Learn about functional medicine and cancer from a whole person perspective for insights into cancer prevention, cancer development, and cancer treatments.
What is functional medicine?
Functional medicine is a science-based field of health care offering personalized medicine for primary prevention and underlying causes instead of symptoms for serious chronic disease. Functional medicine as a system of health care is designed to provide comprehensive support to systems of the body.
Central to the practice of functional medicine is an examination of the core clinical imbalances that underlie various disease conditions. Those imbalances arise as environmental inputs such as diet, nutrients (including air and water), exercise, and trauma processed by body, mind, and spirit through a unique set of genetic predispositions, attitudes, and beliefs. The fundamental physiological processes include communication, both outside and inside the cell; bioenergetics, or the transformation of food into energy; replication, repair, and maintenance of structural integrity, from the cellular to the whole body level; elimination of waste; protection and defense; and transport and circulation. The core clinical imbalances that arise from malfunctions within this complex system include the following.
- Hormonal and neurotransmitter imbalances
- Oxidation-reduction imbalances and mitochondropathy
- Detoxification and biotransformational imbalances
- Immune imbalances
- Inflammatory imbalances
- Digestive, absorptive, and microbiological imbalances
- Structural imbalances
Imbalances such as these are the precursors to the signs and symptoms by which functional medicine practitioners detect and label or diagnose organ system disease. Improving balance—in the patient's environmental inputs and in the body's fundamental physiological processes—is the precursor to restoring health and it involves much more than treating the symptoms. Functional medicine works to improve the management of complex, chronic disease by intervening at multiple levels to address these core clinical imbalances and to restore each patient's functionality and health. Functional medicine is not a unique and separate body of knowledge. Grounded in scientific principles and information widely available in medicine today, functional medicine combines research from various disciplines into highly detailed yet clinically relevant models of disease pathogenesis and effective clinical management.
Functional medicine focuses on functionality at many levels, rather than a single treatment for a single diagnosis. Functional medicine uses the patient's story as a key tool for integrating diagnosis, signs and symptoms, and evidence of clinical imbalances into a comprehensive approach to improve both the patient's environmental inputs and his or her physiological function.
What are some factors associated with the potential for cancer development in a functional medicine model?
Multiple factors are involved in cancer development from a whole person perspective.
“The cellular rhythm and dance of life is altered in response to different environmental signals, and that cancer represents an altered orchestration of that complex symphony. The cell is constantly in dynamic flux; cellular signaling creates messages that induce changes internally and externally and the cell is continually changing and morphing in response to the environment it is exposed to.”
-Jeffrey Bland, PhD, Founder of Functional Medicine
A number of systemic functional changes are associated with the beginning of cancer that include and are not limited to the following1, 2.
- Increased DNA damage
- Decreased DNA repair
- Modified epigenetics
- Genomic instability
- Alteration in cell cycle physiology and check point integrity
- Alternation in specific protein kinase activities
- Alternation in intercellular signal transduction
- Altered immune system physiologic function
- Increased chemokine and cytokine activity
- Increased hormonally driven mitotic activity
Therefore, "multiple factors must work in combination to convert a normal cell into the systemic disease of cancer2."
Components of bodily functions creating a web of networks impacting health are identified through a functional medicine model. Common contributors to increased cancer potential include and are not limited to the following1-3.
- Disturbances in insulin signaling
- Chronic inflammation
- Increases in messages triggering cellular cycling
- Altered intercellular signal transduction
- Increased genomic instability
- Altered mitochondrial bioenergetics associated with oxidant stress
- Altered nucleosome epigenetic methylation patterns
- Cellular hypoxia
- Chronic opportunistic bacterial and viral infections
- Altered post-translational protein composition
What are some strategies to evaluate physiological function associated with cancer development in a functional medicine model?
Common contributors to the potential of cancer in each person have "a series of metabolic markers associated with the degree of distortion or alteration in these processes. It is the system biology pattern of these markers that defines the ‘physiological state function' of the individual and aspects of both risk of and status related to specific cancers. In a sense, the approach for screening using this concept is to develop a genomic, proteomic, and metabolomic profile of the patient that reflects his or her physiological state function3."
This means markers are present in the body contributing to abnormalities that may support cancer development and growth. Evaluation tools measuring a variety of these markers exist. Specific types of disturbed physiological functions identified to be associated with the physiological state function of many cancers can be evaluated. Tests include and are not limited to the following1, 3.
- Insulin and insulin-like growth factor signaling
- Detoxification status
- Gastrointestinal immune function (GALT and MALT) and enterometabolic activity (enterobiome)
- Cellular redox status, mitochondrial bioenergetics, and oxidative stress
- Genomic stability and epigenetics (telomere status, atypical nuclei, promoter methylation)
- Lipid signaling and status including CD36 activity, fatty acid status, and eicosanoid signaling
- Immune status including inflammatory cytokines and hsCRP
- Steroid hormone status and metabolism
- Intermediary metabolism such as organic acid and amino acid analysis
- Occult bacterial or viral infections
"Specific tests are now available for each of these assessment areas and can be employed to define the functional status of the patient that is connected to specific disturbed function associated with tumor initiation, promotion, and progression. The focus of this profile is not to diagnose a specific cancer but rather to better define the physiological state function of the patient that is associated with cancer3."
-Jeffrey Bland, PhD
Providers using functional medicine approaches to support people with cancer may apply different strategies to measure increased potential and physiological state function of cancer. The application of evidence based tests and interventions vary based on the provider and their knowledge base. Despite their scientific viability, many of the evaluation tools and approaches are not widely used today although increasingly recognized and available.
The conceptual functional medicine framework contains components of an integrative cancer care model addressing the whole person. Functional medicine approaches to cancer are relevant to early detection, patient care during active disease, and long-term management of cancer as a chronic disease. The practice is evolving through the synthesis of studies, identification of approaches, research, clinical practice, as well a networks of providers and patients.
What is the history of functional medicine?
Functional Medicine was founded in the1990s by Jeffrey Bland, PhD as a discipline that unites progress in basic medical sciences with clinical medicine to address the growing problems associated with chronic disease.
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References
- Jeffrey Bland, PhD presentation at the 17th International Symposium on Functional Medicine, May 2010
- Bland J. Cancers as systemic functional diseases, Part 1: defining the cancer domain. Altern Ther Health Med. 2010 Mar-Apr; 16(2): 52-54.
- Bland J. Cancers as systemic functional diseases, Part 2: clinical implications. Altern Ther Health Med. 2010 May-Jun;16(3):54-7. PubMed PMID: 20486625.
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