Personalized Cancer Care, Tumors and You

The dawn of personalized cancer care, a mere dozen years since decoding the human genome, has ushered in new prognostic tools, predictive assays, and ways to identify DNA that has gone awry.

Targeted therapies are being developed based upon incredible amounts of data we are collecting, much of which we still don’t know how to decipher. As we undertake to understand the clinical significance of each discovery, remarkable agents such as immunotherapies, monoclonal antibodies, kinase inhibitors, vaccines and hormonal therapies are becoming widely used.

However, it is clear that most of these therapies, including our conventional array of treatments—chemotherapy, radiation therapy and surgery—are focused on tumors and the pathways to best reach and stop them.

Critical as it is for clinical focus on the cancer burden itself, it is time for modern oncology to also look beyond the tumors.

Tumor + Host Environment = The Whole Patient

As cancer treatment becomes more targeted, with less toxicity, fewer side effects and reduced collateral damage, there is a profound need for oncologists, primary care physicians and practitioners across disciplines to also focus more on the host: the patient.

The tumor microenvironment comprises the biochemical setting in which cancer cells live or die. There is a close relationship between the tumor and the surrounding microenvironment; constant interaction between the two.  Per Wiki:

The tumor microenvironment is the cellular environment in which the tumor exists, including surrounding blood vessels, immune cells, fibroblasts, bone marrow-derived inflammatory cells, lymphocytes, signaling molecules and the extracellular matrix.  The tumor and the surrounding microenvironment are closely related and interact constantly.  Tumors can influence the microenvironment by releasing extracellular signals, promoting tumor angiogenesis.

Integrative Oncology Focuses on the Host

Just like no two tumors are exactly alike, the tumor micro-environment of each patient differs. It is my view that a truly comprehensive approach to personalized cancer care must identify a patient’s unique tumor type within the larger context of the host’s unique psychological, emotional, physical and environmental conditions.

Integrative oncology focuses on the whole patient—mind, body and spirit—and, when approached comprehensively, includes the core tenets of lifestyle medicine to induce behavioral change, such as:

  • Dietary changes that eliminate processed foods and sugars and emphasize whole foods, specific cold water fish, wide array of colorful vegetables, and whole grains.
  • Select supplementation using nutraceuticals to address deficits in nutrient levels and target various biomarkers including inflammation and oxidative stress.
  • Physical activity customized to one’s condition, ability and interest.
  • Stress reduction tools and methods to relax a patient and keep them ‘present’, such as deep breathing exercises and the teachings of mindfulness-based stress reduction techniques.
  • Restorative sleep often made possible by the implementation of stress reduction techniques.

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When incorporated as part of an integrative oncology program these changes can positively influence the host environment. Today there is a significant and growing body of medical literature that suggests these core modifications impact the biological environment and create a setting that is less hospitable for cancer to live.

Above all, incorporation can typically help with a patient’s overall quality of life upon diagnosis, during active treatment, and along the road of cancer survivorship.

Every Patient as an n of 1

Modern personalized cancer care, including the best technology, targeted therapeutic agents and incorporation of integrative oncology, allows us to move beyond just the tumors to focus on the whole patient.

Regardless of our cancer diagnosis, we are all unique. Your cancer care program will not mirror my personal approach to a ‘terminal’ diagnosis 25 years ago. Nor should it.

It’s your empowered choice, with the guidance of an oncologist and other medical professionals of your choosing, to design a personalized cancer care approach most suitable for you to become your own n of 1.

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