ARLINGTON, VaStudies indicate that about half of cancer patients are now using complementary and alternative therapies, a finding that is motivating many medical oncologists to discuss such therapies with their patients and make recommendations about their use.
One such physician is Jeremy R. Geffen, MD, a board-certified medical oncologist and founder and executive director of the Geffen Cancer Center and Research Institute, Vero Beach, Florida.
Dr. Geffen and other physicians spoke at the Second Comprehensive Cancer Care Conference, co-sponsored by the University of Texas Houston Medical School and the Center for Mind-Body Medicine, in collaboration with the National Cancer Institute and National Center for Complementary and Alternative Medicine.
Dr. Geffen described how, at age 19, he became interested in Eastern philosophies. After medical school at New York University, he visited India and Tibet to learn about Eastern medical and spiritual traditions, and has since made numerous return trips to learn more. In 1994, two years after completing fellowship training in hematology and oncology at the University of California, San Francisco, he established the Geffen Cancer Center to offer cancer patients the best of both Western and Eastern traditions.
In his talk, Dr. Geffen emphasized strongly that the foundation of modern cancer care isand should bemainstream, conventional Western medicine. This forms the basis for the evaluation and management of patients at the Geffen Cancer Center. However, he believes these therapies are but the beginning of a patients healing journey, because cancer often challenges the mind, heart, and spirit as much as the body. Many Americans have become dissatisfied with Western medicine, he explained, because it focuses primarily on the disease, rather than on the person with the disease.
Thus, in addition to state-of-the-art conventional cancer treatments, Dr. Geffen offers his patients a Seven Level Program that addresses the whole person. It provides education; psychosocial support; advice about nutrition and alternative and complementary therapies; mind-body healing techniques; and other elements of Eastern philosophy.
When people are diagnosed with cancer, they usually feel terrified and overwhelmed by the questions confronting them, Dr. Geffen said, and these need to be answered in a clear and coherent way. The first step in his Seven Level Program is designed to do just that, by addressing patients questions and concerns carefully and conscientiously, so they can feel confident and secure enough in their medical care to allow deeper levels of healing to begin, he said.
Level Two focuses on the importance of psychosocial support. Many studies, Dr. Geffen pointed out, have shown that social isolation is a risk factor for mortality from all dis-eases, including cancer. So Dr. Geffen and his co-workers encourage patients to get involved with support groups, church organizations, or other available programs.
In Level Three, patients are taught to view their bodies not as a machine that simply needs to be fixed, but from the Eastern medical perspective: as a garden that can be nourished and supported in a wide variety of ways, especially during cancer treatment. Here, patients explore the role of diet and nutrition along with a host of complementary therapies, including massage, yoga, relaxation, guided imagery, acupuncture, and Healing Touch, among others. Patients are also encouraged to get regular exercise along with plenty of fresh air and sunshine.
In Level Four, patients are ready to turn inward, with the help of either support groups or private counseling, to defuse the difficult emotions of fear, anger, guilt, rage, and heartbreak that their cancer has provoked. This process is profoundly important, Dr. Geffen said, particularly if patients are to truly heal from their disease.
In Level Five of the program, patients are shown how the unconscious thoughts, beliefs, and meanings that they attach to all the events in their livesincluding cancercan deeply affect their day-to-day experience. As an example, he described two male patients at his cancer center, each with metastatic melanoma. The men had many features in common, including disease stage, socioeconomic status, and family support. Both were also receiving the same standard chemotherapy. Despite these numerous similarities, one patient was consistently angry and miserable while the other was mentally and emotionally at peace.
The reason? The former realized that he unconsciously believed he had gotten cancer because he was a sinner who deserved to be punished. The latter acknowledged that he didnt know why he had gotten cancer but believed it was making him a better person and bringing him closer to his creator and family. Dr. Geffen and his staff assisted the first patient in finding a better outlook about his disease. While this did not change his ultimate outcome, it profoundly transformed his experience of cancer, and that of everyone around him, Dr. Geffen said.
Level Six asks patients to assess their lives and formulate a list of realistic goals for the coming year. Such life assessments, Dr. Geffen said, give patients a sense of control, focus, and fulfillment, and can be very helpful during challenging times. Patients with end-stage cancer are encouraged to explore ways by which they can achieve a sense of completion and fulfillment in their remaining time.
Finally, in Level Seven, patients are guided to a deeper level of healing by acknowledging the nonphysical, spiritual dimension of all of us, which Dr. Geffen calls the pure consciousness that connects all beings. Each day, he said, patients should take time to be still, to enter into prayer or meditation, or simply to sit quietly in nature to connect with this deeper dimension of themselves.
Dr. Geffen has recently completed a book describing his comprehensive approach to cancer care, to be published in February 2000 (The Journey Through Cancer: An Oncologists Seven-Level Program for Healing and Transforming the Whole Person, NY, Crown Publishers). The Geffen Cancer Center also has a website at www.geffencenter.com.