“Integrative oncology” is a combination of mainstream treatment and complementary therapies in cancer care. These are noninvasive, non-pharmaceutical ways of supporting mainstream treatment that improve strength and control the physical and emotional symptoms associated with cancer and cancer treatment.
The Integrative Approach
Although today’s successful cancer treatments cure increasing numbers of patients, they also result in negative effects, some of which are lasting. Side effects are common, and they impact the quality of patients’ lives during treatment and after. Therefore, optimal care requires attention also to patients’ needs during the course of treatment and into the years of survivorship. Unlike disproved or unproven “alternatives,” complementary therapies are evidence-based.
Major Components of Integrative Oncology
The following categories are commonly applied and are available at many cancer centers, including MSKCC:
mind-body techniques including meditation, self-hypnosis, yoga, and tai chi
Advice about nutrition, herbs, and other dietary supplements
Each of these evidence-based approaches has an important role in enhancing well-being and contributing to overall patient and survivor care. A few are highlighted below.
Mind-Body Therapies: Research demonstrates the benefits of mind-body treatments such as meditation and self-hypnosis. Patients can learn to use these techniques as needed, to decrease symptoms and improve quality of life. These therapies are widely used by patients with successful results.
Fitness and Nutrition: Exercise and physical fitness improve clinical outcomes and decrease negative side effects. Physical activity is an important recommendation of virtually every oncology organization internationally. Data show that physical activity increases survival.
Acupuncture: Acupuncture research demonstrates safety, physiologic benefits, and symptom relief. Problems such as neuropathy, xerostomia, and lymphedema often can be treated with acupuncture. This is especially important, as mainstream treatments often do not control these and other difficult problems.
Integrative Oncology in Cancer Programs and Centers
Most U.S. cancer programs include one or more components of integrative medicine. Some offer a full range of Integrative/complementary therapies, conduct research and/or provide educational programs. For example, the Integrative Medicine Department at MSKCC offers inpatient and outpatient clinical care plus education, training and research. We provide appropriate complementary therapies to patients, survivors, their families, staff, and the community.
If you want to include an integrative approach to your treatment plan to relieve stress or pain or other symptoms, speak to your doctor or contact the Integrative Medicine program run by your hospital. At MSKCC and some other hospitals, inpatient integrative therapies are provided at no cost, and outpatient therapies and classes are appointment- and fee-for-service based.
Insurance rarely covers integrative or complementary therapies, but most cancer programs, despite having top-notch, well-trained therapists, cost less than do similar therapies offered in the community. Small-group classes are inexpensive, and of course there is no tipping in programs run by cancer centers or hospitals.
Another area of Integrative Oncology of great interest to patients and family members concerns whether or not to use herbal remedies, botanicals and other dietary supplements, and unproven treatment methods marketed on the Internet and elsewhere. This has been an area of great confusion and frustration for patients and their loved ones, as well as for professional faculty and staff. MSKCC offers a free website that provides physicians and the public with evidence-based information about herbs, vitamins, other dietary supplements and bogus cancer treatments, all at no cost ( www.MSKCC.org/AboutHerbs ). This information is continuously updated and accessed.
Integrative oncology continues to grow in popularity throughout the developed world. It is increasingly available clinically and appropriately subjected to study in growing numbers of academic centers. These therapies are safe, inexpensive, and effective. Many are self-applied, thus providing patients and families some control over what may seem like an uncontrollable circumstance. Integrative therapies are an essential component of today’s cancer care. ■
Dr. Cassileth is Chief, Integrative Medicine Service, and Laurance S. Rockefeller Chair in Integrative Medicine, Memorial Sloan-Kettering Cancer Center, New York. She is the author of The Complete Guide to Complementary Therapies in Cancer Care: Essential Information for Patients, Survivors and Health Professionals. (World Scientific, 2011). Available on Amazon.com and BarnesAndNoble.com .