Dealing with Cancer During COVID

Transcript

• 00:00Support for Yale Cancer Answers
• 00:03comes from AstraZeneca dedicated
• 00:05to advancing options and providing
• 00:08hope for people living with
• 00:11cancer. More information at astrazeneca-us.com.
• 00:14Welcome to Yale Cancer
• 00:15Answers with your host
• 00:17Doctor Anees Chagpar.
• 00:19Yale Cancer Answers features the
• 00:20latest information on cancer care by
• 00:23welcoming oncologists and specialists
• 00:24who are on the forefront of the
• 00:27battle to fight cancer. This week,
• 00:29it's a conversation about Integrative
• 00:30Medicine and the challenges
• 00:32of dealing with cancer during
• 00:34the pandemic with Doctor Gary
• 00:35Soffer. Doctor Soffer is the director of
• 00:38the Integrative Medicine Program at
• 00:40Smilow Cancer Hospital and an assistant
• 00:42professor of clinical Pediatrics
• 00:44at the Yale School of Medicine
• 00:46where doctor Chagpar is a
• 00:48professor of surgical oncology.
• 00:51Gary, maybe we can start off by you telling
• 00:54us a little bit more about yourself and
• 00:56about what exactly you do.
• 00:58Sure, and it's funny,
• 00:59I always start my integrative medicine
• 01:02appointments with, tell me about
• 01:03yourself, and the patients tend to
• 01:05dive into their cancer diagnosis.
• 01:07So I correct them and
• 01:10I'm going to avoid that.
• 01:12I'm going to say I'm a father of two.
• 01:15I am happily married.
• 01:16We live in Connecticut and
• 01:18I enjoy things like yoga and
• 01:20meditation and I love my job.
• 01:22But I will talk about what people are
• 01:24probably a little more interested in,
• 01:27which is what I actually do.
• 01:29I specialize in something
• 01:31called Integrative Medicine,
• 01:32and I also specialize in something
• 01:34called allergy and immunology.
• 01:36I think for awhile people saw this
• 01:38as a strange combination,
• 01:40but as COVID was coming up I think
• 01:42the conversations about Integrative
• 01:44Medicine and immunology are
• 01:45becoming more and more prevalent,
• 01:47so it's giving me an interesting
• 01:50space to talk about these things.
• 01:53Maybe dive a little bit more into
• 01:54what exactly is integrative medicine.
• 01:57I think it's one of these terms
• 01:59that might be a little confusing to people.
• 02:02Yeah, it's a little confusing to
• 02:04me to be quite honest, and
• 02:07it really does depend on where you look,
• 02:10and I think each individual
• 02:12practitioner of Integrative Medicine,
• 02:13for better or for worse,
• 02:15sort of has their own take on it.
• 02:17But the way I see it is
• 02:20that integrative medicine just simply
• 02:22incorporates into conventional care
• 02:24and what kept people healthy before
• 02:26the advent of modern medicine and
• 02:28all these wonderful things that
• 02:30we have and bringing that in and
• 02:32reminding ourselves these things
• 02:34did have value and they had importance.
• 02:37And then
• 02:38the other thing that we really think
• 02:41about is what is the least invasive
• 02:43way to make a patient feel better?
• 02:47And sometimes it's about helping the cancer,
• 02:49but sometimes it's just also
• 02:51about changing the journey
• 02:53and changing how they feel about
• 02:55their disease and how they experience
• 02:58their disease day to day.
• 03:00I mean the least invasive way to make
• 03:04somebody feel better might be not to
• 03:07treat a cancer with things like surgery,
• 03:10radiation, or chemotherapy,
• 03:11but it sounds like that's not really
• 03:15where you're at?
• 03:18I'm speaking to the patient and
• 03:21respecting their autonomy and
• 03:23understanding where they're coming from.
• 03:25I'm on the side of conventional
• 03:28medicine in the sense that I
• 03:31believe in my heart that
• 03:33is the best cure for cancer,
• 03:35but sometimes that's not what the
• 03:37patient is looking for and we
• 03:38have to understand that and we
• 03:40have to have that conversation.
• 03:45And it's important
• 03:50to ask the question of why do patients
• 03:52seek out integrative medicine?
• 03:54What are they looking for?
• 03:56And it's easy to say, well,
• 03:58they're looking for more natural options,
• 04:00and that's true to a certain degree,
• 04:03but I think what we also have to understand
• 04:05is that they're looking for autonomy.
• 04:08They're looking for a way to
• 04:09participate in their care,
• 04:11and so if they do their research
• 04:13and they find some herb that their
• 04:15doctor didn't tell them about, well,
• 04:17that makes him feel empowered.
• 04:19It makes him feel a part of their care,
• 04:23and part of integrated medicine is
• 04:24giving the patients those tools
• 04:26and techniques in a safe way.
• 04:28That they can participate in
• 04:29their care and they don't just
• 04:31have to sit back and
• 04:33get the chemotherapy treatment
• 04:34done to them.
• 04:37I totally get that.
• 04:39And I think the other thing is
• 04:42that when you talk to patients
• 04:44and you ask them why are
• 04:47they seeking out integrative care?
• 04:50A lot of times it's because
• 04:52conventional care is scary,
• 04:53because chemotherapy is scary.
• 04:55People don't want to feel sick.
• 04:59They don't want to feel nauseous
• 05:03and I think that oftentimes I
• 05:05find that integrative care can
• 05:07actually help people to get through
• 05:10conventional treatments and get over
• 05:13that fear that helps them to
• 05:16get through that journey.
• 05:20There's a concept in
• 05:22Tibetan Buddhism called Duhkha and Duhkha
• 05:25roughly translates into suffering,
• 05:27but I really hate that translation and
• 05:30what I think it really means is feeling
• 05:33unsettled and this feeling of just constant
• 05:36stimulation in our head and this chatter
• 05:39that keeps going and going and going.
• 05:41And am I going to feel horrible?
• 05:43Am I going to feel nauseous?
• 05:50And what I try to remind them
• 05:52is at the anticipation of getting a
• 05:55shot or getting a needle is just so
• 05:58much worse than the needle itself.
• 06:00And that's not to diminish the
• 06:02sensations or the experiences that
• 06:04people have while on chemotherapy.
• 06:08But integrative medicine
• 06:10really can help in changing how we
• 06:13sort of view it, how we experience it,
• 06:17and how we approach all of
• 06:20these experiences.
• 06:22And let's unpack a
• 06:24little bit about that.
• 06:26So you know cancer is a
• 06:28scary diagnosis for anybody,
• 06:30no matter how strong you think
• 06:32you are deep down inside,
• 06:34everybody is a little bit fearful
• 06:36of not only the diagnosis but
• 06:38the treatment and the prognosis.
• 06:41So how do you use integrative
• 06:43medicine to get people to
• 06:45settle that unsettled feeling?
• 06:48I mean, we have lots of different
• 06:50techniques and
• 06:52obviously the things that come to mind,
• 06:54are mindfulness and yoga,
• 06:56but every patient is different
• 06:57and every patient needs to find
• 06:59that thing that does it for them.
• 07:01So I have patients who knit and that's
• 07:03a mindfulness exercise,
• 07:06but we don't really think about it that way,
• 07:08or drawing or coloring,
• 07:10or just finding ways to be present.
• 07:14And that's so important,
• 07:17but what about people who kind
• 07:19of have difficulty with that?
• 07:21because I think that
• 07:23oftentimes in mindfulness practice,
• 07:25people tell you to kind of focus on
• 07:28the present and be present and focus
• 07:30on the breath and so on and so forth.
• 07:33But for many patients I can just imagine
• 07:36that you know their head is going to spin,
• 07:39I just was diagnosed with cancer,
• 07:41I've got a doctors appointment in three days.
• 07:44My test results are coming back.
• 07:47I have to think about
• 07:49my next chemotherapy and on
• 07:51top of all of that,
• 07:53especially now we're living
• 07:55in this crazy world of Covid,
• 07:57so I'm worried about my kids
• 07:59getting infected.
• 08:00I'm worried about home schooling or whether
• 08:03they should go to school and how that
• 08:07affects me and all of that chatter.
• 08:12It just might be difficult
• 08:14to be mindful.
• 08:16So what tips do you have
• 08:19for people to
• 08:21settle that unsettled feeling?
• 08:24First of all, anybody who
• 08:25tells you they're a good
• 08:27meditator is a liar. It's hard work,
• 08:32and it's called a practice for a reason.
• 08:34It's because we're constantly
• 08:36striving for a little bit better.
• 08:38There's a concept
• 08:40in mindfulness and meditation that I
• 08:42talk to a lot of my patients about.
• 08:44Which is we can't
• 08:46control the first thought.
• 08:47Whatever pops into your head is human.
• 08:50It's natural,
• 08:51whatever comes into your mind is there.
• 08:54What we have control over is the
• 08:56second thought, and that's where the
• 08:58practice of mindfulness comes in.
• 08:59That's where we learn to exercise
• 09:01our brains in a way that say,
• 09:03OK, the first thought came in,
• 09:05but where's the second thought
• 09:07going to take me?
• 09:08Where are we going to go with this?
• 09:10This isn't a band aid.
• 09:12It's not a quick and easy fix,
• 09:15it takes work
• 09:16and it takes practice and
• 09:18ideally
• 09:18all of my patients have been meditating
• 09:20for years before they get the diagnosis.
• 09:23But let's be honest,
• 09:24the moment that they start to
• 09:26explore these ideas and think about
• 09:28them and see the value in them is
• 09:29truly is when they're struggling and
• 09:31when they're suffering and so we
• 09:32have to meet them there.
• 09:35And I can just imagine that
• 09:37it may be difficult,
• 09:39especially when you're thinking
• 09:41about everything else that's
• 09:42going on in the world now,
• 09:44to try to practice mindfulness.
• 09:46I mean, it's just one more
• 09:48thing and that might not be your
• 09:50thing, and that's sort of
• 09:52the beauty of Integrative Medicine
• 09:54is we have so many different tools
• 09:56in our toolbox to bring patients to
• 09:58that place and it may just not be
• 10:01about sitting cross legged some place.
• 10:03It may just be simply about going
• 10:05for a walk without your cell phone.
• 10:07That's a pretty mindful activity,
• 10:09but people don't think about it like that,
• 10:12So it's about
• 10:14looking at your patients,
• 10:16seeing what their value system is,
• 10:18seeing what's important to them
• 10:20and reminding them of that because
• 10:22it gets so lost all of a sudden you
• 10:25get a diagnosis and your medical record
• 10:27number and you're the next patient on
• 10:29the doctors schedule and you have 15
• 10:32minutes to ask whatever you want to
• 10:34ask your doctor and you forgot 12 of
• 10:37the questions you wanted to ask and
• 10:39then you leave and then you show up
• 10:42the next day and you get your chemotherapy.
• 10:44And nobody knows your name and nobody
• 10:47knows who you are and it can be a
• 10:51very depersonalizing experience when
• 10:53your entire experience is unique,
• 10:56what you're feeling is so unique
• 10:59and so independent.
• 11:02And you treat patients with breast cancer
• 11:05and you know every patient with breast
• 11:08cancer experiences it differently, their
• 11:10pathology, their genetics,
• 11:12everything might be identical on paper,
• 11:15but who they are,
• 11:16how they experience their disease
• 11:18is completely unique,
• 11:19and so I'm not going to prescribe
• 11:21mindfulness to everybody.
• 11:22I certainly don't,
• 11:24I think it's the wrong decision for people,
• 11:27but there are certain patients who it
• 11:29works well with and the reason why we
• 11:32like it so much is going back to
• 11:36this original concept of is
• 11:37this invasive?
• 11:38It's not really that invasive.
• 11:40Is this safe?
• 11:41It is safe,
• 11:43it's generally not a harmful
• 11:45practice for patients,
• 11:46and so it's a really
• 11:48helpful tool in the toolbox,
• 11:50but it's not the only one
• 11:53and the integrative
• 11:56medicine, as you say,
• 11:59has got so many tools in the toolbox,
• 12:03some of which are really
• 12:06kind of mindfulness based.
• 12:08But others are things that may
• 12:11stem from other ancient practices.
• 12:17So I can imagine things
• 12:20like complementary
• 12:22therapies with herbal supplements
• 12:25or acupuncture or acupressure.
• 12:27How do all of these other modalities play
• 12:31into a cancer patients journey as well?
• 12:35So again, it's about meeting
• 12:37patients where they are and what they are.
• 12:41Their hopes and expectations and
• 12:44what they want out of this.
• 12:46We have a lot of success with
• 12:49certain patients with acupuncture.
• 12:51Neuropathic patients who haven't been
• 12:54able to find anything else to help
• 12:56treat that pain or that discomfort.
• 12:58That's really helpful.
• 12:59I also find that
• 13:01finding a patients tradition and
• 13:03where they come from and their roots
• 13:06is also really meaningful.
• 13:07So oftentimes I will talk to patients
• 13:10of Indian descent and talk about
• 13:12Ayurveda because that's what their
• 13:14grandmother did and that grounds them.
• 13:17It roots them in something
• 13:19and on top of that,
• 13:21there are certainly certain herbs that
• 13:23come from Ayurveda that have been shown
• 13:26to be helpful in certain patients.
• 13:28Boswellia, for example,
• 13:30is a pretty safe
• 13:31herb to give patients and it can
• 13:33be helpful and they're looking
• 13:35for something like that.
• 13:40I think that concept of
• 13:42really meeting people where they
• 13:43are and letting them experience
• 13:45their journey and participate in
• 13:48their journey is so important.
• 13:49We're going to learn a lot more from
• 13:52about how to deal with cancer,
• 13:55particularly during these Covid times,
• 13:57right after we take a short
• 13:59break for a medical minute.
• 14:01Support for Yale Cancer Answers
• 14:03comes from AstraZeneca.
• 14:04A science led biopharmaceutical company
• 14:07dedicated to partnering across the
• 14:10oncology community to improve outcomes
• 14:13across various stages of cancer.
• 14:16More at astrazeneca-us.com.
• 14:20This is a medical minute about genetic
• 14:23testing which can be useful for
• 14:25people with certain types of cancer
• 14:27that seem to run in their families.
• 14:30Patients that are considered at risk
• 14:33receive genetic counseling and testing so
• 14:35informed medical decisions can be based
• 14:38on their own personal risk assessment.
• 14:40Resources for genetic counseling and
• 14:42testing are available at federally
• 14:44designated comprehensive cancer centers.
• 14:46Interdisciplinary teams include geneticists,
• 14:48genetic counselors, physicians,
• 14:49and nurses
• 14:50who work together to provide risk assessment
• 14:53and steps to prevent the development
• 14:55of cancer.
• 14:56More information is available
• 14:58at yalecancercenter.org.
• 14:59You're listening to Connecticut public radio.
• 15:04Welcome back to Yale Cancer Answers.
• 15:06This is doctor Anees Chagpar.
• 15:09I'm joined tonight by my guest doctor Gary
• 15:12Soffer. We are talking
• 15:14about dealing with cancer,
• 15:15particularly during the times of
• 15:17Covid and how integrative medicine
• 15:19can really help with that.
• 15:21Gary, before the break we
• 15:23were talking about cancer in general,
• 15:26being a really scary diagnosis and how
• 15:29integrative medicine can really help to
• 15:31meet patients where they are in that journey,
• 15:34and make it just a little bit more tolerable.
• 15:37But I can imagine that particularly
• 15:39now during Covid it's worse.
• 15:41What are you seeing from patients in terms
• 15:44of how they are coping with this?
• 15:48They might not be able to see
• 15:50their doctor face to face without
• 15:52a computer screen in between them.
• 15:55They may have had their therapies delayed.
• 15:57I can imagine that what is normally
• 16:00a stressful experience
• 16:01just got a whole lot more stressful.
• 16:05You know, it's interesting.
• 16:07I mentioned to you before that I see
• 16:10pediatric allergy and immunology patients
• 16:12in addition to my work at Smilow
• 16:15in integrative medicine.
• 16:16Cancer patients
• 16:18are really in a
• 16:20unique struggle right now and there is
• 16:22very real and practical concerns about
• 16:24their immune system being
• 16:27suppressed from their chemotherapy.
• 16:29The added loneliness that
• 16:30we talked about with
• 16:32cancer can be isolating.
• 16:34There's an added loneliness because now
• 16:36you're socially
• 16:38isolating from people,
• 16:39but I also find that many of my
• 16:42allergy immunology patients are doing
• 16:44worse because they haven't quite
• 16:46explored these greater esoteric
• 16:49questions that our cancer patients
• 16:51have. They haven't
• 16:54been forced to explore
• 16:57with the unknown and the unexpected.
• 17:00They haven't been forced to understand
• 17:02what it means when you're
• 17:05body isn't working in your favor.
• 17:08And sure they have
• 17:09their own conditions and their own diseases,
• 17:12but for the most part,
• 17:14the quality of life that they are
• 17:17experiencing is very, very different.
• 17:19You know our cancer patients have been
• 17:22through that journey to a certain degree,
• 17:25so sometimes it's just simply
• 17:27reminding them of what they've
• 17:29already persevered through and that
• 17:32this is simply a part of that journey.
• 17:36It's a mixed bag and there's no
• 17:38good answer.
• 17:41I will say this, we've started
• 17:43doing things almost completely
• 17:45virtually in integrative medicine.
• 17:47I was pretty reluctant at
• 17:49the beginning to do that.
• 17:51I figured,
• 17:52Integrative medicine is about touch
• 17:54and it's about this human connection,
• 17:59but I've been having really,
• 18:01really meaningful interactions with
• 18:03patients just over the Internet,
• 18:05and I think part of that is
• 18:07patients are in their environment,
• 18:10their comfortable they are at home
• 18:12that they love the most.
• 18:17I've really come to hate the term
• 18:19social distancing because I'm
• 18:21continuing to have very meaningful
• 18:23human social interactions with people.
• 18:26And yes, I'm physically distancing,
• 18:28that's for sure.
• 18:29But I'm certainly
• 18:31not socially
• 18:32distancing.
• 18:35I like to think of it as healthy distancing
• 18:38as opposed to social distancing.
• 18:41And something that you
• 18:44said really struck a chord with me,
• 18:47which is that you know,
• 18:49cancer patients often have gone
• 18:51through some of that mental journey
• 18:54of what's life about
• 18:57and what's meaningful and what matters.
• 18:59And I think that for others
• 19:03that this may be a whole new
• 19:07kind of concept to grapple with,
• 19:10and I find that so often many of my cancer
• 19:14patients really use this diagnosis as
• 19:19a teachable or
• 19:21a life changing moment.
• 19:23A chance to nurture relationships.
• 19:26They get even better.
• 19:29Prune some relationships that
• 19:31may not have been so healthy.
• 19:33Grab hold of experiences that
• 19:36they really want to savor.
• 19:38And that whole concept of gratitude
• 19:41and sucking the
• 19:44marrow out of life and knowing
• 19:47how vital it is to really
• 19:50experience all that life has to offer
• 19:53is something that cancer patients
• 19:56really often have come to.
• 20:02I think back about the moments
• 20:04that I really fell in love with the
• 20:06practice of Integrative Medicine.
• 20:08And I had done acupuncture
• 20:10when I was 13 and I had meditated
• 20:12a little older and I traveled
• 20:14around the world and saw
• 20:16different cultures that
• 20:17practice different ways.
• 20:18But one of the moments that I really,
• 20:20really knew this was something that was
• 20:23important to me was when I was reading
• 20:25the integrative medicine textbook.
• 20:27And it said the benefits of ADHD are.
• 20:30And I was like wow.
• 20:33The benefits of ADHD.
• 20:35I mean, I've been taught my entire life,
• 20:37this is a pathology.
• 20:39This is a disease, it is a problem.
• 20:41This needs to be medicated and
• 20:43it shifted my perspective and I
• 20:45brought that up to one patient at
• 20:47one point and they
• 20:50broke down in front of me and they said,
• 20:53You know
• 20:54this isn't how I
• 20:56would have wanted it,
• 20:58but I've strengthened my relationships.
• 21:00I've been reading more.
• 21:02I've been doing the things that I enjoy more.
• 21:05In some ways, I'm happier.
• 21:08And that is really what integrative
• 21:10medicine is about.
• 21:12I think that
• 21:14especially with this pandemic
• 21:15so many of us are going through
• 21:18that same sort of process.
• 21:20On the one hand,
• 21:25who knew everybody loved
• 21:26making sourdough bread?
• 21:29On the one hand we've had this
• 21:31virus and I don't want to diminish
• 21:34its effects at all.
• 21:36I mean, it certainly has caused
• 21:38so many people their lives.
• 21:40It has
• 21:42turned our economy upside down.
• 21:44It has
• 21:46really changed how we do so many things,
• 21:49but there's so much now
• 21:51that we're able to do that
• 21:53we didn't think that we could
• 21:55before and there are so many things
• 21:58that I'm now so grateful for.
• 22:00that I think I used to take for granted.
• 22:05This is what we were talking about before,
• 22:07right? The first thought is
• 22:09this is a horrible thing.
• 22:10Covid is a horrible thing.
• 22:12So what do we do with that thought?
• 22:14And this is where
• 22:15mindfulness practice comes in.
• 22:17What do we do with that thought?
• 22:19Do we continue down that path?
• 22:21This is horrible.
• 22:22I feel horrible.
• 22:22I can't stand this.
• 22:24Or do we say this is horrible,
• 22:27I'm going to go make my sourdough bread.
• 22:30I'm going to go take that course
• 22:32that I never took before online.
• 22:34This is horrible.
• 22:35I'm going to play my guitar for
• 22:37the first time in a very long time,
• 22:41Even though we're not diminishing what
• 22:43this means on a greater level,
• 22:46but there are so many opportunities here
• 22:48to better yourself
• 22:50and better your being and
• 22:51better your experience.
• 22:54I never thought that
• 22:56what I was doing in terms of
• 22:58being grateful or seeing
• 23:00the positives in a pandemic was
• 23:03really a mindfulness practice.
• 23:04But when you put it that way,
• 23:07I guess it kind of is.
• 23:10I like to think so.
• 23:12I want to dig into
• 23:15some of the the things that are
• 23:18really tragic about this pandemic,
• 23:21though because you know there are people
• 23:24who have been diagnosed with cancer.
• 23:26There are people who have been
• 23:29diagnosed with cancer during Covid.
• 23:31There are people who have lost
• 23:33their lives or their loved ones
• 23:36with one or both of those diagnosis.
• 23:39And sadly even in these times
• 23:41when you talk about human
• 23:44connection and not being able to
• 23:46be there to touch your patients.
• 23:47I can imagine what it feels like
• 23:49to be a family member who can't
• 23:51go to a funeral because of
• 23:54regulations regarding the
• 23:55number of people who can attend.
• 23:58How do you get people through that?
• 24:02You know, sometimes you don't.
• 24:03Sometimes you just let them be present.
• 24:06You know we have such a tendency
• 24:08to try to make people feel better.
• 24:10You know this will all be OK.
• 24:13This will all go away.
• 24:14This will all be better.
• 24:16Sometimes it's just a matter of letting them
• 24:19be in that moment and experience that moment
• 24:22because you know you can pardon my French,
• 24:25but it sucks.
• 24:29It's tough.
• 24:32And you want to be there and
• 24:34you can't be there and how you've
• 24:37been conditioned to experience
• 24:39humanity has been completely
• 24:40turned on its head and we have
• 24:43to give people permission to
• 24:45experience that and to be there.
• 24:52It really is difficult.
• 24:54And I can imagine how you know,
• 24:58talking to somebody like yourself,
• 25:00somebody who specializes
• 25:01in integrative medicine,
• 25:02somebody who has been practicing mindfulness
• 25:05for a long time can really give people
• 25:08that space to kind of explore.
• 25:10I want to get back into
• 25:13some of the other
• 25:16alternative therapies to that.
• 25:17Our listeners might be thinking
• 25:19about or wondering about.
• 25:21And I really loved that concept of
• 25:25trying to explore people's own cultures and
• 25:28what might resonate for them.
• 25:30But for people who are just kind of,
• 25:33you know, on the periphery of this,
• 25:36they may have heard about
• 25:38some of these things.
• 25:40Maybe some of their friends have told them,
• 25:45you really ought to try turmeric
• 25:47or vitamin C cleanses,
• 25:50or acupressure or whatever.
• 25:52Are there data
• 25:56that these practices can help?
• 26:00And is there a difference between
• 26:03using them as an alternative form of therapy?
• 26:08Or are they better positioned
• 26:10potentially to help with some of the
• 26:13side effects of standard therapy?
• 26:16Talk a little bit about how
• 26:18people who may be new to the whole
• 26:21space of complementary and alternative
• 26:24medicine might find out more?
• 26:27Yeah, so there's a lot to unpack.
• 26:30First and foremost,
• 26:34is an alternative option better.
• 26:35I don't believe so,
• 26:37and I don't think the research shows that.
• 26:40But what we provide is a space
• 26:42for you to ask those questions.
• 26:45So if we have patients on
• 26:46tons and tons of supplements,
• 26:49we work with the pharmacist to
• 26:51go over to see if they're safe
• 26:53and to see if they're beneficial.
• 26:56You know the state of research in
• 26:58Integrative Medicine
• 26:58certainly lacks,
• 26:59but that's why the questions of
• 27:02is this a burden to the patient,
• 27:05or is this safe for the patient becomes
• 27:09so important because sometimes
• 27:11things that are safe for the
• 27:14patient may also be effective.
• 27:17I think in conventional medicine
• 27:20our biggest issue is that we see
• 27:23medical treatment as a group of
• 27:261000 or 10,000 and out of 10,000 people
• 27:28this worked for 8000.
• 27:30That's a good number, right?
• 27:32That's a really good number,
• 27:34but we're ignoring the 2000 and then
• 27:38on the other side,
• 27:39we might look at this and say
• 27:42this only worked for 10 people out of 100.
• 27:45Well, if you're one of those 10 people,
• 27:49this could be really life changing.
• 27:51This could be really helpful,
• 27:53and so in Integrative Medicine it's
• 27:56important to give space for that while not
• 27:58coming against the wall or
• 28:00hurting the conventional treatment,
• 28:02which is probably the safest bet for you,
• 28:05which is probably the smartest
• 28:06decision for you, so with
• 28:08herbs and supplements,
• 28:09it takes more work diving in because
• 28:12there can be interactions but with other
• 28:14practices such as acupuncture,
• 28:15Massage Therapy,
• 28:16Reiki,
• 28:17these are practices that certainly
• 28:20data exists for some of them,
• 28:22but we also have to put it in
• 28:25the perspective of if it's safe
• 28:26and if it makes that patient,
• 28:29that individual that one person feel better,
• 28:31then it works,
• 28:32then
• 28:33it's meaningful and it's important to
• 28:35honor that patient and their individuality.
• 28:37And the great news is
• 28:39that you can do both.
• 28:41You know it isn't a one or the other.
• 28:45It frequently is both and so I think one
• 28:48of the critical things is to really,
• 28:51talk to your doctor,
• 28:53talk to your team and have that space
• 28:56to have that conversation so that you
• 28:59can take care of all of you.
• 29:03There are things that don't get talked about in that
• 29:0615 minutes that you're with your doctor.
• 29:09And that's things like sleep or
• 29:12nutrition or exercise and coming to
• 29:14Integrative Medicine and being given
• 29:17that space is so important to the care
• 29:20of the patient. NOTE Confidence: 0.865415930747986
• 29:22Dr. Gary Soffer is an assistant professor of
• 29:24clinical Pediatrics and director
• 29:26of the Integrative Medicine
• 29:28Program at Smilow Cancer Hospital,
• 29:30if you have questions,
• 29:32the address is canceranswers@yale.edu
• 29:33and past editions of the program
• 29:36are available in audio and written
• 29:38form at Yalecancercenter.org.
• 29:40We hope you'll join us next week to
• 29:42learn more about the fight against
• 29:44cancer here on Connecticut public radio.