Hodgkin’s Lymphoma: An Environmental Scan
Table of Contents
Of all the current discourse surrounding cancer, diet and particularly nutritional science may in fact be the most complex, controversial yet biologically plausible pathway to treating cancer and importantly preventing cancer. There is intense debate regarding various specific nutritional approaches to preventing and treating cancer. It is clearly beyond the scope of this report to review all the nutritional science; however, it is a notably important body of information and at the very least pertinent to introduce in this discussion. The following section provides an overview of selected approaches to diet, supplements and specific approaches to therapy using naturally occurring substances and nutritional approaches in treating cancer as a whole.
The scientific debate of the effectiveness of many approaches discussed below is the current discourse among many researchers and clinicians. There are a number of methodological, clinical even political issues that impede the development of rigorous scientific investigation and evaluation in the area of diet and nutrition along with other forms of alternative therapy for cancer. Where publications do exist stating the benefits of approaches beyond conventional treatments, there are various other sources refuting their claims. Furthermore, researchers are often caught in the middle of an intense methodological ‘rock-and-a-hard-place’ situation. In medicine, it is standard research practice that new and emerging therapies designed to fight disease go through a rigorous review prior to any type of wide spread acceptance and approval for use with human patients. Additionally, levels of evidence are clearly outlined and followed, whereby randomized double-blind controlled trials (RCT’s) are the ‘elite’ of all research study designs in medicine and for good reason. The methodological practices and scientific conclusions require intense scrutiny. However, some researchers, including Dr. Colin Campbell argue that the RCT is unequivocally the incorrect approach to take with nutrition science as it is over-focused on one entity under examination and associated with one outcome; the RCT is highly suitable to pharmacological studies where one drug is examined for its association regarding one particular outcome; however not well suited for investigations in the area of nutritional science (Campbell 2008a).
Common to alternative therapies is the small-group or case-study whereby individual outcomes and experiences are key to recording what impact treatment had on the patient’s health status. Despite numerous positive outcomes experienced by a number of patients using AT’s, it is impossible to deem many alternative therapies approaches successful in treating cancer. Scientifically, there are always other factors, mediator variables and issues of methodological approaches surrounding how treatment outcomes were documented to definitively declare such an intervention effective in reducing, eliminating or even preventing a cancer. It is important to remain crystal clear, there are sound principles at play in this debate and such research principles are in place, once again for good reason. However, having said that, it also sets up the situation where alternative therapies are disregarded in cancer therapy. There are researchers, clinicians and individuals with cancer along with survivors, who strongly state the lack of advancement in the development of alternative therapies for cancer is the result of an over-focus on pharmaceutical agents and a lack of endorsement at the research level into not only alternative treatments but the need to recognize, endorse and disseminate numerous studies completed in the area of nutritional science that clearly demonstrate the positive effects diet can have on both preventing and treating cancer (Campbell 2010).
Overall, this does not mean that alternative approaches to the treatment and prevention of cancer do not work; it does mean we cannot make empirical statements using strong evidence to state that they do. This is an important distinction. Because we do not have the scientific evidence to date, based on current clinical research protocols in the peer-reviewed academic journals to declare that alternative therapies can treat or even reverse certain cancers under certain circumstances does not make such interventions ineffective. It does mean we have not shown the success of such interventions successfully using current empirical and methodological requirements in research. There is no way to empirically demonstrate many of these interventions definitively impact cancer; however, there is a plethora of experience on the part of clinicians, researchers and patients to suggest otherwise.
The purpose of this section of the report is to leave the Rasch Foundation with information that is worth considering and possibly investigating in more depth in the future. Despite an inability to declare such interventions empirically relevant, other supporting evidence from various sources strongly suggests that all have biologically plausible explanations for why and how they can impact the burden of suffering for individuals with cancer. It must be emphasized that very little research to date in this area has focused on HL, particularly in the area of diet. Some preliminary work is underway for Non-Hodgkin’s Lymphoma; however, there is a great deal of work to do. Therefore, the discussion below is referring to cancer in general versus any specific type of cancer unless otherwise stated.