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Tuesday, September 11, 2012

Alternative Health Practices in Cancer Treatment


I had someone a few years ago ask for an online martial arts group to provide information on “Alternative Health Practices.”  He had a friend who had breast cancer, and he was trying to help her.  She was resisting his attempts to help, "she was too proud," and it sounded like she did not share his belief system.
While I do note that I am an oncology nurse in this blog, I have never actually written about anything related to cancer treatment or my professional life.  This is an issue I still feel strongly about, and I wanted to submit this letter with a few modifications to the larger world.  For those people who identify themselves as Alternative Practitioners, I prefer to use the term Complimentary Therapies - I don't see myself as an "alternative" to you, and I am happy to work with you.  I have used Taiji for years to recover from a number of injuries.  I do practice meditation regularly.  I'm actually not a non-believer.  What I believe just isn't the point.
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There have been many sad and serious situations that I have had to live and work through because well-meaning people tried to have a loved one do or believe something that they simply could not. 

When the body has rebelled in the form of cancer and a woman has to see her feminine identity as the thing that will kill her, she is threatened by everything around her and within her.  She is dying because of herself, literally.  She's already afraid, and already under attack.  

Pride is what passes for inner strength.  I love a sassy patient. I love the ones who talk back.  The ones who are the most compliant are the ones who are dead inside already. They are the easiest ones to do something to, but they are the hardest to help.  Rejoice in her pride.  Guide her passion and pride and feel grateful for it.  You will only lose if you engage in a fight with the last piece of her still standing strong.  Either you'll break on it and lose a friend, or you will break the last piece of her still standing up and choosing to live.

As a nurse I have had families insist on praying over bags of chemotherapy, which I am happy to let happen but once a family insisted on this when a drug was going to expire and be useless within an hour.  I needed to make a choice, and I had them pray as the bag was hanging.  I recognize they had bought into something that mattered to them, and I believe it made a difference.

I have alternative practitioners who insist that the patient lie to their health professional because "we won't understand or we will judge them harshly.”  After 22 years in internal arts and practices, I am better experienced and more versed than some local alternative practitioners who question me because I am "western medicine.”  Most oncology pharmacists are well versed in the available treatments out there, and yes, many of those treatments DO affect what we are trying to do.  Even vitamins can adversely affect some chemotherapies. It is always best for the patient to be honest with us and all other practitioners, and always a problem if they are encouraged to see us as the people they cannot be honest with.

Years ago a desperate woman bought herbal remedies to help with her colon cancer.  She had not explained she was on chemo, as the herbalist said it was all poison, and she never discussed what she was doing with her oncologist (she thought her doctor would laugh at her). Both her chemo and her herbal remedy each gave her diarrhea, and with the nausea from her chemo (the antiemetic pills were "western medicine") she was admitted nearly dead from dehydration and she broke her hip slipping on her own feces while struggling to the bathroom. I had to admit her in this sorry state.  She couldn’t tell me what she'd done, and the relative who had acquired the herbs for her wouldn’t.  It took days to find out what had happened to her, and her family was terrified.  We were ready to stop treatment thinking she could not tolerate her chemotherapy and our best efforts were too lethal.  Her family thought the cancer was out of control and ravaging her body to make her so sick.  If all her practitioners had been fully informed, I don't believe she would have been on both these diarrhea causing agents simultaneously.

Telling someone that they have to buy into a treatment to make it work means the patient gets blamed when it doesn't.  It's their fault they didn't believe enough.  This is not just aimed at Chinese medicine practitioners, but a beef I have with fundamentalist Christianity as well.  "God will cure you if you pray."  So, if no cure, the patient or their loved ones never prayed enough or never believed enough or they were deemed unworthy by God.  "Maybe cancer is God's punishment," soon followed by, "Maybe God doesn't exist."  No one with cancer deserves to feel punished and abandoned by God and the people they love.

Once a woman was given seaweed puree to drink because it was supposed to help her, and there was a huge argument amongst the family when in the midst of nausea she couldn't drink the putrid smelling thick green mess.  The family fought her, then fought me when I supported her getting nutrition in a way that she could stomach. What the family missed was I was there for her, and they were against her.  The patient felt abandoned by her family's display of "love."

I recognize that love is a two edged sword. It's why the loved ones all rally around the patient and love drives the desperation to find a cure. When a wife is trying to force food down her dying husband's throat and starts to cry out, "If you really loved me you would eat this" I recognize that this comes from love. But what a sad last memory for the husband whose throat no longer works and whose digestive system has shut down. He cannot love his wife enough to override reality, and he is punished for this with his dying breath. 

If she's afraid and resisting what you want her to do, be there for her.  It's hard.  You can't force her to believe something she doesn't.  You can't help by being one more attacker in the midst of a whole universe against her.  Support her and help with her and keep your options of the things you would like to offer her open.  They'll be open eventually if you are a friend; those options will close if you try to force yourself on her.  Just be a friend.  

People make their own choices.  It can turn my stomach to see the choices people make sometimes and it can break my heart, but I can only work with them.  I can't act against their will without losing their trust and destroying the most important part of being a caregiver - the therapeutic relationship.


I wrote the original letter in Yahoo, then added material in Word, then posted it here.  The formatting is not what I wanted it to be, so please excuse it.