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.

Earthing; or, A virtual dog walk

Today I walked the length of Takapuna Beach without my shoes on. The sun was out, the tide was low, the sand was smooth and firm. Being near to such beautiful beaches is one of the best things about living in Auckland.

 Walking barefoot on grass or sand is a natural way of “earthing“. Apparently this practice causes a transfer of electrons into the body, thereby helping to neutralise free radicals and reduce inflammation, so bringing about improvements in physiology. Research is still in its early stages but there is some evidence that earthing can help with numerous conditions including pain, insomnia, hypertension, cardiac arrhythmias and autoimmune disease. Certainly I feel in better health when I walk on the beach regularly, and often get new ideas for writing while there.
For eight years I used to take this same walk once a week, rain or shine, accompanied by my mother and a dog called Khymer. Then Khymer and my mother both died, my husband and I were both ill, and I gave up doing it regularly. Now I am determined to resume the routine. Having Khymer with me only in spirit does have one advantage; I no longer have to start early in the morning to comply with local regulations about the times when dogs are allowed on the beach.

Bach flowers in bereavement

My dear cat Felix died last month. On the blog which I created in his memory there is a post about ways of coping with the loss of a pet, which includes a brief mention of the Bach flower remedies. The remedies are equally relevant to human bereavement, and I thought I would expand on the subject here.

The process of grief does not conform to a particular timescale or sequence of stages, but is different for each individual, depending on many factors: the circumstances of the death, the bereaved person’s attitudes and emotions, the quality of their relationship with the deceased, and whether they believe in an afterlife. There can be a complex and apparently conflicting mixture of feelings, for example sadness over the death might be combined with relief that the strain of a long illness is over, which in turn might be a source of self-reproach.

As always with Bach flower treatment, it is best to choose flowers according to the emotions which are uppermost at the present time, without trying to analyse them too deeply. But one flower which might almost always be suitable is Star of Bethlehem. In the words of Dr Bach:

For those in great distress under conditions which for a time produce great unhappiness. The shock of serious news, the loss of someone dear, the fright following an accident, and suchlike. For those who for a time refuse to be consoled, this remedy brings comfort.

Many other flowers might also be relevant. Here are some examples, which are listed alphabetically because they do not belong in any particular sequence.

Agrimony: when grief is denied or suppressed, perhaps with the aid of drugs or alcohol

Gorse: when everything seems hopeless

Holly: for negative feelings towards others

Honeysuckle: for holding on to memories from the past

Olive: for mental or physical exhaustion

Pine: for feelings of guilt or self-blame

Sweet Chestnut: for unbearable anguish and despair

Some of these remedies are also relevant in cases of “anticipatory grief” when a loved one has a terminal illness but has not yet died. Other flowers to consider in this situation could include Red Chestnut for anxiety on behalf of the sick person, and Mimulus for fear about how the survivor is going to cope with the death when it does occur. Lastly, there is Rescue Remedy for use in acute situations such as news of a sudden death.

Nothing can take away the pain of losing a beloved person or pet, but the Bach flowers are among the remedies which can bring some comfort, especially when grief seems unduly severe, complicated or prolonged.

 

Evaluating Bach flower remedies: an audit of 100 treatments

A few years ago I carried out a review of the case notes of the first 100 clients treated in my Bach flower practice. This does not claim to be a scientific study, and would certainly not meet the requirements for publication in an academic journal, due to various limitations: it was retrospective rather than prospective, no standard questionnaires or other valid measurements were used, no independent assessment was carried out, and there was only enough information for a short-term follow-up. All the same, when I came across it again last week I thought some of my readers might be interested in a summary.

These 100 clients, a consecutive series, had come to my clinic either through word-of-mouth recommendations or through my website. They included 83 females and 17 males, and ranged in age between 8 and 87 years.

Their presenting complaints were often complex and multiple, but the most frequent main problems were anxiety (37 cases), depression (13 cases), and physical illness (13 cases). Others included adjustment to change or loss, relationship difficulties or long-term psychological imbalances.

Treatment was usually short-term: 39 clients received only one treatment bottle, and 24 had only two. Others chose to continue taking remedies for several months, and there were four clients who came back for 10 or more bottles.

Six clients did not attend for further appointments, but the other 94 provided progress reports after 2-3 weeks, that is after their first treatment bottle had finished. I classified the outcomes at this stage as follows:

Excellent or very good: 33. Clients in this group spontaneously mentioned feeling calmer, lighter, more focused, more in control, balanced, joyful or peaceful soon after starting their remedies. Comments included ‘The flowers are fantastic’, ‘I need another of those magic bottles’ and ‘I think I’m going to keep taking this stuff for the rest of my life’.

Moderately good: 38. These clients reported definite, but more subtle, changes for the better.

Slight improvement: 18. This category includes three clients who did not actually take the remedies but had found the consultation useful for ventilating and reframing their problems.

No change: 3.

Some of those who showed little or no response to their first treatment bottle went on to take further courses and reported a delayed benefit, but the follow-up on this group is too incomplete to be analysed.

Worse: 2. These two clients were unwilling to continue treatment because of marked healing reactions, despite having been advised that such reactions were usually only short-lived and often predicted a good response. Both of them felt ‘spaced out’ after taking their drops, and one reported worsening of her presenting complaint of tightness in the throat. About ten of the others had also reported healing reactions, of a milder degree, but continued with their treatment.

Though the data was not detailed enough to permit a separate study of individual symptoms, I noted that both physical and emotional complaints often improved alongside each other in those clients who responded well.

The results of this modest audit confirms what all Bach Foundation Registered practitioners already know – that the majority of clients find the Bach flowers to be an effective and pleasant treatment. How much of this benefit can be ascribed to the ‘placebo effect’ is impossible to tell from a descriptive study like this.

And finally: a note to say that my short novel Carmen’s Roses, in which the Bach flowers play a small role, is now available in various ebook formats on Smashwords – price just $2.99 USD. Please click here for details.

 

 

 

 

Update on introducing Bach flowers to medical doctors

My last post on this blog was about preparing a short talk on the Bach flower remedies for a group of doctors and medical scientists. Several readers asked me to report back, so here is a brief update following the event.

My talk seemed to be well received by the  audience, which represented a wide range of specialties: neurosurgery, rheumatology, oncology, paediatrics, general practice and others. Most of those present had never heard of the remedies before. There were plenty of questions, for example: are the same plants used for similar purposes in herbalism and pharmacology? how exactly did Dr Bach select his flowers? would just looking at the flowers have an effect? At least one person thought that the mode of action must be chemical, but another was familiar with the concept of vibrational healing, pointing out that plants have an energy field as demonstrated by Kirlian photography.

It was encouraging to receive so many positive and open-minded responses, and I was left wishing that there were more opportunities for orthodox clinicians and natural therapists to learn about each others’ work.

Introducing the Bach flowers to medical doctors

Later this week I’ll be giving a short talk about the Bach flower remedies to a group of senior doctors with connections to my old medical school in Oxford, UK. Many of them will probably never have heard of the remedies – even though Mount Vernon, the home of the Bach Foundation, is only a few miles away from Oxford city. Even fewer will have had personal experience of using them, or know how much they can help with the management of health problems whether mental or physical.     

I hope and expect that there will be a friendly informal atmosphere at this meeting, and that most people in the audience will be interested in the brief case histories and flower photos I plan to present. However, some orthodox clinicians are sceptical about the value of ‘natural therapies’ in general, and a few are quite hostile towards them, so I need to be prepared to answer criticisms such as the following:

Bach flowers are no more effective than placebo: several randomised controlled trials published in medical journals have reached this conclusion. The placebo effect, in which the beliefs and expectations of both patients and their clinicians work to bring about a self-healing response, is indeed a powerful force for good and if the Bach remedies can mobilise it effectively, so much the better. There is certainly a placebo element in this therapy, as in any other.

It is, however, difficult to believe that the excellent results achieved with the remedies are due to placebo alone – over 80% of clients treated by Bach practitioners respond well, and they include babies and animals. And the occurrence of ‘healing reactions’, in which a minority of clients experience an aggravation of symptoms before they get better, seems unlikely to be a placebo (or nocebo) effect.

The published trials have several limitations, for example they have usually given the same remedies to all participants although it is a key principle of this therapy that an individualised mixture should be chosen for each case.

The challenges of evaluating natural therapies and the ‘holistic approach’ are considered in more detail in my recent book Persons not Diseases (by the way the e-version on Smashwords is on promotion at just $1.50 USD this week, 2-8 March – here’s the link).

Their supposed mode of action is not scientifically credible: talk of ‘vibrational’ and ‘energy’ medicine does not go down well in orthodox circles, where mechanical and chemical approaches hold sway. It must be admitted that the mode of action of Bach flower remedies, like that of homeopathics, is not well understood. However, it is arrogant to assume that a therapy must be ineffective because current knowledge cannot explain why it should work. The phrase ‘the exact mechanism of action is unknown’ quite often appears in the product descriptions of widely-used pharmaceutic drugs!

The remedies give ‘false hope’ of cure, and patients may use them instead of effective medical treatments: It is true to say that Dr Edward Bach envisaged a world in which most diseases could be cured if patients themselves simply learned to recognise the emotional imbalance underlying them, and used the flower remedies to restore harmony to mind and spirit. Although subsequent advances in mind-body medicine would support Bach’s ideas, current claims for the remedies are more modest. They are not a panacea and, as made clear in training courses for Bach Foundation practitioners, they are intended for ‘complementary’ rather than ‘alternative’ use. They do not treat specific medical conditions, but are selected according to the personality and emotional state of each patient, with the aim of improving quality of life. They can safely be used alongside conventional treatments.

If any other points of interest arise from the meeting, I’ll write a follow-up post next week.

Bach flowers in fiction

In 1934 Edward Bach wrote a short piece called The Story of the Travellers about a group of sixteen people who have lost their way on a woodland walk. Each one of them responds differently to their predicament depending on their personality type, for example Oak is determined to struggle on to the end despite his exhaustion, Rock Rose gets into a panic, whereas Chicory is more concerned about the welfare of his companions than anything else.

Stories provide an excellent way of learning about the different flower remedies, and I remember that many of the exercises on my practitioner training course were based on characters from films and novels, or real-life personal accounts in magazines.

I have heard of three novels which feature the Bach flowers: The Pillow Boy of the Lady Onogoro by Alison Fell, Valis by Philip K Dick, and one by Mary Tabor which is currently out of print but may soon be posted on the Bach Centre website. And I’ve just published a novella in the ‘romantic suspense’ genre, Carmen’s Roses, in which the remedies play a minor role. If anyone knows of other relevant books I would be interested to hear about them.