Integrative Oncology

Book Information

Book Order Form

I. What is Integrative Oncology?
         Integrative oncology is the process of bringing together diverse treatments (from Latin, integrare, to make whole) into a single treatment plan so that the person with cancer can become whole, complete and unimpaired.  The root wholeness implies combining parts, uniting, and creating harmonious relationships between the parts.
         Unfortunately, contemporary cancer care does not function this way.  Beyond the painfully obvious fragmentation of the medical system there are divisions between conventional and complementary treatments, between practitioners even within a single medical system, and between patients and practitioners.  Conventional cancer care itself is broken, as described in the Institute of Medicine report, From Cancer Patient to Cancer Survivor: Lost in Transition (IOM, 2006).
         The acute treatment phase of cancer treatment is appropriately focused on eradicating the malignant cells.  It is truly a matter of life and death.  In that process the patients’ other needs may be placed at a lower priority by the conventional medical system.  Surgery, chemotherapy and radiotherapy all have potential side effects.  In some cancers, the potential for cure or life prolongation may make these side effects justifiable to both patient and doctor.
         When the acute cancer-directed treatments are completed patients are still left with the residual side effects as well as all the other damage that a diagnosis of a potentially mortal disease inflicts.  The damage is to the whole person, in all the dimensions of humanity: psychological, spiritual, social, economic, relational, existential, as well as somatic.  Only recently has the conventional system addressed these needs in any organized fashion.
(The Stanford Cancer Survivorship Program: Life After Cancer A Roadmap for Cancer Survivors,  Ernest H. Rosenbaum, MD, David Spiegel, MD, Patricia Fobair LMSW, MPH, Sheila Breslin, RN, MS, OCN, Sandra Horning, MD, Louise Moffitt, BFA, 2007 and Cancer Care for the Whole Patient: Meeting  Psychosocial Health Needs, Committee on Psychosocial Services to Cancer  Patients/Families in a Community Setting, Nancy E.  Adler and Ann E. K. Page, Editors, IOM 2008)

II. Conference on Integrative Oncology
         In May, 2008 40 international specialists in complementary cancer care met for a conference on Integrative oncology.  For 3 days we discussed the impact of complementary treatments on quality of life and the possibilities of extending life.  Our consensus was that lifestyle treatments (including exercise, nutrition, meditation, imagery, psychology and Chinese Medicine) should be more available to cancer survivors.  There was strong agreement that other healing arts such as movement, poetry, and creative expression are important as well as depth approaches to connect with the transpersonal/spiritual dimension of one’s life.  Most of the participants believed that such complementary treatments could extend life for at least some people though more research is necessary to demonstrate that.  (20th Anniversary Lloyd Symington Foundation Conference on New Directions in Cancer Care at Commonweal, May 2-5, 2008)

III. Treating the Cancer
         At the time of diagnosis the priority is treating the disease.  The treatment depends upon the specific type and stage of cancer and the patient’s physical condition.  Often the treatment plan is recommended by a tumor board, a group of specialists (surgeons, radiotherapists, medical oncologists, pathologists, radiologists, etc.) who are experts in treating cancer.  The recommendations depend on the perspective of the doctors and may or may not include complementary modalities or treatments directed to the psychological wellbeing of the patient.  Treatment integration is limited to coordinating the anti-cancer therapies and preventing and/or treating direct side effects of treatment.
         Though there is a trend now to include patient participation in treatment decisions, sometimes patients encounter a system that does not engage in dialogue.  Patients’ needs for psychological, nutritional, and physical support may not be addressed.  In that respect, because the cancer is the focus, the patient is not integrated into the treatment plan and is expected to defer meeting some needs until the acute treatment is complete.

IV. Treating the person
          Treating the person should start with the initial encounter.  The crisis precipitated by the diagnosis of cancer often shifts attention to the disease and away from the “dis-ease” of the person. Though some offices offer special services, most of the time patients are left on their own to find ways of helping themselves.  Many patients instinctively know what they need and with a little effort, can find the resources.  They recognize they must deal with stress or diet and find a counselor or nutritionist.  They know that complementary medicine can supplement the treatments they are receiving and will see an acupuncturist or other healer.
            Other individuals simply know something is missing and need guidance.  They encounter a bewildering mass of information and advice from friends, the internet, the media.  It is a struggle to separate truth from fiction and offers of hope from offers of real help.  There is a vast array of possible supplemental treatments and it can be difficult to know what is right for them.  Finding a physician to guide you in making choices or team of physicians who can integrate diverse medical approaches into a harmonious whole is challenging.
It’s not any easier after primary treatment is complete.  If you listed the cancer survivor’s tasks they would overwhelm a superhero.
  One must:

V. Integrative Oncology Network
      The Integrative Oncology Network (ION) was created to meet the needs of patients and families as they go through cancer treatment and its aftermath.  In the Symonton Conference on New Directions in Cancer care (mentioned above) there were several models of Integrative Oncology presented. 
         One form was based on all the services being under one roof, generally in a large university.  Several institutions have tried this approach with various levels of success.  Alternative clinics, such as found in Mexico, Germany and in parts of the United States, claim to integrate care but often omit conventional care such as surgery or chemotherapy, even when it would be appropriate.  Stanford has a Complementary Medical service but it primarily offers meditation, acupuncture, some exercise, and psychological services with an emphasis on stress reduction.
            Another model is that of a “Patient Guide” who can direct patients to the appropriate providers based on their assessment of needs.  This has been developed by Dr. James Gordon, director of the Center for Mind-Body Medicine in Washington, DC.  Though a promising model, it is limited by the training of these guides and can only be offered in centers that can fund these additional personnel.  Hence, like the first model in a university center, it is often limited to the practitioners on staff at that institution.
            We have developed a third model to integrate cancer care which is based on using the resources that already exist in the community.  This is called the Integrative Oncology Network or ION (integrativeoncology).  Professionals with skills in the various specialties necessary to help patients heal have come together in a network so that patients seeing one of these specialists can be referred to others based on patient needs.  There is established communication between specialists so that the referral source and the other practitioner can inform each other about the progress of the client/patient.  If it seems that additional resources are needed—as indicated by the practitioner or the patient—then there is a system for assisting the patient to find that help.
            Specialties in the network include nutrition, exercise and movement specialists, physical therapy, psychology, acupuncture and Chinese medicine, energy medicine, imagery and hypnosis, body work, meditation and others.  These practitioners have their own offices in the area and see patients with various other problems unrelated to cancer.  Links to their websites and contact information is available at integrativeoncology.

Return to Top