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The Mind, Body and Spirit Approach to Breast Cancer

Dr. Leslie Mendoza-Temple October 20, 2008 12:00 PM This chat has ended. Thank you for participating.
Kristin Philbin (Moderator) - 11:49 AM:
Welcome to NorthShore University HealthSystem’s latest chat: The Mind, Body and Spirit Approach to Breast Cancer with Dr. Leslie Mendoza-Temple. The chat will not start for another ten minutes, but please feel free to start submitting questions to be answered shortly.

Dr. Leslie Mendoza Temple (NorthShore) - 11:55 AM:
Thank you for participating in our Live Chat on Integrative Medicine and our approach to breast cancer. I look forward to receiving your questions and comments!

Vicky (addison, il) - 12:01 PM:
What are the benefits to integrative medicine?

Dr. Leslie Mendoza-Temple (NorthShore):
Thanks Vicky-great question. The benefits of Integrative Medicine is the concept of using therapies from complementary/alternative medicine AND conventional "Western" medicine as we know it today. The broadness of this concept allows greater flexibility in tailoring treatments for patients on a holistic scale. "Use whatever works" which is safe and evidence based as much as possible---that's my guiding principle.

Haley (Chicago, IL) - 12:01 PM:
Are there any types of integrative medicine that a breast cancer survivor should avoid at all costs?

Dr. Leslie Mendoza-Temple (NorthShore):
This depends on which therapy is being proposed, so this is a trickier question. Can you be more specific?

Amy (Chicago) - 12:04 PM:
Hello, Dr. Mendoza Temple. My mother died of breast cancer and I'm already undergoing agressive screening under the care of my physicians. But what can I do in terms of prevention? i.e... are there specific supplements, foods, I should be consuming?

Dr. Leslie Mendoza-Temple (NorthShore):
As a general rule, and depending on what your allergies/sensitivities may be, I recommend a low-inflammatory type diet which consists of little to no red meat (unless you're anemic), low on refined sugars/white flour/ white pasta/white rice with emphasis on whole grains/whole grain pasta/brown rice instead. Heavy on fruits/veggies-organic is best but not required, good vitamin D supplementation (to be discussed individually), fish oils (flaxseed if you're vegetarian or don't tolerate fish oils). Wow, the lsit can go on. But, in general, a heart healthy Mediterranean type of diet is best---which is also good for reducing heart-related problems.

Adriana (Rosemont, IL) - 12:08 PM:
Is acupuncture beneficial to those with breast cancer: why or why not?

Dr. Leslie Mendoza-Temple (NorthShore):
Acupuncture is wonderful for helping the whole person, not just a particular condition. So, from a holistic perspective, the better off the body/mind/spirit from acupuncture, the more resilient one is to face breast cancer. More specifically, acupuncture has been shown to be helpful at reducing severity/frequency of hot flashes. It reduces cancer and cancer-treatment related fatigue, pain and nausea. But acupuncture does so much more than that. I welcome you to try it. There is little downside, and for the needle-shy, we also offer laser acupuncture. This allows for cold laser stimulation of acupuncture points on the body without needles.

Sarah (Glenview, IL) - 12:11 PM:
I have undergone chemo for breast cancer and it was one of the toughest things I have ever done. What do you tell your patients to help ease the side effects? My worst side effects were fatigue and hot flashes.

Dr. Leslie Mendoza-Temple (NorthShore):
Sarah, I just submitted a reply-even before seeing this posting. It's like I'm psychic. Please see the response to Adriana in Rosemont. ;)

Rachel (Winnetka) - 12:12 PM:
Dr. Mendoza-Temple, you mention a good Vitamin D supplement. Are there any tests that can be done to measure my baseline Vitamin D? How will I know if I am taking too much or too little in regards to perventing cancer?

Dr. Leslie Mendoza-Temple (NorthShore):
Wow-such great questions! Rachel, I check serum vitamin D levels (25-OH vitamin D to be specific). There are normal levels, but optimal levels may reside somewhere between 50-70 ng/ml. Toxic levels (which can harm the kidneys) go anywhere from 100-150 ng/ml. Since this is a fat soluble vitamin, we can accumulate vitamin D, so that's why periodic blood tests can help determine if we're getting too much (rare) or too little (common). If you live above Atlanta or stay out of the sun in general, you are probably vitamin D deficient unless you supplement. But, it's best to get your levels checked to determine if this is true. Food sources of vitamin D: dairy, fish, vitamin D enriched orange juice and other D-enhanced foods. I can't say what your daily vitamin D intake should be because it depends on what your serum level is. In general, we don't go above 2000 IU daily of vitamin D3 (cholecalciferol), but I have some patients that take more under my supervision.

Meghan (Lincoln Park) - 12:18 PM:
I am waiting for my hair to grow back after my treatments!! Is there a supplement, such as Biotin, that I can take to make my hair come in more quickly? I don't know if Biotin really works as some people says it does to promote hair growth.

Dr. Leslie Mendoza-Temple (NorthShore):
Hmmm---hair loss has always been a tricky one for me. I think supplements like the B complex and biotin can be helpful but I haven't been impressed with 'amazing' results. Time is the healer here. I am always looking at different treatments for hair loss, like laser, but haven't come across anything that offers impressive results other than taking care of one's self from the inside with good nutrition and healthy stress management.

vicky (addison, IL) - 12:21 PM:
Thanks, doctor. Would it be more beneficial to incorporate integrative medicine while I am foregoing treatment for breast cancer, or after as a preventive measure?

Dr. Leslie Mendoza-Temple (NorthShore):
Vicky, Thanks for clarifying. I think that Integrative Medicine (i.e. nutrition, supplements, exercise, acupuncture, bodywork, counseling, chiropractic, etc etc) can be incorporated at ANY time point of your treatment, whether you decide to forego conventional treatment (chemo/radiation) or combine conventional treatment. These treatments are also meant to help prevent recurrence as well.

Sarah (Glenview, IL) - 12:24 PM:
During my chemo treatments I got to participate in a quality of life trial for reflexology. Do you know if that will someday be a part of the cancer treatments?

Dr. Leslie Mendoza-Temple (NorthShore):
I think reflexology is wonderful and should already be part of one's cancer treatment regimen. We don't offer this currently at the Park Center (where our clinic resides in Glenview), because we have 4 wonderful bodyworkers who practice different kinds of bodywork- Shiatsu, neuromuscular release, etc etc.

Haley (Chicago, IL) - 12:26 PM:
I haven't had any proposed, but was thinking about doing some sort of integrative medicine. In your opinion, are there some therapies that are not ideal for those with breast cancer?

Dr. Leslie Mendoza-Temple (NorthShore):
Thanks for clarifying. There aren't specific therapies that I can think of that ENCOURAGE breast cancer growth, if that's what you mean--unless you're talking about bioidentical hormone replacement therapy (a no-no). At the Park Center at NorthShore, we are very mindful (and avoid) areas of lymphedema with respect to acupuncture. I refer patients to the Lymphedema Center at NorthShore for specific therapies, which include bodywork on swollen extremities.

Adriana (Rosement, IL) - 12:30 PM:
I wanted to know from a professional standpoint, how integrative medicine can help someone with breast cancer?

Dr. Leslie Mendoza-Temple (NorthShore):
In my opinion, probably the main factor that enhances one's quality of life with respect to breast cancer is a greater sense of CONTROL over the treatment process. When YOU are the one buying the organic fruits/veggies, exercising wisely, practicing yoga and/or meditation, finding sources of humor and joy---those are the things that no doctor or other healthcare professional can do for you, yet they help so tremendously. In my clinical experience, I have seen patients go from beginning of treatment to end of treatment with less anxiety, nausea/vomiting, and better overall quality of life with concurrent Integative therapies and traditional cancer care (chemo/radiation/surgery). It's not perfect, but things seem more tolerable for patients.

Shirlene (Waukegan, Il) - 12:33 PM:
What number do I call to request an appointment for a mammogram?

Dr. Leslie Mendoza-Temple (NorthShore):
Shirlene, Kudos to you for bringing this up! Of course, I don't have the number in my brain---but I am sure you can find it somewhere on the NorthShore website after we're done. Don't forget to check your breasts and armpits for lumps/bumps that feel unusual--best done after your period is done because they're less lumpier at the time. Please note that mammograms don't detect all breast cancers---some of my patients or their doctors found a lump that was suspicious on their own, with a normal or only borderline mammogram result.

vicky (Addison, IL) - 12:37 PM:
What can I do to learn more about integrative medicine? Are there any books you'd recommend?

Dr. Leslie Mendoza-Temple (NorthShore):
I like the series that Dr. Andrew Weil (my mentor) has written over the past few decades. His latest one is Healthy Aging. You can get this pretty much at any bookstore, but we also carry this at our Park Center Wellness Shop in the Glen.

Haley (Chicago, IL) - 12:38 PM:
I’m so glad you are holding a chat on integrative medicine! After going through treatment a few years ago, I took up yoga and have felt so in tuned with my body ever since. Are there any other forms of exercise that can have the same effects as yoga has for me?

Dr. Leslie Mendoza-Temple (NorthShore):
Pilates, Nia dance, Feldenkrais have also been successful for many of my patients. I encourage you to explore. It's important to keep the body moving and mixing it up so you don't get bored with one routine, although I can't imagine yoga getting boring!

Adriana - 12:39 PM:
Why would a doctor be against using integrative medicine along with regular care?

Dr. Leslie Mendoza-Temple (NorthShore):
Lack of education in medical school and residency lead to a lack of comfort/familiarity with these therapies for many physicians. A less-than-optimal evidence base of research for these therapies is also a reason for resistance. But, there's a lot of research that's out there, depending on the therapy. That's what I spend much of my time sorting out for patients.

Susan (Evanston) - 12:43 PM:
The phone number for scheduling a mammogram is 1-888-364-6400. I know this because I just made my appointment. Is it true that stress can cause breast cancer? And if so what are some alternative therapies that aren't so costly to do on a regular basis?

Dr. Leslie Mendoza-Temple (NorthShore):
Thanks Susan-- that's so helpful for everyone else who's supposed to schedule their mammogram ;) Stress can contribute to a general state of inflammation, which is not only bad for cancer, but truly bad for your heart (i.e. hypertension, heart attacks, etc). In these tougher economic times, it may not be possible to get regular acupuncture and/or bodywork, so I turn to the books and tapes which offer instruction on how to meditate, self-hypnosis, guided imagery, and so on. We have a good list of books/tapes on our website at www.northshore.org/integrative.

Haley (Chicago, IL) - 12:46 PM:
Thanks for the great tips, doctor. You said it's important to keep the body in motion, would you also recommend swimming and/or water aerobics?

Dr. Leslie Mendoza-Temple (NorthShore):
Yes---thanks for bringing those up---definitely!

Vicky (Addison, IL) - 12:47 PM:
Thanks, doctor! Have you written anything on the topic?

Dr. Leslie Mendoza-Temple (NorthShore):
I've written a chapter (not on breast cancer but on hypothyroidism) in a book geared toward medical professionals on Integrative Medicine. If you are interested in that level of information, there's also good material on integrative treatments with respect to cancer and non-cancer adult medical conditions, stress reduction, etc. The book is Integrative Medicine 2nd ed. by D. Rakel.

Kristin Philbin (Moderator) - 12:49 PM:
Thank you everyone for your great participation, but unfortunately we only have ten minutes left. Please submit any final questions you have.

Adriana - 12:50 PM:
How safe is alternative medicine?

Dr. Leslie Mendoza-Temple (NorthShore):
It depends on which therapy you're talking about. For instance, in the wrong hands, massage therapy can actually create pain. Acupuncture needles jabbed in the wrong places can irritate a nerve or puncture an organ if placed too deeply. That's why it's important to seek a highly qualified practitioner, like at the Park Center. Safety first!

Vicky (Rosemont, IL) - 12:53 PM:
What's the difference between "alternative," "complementary" and "integrative" medicine?

Dr. Leslie Mendoza-Temple (NorthShore):
Alternative= This is chosen INSTEAD of conventional medicine. I am not a fan of strictly "Alternative" medicine because it implies that you are choosing one way or the other, rather than allowing for all kinds of medicine. Complementary= therapies used that help enhance or act synergistically with conventional medicine--- good stuff. Integrative = The use of all of the above with conventional medicine. Example: chemotherapy and radiation therapy, with weekly acupuncture and twice monthly massages, plus vitamin D supplementation with fish oils, refined sugar elimination, yoga and psychotherapy. That's truly integrative!

Kristin Philbin (Moderator) - 12:56 PM:
We only have time for one more question. Please submit any final question you may have.

Adriana (Rosemont, IL) - 12:56 PM:
Thanks, I will have to look into that. It is so scary thinking about malpractice. Other than going to the Park Center, are there any other ways I can tell whether an establishment is filled with qualified practitioners?

Dr. Leslie Mendoza-Temple (NorthShore):
I would look towards an academic medical institution or one led by an M.D. or D.O. physician for general oversight of the practitioners, like I have at the Park Center. I can't speak for other institutions, but here at NorthShore, we meet as an entire team twice monthly to discuss the latest developments in research, talk about our patients, support one another, and share our wisdom. I suggest also looking at websites like www.nccaom.org and the AMTA Illinois Association for Massage Therapy for qualified practitioners. If you're out of state, you can check the website www.integrativemedicine.arizona.edu for physicians and nurse practitioners trained at the University of Arizona Integrative Medicine program. You can find them internationally as well.

Kristin Philbin (Moderator) - 1:00 PM:
Thank you everyone for participating in the chat. A transcript of the complete chat will be available shortly. More information about NorthShore University HealthSystem’s breast cancer services can be found on the Breast Cancer Center’s website.

Dr. Leslie Mendoza Temple (NorthShore) - 1:01 PM:
Thanks everyone for your great questions, and best of luck in your journey to beat cancer! Dr. LMT
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