17 Nov 2017

What is Integrative Oncology?

I have just returned from a trip to Chicago where I attended the 14th annual conference by the Society for Integrative Oncology (SIO).

Wow!

I originally became a member of this organization because I wanted to expand my perspective on cancer care that is available within the current healthcare system. Get to know the challenges, aspirations and accomplishments of this newer take on a conventional approach.

What I found was conventional cancer care redefined in a most promising way!

Let me share my insights with you here.

 

What do we mean by “integrative oncology”?

SIO defines the term “Integrative Oncology” as

 “a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments.

 Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum and to empower people to prevent cancer and become active participants before, during, and beyond cancer treatment.”

 

That sums it up nicely, doesn’t it?

It is a place where conventional treatments such as surgery, chemotherapy, radiation therapy, hormone therapy and the like meet a complementary and alternative medicine (CAM) approach to improve the results for a cancer patient on all levels, from diagnosis all the way through to survival and prevention of recurrence.

“Evidence-informed” modalities are clinically researched treatment interventions that are studied with the usual rigorous scientific parameters using randomized clinical trials, double-blind placebo studies and, where possible, preferably human subjects rather than just in vitro or animal studies.

“Patient-centered” means that every aspect of a patient experience is up for discussion, evaluation and improvement. There is a “human-ness” to this side of oncological care that is encouraging to see in a world of highly standardized, and still often dehumanizing, treatments.

At the conference, I mingled with oncologists from a broad variety of institutions, including some of the more prestigious cancer centers from the US, as well as from countries such as Germany, Switzerland, the UK, Australia and China. During one lunch session I sat next to two oncological nurses from Bratislava who were on a fact-finding mission to improve care in their country. Naturopathic Doctors, Acupuncturists, Massage Therapists, Oncological Vets, Patient Advocates, Oncology Nurses and a few Nutritionists like myself were also represented as well as some proactive patients.

The underlying theme was clear: Large-scale improvements have been made in this special niche, and research proving the efficacy of certain natural modalities in conjunction with conventional treatments to help people with cancer is mounting.

I found it highly encouraging to hear a traditionally trained oncologist deliver peer-reviewed evidence that acupuncture can reduce nausea and vomiting or cancer-related fatigue, that certain Traditional Chinese Medicine (TCM) herbs can reduce the toxic side effects of a certain chemotherapy regimen, enhancing its overall effectiveness.

How the microbiome plays a role in treatment-related toxicity, cancer progression and resistance to treatment effectiveness.

Mind-body interventions and how they share common pathways in the brain.

Imagine hearing about hypnotherapy being used to address not only treatment-related side effects such as hot flashes brought upon by chemo-induced menopause, but also underlying emotional trauma that has been shown to be prevalent in most cancer cases. As one slide showed “Hypnotherapy works best on issues not under conscious control and can address biology, cognition and emotions”.

The evidence presented was almost too much to take in in a short 3 days. It exists! Clinicians are dedicated to pursuing this research, even if it takes years before a conclusive outcome can be presented for peer review.

The passion and commitment I witnessed in the deliveries of countless presentations was truly encouraging! This dedicated group of integrative clinicians who underwent further specialization and often have to fight hard battles to gain recognition by their more traditionally-minded peers who still vastly outnumber them in the hallways of most cancer centers, are worthy of our respect and support. It seems that they often volunteer their time and professional skills to further the cause of making cancer care more personalized and effective.

Nevertheless, we still have to contend with an existing healthcare system in dire need of reform so that many integrative initiatives can become an official part of a treatment protocol and thus be covered. This is indeed the case in many cancer clinics in other countries (some inspiring models were presented at the conference). Despite these challenges, the clinicians I heard speak are not perturbed to begin climbing this monolith mountain. They have a term for this, calling it “financial toxicity”, and acknowledge the impact this has on patient outcomes.

My point is to illustrate that integratively-minded oncologists are not happy with the status quo either, and are becoming creative to try and improve patient’s access to these supportive and complementary modalities.

The road to a truly integrative cancer care system accessible to any patient willing to adopt such an approach is still a long one. A healthy dose of skepticism is still required when evaluating personal cancer treatment protocols. As a patient we need to understand the role we play in this and what tools we have at our disposal to ensure we get a good match that offers curative outcomes. Anything short of that needs to be looked at with an “eyes wide open” approach. Conventional treatments are still the same in terms of delivering high levels of toxicity that can often prove to be fatal, or set the stage for possible recurrences.

What is the treatment supposed to achieve in term of affecting actual cancer growth?

Is it a proven approach, or is it a shot in the dark, a dab at hopefully achieving a wishful outcome. A last resort because it is the only tool left in the mix?

The type of cancer, its stage, and its actual biomarkers are all highly personalized characteristics that need to be taken into account. No single cancer diagnosis is the same. Maybe some biomarkers are, but the terrain never is, our personal bodies are never alike.

And each cancer is attached to a highly individualized human being, is it not? Regardless of their conviction, I firmly believe it is preferable, and worth the time investment, to look for a cancer care team that respects this and treats the person, not the cancer.

Unfortunately, it is still a challenge to find integrative oncologists near you, and then have access to them without having to wait a few months for the first appointment. This scenario frustrates them too!

I see huge potential for collaborative efforts among integrative clinicians and practitioners, and look with hope and enthusiasm to the future and my role in that!

I also see patients demanding better patient-centered care, and this voice needs to resonate louder and wider as well in order to see this fledgling movement gather momentum and gain a solid foothold in the world of integrative cancer care.

For now, I am grateful that I can already offer my clients targeted support on many levels, regardless of whether or not I can work in conjunction with an oncologist. Patient-centered care is what my work is all about.

And I feel truly blessed to work in this field and make a difference in a cancer patient’s life!

 

 

 

 

 

 

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