Julia Hartung | Ep #37 | Integrating Acupuncture in Cancer Treatment

consultations or professional medical advice hey guys i’m tasha hey listeners this is goonie and we’re here to discuss lifestyle medicine hi everyone welcome to daughter of the podcast today we’d like to speak about approaching cancer treatments in a more integrative way and specifically the impact of using acupuncture to support cancer patients in their cancer journey and for this we have dr julia hartung a doctor of internal medicine with a specialization on hematology working as a senior oncology consultant at clinic solingen in germany dr julia is also a licensed traditional chinese medicine practitioner who runs her own private chinese medicine clinic in germany julia welcome and thank you for being here today i’m very happy that i can talk about something which is coming from our heart and so i’m happy to be here well welcome uh julia as tasha rightfully said today we are really talking about something very uh important with regards to oncology and how um people can recover uh how they can find different alternatives as they recover from cancer or as they’re going through cancer and so to to kind of touch base on some of the mindset and um revolves around suffering from cancer is usually a feeling of helplessness and anxiety so as alia crum a psychologist from stanford university says cancer is more than just a physical disease yeah and in her research she she says as we strive to target malignant cells with the latest cutting-edge treatment we should simultaneously strive to provide equally precise treatments for the psychological and social ramifications of the illness and even if you look at the neuroscience and the psychology in the past decades the link between you know mind and body is it’s quite recognized right now having the perspective of a chinese medicine medical doctor which is uh dr hartung and he has the oncology background but also the traditional um chinese medical background as well so before we dive into our conversation today could you tell us your your perspective of what integrative medicine means to you we take the best out out of all the options we have we know we have the kind of western allopathic um treatments and we’re happy that we have them we can do a lot more for cancer patients and getting rid of the cancer through a lot of new treatments with less side effects and we shouldn’t we shouldn’t say just go on and do skip the western medicine we need it because it’s anti-cancer but on the other hand we have learned that a lot of other factors are and therapies can be very very effective this is the kind of medicine which is probably more individual um because we look at the person and not the cancer you could say like the allopathic western medicine and the more holistic natural medicine they’re two important things the the first important thing is if we do complementary medicine we have to be careful not to reduce the effect of the western medicines the other thing is in germany we all have quite often a wording of alternative medicine it’s not alternative that wouldn’t make sense it’s important it is complementary it is an extra next to the the treatment if necessary through through western medicine if we talk about complementary medicine we have like a lot of methods we use natural products we talk about diets about herbs about supplements vitamins that’s a big group of of treating or helping patients then we have a mind and body medicine like the mind and body stress reduction program which is very very modern and very effective for body mind setting but also chikum yoga meditation are really important because as you said before the psychological problems patients have are very big and a lot of discomfort might come because of fear and stress the definition of the word integrative of you’ve mentioned alternative and you’ve mentioned complementary and i think that it’s interesting point to bring up because when we say alternative it’s it strikes as something that is out of this world or weird or not accepted and it comes with baggage right and then when you say complimentary it also comes with baggage because complementary could sometimes sounds less than right because it’s there to complement but it might it might look like it’s less good than the other each modality has its strength yeah and and that’s why i think this conversation with an oncologist brings a very interesting perspective of what it really means integrative uh medicine i had a very individual perspective of the patient very individual understanding of pathology like in western medicine and then i make a diagnosis a chinese medicine diagnosis but i have two worlds coming from two sides with an overlap which makes it more accurate where we’re using a very very old medicine with the whole pathological and system and the diagnostic system so that’s very important for me they have other systems like the ayurveda medicine or the homeopaths um or naturopaths which have they’re not just using something they have an idea a concrete idea why they use it in this patient so i love that a lot and i think it’s very important for patients too essentially like integrative medicine is really a collective of the person you’re seeing in front of you and not just an isolated um you’re in you’re you’re diagnosing just the disease itself right so i guess like from that how have you seen a used acupuncture in your own i guess uh experience with with pic cancer patients it’s important to understand that we can have a lot of indications for acupuncture the most common one is nausea it’s very easy kind of to to choose points for that but we can treat fatigue and nerve system problems we can treat constipation we can treat diarrhea women with anti-hormonal treatment they have a lot of menopausal symptoms we can work on that we can so there are a lot of indications we actually can use and the beauty about chinese medicine is again the mind and body system i’m treating the body but i always use have an idea where i use a point especially because i think it’s working on the spirit or the shen as we say in chinese medicine i know that every patient has cancer has some kind of emotional status were where they need to help or where they can relax better or they feel they’re a lot of patients get up and just say i just feel my body in a better way than i did before so this kind of mind and body set is very much in the acupuncture treatments too so that that’s very important for me when i do acupuncture i do it in the hospital i do it not that much i’m just starting to implement it there but in my private practice i’ve seen many many patients and every problem with which they come with i’m trying to think how they i can help them with acupuncture when you see your patients right is your point of assessment or like of sharing that this isn’t an option that’s available to them is it something that you just share with every patient or is it that you you’re you’re tuning in to see whether this person is going to be receptive to this i have two work sets in the hospital i’m still working as an oncologist too and so i’m trying to bring the idea of integrative oncology listen you have the possibility to do more than just cancer treatment patients who come to my private and clinic they come because i do acupuncture because i do work with chinese medicine they have been looking for it well in the hospital i’m trying to bring the option to a bigger group of patients who have never thought about something like that before so that’s kind of my mission what i’m doing in the hospital while in the private practice i don’t have to discuss it because they come because of my experience in that field you have different type of cancer patients that you know from a different mindset with regards to absolutely absolutely tcm as a complementary modality as they go through the allopathic treatments so we have the ones who who believe in so they you don’t need to do a lot of convincing or explaining i guess then you have the ones who are they’re not aware about it what is your conversion rate if we were to say like explaining to people that there is maybe another aspect for them to to help out with that nausea with their side effects are they are are they receptive is this um many of them because they’re in despair and they’re afraid of side effects and i always call it kind of my box of tools i have which i can use to help them to get through the treatment in a better way there are some patients who just are perfectly fine with the western medicine treatment then i i don’t make any effort and their patients who just want to do everything and a lot of stupid things too to to get rid of the cancer then there’s the group who starts to understand that it might be a very very good idea to get active themselves and i’m trying to bring them pictures to understand why it is happening and it’s quite fascinating i’ve been working quite a while in a more rural area in a hospital and they were kind of ex-farmers or they had a lot of forest around them and they were kind of never had an idea what chinese medicine started talking about nature because that was something they could really easily understand understanding what’s what’s happening already relieved them a lot because understanding is the best thing against fear for your specific example comparing or bringing traditional chinese medicine to a population that you might think that won’t relate to but by using the language that they are most familiar to will make them click and actually when you think about it even say ayurveda or tcm they’re all based on the explanation on natural aspect or environment that are happening out there and so it’s very easy to understand actually and so that’s why i think it’s it’s an easy way for them to actually adopt it i’ve seen some patients in my private practice just two or three times just help them to understand what’s happening and then they find things which are just perfect for them i always tell my patients you have to find your own a puzzle it’s a german more jigsaw puzzle i think it’s in english and then you take all the pieces which are right for you and make your own picture and sometimes they don’t need chinese medline they need something totally different but helping them to to find their way and their way of helping themselves is a very in my view a very important task for integrative medicine i i like how you describe that the analogy of a puzzle right because that makes people feel like they are also co-creators or like masters in the in the process they are the ones who can take ownership and seize some sort of control in their situation you know like a big part of research is that cancer patients tend to feel a complete lack of control in the process with your chinese medicine practice what is the the side effect or the the thing that you’re treating the most out of all your cancer patients two things i guess all the eye problems nausea constipation no appetite fatigue being tired at the same time not being able to sleep think those are two major groups and for the nausea part is there there’s good data actually and the national institute of health in the united states has a list of kind of indications where acupuncture is good and nausea is one of the top indications and there’s a lot of studies for one single point which is just um here called pericardium six and they have a study where they do you know the sea bends the elastic bands with a kind of small teach patients to put acupressure or pressure on that area study could show that they have less nausea doing this on the day and the next day of the chemotherapy you can use your needle there too embodied needle the very thin needle under plaster you can put an in it and patients can do it themselves so and this is is effective just one point and we’re getting more and more effective if we have an idea about the chinese diagnosis and and other points too so that one point is already that effective it’s very fascinating so you said gi what are gi’s a gaster intestinal problems okay um like like everything from mouth to the to the um end of the the gut if we were to break it down you have the malignant cell right so you have oncology chemotherapy that would be that to remove the cell and then you have the side effect of it which could be all as you said gi effects exactly but then there’s another bit which we didn’t really cover which is potentially more the psychological aspect which is we were saying you know the loss of control the anxiety um because again you know as the research argues that there’s a lot of catastrophic thinking because the c word has baggage that comes with it viewing cancer as not manageable or you know feeling like it’s it’s the end that anxiety can sometimes be crippling and have you seen or in your opinion the thinking on the mind overwhelm the body’s ability to heal yes definitely trauma fear only it’s a real trauma for some patients and i’ve seen a few patients seeing them see it looking into their eyes because i was afraid they wouldn’t make it because they were in such a shock that the whole system couldn’t really react and i’ve seen quite a few patients of them and their outcome was horrible on the other hand i see the patients were really good they’re kind of good with themselves and they they have a lot of resources to work on on this trauma and they come out in the end much better so this is definitely let’s name it a risk factor right if you have a severe deep trauma and you can’t get to it this is bad prognosis that’s the reason already the western medicine has a psycho oncology right and and i when my when i talk first first talk to the patients this is one of the things i offer them i tell them perhaps you don’t need it now but keep it in mind if you have the feeling you you you can’t do it yourself please tell us we have great doctors psychologists who can help you to get through that do you think tcm can help alleviate this and how acupuncture and that’s one of the things acupuncture getting finding points i have to go step back if a patient comes he has cancer but he has a constitution too and he has a history and a personal development too that’s right and the oncologist is mainly looking at the cancer the nurses and psychotic psycho-oncologists have the chance to get deeper to the the constitutional part in chinese medicine i look at the constitutional part too i normally can’t palpate cancer in a pulse but i can see where where he is or she is at that moment and i’m treating that i treat what i see what they bring back with the kind of from their life and as i said when i treat i always have some point some points where i relate to the emotional situation the patients are in but sometimes it’s so deep they don’t want to be treated and sometimes it’s so deep whatever you do they’re so blocked with fear and trauma that you need more than one therapeutic tool to get to the to to the thing for somebody who is more an allopathic mindset a scientific mindset a western mindset when you say i see sounds a bit too big or too mystic no i don’t think so a good and many of my western medicine colleagues see that too because we have we have seen so many patients and we know if somebody has fear it’s observation skills right it’s of observation skills definitely okay it is you you can tell if somebody is sad just looking into the eyes and if you if you have a you have seen many many patients and you’re open to that um you can name emotion this is not a chinese medicine medicine only tool i’m i’m not i’m not a psycho-oncologist i’ve i know about what’s going on because i’ve been in oncology over 20 years but just the fact that i put them a mirror and and tell what i see moves already something and then they lie down and i’m not talking anymore but i take needles and then something has happened so what i pick up from what you’re saying is that the reading of what you see in general could come in many different ways does the observation skill of the patient and based on your data set of all the you know the patients you’ve seen so that’s the observation skill and then there’s the pulse i think that’s a way of reading and seeing and i think that the pulse reading for somebody who’s who is more of a western medical mindset might have issues understanding this yeah but there is a real a technique of reading pulse yeah and it’s it’s a long process to learn that and not all chinese medical doctors are trained in that kind of thing and then there’s the other bit which is understanding the feedback of your intervention by acupuncture and how they react to your absolutely absolutely um sometimes they forget about their symptoms they come to to my clinic and i i talk to them first and see how they are what kind of problems they have and they threw yeah i think i feel a bit better and then i look into my previous notices of the previous charge and say what but what’s about your nausea and then they suddenly sit there and say oh i don’t have any nausea i didn’t realize that these patients who kind of go with the flow of chinese medicine learn a lot about their their system and their body and how to interpret it that and how they feel the quality of life is changing in most cases not at all but in most cases from this and you’re explaining of the experiences of your patients can you say there’s such a thing as like success rate with with acupuncture um i don’t like the word success rate because it reminds me a bit more of western medicine like we have progression-free survival and percentage and how long they live um and i don’t like that i don’t like that to use it’s really the quality of life um what the patients are describing me and also what i feel and see it is not we can’t measure it like that in chinese medicine um and the one thing i know that not all patients will have or will feel that they’re getting better then it’s not their way to get through it or they need herbal treatment or they just need another puzzle um element to to for them personal so and then talk to them i i’m not continuing with with acupuncture if i have the feeling it’s not a thing um i start to discuss what could be an alternative for them and that’s the reason you have to know what’s what possibilities are there so that’s quite quite important what you’re seeing is a positive experience say it’s not a success rate but a positive experience of acupuncture or complementary medicine along an oncology treatment is basically sometimes they even forget that they had side effects so that’s that’s a measure of a positive experience absolutely and and then it’s asking questions all the time and seeing if you know they are they’re doing okay and that that’s how you can measure really a positive experience but i think it’s it’s a tricky question um that we’re asking but it’s a question that any medical doctor will ask it’s like how can you measure that whatever you’re doing is effective i can’t use a lot of the techniques which would you use in western medicine and that’s fair that’s fair yeah and that’s a problem with studies in in chinese medicine because we way to think is differently and we can’t use all of the measures of western medicine that’s one of the problems we you have and then it’s even more and exciting if we actually see a study where we can use western medicine tools and say 70 had a profit out of some kind of treatment yeah but that’s that’s not what i do in chinese medicine practice and actually if i have a patient i also in oncology always look what’s happening with him every patient is unique right yeah i think i have to make a point for my colleagues oncology um colleagues we know all about the statistics we know what’s to do what we have to do but really the big group oncologists looking at the single person with their cancer and the whole picture what he’s bringing in they’re still doctors who can’t do that but um i think to become an oncologist you need some kind of of this kind of view to get through a 20 or 30 year career with people um where the majority or not the majority anymore but will die otherwise you can’t survive it if you don’t look at the single patient it goes to show that you know it’s not so straightforward and that’s why having complementary medicine and allopathic medicine trying to merge together is going to be an uphill battle to measure give it some sort of measurement of success so to speak right i see a success that all the big cancer centers actually have some kind of integrative medicine department if you look to the big cancer centers in the state they all have most really most of them have an acupuncture department they have qigong tai chi whatever classes they have mind and body classes so it and that’s not um because it’s nice to do it but because everybody knows it’s it’s an important part or can be a very important part of treatment so you mentioned the u.s and how cancer cancer centers have recognized that there is a holistic aspect to healing and recovery what has been your experience in europe or in germany because where you’re currently based as in germany what is your experience of how people currently are approaching cancer recovery or treatment versus the us one of the big differences is finances so i’m not going to talk about that but we have i’ve been i’m doing some research on that because as i said i’m going to try to bring it into the hospital where i work now there are a lot of hospitals we have which have some kind of an integrative department not specifically only oncology but for the whole hospital for all departments especially in breast cancer women already are asking for things like that they are very well organized most of my patients are women they’re more into things like that right now so the group of gynecology cancers breast cancers are very very well organized and they are going to ask for something like that and they’re going to look for a hospital where they might get something like that definitely wow so basically you’re saying that it’s the demand that is driving the change and it’s it’s the demand is get i guess a lot of my colleagues say oh god do we really need that but um yes it’s a patient’s demand um to have some opportunities to do more than than the western medicine cancer treatment that’s it that’s a good sign to see definitely changing people are also you know more interested in complementary ways and in the context of actually getting treatment right is there a specific time that is good to get treatment in your in your cancer recovery or cancer journey whenever it’s right so i like to see my i would love to see my patients before they go into treatment because then i see i would see more about their very personal constitution but they’re so busy at that time with x-rays and this and that they normally turn up um with me at that time you can do it before cancer treatment you can do it during cancer treatment and after cancer treatment i would like to see them at all three times um where during cancer treatment acupuncture is no problem um there are some things where western medical doctors are afraid our interactions of herbal treatment and chemotherapy so you have to be aware of that but at any point you can treat with acupuncture it’s not going to interfere it’s going going to help most of the patients and during the treatment it can be really getting the infusion and can be after a few days after or even before the next treatment it depends a lot on financial matters but also who’s going to bring the patient to the doctor to get the treatment um it’s very and once again it’s because it’s back to the individual right so it’s whether or not it’s suited for them before during after they need to tune in it’s never wrong to to start some the wrong time to start something and it’s sad to say that it’s because it’s not available it’s because they are at a point they’re at a state where it’s already you know maximum and if it was more i think you know available i i think you would see different trends but that’s my assumption and maybe it’s a wrong one but uh to to close off our conversation um julia my last question to you would be what would you like to see more in the way we approach cancer good question be open to things be open for the patient to tell you what they need one i think very important thing to make it more accessible for more people perhaps that the um social security system or the the healthcare system finding a way to finance patients who who don’t have enough money to to do it and but i must say that even people who have no money and they feel it’s getting better they always they never discuss the price the ones who have the money start to discuss the money and the price um to have a society which is more open to to topics like that and especially the hospitals be more open to integrate it and and to the system and i’m quite happy at the moment because the the hospital is willing me willing to pay me to to start something there even though the patient probably has to pay some some price for it but um they they engaged me because they want to to be open for this kind of thing so and it’s important we have seen and that’s perhaps a good ending we have seen um extra ordinary results in patients who really got active all that we have there are some good documentaries on that that people who really got engaged in their treatment who were able to to change things who looked at their diet their exercise their mindset if we see extra ordinary results in patients we see these things and and that make that’s a good hope for our patients if they know they’re getting engaged in their treatment um as much as possible um to have a better quality of life and even um perhaps a better chance to live longer or to survive at all yeah and actually in one of our research they directly quote that viewing cancer as manageable and recognizing the body as capable and resilient may motivate patients to participate in activities and initiating lifestyle changes like eating healthier getting exercise and patients may become less afraid of side effects from treatment and cancer recurrence afterwards so it’s just like building that strength over a traumatic event and and i think that this is where this it’s a nice way to end because we’re really saying that at the end of the day that it’s there there seems to be a pattern that like everyone goes through and if we start adopting those those best practice it it might help us yeah thank you for that julia and before we close off completely we do our rapid fire questions yeah which is kind of just to get to know you a bit better um so what is the first sign that you are out of balance i can’t sleep um and i can’t eat stop having an appetite and that i love eating so this is really a kind of a sign where i say okay something is wrong what is then what is your method of coping when you recognize those signs um normally i’m going into my garden i’m just going into the earth and i see things growing and i planned if i go into the garden for to have a very small garden um but for two to three hours i come back and i’m fine or i’m going into nature and um cycling hiking i’m i’m into hiking really a lot nature and the realization at what point of the year i am helps me a lot to to recover faster and sleep again better and have an appetite again and chinese medicine i’m taking on a regular basis um um herbal treatment so and what is one book if you had to pick one no but that has that’s difficult with me um i love reading and um i i’m coming out of a family who has been reading a lot my great my grandfather was an author actually but reading is essential for me i need to read um for for relaxation for learning for enjoyment and so reading itself is a process which is really really important for me only book i can tell you is the first book with hardly any pictures in it which i read for myself okay and that that book is still in in my cupboard um because that was so so enormous for me i remember the feeling that i read a book without the help of my parents oh well and suspense what is what is the name of this book um it’s in is the name of a girl is the only child of of of her parents who is getting ready to go to school the first time this is a true reader right here exactly well that’s awesome thank you so much julia it’s it’s that was great i liked learning about you in that sense and thank you so much for sharing your insight we’re glad to have you here today thank you very much i enjoyed it a lot if you enjoyed this episode go ahead and select that follow or subscribe button for now stay safe and we’ll see you next week