Incorporating Integrative Cancer Care Into Your Plan

How much do you know about integrative cancer care? And even more important, how do you proactively create an integrative plan for your treatment and survivorship? On this show, Karolyn talks with Terri Crudup who is an integrative oncology researcher, author, educator, and patient advocate. She is also the lead author of the new ebook Taking Care of the Whole You. Terri offers practical advice on how to get started using an integrative approach to cancer treatment and beyond.

Five To Thrive Live is broadcast live Tuesdays at 7PM ET and Music on W4CS Radio – The Cancer Support Network (www.w4cy.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com).

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Episode Transcript

Speaker 1 (00:00):
Any health related information on the following show provides general
information only. Content presented on any show by any host
or guests should not be substituted for a doctor's advice.
Always consult your physician before beginning any new diet, exercise,
or treatment program.

Speaker 2 (00:41):
Hello everyone, and welcome to Five to Thrive Live. I'm
Carolyn Gazilla and I co host this show with my
good friend doctor lese al Schuler. So over the past
thirty years or so, I've focused on educating people about
integrative oncology. Some people have told me that they want
to use an integrative approach, but it can be difficult,
and I agree it can be hard, but the effort

(01:03):
is certainly worth it. On this show, I had the
perfect expert to give us advice on how to proactively
create an integrative cancer care plan. Terry Krudupp is an
integrative oncology researcher, author, educator, and patient advocate. She is
also the lead author of the new book Taking Care
of the Whole You. It's an ebook that she published

(01:26):
with the Society for Integrative Oncology, a wonderful organization. But
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at doctor Ohira probiotics dot com. Well, Terry, thank you
so much for joining me.

Speaker 3 (02:51):
Yeah, thank you Carolyn for having me. I'm very excited
to be here.

Speaker 2 (02:54):
Yeah. Well, I'd like to start before we dig in,
tell us a little bit about your can. That's your experience.
You are a cancer survivor, So what type of cancer
did you have and how are you doing now?

Speaker 3 (03:06):
Sure, I was diagnosed first with stage zero breast cancer,
so that's known as DCIS. That was in twenty thirteen,
and I had a later almostectomy. They checked a couple
lymph nodes and kind of set me on my way,
and then it came back six years later, so that
was twenty nineteen, and actually one of my lymph nodes

(03:28):
had turned into a tumor, a rather large one, and
that got me into surgery to remove twenty of my
lymph nodes. It turned out it was an eight of them.
I also had eight rounds of chemo and twenty five
rounds of radiation and so this second time was really,
you know, my wake up call, and I found you.

(03:48):
I found integrative oncology through an organization called Unite for Her.
They're a wonderful nonprofit that helps with breast and ovarian
cancer patients. But I really kind of didn't. I wasn't
at a health see that really was integrative. I created
my own plan working with Unite for Her. I changed
a lot of my own lifestyle choices like movement and

(04:08):
nutrition and stress management. And I've actually been living I think,
a healthier life for the past six years. And I'm
six years out from my second diagnosis and I actually
just had a circulating tumor DNA testa and I'm happy
to say I'm completely cancer free and I think really
healthier than I was before cancer.

Speaker 2 (04:26):
Great, well, that is great, and it's great that you
were proactive and created your own integrative cancer care and
that cancer care program. And that's what we're going to
talk about today. But there can be a lot of confusion.
How do you define or describe integrative cancer care?

Speaker 3 (04:44):
YEP, for me, it's pretty simple. It's the combination of
the conventional medicine. So I just talked about, you know, surgery, chemotherapy, radiation,
targeted therapy, meanotherapy, kind of everything you might picture your
oncologists from our western part of the world prescribing, plus
lifestyle modifications like movement, nutrition, sleep, and then other complementary

(05:08):
therapies things that really can help you balance your mind,
your body, and your soul. So things like acupuncture, yoga, mindfulness, meditation,
cheegong and supplements is a big one that patients talk
about a lot. So it's really it's the conventional medicine
plus lifestyle and complementary therapies.

Speaker 2 (05:28):
Yeah, it's the best of all worlds when it comes
to cancer care, right.

Speaker 3 (05:32):
Yep, absolutely, I think so.

Speaker 2 (05:34):
So when talking to people over the years, I've found
that one of the biggest barriers to integrateive cancer care
has been resistance or negativity from the lead oncologist who's
just sometimes not willing to work with an integrated plan.
Now do you feel that that has changed or is changing,

(05:58):
or is that still a pretty big barrier.

Speaker 3 (06:01):
Yeah, that's a great question. You know, I've been in
this field only for five years, so I'm a novice
compared to you, I think, Carolyn. But I do feel
like I've done research with oncologists in the US. So
this is not integrative oncologists. This is you know, over
one hundred institutions represented in a national survey, and I

(06:22):
did that for three years in a row, and what
we found was there's actually a lot of oncologists that
believe in integrative oncology. They believe it helps with side
effect management. They believe it helps patients feel better as
they go through treatment and improve the quality of life.
And there's a good third of them. They even believe
in the survival benefit of adding lifestyle and complementary therapies.

(06:44):
But I do think even though it might be improving
over time, Carolyn, there's still so many practical barriers that
it's hard for even the doctors who believe they might
not be in a system that supports delivering integrative oncology.
Does that make sense?

Speaker 2 (07:01):
It does, It does, And I want to talk about
those barriers. But let's stay with this question because I
would say I agree with you one hundred percent. So
I have been doing this for like three decades, and
I have noticed a shift, and I have noticed that
it's gotten better, but we are nowhere near where we
need to be when it comes to integrative cancer care.

(07:22):
So I would agree with you. So what can listeners
do if they're specific oncologist is unwilling or hesitant to
work with them to create an integrative approach.

Speaker 3 (07:37):
Yep, that's a question I give a lot. So first,
I do think it's important that patients try to have
that discussion with their oncologists or with their broader care team,
because even though the things that we're talking about here
are very safe, very low risk to using them, there are,
for example, some supplements that interfere with chemotherapy. So it's

(08:00):
it's important, I think, to try to have that open
relationship with your doctor. And you know, if you don't
or if you feel like your doctor or your oncologist
isn't willing to hear that, I actually do counsel patients
to seek out second opinions, and that's you know, for
a variety of reasons. It doesn't have to just be
related to integrative oncology, but generally you want to be

(08:21):
with a care team that you're vibing with, you know,
for lack of a better term, some when you feel
you can have that discussion with it doesn't mean they're
going to support everything that you're asking. It just means
you feel comfortable at least having the discussion and being
open about it. And a lot of patients that I
talk to say they are really glad they got a
second opinion, even if they didn't switch. Like I'm on

(08:43):
an example of someone who got a second opinion and
then went back to my original health system. I just
needed the reassurance at that point in my treatment plan,
so beyond kind of just thinking about the discussion, if
you don't have the energy or like the motivation to
explore changing, so maybe that's not an option for everyone.

(09:04):
And I get that you're already in your treatment you
don't want to think about changing. There. I actually did
write into the ebook, which we're going to talk about
a little bit, some tips. There's actually one page that's
like a discussion guide depending on how supportive your care
team is. And so I'm just going to read a
couple of the tips that I wrote into the book,

(09:25):
because these are ways patients can actually approach their oncologists,
maybe from a slightly different angle, to try to get
more of that support. So one of them is being
actively involved in my cancer treatment is important to me.
So other than following the procedures and medications, you recommend
what else can I do to have the best outcomes possible?

(09:46):
So you're sort of acknowledging, yes, I'm going to use
the medicine, the conventional medicine, but I want more. And
that's one of the things that my ebook co author
Bert Rosen says all the time, like what else? What
else can I do? And hopefully you're with it a
health system that is going to help you answer that question.
But if not, there's like one more push I have here,

(10:06):
which is I've heard their guidelines from the American Society
of Clinical Oncology also known as ASCO for using integrative
practices with cancer patients. So doctor, can you help me
understand how the guidelines apply to me? So you're not
just putting it all on the doctor, You're actually putting
it on this like third party that's a very well
respected party and seeing like, look, I know this exists.

(10:29):
Can you help me? And even if the doctor isn't
willing to, maybe others on the care team are. So
that's another question to ask, are there other members of
the care team who can help me? And maybe they'd
send you to a nurse navigator or to a social worker.
And I do think sometimes social workers there's an association
there that doesn't need to be there. They're very helpful

(10:49):
and there's no harm in asking for help. And the
last step is just cancer advocacy groups. That's how I
got my start, So you could ask your care team too,
are there advocacy groups who can help me with resources
to help my well being while I go through treatment?
And my final tip is, you know, if you still
are facing a wall, you're with a oncologist or care

(11:09):
team that's not helping after all these questions, then you
can use trusted resources. Again, I still encourage to talk
to your doctor about it, but the ebook that we'll
talk about has a whole section on vetted resources for
checking things like supplement uses and interactions, or finding community practitioners,
even finding ones for low cost who can help you

(11:31):
to implement these things.

Speaker 2 (11:32):
Yeah, and I love the way your questions are worded.
And I think that you know, having the patient come
across as being very proactive and I want to be
a part of my healing. I think doctors love to
hear that, so I think that's a great, great way
to say that. I want to talk a little bit
about the care team before I go into more barriers

(11:57):
because you've said it a few times, and I think
that sometimes people don't understand that they do have a team.
Who should be on that team?

Speaker 3 (12:04):
Oh, that's a great question. So it's really going to
depend on what center you're at and how many resources
they have. But at the very least, you know, you
obviously have an oncologist. You might also have like a
radiation oncologist, a breast or sorry, a surgeon. This isn't
just breast cancer, so a surgical oncologist. And then there's
usually a host of supportive staff, which is a bit

(12:28):
of a there should be a stronger word for it.
So the nurses. That can be a physician assistant or
a medical assistant. It can be nurse navigators. Actually, it
can be even like psychotherapists. Some places actually have psychologists
on staff. And then social workers I mentioned before that

(12:48):
I think are a huge resource for helping patients find resources.
Like all of those people might be involved, and I'm
probably forgetting some so forgive me. Oh, nutritionist is a
huge one. Yeah, a therapist. Yeah, So again, it really
depends though on the system that you're at, like the hospital.
Some of them really do have that whole staff for you,
and sometimes you have to ask. You'd be surprised sometimes

(13:10):
there's a disconnect between the doctor, like knowing there's a
nutritionist somewhere, but not automatically recommending that to patients. So
being proactive and asking about it sometimes we'll get you
there much easier than you think.

Speaker 2 (13:25):
I would agree. That's a great thing, is to know
who your team is and asking about it. And I
think I think your team is going to enjoy that
you're asking about who's on your team. Okay, So what
are some other barriers to integrateive cancer care and how
can we overcome them?

Speaker 3 (13:43):
Yeah? So I work, you know, kind of at a
macro level here, so zooming out from the individual patients.
I think access and funding are two of the biggest barriers.
So access meaning how do we find that nutritionist or
that exercise on, that exercise specialist or acupuncturist, whatever it is.
And then funding how do I pay for it? So

(14:04):
I do work on kind of other angles with other
organizations to help hospitals deliver or facilitate more integrative oncology,
and then with policymakers because there really is a strong
argument here that it's worth paying for these things, Like,
think about your payers and how much they're paying for
the actual treatments. There's a lot of evidence that says

(14:26):
we can use integrative practices for a lot less money
and get improved outcomes. So, you know, at a big level,
at a high level, I think we need to keep
championing for that. That's the advocacy work that I do macro.
But then if I take it down to like, well,
I'm a patient today, I'm living with cancer, or maybe
I'm going through treatment, or maybe I'm in survivorship, So

(14:49):
what are the barriers there? And there are barriers because
patients want to help themselves. But when it comes down
to the practical aspects, well do I have the time
for that? Well that's going to cost me some money.
How am I going to figure that out in my budget?
And so I ask patients because I think this is
an important part of getting there is even if you

(15:10):
know every option that I've talked about was free and
at your fingertips, would you use it? And it's easy
to sit here and say sure, I would use it,
But actually practically applying it, I think is another barrier
to patients. And so what I like to talk about
is the why, like what is your why? And for
a lot of people, when you are diagnosed with cancer,

(15:32):
your why is well, I want to be here. I
want to be here and I want to feel good
for the people I love, I want to watch them grow,
or I want to be part of their big moments,
or if it's people and you know your parents, your grandparents,
I want to keep supporting them. Or maybe it's just
as simple as I want to live and I want
a good quality of life while I'm living. And so
I think finding that why and linking the practices, the

(15:56):
integrative practices back to your why, it's going to help
motivate because I'm sorry to say that there's not a
magic pill, that there's not an easy way. It does
require work, that there's a reason these things are called practices.
But you know, improving your nutrition, improving your exercise, calming
your mind, if you can remember that when you're practicing

(16:18):
these things, you're doing it to extend your life and
improve your quality of life. And you really don't have
to do a lot all at once. It can all
be done in baby steps. And I think that's like
my best advice for getting over the practical parts of
it as a patient. And Carolyn, I'll tell one reframing
story if we have the time here, because I love

(16:39):
telling this story.

Speaker 2 (16:40):
Yeah, yeah, go for it.

Speaker 3 (16:42):
Cool for me, My wife was, I want to be
here from my kids, right, I have to young kids
and my husband and my family. But I also kind
of love science, and I realized there's a connection. At
some point, I was educated that my thoughts lead to
emotions that then elicit a hormonal response in my body

(17:03):
that can either be productive to my health, so I
can be putting myself in rest and repair, which is
someone going through cancer is highly important, or those thoughts
can be what I would call counterproductive, so I can
be in fight or flight, And in fight or flight
is you know, increasing your blood pressure and increasing your
heart rate and increasing inflammation and doing things that are

(17:23):
counterproductive to healing. Basically, so I'm super motivated to monitor
my thoughts and intervene when something is starting to spiral.
And my reframing is a very simple technique where you
literally just say, Okay, something just caused me stress. How
can I turn it on its side and help that
stress go away? And my example is I celebrate Christmas,

(17:46):
and Christmas twenty twenty, which, if you remember, twenty twenty
was the first year of COVID. I did our holiday
cards like I always do. I ordered them online pictures
and you know, happy holidays from the crew Dux, and
I got them that in the mail, and I was
getting ready to send out over a hundred cards. We
send a lot of cards, and I realized that nowhere

(18:07):
on the card did it say our names, like, not
our first names, not our last names. It was just
just happy Holidays. And I remember, in a split second,
my mind spiraled into, oh my gosh, I've screwed up.
I'm so embarrassed. Everyone's gonna think I'm so stupid. How
am I going to fix this? Maybe I could write
something on every card. Maybe I could put an insert
in that I print out on every card, and like

(18:29):
literally just spiraling within a split second, and I stopped,
and I took a couple of deep breasts, because that's
a really good way to interrupt those thoughts. And I
stepped back and I said, you know what, it's COVID.
Like the whole world just fell apart this year. No
one's going to care, no one's probably even gonna notice.
These are my friends, they know my name. My name

(18:51):
will be on the address return label, they know who
this card is from. And I ended up laughing it
off instead of getting stressed about it. And I just
that's such a nice example of we can control it
if we just take a minute and think and put
in the effort to control it.

Speaker 2 (19:07):
Yeah, I agree. I love that. That's totally something I
would do so I can relate to it. And I
love this idea of small steps because what we're talking
about can feel overwhelming. But if we do take small
steps and we do prioritize based on the why, as
you mentioned, that's all going to be helpful and it's

(19:29):
going to make it less overwhelming. Okay, I'd like to
talk a little bit about the new ebook. Congratulations by
the way, tell us why did you want to create
this and what makes this ebook special?

Speaker 3 (19:44):
Yeah? Cool, I would love to so. I mean, Carolyn,
you mentioned in the beginning, I'm a researcher at heart.
I do love research, and I got a couple of
years into research for integrative oncology and I realized there
are so many great researchers working on this. There is
not a lack of evidence. If anything, there's just more
evidence we need to keep championing and educating about. And

(20:05):
so I kind of pivoted to the practical parts how
people can access integrative oncology and again how they can
do it for you know, low or no cost. There
are some things that cost money, but there are also
some things that don't cost any money, like the reframing
example I just gave. So the ebook is really all
of the basics of what I've learned about integrative oncology

(20:29):
and how people can adopt it into their lives. And
when I say people, I do mean, you know, it's
not even only just people who are having cancer right
now or living with cancer or going through treatment or
in survivorship. These are actually things that caregivers can use.
There's evidence that the doctors doing some of these things
themselves makes them happier and less burnout. So anyone can't

(20:52):
adopt these kind of things. But what I wanted to
do was present like a foundational learning, so like definitions, right.
I think I might have used the term mindfulness earlier.
I didn't know what that was six years ago, and
I take for granted now that mindfulness is being present
in the moment and without judgment. But not everybody knows that.
So that's what the book starts with is just very

(21:14):
basic definitions of some of the most evidence based integrative methods,
and then it goes through the guidelines. So guidelines basically
mean that some really smart organizations have looked at a
lot of clinical trials, a lot of studies and pulled
out and said, here's what has enough data enough science
to support using these methods for things like pain or fatigue, depression, anxiety, nausea.

(21:43):
There's all sorts of great guidelines that we've put in
very patient friendly language and with lots of visuals, so
trying to make it as easy to digest as possible.
And the other part of the book, the section five
is the section I wrote myself, and it's my favorite
because it's the practical tips for how to find the
time to incorporate into your daily life and then also

(22:06):
how to get started, like I said, for little or
no money. And so I'll read you a couple of
the tips. It'll just take a minute. But I want
to mention really quickly first that the ebook can be
found on the website of the Society for Integrative Oncology,
so that's integrativec Dot org integrative onc dot org and

(22:28):
it's under the Knowledge Center tab. It's completely free. You
don't even have to put any information about yourself in
and we just want people to go and download it
and use it. And then some of the tips that
you'll find, you know, when you go and look for
this practical part. There's one part that says, I have
no money, how can I get started for low or
no cost? And you know, for example, the body part

(22:51):
is linked to exercise, so I body mind soul. So
one of the body parts is exercise. And you know
I talk about walking is a great form of exercise. Guy.
It's free, it can be done nearly anywhere. But you know,
I definitely get from patients a lot. But walking is
so boring, Like I just I can't motivate myself to
do that. So there's little tricks like play a game

(23:12):
when you're walking, find something blue, find something orange. Which
house in this neighborhood would be your dream house? Which
building is the tallest building? Listen to an audio book,
call a friend, bring a friend on your walk. Like,
there's all sorts of things you can do to make
it a little more exciting. Don't take the same route
every day. And there's other activities too. You don't have

(23:34):
to walk. There's swimming, there's hiking, there's biking. But my
point is like, if that's your barrier, find something that
works for you, and there's probably something you can do,
and every little bit counts. Every little bit of movement
is important. And my other tips are about I'm a
busy person with no time for new things, So how

(23:55):
can I work this into my schedule? And I'll just
give you a couple of those two. One of mine
is like I call it fine, bang for your buck
and get creative. So like I literally when I'm at
the bus stop with my daughter in the morning, we
walk rather than just stand there waiting for the bus.
Or like when I'm in the waiting room waiting for
doctor to come in. I'm small waiting room, but I
walk in circles. I'm getting in my steps for the day.

(24:15):
And then I love to put things on my calendar
because then I make it happens. So block yourself a
half hour every day for wellness, something something simple, or
an hour on the weekend if that's fits into your
schedule better, and then look for new time. I love
new time opportunities like your kids get a little older
and they start going to school full time, that's found time.
You don't have to spend the new kids anymore before

(24:36):
it gets filled up with something else. Work in some wellness,
and the same thing for if you're commute time shortens.
So I'll stop there because I know I could go
on and on. There's plenty of tips if you download
the ebook.

Speaker 2 (24:48):
Yeah, those are great tips. So to remind us again,
what's the website where we can get that book for free?

Speaker 3 (24:53):
Sure? It's the Society for Integrative Oncology and it's Integrative.

Speaker 2 (24:57):
On dot org and it's the knowledge CAAB Knowledge Center, yep,
knowledge center. Okay, cool, Okay, we have a few minutes left.
And I know that you are also involved with a
free app for people diagnosed with cancer. Where can people
get that free app? And what's entailed with that?

Speaker 3 (25:18):
Yeah? Sure? So the app is called Outcomes for me,
so it's Outcomes and then the number four and then
me all one word. It is available on the App Store,
so whether your Apple iPhone or Google Play, either one.
It's an Orange icon. It's free, it's always going to
be free. It's for anyone affected by cancer patients caregivers professionals,

(25:41):
and it is evidence based as well. And there's already
three hundred thousand patients in the US and other countries too,
mostly the US, who are on the app. And there's
plenty of tools in there, Carolyn, as well as integration
with the NCC and treatment guidelines so that patients can
be empowered to really know, okay, what is recommended for me,
and then you can go have that discussion with your doctor.

Speaker 2 (26:03):
That's a lot of users. That's great. How long has
the app been available?

Speaker 3 (26:08):
The company was founded in twenty seventeen, and I believe
it was a few years later, so about twenty twenty one.
I'm going to say when it actually became available.

Speaker 2 (26:16):
Cool. That's great. Well, this has been a great informative show.
Thank you so much, Terry for joining me.

Speaker 3 (26:24):
Yeah, it's been great talking to you, Carolyn. Thanks for
having me.

Speaker 2 (26:26):
Yeah, great, And congratulations on the ebook and your health
and everything. So let's keep in touch.

Speaker 3 (26:33):
All right, definitely need too. I'm glad to hear you're
doing one of these days.

Speaker 2 (26:36):
Yes, I am. Well. That wraps up this episode of
five to Thrive Live. Once again. I'd like to thank
our sponsors, pro thrivers Wellness sleep formula, Cetria glutath ione,
the superior glutathione to support liver and immune health, cognizancetacoline
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award winning shelf Stable probiotic. Thanks for listening, and remember

(26:59):
you can find and past shows at I thriveplan dot
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podcast that's I thought, I thrive plan dot com. May
you experience joy, laughter and love. It's time to thrive everyone,
have a great night.