Our Time has come at Last!

Blog by Robin Daly – This article first appeared in Health Triangle – check out this great magazine at: https://www.ukhealthradio.com/magazine/

When I set up Yes to Life some sixteen years ago, no-one was talking about Integrative Medicine or Lifestyle Medicine – it was Complementary and Alternative Medicine or CAM for short, and, particularly in the world of oncology or cancer care, we were rank outsiders, working to promote the use of approaches that were seen by many as the domain of crystal-gazing hippies.

At best our efforts were characterised as derisory, at worst,downright dangerous. At that time, the only forms of CAM that had gained any degree of acceptance in cancer care were a narrow range of complementary therapies that had infiltrated some oncology units, charitable initiatives by patients and their families desperate to provide some respite from the gruelling rounds of chemotherapy and radiation and their legendary side effects. A handful of therapies were grudgingly accommodated on the basis that no-one claimed they did any good whatsoever – they were just ‘nice to have’.

Sixteen years ago I had investigated the world of CAM sufficiently to be certain that there was a wealth of valuable resources in there that were being denied to people with cancer, but that even for those few who went looking, it was far too difficult to find reliable and honest providers, and therapies that were genuine, available, affordable and relevant to any particular condition. This spurred me into starting Yes to Life, to provide a trustworthy, not-for-profit initiative to improve access to these resources.

In the early years, almost all the callers to our helpline were right at the end of the road, sent home to ‘put their affairs in order’ having reached the limits of conventional care. These were typically extremely sick people with advanced cancer, additionally suffering from the toxic side effects of large doses of radiation and chemotherapy, hoping for a miracle. For most of these, inevitably their lives were short, as they were beyond the capacity of any sort of medicine to provide a lasting recovery. Despite this, there were still some miracles, incredible victories of the human spirit.

Over the years, I came to realise that, although there were no promises of certain cures to be had, we could make one guarantee to those who approached us: that if they adopted some of the practices of CAM, which were largely based on a growing understanding of health promotion (as opposed to disease treatment), that these life-affirming and positive steps towards their own wellbeing would make whatever life they had left better… and possibly longer.

One of the most effective ways of keeping CAM away from patients has always been the ‘no evidence’ mantra, that is still in widespread use today. When I set up Yes to Life, it was largely true. Today it is largely a fabrication. The only basis for maintaining this stance today is on the basis of alack or RCTs, Randomised Controlled Trials, the ‘gold standard’ for potentially dangerous pharmaceutical treatments, results secured by the outlay of eye-watering sums in the hopes of an even greater ‘return on investment’.

Despite their status, I would argue that these trials have lead to an overall stunting of progress, to the approval of a significant proportion of treatments that actually have little or no benefit for patients, possibly even harming them, and to a natural inclination towards the attractive business model of incremental gains at huge cost. In addition to these shortcomings, RCTs effectively exclude all low-cost, low profit, effective approaches, due to their prohibitive cost, and also their total unsuitability for complex, generally extremely safe, health-promoting natural interventions such as dietary approaches. I’m pleased to report that these artificial RCTs with their track record of manipulated results are now beginning to be superseded by a move towards ‘real world’ data, drawn from a broad range of genuine patients within healthcare. At this point, I can report that we have a wealth of evidence for what is now termed Lifestyle Medicine,much of it of excellent quality, although little of it from RCTs.

Over the years I have witnessed a slow, but steady progression of attitudes in favour of the adoption of lifestyle measures, although it has been galling to witness the ability of our health service to hold back this publicly-driven movement. We are now more than a decade behind the US in what has gained the term ‘integration’, the combining of conventional techniques with Lifestyle and Complementary Medicine with the aim of improving quality of life and outcomes. For example, exercise as a form of cancer care has been demonstrated to outstrip the effectiveness of many hugely expensive, cutting edge targeted therapies, as well as to be applicable to a huge range of cancer types and stages, yet it is still largely absent from oncologists’ treatment plans in the UK.

But genuine change is at last in the air! Beginning the latter half of 2020, the steady pressure from ‘outsiders’ such as Yes to Life to prompt change in our oncology wards, through consistently presenting the best science and the best arguments in favour of integration, whilst simultaneously refusing to subscribe to the fabricated black/white, good/bad, proven/unproven world of extremists on both sides of the old divide between ‘conventional’ and ‘alternative’ is starting to show results. We are at last beginning to move beyond the decades-old battle in which hapless cancer patients get ‘caught in the crossfire’ – to use Sophie Sabbage’s apt phrase – between the self-absorbed warring factions intent on being ‘right’ at the expense of patients.

Our efforts are at last starting to be rewarded with interest coming from within oncology, and at this point, I would say it is just a matter of time before the first shoots of genuine patient-centred cancer care start to take hold in the UK. Patient-centred care has been spoken about in the NHS since the 1980s, but as long as the war against integration persisted, it was always destined to be merely rhetoric and lip service, it was never going to really happen. Integration is a patient-driven movement that really does place the patient at the centre of decision making and care, dispensing with dogmatic agendas in favour of the simple question that every patient wants the answer to: ‘Could this help me?’

At Yes to Life, we aim to respond quickly to changes in the environment we operate in, and to capitalise on opportunities and opening doors, always being ready to engage in dialogue with all the key players, regardless of their historical affiliations. If we see an interest in integration, however small, we are keen to pursue it. This has been reflected over the years in the enormous range of speakers at our events and guests on the Yes to Life Show on UK Health Radio. In this respect, I am enormously excited by two of our most recent initiatives: the CANCERTALK podcast series, and our new course aimed at oncology professionals, ‘An Introduction to Integrative Oncology’.

In CANCERTALK – a development that, sixteen years ago, I could have only conceived of in my wildest dreams – Senior NHS Oncologist Dr Penny Kechagioglou and I co-host guest experts from the world of Integrative Oncology. To be ‘on the same page’ in terms of integration and patient-centred care with Dr Kechagioglou in the way we are is a heartwarming validation for all our efforts, and a victory for people with cancer, as well as for common sense. Do check it out for yourself – it’s inspirational!

In response to the growing interest in integration within oncology, we have developed an eleven module course, delivered by top experts through Horizons, our new e-learning platform. The aim of the course is to provide healthcare professionals with an overview of Integrative Oncology, looking at all the resources available, the role they can play in cancer care, who the providers are, and the evidence for efficacy and safety.

Participants will complete the course with sufficient understanding of integrative modalities to confidently refer their patients on at times and in situations where Integrative Medicine may be able to help. My hope is that this will in turn open many more doors to creative collaboration for thebenefit of those with cancer.

It’s a testament to where we have come, that over the last sixteen years we have moved from a characterisation of ‘crystal-gazing hippies’ to the point where the lifestyle approaches we have advocated all along are, in general, seen as ‘common sense’, and where the idea that people with cancer can do a lot to help themselves is, well, obvious! Next on the agenda are the considerable changes required by UK oncology to fully embrace this 21st century understanding of health and healthcare.

Robin Daly, Founder & Chairman of UK national charity Yes to Life

Robin’s daughter Bryony contracted a rare cancer aged 9, and died at 23 after two recurrences. The immense difficulties the family faced in researching and making their own treatment choices prompted him to set up the charity in 2005 to help others in similar situations.

Website: https://yestolife.org.uk

CANCERTALK: https://yestolife.org.uk/cancertalk-podcasts/

Horizons: https://www.yestolife-horizons.org

Facebook: https://www.facebook.com/RobinDaly.YesToLife

Twitter: @RMK_Daly

Listen to Robin on the radio shows: https://yestolife.org.uk/radio-shows/