Modifiable Risk Factors for Prostate Cancer

November is Prostate Cancer Awareness Month.

Prostate cancer is the most commonly diagnosed cancer in Canadian men [1].

Starting at age 50, men are screened for prostate cancer regularly via a digital rectal examination (DRE). A DRE may also be done if men (regardless of age) experience urinary symptoms such as urgency, frequency, incontinence, dribbling, weak flow, pain on urination, blood in the urine, and/or other symptoms such as erectile dysfunction, painful ejaculation, swollen lymph nodes, chronic low back or pelvic pain, and weight loss. Laboratory testing of PSA (prostate-specific antigen) can also be used during the screening process and is used to monitor cancer progression; however, PSA is not specific to prostate cancer and can also be high due to benign prostatic hypertrophy, prostate infection and/or inflammation.

If any of the above screening measures are abnormal, a transrectal-guided biopsy of the prostate gland is conducted, and is the standard method of diagnosing prostate cancer. The results of the biopsy, as well as the PSA levels, will be used to determine the stage of disease, which is then used to determine monitoring/treatments.

Prostate cancer, unlike the majority of other cancers common in North America, tends to be slow-growing, with a high five-year survival rate (97.8%) [2]. Patient with low-risk disease are usually recommended to undergo ‘active surveillance’, which is monitoring of changes in symptoms and laboratory markers for cancer progression (ie. PSA, DRE) every 6-12 months before any treatment is recommended. This can be an incredibly stressful time for many, however there are various ways in which patients can take an active role in promoting beneficial changes to their health.

One of the ways in which people can promote healthy changes is understanding modifiable risk factors - these are various factors that influence the risk of developing prostate cancer that can be changed, unlike non-modifiable risk factors (such as age) [3, 4, 5]. Some risk factors for prostate cancer include:

Non-modifiable

• Age (risk of prostate cancer increases as we age)

• Having a first-degree family member with prostate cancer (ie. a father or a brother)

• Ethnicity - black men are more commonly affected compared to white, Hispanic and Asian men

• Various genetic mutations

• Chemical exposures (e.g. Agent Orange)

• A history of sexually transmitted infections

Modifiable

• Being overweight or obese

• A diet high in red meat and saturated fat

• Lack of physical activity/exercise

• Low blood levels of vitamin D3

• Smoking

How can we modify our risk factors? Here’s a few examples:

Exercise: A 2015 study found that men with localized prostate cancer who engaged in walking/bicycling for at least 20 minutes per day had lower overall mortality rates compared to men who were less physically active [6].

Diet: A 2014 study on more than 47000 men found that there was a 22% lower risk of overall mortality in men who ate a Mediterranean-style diet after their prostate cancer diagnosis [7].

Naturopathic medicine can be a useful addition to a person’s health care regimen. Naturopathic doctors (NDs) are well-trained to optimize diet, lifestyle, and nutritional status and implement evidence-based therapies that support overall health and emphasize disease prevention. NDs help guide patients toward making healthy changes and reducing their risk factors for disease.

Book a consultation today to find out how naturopathic medicine can support you!

Written by Dr. Dana Kolenich ND

References:

[1] Canadian Cancer Statistics 2019

[2] https://seer.cancer.gov/statfacts/html/prost.html

[3] http://www.bccancer.bc.ca/health-professionals/clinical-resources/cancer-management-guidelines/genitourinary/prostate#Low-Risk

[4] https://www.ncbi.nlm.nih.gov/books/NBK470550/

[5] https://www.wcrf.org/dietandcancer/prostate-cancer

[6] https://cebp.aacrjournals.org/content/24/1/57

[7] https://pubmed.ncbi.nlm.nih.gov/23962747/

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

Omega-3s for Inflammation-Associated Depression

Essential Fatty Acids (EFAs)

Omega-3 and omega-6 fatty acids are essential fatty acids, meaning the body cannot make them on its own so they must be obtained through diet. They are both polyunsaturated fatty acids, however, they are found in different foods and have different roles in the body. Omega-3s are found in fish, nuts, seeds, and plant oils, while omega-6s are found in meats, vegetable oils, nuts, seeds, and processed foods.

The body requires a balance of omega-3 and omega-6 fatty acids for good health. However, the western diet is abundant in omega-6-rich foods, shifting this balance in some cases by 20:1 or higher. While both beneficial and necessary for the maintenance of good health, omega-3 and omega-6s have opposite effects on inflammatory modulation – the omega-6 pathway being more pro-inflammatory, the omega-3 being more anti-inflammatory.

Inflammation & Depression

Neuroinflammation is an inflammatory response within the brain and is a known component of many brain disorders. Rapaport et al., conducted a study exploring whether inflammatory biomarkers might act as measures of clinical response to omega-3 fatty acids – specifically eicosapentaenoic acid and docosahexaenoic acid – in subjects with Major Depressive Disorder (MDD).

The subjects were assessed for their baseline biomarkers of inflammation, as well as the presence and severity of their depressive symptoms using the Hamilton Depression rating scale. They were then randomized to 8 weeks of double-blind treatment with eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), or placebo. Those given EPA who had high inflammation consistently reported a significant decrease of depressive symptoms by treatment week 8. While also critical to brain function, DHA did not produce the same effect. This difference is possibly explained by the fact that EPA has the ability to dampen the inflammatory response, while DHA does not.

This study highlights the importance of individualized assessment and treatment in mental health, and the value of EPA as part of a comprehensive treatment plan for depression.

Written by Dr. Jacalyn Sieben ND

References:

Kalkman H. O. (2020). The Association Between Vascular Inflammation and Depressive Disorder. Causality, Biomarkers and Targeted Treatment. Pharmaceuticals (Basel, Switzerland), 13(5), 92. https://doi.org/10.3390/ph13050092

Rapaport, M. H., Nierenberg, A. A., Schettler, P. J., Kinkead, B., Cardoos, A., Walker, R., & Mischoulon, D. (2016). Inflammation as a predictive biomarker for response to omega-3 fatty acids in major depressive disorder: a proof-of-concept study. Molecular psychiatry, 21(1), 71–79. https://doi.org/10.1038/mp.2015.22

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.

Healthy Mediterranean Quinoa Salad

Ingredients

·         ½ cup extra-virgin olive oil

·         6 tablespoons red-wine vinegar

·         3 tablespoons chopped fresh oregano

·         1 ½ teaspoons honey

·         1 ½ teaspoons Dijon mustard

·         ¼ teaspoon crushed red pepper

·         3 cups cooked quinoa, cooled 

·         2 cups thinly sliced English cucumber

·         1 ½ cups thinly sliced red onion

·         1 cup halved grape tomatoes

·         ½ cup halved pitted Kalamata olives

·         1 can no-salt-added chickpeas, rinsed

·         3 cups baby spinach, arugula or mixed greens 

Directions

Step 1

Whisk oil, vinegar, oregano, honey, Dijon and crushed red pepper in a large bowl. Add quinoa, cucumber, onion, tomatoes, olives, and chickpeas. Toss gently to combine. Cover and refrigerate for 30 minutes.

Step 2

Add your greens, and gently toss to combine. Serve immediately.

Recipe adapted from EatingWell Mediterranean Quinoa Salad

Eating to Prevent Chronic Disease: The Mediterranean Diet

Eating to Prevent Chronic Disease

What is a Mediterranean Diet?

The Mediterranean diet is a diet high in fish, legumes, whole grains, vegetables, fruits, nuts, seeds, and olive oil. It is low in high fat meats and dairy products.

If you want to be on a healthy Mediterranean diet you should try eliminating cream, butter, margarine, carbonated and/or sugared beverages, and processed foods such as pastries, industrial bakery products, industrial desserts (puddings, custard), French fries, potato chips, cakes and sweets.

It is a good idea to limit your consumption of cured meats, red meats, and cured and fatty cheeses. When choosing animal products, choose healthy sources (Grass fed, Free range, wild etc) that have minimal contaminates and a good balance of omega-3 and omega 6 fatty acids.

The Mediterranean diet is also characterized by a high intake of b-carotene, B vitamins, vitamin C, vitamin E, folic acid, polyphenols and a wide variety of phytochemicals that are found in the various plant foods frequently consumed (1).

Research shows adherence to Mediterranean diet is effective in prevention of cardiovascular disease, depression, metabolic syndrome and Type 2 Diabetes. The information to follow summarizes a bit of the research.

Supporting Research

Cardiovascular Disease

The Mediterranean diet has been ranked as the most likely dietary model to provide protection against coronary heart disease. (2)

 In a 2018 study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet (Med Diet) supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet. (3)

• 3 groups studied

o   Low-fat diet

o   Mediterranean Diet with added nuts

o   Mediterranean Diet with added olive oil

• Risk of combined heart attack, stroke and death from cardiovascular disease compared to low-fat diet was reduced by 30% in the Med Diet + Olive Oil and 28% in the Med Diet + Nuts.

Good adherence to a Mediterranean diet resulted in a more favorable health status as reflected by improved cardio vascular disease risk factors, such as lipid profile, blood pressure, and glucose, especially in persons with diabetes and compared with a low-carbohydrate diet. (4)

Higher adherence to a Mediterranean diet was associated with lower mean levels of blood pressure after 6 years of follow-up. (4)

Diabetes

Mediterranean diet supplemented with extra virgin olive oil (EVOO) or mixed nuts has shown to reduce the incidence of type 2 diabetes by 40% and 18%, respectively, compared with a low-fat control diet. (5)

Depression

High adherence to a Mediterranean diet high in whole grains, fruits, vegetables, nuts, lean meats and olive oil was protective for depression at all ages throughout the lifespan. Even moderate adherence to a Mediterranean diet was protective in younger individuals. For older individuals, the research showed that the benefit to mental well-being and depression prevention was only associated with those individuals who adhered to a more strict Mediterranean diet. (6)

A 2017 study examined 56 men and women with major depression who all had a very poor diet containing lots of highly refined foods, very few fruits and vegetables, and few lean types of meats. Implementing a Mediterranean diet that was high in whole grains, fruits, vegetables, nuts, lean meats and 3 TBSP of olive oil per day led to 32% of participants no longer meeting the criteria for depression after only 12 weeks! (7)

Metabolic Syndrome

Metabolic syndrome is a cluster of 3 or more related cardiometabolic risk factors:

• Central obesity (determined by waist circumference)

• Hypertension

• Hypertriglyceridemia

• Low HDL cholesterol levels

• Hyperglycemia.

Research has shown that olive oil supplementation can decrease central obesity and elevated fasting glucose levels. Supplementation with nuts (rather than olive oil) has also been shown to reduce central obesity. (8)

Interested in changing your diet to a Mediterranean Diet? Below is some good information to help you get started!

References

Welcome Nicole Loran

Meet Nicole Loran! She is a 4th year student finishing her training in Naturopathic Medicine at the Southwest College of Naturopathic Medicine (SCNM) in Tempe, Arizona. Nicole is a dedicated and hard working student who currently holds a Bachelor of Science degree in Physiology and Pharmacology as well as a Arts and Science degree in Religion and Culture from the University of Saskatchewan. Nicole is involved in ongoing research through SCNM for psoriasis and is currently class Treasurer and Vice President of the Aesthetics Club at SCNM.

Education is extremely important to Nicole and she continually strives to further her knowledge in many areas including anti-aging, integrative, and functional medicine. She incorporates what she learns into her daily practice and strives to empower the patients with knowledge on how to improve their health.

Nicole has 2 years of clinic experience with a focus on general, naturopathic community and internal medicine, women and men’s health, endocrinology, botanical medicine, nutrition, nature cure, acupuncture, IV therapy, heavy metal toxicity and addictions.

Her interests include: endocrinology, women’s health, nutrition, weight loss, gastrointestinal health, metabolic disorders, stress, chronic fatigue and acupuncture.

Nicole is originally from Saskatoon. She is looking forward to spending one of her final months as an intern under the supervision of Dr. Velichka ND. Once her schooling is complete, she plans on moving back to Saskatoon to start her practice as a Naturopathic Doctor.

You can book in to see Nicole at our clinic ever Monday, Wednesday and Friday during the month of May. Nicole has experience in creating diet plans for patients with diabetes or PCOS and those who require FODMAP, anti-SIBO or ketogenic diets. Nicole will be assisting Dr. Velichka ND in her acupuncture services.

We are excited to have Nicole be a part of our clinic over the next month. We hope you get to enjoy the benefits from having her involved in your care!

Frequently Asked Questions (COVID-19)

1. Is your clinic still open? 

Our clinic remains open with reduced hours (Monday-Friday 9-4) for appointments only.

2. How do we place an order for supplements?

To order supplements call our office at 306-664-2150, let the receptionists know what supplements you need, and pre-pay over the phone. We can either ship your supplements to you for a $15 fee or you can utilize our curbside pick-up. 

3. What is curbside pick-up?

When you get to our clinic to pick-up your pre-paid supplements, park in the loading zone and give us a call. We will run your supplements out to your vehicle.

4. How do we pay for supplements if we cannot come into the clinic?

We ask that you pay for supplement orders using a credit card over the phone. 

5. How does the video telemedicine consultations work?

We book all video consultations the same way we book in-person consultations except at the time of the booking we will ask whether you prefer the link emailed or texted to you.

To access the video consult you will need either a smart phone, ipad/tablet or a computer with a camera and microphone. 

5 minutes before your appointment you will receive a link. Simply click on the link and a web page will open. You will then be asked to enter your name and enable camera and microphone (enable both for best results). 

Once in the virtual waiting room wait until your ND starts the call. 

Visit our blog post for more information on video consultations. 

6. If I have a video or phone consult when and how do I pay?

After your video consultation your ND will put the video on pause and reception staff will appear on the screen to take payment.

Immediately following your phone consult you will be placed on hold and the reception staff will answer the call and take payment over the phone. 

7. What is the cost of video & phone consults?

The cost for video and phone consultations is the same as in-person visits. Please see our fee schedule for more information.

8. Can we still get treatments such as IV therapy or acupuncture at this time?

We have resumed in office services including IV therapy, acupuncture, massage and lab test collections with your safety in mind.

9. Are the counselors still available? 

Our counselling team is currently offering video appointments through Skype, FaceTime or what's app, and telephone appointments.Bookings can be made with any of the counselors by contacting them directly via email, telephone or text. Visit our blog post for their contact information .

10. What is the best way to stay up-to-date with clinic changes including updates on when in-person services will be available again?

During these unpredictable times, we will keep our patients up-to-date through our email newsletters as well as our social media streams. 

Do you follow our clinic on facebook or instagram? Stay connected through social media @yxenaturopathic.