Dr. Standish’s foundational and continued contributions to the field of integrative oncology are too numerous to count. Her breadth and depth of knowledge are extensive, and her drive to perform meaningful research that can improve patients’ access to integrative care is relentless. Learn from Leanna J. Standish, PhD, ND, LAc, FABNO, about her journey to naturopathic oncology and the rapid and collaborative trajectory of the specialty itself. What started as a group of colleagues creating educational and training standards has evolved into a board certification, several NIH research grants, and a growing evidence base for the significant impact of an integrative oncological approach on patient outcomes.
EDITOR’S NOTE: This transcript of podcast interview has been edited for clarity. The opinions of the host and guests on this podcast are their own and do not represent INM. This podcast and its respective transcript and social media posts do not constitute medical advice; and, are not meant to diagnose, prevent, treat, or cure any conditions or diseases. This podcast and its respective content are for educational purposes only. Consult your doctor before implementing any changes to your care. If you would like to find a naturopathic doctor (ND), please see our Find an ND directory. To find a naturopathic doctor who specializes in cancer care, please visit OncANP, the Oncology Association of Naturopathic Physicians (OncANP).
Anna-Liza Badaloo (ALB): Hi there, and welcome to the Institute for Natural Medicine’s podcast, The ND Will See You Now. I’m your host Anna-Liza, and in this podcast, we talk to naturopathic doctors across North America to find out about their whole person approach to health, what patients can expect, and why their work is so very vital to patient health.
Today, I’m absolutely thrilled to welcome Dr. Leanna Standish to the podcast. Dr. Standish is a neuroscientist and naturopathic physician who is board certified in naturopathic oncology, and she holds faculty appointments at Bastyr University’s School of Naturopathic Medicine and Research Institute, as well as the University of Washington’s School of Public Health and School of Medicine’s radiology department. She’s also the Medical Director of the Bastyr Integrative Oncology Research Center, better known as BIORC, has served as principal investigator on several National Institute of Health research grants, and has published widely on integrative oncology. She’s also provided adjunctive naturopathic medical care to literally hundreds of cancer patients. And it’s no surprise that she’s a founding board member of the Oncology Association of Naturopathic Physicians, otherwise known as OncANP.
Now, what about her current research? It includes looking at the medicinal mushroom Trametes versicolor in the treatment of breast and prostate cancer, developing integrative oncology outcome studies, and looking at IV therapies. Finally, Leanna is the co-founder and co-director of the Advanced Integrative Medical Science (AIMS) Institute in Seattle, Washington, where they are dedicated to advancing integrative medical care, research, and education within fields including oncology, psychiatry, neurology, rehabilitation, and palliative care. It’s such a pleasure to have you here. Dr. Standish, thanks so much for joining us!
As I mentioned in the introduction, you’ve conducted a lot of integrative oncology research. This has been going on for over 25 years, and you’ve been doing this in many different settings with many different organizations. And as anybody can tell you (as a quick PubMed search will tell you), there’s more conventional cancer research out there than integrative oncology research. But in recent years, which I’m delighted to see, more and more naturopathic doctors are conducting and publishing research on the patient benefits of including naturopathic care in integrative cancer care. This covers quite a few topics, but I’ll mention a few. This includes, for example, research on reducing adverse effects of conventional cancer treatments like chemotherapy and radiation. It also looks at things like improving survival rates, quality of life, and much more. Dr. Standish, can you give us a sense of how naturopathic oncology research has changed over the last 25 years or so? And why should this matter to the public?
Leanna J. Standish, PhD, ND, LAc, FABNO (LS): I want to thank you deeply for inviting me, because this gives me an opportunity as a doctor, to let people out there – all-over North America (Canada and the United States) – know about this wonderful, emerged field called naturopathic oncology. And I just want to say what that is before we start.
For me, it means that I’m coming at the patient’s cancer diagnosis and treatment plan with an orientation towards quality of life. How you feel is really important all the way through with the point of view of helping patients make good decisions about what kind of surgery they might consider, or what kind of radiation, or chemotherapy may be best. We work as a team with medical oncologists. The way that I do that in my practice, is if a patient comes to me and they have a medical oncologist that they’re already working with, I communicate with that medical oncologist so that we’re providing what I call integrative medicine that’s integrated between these disciplines.
I wanted to talk a little bit about research. My passion since I was a little girl was to discover new medicines for people who are sick. I discovered naturopathic medicine kind of late in my professional life, and I’ve been focused on finding out: does the stuff that we use work? And if not, what can we do better? And so, my whole life has been focused, especially in my cancer research, on measuring what we call outcomes. You go to a doctor, and you get a treatment. Well, what happened to you? Did you get better?
In cancer, we measure our outcomes by two very hard measures. One is: did your cancer come back after treatment? One of the humongous fears if you have cancer and you go through treatment (which is often very difficult psychologically and physically), is that your cancer may come back. This fear is almost like a black cloud hovering over you, because of the fear of cancer coming back. We’ve been very focused on preventing recurrence of cancer and developing new methods. I learned from my teachers about certain intravenous therapies that have been used in naturopathic oncology.
I first learned about intravenous vitamin C, which is actually quite interesting. I must say, I was skeptical when I first encountered it. But for example, at the clinic I work at in Seattle, we’re using intravenous vitamin C along with two other natural agents to treat cancer in patients that have early microscopic evidence of recurrence. And one of the things that naturopathic oncology experts are really good at is being early adopters of big, good, developments in technology. For example, we saw very early on the benefit of this blood test called liquid biopsies, which is a whole field of genetic cancer medicine that’s just appeared in the last 10 years, if that. So, the research is really, really important. There are more studies of naturopathic oncology.
And, I’d like to turn my attention to the study that we’re doing right now, if that’s OK. The study that we’re conducting in Canada and the United States is asking the question: if cancer patients with advanced cancer (stage three and four) go to a naturopathic oncology expert who is a Fellow of the American Board of Naturopathic Oncology, and are credentialed and board certified in naturopathic oncology, for those patients who go to those clinics (and we identified 12 of them that could be research sites) – what happens to you? What happens to your lab work and your clinical outcomes? How long do you live? Did your cancer come back? What is your quality of life? What treatments did you do, both conventional or standard treatments and what we would consider adjunctive treatments – or additional treatments that naturopathic oncology provides? Most of our patients combine standard cancer medicine with naturopathic oncology, and it’s a beautiful integration.
ALB: It certainly is. And thank you for giving us that insight into some of these things, such as your own passion that you had since you were very young, and how that has factored into the research that you have done, are doing, and continue to do. I think IV vitamin C is a great example. There’s an incredible amount of research on this, and I encourage people to hop on PubMed, hop on Google Scholar, please seek out those studies. There’s some very strong research on that. As you mentioned, most of your patients are using naturopathic oncology methods in integration with conventional cancer treatments. And this is a really important point because there certainly is a misconception among some members of the public that when it comes to naturopathic oncology, it’s either, or. You do one or the other. And as you’re indicating, people are doing both and patients are really benefitting from this integration.
LS: I have this lovely patient, a man who’s in his mid-50s, with very advanced colon cancer. He’s coming into the clinic today. And what he’s going to get, because he’s dehydrated from chemotherapy, is intravenous nutrition with us. Because he’s in pain from his surgery and his postural issues, we’re going to give him a massage. We’re going to put [him] on a botanical tincture for his sore muscles to get him out of pain. We’re going to do acupuncture for pain management and mood. These are examples of the things that come to bear and communicating with this patient’s medical oncologist at the nearby hospital in Seattle.
ALB: That is a beautiful example of the type of integration that you’re talking about. Because it’s not just one or two things, it’s really looking at the patient in front of you, as opposed to the disease state in front of you, and really seeing what’s going to help this person along.
I’m very pleased that you brought up this study. And if I may, I’d like to give the members of the public a little bit more detail on that study. Let’s dig into this a little bit. There’s certainly a number of studies out there, naturopathic oncology wise, but this particular one is called CUSIOS which stands for The Canadian/US Integrative Oncology Study. There are a few things that stand out to me about this particular study. First of all, it’s long standing. This has been running since 2015, and it’s not done yet. And as you just mentioned, this is a beautiful cross-border collaboration between naturopathic physicians and doctors in Canada (where I’m located) and in the United States. And consequently, there’s naturopathic research and education institutes getting involved on both sides. On my side of the border, we have the CCNM otherwise known as the Canadian College of naturopathic medicine, and on your side of the border, we have Bastyr University, which of course we know that you have extensive links with.
Now, this study is looking at a number of things. 12 clinic sites have been identified between Canada and the United States, and you’re looking at outcomes. You’re also digging into the actual treatments that the naturopathic doctors are recommending for the folks in this study that they’re using alongside these conventional care treatments. There are even future plans for looking at some sub studies that are digging into things like: what is the cost of cancer care? What are the quality of life impacts, and really looking at what is the qualitative experience of care, and that’s going to be in a subset of Canadian folks. What we see here is a situation where naturopathic doctors, and especially those with the FABNO designation (as you mentioned, that are board certified in naturopathic oncology), are leading the charge on research, which is amazing.
That was a really beautiful example you just gave. More generally, Dr. Standish, do you have any comments on how this type of research might impact the future of patient care? And what about this cross-border collaboration? Why is that important?
LS: Oh, really good question. Well, first of all, CCNM (the Canadian College of Naturopathic Medicine) has been a leader in naturopathic research for many years. And Bastyr in the United States. Those two organizations partnered in 2015. And we’ve obtained funding from a private donor in Canada, who is as interested as we are in ‘Do these complementary and/or alternative methods actually work?’ That is the big question. What we’ve done is collect data from these 12 clinics – extensive data on each patient, and then we have that data in a big, huge database. And what we’re hoping to show is, first, advanced cancer patients who seek naturopathic oncology care live longer and live better. Better than what? The comparison group is always a big issue. We are comparing our outcomes in naturopathic oncology clinics with the data that’s published in the United States. The United States’ CDC (Centers for Disease Control and Prevention) has been tracking every single case of cancer in this country for many years. That database knows diagnosis and demographic information about patients who’ve been diagnosed with cancer, and their stage. We’re comparing survival in that national database with survival in our patients. We’ve started looking at it, and I’m not at all surprised that overall survival is better with naturopathic oncology. Not surprising.
I think we’re all hoping that we’re going to see a signal for a particular therapy that is particularly effective in say – ovarian cancer, or colon cancer, or breast cancer, or pancreatic cancer. And then we will use this data to justify what’s called a randomized controlled trial (RCT). For me, I have hopes that the mistletoe therapy (that we have learned from German physicians in our field) will turn out to be associated with good survival.
We’re hoping that local regional hyperthermia (which is a way of heating up cancer tissue in a non-invasive way) will produce better outcomes. That therapy is being used by just one of the 12 clinics. We’re hoping that patients receiving high dose intravenous vitamin C will do better than those who don’t.
We’re going to use that data, hopefully, to ask the federal government (at least of the United States, the National Institutes of Health) to fund a randomized controlled trial of these therapies in advanced cancer patients. And because we now have these marvelous ways of measuring tumor activity in a small blood sample using what’s called ‘next generation gene sequencing technology,’ we can find out whether our therapies are working in just a few weeks as opposed to waiting months.
That’s what the hope is. We started this in 2015. We recruited nearly 400 patients, and we’ve been following all of them for at least three years. So, we will be able to report how many of our patients survived those three years with life-threatening, terminal cancer diagnoses.
ALB: Well, I will certainly be keeping my eyes out for the results of this because as you indicated, that really is the question, ‘Do these methods work?’
LS: This was kind of a shock to me when I first got into this field. I thought that every hospital in the world tracks their cancer outcomes. You know, finding out what happens to their patients, and reporting their results. But actually, it’s extremely rare that even academic cancer centers report on their outcomes. I just feel this ethical responsibility to do that.
ALB: You know, you’ve really pulled together so nicely why this research is so important, because certainly from the public perspective, there is all kinds of research coming out constantly about all types of things to do with all types of cancers. Much of that research is conflicting, and people do get very confused. It can even add to their stress burden, just keeping up with these studies, and knowing who to trust and what is legitimate. Ultimately, it comes down to what works, but where’s the research that proves that? What is the rigor of that research, and who is actually doing this research? I’m so pleased that you’re bringing this to the fore.
The Canadian College of Naturopathic Medicine has indeed been a leader in many, many types of naturopathic research. I’d love to speak with you again, to find out if the NIH does indeed fund an RCT (randomized controlled trial) for this, because that would be a really logical and also a really impactful next step. One of the things that frustrates me sometimes about research is that researchers spend a lot of time on their work, big funding dollars come in, a beautiful study is produced, and then it ends up sitting on a shelf somewhere.
LS: Especially negative studies.
ALB: Yes, especially! I really the fact that you’re doing this research, that it will be useful to the public, and it’s not going to be kept in these academic silos. It will get out there to the people that it truly affects on a day-to-day basis who it ultimately really matters to.
LS: I want to talk briefly about one example in this intravenous vitamin C. I want to go back to it because what we’ve concluded here at the AIMS Institute in Seattle, is that there is no doubt in our minds, based on the science and based on our results, that intravenous vitamin C, when paired with certain chemotherapy drugs, enhances the effectiveness of the chemotherapy drug on reducing the tumor size. It hurts my heart that this is not widespread knowledge. Until we do these randomized controlled trials, things like intravenous vitamin C will not be covered by medical insurance, whether it’s public or private. One of the goals is to do research, not only to find out what works, but to do the research so that third party payers for health care can make wise decisions about what to cover.
ALB: That is a really great point. And thank you for raising that. And it’s probably something that most of the public doesn’t think about, when you think about how that research gets used. But indeed, for a variety of third-party payers, whether that’s private insurance companies or otherwise, that is what they need to change their own policies. They need that data to inform those decisions. One potential outcome, is that certain types of cancer treatment options, hopefully, in the future may become more affordable, or at least there may be more avenues by which funds can be put towards that. And certainly, there’s a huge difference in our two countries in terms of how the medical system works. But I think that this will apply across the board. Private insurance is very, very important here. Not everybody has it, it doesn’t cover certain types of cancer drugs, and some can be quite expensive. And what you just pointed out is really key. Cancer patients (and also might I add conventional oncologists), increasingly are recognizing the benefit of integrating these. When you give an example that’s really impactful – like IV vitamin C – you’re not only using these things together, (and yes, there may be impacts in terms of reducing some of the adverse effects of those conventional treatments), but it’s actually making the conventional treatments, the chemotherapy more effective. This is huge news for many people.
LS: I have another example. I have been fascinated by brain cancer my whole life. My father died of glioblastoma, which is a quite aggressive form of brain cancer. I’ve been focusing on, is there a natural medicine approach to treating this particular kind of malignant brain cancer? Over the years, I find myself pointing towards curcumin, the molecule that is present in many Indian foods. It’s present in the turmeric root, but that molecule has some very interesting anti-cancer properties. We’re doing a study here at the AIMS Institute for intravenous curcumin in the treatment of recurrent brain cancer, GBM, or glioblastoma. And I’m so happy to be in an environment where we can ask the question, ‘Can plant medicines be useful in oncology?,’ and then carrout these small but significant studies.
I also wanted to say another thing about navigation. One of the things that is so frightening when you’re first diagnosed with cancer, it’s usually one of the most frightening things in your whole life, is that you have no idea what to do unless you’ve had a parent that had cancer. You have no idea what to do, you have no idea who to call. The Fellows of the American Board of Naturopathic Oncology (FABNO) naturopathic doctors are really good at helping patients navigate to get quick, conventional treatment instead of waiting.
The other thing I wanted to add is prevention. Apparently, one out of every two people in North America is going to get some form of cancer in their lifetime. There’s got to be a way to prevent it. We know many nutritional and exercise methods. But I’m very interested in working with patients who have a family history of cancer or have some genetic mutation that puts them at risk. Because we’re treating those patients and following them to find out if they get cancer or not. If they don’t, then our method has succeeded.
ALB: Thank you for those points as well. Plant medicine has a great deal to offer in terms of cancer care. Curcumin is a great example of a substance used in ancient healing traditions, such as Ayurveda from India, such as traditional Chinese medicine, otherwise known as TCM. That is a wonderful thing as well – not only can we draw upon centuries of these rich traditions, but we can also combine these things into new and modern forms. You gave a great example – we have this ancient substance, curcumin – and here you are now testing out its use in IV therapy. What a beautiful meeting of these two worlds.
To wrap up today, Dr. Standish, I’m reflecting upon the fact that we may have some listeners here today who have a cancer diagnosis. Or maybe somebody they know, maybe they have a friend, family member, neighbor, or colleague who has a cancer diagnosis. Maybe some of these folks are thinking about integrating naturopathic cancer care with conventional treatments. And hopefully, everything that you’ve shared with us today has given them some more insight into what that might mean, what the benefits are, and what that might look like. But nonetheless, for those listening to us today, who may have never seen a naturopathic doctor for any condition, they may be a little bit hesitant. To end today, Dr. Standish, two questions for you. First of all, what would you say to these individuals that may be listening to us today? And secondly, where would you suggest that they go to access this research we’re talking about that demonstrates how very evidence-based naturopathic oncology recommendations really are?
LS: Back in 2004, almost 20 years ago, a group of naturopathic physicians, me included, realized that we needed to produce a specialization in naturopathic oncology, and that there’s special training and special experience [involved]. And so, we formed the Oncology Association of Naturopathic Physicians, and developed a board exam and a curriculum.
My advice to anybody out there is go to your internet and type in “naturopathic physician, Fellow of the American Board of Naturopathic Oncology” or FABNO, as we like to say, and find somebody in your state. Call them up and schedule an appointment. Now, not all states in the United States include naturopathic physicians in their medical system, but that’s changing state by state.
[ Editor’s Note: To find a FABNO, visit the OncANP’s directory and click “Display Only FABNO” to filter the search results. ]
The other thing to do is to go to the wonderful website of the Oncology Association of Naturopathic Physicians, or OncANP as we call it. It’s a wonderful website for patients and providers. But for patients, there’s a database that is very up to date, and it’s called KNOW: Knowledge in Integrative Oncology Website. You can look up papers and science that relate to your diagnosis, or your friend’s diagnosis, and get some valid information.
I often find myself with patients who have looked and read on the internet about all kinds of alternative medicines for breast cancer, and a huge deluge comes back. Much of it is probably, as I say in the clinic, “B.S.,” and you have to be careful. To get information from a valid source, I would go to the Oncology Association of Naturopathic Physicians.
ALB: Thanks for that Dr. Standish, because it’s so true. There is this deluge of research, especially if you put in a search term like the one you just mentioned. And that can make people feel overwhelmed. And I think just having you point us in these directions, the OncANP website, the KNOW Integrative Oncology Database that you mentioned. I’ve looked at this myself, it’s a beautiful, beautiful site. There are all kinds of things that you can search by certain naturopathic recommendations, you can see what the studies are. Ultimately, it’s about making an informed decision.
You’ve made some really beautiful comments throughout this interview to indicate that that is one of the strong roles that naturopathic doctors can play in this world of integrative oncology: helping patients navigate. And that word is important because this world of cancer care can be like those rough, choppy seas that you have to navigate. It’s stormy, it’s difficult, but there’s periods of calm. Naturopathic doctors such as yourself, that are able to help patients navigate and make sense of this really complex world, are incredibly valuable.
I wish we could talk further about this. There’s so much more to say. But that’s about all the time we have for today. So again, Dr. Standish, thanks for joining us. You’ve given us a bit of insight into how naturopathic oncology research has evolved. You’ve told us about CUSIOS and how that’s adding breadth and depth to the field of research and why that’s important for patients. You’ve given us some great insight and a lot of specific examples of what that might look like in terms of integrative oncology care that does incorporate naturopathic principles. And, of course, the very solid, evidence-based data that’s behind that. Listeners, if you’re wondering where you can find some of this info that we’ve described, the transcript and links to learn more about this and more about Dr. Standish’s work will be in the podcast notes. Dr. Standish, are there any final thoughts you’d like to leave us with today?
LS: Yes. One of the things that I’ve noticed, and I would feel myself, is when a person is diagnosed with cancer, there is this fear of missing the magic bullet. You know, like standing in the grocery store line and seeing a magazine article about ‘cure your cancer today’ with such and such. Naturopathic physicians, especially the board-certified naturopathic oncology experts, can help you separate out the wheat from the chaff and help you navigate clinical trials, help you navigate what is a therapy that has no basis or has no evidence and might be dangerous. So, naturopathic physicians, I think we’re best in the cancer world for helping people not be afraid that they’re missing the magic bullet. And by the way, I have not discovered a magic bullet. I’m still working on it!
ALB: Hopefully you’ll let us know if you do! And that’s another conversation. Thanks again, Dr. Standish, this is the perfect place to end today. I really value your time. Everyone, thanks for joining us as well. We’ll see you next time!
