According to a new study published in the Journal of Oncology, breast cancer patients treated in facilities offering integrative medicine support had better survival outcomes than patients treated in facilities that did not offer complementary treatment options.
Providing patients access to health systems dedicated to educating their patients on nutrition, exercise, and other lifestyle adjustments was integral to improving survival rates, as well as patients’ quality of life.
The aim of the study was to examine the relationship between institutional involvement with integrative oncology and survival in breast cancer patients.
Before we dig into the study results, for those new to this blog I want to first define the practice of integrative oncology.
What Is Integrative Oncology?
A cancer diagnosis affects the mind, body, and spirit of a patient. Integrative oncology is a patient-centered, evidence-informed approach to healthcare that uses mind-body therapies, natural products, and lifestyle modification as adjunct to conventional cancer treatments, and is ideally provided by a multidisciplinary team of care providers. Integrative oncology aims to increase well-being of the mind, body, and spirit, and to provide patients with skills that enable them to help themselves during and beyond cancer treatment.
Breast Cancer Survivorship Study
In this study, 173 newly-diagnosed breast cancer patients were treated across 103 facilities by 103 oncologists who implemented integrative oncology therapies. Investigators examined the five-year survival rate of the patients, and the level of institutional involvement utilizing integrative oncology.
Medical claims-based data were used to identify 4,815 newly diagnosed breast cancer patients treated between January 2013 and December 2014 to analyze overall survival. A scoring system was developed by polling oncologists on their institutions’ efforts to educate, support, and provide funding for 12 complementary and lifestyle approaches, including:
- Nutrition counseling
- Exercise counseling
- Patient support groups
- Spiritual services
- Psycho-oncology support
- Massage therapy
- Music or art therapy
- Tai Chi or qi gong
Of the 12 modalities investigated during this study, the five most commonly used included exercise counseling, nutrition counseling, psycho-oncology support, chaplain services, and patient support groups. Several of these support services and modalities, in addition to meditation, comprise the core tenets of integrative oncology.
[Related content: Can Integrative Oncology Extend Survivorship?]
The patient ages ranged from 32 to 76, eight percent of whom were metastatic. The data was collected and organized into four groups based on each facility’s level of support of integrative therapies for breast cancer patients, using a scale of low (25 centers), low-mid (26), mid-high (23), and high (26).
Researchers reported that low-scoring institutions had a notably lower five-year overall survival rate (89%), compared with low-mid (96%), mid (96%), and high (95%) scoring institutions. Women treated at a facility that crossed the threshold above a low score into a low-mid score were up to three times more likely to survive beyond the 5-year life expectancy.
This current research may contradict the findings of a study conducted in 2018 that was published in the Journal of the National Cancer Institute that suggested that patients who received alternative treatments had a substantially worse survival rate than those who only received conventional treatments.
The incongruity comes from the assumption that the patients included in the 2018 study were treated using only alternative modalities, rather than using them in conjunction with standard cancer treatments. Integrating conventional treatment and integrative modalities can be key to improving overall survival rates and quality of life for both the patient and their families.
The results of this study came as a surprise to researchers, who noted that even the most modest incorporation of integrative oncology modalities made a profound impact on life expectancy and quality of life for the patients.
Patients receiving integrative treatment at low-mid and mid-high-scoring institutions had, respectively, three times and 48% higher odds of 5-year survival compared to low-scoring institutions. According to the investigators, “the magnitude of this survival advantage is comparable to being treated at an academic medical centre or an NCCN-designated centre.”
While many facilities offer a wide range of integrative oncology services, including nutrition and psycho-oncology, as well as less common therapies like acupuncture and massage therapy, about one-quarter of the facilities had a low score. These low-scoring settings provided less funding and access to integrative oncology than all other institutions.
The Society for Integrative Oncology’s development of clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment, and additional practice guidelines advanced by SIO, are helping to usher in an emerging standard of care that better supports the (cancer patient’s) host environment.
While integrative oncology has steadily become more widely utilized, and recommended, many patients have limited access to complementary therapies.
Increasing the level of integrative oncology support services at the lowest scoring institutions confers increased benefit to overall survival for those living with breast cancer.
Moreover, increasing the scoring of institutions providing the six core therapies that include nutrition counseling, exercise counseling, patient support groups, spiritual services, meditation, and psycho-oncology support, is shown to significantly improve the chances of patient survival, while simultaneously enhancing quality of life.
Making integrative oncology education and therapies more widely available to patients through institutional settings will be key to improving overall survival, elevating quality of life, and helping patients manage the side effects of their treatment.
Want to Hear More on this Subject?
Not long ago I was interviewed by Stacey Richter for the Relentless Health Value podcast on the topic of growing value and opportunity for integrative oncology in hospital settings.
During our spirited discussion we covered lots of ground, including the growing science supporting integrative oncology and the profound opportunity for hospitals and cancer centers to engage and educate their communities on true cancer prevention focused on smart lifestyle—read: beyond vaccines, colonoscopies, mammograms and early detection.
Relentless Health Value is one of the oldest and largest podcasts dedicated to healthcare industry decision-makers. Its mission is to “help transform health care by fostering collaboration and breaking down silos”. So how could I refuse this opportunity to share my thoughts?
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