Integrative Medicine: a Patient's View

When Barbara Lee Epstein was diagnosed with a rare form of appendix cancer, she got the best that high-tech medicine has to offer: treatment at a world- class cancer center and a government-funded, experimental therapy that involved infusing heated chemotherapy into her abdomen. "I had this very experimental, cutting-edge clinical trial," she says.

But Epstein needed so much more. She needed relief from nausea and vomiting after chemotherapy. She needed help with anxiety that kept her from getting to sleep. And she needed the emotional strength to keep fighting in the face of a life-threatening illness that struck not once, but twice.

While she was undergoing surgeries, hospitalizations, and chemotherapy sessions, Epstein surrounded herself with a battalion of nontraditional healers: acupuncturists, reflexologists, therapists trained in meditation and guided imagery, and a medical doctor who prescribed medicinal herbs.

"I have a tremendous support system," says the single, 53-year-old New Yorker, a former magazine advertising sales representative.

The Appeal of Integrative Medicine

Epstein's story highlights the appeal of integrative medicine, in which patients draw from the worlds of conventional medicine and alternative therapies to minister to their bodies, minds, and spirits.

Epstein knows what it's like to feel rushed and ignored in today's medical environment. In 2003, when she was 50, she was dragging herself through the day. "I was extremely tired." But she says she felt dismissed when she complained of overwhelming fatigue to her internist.

"He told me, 'Everybody's tired in New York City.' He didn't really take me very seriously. But I think I'm very intuitive about my body and I really had strong suspicions that I had cancer. I couldn't have told you where it was located, but I knew something was wrong."

Eventually, Epstein developed severe abdominal pain, which lead to extensive medical testing. "It was a rough three months," she says. "It took a long time to get the diagnosis." The conclusion: mucinous adenocarcinoma of the appendix.

A Mix of Nontraditional and Mainstream

She was treated at the renowned Memorial Sloan-Kettering Cancer Center in New York City, which has a large Integrative Medicine Service that opened in 1999. Patients, including children, can take advantage of a broad array of complementary services. Those services include massage, meditation, self- hypnosis, acupuncture, yoga, music and dance therapy, and nutrition and supplement counseling.

Cancer patients still undergo mainstream treatment, and none of the complementary therapies aim to treat the cancer itself, says Barrie Cassileth, PhD, chief of the Integrative Medicine Service. As she puts it, the service is designed to "deal with everything but the tumor." That means helping patients with stress, pain, and anxiety, as well as providing them with ways to manage symptoms and increase their sense of well-being.

Epstein fully embraces conventional treatment for her cancer. But the other world intrigued her, especially when she recalled how her mother had turned to acupuncture many years ago to kick a cigarette habit for good.

"Throughout the entire chemo, I would always go to acupuncture the day before," Epstein says. She believes that it eased her side effects, such as nausea and vomiting. "It also helps with sleep and anxiety," she says. "Sometimes I fall asleep on the [acupuncture] table even."

Seeking Treatments

When she developed nerve damage from chemotherapy, a Sloan-Kettering doctor trained in herbs prescribed vitamin B-6, which Epstein believes helped to improve her symptoms quickly. Whenever Epstein wants to try a new herb or supplement, she has to email him to make sure that he approves.

She has also tried massage, reflexology, and reiki. The Integrative Medicine Service describes reflexology as an "ancient practice of applying pressure to specific parts of the feet and hands" to reduce stress, relieve pain, and increase circulation. Reiki "promotes the healing of physical and emotional ailments through gentle touch."

Seeing nontraditional healers, as well as a social worker and mainstream psychiatrist, helps Epstein to feel cared for and less alone. "If you're like me, where you're not working and you've got a lot of free time during the day, it's hard. I think people who are combating illness can feel pretty isolated."

Epstein also embraces meditation as a means of marshalling hope and gaining some sense of control. "It's very empowering," she says. That's crucial because her cancer recurred in 2004, and she's been battling since then to beat the disease a second time.

"For me, the meditation reinforces all the other things that I'm doing. I'm on chemo and I'm doing the traditional medical treatment. The meditation makes me feel that I'm doing something above and beyond to put this back into remission or to cure it."

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