A Comprehensive Description of Naturopathic Care for Advanced Cancers: Outcomes from the Canadian/US Integrative Oncology Study

Background: There is a paucity of real-world data on the treatments naturopathic doctors (NDs) use for supportive cancer care. We conducted an observational cohort study to comprehensively describe the treatments NDs with experience in cancer care recommend to their patients. Methods: Patients with advanced breast, colorectal, ovarian, or pancreatic cancer were recruited from 12 North American naturopathic clinics and followed for 2 to 3 years. Therapeutic recommendations were abstracted from clinic records. Results: 384 participants (154 breast, 112 colorectal, 71 ovarian, 47 pancreatic) were included in the analyses. The median number of ND visits was 5. The most common types of recommendations were natural health products (NHPs, 99% of participants), nutrition guidance (88%), and parenteral therapies (81%). Mental health (33%) and Traditional Chinese Medicine (29%) were least common. Participants were recommended a median of 11 NHPs throughout the study, with 430 unique products recommended across all participants. Nutrition guidance heavily favoured encouraging foods rather than discouraging them (83% vs. 17% of all dietary recommendations, respectively). Vitamin D, curcumin, intravenous vitamin C, increasing protein intake, and exercise were recommended to at least 50% of participants across each cancer type. Other common recommendations included melatonin, fish oil, Trametes versicolor, subcutaneous mistletoe, increasing vegetable intake, and eating behaviour changes. Recommendations were fairly uniform between cancer types, with the most variation seen in NHPs. Conclusion: NDs frequently recommend NHPs, nutrition guidance, and parenteral therapies for people with advanced cancer. The diversity of unique recommendations suggests individualized care, yet some commonly used treatments demonstrate a degree of consistency.