From foundational nutrition and lifestyle interventions to symptom management and support during conventional treatment, the Naturopathic Therapeutic Order offers a structured framework for individualizing whole-person care throughout the cancer journey.
Cancer is one of the gravest diagnoses a patient can receive. According to Lindlar, however, there is only one disease – toxemia, which results from and causes lowered vitality, abnormal composition of blood and lymph, and the accumulation of morbid matter and poisons. Manifestations of disease are signs of imbalance and the accumulation of toxemia in the system. Cancer is no different, albeit the disease process is generally more progressed and the imbalances seemingly greater. But still, the treatment of cancer is fundamentally the same as any other disease state – Return to Nature and the establishment of normal habits and surroundings, Economy of Vital Force, and Elimination. (Nature Cure, Lindlahr)
The Naturopathic Therapeutic Order, as modeled by Zeff, et al. provides a comprehensive framework for the treatment of disease, especially cancer. It presents a hierarchy of interventions, not as a judgement of their efficacy, but as an appraisal of the degree to which a treatment either supports or suppresses a patient’s natural system. When a patient presents, it is our job as Naturopathic Doctors and Physicians to determine what level of intervention is required, start there, and then make sure we fill in every other level of the Therapeutic Order beneath it to fully support the person’s own body to heal, the Vis Medicatrix Naturae. There is an appropriate time for any intervention, so this is not a judgement of whether a treatment is “right” or “wrong”, simply a framework for when to use them and how to best promote sustainable healing.
One of the beautiful things about Naturopathic Medicine is that the therapies we recommend often overlap multiple levels of the Therapeutic Order that they address. When applied correctly, our treatment plans act like a symphony of harmonious complementary therapies that work together to bring our patients back to health. Below is an example of how I apply the Naturopathic Therapeutic Order to cancer care:
Establish the Foundations for Optimal Health
While patients and practitioners alike regularly overlook the foundations of optimal health for higher level, or seemingly “harder hitting”, interventions, you cannot expect to help someone find true healing without these pieces of the puzzle in place. One of the most important foundations is nutrition, and is likely the reason many people seek out natural medicine practitioners in the first place. Fortunately or unfortunately, there is no one diet that is right for all cancer patients. It is up to you as the practitioner to determine what the individual sitting in front of you needs, taking into consideration food intolerances and sensitivities, genetics, assessment of current needs (what therapies they may be undergoing, OAT, HSR, HMA, etc.), patient morals/values, how they feel, their relationship with food, current nutrition science research, etc. Your patient’s needs will likely vary during the time they work with you and it is important to modify dietary recommendations accordingly. Other foundational issues that are often present in cancer patients are stagnation, and the resultant poor oxygenation of blood, as well as nervous system dysregulation. Simple therapies such as movement, breathwork, proper hydration, and time spent in nature have proven time and again to improve these conditions. In addition, these therapies support increased energy and vitality, proper immune function, improved mental health, and electro-chemical balance. And the best part? They are often free! (Other than food and a good water filtration system) These therapies cannot be an understated part of any treatment plan as they lay the foundational groundwork for other therapies to take root and work effectively.
Stimulate the Self-Healing Mechanisms
Our goal as Naturopathic Doctors and Physicians should not be to heal the patient, it should be to support the patient to heal themselves. This is primarily achieved through the self-healing mechanisms of the body, which are undeniably compromised in cancer patients. Fortunately, we have many tools that support these mechanisms, including hydrotherapy, electrotherapy, homeopathy, fasting, mistletoe therapy and other botanical therapies, and hyperthermia. While you may choose to implement all of these or a select few in your treatment plans, including them is extremely important for helping your patients achieve sustainable healing.
Support and Restore Weakened Systems
In the setting of cancer, there are often multiple systems that have become dysfunctional, dysregulated, or out-of-balance. These include compromised detoxification pathways (both cellular and gross), improper immune system regulation, mitochondrial dysfunction, dysregulated metabolism, and hormonal imbalance. In addition to the tissue involved in the primary cancer and metastatic sites, many other organ systems may need support such as the liver, GI system, adrenals, kidneys, nervous system, etc. A few of the tools we have that are well suited to support restoring these systems include nutrition therapy, sleep hygiene, stress management, hydrotherapy, trophorestorative botanicals, antioxidants in various forms, and nutrient repletion with vitamins, minerals, amino acids, and omega fatty acids.
Address Physical Alignment
Addressing physical alignment if often not directly involved in cancer treatment but may be supportive for other ailments the patient is experiencing and help improve overall quality of life. It should also be noted that proper physical alignment allows for efficient energetic flow through the body, addressing the stagnation that often accompanies conventional cancer treatment. Care must obviously be taken when considering the location of the tumor(s) and cases of skeletal involvement.
Natural Symptom Control
It is at this level of the therapeutic order that we move into the philosophy of Allopathic Medicine. That is not to say there isn’t a time and place for this level of intervention, as there absolutely is! Many patients are dealing with one or more of the debilitating symptoms associated with the cancer process, such as pain and inflammation, or the side effects of conventional therapy such as fatigue, GI issues, neutropenia and anemia, and dermatitis. We can use botanical medicine, nutraceuticals, homeopathy, hydrotherapy, physical medicine, and many other tools to address the specific issues our patients are facing, often with alternatives when our first attempt does not succeed. The direct killing of cancer cells with natural medicines, such as high dose botanical extracts and high dose IV Vitamin C, should be considered at this level of intervention as well.
Synthetic Symptom Relief
Sometimes pharmaceutical intervention is necessary to manage various parts of a case as they present. It can be helpful in cases where direct management of a patient’s cancer symptoms are necessary, such as pain, and are often used to mitigate side effects of conventional therapy, such as nausea, diarrhea or constipation, inflammatory or autoimmune flares, and infection. It could be argued that hormonal therapy, such as SERMs, aromatase inhibitors, anti-androgens, and LHRH agonists also fall under this category of intervention, as they suppress the body’s natural hormonal cycles, but would not be considered as high force an intervention as those discussed in the next section.
High Force Interventions
This is where the majority of conventional treatments for cancer fall, including surgery, chemotherapy, radiation, immunotherapy, and targeted therapy. These will not be discussed in detail as they fall outside of the scope of Naturopathic Doctors and Physicians and are therefore not the focus of this article. Please refer to previous levels of the Therapeutic Order to see how our medicine beautifully complements and supports patients as they undergo these types of interventions.
Ultimately it is not about what you do, it is about how you apply it. Any given therapy can be used with various intentions and affect multiple levels of the therapeutic order and therefore support healing. It should also be stressed that addressing comorbidities, using these same principles, is imperative, as imbalance in one system will inevitably have an impact on other systems.
Now let’s apply this to a case and discuss how the therapeutic order can be applied throughout the course of cancer treatment.
“Ultimately it is not about what you do, it is about how you apply it.”
Clinical Case
Alice was a 50 y/o F when she first presented with stage 3 ER/PR+, HER2-breast cancer with metastasis to 2 localized lymph nodes.
Patient underwent neoadjuvant chemotherapy with doxorubicin and docetaxel
- High Force Interventions: Chemotherapy
- Synthetic Symptom Relief: Zofran for nausea
- Natural Symptom Control: Glutamine powder around infusion date to support GI tract, fasting around infusion date, supplements to directly address cancer cells (EGCG, curcumin on weeks off chemo to avoid interactions)
- Support and Restore Weakened Systems: Botanical support for GI system and prevention of anemia/neutropenia, carnitine & CoQ10 to prevent cardiotoxicity of doxorubicin, DIM for hormonal support, melatonin for immune and mitochondrial support, mushroom complex for immune system support; basic vitamins and mineral for nutrient repletion and support
- Stimulate the Self-Healing Mechanisms: Mistletoe therapy, bi-weekly constitutional hydrotherapy
- Establish the Foundations for Optimal Health: Food intolerance evaluation was performed at the onset of our work together, general nutrition guidelines provided, time in nature, movement to capacity, proper hydration
Patient opted for double mastectomy without reconstruction
- High Force Interventions: Surgery
- Synthetic Symptom Relief: Multiple prescribed by surgical team
- Natural Symptom Control: Botanical pain formula with California Poppy and Jamaican Dogwood provided to curb reliance on other pain meds
- Support and Restore Weakened Systems: Nutrients to support wound healing, combination homeopathic for surgery support
- Stimulate the Self-Healing Mechanisms: Mistletoe continued, constitutional hydrotherapy paused, patient did contrast hydrotherapy in the shower
- Establish the Foundations for Optimal Health: Continued same as before; ensured diet was nutrient rich going into surgery, moved to easier to digest foods after
*Supplement protocol was continued except for those specific to chemotherapy support
Patient underwent ddAC-T (dose dense doxorubicin, cyclophosphamide, and paclitaxel)
- The treatment plan looked very similar to neoadjuvant therapy due to the similarity of the drugs.
- Ensuring adequate hydration was stressed due to the bladder toxicity of cyclophosphamide.
- Fish oil was added in an attempt to prevent peripheral neuropathies.
Patient underwent 5 weeks of radiation
- High Force Interventions: Radiation
- Synthetic Symptom Relief: None
- Natural Symptom Control: Topical calendula salve on radiation sites, high dose melatonin and curcumin as radiosensitizers
- Support and Restore Weakened Systems: Glutamine to prevent collateral damage from radiation near GI system, nutraceutical support added after to support cellular cleanup and restoration of mitochondrial function
- Stimulate the Self-Healing Mechanisms: Mistletoe treatment continued, homeopathic X-ray after treatments to support detoxification
- Establish the Foundations for Optimal Health: Same as before. Switching to a ketogenic diet during radiation was discussed but not implemented
Patient was put on Tamoxifen
- High Force Interventions: None
- Synthetic Symptom Relief: SERM
- Natural Symptom Control: Sepia 30C for hot flashes; Curcumin discontinued
- Support and Restore Weakened Systems: Botanical support for liver and nervous systems (most other supplement regimen continued)
- Stimulate the Self-Healing Mechanisms: Mistletoe continued, patient received weekly constitutional hydrotherapy
- Establish the Foundations for Optimal Health
The patient discontinued Tamoxifen due to intolerance of side effects. She was then put on letrozole and experienced debilitating joint pain and hot flashes, despite attempts to mitigate side effects. She tried multiple aromatase inhibitors without success and eventually stopped hormonal therapy.
Post conventional therapy
- High Force Interventions: None
- Synthetic Symptom Relief: None
- Natural Symptom Control: Occasionally patient needed botanical pain formula, Sepia 30C continued for hot flashes (that were greatly improving off hormonal therapy), EGCG & Curcumin (which also address lower levels)
- Support and Restore Weakened Systems: Botanical support for immune and detoxification support, DIM, Mushroom Complex, melatonin, supportive vitamins, minerals, and EFAs
- Stimulate the Self-Healing Mechanisms: Mistletoe continued for 1 year, shower contrast hydrotherapy integrated into daily routine, two to three 5-day fasts per year
- Establish the Foundations for Optimal Health: Worked on finding a sustainable diet for her, starting diving deep into the mental and emotional components of her health history
- Other comorbidities and health issues addressed
Post conventional treatment is an incredible time to focus on the lower levels of the therapeutic order. Often patients are so consumed with making it through treatment there is little capacity to incorporate the foundational aspects of health, such as finding a sustainable healthy diet, implementing supportive lifestyle habits, and engaging in mental/emotional/spiritual healing. So, it is ok to wait until they have completed conventional treatment to implement your whole treatment plan.
7 years after her diagnosis, this patient is still cancer free!
