The Canadian College of Naturopathic Medicine's research posters from the recent Canadian Association of Naturopathic Doctor's conference on June 25-26 in Calgary. _off_

1. A cross-sectional study of patients of the Robert Schad
Naturopathic Clinic using the Naturopathic Patient Database
Christopher Habib ND (1); Stefan Podgrabinski (2), Matthew Gowan ND (1,2), Brenda Leung ND, PhD (3), Dugald Seely ND, MSc (1,4), Kieran Cooley ND, MSc (1)
1. Canadian College of Naturopathic Medicine 2. OM Corporation 3. Boucher Institute of Naturopathic Medicine 4. Ottawa Integrative Cancer Centre
Integrative
Background Results Table 1. Conditions Seen at RSNC 2009-2010.
ICD-10 % of All % of Patients
The Naturopathic Patient Database (NPD) is a data management tool developed Females (76%) and people in the 20-30 (31.8%) and 31-40 (18.4%) year old age Conditions
Code Range Diagnoses Diagnosed
by the Canadian College of Naturopathic Medicine (CCNM) to collect patient groups have the highest representation in the NPD. The pediatric population is Pregnancy-related O00-O99 0.2 0.6
data from its teaching clinic, the Robert Schad Naturopathic Clinic (RSNC). This disproportionately underrepresented. Psychosocial problems, musculoskeletal
Accidents, poisoning, violence S00-T98 3.0 8.2
database was created in 2006 and has evolved to meet the various academic disorders, symptom-based conditions (e.g. fatigue and abnormal laboratory results),
endocrine disorders, and gastrointestinal disorders were the most prevalent ICD Cardiovascular disease I00-I99 4.0 11.8
and research needs of CCNM. This study describes demographics of patients
and conditions treated by student interns at the RSNC from 2009-2010. groups seen during this period. Health maintenance Z00-Z99 4.1 12.1
Infectious disease A00-B99 4.2 9.5
Funding support for the development and use of the NPD was provided by a
Figure 2. Conditions Seen at RSNC 2009-2010. Respiratory disorders J00-J99 4.4 12.2
grant from the Lotte and John Hecht Foundation.
Cancer, neoplasms, hematologic C00-D89 4.8 13.4
Pregnancy-related
Methodology Accidents, poisoning, violence
Nervous system, sensory organs G00-G99 5.4 14.4
Skin disorders L00-L99 7.1 20.9
Fourth year naturopathic interns input data into the NPD as part of an academic Cardiovascualr disease Genitourinary disorders N00-N99 7.8 21.1
requirement. Patients can only be entered into the NPD after a minimum of 3
Health maintenance Gastrointestinal disorders K00-K93 9.1 23.3
visits. The majority of patients and patient visits are included in the NPD, but not
Endocrine disorders E00-E90 10.6 26.8
all. Thus, the NPD provides a snapshot of the data captured by interns on Infectious disease
patients and health care services provided at the RSNC. Other medical R00-R99 10.9 28.3
Respiratory disorders
Musculoskeletal disorders M00-M99 11.7 26.9
All data from patient files must be entered, beginning with age and gender. The Cancer, neoplasms, hematologic Psychosocial problems F00-F99 12.6 30.0
NPD is divided into sections similar to a chart: Subjective, Objective, Nervous system/sensory organs
Assessment, and Plan. The NPD also contains a section for outcomes, which Figures 3. RSNC Ages. Figures 4. RSNC Genders.
Skin disorders
includes data from the Measure Yourself Medical Outcome Profile (MYMOP). The
Genitourinary disorders 0 to 10
MYMOP is used as a universal outcome measure of effectiveness of
individualized patient-defined symptoms. 11 to 19
Gastrointestinal disorders M
20 to 30
Figure 1. Screenshot of NPD. Endocrine disorders
31 to 40
Other medical
Musculoskeletal disorders
41 to 50 F
51 to 60
Psychosocial problems
61 to 100
Discussion
The majority of patients seen at the RSNC are female, likely because females tend This is one of the first Canadian studies using an effective
to seek complementary and alternative medicine more than males. The pediatric database tool to obtain a clinical profile of patients seen by
population is possibly underrepresented in the NPD because those cases may be naturopathic doctors. Future work is needed to evaluate the
more complicated and interns may choose not to select those cases for their delivery of care and utility of the NPD as an effective teaching aid
academic requirements or because those patients only come to the clinic for acute and research tool.
care.
Selected References Acknowledgements
Although a wide spectrum of diseases are treated at the RSNC, chronic diseases 1) International Classification This project could not have taken place without
The NPD was used to explore RSNC patient cases from 2009-2010. The (diabetes, mental health conditions), diseases with low perceived risk to benefit of Diseases, 10th revision. important contribution from RSNC interns and clinic
supervisors from 2006-2010.
assessment section of the NPD contains a column for diagnosis that uses the profiles with conventional treatment (chronic pain), and diseases that have a large, 2) Gowan et al. The Naturopathic
International Classification of Diseases, 10th revision (ICD-10) coding system. modifiable lifestyle component to them (cardiovascular disease), are seen with high Patient Database: a Clinical Tool
frequency. More research is needed to understand patient choices to receive care for Research and Education.
ICD-10 codes were extracted and reviewed by an expert (CH) for accuracy
before being tabulated. from this institution and to evaluate the effectiveness of care for these disorders.

2. Treating Type 2 Diabetes: A cross-sectional audit of
Naturopathic care within a naturopathic college teaching
clinic using the Naturopathic Patient Database
Christopher Habib ND (1); Stefan Podgrabinski (2), Matthew Gowan ND (1,2), Brenda Leung ND, PhD (3), Dugald Seely ND, MSc (1,4), Kieran Cooley ND, MSc (1)
1. Canadian College of Naturopathic Medicine 2. OM Corporation 3. Boucher Institute of Naturopathic Medicine 4. Ottawa Integrative Cancer Centre
Integrative
Background Results
Type 2 Diabetes Mellitus (T2DM) is a multi-factorial disease characterized by a The mean patient age was 60 and the female gender was more common (62%). Care Figure 3. Percentage Use of Therapies.
decreased response to insulin. The Naturopathic Patient Database (NPD) is a data being provided was predominantly adjunctive care rather than primary care. The
management tool developed by the Canadian College of Naturopathic Medicine (CCNM) mean core audit score was 55.5 out of possible total of 90. There was no cut-off 100.0
to collect patient data from its teaching clinic, the Robert Schad Naturopathic Clinic score used to determine what was considered adequate care.
(RSNC). This study investigates how T2DM is managed at the RSNC from May 2009 to 75.0
Percentage
February 2011 for the purposes of auditing clinical supervisors and ultimately Figure 2. Audit Scores for Major Categories.
improving patient care. 50.0
2.5
Funding support for the use of the NPD was provided by a grant from the Lotte and
25.0
John Hecht Foundation and the Diabetes Alternative Research and Healthcare 2
Foundation. 0.0
1.5
Methodology
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A core audit form was created using the American Diabetes Association 2010
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standards of medical care. Multiple categories in diagnosis, physical exam, lab tests,
0
and management were graded on a 0-2 scale. Criteria being assessed included:
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inquiring about current medications, obtaining a detailed history of complications,
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Figure 4. Relationship of Audit Score vs. NPD Visits Missing.
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measuring blood pressure, palpating thyroid, doing a foot exam, obtaining lab results
IN
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for HbA1c and lipid profiles, providing referrals to medical doctors, setting appropriate
AL
90
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treatment goals, and utilizing evidence-based prescriptions. 80
Audit Score (Out of 90)
Figure 3.
70
Additional audit criteria were created that did not apply to all cases, since some 60
guidelines only apply to specific patient populations, (eg. referring for bariatric surgery The therapy most commonly used was nutritional supplementation (93%) followed
50
if Body Mass Index is over 35). Audit criteria that focused on naturopathic interventions by botanical medicine (69%). Other naturopathic modalities were rarely used to treat
40
and RSNC operations were also assessed. These included the recommendations for T2DM or its complications. Of the supplements, omega-3 fatty acids (mean dose:
30
various supplements, botanicals, physical medicine, homeopathy, Traditional Chinese 1818 mg daily) was the most common, followed by chromium (mean dose: 681
20
Medicine, therapeutic counseling and use of the Measure Yourself Medical Outcome mcg daily).
10
Profile (MYMOP) as a universal outcome measure of effectiveness of individualized Interns enter information into the NPD after a minimum of 3 patient visits. An 0
patient-defined symptoms. analysis was done to see how audit scores compared to the number of visits that 0 2 4 6 8 10 12 14
were omitted in the NPD. There were no differences among the audit scores,
One auditor (CH) conducted a search of the NPD from May 2009 to February 2011 to NPD Visits Missing
indicating that the quality of care was largely determined within the first 3 visits.
identify patients assessed with T2DM. The assessment section of the NPD contains a
column for diagnosis that uses the International Classification of Diseases, 10th revision
(ICD-10) coding system. The inclusion criteria were all patients assessed with T2DM, so Discussion
that the audit could also capture a realistic representation of naturopathic care for
The audit scores evaluating the patient intake were high. This is likely because Feedback is key in improving audit scores and patient care. Audit findings
those with comorbidities, as is often the case in patients with T2DM. The code for
interns spend one hour per visit with patients and so have large amounts of time to were presented to clinical supervisors and to current clinic interns. They were
T2DM (E11) was employed and captured 29 patient cases.
accumulate information. The audit scores for lab tests were also high and this is also integrated into the curriculum. The poorest scoring categories were
likely because naturopathic doctors in Ontario cannot directly requisition lab tests, so emphasized. A checklist was created to help guide interns in their first 3 visits
Figure 1. Process of Case Selection for Audit. credit was given in the audit if an intern requested lab work from the patient. with a diabetic patient. Education and creation of a naturopathic standard of
care may improve audit performance and patient outcomes for patients with
The three lowest scoring categories in the audit were: a thorough physical exam,
13,824 39 T2DM 37 T2DM 29 T2DM T2DM. Larger scale follow-up audits are planned to examine the impact of
Cases (May Cases With
referring patient care, and setting specific treatment goals. The physical exam
Total NPD Cases With audit feedback and continue the process of practice improvement.
Cases (2006 2009 to Feb Complete Patient File
component scored poorly because there are guidelines for T2DM that fall outside of
to 2011) 2011) NPD Data Identifiers the RSNC’s screening physical exam form. Referring patient care scored poorly, in Selected References Acknowledgements
part, because according to the American Diabetes Association, patients must be 1) American Diabetes Association Standards 1) Robert Schad Naturopathic Clinic
13,785 Excluded 2 Excluded 8 Excluded
referred to many health care practitioners who’s capabilities often overlap with those of Medical Care in Diabetes 2010.
2) OM Corporation
of NDs. Setting specific treatment goals likely scored poorly because there are no 2) Bradley R, Kozura E, Buckle H, et al. 3) Lotte and John Hecht Foundation
current guidelines for naturopathic standards of care for diabetes. Collection and Description of Clinical Risk Factor Changes
During Naturopathic Care for Type 2 Diabetes. 4) Diabetes Alternative Research and
reporting of subjective outcomes (MYMOP) could be improved. Healthcare Foundation

3. Evidence for the Topical Application of Castor Oil:
A Systematic Review
Deborah A. Kennedy ND1 and Dana Keaton ND LAC2
1Canadian College of Naturopathic Medicine 2Center for Natural Medicine
Results Seventeen participants with “fatigue” were recruited to
Background participate in an investigation of longer use of COPs.
Castor oil, also known as Palma Christi, is derived from the Search Strategy Flow Chart Constipation Participants applied the COPs for 1.5 hours per day over the
bean of the plant Ricinus communis, through cold mechanical 462 articles found
Researchers Arslen and liver area for 5 days per week for 2 weeks. During the course of
pressing. Ricinus communis is native to India and during initial search Eser evaluated the treatment, the mean total lymphocyte counts normalized within
(July 2009)
approximately 90% of the oil is produced in Brazil and India. 400 articles rejected effectiveness of COPs on the group and were lower at the end of treatment vs baseline.
Castor oil is composed chiefly of ricinoleic acid, which based on title review constipation in 35 elderly As an unexpected outcome, 2 participants with elevated liver
62 abstracts screened
represents approximately 80 - 90% of the total fatty acid for inclusion nursing home residents. enzymes and cholesterol levels normalized these variables by
content. Castor oil has been used since the 16th century BC Constipation symptoms the end of the study.
in many forms. It can be taken internally, used topically and 10 articles retrieved for were tracked for 14 days
incorporated into cosmetics and drug delivery systems. It is full analysis
using the Defecation Pain Reduction
the evidence associated with the topical application of castor
Search re-executed
(May 2011) 2 articles Monitoring form and Viera et al compared the anti-inflammatory and antinociceptive
oil that is the focus of this review. 9 articles included in
Visual Analog Scale, with effects of topical castor oil and capsaicin. Their findings
systematic review
COPs applied on Days 8, suggest that castor oil is devoid of irritant properties, unlike
9 capsaicin. Ricinoleic acid was found to deplete substance P.
Methodology Capsaicin is used to treat neuropathic pain and the authors
and 10. Findings included improvements in evacuation, fecal
suggest that castor oil maybe as effective as capsaicin, without
PubMed, Embase, Alt-Med and CINAHL databases were consistency and a reduction in straining. There were no
its irritating properties.
searched using the terms castor oil/therapeutic use, changes to the frequency of bowel movements nor the
ricinoleic acid and Ricinus communis/therapeutic use, not amount of feces evacuated. Discussion
ricin, from inception to July 2009 and updated May 2011. For Artifical Tears Both castor oil and its main constituent, ricinoleic acid, have
inclusion in the review, articles had to be related to the A double-blind placebo-controlled crossover study by Goto et been found to be non-toxic for both internal and external use.
topical use of castor oil. Articles dealing with castor oil used al evaluated low-dose castor oil eyedrops, or artificial tears in Case reports in the literature document evidence of contact
in manufacturing, as a food additive, or as a cathartic were 20 patients with obstructive meibomian gland dysfunction. dermatitis from castor oil in cosmetic products.
excluded, as was the use of castor oil to aid in the delivery of Treatment with castor oil demonstrated improvement in Historically, castor oil has been reputed to provide relief for
pharmaceutical drugs. symptoms and objective findings. Maissa et al also found that dermatologic conditions, contusions, inflammatory and ocular
eyedrops containing castor oil produced a more stable tear disorders. This review disclosed no cohesive evidence regarding
Results film and a significant decrease in ocular dry eye symptoms. the mechanism of action of castor oil or its main constituent,
Nine studies investigated the topical use of castor oil ricinoleic acid.
Immune and Liver function
through direct application of the oil or in the form of castor Preliminary evidence suggests that castor oil may modulate
A double-blind controlled study of a single use of COPs vs
oil packs (COPs). white blood cell count and may have a positive effect on liver
paraffin oil packs in 36 healthy adults found an increase in
Transdermal Absorption function and cholesterol levels; further research is needed in this
total lymphocytes which peaked at 7 hours with T11 cells
Mein et al conducted a small study to assess castor oil area. The topical application of castor oil has been shown to
contributing to the overall increase. COPs were applied over
absorption through the skin vs oral intake. A 2-phase study reduce the pain of neurogenic inflammation, improve symptoms
the liver and abdomen for 2 hours with heat. At the 24-hour
comparing abdominal COPs for 3 consecutive days versus of constipation and to lubricate the eyes as artificial tears.
mark, total lymphocytes declined, although they remained
oral consumption found no significant difference in the
within normal limits.
urinary metabolites of castor oil pre- and post-COP while Acknowledgements.
significant differences were found pre- and post-oral intake. Deborah Kennedy’s efforts on this project were supported by a
career development grant from the SickKids Foundation.

4. Xenoestrogens & Breast Cancer:
Chemical Risk, Exposure and Social Determinants
Sarah Young, MA (1) & Dugald Seely, ND, MSc, FABNO (1,2,3)
1. Ottawa Integrative Cancer Centre 2. Department of Research & Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto 3. Ottawa Hospital Research Institute
Medicine,
Background Xenoestrogens and Breast Cancer
Incidence of breast cancer has risen in Canada by more than 25% Table 1: Common Xenoestrogens, sources and effects
over the past twenty-five years, is the leading cause of death in Xenoestrogens are chemicals that
women aged 20-44, and comprises over thirty percent of all cancer mimic the effects of estrogen due to
XENOESTROGENS FOUND IN EFFECTS
diagnoses in women. Nearly two-thirds of breast cancer cases result structural chemical similarities. As
from a combination of gene-environment interactions, lifestyle opposed to endogenous hormones, Bisphenol A (BPA) bottles, tin cans, drink containers, In vitro and animal studies:
water pipes, dental composites, optical neoplastic development,
factors (including lack of physical exercise, alcohol intake, and xenoestrogens come from sources lenses, adhesives, compact discs, paper proliferation of epithelial cells,
coatings expression of estrogen receptors
obesity), and exposure to environmental pollutants. Exposure to external to the body. Like other (ERs) and progesterone receptors
(PRs), and a decreased vaginal
estrogen is the most important identifiable risk factor responsible endocrine disruptors, xenoestrogens weight, transgenerational
for the development of breast cancer. While endogenous estrogen is can alter normal hormonal function, amplification.
clearly important, the contribution that xenoestrogens have on producing adverse health effects for Polychlorinated electrical equipment, plasticizers in Human studies: high levels found
breast cancer causation is just starting to be documented. both adults and their children. Biphenols (PCB’s) paints, plastics, and rubber products,
pigments, dyes, and paper. Though
in breast milk of northern
communities
banned in 1979 PCBs are still released PCBs are now regularly found in
Mammary tissue cells express specific into the environment from hazardous
waste sites. PCBs do not readily break
mammals and ocean wildlife in
the far north
Chemicals in Our Environment receptors, known as alpha-receptors down and remain for long periods of
time recycling between the air, water,
that can be stimulated by estrogens to and soil.
There are over 80,000 synthetic chemicals in and around us: they are induce the proliferation of end buds in Certain Pesticides used extensively in agriculture, in In vitro and animal studies:
sprayed directly on our food in the form of pesticides; they get the breasts. Proliferation of these end (i.e. DDT, heptachlor,
atrazine, chlordane,
homes, in workplaces, and throughout
cities on private and public lawns
immunotoxic, mutagenic,
carcinogenic, enhances the
pumped into the air by diesel exhaust and industrial emissions in the buds increases the risk of breast aldrin, lindane, 2,4,5-TP
and the captans)
metabolism of other xenobiotic
chemicals
form of polycyclic aromatic hydrocarbons (PAHs); they are used as cancer by augmenting the chance of Occupational studies: women
working in agriculture 3 times
liners in tin cans, are built into plastic water bottles and are found in mutation during cell division. more likely to have breast cancer
dental composites in the form of bisphenol A (BPA); are added to There are over 200 xenoestrogens used in industry, cosmetics, Cadmium from burning fossil fuels and In vitro and animal studies:
personal care products in the form of parabens; leach into the soil agriculture and food processing that act as mammary carcinogens
municipal waste, the smelting of zinc
and copper, and tobacco smoke.
induction of single-strand DNA
breaks, inhibition of DNA repair
and water from electronic waste in landfills in the form of cadmium, Cadmium is used in electroplating, in by inactivation of the mismatch
and have been found in over 95% of human tissue. Twenty-nine of alloys, as a de-oxidizer in nickel repair system, activation of
and are found in high amounts in the fish we eat as polycyclic plating, in Cd-Ni batteries, as oncogenes, inhibition of
these compounds are produced at over a million pounds per year pigments in glazes and enamel paints, programmed cell death
biphenols (PCBs). in plastics, and in fertilizers. Parts of (apoptosis).
in the USA. North America are known to have
high levels of cadmium in the soil.
Occupational studies: Women
working in automotive were 4
Since the 1950’s more than 750 million tons of toxic chemical waste times more likely to have breast
cancer.
have been discarded across 50,000 hazardous waste sites in the Relevant Social Determinants
United States alone. Among all North American jurisdictions, Ontario Parabens, Pthalates Personal care products, including Breast cancer rates amongst
Exploring the impact of xenoestrogens from a social determinants shampoos, creams, conditioners, African American women under
is the fourth highest emitter of cancer causing chemicals into the air, hairsprays, deodorants, cosmetics, and age 30 are 50% higher than white
of health model, we found that early life, food security, social perfumes women and their use of estrogenic
emitting over four million kilograms of reproductive toxins each year. personal care products is ten
exclusion, education, working conditions, income, housing, and times higher
Xenoestrogens consist of a class of endocrine disrupting chemicals availability of a social safety net had a significant impact on the Polycyclic Aromatic fossil fuel combustion, diesel exhaust, In vivo, in vitro and human
(EDCs) that have causative links to cancer and particularly to breast risk of exposure. These issues speak directly to breast cancer Hydrocarbons (PAH’s) consumption of smoked and grilled
foods, and from cigarette smoking
studies: mutagenic, increased
proliferation of cells, effects on
cancer. Common xenoestrogens include Bisphenol A, PCB’s, risk and chemical exposure and inequities in society as well as the estrogen receptors, enzymes of the
CYP 450 family and on the
Cadmium, Pesticides, PAHs, Parabens and Pthalates (see table on issue of vulnerability. The timing of exposure to increased levels of tumour suppressing gene
right for more detail and examples). both natural and chemical xenoestrogens in a woman’s body,
embryo, fetus, and infant plays a key role in the development of Acknowledgements. This review was funded by the National
cancer. Network on the Environment and Women’s Health

5. An observational study of adjunctive cancer care at the
Canadian College of Naturopathic Medicine
Gillian Flower ND1, Natalie Bozinovski ND(c)1, Gabriella Chow ND1, Kieran Cooley ND1, Martha Grant ND1, Christopher Habib ND1,
Daniel Lander ND, FABNO1, Tara O’Brien ND1, Jill Shainhouse ND, FABNO1, Dugald Seely ND, FABNO1,2.
O’
1. Canadian College of Naturopathic Medicine; 2. Ottawa Hospital Research Institute
Table 1. Select patient characteristics by cancer type Diet, lifestyle and mind-body interventions were common, as
Background was individualized homeopathy, tinctures and teas.
Mean age at % reporting
The Adjunctive Cancer Care (ACC) shift provides Primary cancer Female / Number of Analysis of EORTC, MYCAW, MYMOP and KI showed that
diagnosis – years conventional
naturopathic care to patients with cancer at the Robert type male patients scores improved or were unchanged more frequently than
(range) care pre-RSNC
Schad Naturopathic Clinic (RSNC), the teaching clinic of the Breast 31 / 0 31 49 (30-76) 80.6 they worsened (Figure 1). This was true across all scores and
Canadian College of Naturopathic Medicine (CCNM). This Digestive1 17 / 10 27 55 (2-83) 88.9 subscores in all measures used. The subset of eligible
cross-sectional, observational study summarizes Prostate 0 / 20 20 61 (48-79) 40.0
responses per tool was small (n= 11-30) although 39.1% of
demographic, outcome and treatment data for patients all charts yielded eligible responses for at least 1tool.
Hematologic 8/6 14 45 (23-63) 78.6
seen on the ACC over a 13-month period.
Female reproductive2 13 / 0 13 52 (26-71) 100.0 The 5 most common patient-identified concerns, elicited
Neurologic 4/5 9 21 (0-67) 88.9 through MYCAW use included: references to cancer, to pain
Methodology Head and neck3 5/2 7 53 (32-74) 85.7 or discomfort, to energy or fatigue, to weight or
Other4 9/8 17 54 (33-83) 47.1
nutrition or to gastrointestinal symptoms. 84.2% of
Point-of-sale software was used to identify patients that had evaluated patients named at least one of these 5 concerns.
been seen on the ACC from December 2009-December 1 – Colorectal, hepatic, pancreatic, gastric; 2 – ovarian, uterine, vaginal; 3 – salivary, oral, thyroid,
sinus; 4 – includes lung, skin, testicular, osseous, diverse types not included elsewhere
2010. The in-house Naturopathic Patient Database (NPD)
was consulted for patient information, but a lack of 18% of patients reported a refusal of conventional treatment at some point,
Discussion
sufficient data led to a full patient chart review. many having tried chemotherapy or radiation previously. 9 deaths (6.5%) A diverse range of patients and cancers (type and stage) are
Patients were included if they had a diagnosis of cancer and were confirmed. seen by student interns on the ACC at the RSNC. Treatments
had >1 visit on the ACC. 35 data points were collected in include supplemental, lifestyle and dietary therapies and reflect
51% of all patients received intravenous vitamin C therapy (IVC), with use a blend of cancer-focused and individualized care.
addition to scores on 4 validated assessment tools: the ranging from 45%-71% across various cancer types. Far fewer patients
Karnofsky Index (KI), the Measure Yourself Medical with neurologic cancers received IVC (11%), but only 4 patients in this Patient-defined symptoms commonly include concerns with pain
Outcomes Profile (MYMOP), the Measure Yourself Concerns group were eligible to receive this treatment in Ontario (>13 years old). and energy. EORTC results show fewer patients worsening in
and Wellbeing scale (MYCAW) and the European these subscores than the number that maintain their current
Organization for Research and Treatment of Cancer quality Oral supplementation was recommended in 98.5% of patients that had at status or improve. Other patient- and intern-based assessments
of life questionnaire (EORTC). Intern prescriptions were also least 1 consult-type visit. All supplemented patients were given at least one of symptoms and function include the MYCAW, MYMOP and KI.
counted. of the following 5 prescriptions: Vitamin D, curcumin, EGCG, All suggest a trend towards patient stabilization or improvement
melatonin and fish oil. in evaluated outcomes.
Results Figure 1. Percent of patients improving, not changing and worsening according to
EORTC(1-5), MYCAW (6-7) and Karnofsky (8) results (>27 days of evaluation).
Some limitations to this study include the small amount of
eligible data for each tool. Responses were included if the same
189 patient charts were reviewed and 138 met criteria for tool was used on more than 1 occasion and if the time elapsed
inclusion. 64% of patients seen were female. Breast cancer 100% between administration was >27 days yielding as few as 11
was the most common diagnosis, seen in 22.5% of all 80% responses in one instance. The original goal of using the NPD as
cases. Mean age at diagnosis was lowest among neurologic Worsened a source of data could not be met, necessitating a chart review.
cancers where 5/9 patients were 3 years of age or 60% Unchanged
younger. Short- and long-term naturopathic care may successfully
40% Improved address some of the most important concerns of individuals
Table 1 summarizes select patient characteristics. with cancer. Further research investigating patient experiences
20% and comparative effectiveness of naturopathic treatment of
Average duration of care was 298.4 days (range 2-2163),
0% cancer are warranted.
with an average of 7.4 (0-70) consult-type visits per patient.
51.5% of all patients had conventional treatment (surgery,
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Our thanks to the interns of the ACC shift 2009-
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