Janie Brown: The Power of the Integrative Approach in Breast Cancer Treatment

Updated June 19, 2023

I have been an oncology nurse for over thirty years, and thanks to the inspiration of Michael Lerner and Rachel Remen of Commonweal, I co-founded a cancer retreat program and centre in Vancouver, British Columbia, twenty-three years ago. My partner Daphne Lobb has been a palliativerelieving pain or suffering without dealing with the cause of the condition care doctor for twenty-eight years, and when she was diagnosed with breast cancer a year ago, we were catapulted from being professionals into the role of patient and caregiver.

We both thought we deeply understood the experience of cancer because of our years of work in the field but it wasn’t what we expected. The shock of the diagnosis was visceral, it was no longer hypothetical, it was real. Our professional knowledge didn’t make things easier. We were in shock, discombobulated, confused and sad, like every other patient we had met. Cancer is the great equalizer.

Decision about chemotherapy

We have many oncologist friends, and there was no shortage of advice. The treatment of a 0.8 cm, intraductal, Stage 1, Grade 3, node-negative breast cancer, with a Prosigna score of 78/100 was not clear. The lumpectomy and sentinel node biopsy was the definitive surgery, but there was no research data that clearly indicated what chemotherapy Daphne should have: 8 cycles of AC-T, 4 cycles of DC, or 6 cycles of DC. We were left to make the decision for ourselves. At that time there was no BCCTBeyond Conventional Cancer Therapies (predecessor website to CancerChoices)/CancerChoices website. This is a truly wonderful resource now available for patients and families, one which we would have turned to.

Dr. Keith Block

I had met Keith Block at a conference of integrativein cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan oncologists the year before and I remember thinking if I ever had cancer I would want to consult with him. His center in Chicago was the most progressive, wholistic and beautiful center I had encountered to date, and his approach in combining complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies with conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy cancer treatments made logical and wise sense to me.

With the confusion around the treatment decision, we decided to consult with Keith Block and ask him to look at the pathology and test results to see if he could shed any light on our confusion.

The hour we spent with Keith on the phone was one of the most inspiring conversations we had had with a cancer doctor, and somewhat to Daphne’s surprise (she assumed that an integrative physician might err on the side of less rather than more chemo) Keith said that if this was his wife he was discussing, he would strongly advocate 8 cycles of AC-T, the heaviest of the three chemotherapies that had been suggested. Keith not only helped with the decision, he also gave us some extremely helpful, evidence-based advice on how to manage the side effects of surgery, chemotherapy and radiation.

Stats on the side effects of Adriamycin, cyclophosphamide and Taxol chemotherapy (we were given this information by our chemo nurse at the first treatment):

Mucositisinflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer	54%
Peripheral neuropathydamage to the peripheral nerves outside the brain and spinal cord	42%
Neutropeniaan abnormally low number of neutrophils in the blood, leading to increased susceptibility to infection	30%
Anemia	54%
Nausea/vomiting	50-60%
Fatigue	90%

Interventions suggested by Keith Block

For mucositis

• L-glutamine 20 g in 1 litre water, swish and swallow 2 days before chemo, day of chemo, and 2 days following           

NO MUCOSITIS

For peripheral neuropathy

• Ice regime/surgical gloves: Hands in tight surgical gloves submerged in bowls of ice for 20 minutes before the Taxol infusion, during the infusion and for 20 minutes after. Feet in ice booties (Natracold) for the same time frame as hands.
• Alpha-lipoic acid 600 mg twice a day                           

NO NEUROPATHY

For fatigue/nausea  

• Antinauseants: dexamethasone, apprepitant, ondansetron       
• Exercise: minimum 10 minutes of cardio 1 to 2 hours before chemo, and recovery aerobics and aerobic exercise as many days as possible

NO NAUSEA, LITTLE FATIGUE, SLIGHT ANEMIA

For neutropenia

• G-CSF (Filgrastim) 1 S/C inj. starting day 3, times 5-6 doses per cycle

NO DELAYS AND NO INFECTION

Supplements

• Coenzyme Q10 (Ubiquinol)
• Vitamin E with mixed tocopherols
• Hawthorn 
• Reishi mushroom ›

• Probiotics ›
• Curcumin ›
• ECGC (green tea extract) ›
• DIM (cruciferous vegetables) ›
• Milk thistle ›

• Vitamin C ›
• Coriolus mushroom ›
• Vitamin D ›
• Fish oil DHA/EPA ›
• Melatonin ›
• Alpha-lipoic acid   

Nutrition

Plant-based diet, little sugar, low dairy, whole grains

Chronotherapy

Keith also suggested Daphne try to have her chemo scheduled for the morning as the cells divide more rapidly then and therefore the chemo would supposedly be more effective.

Gratitude

Having been a chemotherapy nurse for many years, I was astonished at how well Daphne tolerated the chemotherapy. We both give deep thanks to Keith and his team at the Block Center for making what could have been a horrible experience with chemotherapy into one that was fairly easily tolerated.

We both know that we also did well because of what we called our ‘Love Posse,’ our family and friends who fed us, walked with us, made us laugh, and let us cry, and generally reminded us that we had much to be grateful for.

We also attended a week-long cancer retreat with the brilliant team at the Cancer Help Program at Commonweal, Bolinas, California, which helped us both process, integrate and heal from the cancer journey we had been on for a year. It was a life-changing and life-strengthening process and reinforced the value and healing potential of our own work with cancer retreats in Canada.

Four months after the treatment finished, Daphne cycled a 100-km Fondo ride with her cycling team, and one year after her diagnosis she is back working as a palliative care physician, and loving it as much, or more, than she ever did.

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