May 10, 2019 | By Diane Mapes / Fred Hutch News Service
The first time Dr. Heather Greenlee personally came in contact with cancer, she was in high school. The patient was her stepfather, a physician. The diagnosis was glioblastoma, an aggressive type of brain tumor. Greenlee was 17 when he was diagnosed, and she never forgot what it felt like to see someone she cared about suffer from cancer.
“I experienced firsthand the ways that oncology care could be better,” said Greenlee, now a Fred Hutchinson Cancer Research Center public health researcher and medical director of the Integrative Medicine Program at Seattle Cancer Care Alliance, the Hutch's clinical-care partner. “His medical treatment was excellent, but much more could have been done to improve his quality of life. Everybody wants to know what they can do in addition to conventional cancer treatment to help manage symptoms and improve survival. Unfortunately, there’s a dearth of information in these areas, and patients need the information.”
Fulfilling these needs is what inspired Greenlee to join Fred Hutch as a faculty member.
“Cancer can cause a great deal of suffering,” she said. “We want to reduce suffering. That’s the whole point. We want to support people so they can receive the most effective treatments possible to eliminate their cancer. And obviously, if we can prevent cancer from the get-go that would be the best.”
A native of the Pacific Northwest, Greenlee studied medical anthropology and public health at the University of Washington (and naturopathic medicine at Bastyr University) before obtaining a Ph.D. in epidemiology from Columbia University. She joined the Hutch faculty in the summer of 2017 to pursue her two passions: cancer survivorship and integrative medicine.
Greenlee conducts research on obesity and cancer with a focus on minority populations; she also conducts research on integrative therapies such as acupuncture, meditation, dietary supplements and yoga. A past president of the Society for Integrative Oncology, or SIO, Greenlee currently sits on the National Comprehensive Cancer Network’s Pain Guidelines panel, one of 53 expert panels designed to guide and improve cancer care.
In late 2017, Greenlee and colleagues from the SWOG Cancer Research Network published the largest randomized clinical trial ever done on acupuncture. The study, involving 226 breast cancer patients, found that acupuncture was effective for relieving joint pain caused by an anti-hormone drug commonly given to these patients.
Greenlee also spearheaded the development of integrative oncology guidelines for breast cancer patients. This set of treatment guidelines, which has been endorsed by the American Society of Clinical Oncology, or ASCO, marked a milestone for the use and acceptance of evidence-based integrative medicine in oncology, said Greenlee, who co-chaired the SIO guidelines work and was on the ASCO endorsement panel.
“There is a growing acknowledgement that it is important for the oncology field to understand how to use effective integrative therapies as part of routine cancer care,” she said. “It was a milestone for SWOG and the National Cancer Institute to support this kind of trial. Most of all, it’s really great for patients to have solid data to inform their treatment decisions. Patients are using these therapies and it is important for us to understand what works, what doesn’t work and what is safe.”
It’s all about articulating where there is and isn’t evidence, she said.
Greenlee’s hope is that by bringing evidence-based offerings like acupuncture, massage, yoga and mindfulness into a formal oncology setting, patients will have effective options for managing some symptoms, like pain and fatigue, that can be difficult to treat. And, importantly, patients will be less likely to pursue techniques that don’t have legitimate research behind them.
“Our work can help patients make clear, informed decisions about their options,” she said. “Both patients and providers need evidence on which to base their decisions.”
Greenlee also wants to help people sidestep cancer in the first place, particularly through behavior change. Strong scientific evidence shows that healthy food and smart lifestyle choices all contribute to good health — both for cancer patients and the general public. But not everyone follows these recommendations.
“Much of our work is focused on how we can help people achieve and maintain a healthy lifestyle,” she said. “We’re trying to find the sweet spot in terms of what kind of behavioral supports people need to make behavioral changes — and maintain them over time.”
She’s also determined to make sure everyone can benefit from her cancer prevention research, regardless of their financial status or health insurance coverage.
“We have to figure out how patients can pay for these things, which is why we’re also involved in policy,” she said. “We have to figure out ways for our health care system to build in an insurance reimbursement model. In other words, we need to make sure everybody has access to effective services.”
In the meantime, this researcher is definitely practicing what she’s preaching.
Her favorite dish?
“Probably something with cruciferous vegetables like Brussels sprouts,” she said. “Cruciferous vegetables taste great and they’re a terrific cancer-fighting food.”
Diane Mapes is a staff writer at Fred Hutchinson Cancer Research Center. She has written extensively about health issues for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor, she blogs at doublewhammied.com and tweets @double_whammied. Email her at firstname.lastname@example.org.