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From the Townsend Letter
December 2017

Dugald Seely and the Rogers Award
Small Country-Big Prize: What's the Story?
by Jacob Schor, ND, FABNO
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What is hard to convey by listing all these hats Dr. Seely wears during his workday and by listing his steady published study output is that he is a nice guy. Again, Dr. Alschuler:

With a 25-page curriculum vitae, one might suppose Dr. Seely to be either entirely reclusive or a braggart. However, nothing could be farther from the truth. Despite his herculean work ethic and staggering accomplishments, Dr. Seely is one of the most kind, respectful, engaging and delightful people that I know. He builds consensus, cares about the ideas of others, is passionate about the future and, above all, is fundamentally dedicated to the betterment of the human community…..

I am so thrilled for Dugald – literally smiling ear to ear!  Dr. Seely has led the charge for the validation of the practice of naturopathic oncology in Canada and North America.

Of course, there is an elephant trampling around in the background, one of those big obvious things that I have so far failed to mention. There is a fundamental difference in Canadian healthcare compared to healthcare in the US that cannot help but impact complementary and alternative practice in their country. Basic healthcare is afforded to every Canadian resident. Healthcare is considered a basic right of citizenship. Try to explain that to a US citizen. It is hard for us to comprehend. Try to explain monthly insurance premiums, co-pays and the need to meet a deductible before care is reimbursed to a Canadian; this is impossible for them to comprehend. If they nod their heads yes, pretending to understand, take it a step further: explain the increasing frequency of elective procedures late in the year after people have met insurance deductibles. Most of us speak English, but the fundamental realities that separate our countries couldn't be wider. So yes, integrative healthcare is more evolved and better appreciated in Canada. The Rogers Prize is amazing but so is Health Canada; healthcare itself is a basic human right in Canada. Here in the US, this simple idea is still open for debate. 

So, congratulations, Dr. Seely, and well done, Canada, for having the prescience to appreciate him.

The Family: A Seely of Doctors

"My father was greatly supportive of the vision for the OICC and joined the board of governors of the Canadian College of Naturopathic Medicine before his diagnosis. He fully believed in and exemplified whole-person, patient-centered care. A medical doctor like many in my family, my father was wholly supportive of integrative medicine and an approach to care that benefits the patient the most."
– Dr. Dugald Seely, ND

There are specific names for collectives of various types of animals. You have seen the lists: a "pride" of lions, a "shrewdness" of apes, a "parliament" of owls, a "cauldron" of bats, a "troop" of monkeys, and so on. Reading about Dugald Seely's family background, I want to propose a new collective grouping, a "Seely" of doctors. They are all doctors, generations of doctors. Seely's great-grandfather Dr. Dugald Christie, established the first Western-style medical clinic, then hospital, and finally medical school in Shenyang, China, in the late 1800s. His grandfather Dr. Ronald Christie worked with Fleming to develop penicillin and was Dean of Medicine at McGill University. There's still an award, the Christie Award, named after Ronald, which is presented by the Canadian Association of Professors of Medicine to an outstanding member each year. Our Dugald's grandmother Phoebe Seely was one of the founders of Meals on Wheels. Dugald's late father, Dr. John F. Seely, was an internationally recognized clinician; he passed away from cancer in 2009. John Seely was Dean of the Faculty of Medicine at the University of Ottawa and developed the palliative care program for The Ottawa Hospital.
Dugald's mother, Dr. Janet Christie-Seely, is a family therapist, teaches family medicine at the University of Ottawa, and practices family therapy. Janet focuses on "systems theory" in her practice, looking at family interactions or the family as a whole and how these correlate with illness.
Dugald Seely is one of four siblings that all practice medicine. His older sister Jean is head of breast imaging at the Ottawa Hospital. Dugald's brother, Dr. Andrew Seely, is an intensivist and thoracic surgeon at the Ottawa Hospital. This is how Ottawa Life Magazine described Andrew's specialization: "Andrew is an international leader in the bedside application of complexity science using mathematical analysis of patterns of variation of vital signs."3 I guess I can be forgiven when I don't always follow what Dugald is talking about. Look where he comes from!

Dugald's sister Allison is a veterinarian who has specialized in providing chiropractic care to animals of all sizes, from cats to horses. Dugald is the youngest of the family and continues a long tradition of clinical practice that is dedicated to supporting patients. The fact that he has embraced naturopathic medicine has not dimmed an appreciation of conventional medicine or rigorous science. Living with his family, he has had to learn the value of integrating alternative medical practices with conventional medicine. No, that isn't right. Heidi Vincent who works with both OICC and ONCANP corrects me: "He didn't ‘have' to learn to come around to integrative medicine…he had an openness of bringing the two modes of care together from the beginning, which he instinctively learned, given that he was part of a conventional medical care family." 
Researched NutritionalsKeeping with the familial theme, Sarah Young, Dugald's wife, has also been a major contributor in the creation of the Ottawa Integrative Cancer Centre. Following a two-year feasibility study they conducted after moving to Ottawa in 2009, the OICC was opened in the fall of 2011. Currently the center sees over 700 patient visits monthly, caring for nearly 500 unique new patients and their families annually.
Dugald Seely has inherited a family model of dedicating one's life to closely caring for individual people while at the same time stepping back far enough that he can examine the practice of medicine in a larger perspective so as to ponder how to advance the field as a whole. See why I'm only half joking about this collective term; it's easy to say that Dugald comes from a Seely of doctors. Or perhaps we could turn it the other way around and instead say, an "integration" of Seelys in order to describe a family reunion.

The Thoracic-POISE Study
Dugald Seely, ND, and his brother Andrew Seely, MD, are the co-principal investigators in this first of its kind research trial to determine if naturopathic therapies can help thoracic cancer patients to improve long-term survival and adverse events associated with surgery.  Lung, esophageal and gastric cancer patients are all included in the trial.  Ottawa, home of the Seelys, is the primary site. The trial protocols have been developed from previously published work.
In a recently completed randomized clinical trial, another study co-led by the Seely brothers, 710 participants were enrolled in collaboration with the Canadian Association of Thoracic Surgeons in eight hospitals across Canada. This earlier study called AMPLCaRe, explores the effect of melatonin for lung cancer recurrence and survival results of which are expected to be ready and published within the next 6 to 12 months. According to Ottawa Life Magazine, "If trial results reflect what has been shown in other studies, there is real potential for reducing lung cancer recurrence after lung cancer resection, and thus improving quality and efficiency of care to the health care system through the use of this low cost non-patentable natural health product."3 This study and the new TPOISE trial are compelling examples of the pioneering complementary cancer care research efforts led by Dugald.
by Heather Wright, ND, FABNO

For the past several years, the Oncology Association of Naturopathic Physicians (ONCANP) has funded an initiative to assemble human level data on natural therapies in cancer care to help our members better access, understand, and refer to the evidence basis of our medicine.
The goal was to provide members ready access to curated data to allow for meaningful discussions with patients and other providers.  This project is led by KNOW project research directors Jen Green, ND, FABNO, Heather Wright, ND, FABNO, and Dugald Seely, ND, FABNO, and is supported by research assistants Anne Thiel, ND, Julia Dean, ND, and Sarah Soles, ND, in addition to others as well as volunteers.
Becky Skidmore, BA, MLS, a research librarian, helped design both the PubMed CAM search filter as well as an expanded and more detailed CAM search filter with input from naturopathic doctors in oncology specifically for KNOW to help find increased numbers of relevant studies vs. the standard PubMed search.
The initial KNOW literature search looked at clinical trials using natural therapies related to ‘breast cancer' in PubMed and Embase (the European equivalent) and yielded over 54,000 citations. Reviewers screened these articles using a program called Abstrakr, selecting ones that met inclusion criteria and excluding others. Selected articles are uploaded to the website using a reference manager software called Mendeley. Full text articles are pulled for these studies and reviewed by a team of research assistants who summarize and tag them.
Thus, for breast cancer, the original 54,061 papers were winnowed down to just 451 papers.  For neuropathy, the 1500 initial papers were reduced to 40 and for curcumin, the initial 1200 were reduced to 18. This process occurs to select papers that are clinically meaningful and that meet criteria specific to integrative oncology.
After those four initial topics, (breast, neuropathy, curcumin and thanks to Dugald Seely's interests, lung cancer) were included in a beta version of KNOW, the search methodology was shifted to make the process more efficient and improvements continue. KNOW was presented at the conference for the Society of Integrative Oncology in Miami in 2016, and at the Oncology Association of Naturopathic Physicians conference in 2017, and supplied both oral and poster presentations to each. To date, KNOW holds about 750 human clinical trial summaries, and these are searchable in the database. KNOW website also has an 'unsummarized' section that contains articles that are waiting to be summarized and tagged.
The KNOW project team plans to continue to search PubMed and Embase each year using their specialized filters to get relevant articles on integrative oncology human studies for that year. Currently, KNOW searches include data from 2010-2016.  Summarizing articles is a rigorous process. The KNOW team of five research assistants working five hours a week completed about 275 summaries over the summer.
KNOW also contains files of support literature, which includes a range of handouts, protocols, and other work authored by naturopathic doctors. Submissions are always welcome. These allow the expert group of physicians to share with those starting out, and this dialogue is supportive to raising the bar of the profession.
At this point in time, use of KNOW is limited to OnCANP members who can cut and paste citations or whole summary charts into emails or word documents for best communication and collaboration on treatment plans or with providers. In the future, KNOW project hopes to be able to license copies to other organizations so that their members will have access. KNOW also looks to develop collaborations that will add new data to the site and support in-kind work. One goal in the future is to cover data on topics that have been excluded from KNOW to keep the numbers manageable. Topics such as mind-body therapies and acupuncture are yet to be added, and the KNOW project looks to forge partnerships with other research groups to help add these segments of research to widen the holdings that are of interest to clinicians in cancer care. The KNOW project's newly formed advisory board, made of leaders in integrative oncology, is helping the project improve and grow.

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1.     Glouberman S, Millar J. Evolution of the Determinants of Health, Health Policy, and Health Information Systems in Canada. Am J Public Health. 2003 March;93(3):388–392.
2.     Bayer R. Tobacco, Commercial Speech, and Libertarian Values: The End of the Line for Restrictions on Advertising?
Am J Public Health. 2002 March;92(3):356–359.
3.     The Seely's – A Family of Medical Pioneers.
Ottawa Life Magazine. November 2013.

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