Download Integrative Oncology - Alaska Chiropractic Society

04/25/15
Chiropractic in an
Integrative
Oncology Setting
Charles A. McDonald, DC
Chiropractic Physician
Director, Chiropractic Services
Cancer Treatment Centers of America
@ Western Regional Medical Center
Goodyear, AZ
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Cancer Treatment Centers of America
© 2015 Rising Tide
CTCA Chiropractors
Newnan, GA (Atlanta Suburb)
James Rosenberg, DC,
National Director
[email protected]
847-910-6773
Philadelphia, PA
Jeffrey Sklar, DC
[email protected]
215-537-7168
Craig Steingraber, DC
[email protected]
770-400-6493
Tulsa, OK
Jack Sibley, DC
[email protected]
918-286-5179
Goodyear, AZ (Phoenix Suburb)
Chuck McDonald, DC
[email protected]
602-881-3800
Zion, IL (Chicago Suburb)
Brent Paxton, DC
[email protected]
847-872-4788
© 2015 Rising Tide
Credentialing
• The Joint Commission (JC), formerly the Joint
Commission on Accreditation of Health Care
Organizations, accredits over 20,000 different health
care entities.
• Joint Commission credentialing is the standard that all
successful hospitals, including government facilities,
attain.
• Failure to have JC accreditation would very likely lead to
the closure of a hospital.
• The Joint Commission now
recognizes chiropractors as physicians
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It’s About Time!!!
• The new Joint Commission standard of care from
January 2015 for pain management now includes
chiropractic and acupuncture
• The standard affirms that tx strategies include both
pharmacologic AND non-pharmacologic approaches
• This is a huge cultural shift. Chiropractic is mentioned by
name as an option.
• This means that over 20,500 hospitals will have to show
documentation that they have referred out for
chiropractic etc., or risk losing accreditation
- from ACA NEWS Jan/Feb 2015 by Lori Burkhart
© 2015 Rising Tide
Cancer Consult: Expertise for Clinical Practice
Syed A. Abutalib (Editor), Maurie Markman (Editor)
ISBN: 978-1-118-58921-2
968 pages
September 2014, Wiley-Blackwell
Chapter 140
Musculoskeletal care in
oncology, pg. 893
by
James E. Rosenberg, DC
Charles A. McDonald, DC
© 2015 Rising Tide
Review of
Cancer Facts
and
Metastases
© 2015 Rising Tide
Cancer Facts
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More than 1.2 million Americans develop cancer per year
A new cancer is diagnosed every 30 seconds in the U.S.
Lung and prostate are the top killers of men
Lung and breast are the top killers of women
One in two men will be diagnosed with cancer
One in three women will be diagnosed with cancer
Heart disease and cancer are neck and neck as far as
leading cause of death in the U.S.
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Reference: National Cancer Institute
© 2015 Rising Tide
Metastatic Cancer
• Cancer that has spread from it’s primary site; it maintains the
same name and type of cancer cells as the original cancer
• 3 most common sites are lung, liver, & bone
• A single tumor is a metastasis or metastatic tumor, 2 or more
metastatic tumors are called metastases
• Bone mets can occur in any bone but are most often found in
bones in the center of the body (spine, pelvis, skull, ribs)
• About 70% of metastatic spine tumors are in the thoracic
area, while 20% are lumbar and 10% cervical spine
• The sites of metastatic bone lesions in order of frequency:
Vertebrae, Femur, Pelvis, Ribs, Sternum, Humerus, Skull
© 2015 Rising Tide
Where Does It Spread?
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Bladder: liver 47%, lung 45%, bone 32%, peritoneum 19%
Breast: bone 65%, lung 62%, liver 58%, also pleura, brain, adrenal
Colorectal: liver 28%, lung 12%, bone 2%
Kidney: lung 75%, soft tissue 35%, bone 20%, liver 20%,
adrenal gland 19%
Lung: adrenal gland 40%, liver 3-50%, bone 20%
Melanoma: skin/muscle 55%, lung 47%, brain 37%,
liver/spleen 27%, bone 21%, GI tract 17%
Ovary: liver 46%, lung 36%, pleura 25%, adrenal gland 18%,
spleen 17%, bone 11%
Pancreas: liver 60%, lung 17%, bone 11%, in exocrine the
peritoneum, brain, pleura, bone are 27%+
Prostate: bone 90%, lung 46%, liver 25%, pleura 21%,
adrenal gland 13%
Stomach: liver 37%, lung 16%, bone 16%, lymph nodes 14%
Thyroid: lung 49%, bone 24%
Uterus: liver 33%, lung 35%, bone 15-29%
© 2015 Rising Tide
Lytic vs. Blastic
Lytic bone metastases occur in the following cancers:
renal, lung, breast, thyroid, melanoma, chordoma,
paraganglioma, GI tract, urothelial, ovarian, and multiple
myeloma
Blastic bone metastases occur in the following cancers:
prostate, breast, carcinoid, lung, GI, bladder, nasopharynx,
and pancreas
Remember – both lytic and blastic lesions are susceptible
to fracture and both can cause bone pain
© 2015 Rising Tide
Practice Building Tip
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What Is Integrative
Oncology Care?
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What Is Integrative Oncology Care?
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Team approach to patient care
Leading edge conventional oncology treatments
Broad array of complementary and alternative therapies
Offered under one roof
Individualized to meet the needs of each patient – mind,
body and spirit
• Delivered in a seamless manner by a single team
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Patient Empowered Care Model
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Naturopathic
Medicine
Surgical
Oncology
Chiropractic
Pastoral Care
Medical Oncology
IntegrativePatient
Care
&
Family
Mind
Body
Medicine
Model
Oncology Rehab
Nutrition
© 2015 Rising Tide
Acupuncture
Radiation Oncology
Chiropractic & Cancer
• Pre-existing conditions
• Anxiety and stress from a diagnosis of cancer
• Side effects of chemotherapy and radiation: tissue
fibrosis, muscular adhesions, headaches, nausea,
neuropathy, fatigue
• Acute pain from new conditions due to positioning for
radiation treatment or from sedentary situations during
in-patient status
• Pain from gait abnormalities or other functional deficits
• Post surgical trauma to connective tissues and joints
© 2015 Rising Tide
No Chiropractic
• Primary bone cancer: no treatment within five spinal
segments or to the affected extremity
• Unstable bone metastases: no force treatment available
within five spinal segments (instrument?)
• Cord compression from space occupying lesion
• Do not treat any extremity with a thrombosis
• Extreme low levels of platelet count (below 50k)
• An essential part of chiropractic treatment of a cancer
patient is access to the most recent records: PET, CT,
MRI, X-ray, blood work, etc.
• It is just as important to know what you can’t do as can.
© 2015 Rising Tide
M.D. Testimonials
• “Chiropractic care has been of benefit for my patient’s quality
of life by improving their pain, mobility and functional capacity.
These are measurable, and in oncology can often positively
impact other factors such as overall survival. “
Anthony Perre, MD, Medical Director of New Patient
Intake, Eastern Regional Medical Center
• “Chiropractic care offers immense value to our patients. In a
brief visit, patients can have alleviation of their muscle, joint
and soft tissue pain. Pain relief greatly improves their quality
of life. I believe that Chiropractic is an integral part of our
comprehensive care model. Due to personal experience, I am
a firm believer.”
Glynis Vashi, MD, Intake Physician, Midwestern Regional
Medical Center
© 2015 Rising Tide
M.D. Testimonials
• “Chiropractic care at Cancer Treatment Centers of America is
an integral and potent weapon in our integrative approach to
cancer care. In combination with naturopathic care, nutrition
and psychosocial support, this treatment helps provide the
broadest support for our patients as they fight to restore their
health.”
Jeffrey M Weber, MD, Chief of Medicine, Director of
Gastroenterology and Metabolic Support Services,
Western Regional Medical Center
• "From patient feedback, the incorporation of chiropractic
medicine into integrative oncology definitely adds value for
our comprehensive care model."
Glen J. Weiss, M.D., M.B.A., Director of Clinical Research,
Western Regional Medical Center
© 2015 Rising Tide
Outcomes
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Colon Cancer Survival, Stage IV
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www.cancercenter.com
Lung Cancer Survival, Stage IV
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www.cancercenter.com
Pancreatic Cancer Survival, Stage IV
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www.cancercenter.com
Prostate Cancer Survival, Stage IV
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www.cancercenter.com
Breast Cancer Survival, Stage IV
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Conclusions
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Key Take Aways
• CTCA has been using a truly integrative approach
focused on cancer patients, and as you have seen had
tremendous results.
• There is much room for expansion of chiropractic
services to other aspects of hospital care.
Collaboration is much better for both the patient and our
profession.
• Chiropractic is needed and requested by patients in a
hospital setting. We need to be the “front runners” in the
Integrative health care model.
© 2015 Rising Tide
Integrative Cancer Care
• People diagnosed with cancer
engage upon a course of
healing that encompasses:
 Education and information to
create an optimal treatment plan
 State of the art conventional
treatment options
 Collaborative Co-management
• Providing a truly integrative
approach to care can play a
crucial role in improving
outcomes and quality of life.
Chiropractic deserves to be a
part of that!
© 2015 Rising Tide
Partnering Together
• CTCA has embraced the chiropractic profession and it is
my opinion that we need to embrace them back
• We want to be a resource and a solution for you and your
practice and patients
• Referring a patient, friend, or family member to us for care is a
Win-Win-Win
• You can feel good about referring to a pro-chiropractic likeminded facility that will encourage your patient to continue
seeing you for their chiropractic care
• CTCA gets the opportunity to love and serve another patient
• The patient gets to be treated at a state of the art facility that
offers whole person care and has better outcomes
• Again, we want to be a resource and a solution for you
• Call me anytime on my cell: 602-881-3800
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Questions
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Thank You!