Why Integrative Oncology?

The field of integrative oncology represents the synthesis of mainstream cancer treatment and rational, databased complementary therapies. These therapies are used not to treat cancer, but to reduce physical and emotional symptoms using noninvasive, nonpharmacologic modalities such as massage and music therapies, acupuncture, meditation, and other mind-body therapies, fitness programs, and the like. These adjunctive interventions are comforting and inexpensive as well as effective. They are decidedly not bogus "alternatives"—those unproven, often fanciful, and frequently harmful approaches falsely promoted as viable alternatives to mainstream cancer treatment.

Public and cancer patient interest in complementary modalities arose in the context of scientific and sociocultural change. Increasingly successful treatments for cancer enabled today's 64%-and-growing cure rates, while producing discomfort and toxicity throughout and after treatment. As cancer treatments became simultaneously more effective and more difficult, causing major physical and emotional problems, often for years, we concerned ourselves as oncology professionals not only with maintaining life, but also with preserving its quality.

Along with the new emphasis on quality of life in oncology research and treatment, other trends contributed importantly to the rise of complementary medicine. These include increasingly brief medical interactions, patients' desire to play a role in regaining and maintaining their health, imperfect mainstream interventions for symptom relief, and patients' attraction to the individualized comfort of complementary therapies.

The current widespread public use of herbs, herbal compounds, and other botanicals such as medicinal mushrooms is especially prevalent among cancer patients. Some of these products are promising and may well have a place in cancer treatment, but rarely in their current form. Inadequate government oversight, a paucity of research data, and major concerns about herb-drug interactions can leave patients playing Russian roulette.

The NIH National Center for Complementary and Alternative Medicine and the NCI Office of Cancer Complementary and Alternative Medicine, in place now for almost a decade, strive to change this situation through their support of basic and clinical research on herbal remedies and other agents, as well as complementary therapies.

Increasingly higher cure rates produce larger numbers of cancer survivors—approximately 10 million in the United States today, according to the American Cancer Society. This situation also grants us the good fortune to address not only tumor destruction in oncology, but also the important issues of patient and survivor quality of life. This is where complementary therapies play a significant role. As they are proven safe and effective, these therapies become part of mainstream care, producing integrative oncology.

Such integration is evolving. The terms "integrative medicine" or "integrative oncology" are now applied to programs in North America, Europe, Australia, and elsewhere. The Society for Integrative Oncology (SIO) and its Medline-listed journal, formed by leading oncologists and major cancer centers and organizations, deliberately use terminology meant to distinguish our mission from bogus "alternatives" as well as to encourage quality research and appropriate application of complementary modalities.

These are indicators not only of a necessary semantic shift, but also of complementary therapy assimilation into mainstream cancer research and care. Some complementary therapies, such as massage therapy and acupuncture, are passive; others, like self-hypnosis, yoga, and meditation, require active patient involvement. Many use both types, depending on the problems they hope to address. The majority, however, appreciate the opportunity to contribute to their own care. In addition to their clinical utility, complementary therapies enable patients to select and participate in their cancer treatment, a highly valued opportunity.

A substantial majority of cancer patients seek complementary therapies to deal with the stress and pain of cancer and its treatment. Most also use herbal compounds. It is in this environment that leading cancer centers around the world now establish programs for complementary cancer care, and do so increasingly under the scientific rubric of integrative oncology.