We spoke with Mark Fontes, Doctor of Naturopathic Medicine. Mark has an integrative healthcare practice with a focus on adjunctive cancer care. We found out the many benefits of naturopathic oncology, how naturopathy integrates with conventional care, and why his own experiences inspired him to help others loved ones.
What is Naturopathic Oncology?
Naturopathic oncology is a term that describes the application of the art and science of naturopathic medicine in the field of cancer care and treatment. The goals of naturopathic oncology are to safely and effectively improve overall survival, minimize the side effects of chemotherapy, radiation therapy and surgery, and to improve quality of life for patients living with cancer. As trained naturopathic doctors in this area, we strive to work alongside medical doctors and oncologists in order to provide patients with the most comprehensive, whole-person integrative medical approach to cancer care.
Are you a Naturopathic Doctor or Oncologist first?
I view myself as a naturopathic doctor and teacher first, who is knowledgeable in the field of oncology. After naturopathic medical school I completed a two-year residency program focused in naturopathic oncology. In this field we are required to know the best and most up to date naturopathic support to offer to patients, but also keep updated on conventional treatments. I say that I’m a teacher in that some patients I see come for clarification as to what’s to come (surgery, chemotherapy, radiation). Since we spend more time with our patients, we can explain the rationale of treatment while having the time to really get to know our patients and understand their unique goals.
Is the goal to cure/get rid of the cancer?
In conjunction with conventional treatment, I believe that is the ultimate goal and what I strive for in every case. Interestingly it is not always the patient’s goal. I see patients who come to see me just for advice on how to manage their nausea, pain or peripheral neuropathy due to their chemotherapy treatments. Other patients want to focus on the mental/emotional aspect of receiving a diagnosis of cancer.
‘Goal setting’ is a conversation I have with patients right when we meet each other, so that we are on the same page and expectations can be managed and met. The goals are also dynamic and constantly changing. For example, with a patient starting their chemotherapy treatments, our goals are to ensure they get through the treatments safely and reduce side effects, while recommending treatments that ensure the greatest likelihood of a positive response. Once treatment is complete, our goal then becomes to prevent recurrence.
What therapies do you use?
As naturopathic oncologists we are fortunate to have a variety of therapies that we can use to treat cancer and the side effects of chemotherapy, radiation therapy and surgery. These include specific dietary and lifestyle recommendations, supplements, botanical medicine (teas, herbal tinctures, creams/ointments), acupuncture, exercise programs, mental/emotional support and counseling, low intensity laser therapy, mistletoe injection therapy, and a variety of intravenous nutrient therapies including high dose vitamin C. Every treatment plan is tailored for each patient according to their diagnosis, recommended conventional treatment, past medical history, co-morbidities, results of bloodwork and imaging, and symptoms.
Do patients see you instead of a Medical Oncologist?
Most patients I see have already had an appointment with their medical oncologist to arrange their treatment plan in the hospital. Occasionally, I see a patient who comes to see me first. When this happens I always strongly recommend the patient to see their medical oncologist. They may not agree to the treatment, which is their decision, but I believe a medical oncologist is an incredibly important ally – due to their knowledge, and ability to run important blood work and requisition imaging tests. This provides the patient with the very best of integrative care with multiple practitioners working towards one goal – improvement of the patient’s condition.
Do you have the same amount of training?
As is the case with medical doctors, naturopathic doctors firstly complete four years of undergraduate education and then four years of naturopathic medical school. I was then accepted into a competitive two-year clinical residency program at the Canadian College of Naturopathic Medicine focused on naturopathic oncology and intravenous nutrient therapy. Medical oncologists do have more time in clinic and more interaction with patients living with cancer, due to the set up and volume in a hospital setting. Our training is not just solely focused on cancer care. Although I do focus on naturopathic oncology in my clinic, it is important to note that our skill set as naturopathic doctors allows us to treat other conditions that may be affecting the patients quality of life – anxiety, muscle pain, insomnia, etc.
Do you have a healthy relationship with Medical Doctors?
I try my best to establish healthy relationships with my patients’ medical doctors and medical oncologists as soon as we meet. I do this by writing detailed letters to the doctors explaining my role in the patients treatment plan, including recommendations I have made, evidence for the recommendations and demonstrating that there are no interactions with their prescribed medications and chemotherapy treatment. It is important for our profession to foster these relationships in order for medical doctors to become more familiar with what we do and understand our role in the patients care.
When do you recommend patients start seeing you?
Ideally, I always recommend patients to see me as soon as they have visited with their medical oncologist. At this point we will have all the information we require – specific diagnosis, imaging results, bloodwork results and the recommended conventional treatment plan. I have observed the best results clinically when patients start our recommendations prior to or shortly after they have started chemotherapy or radiation therapy. However, patients can see naturopathic oncologists at any time – whether it be for prevention (due to a strong family history or personal past history of cancer), during their conventional treatment, or for prevention of recurrence and improving quality of life after treatment is complete.
As a naturopathic doctor, what is your stance on chemo, surgery, and radiation?
I believe incorporating the best of medical treatments (chemo, surgery and radiation) with the best of naturopathic medicine provides the patient with the best outcome. Chemotherapy, surgery and radiation can have significant effects on cancer cells and are an important piece of the treatment plan. However, they do come at a cost with a variety of side effects. As a naturopathic doctor, I counsel my patients on why these treatments are important, the role they provide in their care, and how we can help increase the efficacy of these treatments while reducing side effects. However, it is important to note that in cases where the recommended treatment provides little benefit at the cost of poorer quality of life, then the cost/benefit of treatment must be addressed and clearly communicated to the patient.
Do all ND’s offer cancer care?
Not all naturopathic doctors offer cancer care to their patients. This is an area of expertise that requires much time and dedication to establish working relationships with medical oncologists, learn the different chemotherapy medications, how they are used and when, how they impact the quality of life of patients and keep up to date on the latest evidence regarding our treatments. As a result it requires additional training and continuing education. I am fortunate to have wonderful colleagues who refer these cases to our clinic. It is important to note that although this is my particular focus, other naturopathic doctors focus on other areas such as women’s health, mental health and fertility.
Why did you choose to concentrate in this area?
I decided to concentrate in this area for personal and professional reasons. When I was younger seeing my grandfather undergo treatments for his cancer impacted me. At the time I knew he was receiving the best medical treatment that was available, but it left me wondering that there must be more that can be offered to help improve quality of life outcomes and offset the side effects of treatment. I told myself that I would do what I can to ensure someone’s parent, grandparent, sibling or other loved one would be able to have these options provided to them to ensure they get through treatment in the best possible way, and have the best chance of outcome and prognosis. Professionally I enjoy the challenge of treating patients with cancer, and appreciate that not everyone’s case is the same. Each patient I see has their own story, their own motivations for getting better and their own unique capacity and capability to heal. I learn a lot from my patients in observing their strength, courage and perspective on life. I am forever grateful for that and it is for these reasons I continue to be inspired by this field.
Do you think there should be more specialists in Naturopathy?
Absolutely! As our profession continues to grow I believe this will happen. Being able to focus on a specific condition allows the naturopathic doctor to hone their skillset and provide patients with the very best care.
Do you live a preventative lifestyle?
Although it can be difficult at times with a busy clinic schedule I do my best! I have to live by the words I continually preach to my patients. I use the World Health Organization recommendations for cancer prevention as a template (as per the WHO, these recommendations can prevent nearly one-third of all cancer cases). These include: avoidance of tobacco use, regular physical activity, maintaining a healthy diet and weight, minimizing alcohol use, preventing infections by supporting the immune system, and making necessary changes where possible to provide clean air and water. I believe a preventative lifestyle comes from incorporating these factors while also maintaining strong social support systems with family and friends, and practicing mindfulness based exercises like meditation and prayer.