Talk with Serena MacMullan about her battle with breast cancer and she makes one thing perfectly clear: Mary Morgan saved her life. Morgan is not an oncologist, radiologist or surgeon. She’s not MacMullan’s mother, sister or best friend. Mary Morgan is an acupuncturist.

When MacMullan was diagnosed with breast cancer at the age of 52, she was prescribed chemotherapy, a potent mix of drugs that travel throughout the body to destroy cancer cells. She quickly discovered that the medicines designed to save her life made her feel like she’d “been hit by a bus.”

“I was so sick,” she recalls. “I couldn’t eat or drink. I got severely dehydrated. At times I thought I just couldn’t do it. But Mary was there for me the entire time. She got me through. If it wasn’t for her I don’t know what condition I would be in now.”

Like MacMullan, many in Santa Cruz are turning to traditional Chinese medicine to combat the side-effects of conventional cancer treatment. It’s one modality in a large and growing complementary medicine community that encourages cancer patients to take an active role in their treatment.

Conventional treatments are those which are taught in medical school, including radiation, chemotherapy and surgery. The word complementary is used to describe treatments that fall outside this scope and include mind-body interventions (hypnosis, meditation, aromatherapy), traditional Asian practices, nutritional counseling, manual healing methods (massage, chiropractic, therapeutic touch), and psychological and behavioral therapies. Many patients use an integrative treatment approach, which involves both complementary and conventional methods, to support the immune system, enhance quality of life and give patients a pro-active role in their recovery.

 “Chinese medicine is not an either/or proposition with Western medicine,” explains Emmy Cushnir, a licensed acupuncturist who specializes in supportive cancer care and pain management. “It’s in addition to. Chemotherapy can cause gastrointestinal problems like nausea and vomiting and while there are a number of new drugs to help with that, they don’t work for everyone. Fatigue is also huge for people going through chemo or they might need help with appetite. Pain is another big one, after surgery or if the cancer has metastasized. One of the most important things I can do is help keep patients in their treatment.”

A registered nurse with more than 20 years of healthcare experience, Cushnir exudes a combination of personal warmth and professional knowledge. She speaks with quiet conviction about Chinese medicine, in which health is believed to result from the free flow of energy, called chi, throughout the body. Illness is attributed to blockages in this energy flow, which can be relieved by the placement of thin needles at various points in the body. Practitioners of Chinese medicine also maintain that specific herbs and supplements can be used to strengthen the body’s immune system, support certain organs, and decrease the side effects of chemotherapy and radiation.

Cushnir describes how during a typical appointment she’ll ask a patient about their current diagnosis and treatment plan, and then make her own assessment using the tongue and pulse. From that, she’ll get an idea of what organs are depleted and therefore where to place the needles and/or which herbs to recommend.

The patient lies down on a comfortable treatment table while the needles are inserted. We’re not talking about poke-you-in-the-arm vaccination needles. These needles are sterile, disposable and so thin that most patients can barely feel their insertion. Then you rest for about 30 minutes, enjoying the silence or listening to relaxing music.

 “For a lot of patients it’s about calming the mind,” says Morgan, a licensed acupuncturist in private practice who has treated a number of cancer patients. Like Cushnir, Morgan speaks with calm assurance about the medicine she has studied since she was 19.  “Acupuncture shifts patients from fight or flight mode into rest and digest mode. It helps to calm the nervous system after the shock and trauma of a cancer diagnosis.”

 “It really does help,” attests Carol Donald a 62-year-old who battled breast cancer with radiation. “I had such exhaustion and dizziness. I would go to Emmy feeling so tired and it was if I’d come back to myself after treatment. There’s such a centeredness that happens.”

“Emmy sees me as a whole person, not just a regimen,” she continues. “It’s like when someone loves to cook so the meal tastes incredible because of that passion. She’s doing her life’s work. It feels so good to be in her hands and have that kind of guidance and caring. It helps you take a little bit of a breath.”

“Emmy does her homework,” confirms Lillian Roybal Rose a 64-old breast cancer patient. “She supports you with the latest studies and information, but she also supports you emotionally. She understands the absolute terror that one feels with a diagnosis of cancer. Emmy helped me to feel as if I was taking charge of my recovery.”

Many patients find Cushnir through WomenCare, a cancer advocacy and resource center where she runs a complementary treatment group. WomenCare offers support groups, workshops, information, referrals, legal services, and even practical support such as meals, light house cleaning and childcare.

“At WomenCare we honor any path that a woman chooses to take,” says Allison Titley, sitting in a bright, sun-filled office on 41st Avenue. (WomenCare also has a Spanish-speaking program called Entre Nosotras based in Watsonville.) “My only question to our clients is, ‘What can I do to support you?’”

 As we talk, laughter rings out from behind a closed door where a support group is meeting. A woman browses in the resource library while two others chat in the lobby. Sitting on the table in front of Titley is a thick binder filled with the names of complementary health practitioners who offer free or low-cost services to WomenCare clients. The dividers read Nutrition, Massage, Acupuncture, Energy Work, Meditation, Hypnotherapy…. Another binder contains the latest articles on integrative and conventional cancer therapies, including research on various herbal supplements and antioxidants.

Not far way is the Bennett and Suzy Katz Cancer Resource Center at Dominican Hospital. Staffed by oncology nurses Michele Finch and Anne Lindberg, the center offers one-on-one guidance, support groups, patient education, and assistance utilizing cancer-related community services.

According to Finch, you have to be very careful with language when discussing cancer treatment. “There’s a difference between complementary and alternative care,” Finch says. “Complementary approaches work alongside traditional approaches such as chemo and radiation, while alternatives tend to be instead of. Although we try to support patients in their choices, we tend to follow standard medical practices.”

Many doctors agree. Some feel that with an immune system already compromised by cancer, anything invasive such as acupuncture could cause infection.

“There’s always a risk of bleeding or infection any time you pierce the skin, whether it’s an IV or a blood draw,” says Dr. Emily Ratner. “The incidence after acupuncture is extremely low, but higher in patients who are imuno-compromised. So they just need to be monitored.”

Ratner is an Associate Professor in the Department of Anesthesiology and Co-Director of the Division of Medical Acupuncture at the Stanford Center for Integrative Medicine (SCIM). Founded in 1998, the SCIM is committed to “evidence-based practices” from both complementary and mainstream modern medicine.

With “one foot in Western medicine and one foot in Eastern” Dr. Ratner recognizes that even those who support the use of acupuncture may be leery of herbal supplements and antioxidants, concerned about side-effects or interactions with other medications.

“I insisted on taking [a certain supplement] much to my doctor’s chagrin,” Rose says. “Her position was if I had any side effects she wouldn’t know if it was a reaction to the chemo drugs or to the supplements, which would confuse the issue. I understand that she has the best of intentions, but my position is then you should learn more about the supplement. Emmy had done her research on it and the studies were pretty reputable. I knew I could trust her to customize the treatment specifically to my situation.”

“Not all physicians are familiar with the studies,” admits Lonna Larsh, a family physician who has done training in acupuncture. “When it comes to supplements, you have to find out exactly what the patient wants to take, look at the latest studies and consider it on an individual basis. The problem is, that’s very time consuming and that time factor is really missing in Western medicine.”

Dr. Ratner sympathizes with busy oncologists. “There are so many changes in chemo-pharmaceutical regimens and the treatment of cancer in their primary field, let alone these other fields,” she says. “Remember, acupuncture wasn’t taught 20 years ago when I was in medical school!”

Evidence is mounting that it should be. A 1997 National Institutes of Health Consensus Development Panel concluded that scientific evidence “validates acupuncture’s effectiveness in controlling chemotherapy-related nausea and vomiting”. Subsequent studies have shown its efficacy in treating fatigue and post-operative pain. The panel also found that acupuncture is widely used by thousands of physicians, acupuncturists and dentists for relief or prevention of pain and other health conditions. According to a 2002 National Health Interview Survey, about 8.2 million U.S. adults have used acupuncture.

 “It gets tricky when it comes to herbs,” Morgan admits. “It’s important to be under the guidance of someone who is educated and trained. You want the chemotherapy to do its job. You don’t want to interfere with that, but there are ways to support the liver, the heart, and the digestive system.”

 Whatever you do, don’t go to an herb store on your own and start looking for tonics. Instead, choose a practitioner who is licensed in acupuncture and Chinese medical herbology. In California, the intense, four-year licensing program culminates with students sitting for the California State Board Exam. Speak with your medical doctor about any supplements you may be considering. Better yet, encourage your healthcare practitioners to work cooperatively to provide the very best care from both conventional and complementary approaches.

 “There’s a huge need for people to have the type of integrated care that we provide,” Ratner asserts. “There is definitely a role for all of us.”

“The biggest thing for people to heal themselves is to have hope and light,” Morgan concludes. “They need to know that there are options out there and things that can help them through this process. Maybe acupuncture isn’t going to cure them of cancer, but it can support their body, mind and spirit.”

A grateful Serena MacMullan concurs. “Everyone is different and what works for one person doesn’t always work for everyone. But patients are entitled to know our options and make our own choices. You’re empowered by that instead of letting someone else make them for you.”

This article first appeared in Santa Cruz Magazine, Summer 2008.