Conscious Choice: Doing What Works Best

November 1999

Doing What Works Best

by Bobbye Middendorf

Under the leadership of the husband-and-wife team Keith and Penny Block, the Block Medical Center and the Institute for Integrative Cancer Care has been making waves for twenty years. Dr. Keith I. Block is medical director. Penny Block, a doctoral candidate at the University of Chicago, serves as executive director as well as director of complementary care. Aligned exclusively with neither alternative practitioners nor conventional medicine, they have focused the Block Center on incorporating what works best for each individual patient. Their method? They select the "best practices" from scientifically credible and reasonable sources, resulting in a program that includes nutrition, stress reduction, physical care, and conventional interventions.

A medical maverick, Dr. Keith Block has been criticized by some purist colleagues in conventional medicine; neither is he generally perceived as an alternative practitioner. Yet Dr. Block and the Block Medical Center maintain a formidable reputation in the area of integrative or complementary medicine. A pioneering model sometimes billed as "the alternative to alternative medicine," the Block Medical Center centers its healing work on all aspects of the individual, offering nutritional care, supplementation, conventional modalities, and promising experimental treatment. Clinically and scientifically rigorous, the Evanston-based Block Medical Center is nationally renowned as one of a handful of integrative medical practices that has achieved remarkable results.

According to Advances: The Journal of Mind-Body Health, published by the John E. Fetzer Institute, "One of the large unexplored problems of mind-body medicine is how to integrate its emerging treatments with the treatments of biochemical medicine." It is in this area that the Block Medical Center makes its unique contribution. "We are seeking to be reasonable and responsible and bring to the table what is meaningful with a good scientific base to it — what makes good sense. We want to use what will work best," observes Keith Block.

Dr. Block’s article in Advances, "The Role of the Self in Healthy Cancer Survivorship: A View From the Front Lines of Treating Cancer," is one of the first to "integrate the medicine of the mind-body with the medicine of biochemistry, for cancer or anything else," says Advances editor Harris Dienstfrey. "Block calls his approach to cancer‘biopsychooncology.’ It is a deliberate effort to combine, for the benefit of his patients, the best of biological cancer treatments with the lessons to be drawn from a cumulative record of mind-body studies of cancer patients."

Dr. Block himself encountered a chronic illness early in his medical career, putting him, as he describes it, "on the other side of the stethoscope. At that time, there was a scarcity of tools to take care of me. I figured that I was going to have to heal myself before I could be in a position to heal others. This process really fixed my lenses. Medicine as it was practiced more than twenty years ago, and in many instances [as it is practiced] today, didn’t focus on the totality of me. This was an opportunity for me to refocus and look at medicine differently."

He had come to medicine with a commitment to the well-being of humanity, inspired in part by Victor Frankl’s seminal work, Man’s Search for Meaning, but Block’s own health problems ripened in him a radically compassionate and empathetic attitude. "Communication with compassion, tact, sensitivity, and honesty is critically important," he notes.

A radical change in diet, nutritional supplementation, stress release exercises, and physical activity based on Eastern traditions combined to help change the trajectory of Block’s illness. His recovery, coupled with his early work and research in nutritional oncology, became the basis for his medical practice as well as his philosophy of health and healing. It has evolved from there over the years. Adds Penny Block, "Early on, we each had unfortunate experiences with medicine. We wanted to reconceptualize it in the positive terms of health and vitality, not just the absence of symptoms."

The Blocks’ integrative approach is notable for equipping both the healthy and the ill with access to a superior lifestyle — one that results in a greater ability to fight and survive disease. The Blocks have identified three major areas that are critical to health and healing.

Laying the Core Foundation with an Internal Matrix

"First and foremost we consider what we call the internal matrix," says Dr. Block. Although it sounds technical, this term simply aims to identify the core of who a patient is in all his or her complexity. The clinic staff explores and documents the physical, emotional, psychological, and biological makeup of clients. It profiles how people take care of themselves, what their interactions and relationships are with family, loved ones, friends, coworkers. Block elaborates, "We are developing a database to assist our patients in these areas. We also profile patients, each of whom has a personal and metabolic‘fingerprint’."

At the level of what they call the internal matrix, the Blocks encourage life-affirming and life-enhancing attitudes. They work to create an environment of realistic hope, to help patients be active and equal participants in their care. "This is the area where we assess and encourage passion for living, passion for battling the disease. This is the place of inspired action in the world, the place where vitality and quality of life reside. It is here where prayer and play come together. Self-empowerment has a quality of life impact that affects the outcome of treatments."

Penny Block observes, "We are committed to a collaborative approach. We commit to listening to the patients, to helping them define their vision. We learn by listening to what is going on with our patients and what they say their needs are."

Keith Block expresses concern about what often passes for communication with patients. "There’s no such thing as false hope," he says. "Hope is an experience of the soul. Hope is what allows us to go forward. Hope is the spirit to get through tomorrow. And communicating diagnoses to patients requires the utmost sensitivity and tact. I am more worried about those health professionals who communicate a sense of hopelessness and generate an attitude of despair — because studies have shown that the psychological damage of that can lead to the biology that hastens the disease process. We need to encourage a communication that has tact, sensitivity, and honesty."

"There is immense value in conventional medicine," says Block. "But the system has been too one-dimensional. There’s been too much of a procedure focus. Our studies show there is biological and psychological relevance in patient involvement. Self-empowerment has a quality-of-life impact that can change the outcome. For too long people have been under a patriarchal medical system, and that has gotten in the way of patients helping themselves."

Building a Complementary Foundation

In discussing the second part of his method, Keith Block begins with an analogy. "You wouldn’t go up Mount Everest without pre-climb preparation, the right equipment, and a post-climb readaptation." At the stage of the complementary foundation, the goal is to help the patient get as fit as possible, physically and emotionally strengthened to face some of the rigors of conventional treatments that may be required.

Says Block, "Conventional medicine more often than not puts people into mega-treatment regimens with no preparation. Our goal with the complementary foundation is to first provide patients with the tools — before, during, and after treatment — to face conventional treatments with a more nutritionally, physically, emotionally toned body, mind, and spirit."

He continues, "Every doctor ideally wants the patient more fit. We have found that the complementary foundation itself can offer patients profound changes remarkably quickly. We have been able to take patients who have been bedridden, started them with physical and massage therapy, some exercise, and you could see an increase in their strength within even a day or two. Sometimes there isn’t time for patients to have this preparation. But what is possible, given the space and tools, is remarkable."

There are four components to the complementary foundation stage: nutrition, physical care, stress care techniques, and biological response modifiers (BRMs). Acknowledges Block, "There is a meaningful synergism in the biochemistry of disease, pharmacology, and treatments. There are clinically proven side effects of certain drugs and treatments that tie to particular nutrient deficiencies. However, Block warns against self-treatment. He notes that, often, a patient will see both conventional and alternative health care providers, and neither provider knows about the recommendations of the other. This sort of smorgasbord approach can pose serious risks to patients. "Maybe the area is growing too fast for the level of practitioner knowledge that’s out there. Somehow we have to find a way to bring these two systems together," says Block.

At the Block Medical Center, intensive and rigorous medical chemistry matches the disease, the individual, stage of treatment, and numerous other complex factors to highlight the ideal nutrient and supplement regimen for a particular patient in a specific situation. At the core is nutrition. The typical American diet creates a "biochemical terrain that is tumor-promoting," according to Block. There are good fats and bad fats. The bad fats create an environment conducive to the growth of cancer cells. "If you eat healthier — an Asian-inspired diet, with lots of fresh vegetables, fruits, grains, legumes (especially soy), and focus on the Omega-3 fats that are relatively scarce in the normal American diet (using oils like canola, flax, and walnut, and eating cold-water fish high in this type of good fat) — you will be producing more of an anti-cancer terrain and you’ll be enhancing your immunological functions." Block cites studies in which the risks both for prostate cancer in men and breast cancer in women are increased with high levels of these bad fats from dairy and processed foods, while survival times can increase by following an Asian-style diet.

"No one has to sacrifice pleasure in eating," emphasizes Penny Block. She notes that many of the chronic diseases so prevalent in America may be dramatically improved simply by eating a semi-vegetarian diet rich in fresh organic foods.

"There are plenty of ways to enjoy delicious meals without requiring refined products," adds Keith Block. The Block Medical Center even has a cookbook available. Authored by Penny Block, it used the Block family kitchen and four growing children to create healthful, satisfying meals that people in the real world could make.

The Block fitness program is another component of the complementary foundation. It employs a team of movement experts to help patients increase energy while relaxing. This combination is common in Eastern disciplines such as yoga and qi gong, which offer deeper focus on energy, movement, and healing. Massage plays a critical role in the physical care program, as does Ortho-bionomy, a therapeutic form of bodywork that helps access the body’s innate resources and reflexes to stimulate awareness and balance.

"The issues we address in this component of care include stamina,...muscle fitness, cardiac aerobic maintenance, and stretching, done in both small groups and individual work. The Asian techniques like qi gong and yoga work off the acupuncture meridians. This is routine therapy for cancer in China," notes Block. Asian healing traditions are integrated as naturally in Dr. Block’s conversation as chemotherapy or radiation.

With the third component, stress techniques, the Blocks aim to connect with people’s internal resources. "These are highly individualized, based on the background, interests, and capabilities of the specific patient. Some choose to work with meditation, some with biofeedback. Others use imaging techniques, hypnotherapy, prayer. We even offer cognitive restructuring tools, so people don’t repeat the negative patterns that may have hastened the disease progression. We train people to think in constructive ways," says Block.

The fourth component in the complementary foundation is a set of BRMs. This may include herbs, vitamins, and phytonutrients. Block expresses concern about the quality of supplements available in the marketplace. "Reports are that 28 percent of Chinese herbs are laced with conventional drugs. Issues related to contamination and adulteration are of special concern to us. We need really careful work in this area.... We need the clinical studies done with expertise, knowledge, and sensitivity, and careful, thought-through biochemistry."

Conventional Interventions Ideally Come Last

The philosophy of the Block Medical Center is to work, whenever possible, with the least invasive methods of treatment, moving on to more invasive interventions only as needed. Once the internal matrix and complementary foundation are in place, conventional treatment interventions such as chemotherapy and radiation may become part of the process. Explaining in one swift stroke his judicious use of both experimental and conventional treatments, Block points out that radiation used to be experimental. Now it has become accepted as mainstream conventional treatment. With his research and work on the teaching staff at UIC Medical School, Block is aware of the cutting-edge experimental therapies that are being tested now.

Block and his patients may elect to explore a therapy that is still experimental if conventional treatments aren’t doing their job. "When conventional treatments fail the patient, it is appropriate to think out of the box." And Block is adamant that the terminology emphasize that the treatment failed the patient, rather than the traditional terminology of the patient "failing" in any way. Indeed, it seems as if Block’s patients are unique in being able to declare that they successfully sought out the best among many alternatives.

The Blocks’ commitment to rigorous science only enhances the credibility of their findings. With several research studies under way, Dr. Block emphasizes, "We constantly evaluate and assess what we are doing, looking for better ways. We are willing to investigate. We face all these issues with intellectual honesty: Is what we’re doing right and effective for our patients? And we recognize that, despite good diet, nutrition, exercise, managing stress, even those doing everything right are still at risk. We are all at risk. We breathe the same air. We are exposed to the same environment. These are [simply] some ways to invite better health and better possibilities."

Future Vision

With its focus on the individual, its truly collaborative atmosphere, and its policy of willingness to go after what works, the Block Medical Center is blazing a unique path. It is bringing together the polarities of the medical world that have too long been apart. Yet the Blocks and their committed staff are looking to create a medical environment in which they will no longer be unique. "One of our long-term points of focus and hope is to annihilate the uniqueness of what we do. We want to help create a continuity that goes beyond our center." Thus the Blocks do lots of speaking, both before the public and medical and health professionals of all types, to try to get the rest of the medical profession — as well as alternative practitioners and scientists — to replicate their methods.

The other part of the vision involves providing a space in which they can educate both professionals and patients in their methods. "We are providing a full educational environment for the training of patients and doctors," says Dr. Block. "We are creating a teaching model for all kinds of health care workers." And, in addition to the talks, seminars, teaching at UIC, lectures, and work on several journal articles, Keith Block is working with other medical professors on two textbooks.

Having addressed a wide range of health issues over the years, the Blocks have developed a full wellness program. Their concepts in practice not only maximize healing, but offer the components for peak performance. "We have designed regimens for athletes as well as for everyday people to optimize their well-being."

Bobbye Middendorf is an independent writer and artist in Chicago.

Resources

The Block Medical Center and Institute for Integrative Cancer Care is located at 1800 Sherman Ave., Suite 515, Evanston, IL 60201. To contact the center, call 847-492-3040, or visit their web site.

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