Chain Reaction

By Lise Alschuler, ND, FABNO
AANP Past-President (2008-2009)

Photo by Don DeBold via Flickr, used under the Creative Commons License.

There is an interesting and, frankly, ear-splitting phenomenon occurring in my household. We love birds, so we installed a variety of feeders in both our back and front yards. We diligently fill the feeders as they are drained by hungry birds. Our efforts are worth it. We are treated to a plethora of warblers, wrens, finches, woodpeckers, chickadees, doves, and hummingbirds. The colors are spectacular and we grin with satisfaction at the busy chomping occurring outside of our windows.

We are not, however, the only ones grinning. Our neighbor’s cat now loves us, or rather our yard. Not only can he sit in-wait for a bird, but the seed droppings have attracted a variety of other delectable critters. We have what seems to be several families of chipmunks and squirrels that come to eat the discarded seeds on the ground. Unfortunately, the cat has made off with quite a few of these little ones.

And that brings me to Nora, our dog. Upon waking in the morning, after a good stretch, she eagerly trots out of the bedroom and hustles down the stairs. She gains momentum as she goes so that by the time that she reaches the main floor she is galloping towards the bay windows in our kitchen nook. With her tail a blur, she carefully scans the yard. She is usually rewarded with one, and then several more, chipmunks; and on a good day a squirrel; and on a particularly phenomenal day, the cat. She greets each one of these critters with a wildly enthusiastic barrage of barking, moaning, squeaking and (dog) talking. The bigger the animal, the louder she is. Unfortunately, our house has wood floors and minimal carpeting, so her barks bounce off the interior of our home with ear-splitting volume. Inevitably, after about 10 seconds of this cacophony, we command her to stop. She does, but proceeds to whine/talk/moan at the world on the other side of the glass. Exasperated, we often let her out on the porch where she barks her way into the upper hand and clears the lawn of all creatures – winged and tailed. And then there is blessed peace and quiet. She comes in content, we settle in, and soon the birds come back and it all starts over again.

Despite the fact that we are probably losing the upper register of our hearing, we just won’t take the bird feeders down. We recognize that we are completely responsible for initiating this chain of events and, as such, have no right to complain. It is a daily lesson for me too as I can’t help but wonder what other chain of events I have unknowingly or inadvertently set into motion. Wondering about that also gives me pause whenever I start to blame someone for something as I realize that there is very likely possibility that a long series of events, decisions, and situations led up to what I see before me.

Actually, just about everything seems to work this way – illness included. A sickness is usually the result of a long series of events, decisions, and circumstances. What we see manifested is the tip of a vast iceberg of interconnections. Perhaps, spending some time taking a look underneath would be a good idea, and certainly recognizing the ever-present connectivity in the world gives us deeper understanding and, ultimately, compassion.

President's Message: A Summer of Community

By Carl Hangee-Bauer, ND, LAc
AANP President

May was a wonderful month for the AANP and the naturopathic profession. Our annual Federal Legislative Initiative (aka the DC FLI) and our historic meeting with the AMA were significant successes. Thankfully, there has been a period of calm in my AANP duties before beginning to ramp up our summer activities, culminating with the ever-wonderful AANP Convention in August. It’s always good to have these more quiet times to reflect on all the trends and projects in progress, as well as take a few deep breaths. Having just returned from a Hawaii vacation, I feel refreshed and ready to focus on the next steps, and to see you all in August.

Summer is a season where we tend to get out more and be with others. The longer days and warmer weather foster opportunities like picnics, beach time, barbeques, and other activities that reinvigorate and deepen our connections with friends and family.

The naturopathic community reflects this greater seasonal trend. In early summer, the various elements of our profession begin to communicate more frequently as August approaches. Committees of both the Board and House of Delegates are meeting in preparation for the business of the convention. Our scientific community is busy preparing for the Naturopathic Research Summit on August 16. Students and NDs are preparing for the ZRT Cup.

At least as important as these formal relationships is the gathering of our tribe. This year we find ourselves back at the Biltmore in Phoenix, the most popular site for the AANP Convention, as well as at the East Coast remote convention site in Stamford, Connecticut. At both venues we will come together to learn new skills, find out what’s new in our field, be exposed to new products and diagnostic tools, have fun, and reconnect with our old friends and acquaintances. The latter is one of my favorite reasons for attending the convention. It is the one week each year that I can immerse myself in my profession and deepen my relationships with my colleagues. This always leaves me reinvigorated when I return to my practice.

Whether you are an AANP member or not (why not?), please join us at either site and experience the uniqueness of our community and the joys of being together.

A few reminders:

Vote! This year we are electing a new Treasurer to the board as well as three board positions. We have eight people running for these three positions so it will prove to be a competitive election. Packets containing candidate statements and other materials will be mailed to Members shortly. Voting will begin online on July 17 and continue into the Convention until August 19.

Nominate one of your colleagues for an award. The AANP is calling all of its members to nominate qualified candidates for the 2011 AANP Physician of the Year, Corporation of the Year, VIS, and New!!! Champion of Naturopathic Medicine Award (the "Champion Award"). This year's award recipients will be recognized at the closing banquet of the AANP's 26th Annual Convention and Exposition on Saturday, August 20, 2011, in Phoenix, AZ. All nominators and nominees must be members of the AANP in good standing. Click here to learn about the individual awards and download the nomination forms.

I am already thinking about who will get this year’s Presidents Award. So many deserving choices…

Our unity is our strength, and our community – represented by the AANP – is the vehicle we have to tell the wonderful story of naturopathic medicine. I invite all of you to help us build it even better. There is much to do. So, with all of the changes in health care, advances in medical knowledge and trends, and successes in our profession, the AANP Convention is the place to be to digest, absorb and grow – and connect.

I look forward to seeing you all there.

'Til Death Due Us Part

By Bill Benda, MD, FACEP, FAAEM

Dr. Jack Kevorkian speaks at UCLA in January 2011. Photo by Halebtsi via Wikimedia Commons.

Dr. Jack Kevorkian died last Friday in Royal Oak, Michigan, from pneumonia and kidney failure. If you will remember, Kevorkian defied prosecutors and the courts to help terminally ill patients end their lives at times of their own choosing, and paid for his work with eight years in prison after being convicted of second-degree murder in the death of the last of the more than 100 patients whose suicides he assisted.

So why is such ancient history relevant to us today? Because the fact is that our unprecedented longevity, courtesy of medical technology, often brings with it incalculable pain to patients, families, and the collective economy. I clearly recall the doctor-as-god mentality of the 1970s and ’80s, with white-coated knights heroically battling death by whatever means available, unaware of and unchallenged by the wishes of the afflicted patient. This mindset has not disappeared from our professional ethic, as we find ourselves compelled to combat the incurable cancer, tube feed the severely compromised newborn, or pump the heart of the nursing home patient whose time has come to stop beating.

So where does the integrative medicine community stand on this issue? I am not aware of any research, educational conference, or journal article that has engaged our attention and conversation on the topic of facilitating another’s desired death. Dying a good death, yes. “Dying healthy,” our integrative goal for the terminally ill, that too. Reincarnation, survival of consciousness, illness as teacher, wounded healers; all discussed, explored, philosophized, and meditated upon. But not the uncomfortable social issue of actually helping another to end the journey of living. We strive to be in intimate partnership with our patients, sharing in their spiritual path as well as caring for their minds and bodies. But how should we respond if asked to participate in alleviating another’s torment through an ultimate act compassion? Or is it felony? Does our holistic philosophy lean either way? Or do we hesitate lest the wrath laid upon Jack Kevorkian visit our young and vulnerable profession?

With baby boomers heading over the hill like lemmings in the next few decades and Alzheimer’s predicted to be epidemic by the year 2020, it is time to clarify our professional stance on this issue. I personally believe that we serve each patient best by respecting their authority over what is to be their last earthly act, yielding to them ultimate control over what has become their last earthly possession. Of course the topic is fraught with legal, political, and moral jeopardy. But I am certain that this is a conversation whose time has come, a time to grapple with our responsibility to facilitate both a good life and a good death for our patients. Kevorkian’s advocacy for the right of the terminally ill to choose how they die is widely credited with sparking a boom in hospice care in the United States, encouraging physicians to become more sympathetic to their pain and more willing to prescribe medication to relieve it. We should do no less.

Will Asparagus Cure Cancer?

By Jacob Schor ND, FABNO

Photo by La Grande Farmers' Market via Flickr, used under the Creative Commons License.

If you have cancer, you have likely read that asparagus will cure it. A letter gone viral online claims this. If you haven’t seen it yet, it’s only a matter of time until a copy is forwarded to you by some well-meaning friend or relative.

Those of us who specialize in naturopathic oncology hear about this asparagus business often from our patients, many of who assume the information is true. It’s not.

There is no reason to believe that asparagus will cure cancer. It may actually make a few cancers worse.

Here is what we do know about these claims:

The “Asparagus Cure for Cancer” first appeared in print in the February 1974 issue of Prevention magazine. A second, similar article was printed in the December 1979 issue of Cancer News Journal, a magazine once distributed in health food stores. Both articles claim that a dentist named Richard R. Vensal discovered that eating asparagus could cure cancer.

According to the letter, a cure can be achieved by consuming four tablespoons of pureed cooked asparagus twice a day. Improvement is supposedly seen in two to four weeks.

Unfortunately there is little reason why we should believe this information. Richard Vensal never had anything published to substantiate this claim.

There is one study from 2009 that suggests asparagus has an anti-cancer effect. Chinese researchers reported that a chemical, which they named asparanen A, showed an anticancer effect when added to liver cancer cells.ⁱ

No studies describe the results of feeding asparagus to animals with cancer. Nor are there any published clinical trials on giving asparagus to human cancer patients.

It is certainly widely understood that diets high in vegetables are anticancer. Yet no evidence singles out asparagus in particular, suggesting it has an anticancer effect. There may be some health benefits from eating asparagus because it is a vegetable, but there is little reason to think that asparaguses are special.

In contrast there is substantial information on the anticancer effect of other vegetables. For example, a current search of the National Institute of Health’s National Library of Medicine, lists 597 published articles related to the anticancer effect of broccoli.ⁱⁱ A search for published papers on garlic and cancer yields 648 references.ⁱⁱⁱ

There are only two clinical trials involving asparagus and humans. One paper published in 2009 describes a study in which patients with high blood pressure took a combination of parsley and asparagus extracts in the hope that their blood pressure would go down. Unfortunately, no effect was seen.^iv An earlier study published in 2008, reported that a combination of asparagus and elderberry extracts helped patients lose weight.^v Losing weight is not curing cancer.

While there is little reason to think that asparagus will cure cancer, there is good reason to think that asparagus may make some cancers, in particular acute lymphoblastic leukemia (ALL), worse.

There is a long established link between asparagus and leukemia. In 1953, John Kidd discovered that blood serum taken from healthy guinea pigs, if injected into mice, killed leukemia cancer cells.^vi It wasn’t until ten years later that John Broome explained why. Guinea pig blood contains an enzyme called l-asparaginase, which breaks down the amino acid l-asparagine. Healthy cells make l-asparagine, but certain leukemia cells do not. These leukemia cells must rely on nearby healthy cells to supply them with l-asparagine. The enzyme in the guinea pig blood breaks down the needed l-asparagine depriving the cancer cells of this chemical that they need to grow.^vii

L-asparaginase enzyme is sold as a drug (Elspar) and is now part of the standard protocol used to treat acute lymphoblastic leukemia (ALL). Taking the drug decreases l-asparagine and starves the cancer cells. Most types of cancer do make l-asparagine, so Elspar is only useful in treating a few specific cancer types.

As the names hints, asparagus contain l-asparagine. Eating asparagus would seem ill advised for people who have cancers that respond to l-asparaginase. This enzyme may be useful in treating lymphoma and multiple myeloma.^{viii ix} Eating asparagus may make all of these cancers grow faster, most especially ALL.

People diagnosed with cancer are often desperate to do everything in their power to fight the disease. They grasp onto every story and rumor about anything that might possibly help them. The myth that asparagus cures cancer is a good example. Eating daily doses of asparagus will not cure anyone. Some of these people may actually worsen their situation.

A wiser course of action than believing everything you read online would be to consult a medical practitioner who specializes in naturopathic oncology. There is ample knowledge and evidence that dietary changes and specific foods and supplements may be useful in fighting cancer. It makes sense to base these diet and food choices on evidence and knowledge rather than web-based ‘urban myths.’ When you need specialized knowledge go to a specialist.

The Oncology Association of Naturopathic Physicians (OncANP), an affiliate of the American Association of Naturopathic Physicians, lists naturopathic doctors who specialize in caring for cancer patients on their website: www.oncanp.org

This group tests and provides board certification in naturopathic oncology to those members who meet specified standards of education and experience.

If naturopathic physicians are specialists in natural medicine then OncANP members are specialists in using natural medicine in an oncology setting.

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ⁱ Liu W, Huang XF, Qi Q, Dai QS, Yang L, Nie FF, Lu N, et al. Asparanin A induces G(2)/M cell cycle arrest and apoptosis in human hepatocellular carcinoma HepG2 cells. Biochem Biophys Res Commun. 2009 Apr 17;381(4):700-5.


ⁱⁱ To search yourself, go to: http://www.ncbi.nlm.nih.gov/pubmed?term=broccoli%20and%20cancer


ⁱⁱⁱ To search yourself, go to: http://www.ncbi.nlm.nih.gov/pubmed?term=garlic%20and%20cancer


^iv Chrubasik S, Droste C, Black A. Asparagus P(R) cannot compete with first-line diuretics in lowering the blood pressure in treatment-requiring antihypertensives. Phytother Res. 2009 Sep;23(9):1345-6.


^v Chrubasik C, Maier T, Dawid C, Torda T, Schieber A, Hofmann T, Chrubasik S. An observational study and quantification of the actives in a supplement with Sambucus nigra and Asparagus officinalis used for weight reduction. Phytother Res. 2008 Jul;22(7):913-8.


^vi H. D. Moon Presentation of the Gold Headed Cane to John G. Kidd. February 24, 1973. Am J Pathol. 1973 October; 73(1): 1–6. PMCID: PMC1904051
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1904051/pdf/amjpathol00248-0005.pdf


^vii Broome JD. Evidence that the L-asparaginase of guinea pig serum is responsible for its antilymphoma effects. I. Properties of the L-asparaginase of guinea pig serum in relation to those of the antilymphoma substance. J Exp Med. 1963 Jul;118:99-120.


^vii Jaccard A, Gachard N, Marin B, Rogez S, Audrain M, Suarez F, et al. Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study. Blood. 2011 Feb 10;117(6):1834-9. Epub 2010 Dec 1.


^ix Taylor CW, Dorr RT, Fanta P, Hersh EM, Salmon SE. A phase I and pharmacodynamic evaluation of polyethylene glycol-conjugated L-asparaginase in patients with advanced solid tumors. Cancer Chemother Pharmacol. 2001;47(1):83-8.