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Can Integrative Oncology Extend Survivorship?

Integrative oncology therapies such as massage, acupuncture, and select supplements are typically offered to ease and control harmful side effects from conventional treatments like chemotherapy and radiation. However, there is growing evidence that an integrative approach to cancer care may also extend survival time.

My colleague Dr. Moshe Frenkel, founder of and former medical director at MD Anderson Cancer Center’s integrative medicine program recently shared a fascinating paper he led called “Effects of Complementary Medicine and Integrative Medicine on Cancer Survivorship”. (The abstract from Current Oncology Reports can be found here.)

The paper’s introduction explains that, even when cancer patients successfully complete their treatments and receive follow-up care, they often have significant unmet physical, emotional, and spiritual needs.  These usually include an intense fear of relapse of disease, fears which—for some—can be all-consuming.

While integrative oncology research has focused on treatments for symptom control—nausea, fatigue, pain, neuropathy, and anxiety—and concentrated on improving a patient’s quality of life, the paper’s authors report little attention has been given to whether or not these therapies prolong life.

This new review of the medical literature, which contains several clinical trials, evidences the combination of several integrative cancer care approaches, including lifestyle and behavioral change, may extend survivorship.

Here is a small sample of study outcomes from Dr. Frenkel’s paper:

Key

n = sample size of participants

metastatic = disease which has spread beyond original site

control group = those not receiving active therapy

Breast Cancer

Author: Spiegel, et. al.

n = 86 patients with metastatic disease

Therapy: Mind-body: weekly supportive group therapy with self-hypnosis for pain.

Outcomes: 36.6 months survival versus 18.9 months in the control group.

Author: Spiegel, et. al.

n = 122 patients with metastatic disease or locally recurrent (n=3) disease

Therapy: Mind-body: weekly supportive-expressive group therapy.

Outcomes: ER-Negative participants survived longer (median: 29.9 months) versus ER-negative control group (median: 9.3 months).

Melanoma

Author: Fawzy, et. al.

n = 68 patients with malignant melanoma

Therapy: Psycho-education intervention groups of 7-10 patients met for 1 ½ hours weekly for six weeks.

Outcomes: At five to six year follow-up, participation in the intervention group lowered the risk of recurrence by more than 2.5-fold and decreased the risk of death approximately 7-fold. At the 10-year follow-up, a decrease in risk of recurrence was no longer significant, and the risk of death was 3-fold lower than those in the control group.

The Frenkel, et. al. paper highlights 32 studies. In addition to various mind-body and psycho-support trials like those cited above, several studies show prolonged survivorship correlation, across several populations of disease, for those supplementing with various nutrients such as omega 3 essential fatty acids, increasing dietary consumption of cruciferous vegetables (specifically broccoli), and  partaking in regular vigorous physical activity.

Though most of the trial sizes were relatively small, between 15—5000 participants, there were a few larger studies encompassing several hundred thousand participants.

The Data Looks Impressive.  But More Research is Needed.

Almost every publication in the medical literature focusing on lifestyle approaches to cancer care ends with “… but more research is needed”.  The problem is that the lion’s share of this type of research, that which is focused on diet, exercise, restorative sleep, psycho-social support, or natural products like supplementation, is not commercially viable.

Corporations of all sizes are cautious when it comes to investing in research and development. It’s all business; companies will not spend money on large clinical trials to prove the safety and effectiveness of products for which they cannot secure intellectual property rights (ownership of invention) and make money from.

My outlook on all of this is quite simple:

  • if the science is growing in its support;
  • if it does not interfere with other treatment;
  • if it is generally regarded as safe;
  • if it feels good and seems to make a difference;
  • if it is of high quality (product, service)
  • if it is affordable…

…then GO FOR IT!

After all, if you’re living with disease you are making decisions in real time.

Should you wait until more research comes out that makes the connection between a plant strong diet, physical activity, stress reduction, and restorative sleep before taking a proactive approach?

Do you need the blessing of your oncologist to engage in healthy activities and practices?

There will always be more studies, but therein lies the problem:  those results will be filed in the future. You are present tense, as are your actions.