Integrative Oncology Setting

Transcription

1 04/25/15 Chiropractic in an Integrative Oncology Setting Charles A. McDonald, DC Chiropractic Physician Director, Chiropractic Services Cancer Treatment Centers of Western Regional lmedical lcenter Goodyear, AZ 1

2 Cancer Treatment Centers of America

3 CTCA Chiropractors Newnan, GA (Atlanta Suburb) James Rosenberg, DC, National Director Craig Steingraber, DC Goodyear, AZ (Phoenix Suburb) Chuck McDonald, DC Philadelphia, PA Jeffrey Sklar, DC Tulsa, OK Jack Sibley, DC Zion, IL (Chicago Suburb) Brent Paxton, DC

4 Credentialing The Joint Commission (JC), formerly the Joint Commission on Accreditation of Health Care Organizations, accredits over 20, different health care entities. Joint Commission credentialing is the standard that all successful hospitals, including government facilities, attain. Failure to have JC accreditation ti would very likely l lead to the closure of a hospital. The Joint Commission now recognizes chiropractors as physicians

5 It s About Time!!! The new Joint Commission standard of care from January 2015 for pain management now includes chiropractic and acupuncture The standard d affirms that t tx strategies t include both pharmacologic AND non-pharmacologic approaches This is a huge cultural shift. Chiropractic is mentioned by name as an option. This means that over 20,500 hospitals will have to show documentation ti that t they have referred out for chiropractic etc., or risk losing accreditation - from ACA NEWS Jan/Feb 2015 by Lori Burkhart

6 Cancer Consult: Expertise for Clinical Practice Syed A. Abutalib (Editor), Maurie Markman (Editor) ISBN: pages September 2014, Wiley-Blackwell Chapter 140 Musculoskeletal care in oncology, pg. 893 by James E. Rosenberg, DC Charles A. McDonald, DC

7 Review of Cancer Facts and Metastases

8 Cancer Facts More than 1.2 million Americans develop cancer per year A new cancer is diagnosed every 30 seconds in the U.S. Lung and prostate are the top killers of men Lung and breast are the top killers of women One in two men will be diagnosed with cancer One in three women will be diagnosed with cancer Heart disease and cancer are neck and neck as far as leading cause of death in the U.S. Reference: National Cancer Institute

9 Metastatic Cancer Cancer that has spread from it s primary site; it maintains the same name and type of cancer cells as the original cancer 3 most common sites are lung, liver, & bone A single tumor is a metastasis or metastatic tumor, 2 or more metastatic tumors are called metastases Bone mets can occur in any bone but are most often found in bones in the center of the body (spine, pelvis, skull, ribs) About 70% of metastatic spine tumors are in the thoracic area, while 20% are lumbar and 10% cervical spine The sites of metastatic bone lesions in order of frequency: Vertebrae, Femur, Pelvis, Ribs, Sternum, Humerus, Skull

10 Where Does It Spread? Bladder: liver 47%, lung 45%, bone 32%, peritoneum 19% Breast: bone 65%, lung 62%, liver 58%, also pleura, brain, adrenal Colorectal: liver 28%, lung 12%, bone 2% Kidney: lung 75%, soft tissue 35%, bone 20%, liver 20%, adrenal gland 19% Lung: adrenal gland 40%, liver 3-50% 50%, bone 20% Melanoma: skin/muscle 55%, lung 47%, brain 37%, liver/spleen 27%, bone 21%, GI tract 17% Ovary: liver 46%, lung 36%, pleura 25%, adrenal gland 18%, spleen 17%, bone 11% Pancreas: liver 60%, lung 17%, bone 11%, in exocrine the peritoneum, brain, pleura, bone are 27%+ Prostate: t bone 90%, lung 46%, liver 25%, pleura 21%, adrenal gland 13% Stomach: liver 37%, lung 16%, bone 16%, lymph nodes 14% Thyroid: lung 49%, bone 24% Uterus: liver 33%, lung 35%, bone 15-29%

11 Lytic vs. Blastic Lytic bone metastases occur in the following cancers: renal, lung, breast, thyroid, melanoma, chordoma, paraganglioma, GI tract, urothelial, ovarian, and multiple myeloma Blastic bone metastases occur in the following cancers: prostate, breast, carcinoid, lung, GI, bladder, nasopharynx, and pancreas Remember both lytic and blastic lesions are susceptible to fracture and both can cause bone pain

12 Practice Building Tip 12

13 What Is Integrative ti Oncology Care?

14 What Is Integrative Oncology Care? Team approach to patient care Leading edge conventional oncology treatments Broad array of complementary and alternative therapies Offered under one roof Individualized to meet the needs of each patient mind, body and spirit Delivered in a seamless manner by a single team

15 Patient Empowered Care Model

16 Naturopathic Medicine Surgical Oncology Chiropractic Pastoral Care Medical Oncology Mind Body Mdii Medicine Integrative Patient Care Model & Family Acupuncture Radiation Oncology Oncology Rehab Nutrition

17 Chiropractic & Cancer Pre-existing existing conditions Anxiety and stress from a diagnosis of cancer Side effects of chemotherapy and radiation: tissue fibrosis, muscular adhesions, headaches, nausea, neuropathy, fatigue Acute pain from new conditions due to positioning for radiation treatment or from sedentary situations during in-patient status Pain from gait abnormalities or other functional deficits Post surgical trauma to connective tissues and joints

18 No Chiropractic Primary bone cancer: no treatment within five spinal segments or to the affected extremity Unstable bone metastases: no force treatment available within five spinal segments (instrument?) Cord compression from space occupying lesion Do not treat any extremity with a thrombosis Extreme low levels of platelet count (below 50k) An essential part of chiropractic treatment of a cancer patient is access to the most recent records: PET, CT, MRI, X-ray, blood work, etc. It is just as important to know what you can t do as can.

19 M.D. Testimonials Chiropractic care has been of benefit for my patient s quality of life by improving i their pain, mobility and functional capacity. These are measurable, and in oncology can often positively impact other factors such as overall survival. Anthony Perre, MD, Medical Director of New Patient Intake, Eastern Regional Medical Center Chiropractic care offers immense value to our patients. In a brief visit, patients can have alleviation of their muscle, joint and soft tissue pain. Pain relief greatly improves their quality of life. I believe that Chiropractic is an integral part of our comprehensive care model. Due to personal experience, I am a firm believer. Glynis Vashi, MD, Intake Physician, Midwestern Regional Medical Center

20 M.D. Testimonials Chiropractic care at Cancer Treatment Centers of America is an integral and potent t weapon in our integrative ti approach to cancer care. In combination with naturopathic care, nutrition and psychosocial support, this treatment helps provide the broadest support for our patients as they fight to restore their health. Jeffrey M Weber, MD, Chief of Medicine, Director of Gastroenterology and Metabolic Support Services, Western Regional Medical Center "From patient feedback, the incorporation of chiropractic medicine into integrative oncology definitely adds value for our comprehensive care model. " Glen J. Weiss, M.D., M.B.A., Director of Clinical Research, Western Regional Medical Center

21 Outcomes

22 Colon Cancer Survival, Stage IV

23 Lung Cancer Survival, Stage IV

24 Pancreatic Cancer Survival, Stage IV

25 Prostate Cancer Survival, Stage IV

26 Breast Cancer Survival, Stage IV

27 Conclusions 27

28 Key Take Aways CTCA has been using a truly integrative approach focused on cancer patients, and as you have seen had tremendous results. There is much room for expansion of chiropractic services to other aspects of hospital care. Collaboration is much better for both the patient and our profession. Chiropractic is needed and requested by patients in a hospital setting. We need to be the front runners in the Integrative health care model.

29 Integrative Cancer Care People diagnosed with cancer engage upon a course of healing that encompasses: Education and information to create an optimal treatment plan State of the art conventional treatment options Collaborative Co-management Providing a truly integrative approach to care can play a crucial role in improving outcomes and quality of life. Chiropractic deserves to be a part of that!

30 Partnering Together CTCA has embraced the chiropractic profession and it is my opinion o that we need to embrace them back We want to be a resource and a solution for you and your practice and patients Referring a patient, friend, or family member to us for care is a Win-Win-Win You can feel good about referring to a pro-chiropractic likeminded facility that will encourage your patient to continue seeing you for their chiropractic care CTCA gets the opportunity to love and serve another patient The patient gets to be treated at a state of the art facility that offers whole person care and has better outcomes Again, we want to be a resource and a solution for you Call me anytime on my cell:

31 Questions

32 Thank You!