Supportive Care in Oncology
Author: Dr. Heidi Kussmann, ND, FABNO
Supportive care is part of the naturopathic treatment approach for cancer. It involves improving quality of life by managing common symptoms associated with cancer. It can also involve managing the side effects of conventional cancer treatments. In a clinical trial of patients with advanced cancer, proper supportive care significantly increased survival, with an benefit equivalent to that of many chemotherapy treatments.
Benefits of Supportive Care
The benefits of naturopathic supportive cancer care include:
- Decrease the severity, incidency and duration of common cancer symptoms.
- Decrease the severity, incidence and duration of side-effects commonly occuring with chemotherapy and radiation therapy.
- Improve surgery outcomes and recovery.
- Improve life span (survival) 
- Improve overall immune health
Common Symptoms Associated with Cancer
There are many symptoms associated with cancer or that are a side-effect of cancer treatments including:
- Pain can develop as a symptom of cancer or as a side effect of cancer treatment. Pain control improves quality of life, strengthens the immune system, decreases depression, and enhances survival.
Bone Marrow Suppression
- Constipation occurs as a symptom of cancer in the digestive tract or pelvis, as a side effect of pain or anti-nausea medications, and as a consequence of surgery or some chemotherapies.
- Bowel obstruction is a medical emergency involving blockage or paralysis of digestive function. Causes include tumor pressing on the bowel or its nerves, pain medication, severe constipation, or complications of anesthesia or abdominal surgery. Consult a doctor immediately if you have not had a bowel movement in 3 days or if you develop abdominal pain with nausea or vomiting. If you have recurrent or ongoing bowel obstruction, sometimes it is necessary to get nutrition via a feeding tube or intravenously.
- Diarrhea: While occasional loose stools are normal, chronic or profuse diarrhea can lead to dehydration or to imbalances in the electrolytes that control heart function. In cancer patients, diarrhea can develop as a side effect of cancer treatment or as a complication of cancer in the digestive system.
- Naturopathic care can be very helpful in preventing and treating diarrhea.
- Maldigestion, such as foul-smelling stools, gas and bloating, or diarrhea occurs when the pancreas is blocked, surgically removed, or unable to release sufficienct digestive enzymes.
- Digestive enzymes, chewing thoroughly, and consuming liquids away from meals can be helpful. For some, prescription-strength digestive enzymes are necessary.
- Nausea and Vomiting can develop as a side effects of chemotherapy, radiation, or medications. Tumors or ascites in the abdomen can also cause nausea.
- Dry mouth: Medications that can cause dry mouth include antidepressants and antinausea medications. Radiation or surgery to the head and neck also causes dry mouth. A medication review can help identify medications that are contributing to dry mouth.
- Ascites: Tumors in the abdomen can produce a fluid called ascites. Ovarian, pancreatic, appendix, and colon cancers are more likely to produce ascites. Ascites is a protein-rich fluid, and frequent draining of this fluid increases the risk for protein-calorie malnutrition.
- If you have ascites that is being drained, it is very important to eat a high protein diet and to stay hydrated.
- Short gut syndrome: After extensive digestive surgery, a patient may develop short gut syndrome, a digestive condition that occurs when a surgically-shortened intestine is not able to adequately absorb certain nutrients.
- Management of short gut syndrome requires nutritional supplementation and a modified diet. A naturopathic doctor or bariatric nutritionist can provide helpful advice on this topic.
- Peripheral neuropathy develops when nerves are damaged by chemotherapy, surgery, or diabetes.
- Natural therapies can be used to prevent or heal peripheral neuropathy.
- Insomnia can be caused by many different factors including: medications such as prednisone in chemotherapy regimens and antidepressants. It can also be due to pain or anxiety.
- Anxiety can develop as a normal response to difficult life circumstances (situational anxiety), as a pre-existing chronic condition (generalized anxiety disorder), or as a side effect of medical treatment. Ask a doctor or pharmacist check your medications to see if any may be worsening anxiety. Prednisone, Ritalin, Benadryl, and some antidepressants are some of the common medications to evaluate. Note that prednisone and Benadryl are often included in IV chemotherapy mixtures.
- Depression and sadness commonly develop during the course of living with a chronic illness. Adjusting to chronic illness can involve a grieving process, with depression as one of the normal phases in grieving. Depression can also arise as a biological response to cancer; this is documented in pancreatic cancer and suspected in other cancers.  It is important to treat depression rather than "toughing it out". Depression affects survival, pain control, and quality of life.
- Fatigue is a very common symptom, especially with those individuals dealing with cancer. Both cancer itself and cancer treatments can cause fatigue.
- Cardiovascular Conditions. Natural therapies can decrease the heart-toxic effects of the cancer drugs adriamycin and Herceptin.High blood pressure is a side effect of Avastin, prednisone, and other cancer drugs.
- Natural therapies need to be taken while a patient is taking the drug, and for a period of time afterwards.
- Radiation Damage can occur with any form of radiation therapy.
- Coughing in a person with cancer can be an important sign of changes in the body. These conditions can include gastroesophageal reflux, infection, lung damage from radiation, or a lung tumor. If you have a cough lasting longer than a week or are coughing up blood, consult a doctor.
- Brittle bones can result from people taking antihormone therapy or long term prednisone therapy.
- Painful joint aches are a side effect of antihormone therapy and of drugs that build up white cell count. The choice of therapy is specific to the cause and character of the joint pain.
- Anorexia Cachexia Syndrome is a condition that causes significant weight loss in cancer patients. Cachexia arises from changes in a person's metabolism that are caused by the tumors. Tumors release proteins (cytokines) that cause inflammation, increase oxidative stress, suppress appetite, and cause the body to break down muscle and fat to feed the tumor.
- Good nutrition is vital to preventing and treating anorexia cachexia syndrome. However, due to the metabolic changes that the tumor produces, simply eating more calories is often an incomplete solution. In clinical trials, certain natural therapies have reversed the metabolic abnormalities in anorexia cachexia syndrome as well.
Consult a naturopathic doctor to develop a personalized care program. Therapies are safest and most effective when individualized to the patient. If taking chemotherapy or medications, consult a naturopathic doctor prior to starting any natural products.