Experts Consider Universal Definition of Integrative Oncology

A recent literature review and analysis to create a more universal definition of the term “integrative oncology” yielded a shorter and more comprehensive understanding of the term, according to the Journal of the National Cancer Institute Monographs.

In research led by Claudia M. Witt, MD, MBA, of the Institute for Complementary and Integrative Medicine at the University of Zurich and University Hospital Zurich in Switzerland, experts worked in tandem with the Society of Integrative Oncology (SIO), a Strategic Alliance Partner with CancerNetwork®, to create a condensed 2-sentence definition of integrative oncology to encompass its wide range of meanings, as follows: “Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum and to empower people to prevent cancer and become active participants before, during, and beyond cancer treatment.”

When the investigators began their initial research, they found 20 different manuscripts referencing integrative oncology in different ways yielding 6 main themes. There were 14 papers which were evidence informed; 18 in which conventional cancer treatment was referenced; 7 that referenced addressing outcomes related to mind, body, and spirit; 3 focused on health and not medicine; 4 distinguished a team of healthcare providers; and 2 mentioned patient-centered or personalized care to the patient.

This resulted in the first definition, as follows: “Integrative oncology is a patient-centered, evidence-informed approach to health care 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 mind, body, and spirit and to provide patients with skills enabling them to help themselves during and beyond cancer treatment.”

The Delphi method was used to refine and reach a consensus on a definition internationally. In the first survey, 28 SIO members responded of whom 50% were oncologists; however, only 43% of them were practicing integrative oncology. The definition was rated a 9 overall and was considered understandable, efficient at explaining the meaning of integrative oncology, and easy to use.

In the open response section, participants noted that the inclusion of specific types of therapies and expansion upon the theme of evidence may be favorable. From this feedback, investigators added the phrase “from different traditions” to reflect diversity. The reference to a multidisciplinary care team was also dismissed as an interdisciplinary team was already discussed.

With the new definition of, “Integrative oncology is a patient-centered, evidence-informed approach to health care that utilizes mind-body therapies, natural products, and lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes and to empower people to become active participants in their care during and beyond cancer treatment,” a second round of surveys was sent to all members of SIO, and 19.6% partook in the survey. The feedback showed an agreement rating of 10 whereas understanding of the definition and its ability to explain what integrative oncology meant overall both received a score of 9.

The survey found that two-thirds of respondents thought certain interventions were missing, such as acupuncture, and were not represented in the definition. They also indicated that the term “health care” alluded to a broader area than integrative oncology, and it was decided to adopt “cancer care” in the final version. Through this feedback, the final definition was developed.

Reference

Witt CM, Balneaves LG, Cardoso MJ, et al. A Comprehensive Definition for Integrative Oncology. J Natl Cancer Inst Monogr. 2017;2017(52):10.1093/jncimonographs/lgx012. doi:10.1093/jncimonographs/lgx012