Robert A. Hayden, DC, PhD, FICC
I just realized how alliterative that title is. I assure you that was accidental, but notice that I left it as is.
Early this morning, a potential patient approached me for a consultation. This lady has a form of cancer with which she has been coping for several months. A more recent development has been hip pain that radiated down to the knee.
If you have cancer, any new pain can be very frightening for the implications alone. This particular pain was worse at night, and anything that awakens you with pain in the middle of the night can be imagined to be something awful. It is easy to see why she was worried.
I am often asked whether chiropractors treat people with cancer. There was a time when cancer was considered a contraindication for chiropractic care. That is a false notion.
One of the most visible and respected cancer institutions is the Cancer Treatment Centers of America (CTCA). I was present at the groundbreaking for the hospital in Newnan a few years ago. These hospitals have chiropractic departments to serve the needs of patients who have musculoskeletal pain and who happen to also have cancer.
Some cancer patients experience joint pain and stiffness, muscle pain, tendonitis, or ligament issues that can decrease mobility. Sometimes these problems are related to the cancer, but sometimes they are related to the cancer treatment itself. These patients are in a vulnerable position because we do not want to drug them unnecessarily. Their systems are under siege enough without added problems of narcotics, heavy anti-inflammatories, and muscle relaxers.
That is where the non-drug, non-surgical, holistic approach of the chiropractor comes into play. Back and neck pain, extremity pain, peripheral neuropathy, stiffness, sciatic pain, and fatigue are all issues common to the cancer experience, and are all issues treatable with conservative chiropractic care.
The care of a cancer patient begins with a careful history, physical exam, imaging when needed, and a close look at the diagnostic workup from the cancer specialist and other members of the health care team. This helps me understand the current source of pain as well as the nature of the cancer, its location, the extent of skeletal involvement (if any), and how the patient is responding to cancer care.
When the skeleton is not involved, I have a fuller range of options for adjustment techniques. If the skeleton is involved, I still may feel comfortable with some form of decompression manipulation.
But the chiropractic adjustment is only one arrow in our quiver. We also have ultrasound, cryotherapy, lasers, infrared therapy, a wide range of electrotherapies, nutritional intervention, traction, therapeutic exercises, stretching, bracing, athletic taping, and other modalities at our disposal. My goal is to look through the cancer to see a person with a need that I can help, and to render that help safely and effectively.
Communication with other members of the health care team is important, but only with the authorization of the patient, as all patients have the right to control who knows what about their care. I have not had a patient decline my communications with other attending doctors, however, because I explain that it is always a good idea for the right hand to know what the left hand is doing. Additionally, when we work as partners in a cohesive, coordinated effort, patients are the winners.
Back to the lady who came to see me: we looked together at the scans she brought, as no one had shown them to her. We discussed the implications of what we saw and decided, based on my exam and the records before me, to adjust her hip. Immediate results were that she felt looser and steadier walking, but since her pain is worse at night, we will have to see how she does tonight.
Meanwhile, we discussed her sleeping posture. I advised her to get a body pillow and sleep on her side, hugging the pillow with her upper knee and upper arm supported to keep her spine aligned. We will see her next week to find out how she is doing and alter our course if needed.
So, what does chiropractic offer the cancer patient? Like with any other patient, I will work to offer her a degree of relief, hope, and support with safe, effective, evidence-based care. Hugs are also offered as needed.