Advancing the Global Impact of Integrative Oncology

There is an incredible amount of inaccurate information on holistic, integrative, and alternative approaches to preventing cancer, treating cancer, managing the symptoms of cancer treatment, and supporting long-term survival.

The importance of clarifying and disseminating vital information led to the founding of the Society for Integrative Oncology (SIO) in 2003. The organization’s mission is to bring scientific rigor to the evolving field, and to help translate these findings to most safely and effectively support cancer patients through the continuum of care.

Fourteen years ago, the leaders of integrative oncology from MD Anderson Cancer Center, Dana-Farber Cancer Institute, and Memorial Sloan Kettering Cancer Center, came together to create SIO. The organization brings together a global group of scientists, integrative cancer clinicians across disciplines, and patient advocates, to present current research and discuss how it can be most appropriately translated to improve clinical care.

I was proud to serve on SIO’s board for a three-year stint during 2010—2012, and to participate on the organization’s scientific and conference planning committees over the years. This deeply rewarding experience marked the beginning of many special long-term relationships with the leading lights of integrative oncology.  My involvement with SIO also catalyzed my ‘science-first’ approach: for my own health, for my writing, for the companies with which I consult, and for the patients I coach.

The most recent body of work spearheaded by SIO is the current Journal of the National Cancer Institute (JNCI) Monographs, titled ‘Advancing the Global Impact of Integrative Oncology’. This special publication, available free of charge, here, features 16 papers on evidence-informed approaches to improve integrative oncology clinical care. The papers cover important research methods and the state of the field by investigators, clinicians, and patient advocates from the Middle East, Asia, South America, Europe, and North America.

Though you may primarily obtain cancer information from reading articles in consumer magazines and through blogs such as mine, I felt it was important to introduce you to the scientific papers that inform the most credible consumer articles about the state of integrative cancer care.

Scientific papers undergo a rigorous peer-review process and become indexed in the medical literature. Responsible consumer media—from the largest, dominant players to independent bloggers—rely on this growing body of medical literature to shape their reporting and commentary.

Below are brief synopses and links to 11 of 16 papers comprising a monograph. These are the key papers that I believe to be the most relevant and interesting for readers.

JNCI Monographs, Volume 2017, Issue 52, 1 November 2017: ‘Advancing the Global Impact of Integrative Oncology’

  1. A Comprehensive Definition for Integrative Oncology

Authors: Claudia M. Witt; Lynda G. Balneaves; Maria J. Cardoso; Lorenzo Cohen; Heather Greenlee, et al.

Tragically, there remain situations in which susceptible cancer patients are offered treatments that are dangerous or have no scientific evidence, and are often expensive. Thus, a clear definition for integrative oncology is critically important for patients, families, and healthcare professionals alike.

The article illustrates a comprehensive and illuminating process that led to…

Integrative Oncology Defined

Integrative oncology is 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.

In their conclusion, the authors state that not everything that is labeled integrative oncology belongs to this field, and further note: in integrative oncology, the scientific evidence, termed “evidence-informed” in the definition [above], has a major role.

  1. Integrating Traditional and Allopathic Medicine: An Opportunity to Improve Global Health in Cancer

Authors: Edward L. Trimble; Preetha Rajaraman

A significant percentage of cancer patients across the globe use some form of ‘traditional’ medicine, endemic to their culture, while undergoing conventional treatment and recovery. For many, access to traditional medicine providers is often easier than to conventional oncologists. So it is critical for open communication between all healers and their patients, in order to most safely and effectively support them.

  1. Association Between Use of Traditional Chinese Medicine Herbal Therapy and Survival Outcomes in Patients With Stage II and III Colorectal Cancer: A Multicenter Prospective Cohort Study

Authors: Yun Xu; Jun J. Mao; Lingyun Sun; Lin Yang; Jie Li, et al.

This multi-center prospective study showed statistical significance in both disease-free progression and overall survival outcomes for a group of patients who underwent conventional therapies for colorectal cancer, with the addition of personalized formulations of Traditional Chinese Medicine herbs.

  1. Integrative Whole-Person Oncology Care in the UK

Authors: Catherine Zollman; Axel Walther; Helen E. Seers; Rachel C. Jolliffe; Marie J. Polley

Many readers of this blog hail from the United Kingdom. So, it was enlightening for me to learn about the significant contrast between the U.K. and U.S. in both the academic research activities of integrative oncology, as well as patient access to integrative cancer care, which is typically called ‘whole-person oncology care’ in the U.K.

  1. Growth of Integrative Medicine at Leading Cancer Centers Between 2009 and 2016: A Systematic Analysis of NCI-Designated Comprehensive Cancer Center Websites

Authors: Hyeongjun Yun; Lingyun Sun; Jun J. Mao

The investigators compare, using comprehensive website reviews, the growth of information on integrative oncology/medicine methods, as well as clinical services offered patients at 45 NCI-Designated Comprehensive Cancer Centers. Fact: today, 60% of these centers of excellence provide comprehensive integrative medicine consultations to patients.

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  1. Comprehensive Lifestyle Change: Harnessing Synergy to Improve Cancer Outcomes

Authors: Lorenzo Cohen; Alison Jefferies

Dr. Lorenzo Cohen, whom I recently wrote about here, and his partner Alison Jefferies, a registered dietician, discuss the core lifestyle factors, including environmental impacts that can positively affect cancer outcomes.  The influences discussed here are linked to various hallmarks of cancer that allow the disease to form, grow, and survive. The authors describe a study that focuses on a year-long program working with post-treatment breast cancer patients on significant lifestyle change that looks at survival outcomes.

  1. Distress Management Through Mind-Body Therapies in Oncology

Author: Linda E. Carlson

In this article, the author discusses the high prevalence and various degrees of depression, anxiety and fear among cancer patients—and focuses on proven mind-body therapies that should be more widely available, given their ability to empower survivors to manage the emotional rollercoaster that can often start at the time of diagnosis.

  1. The Role of Physical Activity in Oncology Care

Authors: Justin C. Brown; Jennifer A. Ligibel

A growing body of evidence suggests that physical activity supports cancer survivors in myriad ways. Observational studies show that prescriptive exercise programs may be associated with lower rates of cancer recurrence and cancer mortality. This article confers the known biologic mechanisms through which cancer is impacted, current physical activity guidelines, and a new phase III clinical trial called CHALLENGE for stage I and II colorectal cancer survivors.

  1. Including the Patient Voice in Patient-Centered Outcomes Research in Integrative Oncology

Authors: Jodi MacLeod; Edward Wolff; Alice McAllister; Jun J. Mao; Sheila N. Garland

A group of eight cancer survivors, comprising an advisory committee, worked with a team of researchers to develop a retrospective study design to compare the effectiveness of acupuncture to cognitive behavioral therapy for insomnia in cancer survivors. This paper shares a process through which patient advocates can engage directly with scientists to include the patient in a patient-centered approach to integrative oncology research.

  1. US National Cancer Institute–China Collaborative Studies on Chinese Medicine and Cancer

Authors: Libin Jia; Hongsheng Lin; Joost Oppenheim; O. M. Zack Howard; Jie Li, et al.

For over a decade, the National Cancer Institute’s Office of Complementary and Alternative Medicine has been collaborating with the China Institute of the China Academy of Chinese Medical Sciences on the study of Chinese medicine.  Through this association, Chinese drugs and compounds, including botanicals—some of which have been used as standard care for thousands of years—have been explored to assess their safety, quality, how they work, their impact on cancer prevention, and their anticancer properties. This paper discusses these ongoing collaborations and the birth of a newly established global organization called the International Consortium for Chinese Medicine and Cancer, whose purpose is to foster more collaboration in this emerging field.

  1. State of the Science: Cancer Complementary and Alternative Medicine Therapeutics Research—NCI Strategic Workshop Highlights of Discussion Report

Authors: Dan Xi; Ting Bao; Qi Chen; Sushing Chen; Yung-chi Cheng, et al.

In May 2016, the Office of Cancer Complementary and Alternative Medicine, Division of Cancer Diagnosis and Treatment of the National Cancer Institute, organized a workshop comprised of panels led by top NIH-funded integrative oncology investigators. This report captures consensus on the current state of the science, identifies gaps, challenges, and opportunities in this quickly evolving field.

In Closing

The field of Integrative oncology did not exist when I was diagnosed with incurable leukemia in 1991. A quarter century has elapsed since I began employing a self-directed integrative approach for my own healing. At first—for years—there was limited research to support my regimen. The research would have to catch up, over decades, to my lifestyle activities.

And it largely has, thanks to a small army of dedicated investigators. The literature base continues to grow in support of evidence-based and sensible evidence-informed methods—especially the core tenets of lifestyle approaches—to support the host environment. It is especially gratifying to see more and more patients incorporate various modalities shown to be safe and effective for the management of cancer.

From the perspective of a cancer patient, progress will always seem like it’s moving at a snail’s pace—especially the speed in which research findings are translated to clinical utilization. But, during the last decade, much credit is due to the Society for Integrative Oncology being an organizing force for the field. The accomplishment of this monograph, and the clinical guidelines that have come before, are testament to the health and vitality of this important organization.

I encourage you to dig deeper into the highest quality and most accurate information—exampled in the preceding papers. Let’s be clear: this is your life in your hands. Accessing high quality information will allow you to better understand your particular health challenge. Place yourself in a proactive position to assess the science, or lack thereof, that backs the myriad cancer cures or cancer support offerings traversing the internet.

While high quality consumer articles are available online, from trusted sources, I recommend spending time searching PubMed, which houses the enormous scientific body of peer-reviewed and published articles, for a specific condition or medical interest. Determining, then dismissing, low quality misinformation—worse yet, disinformation—is the starting point in making life-enhancing, informed decisions.

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