Movement is Medicine - It's never too late to start if you have (or had) Breast Cancer!

The Importance of Physical Activity in Breast Cancer Patients

The World Health Organization (WHO) recommends 150 minutes (about 2.5 hours) of moderate to vigorous-intensity physical activity per week for adults, which has been shown to reduce the risk of developing cardiovascular disease, diabetes and depression, can improve bone health, and reduce all-cause mortality [1, 2]. Additionally, regular physical activity has also been demonstrated to support breast cancer patients before diagnosis, during treatment and in survivorship.

IMPACT OF PHYSICAL ACTIVITY BEFORE DIAGNOSIS

Research has shown that women who were physical activity before being diagnosed with breast cancer had decreased mortality from breast cancer and all-causes compared to women who were not physically active before diagnosis [4, 6]. One of these studies also found that women who were sedentary (not physically active) before diagnosis but started exercising after diagnosis had a 45% lower risk of death from breast cancer compared to women who were not physically-active before or after diagnosis [6]. This impact was achieved just by engaging in brisk walking 2-3 hours per week!

EXERCISE DURING CANCER TREATMENT IS SAFE AND EFFECTIVE

One study looked at how exercise impacts the health of patients with stage II+ breast cancer. They found that engaging in exercise was safe for these patients, and was associated with improvements in quality of life, fitness level, fatigue, strength, mental health, and weight [3]. Another study conducted on breast cancer patients undergoing chemotherapy found that more intense exercise regimens (50-60 minutes 3 times per week) were slightly better than moderate-intensity exercise regimens (25-30 minutes 3 times per week) in improving pain, hot flashes, and strength, however both regimens were effective in managing side effects from chemotherapy [5].

PHYSICAL ACTIVITY AFTER TREATMENT IS STILL BENEFICIAL

Research on breast cancer survivors has also shown benefit. One study found that breast cancer survivors who practiced 150 minutes of moderate-intensity exercise per week had a 27% decrease in all-cause mortality (ie. dying from any cause) and a 25% decrease in breast cancer mortality, compared to women who had lower levels of physical activity [2].

MOVEMENT IS MEDICINE

So, what does this mean? It’s never too late to increase your levels of physical activity! No matter where you are on your health journey, physical activity appears to benefit health by reducing risk of dying from cancer and other causes and improving side effects during treatments. As always, talk to your doctor to make sure you are engaging in physical activity that is safe for you!

WHAT CAN I DO TO INCREASE MY PHYSICAL ACTIVITY LEVELS?

There are a number of ways to increase physical activity and movement in your daily schedule! An easy way to remember the difference between moderate-intensity and vigorous intensity exercising is talking and singing - at a moderate level of intensity, you can talk but would find it difficult to sing; at vigorous-intensity, it would be difficult to talk. Here’s a few ideas:

• Take the stairs instead of the elevator

• Walk or bicycle to work, or walk the kids to school

• Go for walks before or after work, or during the day

• Take up a sport or hobby that involves movement, like dancing, tennis, swimming

• Raking the leaves, shovelling snow, gardening

• Yoga, tai chi and Qigong

• Household chores like vacuuming, mopping

• Our favourite at Saskatoon Naturopathic Medicine: 15 minute at-home dance session - just turn on your favourite song and dance!

References:

[1] https://www.who.int/dietphysicalactivity/physical-activity-recommendations-18-64years.pdf

[2] Beasley, J. M., Kwan, M. L., Chen, W. Y., Weltzien, E. K., Kroenke, C. H., Lu, W., Nechuta, S. J., Cadmus-Bertram, L., Patterson, R. E., Sternfeld, B., Shu, X.-O., Pierce, J. P., & Caan, B. J. (2012). Meeting the physical activity guidelines and survival after breast cancer: Findings from the after breast cancer pooling project. Breast Cancer Research and Treatment, 131(2), 637–643. https://doi.org/10.1007/s10549-011-1770-1

[3] Singh, B., Spence, R. R., Steele, M. L., Sandler, C. X., Peake, J. M., & Hayes, S. C. (2018). A Systematic Review and Meta-Analysis of the Safety, Feasibility, and Effect of Exercise in Women With Stage II+ Breast Cancer. Archives of Physical Medicine and Rehabilitation, 99(12), 2621–2636. https://doi.org/10.1016/j.apmr.2018.03.026

[4] Lahart, I. M., Metsios, G. S., Nevill, A. M., & Carmichael, A. R. (2015). Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncologica (Stockholm, Sweden), 54(5), 635–654. https://doi.org/10.3109/0284186X.2014.998275

[5] Courneya, K. S., McKenzie, D. C., Mackey, J. R., Gelmon, K., Friedenreich, C. M., Yasui, Y., Reid, R. D., Cook, D., Jespersen, D., Proulx, C., Dolan, L. B., Forbes, C. C., Wooding, E., Trinh, L., & Segal, R. J. (2013). Effects of exercise dose and type during breast cancer chemotherapy: Multicenter randomized trial. Journal of the National Cancer Institute, 105(23), 1821–1832. https://doi.org/10.1093/jnci/djt297

[6] ​​Irwin, M. L., Smith, A. W., McTiernan, A., Ballard-Barbash, R., Cronin, K., Gilliland, F. D., Baumgartner, R. N., Baumgartner, K. B., & Bernstein, L. (2008). Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: The health, eating, activity, and lifestyle study. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 26(24), 3958–3964. https://doi.org/10.1200/JCO.2007.15.9822

Mistletoe and Cancer Care - It does more than spark a kiss!

Mistletoe and Cancer Care - It does more than spark a kiss!

A plant commonly associated with the holidays, Viscum album, also known as mistletoe, is a natural therapy used often in integrative cancer care. Mistletoe is a semi-parasitic plant that grows on a variety of trees from which it obtains its nutrients. It contains a variety of compounds, the most commonly studied of which are lectins, that have been shown to stimulate the immune system and have anti-cancer effects. Cell studies on mistletoe extracts have demonstrated inhibition of cancer cell growth [3] and increase in immune function parameters, including natural killer cells, which are white blood cells responsible for the destruction of tumor cells [4, 5].

Mistletoe is primarily administered as a subcutaneous injection, and commonly used alongside chemotherapy, radiation therapy and/or other conventional treatments in countries such as Switzerland, Germany, and Austria to improve quality of life and manage side effects associated with treatments in patients with cancer [2]. 

Numerous studies have been conducted on the therapeutic use of mistletoe. One of the best methodologically-designed studies was conducted on mistletoe in advanced pancreatic cancer patients, which suggested that patients in the mistletoe treatment group had longer overall survival times compared to those in the control group [6]. The majority of research on mistletoe suggests it supports quality of life in cancer patients and decreases severity and frequency of treatment-related side effects [8, 9]. Mistletoe is generally well-tolerated and safe to use alongside various common chemotherapeutic agents [7].

To learn more about mistletoe therapy, contact us and/or book an appointment with Dr. Dana Kolenich ND!

[1] Pelzer F, Tröger W. Complementary treatment with mistletoe extracts during chemotherapy: safety, neutropenia, fever, and quality of life assessed in a randomized study. J Altern Complement Med. 2018; 24(9-10):954-961. https://pubmed.ncbi.nlm.nih.gov/30247950/

[2] Melzer J, Iten F, Hostanska K et al. Efficacy and safety of mistletoe preparations (Viscum album) for patients with cancer diseases. A systematic review. Forsch Komplementmed. 2009; 16(4):217-226. https://pubmed.ncbi.nlm.nih.gov/19729932/

[3] Eggenschwiler J, von Balthazar L, Stritt B, et al. Mistletoe lectin is not the only cytotoxic component in fermented preparations of Viscum album from white fir (Abies pectinata). BMC Complement Altern Med. 2007; 7:14. https://pubmed.ncbi.nlm.nih.gov/17493268/

[4] Büssing A, Rosenberger A, Stumpf C et al. Development of lymphocyte subsets in tumor patients after subcutaneous administration of mistletoe extracts. Forsch Komplementmed. 1999; 6(4):196-204. https://pubmed.ncbi.nlm.nih.gov/10529579/

[5] Beuth J, Ko HL, Gabius HJ, et al. Behaviour of lymphocyte subsets and expression of activation markers in response to immunotherapy with galactoside-specific lectin from mistletoe in breast cancer patients. Clin Investig. 1992; 70(8):658-61. https://pubmed.ncbi.nlm.nih.gov/1392440/

[6] Viscum album [L.] extract in patients with locally advanced or metastatic pancreatic cancer: a randomised clinical trial on overall survival. Eur J Cancer. 2013; 49(18):3788-97. https://pubmed.ncbi.nlm.nih.gov/23890767/

[7] Weissenstein U, Kunz M, Urech K et al. Interaction of standardized mistletoe (Viscum album) extracts with chemotherapeutic drugs regarding cytostatic and cytotoxic effects in vitro. BMC Complement Altern Med. 2014; 14:6. https://pubmed.ncbi.nlm.nih.gov/24397864/

[8] Beuth J, Schneider B, Schierholz JM. Impact of complementary treatment of breast cancer patients with standardized mistletoe extract during aftercare: a controlled multicenter comparative epidemiological cohort study. Anticancer Res. 2008; 28(1B):523-7. https://pubmed.ncbi.nlm.nih.gov/18383896/ 
[9] Tröger W, Galun D, Reif M, et al. Quality of life of patients with advanced pancreatic cancer during treatment with mistletoe: a randomized controlled trial. Dtsch Arztebl Int. 2014; 111(29-30):493-502. https://pubmed.ncbi.nlm.nih.gov/25142075/

Integrative Cancer Supports During Treatment for Ovarian Cancer

Indole-3-carbinol (I3C) and epigallocatechin-3-gallate (EGCG) combined with conventional therapy for ovarian cancer.

Ovarian cancer is the 7th most common cancer in females [1]. Depending on the stage at diagnosis, treatment typically involves surgery and platinum-based chemotherapy regimens, which have a range of side effects including but not limited to fatigue, nausea and vomiting, pain, insomnia, anemia, and peripheral neuropathy.

A 2018 study published in BMC Cancer looked at the effects of indole-3-carbinol and epigallocatechin-3-gallate (EGCG) in addition to chemotherapy and surgery on overall survival [2].

I3C is a natural compound found primarily in cruciferous vegetables (such as broccoli, kale, and Swiss chard), and EGCG is a natural compound found in green tea. This study demonstrated that I3C and EGCG as 5-year maintenance therapy given before, during and after platinum-based neoadjuvant and adjuvant chemotherapy and surgery significantly prolonged both progression-free and overall survival in patients with stage III and IV ovarian cancer, and also reduced incidence of ascites in recurrent ovarian cancer patients, compared to conventional therapy alone.

[1] https://www.wcrf.org/dietandcancer/ovarian-cancer

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6148762/

Written by Dr. Dana Kolenich ND

Acupuncture for neuropathy in Multiple Myeloma patients

Acupuncture for Neuropathy in Multiple Myeloma patients

Multiple myeloma is a common cancer of the blood, specifically the plasma cells (a type of white blood cell that makes antibodies). Abnormal plasma cells divide rapidly and crowd out healthy bone marrow cells, including white blood cells and red blood cells, which can cause anemia, and also lead to bone damage and other organ damage. Tumors, called plasmacytomas, can also develop within bones and outside of bone.

Treatments for multiple myeloma, like proteasome inhibitors, can cause multiple side effects including peripheral neuropathy. In some cases, the severity of peripheral neuropathy may lead to a reduced number of treatment cycles or possible discontinuation of treatment. Therefore, decreasing the severity and incidence of peripheral neuropathy is an important factor in continuing treatment.

Various naturopathic medical therapies have shown benefit in reducing symptoms and severity of peripheral neuropathy, including acupuncture. A 2017 research study in BMC Cancer examined the effects of vitamin B12 with or without acupuncture in multiple myeloma patients with peripheral neuropathy. The study found that after 84 days of therapy, patients in both the vitamin B12 and the B12+acupuncture groups experienced an improvement in pain, with the B12+acupuncture group experiencing a greater improvement in pain compared to the B12-only group [1].

Acupuncture (18 sessions over 8 weeks) has also shown benefit in the treatment of chemotherapy-induced peripheral neuropathy in breast cancer survivors [2].

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223334/

[2] https://pubmed.ncbi.nlm.nih.gov/32297442/

Written by Dr. Dana Kolenich ND

Fasting-mimicking diet during treatment for Breast Cancer

Fasting-mimicking diet during treatment for Breast Cancer

Cancer cells are well equipped to accumulate nutrients, which are necessary for them to grow and divide rapidly, called proliferation. Short term fasting, which reduces nutrient intake for a period of time causes normal cells to switch from their proliferating or “growing” phase toward a maintenance phase. However, cancer cells are unable to switch off their proliferation phase - and therefore, they are deprived of nutrients, which can make them more sensitive to cancer therapies and increase cell death, all while sparing healthy cells. Fasting mimicking diets have been found to decrease insulin-like growth factor-1 (IGF-1), which is a known growth factor for cancer cells.

Research in Nature Communications studied the effect of fasting-mimicking diet surrounding neoadjuvant chemotherapy in HER-2 negative early stage breast cancer patients [1]. The study found that reducing caloric intake three days before and on the day of chemotherapy increased the sensitivity of tumor cells to chemotherapy with no additional side effects compared to those receiving chemotherapy and eating their regular diet. The study also found that fasting-mimicking diet decreased damage to healthy cells compared to those that did not change their diet.

[1] https://www.nature.com/articles/s41467-020-16138-3

Written by Dr. Dana Kolenich ND

The Role of Naturopathic Medicine in Integrative Cancer Care

Many people diagnosed with cancer seek out the use of naturopathic therapies. It is important to ensure patients implement naturopathic supports under the direction of a knowledgeable naturopathic doctors. Cancer is a multifaceted disease and each individual’s health journey with cancer is unique. From prevention to active surveillance to receiving conventional care, regardless of where a patient is on their cancer journey, naturopathic medicine can provide support through:

1. Addressing fundamental basics of health: Naturopathic doctors have extensive knowledge about lifestyle, diet, sleep, stress, environmental factors and other fundamental aspects of health. NDs can provide information on optimal dietary and lifestyle choices for pre- and post-surgery, chemotherapy and radiation, as well as during survivorship and for promoting prevention. In addition to diet, naturopathic medicine can support quality sleep,  reduce stress levels, support mental health, and optimize overall health. 

2. Conventional treatment support: Naturopathic medicine can support conventional treatments through implementing evidence-based therapies that can limit or reduce side effects and that work synergistically with conventional care. Naturopathic doctors are trained in interpreting lab reports and understanding safety and interactions between naturopathic and conventional medicines.

3. Education and advocacy: NDs provide education to patients and family members with the goal of empowering patients throughout their journey with cancer. We understand the importance of communications and referrals, and we work alongside a patient’s conventional care team to provide patient-centered comprehensive care. 

A diagnosis of cancer can be overwhelming and take a significant toll on a person’s overall health. Naturopathic doctors  strive to learn about their patients and their experiences in order to provide them with purely individualized care, education and empower them and their loved ones to optimize their health throughout their cancer journey.

Micronutrient Testing at Saskatoon Naturopathic Medicine

At Saskatoon Naturopathic Medicine we proudly offer Spectracell Micronutrient testing, one of the most comprehensive nutrient tests to assess the nutrient stores in your body that will keep you performing at the top of your game.

The Spectracell Micronutrient test allows your Naturopathic Doctor to assess how well your body utilizes 31 vitamins, minerals, amino/fatty acids, antioxidants, and metabolites (listed below).

Why is this information important?

 Nutritional balance plays a key role in optimal wellness, chronic disease prevention and managing the aging process. Each nutrient in our body is responsible for specific physiological functions that make them unique and irreplaceable. Virtually all metabolic and developmental processes that take place in the body require micronutrients, and strong evidence suggests that subtle vitamin, mineral, and antioxidant deficiencies can contribute to degenerative processes such as arthritis, cancer, cardiovascular disease and diabetes. As well, evidence suggests that a lack of these vital nutrients may have a profound impact on the body’s immune system. Eating a balanced diet, exercising and taking a multivitamin may not be enough. Every individual is unique and a micronutrient test will allow your Naturopathic Doctor to see where you might be lacking.

Who may benefit from having the Spectracell Micronutrient test?

Spectracell micronutrient testing can be very beneficial for individuals with the following conditions and disease:

            - Cardiovascular disease

            - Diabetes

            - Neurological disorders/Alzheimer’s          

            - Mood disorders

            - Osteoporosis

            - Fertility issues

            - Cancer

 It may also be helpful to get tested if you feel like you are suffering from a nutritional deficiency or just want to stay on top of your health. Some of the signs and symptoms of a nutrition deficiency include: fatigue, anxiety, weight loss or weight gain, loss of appetite, tingling hands, muscle cramping, vomiting, heart flutter, skin conditions, depression, bruising, reduced muscle mass, muscle weakness, diarrhea, hair loss, digestive problems, numbness, nausea, constipation, impaired wound healing, and low libido.

The cost for this test is 620 dollars, which is pricey, but the results may help you save money in others areas by helping you cut out supplements you are currently taking that are not necessary for you at this time, and re-prioritizing the supplements that are truly addressing your body’s needs. For more information on the Spectracell micronutrient test book an appointment to speak to your Naturopathic Doctor or call our office to book in for a sample collection today!

**content adapted from Micronutrient Testing Nutrition at the Core of Personalized Wellness

Naturopathic Medicine Week Presentation

Integrative Cancer Care and Naturopathic Medicine

Join Dr. Velichka ND on May 16th, during Naturopathic Medicine Week for an informative presentation on Integrative Cancer Care.

Learn about the benefits of having a naturopathic doctor trained in integrative cancer care on your team. Dr. Velichka ND will briefly review the safe and effective use of some natural and supportive therapies that may be used to assist patients through their conventional treatments.

Who: Dr. Amy Velichka ND (Naturopathic Doctor at Saskatoon Naturopathic Medicine)

What: Presentation on Integrative Cancer Care and Naturopathic Medicine

When: May 16th 2019 – 7pm

Where: McNally Robinson Bookstore on 8th Street in the travel alcove