Snacksize 7: Integrative Cancer Therapy

医生的厨房。

Doctor's kitchen.

食谱、健康与生活方式。

Recipes, health, lifestyle.

欢迎收听《医生的厨房》短篇版，这里是主节目精选的片段，聚焦饮食、医学、生活方式，以及如何当下就改善你的健康。

Welcome to Doctor's kitchen snack size, snack size snippets from the main podcast all about food, medicine, lifestyle and how to improve your health today.

今天的短篇内容，讲的是癌症的整合疗法。

Today's snack size is all about integrative approaches to cancer.

这显然是个情感强烈的话题，但我坚信，我们还能做更多来预防和治疗日益增多的癌症，尤其是在西方国家，癌症发病率的上升与肥胖率的升高密切相关。

Now, this is obviously a hugely emotive topic, but I'm a firm believer that more can be done to prevent and treat the multitude of cancers that we are seeing, especially in Western nations where there is a correlation with rising rates of obesity.

你可以在第72期和第159期节目中听到佐尔曼医生深入探讨整合医学的兴起，以及它在癌症预防、治疗和防复发中的应用。

You can catch Dr Zollman on episode seventy two and one hundred fifty nine, talking all about the rise of integrative medicine and how it applies to cancer prevention, therapy, and preventing recurrence after treatment.

我们来深入聊聊，整合肿瘤学对你来说具体意味着什么？大众是怎么理解这个词的？有没有官方定义可以讨论？因为我觉得很多人对这个话题很感兴趣，而我希望能为佩妮·布朗树立一个标杆——让所有肿瘤中心都以她为标准去努力。

Let's dove in and let's talk a bit about what exactly integrative oncology means to you and what people understand it to mean and if there are any sort of official definitions that we could discuss as well because I think people are fascinated by this subject and I I'm trying to be a big signpost for Penny Braun as you know, the sort of benchmark, the standard by which all oncology centers should aim towards.

不过，我们还是先聊聊整合肿瘤学吧。

But yeah, let's talk a bit about integrative oncology.

其实吧，我觉得词语有时候能帮上忙，有时候反而会造成误解。

Well, it's, you know, I think words can be such a help and such a hindrance.

对我来说，整合肿瘤学本质上和整合医疗是一回事，也许我更愿意叫它整合癌症护理。

You know, I think for me, integrative oncology is the same really as integrative you know, I'd call it integrative cancer care maybe.

‘肿瘤学’这个词听起来像是必须在医院里进行，得由穿着白大褂、用高科技设备的专家来操作。

Oncology makes it sound like it's an ology that has to happen in a hospital and that has to be specialists in white coats with high-tech stuff.

但事实完全不是这样。

It absolutely doesn't.

整合肿瘤学其实就是整合医学在癌症治疗中的应用。

Integrative oncology is really integrative medicine as applied to a cancer situation.

我们现在看到整合医学、整合风湿病学、整合胃肠病学都在兴起。

And I think we're seeing movements in integrative medicine, integrative rheumatology, integrative gastroenterology.

所以说，整合方法其实可以应用到各种临床场景中。

So I think it's just sort of saying integrative approaches can be applied to all sorts of clinical situations.

而癌症恰恰是最能体现这种做法价值的例子，事实上，已经有越来越多的人用实际行动选择了这种方式。

And I think cancer is best of examples of where it can really make a difference and where it has, you know, people have been voting with their feet.

很多癌症患者都会使用辅助疗法，可以说是绝大多数人。

People use people with cancer overwhelming, you know, a majority of them.

这其实取决于你怎么定义整合疗法。

It depends how actually define what integrative approaches are.

但在不同研究中，有百分之六十到八十的癌症患者会在常规治疗之外，额外采取一些其他措施。

But in different studies between sixty and eighty percent of people with a cancer diagnosis are doing something in addition to their conventional medicine.

所以人们正在用行动做出选择。

So people are voting with their feet.

他们选择这些方法，是因为有时候常规治疗效果很好，但很多情况下效果有限，也不能保证治愈。

They're using it because sometimes because the actual solutions, the conventional solutions, in some situations are great, but in many leave a lot to be desired and not guarantees of cure.

而且常规治疗的费用往往也很高。

Also partly because they come at quite a high price.

因此，治疗带来的副作用通常相当严重。

So the toxicities of treatment can be quite considerable.

所以人们很自然地想寻找减轻副作用的方法，或者找到能帮助自己的途径。

So people are understandably looking for ways to reduce that toxicity or to find ways that they can help themselves.

而且癌症常常是人生中一场真正的危机。

And also cancer is often a real crisis in people's lives.

这不是大多数人能轻描淡写、照常过日子的事情。

It's not something that many people can just sort of take in their stride and keep on going as normal.

它往往让人停下脚步，重新思考，调整人生方向。

Often it does precipitate a bit of a stop and a think and a reorientation in life.

而这恰恰可能是一个契机。

And that can be such an opportunity.

我们在彭尼·布兰纳斯经常说，危机有两个层面。

We often talk at Penny Brannas, a crisis has these two elements.

一方面有危险，但另一方面也藏着绝佳的机会。

It's got the danger bit, but it's also got this fantastic opportunity.

如果我们能帮人们抓住这些机会，就能把原本可能带来巨大伤害和创伤的事件，转化为促进成长的可能。

And if we can help people harness some of that opportunity, we turn what could otherwise be a really negative and damaging event, traumatic event, into something which allows the possibility of growth.

所以整合式癌症护理、整合式肿瘤学，我认为本质上是一种明智的结合：找出哪些方法能帮助患者应对癌症诊断带来的影响，尽可能好地生活，尽可能长久地活下去，同时增强他们的韧性，提升他们面对癌症乃至整个人生的应对能力。

So integrative cancer care, integrative oncology is really, I think, again, it's that intelligent combination of saying, what are the things that can help this person deal with the impact of the cancer diagnosis, live as well as possible, and live as long as possible going forward in a way that builds their resilience and builds their own capacity to move forward, not just with the cancer, but with life in general.

我觉得吧，这里面涉及好几个方面。

And I think it's you know, there are different areas.

当然，常规治疗在很多情况下对他们来说都特别重要。

So there's obviously the conventional treatment that's gonna be really helpful for them in many cases.

有些情况就比较微妙，需要权衡一下。

In some cases, it's gonna be a bit more in the balance.

这个有用吗？

Is this helpful?

不是吗？

Isn't it?

要是能多一些其他选择或替代方案，也会很有帮助。

And, again, having some other alternatives or other things to bring to the table can be really helpful.

生活方式医学非常重要。

So lifestyle medicine is hugely important.

我觉得，跟你一样，这就像一张紧密相连的网。

I think like you, I see that as a real connected web.

饮食、运动、睡眠、休息、你如何看待这个世界、如何应对日常压力、如何与生命中真正重要的事物建立联系——无论是人和社群，还是热情、灵感和你汲取力量的源泉。

It's what you eat, it's how you move, it's how you sleep, it's how you rest, it's how you think about the world, it's how you manage stress, the sort of everyday stresses of life, it's how you connect with the things that really matter to you in your life, both the people and the communities, but also the passions and the sort of inspiration and where you draw your strength from.

我觉得这些全都是生活方式医学，它们彼此支持，往往只要有一件事开始往好的方向走，哪怕只是小小的改变，也会产生连锁反应，真正改变一个人的心态和身体健康。

All of those things I think are sort of lifestyle medicine and all of them have a wonderful way of kind of supporting each other to sort of once one thing starts moving in the right direction, often it's small steps that can have a bit of a domino effect and can really start to change people's attitude and actually physical well-being.

所以，即使那些根本没想着要治愈癌症的人，也可能开始意识到：等等，其实……

So even people who aren't really necessarily even thinking about having their cancer cured can actually start to say, know what?

但我现在活得更舒服了。

But I feel I'm living better.

在Pennybrown，我最感动的时刻之一，就是和那些临近生命终点的人交谈，他们却活得如此有活力、有生气，甚至说这是他们一生中感觉最充实的时刻。

And some of my most moving experiences at Pennybrown have been talking with people who are close to death sometimes, but who just are living in such a vibrant and alive way that they say sometimes it's the most alive they felt in their whole experience.

我觉得这特别关键。

And I think that's really key.

对我来说，整合肿瘤学、整合癌症照护还有另一个层面，就是帮助人们自助，同时也给予支持。

And I think integrative oncology, integrative cancer care for me has another sort of dimension, which is this helping people to help themselves, but also supporting them.

因为这个过程就像过山车一样，能量时高时低。

Because it's a real roller coaster in terms of energy up and down.

有时候，治疗或者疾病的症状真的会把你拖垮。

Sometimes the treatments or the symptoms from the actual disease really take it out of you.

我觉得我得挑战一下这种观念。

And I think I do want to challenge this thing.

我们并不是说，这里有套标准流程，你拿去自己搞定癌症。

We're not saying here's the sort of instructions, you go away and you sort your own cancer out.

这不公平，把太多责任压在了个人身上。

I think that's unfair and it puts far too much responsibility on the individual.

所以我们其实可以做很多事来支持患者。

So I think there's a lot that we can do to support people.

这可以通过他们的常规肿瘤治疗团队实现，也可以通过更广泛的支持网络，比如心理咨询师、营养师、运动指导员，还有提供按摩、针灸等疗法的辅助治疗师，这些都能在艰难的治疗过程中，给身体带来一些舒适和慰藉。

And that can be again through their conventional oncology teams, but also through a wider network of other people, counselors, nutritional therapists, exercise facilitators, complimentary therapists who can give massage or acupuncture or treatments that can actually give the body a sort of feel good experience in the middle of all of that difficult and challenging treatment.

所以我认为，整合型和高质量的照护，如果要把所有方面都涵盖进去的话……

So I think integrative and quality, if I said all the aspects.

也就是说，把多种方式整合起来，包括常规的、生活方式的，还有辅助疗法。

So it's integrating a range of different approaches, which include conventional lifestyle and complementary.

我觉得让患者感受到自己是一个完整的整体，这一点也非常重要。

I think it's also really important to integrate that people feel themselves as integrated.

很多人进医院后，总觉得别人只关心他们的身体。

So often people describe the experience of going into hospital as if all they're interested is in my body.

但其实连身体都不是全貌，他们只关注扫描图像上那块在变大或变小的区域，或者PSA数值的升降。

And in fact, it's not even the whole of my body, it's the bit on the scan, which is either shrinking or growing or it's the blood marker that's showing my PSA going up or down.

我知道医生本人并不真这么想，但整个医疗系统却在无形中要求他们这样去应对。

And I know it's not when you talk to the oncologist, that's not what they really believe, but that is sort of how the system is expecting them to react.

于是患者常常觉得自己像传送带上的一块肉，被系统来回运送。而帮助他们重新与自己的身体建立连接，其实并没有让他们失望。

And so people often feel a bit like a slab of meat on a conveyor belt going through the system and really helping people to connect back to their body hasn't let them down.

这并不是一片敌对的领地，帮助他们重新与自己的身心、情绪和精神建立联系，让他们感受到自己是一个完整的个体在经历这一切，这种整体体验是真实而重要的。

It's not a sort of enemy territory and helping people make friends again and connect their minds, bodies, their emotions, their spirits, so that they feel like an integrated whole person going through this journey and they feel that their whole person experience is really valid.

我认为另一个关键的整合，是把患者真正放在自己医疗团队的中心位置。

And then I think it's really the other bit of the integrating that I think is really important is integrating them at the centre of their own healthcare creation team.

要真正把他们看作自己身体的专家，尊重他们对自己体验的了解，明白什么对他们有效，什么对他们重要，他们的优先事项究竟在哪里。

So really seeing them as expert body, their in their own experience and in their own inner knowledge of what works for them and what they feel is important and what their priorities are really importantly.

希望你今天喜欢这期《医生的厨房》短篇内容。

I hope you enjoyed today's Doctor's Kitchen snack size.

别忘了，完整版节目可以在医生的厨房官网 thedoctor'skitchen.com 上收听。

Remember, you can find the full length episodes on the doctor's kitchen website at thedoctor'skitchen.com.

我是鲁皮医生。

I'm doctor Rupi.

我们下次再见。

I will see you here next time.