Chiropractic was founded in 1895 and has evolved into a profession that now has more than 60,000 licensed chiropractors in the United States and thousands more worldwide. If there is one word that describes both the public’s and other healthcare providers’ understanding of chiropractic, it would have to be “confusion.” All 50 states license chiropractors, but each state has its own set of laws. Our purpose in this chapter is to address the most commonly accepted aspects of the science, art, and philosophy regarding chiropractic efficacy.

Our approach to answer the questions in this chapter will be where chiropractic is being incorporated into a plan of care that is integrated and where the chiropractor is treating the musculoskeletal and biomechanical deficiencies that commonly occur in all patients but especially in the oncology patient.

So, what is a chiropractic adjustment and how could it benefit an oncology patient? We are going to focus on key benefits that come from treatment to the musculoskeletal system, paying extra attention to the spine. Since its beginning, chiropractors have been saying that besides pain or joint relief, the adjustment can have a direct effect on the nervous system by relieving pressure on a nerve. Not only have we been saying it, but also we have been experiencing or witnessing these benefits personally and professionally with our patients. We have been right all along that the adjustment was affecting the nervous system, but wrong about how it was actually happening. Relieving direct pressure off of a spinal nerve is old school thinking and inaccurate. The current understanding is that joint complex dysfunction creates neuropathologic effects that have been termed “dysafferentation.” Nociceptors and mechanoreceptors are the two main types of sensory nerve receptors involved. Potential outcomes of nociceptive input to the spinal cord include pain, autonomic symptoms, vasoconstriction, and muscle spasms. There are other mechanisms involved, but our point is that chiropractic does have a beneficial effect on the nervous system. We like to call it a “quieting of the nervous system” so the body can focus on more important things. Certainly this is a complicated topic and not the primary purpose of this discussion. However, we do want to point out that there is ongoing and mounting evidence that explains the clinical results we see from chiropractic treatment to our patients.

The results of a study in 2005 of patients with moder­ate to severe musculoskeletal pain ranked chiropractic the highest in pain relief over nerve blocks, narcotics, muscle relaxants, massage, acupuncture, and OTC pain medications.

Oncology patients typically tell us that after a chiropractic adjustment they feel better, have more energy, have a general sense of well-being, sleep better, and can’t wait to have another treatment.

If whole person care is the goal, then we feel there is enough potential benefit for any patient diagnosed and being treated for cancer to at least be evaluated by a chiropractor physician to see if chiropractic treatment is indicated. These benefits will improve the patient’s quality of life, which should be one of the goals of any treatment plan.

Oncology patients, at all stages of the disease, are very likely to suffer from neuromusculoskeletal pain and dysfunction. The discovery of the cancer and the subsequent anxiety in itself will cause joint swelling and muscle spasm moderated through the body’s natural stress reaction mechanisms. This increases pain and dysfunction.

Musculoskeletal deconditioning is common and accelerated through decreased activity from pain, anxiety, and chemotherapy side effects including pain, nausea, lack of appetite, and decreased energy. Fibrotic changes to normal muscle tissue from radiation therapy also commonly result in musculoskeletal dysfunction.

In another study, David Chapman-Smith (based in Canada) cited low-back pain as the leading cause of disability worldwide, with 80% of the population at some point suffering from severe, debilitating low-back pain. If we add all of the above factors to the oncology patient, then there is increased probability of musculoskeletal pain, which becomes a limiting factor in the patient’s ability to travel, ambulate, or tolerate further therapy.

Lack of exercise has been shown, in a recent article published in a physical therapy journal, to increase estrogen levels, which obviously is a factor in numerous cancers.

Chiropractic is, by definition and law, both nonsurgical and without prescription drugs. We are, however, very effective at reducing pain and restoring the patient’s physical status. To do so without risking undesirable interaction between pain medications and other medications that the patient needs is to the advantage of the patient and the medical doctor alike. It has been our experience that adding conservative treatments and therapies to the arsenal, which have very little risk when performed by skilled practitioners, is invaluable.

Beyond pain relief and restoration of mobility, numerous studies have shown spinal manipulation to have other general health benefits. Several published studies have documented the benefits of spinal manipulation for hypertension, asthma, and antibody production. Although we are not suggesting that patients should view these as replacements for traditional medical treatment for these conditions, the fact that spinal treatment has created benefit to visceral function is certainly a desirable side effect.

Schneider and Gilford (2001) stated that “the chiropractor provides noninvasive and non-pharmacologic options for decreasing pain and improving function. Chiropractic care can enhance a cancer patient’s quality of life at any stage in the disease process by decreasing pain and improving function.”