The Cancer Terrain: Key to Organizing an Integrative Cancer Treatment Plan

  • June 10, 2019
Cancer Treatment Plan

Written By:  Todd Robinson, N.D.

Every day I consult with and advise clients on how they can integrate natural medicine into their cancer treatment plans.  In doing this work, I’ve seen firsthand how little the average medical oncologist discusses topics like diet, nutritional supplements, and botanical medicines with their patients.  In fact, the research suggests only about 10% of oncologists actually initiate conversations about herbs and supplements with their patients (PMID: 25403205).

And, since a majority of cancer patients use natural medicine at some point during their journey (PMID: 27444312), this leaves a pretty big gap in cancer care.  This gap is often filled by the patients themselves with a heavy assist from the internet.  The end result is usually confusion.

I see this every day.  At their first consultation, almost all of my clients present me with a lengthy list of self-prescribed dietary changes and natural products that they are already using.  These homemade regimens are often poorly designed. That is, they contain unnecessary redundancies while completely missing other potentially important interventions. It’s not uncommon for people to be taking 4 or 5 natural products to support healthy immune function while completely missing other targets for inhibiting cancer growth.

Here’s where the concept of the cancer terrain can be helpful.  “Cancer terrain” is a shorthand phrase referring to the total biochemical and physiologic environment within the body as it relates to cancer.  It also includes an acknowledgment that certain conditions within that environment can be more or less friendly to the development, growth, and spread of cancer cells.  It’s analogous to the soil. Just as some soil supports the growth of some plants but not others, some conditions within the body are more or less supportive of cancer growth.  

As such, the cancer terrain is a key concept for organizing an individualized integrative cancer treatment plan.  

The cancer terrain includes many elements.  In my work, I typically focus on the elements of blood clotting, immune function, inflammation, metabolic health, and stress chemistry.  Each of these elements has been shown to impact cancer progression and outlook.

Take, for instance, inflammation.  Elevated inflammation is friendly to cancer, while balanced inflammation is not.  Therefore, assessing and addressing inflammation can be helpful.

One reliable and remarkably inexpensive method of assessing inflammation is the neutrophil-to-lymphocyte ratio (abbreviated as NLR).  Virtually every cancer patient receiving treatment will have their red and white blood cell counts assessed through a CBC (i.e., complete blood count).  If that CBC includes a differential, it will also provide the absolute number of neutrophils and lymphocytes present in the sample. By looking at the ratio of one to the other, one can get a sense of the systemic inflammation present in that person’s body.  A high ratio, meaning a much greater number of neutrophils to lymphocytes, is considered indicative of high inflammation and is associated with a poorer cancer prognosis (PMID: 23602134).

Furthermore, emerging evidence indicates that positive changes in the NLR in response to conventional treatment is predictive of a better outcome (PMID: 26924770; PMID: 29930287; DOI: 10.1200/JCO.2018.36.4_suppl.17).  Improving the NLR may be a worthwhile goal in cancer treatment.  

Natural therapies can impact the NLR.  

For instance, a 4-week trial of diet and exercise in overweight adolescents found significant improvements in the NLR (PMID: 22131204).  While this trial is not specific to cancer, it does highlight the potential of lifestyle change to impact the NLR.  Vitamin D levels are also connected with the NLR – lower vitamin D levels are associated with a higher NLR (PMID: 27478451).  Low vitamin D levels are easily corrected through appropriate supplementation, and such supplementation might be expected to improve the NLR.  Evidence also suggests that green tea might be expected to improve NLR (PMID: 12682270).  The list goes on.

While I have so far focused only on inflammation and the neutrophil-to-lymphocyte ratio, the other elements of the cancer terrain can also be assessed and imbalances in them can be addressed using natural medicines.

By understanding the big picture of a person’s total cancer terrain, one can focus on the elements that require more attention and support.  A cancer patient with imbalanced stress chemistry will require a different set of interventions than one with imbalanced metabolic health.

The cancer terrain is a key organizing principle for developing a comprehensive yet focused integrative cancer treatment plan.  Consulting a healthcare professional with expertise in this area is absolutely a good idea for cancer patients seeking to integrate natural medicine into their treatment plan.

Dr. Robinson is owner and natural cancer advisor at Wellness Working Group.  He consults with clients throughout the U.S. on the safe, effective, and evidence-based integration of natural medicine into their cancer care.         

To learn more please visit https://wellnessworkinggroup.com/