The following is a transcript of Season 1, Episode 9 of The ND Will See You Now, a podcast by the Institute for Natural Medicine.
On this episode of The ND Will See You Now, our host Anna-Liza Badaloo talks with Sonia Malani, ND, FABNO, a naturopathic physician, researcher, yoga instructor, and meditation teacher with a strong focus in naturopathic oncology. Among other research projects she has been involved in, Dr. Malani is a co-investigator of the AIMS Cancer Outcome Study, which measures overall survival rates in cancer patients who are receiving integrative oncology care. Listen in as we explore how her personal experience led to Dr. Malani pursuing a career in naturopathic oncology and discover how naturopathic doctors are working to improve cancer outcomes nationwide.
DISCLAIMER & EDITOR’S NOTE: 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. For more on the Oncology Association of Naturopathic Physicians (OncANP) visit their website.
Anna-Liza Badaloo (ALB): Hi there, and welcome to the Institute for Natural Medicine’s podcast, The ND Will See You Now. In this podcast, we talk to naturopathic doctors across North America about their whole person approach to health, what patients can expect, and why their work is vital to patient health.
I’m your host Anna-Liza, and today I’m just delighted to welcome Dr. Sonia Malani to the podcast. Dr. Malani is a naturopathic physician, researcher, yoga instructor and meditation teacher with a strong focus in naturopathic oncology. After obtaining her doctorate in naturopathic medicine at Bastyr University, she completed a two-year accredited, integrative oncology residency at the AIMS Institute, (AIMS stands for Advanced Integrative Medical Science). While there, she helped build the IV therapy (that intravenous therapy) clinic and developed several evidence-based IV formulas for pain, hydration, energy, and more.
She’s implemented two clinical trials investigating the effectiveness of integrative medicine in both oncology and psychiatric settings. She’s also a contributing author to the fifth edition of the book Principles and Practice of Palliative Care and Supportive Oncology, known as a vital reference text used by both conventional and integrative providers alike. Among other research projects, Dr. Malani is a co-investigator of the AIMS Cancer Outcome Study, which measures overall survival rates in cancer patients who are receiving integrative oncology care. Finally, Dr. Malani is also a new member of the Oncology Association of Naturopathic Physicians, which we know as OncANP. Thank you for joining us, Dr. Malani, so wonderful to have you here!
Dr. Sonia Malani, ND, FABNO (SM): Thank you. I’m really excited to be here today.
ALB: Let’s start from the beginning. From a young age you had this sense, this feeling, this calling that naturopathic oncology (by which I mean cancer care) was the direction that you wanted to go. Now, I understand that a family member of yours did play a key role in your choice of career path. And I’ll tell you something, Dr. Malani, you’re not the first naturopathic doctor I’ve spoken to who has had some type of early life experience with somebody with cancer, and ended up having that inspire their career path as a naturopathic doctor. And I don’t think you’re the last naturopathic doctor that I’ll speak to in this situation, either.
Can you tell us a little bit about this Dr. Malani? Not only your own story, but how common do you think this is, when either cancer patients or the patient’s family members choose a career in integrative or naturopathic oncology? Why might this be the case?
SM: It’s such a good question. I never really planned to be a doctor. What happened was, cancer just kept coming up in my life. My mom was diagnosed with stage 3 breast cancer when I was six years old, and my father was diagnosed with stage 4 gastric cancer when I was 19 years old. Both parents were diagnosed with very advanced cancers. When my dad was diagnosed, I was in the middle of college. I was picking a major, I was trying to figure out what I wanted to do with my life. When he was diagnosed, we were going to all of these different oncologists and going to all these different consults and hospitals, trying to figure out what steps to take for his treatment.
I just felt like this was the field that I needed to be in. But I knew that I didn’t exactly want to be in the standard oncology world (chemotherapy, radiation surgery, and that’s it). I wanted to know more. I wanted to know what else there was, and I wanted to know how to make those treatments work better, and how the patient could come out of treatment feeling more alive than when they went in. Through that passion and intention, Bastyr University and naturopathic oncology kind of found me.
You’re exactly right. This is not a unique situation that I experienced. For those people who find a career or find a path through a diagnosis like this, it feels much more like a calling than it does a profession. I remember when I was 19. I just learned about Bastyr University. I was trying to Google it and figure out where the school was, where do I go, and all of that. It just felt like the world was conspiring for me to go there, my classes all fell into place. I was able to go shadow NDs, I was able to fly out to Seattle and visit the school. Nothing about it was hard. It just felt like that was the path I had to be on. And so, it was very clear that that’s where I needed to be. I’m very grateful to be here.
ALB: Conspiring is one way to put it, or supporting. It sounds like the universe was supporting this career path of yours. Thanks for sharing that. As you mentioned, in your case it wasn’t just one family member, it was two family members. And it wasn’t a distant cousin or a distant aunt, these were your parents. I can absolutely see how strong that is. When you think about your role now, working in naturopathic and integrative oncology, how do you feel that those experiences impacted how you communicate and empathize with patients?
SM: I’ve said this to a few of my patients. Every day when I wake up and prep for my patients and start practicing, I strive to be the physician that I wish both my parents had had. Someone that was able to speak both languages, understand all of the conventional standards of care, understand everything else that there is in the field of naturopathic oncology, and someone that’s able to bridge the gap between those two.
Part of my residency training and postgraduate training was making sure that I was rotating in hospitals and shadowing medical oncologists, radiation oncologists and surgical oncologists, and spending months in the OR watching reconstructive surgeries. I made sure that I understood every single step of the cancer journey from the conventional and the naturopathic standpoint, because that’s what I felt was the most stressful piece of being a caregiver to my parents, or being on the other side of the doctor’s visits, or not being in the doctor’s seat. I was trying to ask questions and having someone say, “Well, I really don’t know anything about that, you should find someone else to talk to”. It was really hard to follow your primary oncologist’s advice, but then have a totally different provider say, “Well, this is what you should do diet-wise, and this is what you should do lifestyle-wise”. And when you try to run those recommendations by each doctor, they’re like, “I don’t know, that’s not my area of expertise”. And so, what I hope to be for my patients is that bridge where they can come and sit, where they can come and ask questions about everything from chemo, surgery, radiation, diet, lifestyle, supplements, herbs, IV therapies, and for me to give the most evidence-based answers.
ALB: Dr. Malani, you’re pointing to a very strong role that naturopathic oncologists and integrative oncologists have to play with patient education. As you mentioned, I daresay that experience is not unique, your experiences on the other side of things trying to advocate for your parents, where you’re trying to understand all the information that’s being provided to you and sort through it. And the answers that you so badly desire are not always available to you, from all of these practitioners.
Speaking of these educational dealings, I wanted to ask you about how you do that nowadays in your practice, because that is quite a focus for you. You were born in New York, you live in Kentucky, but you educate patients virtually all across the United States via your tele-education practice. That’s a very interesting constellation of things. One, because Kentucky is what we call a pre-licensed state, meaning that naturopathic medicine is not licensed there. You’re in this really interesting position. You’re living in Kentucky, you don’t actually see patients in Kentucky, but you live there, so you have a sense of what that is like. I wonder what you would say to patients who do live in pre-licensed states such as Kentucky? For patients living in the United States who want to avail themselves of integrative oncology care and naturopathic oncology care – what advice do you have for such individuals?
SM : I went to Bastyr in Seattle, I did my residency in Seattle, and I practiced in Seattle after residency, but recently relocated to this part of the country. I have found that I was so used to a market in Seattle where naturopathic oncologists were like yoga studios and coffee shops – on every block. It was a very saturated market. This part of the country unfortunately, does not have many practitioners who are well versed in this type of medicine. There are only around 130 naturopathic oncologists in this country, so we can’t realistically serve every community.
That was a catalyst for the way that I wanted to practice. With COVID opening up tele-education telemedicine, and telehealth opportunities, I built a tele-education consultation service or tele-education practice where patients can access me. I can provide questions or recommendations, not necessarily medical advice. What I do with my education clients is dialogue about their decisions. We can still do some dietary conversation, we can still do some supplementary education, we can still do some chemotherapy education, we can do surgical education. We can educate so that patients can then go back to their oncologist or primary care provider and ask really informed questions. I think a good question is just as beneficial as good medical advice. Because if you’re asking the right questions, you’re ultimately going to be able to elicit the right and informed decisions for your body. A huge part of my practice has always been education. If we could get some of the naturopathic and general health information into high schools, middle schools and elementary schools, that would be amazing because people should have a right to know about their body.
ALB: That’s a really interesting point. When I think about high school education, for many people that may be the last time that they would have taken a biology or chemistry class, or basic anatomy. For many of us, that was certainly a long time ago. As an adult, if that’s the level of health literacy and health education that you have, and then you find yourself receiving a cancer diagnosis, all of a sudden you’re diving into this world with all of the technical language. That in and of itself can be really difficult to understand. Getting the diagnosis itself is overwhelming. You’ve mentioned a couple of examples of the type of patient education that you’re doing. Can you expand on that a little bit? When you think about the most common questions that you receive, or the questions that you find patients are most relieved to hear the answer, what would some of those things be Dr. Malani?
SM: A lot of patients think that naturopathic oncologists have a silver bullet, natural cure for cancer. And while I wish that there was a world of cancer treatments that you uncover when you specialize in this, what we really do is combine the best of conventional medicine with the best of natural medicine.
The biggest question I usually get is, can we do something completely alternative? Or can I turn down this treatment? Those are the types of questions I get a lot. What I spend a lot of time doing is educating about how those treatments are going to be beneficial for the patient. Basic teaching about what chemotherapy does, what the surgery can do, what a surgical resection can do, or what radiation treatment does. For a lot of people, oncology visits usually have to be somewhat quick and there may not be a whole lot of time to ask questions. The other thing, is that it’s a very stressful experience to go into an oncology visit, be told that you might be diagnosed, and then try to come up with the right questions. Visits with a naturopathic oncologist give you the opportunity to step off the cancer conveyor belt and zoom out and say, “Can you explain what this diagnosis is? Can you explain what these treatment options are?” And so, a lot of what we do is just treatment education. That allows the patient to understand why they’re doing what they’re doing, and therefore have a greater compliance.
Other questions that I get that are very top – definitely diet. What can I do for my diet? There’s so much education we can do there. For a lot of my patients, when they have this cancer label or cancer diagnosis, friends and family will come out of the woodwork and say, “You have to try this treatment. You have to try this remedy. Look at this article that I found online and try this”. What I also tell my patients is, when you are getting those articles sent from your cousin or uncle or whoever it is, forward them to me, let me do the research. Let me figure out whether this treatment has merit, or whether this clinical trial has merit, and then we’ll talk about it in our next visit. Because a patient should not have to focus on reading medical literature and researching. They just need to focus on getting well. I hope to be that advocate for my patients to take in all the resources and research and do that work for them. That’s what we’re really trying to do – support the patient as much as we can.
ALB: Well, that in and of itself sounds like a beautiful service for you to be able to say to patients, your second cousin twice removed sent you this article that they are convinced is going to be your silver bullet. I think that’s a wonderful, wonderful thing you can provide to people because frankly, even for those of us (I include myself) that are used to looking at medical research, this is hard stuff to wade through. Not only the language, but simply the way that these medical studies are written. For the average person that can really be challenging, not only to figure out if it’s valid, like you said, but to understand what the study is actually saying.
Now, this is something that you’re particularly well qualified to speak to patients about. As you mentioned, naturopathic doctors do have that strong role in patient education. But in addition to that, you have a lot of research experience. I want to ask you about one of these, because it’s a really interesting study. You’re working right now with the AIMS Institute that I mentioned on the Cancer Outcomes Study. This explores integrative oncology approaches and how they’re working for patients. I had the distinct pleasure of speaking to Dr. Leanna Standish (naturopathic doctor Leanna Standish), who you studied under when you were doing your residency when you first got your naturopathic degree, and you were at the AIMS Institute. This is a beautiful thing that you’re now back there, doing this study. Not too long ago I spoke to Dr. Standish. What Dr. Standish said, was that ultimately the question is: do these integrative approaches work? A lot of things can get complicated around this issue. But that really is the basic question. Dr. Malani, what are you seeing so far from the Cancer Outcomes Study, in terms of answering that question? What’s working and what’s not? What are you discovering so far?
SM: If you haven’t yet listened to Dr. Standish’s podcast, the AIMS Cancer Outcomes Study is (the technical jargon is) a prospective outcome study. What that really means, is that any patient that comes to the clinic AIMS Institute (which is located in Seattle), anyone that has a cancer diagnosis is asked to enroll in an outcomes study, where we track what treatments we are recommending. Whether that’s a supplement, green tea extract at 500 milligrams twice a day, or whatever we’re recommending. We’re tracking those recommendations, and then tracking the survival outcomes of our patients.
What we’re hoping to see in the next few years (because this is going to take probably four or five more years to figure out results) is, are our recommendations working? It’s hard to do botanical medicine research. Every patient is different, everyone has a different diagnosis, it’s hard to find a large number of patients all with the same diagnosis who are willing to enroll in maybe a green tea extract trial. Instead of doing each different supplement, or each different diet recommendation, or each different lifestyle recommendation and doing a single study for each of those, what we’re doing is trying to capture how all of those recommendations affect our patients in the long term.
And ultimately, if we can show that our overall survival of our patients is longer, with a better quality of life and standard of care, then we know what we’re doing is working. What I think a lot of patients might resonate with, is that there’s a lot of noise in this wellness world, there’s a lot of noise in the field of medicine in general. And it can be really confusing to know, should I take this supplement? Should I try this diet? Should I completely change my lifestyle? How do I know it’s working? As physicians, I feel like it’s our responsibility to be researching the recommendations that we’re making. That’s why I’m really grateful to be part of this study. In a few years when we’re able to analyze and look at all of the data, we can say, “Our cohort of breast cancer patients who all got this supplement recommendation, or who all did this IV therapy, lived this much longer than patients who just did conventional standard of care. And then we can show that adding both medicines and using the best of both worlds really does make a beneficial outcome or difference for the patients.
ALB: I can’t wait to see what the study reveals. I know you have a few more years ahead of you, which is quite right. Sometimes we do see in these studies that they’re very short-term studies. When we look at the long-term studies, when we look at what we call the chronic impacts and effects of what these interventions are that you’re testing out, it can be different. As you mentioned, you’re quite right to say that with botanical research and supplement research and so forth, it’s very difficult to get that critical mass of people that you need to make the study valid with these specific things. And you’re there at the Institute, this is what you folks are doing anyway, so it just makes sense.
SM: There’s the OncANP and Dr. Standish, and there’s some physicians in Canada who have been doing a lot of these outcome studies already. We’re hoping in the next few years that we can start getting this data and building standards of care for the naturopathic oncology world too, so that every patient around the country, if they’re diagnosed with something, based on this research and based on our studies, can get these specific treatments. That’s the end goal.
ALB: Not to give away too much of Dr. Standish’s podcast, but we did talk a little bit about the CUSIOS study that’s being done. I’ll leave listeners to dig into that podcast, but this is a study that’s happening between our two countries, between naturopathic researchers in Canada, and also American naturopathic researchers in the United States.
There’s no lack of integrative, naturopathic oncology research going on that is evidence-based, and will provide not only the profession, but also patients with the answer to that all important question: does it work? That’s what it all comes down to: does it work?
I wish we had more time, but we’ve covered quite a lot today. Dr. Malani, thanks for being very authentic and vulnerable, and sharing your own story about your parents, and how their cancer diagnoses (different cancers, different stages, coming at different periods of time for you as a young person) impacted you. We’ve also talked about what naturopathic oncology care may look like in pre- licensed states such as Kentucky, and also how you’re using that strong component of naturopathic medicine (doctor as teacher), to help patients understand not only what the naturopathic interventions are, but often explaining what the conventional treatments are, and what those mean. Listeners, if you’re wondering where you can find a transcript of this interview links to learn more about Dr. Malani’s work, you’re going to find that in the podcast notes.
Dr. Malani, what final words do you have to leave us with today?
SM: Thank you for this opportunity again. I would say for anyone that’s listening, if you can link up with a naturopathic doctor or link up with a naturopathic oncologist, we are here to be allies. We’re here to support you through your journey. It can be incredibly overwhelming and scary, and just overwhelming at times. We want to help support and make sure that your overall survival and your outcome is as beautiful as we can make it. I really love this field. And I really love what we do.
ALB: I think your patients would probably say the same thing, if they were here right now. Thanks so much again, Dr. Malani. This is the perfect place to end our conversation today. I really appreciate you joining us, much gratitude to you. Listeners, thanks for joining us as well, and we’ll see you next time!
