Complementary therapies in cancer care

This short overview is based on a talk I recently gave to the members of Sweet Louise, a New Zealand charity for the support of people with incurable breast cancer.

Complementary therapies can be loosely defined as those not included in orthodox medical training or practice, though this can change, for example acupuncture has been used in pain clinics for many years. Some therapies involve physically touching the body – examples include massage, reflexology, acupuncture. Others involve taking substances by mouth – herbal remedies, homeopathy, flower essences, special diets. Then the mind body therapies such as relaxation, meditation, yoga, visualisation and guided imagery, energy healing. And creative therapies with art, music, writing and dance. Several types can be combined.

They are often known as “natural” therapies, and the same ones may be called “complementary” when used alongside orthodox medical treatments, and “alternative” when used instead. The “integrative” approach combines them both but has been slow to get established, perhaps because of prejudice and misunderstanding on both sides. All these therapies are grounded in the “holistic” approach, which aims to balance the whole person in body, emotions, mind and spirit, and mobilise the potential for self-healing. This is in contrast to the approach of conventional medicine, which uses powerful drugs, surgery or radiation to suppress symptoms and destroy disease, and in which patients have a passive role. Both approaches have their place and can often be used alongside each other.

Surveys show that as many of two thirds of women with breast cancer are using one or more natural therapies, and there is good evidence that they can improve quality of life – helping to relieve physical symptoms such as pain and nausea, mental symptoms such as anxiety and depression, reducing the side-effects of radiotherapy and chemotherapy. They appeal because, in general, they are safe and natural and many of them are pleasant to receive. When I was practising with the Bach flower remedies, many of my clients told me they wanted a therapy that treated them as a unique person, rather than just one more case of a diseased body part.

While all the modalities have specific effects, their benefit is partly due to their positive influence on mind-body relationships. The self-help element, especially with therapies that require some active user participation, enhances a sense of choice and control. Spending time with an understanding therapist in a relaxed setting is comforting. Expectation of improvement can help to bring it about. Such general factors are important, and it is a mistake to devalue them as “just placebo”.

A key question is whether using these therapies can lead to a longer life expectancy or even to remission of the cancer. Many individual cases of remarkable recovery have been reported. But there are few formal research studies on this aspect, and it is a difficult thing to investigate for many reasons – for example treatments are used in individual combinations rather than standard protocols, and patients’ beliefs and motivation affect the outcome.

Some of the therapies carry risks, for example herbal remedies can have adverse interactions with prescribed drugs; massage and acupuncture occasionally cause physical injury. They can be expensive. The field is not tightly regulated and, while most therapists are skilled and honest, there are a few self-styled practitioners who cause more harm than good by making unrealistic promises of curing cancer while advising clients to refuse conventional treatment that would have been effective.

More detail about these topics, with case histories, can be found in some of my non-fiction books.

A writer’s purpose

My writing career has been at a standstill lately, perhaps due to being distracted by various health concerns and family events, and discouraged by a couple of negative reviews. Looking back at my own advice about dealing with writer’s block, taken from my short ebook Wellbeing for Writers:

“Inspiration tends to come in waves. There are times when writers are full of ideas. At other times they may have none, which is always frustrating, and presents a major problem for those who earn their living from writing or have publishing deadlines to meet.

There may be an obvious reason for feeling blocked. I always find myself unable to engage with a new book immediately after finishing the last one, even though I am only really satisfied and happy when I have a writing project underway. I make use of such fallow periods to organise and de-clutter the paperwork in my office and the files on my computer, and to market the book I have just completed.

Some of the other causes for writer’s block, for example striving too hard for perfection, feeling upset about rejection or criticism, adverse experiences in another sphere of life, having too many other things to do, or suffering from a depressive mood swing, are discussed in other chapters.

Besides dealing with any remediable underlying causes, there are various strategies for overcoming writer’s block. If circumstances permit it can be a good idea to take a complete break from writing, and do something else for a day or two or even much longer. Preferably this will involve activities, people and places completely different from those encountered in your usual routine, which may provide new ideas. Other forms of creativity, such as painting or dancing, can help.

The opposite approach is to discipline yourself to keep on writing for a set period each day, but again try doing it with a new approach. Clear the clutter from your desk to encourage a fresh start. Write a short and simple piece instead of attempting the major work on which you feel stuck. Some authorities suggest inducing a relaxed state with deep breathing or slow music and then using your non-dominant hand to write something – anything – which even if it turns out to be nonsense may still stimulate the creative flow. Or try writing late at night or early in the morning, when you are half-asleep and more able to access the reservoir of images and memories in the subconscious mind.

Getting started again often presents the biggest barrier, and if you can get past that it will usually be much easier to continue.”

Fair enough, but I also find myself asking what is the point of writing at all? This is what I said in Wellbeing for Writers:

“The most fundamental and compelling motive for writing is for the sheer love of it. Some people feel they were born to write, in the same way that others know from early childhood that they were born to climb mountains, to heal the sick, to do scientific research or to make music. Writing is their vocation, destiny or soul’s purpose; the one activity which brings them ‘into the flow’ and if they are prevented from doing it they will feel frustrated and unfulfilled.

Even if you do not feel quite such a passionate commitment, you may find that writing brings other personal benefits. These could include making sense of your life experiences and challenges, expressing emotion, exploring new subjects, exercising your intellect, or feeling that you are creating something original to form a lasting legacy of your time on Earth.

These inner rewards of writing can be seen as doubly important when you consider that it takes long hours of solitary work to complete a book, and that the fate of the eventual product is unpredictable. Finishing your book, getting it published, receiving positive responses from readers, and receiving royalty payments are all worthwhile outcomes and not to be devalued. But not all writers will achieve these goals. Some books are never finished; others do get finished but are never published; many of those that do get published are seldom read or reviewed; and few authors make a good living from their royalties. The market is currently supersaturated with self-published books many of which, however good they are, will be overlooked. So it is highly desirable for the actual process of writing to be perceived as satisfying and worthwhile. In other words it is just as important to enjoy the journey as to reach the destination.”

I hope my inspiration for writing will return again soon. Meanwhile, remembering what I put in the section on writers’ health, it is better to spend time walking outdoors in the bright sunshine of the New Zealand winter than sitting down at the computer.