In this episode, Dr. Diane Reidy-Lagunes speaks with Dr. Jun Mao, Chief of MSK’s Integrative Medicine Service, and Jason Hou, herbalist and acupuncturist at MSK, to break down the facts about alternative medicine—an approach that combines conventional cancer treatments like surgery, radiation, chemo, immunotherapy and targeted treatments, with holistic therapies like acupuncture, mindfulness, natural herbs and supplements. They tackle common misconceptions about alternative medicine, explaining what the science says, what’s safe, and what to avoid. Offering guidance on how these natural therapies can complement other cancer treatments – and how to recognize misleading claims – this episode empowers patients and caregivers with the knowledge they need to make informed choices about their cancer care and the use of alternative therapies.
Dr. Diane Reidy-Lagunes:
A cancer diagnosis is a challenging journey and it's understandable to seek all available options for healing. I get that. As a doc, I too want to know what else might be out there. We're all looking for ways to better treat cancer. The truth is, however, Dr. Google floods us with miracle cures that often lack any evidence and may even be harmful. So today we're going to dive into integrative therapies and separate fact from fiction. We'll get advice from world experts who dedicate their lives to testing and prescribing integrative approaches to help our patients.
Hello, I'm Dr. Diane Reidy-Lagunes from Memorial Sloan Kettering Cancer Center and welcome to Cancer Straight Talk. We're bringing together national experts and patients fighting these diseases to have evidence-based conversations. Our mission is to educate and empower you and your family members to make the right decisions and live happier and healthier lives. For more information on the topics discussed here, or to send us your questions, please visit us at mskcc.org/podcast.
Today, we are thrilled to be joined by Dr. Jun Mao, the chief of MSK's Integrative Medical Service. Dr. Mao combines Eastern and Western approaches to help patients manage symptoms that may arise from the conventional chemotherapy treatments, which include pain, fatigue, insomnia, hot flashes, anxiety, and depression. And here's a fun fact: MSK started its Integrative Medicine Service back in 1999, and it was the first integrative oncology program in the country. It was built on the premise that healing cancer goes way beyond standard medical treatments, and promoting wellness in the mind, body, and spirit are critically important. We're also joined today by Jason Hou, who is an herbalist and acupuncturist here at MSK. Jason will share his expertise on the role that herbs and supplements can play in cancer treatment. Jason and Jun, thank you so much for joining us today.
Jun, if we could just start off, can you define for us what integrative medicine actually is and how these therapies can help our patients?
Dr. Jun Mao:
To a lot of patients and families, the term can be very confusing. I think the term the public knows more is called alternative medicine. So let me start with the definition. Alternative medicine is using a therapeutic approach instead of a conventional treatment such as chemotherapy and surgery and radiation.
Integrated medicine, on the other hand, brings therapies and practices often from other cultures and traditions – such as acupuncture, mindfulness, yoga, herbal supplements, and lifestyle modifications such as exercise, stress management, sleep management, diet – together with conventional oncological treatment to help patients feel empowered to be active participants during and beyond cancer treatment. So the major differentiator is to use it in a synergistic way rather than choosing alternative medicine and foregoing conventional treatment.
Dr. Diane Reidy-Lagunes:
I know firsthand how you've helped my patients with symptoms that arise from either the treatments and/or the disease. Can you explain how one might approach, as a physician like yourself, these types of integrative therapies for different types of patients?
Dr. Jun Mao:
I do think integrative medicine helps patients in several ways. In terms of the symptoms, we now have evidence-based interventions backed by randomized clinical trials for specific symptom management. For example, acupuncture and massage can be utilized for pain management during cancer treatment, as well as in palliative care or in survivorship. Exercise, yoga, or tai chi can really help patients to reduce their fatigue during treatment and survivorship. Cancer can cause a lot of psychological distress such as anxiety, depression, worry, and fear of recurrence. Therapies like mindfulness or music therapy can be incredibly powerful.
So as a physician, I first of all listen to the patient's story, understand their needs, and understand what they prefer to do. Then I work with them to incorporate their preference to formulate a plan that is right for that individual. A lot of patients feel this profound loss of control. But with the integrative approach, with a lot of the options we have, they can choose. They're actively engaging in that decision making. So by participating in integrative care, we hope to return some of that level of control back to our patients.
Dr. Diane Reidy-Lagunes:
I love it. When you think about prescribing these different types of integrative approaches to the patient, does that tend to be symptom-specific, disease-specific, or both?
Dr. Jun Mao:
When we think about an integrated approach, we look at three major things from a medical decision perspective. Number one is the symptoms.
The second is the specific type of disease. There are certain diseases like breast cancer and ovarian cancer that are very hormone-driven, so we need to be careful about hormone-inducing herbs and supplements. And then there are certain disease like GI cancers that tend to induce weight loss, poor appetite, nausea, vomiting – those things are particularly profound in those type of cancers – so we try to work with patients on diet to allow them to maintain their weight and have appetite.
Another key factor driving the decision making is the treatment phase. For early-stage cancer when curative treatment is very evidence-based, we need to really prioritize the oncological treatment.
In the context of survivorship, a lot of people don't want to add another pill to manage their symptoms. They feel like, “Gosh, I'm taking this pill. Yes, it helped me with this problem, but it gave me this side effect and two other problems, and I need to take two other pills.” So they want something more non-pharmacological.
We're also dealing with people living with advanced cancer, maybe closer to end of life. In that setting, the lines of chemotherapy are even exhausted, so we work with families and patients to understand: What is important to you? What are the goals for your care? We really design the treatment that is appropriate for them.
Dr. Diane Reidy-Lagunes:
That's right. Along those lines, your team really helps us take care of a patient as a whole and I think some of the symptoms that you try to address, including mind-body, is so critically important. But the treating of the cancer is clearly something that our patients are most concerned about at times. Can you talk to us a little about preventing it from recurrence and/or treating it as sort of an anti-cancer therapy treatment?
Dr. Jun Mao:
When we think about treating cancer, what is really the goal of that treating cancer? It’s to live a better quality of life for a longer period of time, right? With that goal, if we can use appropriate integrative therapies like exercise or mindfulness to allow you to mitigate the side effects of treatment, then you can tolerate the cancer treatment better and eventually you will have a better quality of life and longevity of life.
But to envision the therapies we do to target the cancer cell specifically, unfortunately the data is just not there. We don't have good high quality clinical trials, so we have to be very clear about where the evidence is and where the evidence is not.
So I don't think the evidence for integrative therapy is treating cancer as a biological disease. But where the evidence is incorporated together with conventional oncological treatment, we can improve the quality of life and potentially the longevity of life.
Dr. Diane Reidy-Lagunes:
Yeah, I think that's so critically important. I've heard you speak a lot about, in addition to managing symptoms and trying to lower stress, the power of human connection is something that is hard to do a study on but probably does have something there that I think is really fascinating. Can you talk to us about the role of mental health, lowering stress, and how integrative medicine may be a solution, particularly for some of our patients that may not have integrative therapies at their hospitals?
Dr. Jun Mao:
There are actually observational studies looking at things like social connectivity or loneliness as a factor associated with poor outcomes. We are actually studying this in the context of clinical trials with some of the programs we do.
One of the key factors is trying to connect people, connect the community of cancer patients and cancer survivors, to support one another and also be supported by their extended network. During our integrative medicine consultation, I always ask the patient, “What is your family situation? What is your social network? Do you feel like you're getting adequate support in that way?” The range of responses really varies.
I think, as a health system and a society, we need to figure out better ways to support patients beyond the walls of the hospital and use a variety of other social or religious or other programs to help people to feel that they are going through this horrible disease with love and support around them.
Diane Reidy-Lagunes:
Jason, I do want to talk about alternative approaches because I get asked this every single day. Our patients just want to know, and there are a lot of popular alternative therapies out there. So if you don't mind, we're just going to go through them.
Let's start with Ivermectin. What is it, and does it help treat cancer?
Jason Hou:
Ivermectin is actually an anti-parasitic. It actually has a Nobel Prize. But in terms of Ivermectin for treating cancer, right now we just cannot say that this drug can treat cancer.
Diane Reidy-Lagunes:
So a great drug to treat parasites, but not for cancer. What about cannabis oil?
Jason Hou:
Cannabis oil, it's often referred to as Rick Simpson's oil. It's a highly concentrated oil. But no. It's only anecdotal. Some may benefit from just rubbing oil on the lesion, but it's very controversial.
We even got another oil that National Geographic approached Dr. Mao about to ask whether castor oil has any effect on breast cancer because on TikTok there's this viral video that says just by rubbing castor oil on the lesion, you can cure the breast cancer. National Geographic had to quickly come to Dr. Mao and say, “Hey, is there any truth to this?” Same thing. We had to quickly go through all the public literatures see if there's any clinical studies, and then the results came back. There's no evidence to support castor oil curing any cancer.
Dr. Diane Reidy-Lagunes:
I love how you said that. We're not just naysayers and saying, “Don't even think about it.” You're dedicating your lives to trying to explore these therapies and options and looking at the best available data. It's just not there.
Jason Hou:
Some of these therapies are very cultural, so they might have been passed down from generations. Maybe there's some science to it that we still haven't explored. So I always have to go back to the literature and see if there's any study relevant to this particular herb and cancer, and we publish it.
Dr. Diane Reidy-Lagunes:
In fact, there was a recent study that suggested that the combination of cannabis oil and immunotherapy may not be so good. So in patients that are on immunotherapy and also taking cannabis, that immune response may have been blunted. I think that's critically important because immunotherapy may be lifesaving for many different types of cancers.
What about high-dose vitamin C?
Jason Hou:
That's also a very controversial topic. When you are vitamin C deficient, you get scurvy, and we use vitamin C as anti-scurvy. But to have it in high doses and intravenously administered, it works in a different way. Right now there are a few studies going on, but we just don't have evidence to support what population high-dose vitamin C works in. So until then, we're going to say no to vitamin C.
Dr. Diane Reidy-Lagunes:
Yeah, I think that's right. For our listeners, there was a very small study in a very small journal on the role of vitamin C plus chemotherapy for pancreas cancer. Although the results looked positive and it got a lot of press, there were a lot of major flaws with that study. So again, it's not that we don't want to give vitamin C out to all of our patients, but there were so many problems with that study that most of us don't feel comfortable saying that the data itself was exciting enough to do something different or make it practice-changing.
Dr. Jun Mao:
Also, things like high-dose vitamin C are not new, right? It's not something so obscure that you couldn't develop a formulation. So the fact is, we haven't really seen any convincing data beyond the anecdote. And it's not cheap when a patient's paying out of pocket for those types of therapies. It's not cheap.
Dr. Diane Reidy-Lagunes:
No, it's not. And I’m very glad we're talking about it because the reality is people are doing that and though some may be blessed to be able to afford it, others can't. I think that if the data were there, there would be more excitement about it.
There are other studies as well with other types of vitamins where it actually made it worse. These drugs, people think that they, quote, go to the immune system. But they can actually go to the cancer as well, right? The cancer cells are the ones that are often taking up these nutrients in a faster way than our normal cells. So again, just use caution. We just don't have enough data.
What about turmeric?
Jason Hou:
It's also a very cultural remedy. When I hear turmeric, my family yanks it out from the ground. We wash it, we dice it, we cook it with fish, and we drink it as a soup. It's good for GI, it's good as an anti-inflammatory. But in the US, it's in a capsule. There are studies in the anti-inflammatory realm, but in regard to cancer, we don't know. As a food, yes, but as a high-dose supplement? Maybe for anti-inflammatory aches and pains, but not for cancer. Not to treat cancer.
Dr. Diane Reidy-Lagunes:
What about medicinal mushrooms, like turkey tail and lion's mane?
Jason Hou:
They’re a form of fiber so it cannot directly kill cancer, but we have studies that show that it can basically awaken the immune cells and actively gobble up the harmful bacteria, viruses, and potentially cancer cells. It kind of activates what immune system you have in the body to look for cancer cells and kill them.
Dr. Diane Reidy-Lagunes:
Great. And then lastly, ashwagandha. That's a hot one.
Jason Hou:
It’s Ayurvedic, same with turmeric. There are some studies on how it can relieve stress. It can help lower cortisol levels and calm you down. But as far as killing cancer cells, it's a far stretch.
Also, when I look up consumer labs to see the quality of the available products in the US market, there's minimum to none. Because it’s a root, it can absorb all the heavy metals and pesticides in soil. Make sure the quality is there before you even say, “This is the ashwagandha that's supposed to help me with stress.”
Dr. Diane Reidy-Lagunes:
Got it. Jason, can you share with us your fascinating study where you looked at this large database of patients in Taiwan that received traditional therapy for breast cancer. In that same database, there was another cohort of patients that received the same traditional breast cancer therapies such as chemotherapies, radiation, and surgery, but that cohort of patients also received traditional Chinese medicine, which included herbs and acupuncture. I thought your results were fascinating. Can you share that with us?
Jason Hou:
It's a population-based study coming from a Taiwan health insurance research database. This is a very unique database. It's basically a national insurance program where patients can not only get their conventional medicine, but they also have the choice of getting traditional Chinese medicine. When you are diagnosed with cancer in Taiwan, your medical fees are waived completely. So we're not really studying the rich or whoever can get access to these traditional medicines. All are equal, or at least the bias is minimized.
When we compare people who are taking conventional-only treatments versus conventional treatments-plus-traditional Chinese medicine, and we looked at breast cancer prevention and survival rates, there's an association of better outcomes in the arms where conventional treatments are combined with traditional Chinese medicine. So it's worth looking into further, and we need to design bigger trials to really answer the questions of: What specific breast cancer types and what symptoms can be alleviated with the combination of traditional Chinese medicine?
Dr. Jun Mao:
I do think the Taiwan insurance database provides a really great opportunity to look at the real-world effect of how traditional Chinese medicine and herbs can be combined with conventional cancer treatment, because in the US we don't have database like this. A lot of the time, people who have money, who are highly educated, tend to be able to afford those supplements and herbs. So you're just studying if rich people have better cancer outcomes, and the answer, we know, is yes. But I think the Taiwan database allows us to more clearly understand the benefits of Chinese medicine and herbs in the context of cancer care. That will allow us to potentially develop more targeted clinical trials in the United States.
Dr. Diane Reidy-Lagunes:
Yeah, I think that's fascinating. The illuminizing, what we call the selection bias, is incredibly powerful. It's almost impossible in the US to do those types of studies by just looking at databases.
I want to end on the question that a lot of patients end up posing to me, which is: Why not? Can you talk to us about the concerns that you may have on some of these alternative approaches? I think the integrative therapies that you've provided and prescribed are clearly thought through carefully, as a physician to your patients, but so many patients can go on Amazon and get whatever they want, and they do. How do you deal with that? We do, I should state, have the largest supplement database online where patients can look up these therapies and learn about them. But any advice for our patients that just want to try?
Dr. Jun Mao:
Thank you for mentioning the “About Herbs” database. Jason does a wonderful job managing that together with our other wonderful colleague, Jyothi. It has over 280 monographs that carefully curate what the herbs and supplements are, what their intended uses are, what we know in animal or laboratory settings, and if there are any clinical trials and potential herbal-drug interactions. So for any patients or families who are consider using herbs and supplement during cancer treatment, they should check on that website before they just trust what's published in the herbal company's website. Make sure you are informed and also talk to your doctors.
One thing I often tell patients is: a lot of herbs and supplements are relatively safe for people without cancer or without health conditions. But for people with cancer, especially in the context of receiving oncological treatment, your liver and your kidneys are working incredibly hard to metabolize drugs. Adding a lot of herbs – and some of these herbs even have kidney or liver toxicities – for a normal liver that’s not challenged, that may be okay. But in this setting, the risk is really magnified.
Secondarily, a lot of time we just don't know how the herbs will interact with the drug. You go in with the goal of helping your cancer, but at the end of the day, you may end up hurting yourself. So that's also why you need to be really careful.
The third thing is that many cancer patients nowadays live with advanced cancer for many years. So often, because cancer can cause coagulation issues, they're on an anticoagulant. Some of the herbs may interact with those agents and increase the bleeding risk, especially for GI cancers. Some of those are not trivial, and when you have a major GI bleed event, it can be really costly to the morbidity and mortality of the patient. So we just need to be careful.
That's why taking herbs and supplements is not such a simple decision for the family and patient to make. I would recommend talking to your doctors and to really have an open mind. I also encourage the doctors and nurses to be open-minded. I think most patients and families bring this up out of their love for the patient, wanting the best for the patient. We can acknowledge where they’re coming from and understand why they're using it and what it’s for, and then negotiate when to use it and when to avoid it rather than just a blanket answer of, “Don't use anything.” Because the reality is the patient may go out and just do something without even telling us.
Dr. Diane Reidy-Lagunes:
I think that's beautifully said. Lastly, some patients don't have access to integrative medicine in their community centers or even in some cancer centers. Any advice on where they might go to look for such a resource?
Dr. Jun Mao:
On MSK’s website, we do have the “About Herbs” information completely free to the patient. We have also worked with some experts to create a “Meditation Library.” It has really wonderful, guided imagery, meditations, breathing exercises for those patients in the chemo room, waiting for a procedure or surgery and even hospitalized. I think when you feel that stress or anxiety, those resources are at your fingertips that you can access.
We also have a wonderful integrative medicine home virtual program. We have patients from 23 states and 3 countries enrolled in that program where people come together to exercise, do yoga, meditation, and participate in music therapy to help maintain physical activity, deal with anxiety and stress, and build that social connectivity to support each other through this journey.
Dr. Diane Reidy-Lagunes:
We'll be linking these resources in our show notes. Jason and Jun, thank you so much for joining me today.
Jason Hou:
Thank you.
Dr. Jun Mao:
Thank you so much, Diane.
Dr. Diane Reidy-Lagunes:
Thank you for listening to Cancer Straight Talk from Memorial Sloan Kettering Cancer Center. For more information or to send us your questions, please visit us at mskcc.org/podcast. Help others find this helpful resource by rating and reviewing it on Apple Podcasts or wherever you listen. Any products mentioned on the show are not official endorsements by Memorial Sloan Kettering Cancer Center. These episodes are for you but are not intended to be a medical substitute. Please remember to consult your doctor with any questions you have regarding medical conditions. I'm Dr. Diane Reidy-Lagunes. Onward and upward.
Chapters
2:05 - Integrative vs. Alternative medicine
3:14 - Which integrative therapies are right for me?
6:29 - Do these therapies actually treat/kill cancer?
7:59 - The very real benefits of human connection
9:36 - Ivermectin
10:18 - Cannabis oil and Castor oil
11:55 - Vitamin C
13:53 - Turmeric
14:30 - Medicinal mushrooms
14:59 - Ashwagandha
15:42 - Traditional Chinese medicine
18:25 - The dangers of "Why not try?"
21:49 - Resources: herbs, meditation, yoga, music, etc.
Highlights
What is integrative medicine, and how can it help cancer patients?
Integrative medicine combines evidence-based complementary therapies—such as acupuncture, massage, mindfulness, exercise, and herbal supplements—with conventional cancer treatments like chemotherapy, surgery, and radiation. Unlike alternative medicine, which replaces standard treatment, integrative medicine works alongside it to help manage symptoms like pain, fatigue, anxiety, and sleep disturbances. This approach empowers patients to actively participate in their care and improve their quality of life during and after cancer treatment.
Can integrative therapies help treat cancer or prevent recurrence?
There is no strong clinical evidence that integrative therapies can directly treat cancer or prevent its recurrence. However, practices like exercise, stress management, and acupuncture can help patients better tolerate conventional treatments, potentially leading to improved quality of life and longevity. While integrative medicine supports overall well-being, it should not be seen as a replacement for standard oncological care.
How does integrative medicine address different cancer symptoms?
Integrative therapies are tailored based on the patient’s symptoms, cancer type, and treatment phase. For example, acupuncture and massage can help with pain, yoga and exercise can reduce fatigue, and mindfulness or music therapy can ease anxiety and depression. Patients with gastrointestinal cancers may benefit from dietary support to maintain weight, while those with hormone-driven cancers need to be cautious about certain herbal supplements.
What is the role of social connection in cancer care?
Social support plays a significant role in a cancer patient’s well-being. Studies suggest that loneliness is associated with poorer outcomes, and integrative medicine emphasizes the importance of community and emotional support. Programs that connect patients with caregivers, families, and support networks can improve mental health and help individuals navigate their cancer journey with a stronger sense of connection and care.
Are there any alternative treatments that have been proven to work against cancer?
Many widely discussed alternative treatments lack scientific evidence for treating cancer. For example, Ivermectin, cannabis oil, and castor oil have no proven anti-cancer benefits. Some herbal remedies, like turmeric and medicinal mushrooms, have potential immune-boosting or anti-inflammatory properties, but they do not directly kill cancer cells. High-dose vitamin C remains controversial, with no conclusive evidence supporting its effectiveness in cancer treatment.
Can herbal supplements and vitamins interfere with cancer treatments?
Some supplements may interact with cancer treatments or even reduce their effectiveness. For instance, studies suggest that cannabis oil could blunt the immune response in patients undergoing immunotherapy. Additionally, certain vitamins and herbal remedies, like ashwagandha, may contain contaminants such as heavy metals. Patients should always consult their oncologist before taking any supplements to ensure they are safe and do not interfere with treatment.
How does MSK approach research on integrative therapies?
MSK conducts rigorous research to evaluate the effectiveness of integrative therapies. MSK reviews scientific literature, runs clinical trials, and investigates potential benefits and risks of various complementary approaches. MSK’s Integrative Medicine Service was the first integrative oncology program in the country, and it continues to lead efforts in providing safe, evidence-based integrative care for cancer patients.