One Oncologist’s View of Integrative Care: Keynote Address, Comprehensive Cancer Care Conference, April 2003 (2004)

People are confused about antioxidants. Every day I see people come in and they say, “My doctor says,” “My radiation oncologist says,” no fruits, no vegetable juices, no tea because they contain antioxidants. And I ask, “So what are you eating?” and they say, “Water and pretzels are all that’s left.” It is wonderful to have a conference on integrative care so that people can really share information and science—in something more thorough than press releases. I became interested in integrative oncology in 1987 when I was at Rockefeller University in the lab of Dr Joseph Nevins looking at the immune system and at cancer-gene interactions. I began reading initially dozens, and later hundreds, of articles explaining nutrient-gene interactions critical in the development as well as prevention of cancer. I was absolutely flabbergasted that in all of my medical training, my internship, serving as chief medical resident at Cornell, during my hematology and oncology fellowship, also at Cornell, nobody had ever taught me what I was now reading—that hundreds of scientific papers demonstrated how various nutrients could affect genes that contribute to promoting or preventing cancer. Nutrients, I learned, could turn on and off cancer cells, could affect the growth and proliferation of cancer cells, could profoundly affect the very parts of the immune system that are responsible for preventing a recurrence of cancer. I subsequently became associate medical director and director of medical oncology at the Strang Cancer Prevention Center. Throughout my career, I have focused on combining the very best that medical science had to offer in the fields of new chemotherapeutic advances, monoclonal antibody therapies, and advances in stem cell transplantation. I have incorporated these with mind-body practices and nutritional modalities, both of which affect the immune system, the endocrine system, and the body’s detoxification system. For instance, there is a lot of research about antioxidants in terms of free radicals, but the molecules that we call antioxidants have a host of other effects besides being antioxidants. Antioxidants—vitamin A, vitamin C, vitamin E, and other antioxidants, even nutrients found in soy and turmeric—bind to the antioxidant response element in our DNA and can upregulate the transcription of detoxification enzymes. These enzymes break down many of the carcinogens in our environment to which we are exposed. Awareness of our environment is also becoming more important in cancer care. There are many gene-environment interactions. For instance, we have various susceptibilities to toxins such as dioxin, furans, arsenic, cadmium, and lead. Because of current actions by the Bush administration to roll back several provisions of the Clean Air Act, we and our children will for decades to come be increasingly exposed to many more of these toxins. I think that that is a huge problem in a country where already 1 in 3 Americans are going to hear the words “You have cancer” at some point in their life. Integrative oncology really focuses on all of these facets of cancer. Gaynor