapy, and other therapies like music therapy, art therapy, and acupuncture are very helpful in helping patients with anxiety. The other thing, for example, at UCLA and I know at Henry Mayo, as well, there are practitioners available that help in mindfulness. So, we actually have a course in mindfulness where patients—it’s a six-week course—where patients come in and learn how to be better in touch, recognize their anxieties and their fears so they can better deal with it down the road. So, there’s a lot of modalities available to help patients from day one of their diagnosis, and let’s not forget, support groups and other support modalities that are available, and again, Henry Mayo Hospital has a lot of these available, you know, on campus, on site.
Host: Doctor, it’s so important that patients feel that they’re doing something more to help their own care, and I thank you for that last answer, but for the listeners, can you tell us the difference between complementary medicine, alternative medicine, naturopathic medicine because people don’t know really what those all are, and how they fit into, now that we’re combining Western medicine and Eastern medicine, and they’re all kind of coming together for a more holistic care, aren’t they?
Dr. Sudan: Yes, they are, and there’s a lot of words that fly around like complementary medicine, alternative medicine, Eastern medicine, Western medicine. So, so it’s good. Let’s talk about some definitions. So, your standard Western medicine is again, like I mentioned, things like chemo, surgery. The medication that you get when you go to the doctor, okay? Complementary means just that—complements Western medicine. So, anything you use that adds on possibly to Western medicine. Alternative is just that—it’s an alternate to Western medicine, so a lot of people will decline chemo and surgery and seek other treatments for their cancers. Now, you know, that leads us to another issue, another challenge that unfortunately, there are a lot of—how should I put it—false information out there that entice patients to decline standard medicine and pursue alternative medicine. For most alternative medicine modalities, I counsel patients very intensely against, you know, especially if I think they’re making a mistake, definitely, you know, I’ll counsel against, because I think the best approach is complementary medicine, which is use the best of both worlds, you know. Use the Western medicine and if you’d like, add on Eastern medicine, like Ayurvedic medicine or acupuncture to help and augment the standard treatments that they’re receiving, and that is the best-case scenario for any patient to really pursue both complementary and standard medicine.
Host: Well, as an exercise physiologist, I certainly hear that, Dr. Sudan. I, you know, I know that exercise can be such a good complement and help really when you’re going through some of these treatments. It can be difficult and limiting, but it can also really help you to feel better. Now, some of the things that we’ve been discussing are not always indicated. Natural doesn’t always mean safe, correct? Tell us a little bit about some of the considerations you would like patients to think about that they might really want to discuss with their doctor that might have interactions with what they are doing.
Dr. Sudan: So, that is a big issue—the word interaction. So, you know, you’re right, natural does not mean safe. If you really think about it, we have a lot of medications we use, you know, your doctor might prescribe, that are from natural sources, such as even I use them: Taxol, you know, it’s a type of chemotherapy, and there’s other chemotherapies that were initially derived from plants or natural sources and look what chemotherapy does to you, right? Nausea, hair loss, neuropathy, etc., etc. So natural does not always mean safe. That is a very important statement, and not only that, a lot of herbs and natural medications can interact with regular medication. So, you know, medications like ginseng has been shown to interact with a lot of different chemotherapies and other medications you might take, so you have to be very careful with the herbal supplements that you take. There are resources online. There are databases online where you can look to see if your herbal supplements interacts with some of the medications that you’re on, but the reality is—we don’t know a lot of the interactions because they just have not been studied. The other thing is anything you take at a high dose, will have and can have significant side effects. So, for example, if you take a certain vitamin, okay, let’s say Vitamin D. Let’s say your Vitamin D is low. You take Vitamin D. It’s great. Your bones, you know, Vitamin D is suggested for stronger bones, but if you take high doses for a long time, it can cause problems like high calcium which can lead to kidney stones and other issues. So, just because something is good at a normal standard dose doesn’t mean it’s a lot better at a much higher dose. It can be harmful. So, there’s things like interactions to worry about. Anything you put in your mouth can have side effects. So, herbal supplements can also have side effects. I’ve had people who come in with nausea, you know, altered kidney function, altered liver function because of supplements they’ve taken. So, you have interactions; you have side effects. So, you do have to be very careful with what you take. The best thing to do is to be open whenever dialogue with your healthcare providers and talk to them about it. Say, you know, “I am taking this, you know, do you have any known interactions to the medications you’re prescribing, and do you have any suggestions?” You know, most physicians will be very open to talking to you about, you know, the complementary and herbal supplements that you might be on.
Host: Certainly true. Great information. As we wrap up, Dr. Sudan, tell the listeners what you’d like them to know—the take home message from this really important and very interesting segment about the complementary and alternative approaches, things they can look to as adjuvant therapies to go along with their cancer treatment, and why they should really discuss these with their physician.
Dr. Sudan: We’ve talked about the harmful side of things. Let’s talk about the positive side of things. So, you’ve actually mentioned you’re an exercise therapist. So, if you actually look at studies—if you look at data that’s out there, exercise has been shown to reduce relapse of cancers, has been shown to help the standard treatments such as chemotherapy and radiation therapy have a better outcome with exercise. So, if you really look at studies, things like your weight, your exercise, your diet—more plant based—so you don’t have to be vegetarian or vegan but add more fruits and vegetables to your diet. Those interventions actually have studies. Some studies have shown 20, 30% improvement in cancer outcomes with exercise and following a good diet.
Finally, one of the very important things is controlling your blood sugars if you’re a diabetic, okay. If you’re a diabetic, and your sugars are out of control, not only is there increased risk of cancer per studies that have been done, but there’s also decreased or worse outcomes with people getting treatment for cancers or people who are survivors. There’s a worse outcome with relapse rates. So, if you’re overweight; lose some weight. If you’re a diabetic, make sure your sugars are under control. Make sure you eat a well-rounded diet and make sure you exercise. Now exercise, you don’t have to run a marathon, but be active, 20, 30 minutes, mild to moderate exercise—20, 30 minutes; four, five days a week. Those are interventions that have definitely shown to be a benefit that anybody can do. You don’t have to go buy exercise, right? You can go out for a walk every day. So, there are a lot of interventions that are very helpful in your outcomes and will make you feel better. A lot of studies are being done. For example, CBD is really in the news these days and there’s a lot of studies—national studies—that are being done on CBD and other alternative medicine. I am certified in acupuncture, although I don’t practice it currently. Acupuncture has been shown to help with many, many symptoms during and after treatment of cancer. So, seek out a good acupuncturist in your area. Meditation, massage therapy, those are all modalities that have been shown with studies to help actually. There is actually currently standard guidelines out there for treatment of breast cancer and what alternative and complementary medicines work and what kind of data, what kind of studies that have been done on it. So, I would advise you to look these up. Just put in, you know, just search online for guidelines for alternative and complementary medicine for breast cancer. It’s really eye-opening, but there are things out there that work that you can work with your physician or your or healthcare provider as complementary to your standard treatment.
Host: Wow, what a great segment and so important for people to hear, and I love that you listed them out at the end. You mentioned music therapy and yoga and relaxation, meditation. These are all wonderful ways to help with cancer treatments. Thank you so much, doctor, for joining us today, and that wraps up another episode of It’s Your Health Radio with Henry Mayo Newhall Hospital. Head on over to our website at henrymayo.com for more information and to get connected with one of our providers. If you found this podcast as interesting as I did, please share. I’m sure you know somebody going through cancer treatments and for them to hear from the experts that they can try some of these therapies will really be uplifting and such a big help, and be sure not to miss all the other interesting podcasts in our library. Until next time, I’m Melanie Cole.