What is Integrative Oncology and How Can it Help Your Cancer Journey?

A cancer diagnosis can bring about a wide range of emotions, such as feeling overwhelmed, fearful, or isolated. It can also introduce many new tasks, like navigating insurance, checking benefits, finding in-network doctors, coordinating child care during treatment, filing FMLA paperwork, and arranging transportation to treatments. Amidst this, patients often wonder:  

"What else can I do for my cancer?"

"What should I eat?"

"Can I exercise?"

"How can I manage these side effects better?"

Fortunately, the approach to cancer treatment is evolving positively. Patients are seeking more comprehensive care, better symptom management, and a focus on quality of life. A growing specialty that can help enhance cancer care is Integrative Oncology. Let's explore this specialty and how it can complement cancer treatment.

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What is Integrative Oncology?

The definition of Integrative Oncology is continually evolving. Simply put, integrative oncology combines conventional oncology treatments (such as chemotherapy, immunotherapy, surgery, and radiation) with evidence-based integrative medicine approaches (including lifestyle, diet, botanical medicine, and IV therapy). Integrative oncology aims to enhance quality of life, help manage treatment side effects, and support patients in regaining their health after treatment.

The three main groups of patients that may benefit from integrative oncology are:

• High-risk patients who want to support their overall health
• Those in active treatment seeking to improve quality of life and manage side effects
• Cancer survivors looking to maintain health and well-being

Professionals trained in integrative oncology have knowledge of both conventional and complementary cancer treatments. Importantly, they understand how to safely integrate non-conventional treatments with chemotherapy, immunotherapy, surgery, and radiation.

A benefit of incorporating integrative oncology into your cancer care team is the time that the provider can spend with you. An average medical oncology visit is 23 minutes. However, an integrative oncology visit can last from 45 to 60 minutes. This allows patients to ask questions about the risks, benefits, and potential alternatives to their treatment plan. It also provides an opportunity for a longer discussion about the patient's quality of life, including energy levels, work accommodations, sleep, and anxiety. These conversations can significantly impact a patient’s overall well-being.

How Can Integrative Oncology Support Someone Who Was Recently Diagnosed?

There are many evidence-based resources indicating that Integrative oncology can support patients in various ways, including:  

• Supporting post-operative surgical recovery
• Addressing and managing pre-existing conditions (such as diabetes, anxiety, autoimmune conditions)  
• Helping manage chemotherapy-related side effects with safe, botanical options
• Supporting better sleep and addressing insomnia
• Monitoring and encouraging adequate nutrition
• Helping manage cancer-related fatigue
• Providing supplement recommendations and education to avoid interactions
• Incorporating acupuncture and other traditional practices (such as Ayurveda)
• Supporting the body's ability to handle anti-cancer therapies
• Addressing the spiritual and emotional needs of a patient
• Providing recommendations and referrals to address the emotional impact of a diagnosis

What Are Some Common Integrative Oncology Approaches?

The range of integrative oncology approaches is broad and can include IV therapy and yoga therapy. Most integrative oncology approaches aim to enhance the quality of life for cancer patients. Some integrative oncology methods may also support the body's natural defenses.

Phytomedicines (or botanical medicine)

"Phyto" means "of a plant or relating to plants." Therefore, phytomedicines refers to plant-derived or botanical medicine. Some phytomedicines are studied for their potential health benefits. Commonly used phytomedicines include:

• Epigallocatechin Gallate (EGCG) - found in green tea, studied for its potential health-supporting properties.
• Resveratrol - a polyphenol found in wine, researched for its potential to support cellular health.
• Curcumin - from turmeric root, known for its potential to support the body's response to treatment side effects.
• Quercetin - an antioxidant found in onions, studied for its potential benefits in certain health conditions.

IV Therapy

Many botanical medicines, as well as vitamins and minerals, can be administered intravenously. These IV infusions, alongside chemotherapy, may help improve quality of life and manage side effects. For example, high-dose IV ascorbic acid (vitamin C) is studied for its potential to support patients undergoing chemotherapy. IV therapy recommendations are personalized and typically require lab work to ensure proper liver and kidney function.

Acupuncture

In recent years, research on acupuncture has increased significantly. Acupuncture is a form of Traditional Chinese Medicine (TCM) that involves using thin needles on specific body points. Acupuncture is studied for its potential benefits in managing chronic pain, migraines, reproductive issues, and stress. In oncology, it may be used for:

• Cancer-related insomnia
• Perioperative pain and anxiety
• Chemotherapy-induced peripheral neuropathy (CIPN)
• Aromatase inhibitor-related joint pain
• Helping manage treatment-related nausea

Diet

“What should I eat?" is a common question for many cancer patients. Unfortunately, there is a lot of information online about diet and cancer, and much of it is not evidence-based. During an integrative oncology visit, a practitioner can review your current diet and make individualized recommendations on improving your diet from a nutritional standpoint. It's important to remember that loss of appetite, nausea, and vomiting are common chemotherapy-related side effects. If not well managed, these side effects can make a patient nutritionally depleted and dehydrated. If you are undergoing active treatment, the dietary suggestions recommended will be very different for a patient who has finished treatment and is in active surveillance.

Lifestyle

Movement, meditation, and mindfulness have all been shown to improve the quality of life in cancer patients. Exercise is helpful both preventatively and during active treatment. Research now highlights the positive effect of exercise on the immune system, such as elevation in T-cell proliferative capacity, increased neutrophil function, and natural killer (NK) cell cytotoxic activity.

Exercises like resistance training and or aerobic activities have been found to be helpful in reducing the fatigue associated with cancer.

How to Find an Integrative Oncology Clinic?

If you or someone you know are interested in integrative oncology services, the best place to start is by asking your care team if your hospital has integrative oncology providers. Many major cancer centers have departments dedicated to integrative oncology and integrative oncology research. There are also over 100 board-certified naturopathic oncologists (FABNO) in North America who have specialized training in working with cancer patients.

• Integrative Oncology Centers

Summary

The field of integrative oncology is meant to work in consort with medical oncologists, radiation oncologists, and surgical oncologists. Integrative oncology aims not to replace any members of your primary care team, but instead to complement your team. Those with training in integrative oncology are there to support the patient and help them navigate their cancer diagnosis, as it can be overwhelming. The spectrum of integrative oncology therapies is vast. However, the recommendations should be personalized to a patient's individual diagnosis in order to provide them with the best overall outcome.