Naturopathic physicians and cancer- prevention researchers alike feel that the best way to counteract disease is to stop it before it starts.
That mutual conviction is what drew naturopath Dr. Heather Greenlee to the Hutch, where she is beginning to conduct prevention research with Dr. Johanna Lampe in the Public Health Sciences Division.
Greenlee, who is the Hutch's first naturopathic postdoctoral fellow, is the recent recipient of a three-year training grant from the National Center for Complementary and Alternative Medicine (NCCAM), a recently established branch of the National Institutes of Health.
"Ideally, we shouldn't have to treat disease at all," Greenlee said. "The fundamentals of naturopathic medicine are focused on disease prevention, and I see my research in the Cancer Prevention Research Program as a good fit with the naturopathic approach."
Greenlee and Lampe plan to evaluate the impact of natural "alternatives"- including diet, exercise, herbs, nutritional supplements and other lifestyle modifications - on estrogen metabolism in women. Greenlee eventually plans to study these effects in women at high risk of developing breast cancer. Estrogen is a known risk factor for the disease.
In clinical practice, naturopaths use combinations of many of these natural remedies to regulate hormone levels, Greenlee said.
"We know many of these interventions can have potent biologic effects on different hormonal pathways in the body," she said. "While researchers have focused on some of the individual therapies, no one has investigated the effects on estrogen metabolism of the multidimensional approach used routinely by naturopathic physicians."
Few studies
In fact, although millions of Americans use complementary and alternative medicine, there have been few government-funded studies to evaluate their safety and effectiveness. NIH responded to this issue in 1992, first establishing the Office of Alternative Medicine, which became the NCCAM in 1998.
A nutritional biochemist who studies cancer prevention, Lampe views her work with Greenlee as a novel way to address a fundamental issue.
"Despite widespread use of natural products, such as herbal and nutritional supplements, scientific inquiry into complementary and alternative treatments such as these is a relatively new area of research," Lampe said. "There is lots of work to be done to evaluate the safety and efficacy of these products, as well as understand their biologic actions.
"It is exciting to have the opportunity to work with Heather to establish some of the methodologies to address research questions in this area."
Greenlee received her doctorate in naturopathy from Bastyr University in Kenmore, Wash., internationally recognized as a pioneer in the study of natural healing and the nation's leading university in natural-health sciences. She continues to see patients at the Bastyr Center for Natural Health in the Wallingford district of Seattle, where she is a clinical-research fellow.
Prior to her enrollment at Bastyr, Greenlee worked as a research assistant at the Hutch and the University of Washington, where she pursues a master's degree in public health in the School of Public Health and Community Medicine as part of her NIH-funded training.
Greenlee cautioned that her NIH-funded work is preliminary.
"Before we can study the effects of naturopathic treatments on estrogen metabolism in women at high risk for breast cancer, we need to understand how these substances and behavioral changes affect women in the general population," she said.
"We also need to conduct feasibility studies to see how best to design the research and answer these questions. There is a great deal of scientific debate about how best to study components of complementary and alternative medicine."
Blended approach
According to the American Association of Naturopathic Physicians, naturopathic medicine blends natural therapies with current medical and scientific advances in the study of health and human systems, covering all aspects of family health, from prenatal to geriatric care.
Naturopathic medicine focuses on whole-patient wellness, emphasizing prevention and self-care. It attempts to find the underlying cause of a patient's condition rather than treating symptoms.
Using a personalized and comprehensive approach to diagnosis and treatment, naturopaths aim to stimulate the inherent healing capacity within the patient through natural approaches ranging from clinical nutrition and botanical (plant-based) medicines to hydrotherapy (the use of water) and physical medicine.
Naturopathic physicians are licensed as primary-care physicians in the state of Washington. They cooperate with all other branches of medical science and, when appropriate, refer patients to other practitioners for diagnosis or treatment.
