Breast cancer patients turning to alternative care

　

乳腺癌患者寻求替代疗法

Growing majority combine holistic therapies with traditional medicine很多患者接受整体和传统结合疗法
Six months of chemotherapy for breast cancer weighed heavily on Karen Lehman. "I felt crummy," says the normally cheerful 49-year-old. "There was the fatigue and the constant queasiness." To help cope, she tried acupuncture and craniosacral massage and is considering other alternative therapies as she continues battling cancer.用化学疗法治疗乳腺癌6个月以后，Karen Lehman的心情很糟。这位患病前性格开朗的49岁女人说："我感到情绪低落，全身疲乏，不断地头昏作呕。"为了解除这些烦恼，她试过针刺和颅骶骨推拿，目前她正在考虑在以后治疗癌症过程中选用其它替代疗法。
HER HOLISTIC APPROACH is not unusual. In fact, Lehman is one of a growing majority of breast cancer patients who are turning to alternative therapies to help deal with the side effects of conventional treatment or compensate for the times when mainstream medicine falls short.Karen Lehman的整体治疗方法并非与众不同，事实上，Lehman只是越来越多寻求替代疗法的乳腺癌患者中的一员，她们想靠这些疗法解决常规抗癌治疗造成的副作用或补充主流医学未能达到的疗效。
As many as 70 percent of cancer patients use alternative therapies, including dietary supplements, acupuncture, hypnotism, massage, guided imagery, magnets and biofeedback, according to a recent report in The Journal of Alternative and Complementary Medicine. The study, a telephone survey of more than 350 cancer patients in Washington State, found that breast cancer patients were the group most likely to try holistic approaches and that almost all respondents believed the treatments improved their well-being. Other studies have also shown that alternative medicine use is common among people with life-threatening illnesses.据《替代和补充医学》杂志最近的一篇报道说，高达70%的癌症患者使用替代疗法，包括食疗、针刺、催眠、推拿、引导想象、磁疗和生物反馈。该研究通过电话调查了350多位华盛顿州的癌症患者后发现，乳腺癌患者最可能尝试接受整体治疗，并且发现几乎所有被调查的乳腺癌患者都相信整体治疗有利于自己的康复。其它的研究也表明，在患有致命疾病的患者中，使用替代医疗的现象十分普遍。
"I expected there to be a high percentage of cancer patients using alternative therapies because I think these patients are looking for ways to help their health and to take control of their health care," says study author Ruth Patterson, a scientist at the Fred Hutchinson Cancer Research Center in Seattle. "The unexpected piece of this is just how high the satisfaction level was. Patients felt these things helped them feel better - that's nothing to sneeze at."西雅图Fred Hutchinson癌症研究中心的科学家Ruth Patterson是该研究报导的作者。他说:"我期待将来有更高比例的癌症患者使用替代疗法。因为，我认为，这些病人会寻求各种有益于身体健康和能控制自我保健的方法。但是，替代疗法不能预测到病人的满意度多高。不少病人感到这些疗法使自己感到好多了，这就使人对此不能等闲视之了。Alternative practitioners, who emphasize mind/body wellness, can be a welcome change to patients frustrated with hurried doctors who don't always have the answers - or who give conflicting advice on key issues like mammograms and breast self-exams.替代医学的行医者强调身心合一的健康，这种有新意的思想在病人中颇受欢迎，因为这些患者已被急躁不安和不能圆满解答自己问题的医生弄得灰心丧气。在一些关键问题如乳房摄片和乳房自检结果上，医生的意见也常常不一致。INDIVIDUALIZED APPROACH个性化疗法"People feel that alternative medicine is more tuned into their bodies, rather than a one-size-fits-all approach that tends to be common in Western medicine," says Dr. Debu Tripathy, director of the breast cancer research program at the University of Texas Southwestern Medical Center at Dallas and co-editor of the new book "Breast Cancer: Beyond Convention"."人们感到替代医学从整体上调节身体功能，而不象西医常见的头痛医痛局部治疗法"。"德州大学达拉斯西南医学中心乳房癌研究计划的负责人Debu Tripathy博士说，他也是新书"乳癌，超常规治疗"的副编辑。
But the new survey findings raise questions that are at the heart of the ongoing debate over alternative therapies. Do they actually fight disease? Or is the effect just psychological? Or a combination of both? When it comes to breast cancer, as with many diseases, there are few clear answers.但是这项新调查的结果也对正在进行的有关替代疗法争论的核心问题提出质疑。替代疗法的确能治疗疾病吗？或者它可能只是心理效应？或者只是治病和心理效应的两者结合？正如替代疗法用于治疗许多疾病一样，它对乳腺癌疗效如何，对上述问题仍说不清道不明。
Supplements are one of the most popular alternative therapies for breast cancer, but experts say there is no convincing evidence to support their use. "Most of what is sold to treat or cure cancer are concoctions that people put together," says Barrie Cassileth, chief of the integrative medicine service at Memorial Sloan-Kettering Cancer Center in New York. "They should be looked at with a jaundiced eye."服用补给品是治疗乳腺癌最流行的替代疗法之一，但是，专家们认为，并没有令人信服的证据证明这种疗法。纽约纪念Sloan-Kettering癌症中心综合医务部主任Barrie Cassileth说："目前大多数市售的所谓治癌的补给品只不过是一些混合物，对它们人们应另眼相看。"
SUPPLEMENT DANGERS补给品的危险
What's more, certain supplements may be dangerous. "Herbs can interfere with the amount of medicine that can get into the body and can also interfere with the coagulation of blood, which can be a problem with surgery," Cassileth warns. For instance, St. John's wort and various antioxidants, including vitamins C and E, may reduce the effectiveness of standard treatments like chemotherapy. And experts say that although soy in the diet may offer some protection against breast cancer, high-dose soy supplements or other products containing plant estrogens may, paradoxically, have the opposite effect - fueling the growth of tumors - in women with the disease.况且，某些营养补给品可能是危险的。Cassieln警告说："草药可能会干扰进入人体的药物含量，也可能干扰血液凝固，使相应的手术出现问题。"例如，St.John麦芽汁和各种抗氧化剂，包括维生素C和E都可能会降低规范治疗如化疗的疗效。有专家说，虽然饮食中的大豆可能提供人体某种蛋白质以治疗乳腺癌，但反过来，摄入过多的豆类或其它含有植物雌激素的食物，却有相反的效应，它可促进乳腺癌患者身上的肿瘤生长。

　

Another concern is that a supplement may not contain what the label claims or may be contaminated with harmful substances, says Leanna Standish, a naturopathic doctor at Bastyr University in Kenmore, Wash. Supplements are not subject to the same strict safety and effectiveness standards as dru gs. Because of this, Standish generally advises patients to avoid over-the-counter supplements.地处华盛顿Kenmore的Bastyr大学的自然疗法医生Leanna Standish说，另一个问题是，某种营养补给品并不含有标签上所称的物质，或者可能受到有害物质的污染。 因为这些营养补给品不必达到与药物一样严格的安全和有效标准，所以，Standish通常奉劝患者不要服用那些没有处方的营养补给品。
In some cases, though, supplements prescribed by a qualified naturopath or herbalist may be used safely as an adjunct to standard care, she maintains. Standish receives many referrals from oncologists whose patients are interested in trying alternatives. Though not definitively proven to work, she often prescribes coenzyme Q10, vitamins E and B6, quercetin and garlic because laboratory studies have suggested they may be beneficial. Standish is tracking her patients to see if the supplements actually work. But she cautions patients against rushing to take these supplements on their own, since they may cause problems depending on the dose and other treatments used.然而，她认为，在某些病例中，由称职的自然疗法医师或草药师开出的营养补给品可以安全地用于辅助规范治疗。Standish接收了许多从肿瘤学家诊所转来的病人，他们都有兴趣试用替代疗法。她也经常开出服用辅酶Q10，维生素E和B6、槲皮苷和大蒜的处方，尽管不能确定它们是否有效，但实验室研究已表明它们对患者是有益的。Standish正在追踪她的病人，观察这些营养补给品是否真的有效。但是，她提醒病人不要一窝蜂自做主张地服用这些营养补给品，因为服用剂量的差别和是否同时使用其它疗法，服用补给品可能会造成各种问题。
Tripathy also is studying herbs to see if they can help with the side effects of chemotherapy or as actual cancer fighters. One of his studies is testing whether herbs such as skullcap, which showed promise in the lab, can help shrink breast tumors in patients with advanced disease who cannot be cured by conventional medicine.此外，Tripathy正在研究草药，观察它们是否能有助于减少化疗的副作用，或者它们本身就是抗癌药品。的研究内容之一就是测试像黄岑属这种在实验室中已显示希望的草药，是否在实用中能够帮助晚期乳腺癌患者缩小乳房肿瘤，而常规医疗对这些病人早已无能为力。
While the jury remains out on supplements for breast cancer, some alternative therapies are gaining acceptance as potentially beneficial modalities when used in conjunction with standard care. Such "complementary" approaches as massage therapy, meditation and yoga may boost patients' mood and well-being, experts say. "Some of the mind/body techniques can certainly help the emotional state and that's a valuable thing," says Tripathy. "The question is, Can they help the cancer itself?"专家说，虽然，人们对营养补给品对于乳腺癌治疗作用褒贬不一，但另一些替代疗法正在被人们所接受，当它们与规范治疗联用时，可能有益于患者。这些"补充"疗法如推拿、静思和瑜珈可以改善病人的心情和健康。Tripathy说："某些调节身心的技术肯定有益于患者的情感状态，它们是有价值的疗法。问题是，它们会不会帮助癌症？"
Lehman has had mixed results with the alternative approaches she's tried. Though acupuncture has been shown to fight chemotherapy-induced nausea, she doesn't think her 10-week treatment helped all that much. "I had one week where it was wow - I was symptom-free - but it went downhill after that," says Lehmane . (the end) NewsweekLehman试用替代疗法所获得的结果有好有坏。虽然针灸帮助她阻止化疗引起的恶心，但她认为，10周的治疗并没有完全解决所有问题。Lehman说："一周的疗效好得惊人，症状全没了，但后来又渐渐不行了。"