You may have heard the term “integrative oncology” bandied about quite a bit lately. According to Dr. Steven M. Sager, (in the Journal of the Society for Integrative Oncology, winter 2006) integrative oncology “combines the discipline of modern science with the wisdom of traditional healing. It is an evolving evidence-based specialty that uses complementary therapies in concert with medical treatment to enhance its efficacy, improve symptom control, alleviate patient distress and reduce suffering.”
You would be forgiven for thinking this sounds very similar to what people usually refer to as complementary and alternative medicine (CAM). Integrative oncology, as a subspecialty of integrative medicine in general, stems from a philosophy of treating the whole person: body, mind and spirit. It uses many CAM approaches such as natural health products (botanicals, vitamins and minerals), nutrition, acupuncture, meditation and other mind/body approaches, music therapy, touch therapies (such as massage) and physical activity, to name a few.
The key element that distinguishes integrative oncology from CAM is that it is a system of interdisciplinary care, blended throughout cancer care as necessary for each person. This system employs a collaborative team approach that is patient-centred, so that the patient’s needs and views dictate the course of care, not those of the practitioners. The idea is to avoid medical paternalism and instead to provide evidence-based advice that is consistent with each patient’s values. It is meant to treat the whole person through a partnership between patient and practitioner, and to promote health and wellness, prevention of disease and to bring out the innate healing capacity in each person.
One overall goal of integrative oncology is to increase the efficacy of conventional cancer treatment programs such as chemotherapy and radiation by reducing side-effects and improving tolerance, reducing symptoms and improving quality of life. Some of the approaches may also have potential to extend life, but this is a controversial topic that is currently the focus of much investigation. Integrative oncology typically uses complementary approaches, as distinguished from alternative medicine approaches, which usually eschew standard treatments while promising cure. Alternative approaches are typically lacking evidence for their efficacy and often rely on anecdotal reports alone.
A hallmark of integrative medicine is that interventions are evidence-based and, where evidence doesn’t exist, research is conducted with promising treatments. Currently there is a lack of evidence for many integrative oncology interventions as this field of research is still quite young. I’ve already reviewed some of those with good evidence for this column, including meditation, yoga, exercise, support groups and creative therapies.
At the Tom Baker Cancer Centre, as part of my research chair in psychosocial oncology, one focus area is integrative oncology. Over the next five years we plan to step up this research program and expand from our expertise in mind-body approaches into better understanding of natural health products, such as vitamins and botanicals. Hopefully we will be able to provide better information for patients and begin clinical trials to investigate the utility of some of the more promising integrative interventions.
READ: Dr. Sagers’s article, “The State of the Art and Science Integrative Oncology,” www.sunshineih.com/Health/wp-content/uploads/2010/11/integrative-oncology.pdf