Increasing knowledge of integrative oncology can help reduce cancer burden
As cancer patients have varying levels of access to care and treatment around the world, factors such as how quickly they are diagnosed and the intervention methods used are largely tied to their location.
The Society for Integrative Oncology (SIO) is leading an initiative to bring equal access to cancer care no matter where a patient is in the world. A recently published review article explores the global challenges of cancer treatment and how cancer could be prevented.
Jun J. Mao, MD, MSCE, lead author of this study and a specialist in integrative medicine at Memorial Sloan Kettering Cancer Center in New York City, explained why integrative oncology is important for cancer patients.
“We don’t have enough health care providers, like traditional and complementary health care providers like healers, massage therapists or yoga instructors. They could potentially help patients get involved in cancer prevention activities, quit smoking, or get screened. Cancer can be diagnosed at an earlier stage or prevented as a whole,” Mao said.
In an interview with CancerNetwork®, Mao talks about what the authors aimed to accomplish, the recommendations that were made, and how clinicians can adapt to integrative oncology.
What is integrative care and how does it apply to treating cancer patients?
Integrative oncology is a field that seeks to bring together therapies and practices from other cultures and traditions into conventional cancer care to help patients manage physical and psychological disorders. [adverse effect] cancer and empower them during cancer treatment, and [throughout] survival. He uses lifestyle modifications, appropriate mind and body therapies, and natural products.
What were some of the objectives of this study?
What motivated us for this article is that the National Cancer Institute [NCI] has a Complementary and Alternative Medicine practice and [I was asked] to lead the writing of this article based on the conference that the NCI and NIH [National Institute of Health] organized. The aim is to highlight some of the potential challenges in the global fight against cancer, namely prevention, treatment, survivorship and palliative care, and [ease] the tensions between traditional and integrative medicine and conventional modern oncology as they become available in these settings. Then, [we outlined] some of the solutions for the field to move forward to address some of the global inequities in cancer care.
What are the approaches described in the study?
After almost a year of process, a group of international academics with people from all parts of the world as well as NIH and WHO, or the World Health Organization, came up with 3 recommendations. The first is to train traditional complementary and integrative health care providers in evidence-based principles and practices of cancer control and management. In many regions, for example in Africa or South America or parts of Asia, conventional oncology or cancer control is simply not [enough].
[These integrative care providers] don’t necessarily know what evidence-based cancer prevention is. Training this workforce can increase their ability to provide effective care, as well as cancer prevention and detection strategies.
The second [recommendation] is to develop, test and conduct rigorous research interventions in traditional, complementary and integrative approaches to treat cancer symptoms, quality of life issues [associated with] cancer treatments, as well as palliative care and survivorship. Many of these traditional healing practices are culturally more in line with a population and have been used to support the more holistic nature of the mind, body, and spirit of the person with cancer. Modern oncology treatments such as radiation oncology, surgery or chemotherapy are more widely available in low- and middle-income countries around the world. The suffering of cancer is immense and relying solely on medication to treat pain, fatigue, nausea and vomiting may not be adequate or consistent with people’s cultural beliefs. Especially in the context of survival, we want people to get back to their normal lives and be independent. Many pharmaceutical interventions may not be the best way for people to regain a sense of self and fit into our culture and environments. [Clinicians should] learn what we can from these cultural and social contexts and distill interventions and go through rigorous research [to determine] ultimately, if can we allow these therapies to play a vital role in cancer care and survivorship.
The third recommendation is to implement therapies and practice [management] that have already been established with intervention evidence to improve cancer pain symptom control in a culturally appropriate way, [both] in local environments and around the world. For example, thanks to 20 years of research and thanks to the work of many researchers, many of whom are part of the SIO, we have been able to demonstrate practices such as meditation, yoga or acupuncture massage that can help treat psychological distress. related to cancer treatment. In survival situations, [these practices can help manage] fatigue, hot flashes, sleep and pain. Many of these practices are much cheaper than drugs in many countries and cultures and are more readily available. We need to figure out how to train these health care providers to get them up to speed on the job [patients with cancer] and influencing the local health system to adapt these interventions to the care of their [patients with cancer] and ultimately, evidence-based interventions can be turned into real clinical practice to improve people’s lives.
How do you think clinicians can start implementing these recommendations in their practice?
SIO is working on several [endeavors]. The first is education. We need to expand training for oncologists, oncology nurses and integrative health care providers. We need to create the dialogue between oncologists and oncology nurses and know what are some of the safe and effective strategies of integrative health interventions to treat the symptoms of [patients with cancer]. Next, integrative health care providers need to be aware of common cancer treatments, common symptoms, and potential risks. [adverse] the effects and interactions of the drugs and therapies they use. We need to ensure that we integrate these therapies into conventional oncology treatment in a way that is safe and effective for the patient.
Finally, we must also equip ourselves [patients with cancer] and cancer survivors or advocates with the knowledge and skills necessary for the patient or family to learn about these therapies. This is the first step. It is a dissemination of knowledge. In terms of implementation, I think there will be many challenges as well as opportunities. There are financial and logistical political barriers that must be overcome for some of the therapies to be implemented. Any challenge could represent an opportunity. There is a whole new type of science called implementation science, using a specific scientific framework and models with the implementation of evidence-based interventions or strategies at the population level. I think a scientist should also start applying these rigorous methods of implementation science, to study how best to implement these practices in clinical settings to really improve people’s lives.
Mao JJ, Pillai GG, Andrade CJ, et al. Integrative oncology: addressing global challenges in cancer prevention and treatment. CA Cancer J Clin. 2022;72(2):144-164. doi:10.3322/caac.21706