Whole-Person and Genome-wide Integrative Approaches
Expand your Options: Integrative Cancer Care for the Whole Person
When it comes to your health and well-being, everything matters.
At I2B, a person with cancer is more than a diagnosis and a standard cancer treatment plan.
At the personal level, each person is a member of a family—a father, a mother, a brother, a daughter. They may face many other physical and spiritual challenges with cancer, such as depression, fatigue, pain, and difficulties with their relationships. At the cellular and molecular level, the tumor of any individual patient is enormously complex and dynamic, bearing all the hallmarks of cancer along with deregulation of core cellular signaling pathways. The complexity of the disease is why we strive to treat and support the whole person, and their family, including them as active participants in decisions about their cancer treatment. Each person is unique and therefore each treatment plan is also unique.
Integrative oncology is a growing field dedicated to combining the best of conventional cancer treatment with evidence-based complementary therapies, including nutritional approaches that suppress inflammation and tumor growth, botanical medicine(phytochemicals as active ingredients), and mind-body interventions including meditation and prayers. It may also incorporate other systems of healing, such as Traditional Chinese Medicine(TCM), especially while patients are going through chemotherapy and radiation. Integrative oncology seeks to optimize the treatment of cancer by creating a foundation of wellness in the person being treated, such that all interventions are able to work together holistically to enhance the best possible outcome.
I2B offers patients the hope they need with the state-of-the-art integrative cancer care they deserve. We know what a frightening and confusing time this is for you and we are here to help you through it every step of the way.
Integrative Interventions at the Personal Level
At our Center, we don’t just medicate your cancer–we treat the whole person by addressing any and all cancer-related issues, including pain, fatigue, anorexia, depression, and sexual dysfunction. And, we address these issues through a holistic approach. Success in managing the complex and multiple symptoms in cancer is of the utmost importance to us, and we are dedicated to improving the quality of life of cancer patients. We choose chemotherapies carefully and utilize ancillary care methods such as natural substances and medical acupuncture.
Integrative Intervention at Genome Level
Genome-wide screening of tumors is not only improving our understanding of cancer behaviors but also helping us identify the best treatment methods by identifying the alterations in the cancer genome that are amenable to therapeutic intervention, thereby providing an opportunity to develop more precise medications. With more therapeutic options, such as repurposed FDA drugs, phytochemicals, as well as chemotherapies and targeted therapies, we will be able to use genomic information about a patient’s specific tumor to guide the selection of a specific treatment.
At the cellular level, the complexity of cancer can be reduced to a small number of underlying principles, referred to as the “hallmarks” of cancer, proposed originally by Drs. Douglas Hanahan and Robert Weinberg.
All cancers share six common hallmarks:
1. Cancer cells stimulate their own growth;
2. They resist inhibitory signals that might otherwise stop their growth;
3. They resist their own programmed cell death (apoptosis);
4. They stimulate the growth of blood vessels to supply nutrients to tumors (angiogenesis);
5. They can multiply forever; and
6. They invade local tissue and spread to distant sites (metastasis).
Additional hallmarks of cancers have been proposed since, including:
7. Activation of abnormal metabolic pathways;
8. A capacity to evade the immune system;
9. Presence of chromosome abnormalities and unstable DNA; and
The core cancer pathways define the underlying biology of tumors and provide a link between the genome and hallmarks of cancer. Nearly every known signaling pathway can play a role in cancer. Some common signal transduction pathways are ubiquitously altered in all cancer types and some unique pathways are involved in different cancer types. The core pathways are nuclear factor-κB (NF-κB), Wnt/β-catenin, mammalian target of rapamycin (mTOR), epidermal growth factor receptor (EGFR)/mitogen-activated protein kinase (MAPK), and proliferation/stem cell pathways. Activation of one pathway can instigate the development of multiple cancer hallmarks. This high level of redundancy makes cancer difficult to cure. Another distinctive characteristic of cancer cells is that they mutate constantly, so a therapy that acts on only one target can quickly become ineffective if a new mutation emerges. Moreover, certain cancer therapies can also select for new mutations, which are resistant to therapy, making the residual cancer even more aggressive than the primary tumor.
Because multiple core pathways are dysfunctional in most cancers, and cancers accumulate new driver mutations as they progress, the greatest and most durable therapeutic benefit will likely be achieved with a combination of regimens or cocktails that target several cellular pathways simultaneously.
A broad range of compounds are known to target core pathways in cancers. They include commonly-used chemotherapies, targeted therapies and FDA-approved drugs used to treat other diseases, as well as thousands of naturally-occurring plant-derived or dietary phytochemicals. Many of these compounds are being tested in clinical trials or preclinical models in isolation, or in combination with existing therapies, with limited success to date. The design of a highly-effective cocktail based on cancer hallmarks and core pathways derived from the genomic data in individual cancer patients is the next challenge. At our clinic, we know that it is not possible to know the answer in every case. However, we attempt to consider the cancer hallmark principles as a way to inform the choice of the therapeutic cocktail formulation for each patient. By using hallmark-targeting agents, we can potentially achieve more effective and durable therapies by co-targeting multiple cellular pathways that have been deregulated to generate the cancerous phenotype.