Our next speaker this morning is the niece mills thing doctor mills teen is a member of our division of integrative medicine an expert in the field of all the additional therapies some people call it natural path sick other people give it various names but you know truly we don’t look at the different ways of treating patients as being separate buckets it is all about health and wellness and doing a what whatever helps you live your best possible life in doctor mill scene is true leader in this field so these, please. Well good morning it’s just amazing to see all of you braved the cold weather this morning and any snow or rain that we still had I think we’ve got a little bit out of order which is fine I’m resilient and we can roll with that’s fine I if I can just have my slides I think Bruce is working on that and you know was a little bit nervous this morning because it’s difficult to come on stage following Derrick hall and then doctor who’s an amazing speaker so maybe I lucked out that I only have to follow their call though of course, he’s a tough act I’ll just start by talking about what integrative medicine is so integrative medicine is an approach to health and healing regardless of your burden of disease in a moment I’ll show you that these three shields of Mayo Clinic which are of course patient care. Research and clinical excuse me could go practice research and education in our integrative medicine branding have been changed to three leaves to give you the more natural feel of what it is that we bring it to your journey all that you were dealing with so.
In integrative medicine that we manage a number of modality is that are a bit different than what you might discuss when you come to see Dr price or doctor secular court one of the other physicians who you’ll hear from later today we talk about mind body practices as well as many other natural healing practices including other forms of medicine such as traditional Chinese medicine and then using your diet your exercise how you move your body and also and natural products which many of you I’m sure we’ll have many questions about I’m still waiting for those slides on just going to keep going let me start with this I’m gonna ask you is it possible to be healthy when you have cancer I think we’ve just seen it two remarkable examples of that in Derek and Mrs hall in terms of how healthy you can be regardless of your burden of disease I have you think about somebody in your life maybe who has even in advanced cancer or a difficult to treat cancer and you see them kind of glowing and thriving and living their life and making the most out of every day you can probably think of somebody else in your life who maybe doesn’t have a high disease burden who kinda has that like gray appearance they kind of trudged through life and they’re not healthy soon integrative medicine we think health isn’t necessarily what your disease state is that we can achieve health regardless of the burden of disease that you’re living with so this is me. And these are the three leaves I mentioned instead of the three shields. The several domains of integrative medicine that the National Institute of Health has put forward and mention those to you as well. I’ll comment on how many people with cancer are actually using integrative medicine or what was formally called complement complementary and alternative medicine so you see in that first line the range is broad and that really depends on what you’re including in the umbrella of integrative medicine but you have up to ninety five percent of patients have been diagnosed with cancer participating in what some people are some researchers would actually include integrative medicine I think that next set of information is more impressive to me is so up to three quarters of people who’ve been diagnosed with cancer don’t discuss their use of integrative medicine with their cancer and what they reported the reason for that being is that their providers just didn’t ask them or they came in thinking that if they told their doctors they were using these natural therapies there would be some disapproval or dis interest or they thought their physicians are providers weren’t able to advise them on the use or not using or they thought it doesn’t matter it’s natural it’s not gonna hurt me so I can interfere with my treatment but I want you to get that file that final point especially that for those who did discuss their use of integrative medicine with their providers they had a higher satisfaction with their care and that there are people like me and my team who work to help guide you if your providers don’t feel like they have the background to advise you. We ask group similar to you several years back whether they were using integrative medicine or not and you could see that more than half of you or people like you were using nutrition meditation their movement or exercise and natural products in about a third of people so when I say that we’re not talking an integrative medicine to me it means we’re just missing the boat we need to be having these conversations. Interesting that doctor crime provided us with the garden analogies said this is the analogy I like to use and this was given to me by a really wise physician Dr. Gladys me Gary that I think if people as if they’re a tree with a very intricate root system that their cancer is like a boulder in that root system and that most of the people you come across in your cancer treatment are focused on the boulder can we cut it out can we poison it can we zap it with X. rays what can we do to get that out of your body or at least containing it I like to think of the tree and the soils so while all these really brilliant people are focused on that flight which is so necessary what can we do to keep the rest of that soil healthy so that your tree can continue to thrive.
There is a society of integrative oncology also called S. I owe that puts out guidelines to using and incorporating integrative medicine in the care of cancer and much of my talk is going to be based on their guidelines and the level of evidence that they provide for us using these strategies in care. Sorry this is a little twitchy let me use the keyboard okay some introduce you to a patient who I met earlier this year his name was Carlos sixty two years old he’s been diagnosed with prostate cancer a couple of years ago he’d gone through chemotherapy at the time that I met him he was doing radiation and taking oral medications he really struggled with the Robert the from his chemotherapy and he felt tired he just couldn’t get done the things that he wanted to get done and he was pretty anxious about his cancer burden and what was going to happen in the future he and his wife had made a new year’s resolution to go low carb and they took the sugar out of their diet and this was the end of January and they’re still doing it which I thought was pretty impressive in wonderful he didn’t sleep so well because of his treatment and his condition he was up several times per night and you just felt basically exhausted he kept himself busy kind of pondering around the yard but he didn’t want to go in and write his bike which he used to like to do because of the Opeth he was afraid he was going to get injured his stress was pretty high he loved to this job that he had when he was originally diagnosed and he just recently had to leave it because of his energy issues so you didn’t have that supportive community around him anymore and it was taking a number of supplements will come back to Carl’s. So let me start with us as I guidelines and if you kind of drift off during my talk this is the one slide I want you to pay attention to the next three okay so exercises seems like a very obvious statement but let me just read it anyways regular physical activity can have a positive role in cancer you can insert any condition and they’re right and heart disease and diabetes right regular physical activity is good for you in many many ways but it is incredibly impressive what happens in cancer care when you move your body compared to when you don’t if you move regularly you improve your chance of survival you in you decrease your chance of cancer recurrence the study I’m showing you here and it is by far not the only one was in about three thousand people in a multitude of cancers these people were exercising only one day per week and they showed a thirty-three percent survival advantage this is a big out con. Another study of four thousand people showed that when patients exercise or subjects exercise they had improved quality of life emotional well-being fatigue pain and anxiety and I chose this picture at the bottom because I want to remind you that whatever type of exercise you like to do you will continue to do so you can walk you can bike you can hike well maybe not in the rain and snow this week but in general we live in a great place for all these outdoor activities or you can go to the gym or hit the treadmill if that’s what you really like to DO. What I summarize for people is that two hours of exercise moderate-intensity exercise provides this survival benefit two hours per week of moderate-intensity exercise and intentionally you need to remember moderate-intensity exercise is not the same as it was when you were twenty if you’re fifty if you’re seventy or if you’ve just gone through cancer treatment so it’s moderate intensity for you not for your neighbor or your spouse or whoever it is that you’re exercising next to. Just a comment quickly on some specific types of exercise so we encourage yoga often for cancer-related fatigue it doesn’t lead to better sleep improved quality of life and stress and also improve sexual dysfunction import in many many types of cancer and after their care resistance training which could be anything from Palade is to bar work to bodyweight things you can just do at home squats and lunges at Cetera has been shown to reduce those muscle aches that calm and women who are treated with and you can therapy after a diagnosis of breast cancer and also helps you to maintain your physical fitness level we encourage people to exercise early in their can in their diagnosis in their course so for Carlos let’s get back to exercising regularly within a rob with the let’s stop pounding on those feeds we’re gonna put him in the pool may be going to get him into an exercise class because he’s missing that idea of community that he was getting from work and is no longer getting or I can just go out for a walk with his wife she wasn’t.
Are you gonna the whole talk about nutrition so this will be speedy but I can’t give a talk about integrated medicine and cancer and not talk about nutrition? So here is what the skews me world cancer research fund has put out in terms of recommendations for healthy nutrition for the prevention or reduction of burden of cancer be lean but not under weights avoid sugary drinks I’m gonna modify that to just say avoid added sugar limit your consumption of energy-dense foods eat a lot of vegetables fruits whole grains and by the way hold cranes are the greens you can actually see how the whole grains that they then pulverized into flour and put into fruit loops it says it on the front of the pack it in case you don’t believe me check next time and then beans or legumes limit your consumption of red meat is any meat that comes from an animal and season comes from a mammal. Especially if it’s been processed and then limit salty and processed foods a great that was brilliant right eat less and exercise more that’s the most ridiculous fad diet I’ve ever heard but let me tell you there’s actually a study that came out that showed how effective this is so using those very simple diet recommendations that I just showed to you they looked over a course of many patientsEspecially if it’s been processed and then limit salty and processed foods a great that was brilliant right eat less and exercise more that’s the most ridiculous fad diet I’ve ever heard but let me tell you there’s actually a study that came out that showed how effective this is so using those very simple diet recommendations that I just showed to you they looked over a course of many patients over many studies to show if they get here to that hi it here it’s versus low it here it’s what happened and they dropped their incidence of cancer by ten to sixty one percent huge drop in cancer rates for very simple easy to accomplish diet recommendations and I think it’s so important to have resources it’s fine for me to say just cook healthy food but I like to give people these two cookbooks when they come to see me the one on the left to cook for your life is written by a breast cancer survivor in her intention in writing that cookbook is that you would prepare that food for yourself or it would be simple enough to hand the recipe to a friend who says he is there anything I can do with it out of your person say yes you can make this for me I would love that instead of them cooking you you know some of those on healthy foods that comfort food that we tend to want to bring to people when they’re going through something like that and the cancer fighting kitchen is just a beautiful book by Rebecca cats but it’s really geared towards people who like to cook and who don’t mind finding unusual ingredients. I am selfishly putting this out because in conjunction with other integrative medicine providers and I’m a medical oncologist at mail we put together a pamphlet on healthy nutrition and cancer so for those of you who are treated at Mayo this is easily available to you as well. All right back to Carlos keep going with that new year’s resolution keep eating real food limit your added sugar talking about body-based therapies. Some massage can reduce anxiety and pain but important to use an oncology trains provider if you’ve had manipulation of your tissue so particularly if you’ve had surgery and or radiation. So even in patients with advanced cancer massage is a very helpful six thirty-minute massages over two weeks so basically every other day reduce pain and improved mood and patients who had advanced cancer in patients who live with metastatic bone pain they also showed that massage has improved pain and has wrought relaxation and also enhanced that ability to sleep which is really critical.
Massage reduces pain compared to no treatment end compared to conventional care this is important in this era where we worry about controlled substances and our opiate crisis that we currently have in this country so it’s something I want you to put in your mind as a therapy not necessarily something you do on vacation as a treat to yourself especially have surgery-related pain massage can be helpful and I put this image on here to remind you that reflexology which is putting points putting pressure on certain points typically on the foot sometimes on the hand sometimes on the Is very effective in managing pain as well and the reason I say this is that you can do reflexology very easily you don’t need to just very effective in managing pain as well and the reason I say this is that you can do reflexology very easily you don’t need to disrobe you don’t necessarily even need to be in a very private setting it’s typically very inexpensive and unfortunately message doesn’t tend to be well covered by our insurance as. Yes he’s a lot of acupuncture in cancer care so this is a component of traditional Chinese medicine the philosophy of which is the movement of your vital energy which is termed chi and their philosophy we know acupuncture reduces pain separately things like headaches chronic pain back pain we use this all the time but also for nausea and vomiting and for fatigue and even though we’re sticking these hairs then so one of these needles is the size of a piece of your hair into the body it’s a very very low-risk intervention that’s accessible and I’ll just mention because I said it about massage typically well covered by insurance accept Medicare, unfortunately. So I had mentioned that Carlos has and neuropathic pain from his chemotherapy and I’ll mention about the regular acupuncture which is acupuncture done on the ear another form I like to just bring to mind because again this can be done in a public setting it’s typically very inexpensive in a group setting we use acupuncture also for those of you who are living with head and neck cancer for the dryness of the mouth that comes if you’ve had radiation to the top part of your body. Accu pressure can be helpful for nausea as well so I’m showing you that P. six-point isn’t just below your pinky on that side of your wrist you have mild nausea or if you are going through an experience where you tend to get nauseous and you’re starting to feel that kind of queasiness you can just simply put pressure on this point they also sell bands that’ll put pressure on that we’re this is something that somebody comes to their queue with you could do for you know a lecture acupuncture where you place the needles and you add some stimulation is also quite effective in reducing vomiting we had quite a bit of ginger which is effective for knowledge in its dried form so this would be the spice that you probably all have in your pantries or in a T. or crystallized ginger which is easy to keep on hand and in addition we use some hypnotherapy for Nasha.
Back to Carlos so we thought we’d try acupuncture for his Iraq the tea is fatigue and his anxiety and we talked a bit about So natural products they could spend the rest of the day talking about natural products so just try to hit a few highlights for you all this is what happens when you walk into one of these health food stores on last checked there were eight hundred thousand products on the market that are labeled as natural products either botanicals or supplements it is very difficult to navigate this landscape so here’s how I do it I think about whether or not this product has scientific evidence that it’s going to help you and whether or not I think it’s going to hurt you so if it’s going to help you and it’s not going to hurt you I’m gonna say please take this I’m not sure it’s going to help you but I’m pretty sure it’s So natural products they could spend the rest of the day talking about natural products so just try to hit a few highlights for you all this is what happens when you walk into one of these health food stores on last checked there were eight hundred thousand products on the market that are labeled as natural products either botanicals or supplements it is very difficult to navigate this landscape so here’s how I do it I think about whether or not this product has scientific evidence that it’s going to help you and whether or not I think it’s going to hurt you so if it’s going to help you and it’s not going to hurt you I’m gonna say please take this I’m not sure it’s going to help you but I’m pretty sure it’s not going to hurt you I say if you want to take it go ahead I think it’s gonna hurt you I’d better be convinced that it’s going to help you in order to tell you to continue to take at.