Integrative Medicine: a shift in mindset for better population health
Updated: Jun 12, 2022
I am an Oncologist and a mainstream medicine doctor, with years of experience in the use of chemotherapy, radiotherapy and targeted therapies to combat cancer. In the last three years, I have had the privilege to work with people who have studied and practiced Integrative Oncology, which is all about treating the whole person and not just the cancer illness. In scientific terms, Integrative Medicine is about combining traditional medicine with complementary and alternative medicine (CAM) and lifestyle change, leading to synergistic therapeutic and quality of life effects. I have thus appreciated that my role as an Oncologist is as much a clinical cancer specialist as well as a people healer, supporting patients to improve their body and mind health.
Integrative Medicine approaches range from simple lifestyle changes such as healthy nutrition and regular exercise to specific interventions such as herbs and botanicals, massage, acupuncture, reflexology and mind-body therapies such as meditation, yoga and music. Given that there is no specific complementary regime for specific cancer conditions, patients often need to trial different methods to see what works best for them. Clinicians need to appreciate that ‘one size does not fit all’ when it comes to Integrative Oncology and that a more personalised patient approach will lead to better patient outcomes and experience. What’s even more important is for cancer specialists to utilise the art of active listening when they consult their patients, to try and understand their priorities and also advise them on the safest complementary treatment options for them, which will not compromise their mainstream cancer therapies.
The fact is that between 40% and 90% of cancer patients use some form of complementary and alternative medicine (CAM) therapy together with their mainstream cancer treatment. Sadly, only few will tell their oncologist or cancer nurse specialist because of the fear of being unsupported. Oncology consultations tend to focus almost entirely on the communication of the cancer treatment plan, with often no time devoted to the holistic treatment aspect. The limited knowledge of Integrative Oncology amongst cancer specialists can make it even harder for them to voluntarily initiate an exploration of CAM therapies with patients.
An Integrative Oncology approach can help combat side effects of cancer treatments such as nausea, pain and fatigue, enabling patients to feel better and more in control of their illness, often potentiating the effect of mainstream cancer therapies. It is thus very important that cancer specialists are aware of the evidence behind Integrative Oncology and work with their patients to enable them to choose the right approach for them. In addition, Oncologists and cancer nurse specialists have to be aware when patients are taking supplements or other alternative therapies together with their mainstream treatment, to ensure that there is no harmful interaction between treatments. The role of the Oncology pharmacist is key in informing clinical teams about potential treatment interactions, assuring the safe use of complementary and alternative therapies. This multidisciplinary team support can result in patients with cancer feeling more empowered to have a choice in treatment, which can boost their personal resilience.
Cancer diagnosis is a critical event in people’s lives and often gives people the drive to make lifestyle changes for themselves and people close to them, hence preventing further illnesses. The role of Integrative Oncology in cancer prevention needs further exploration and it comes with good scientific evidence. For example, the adoption of regular moderate level exercise and a plant-based wholefood diet can reduce body fat which in turn reduces the level of carcinogenic proteins in the body. When regular exercise and wholefood diets are combined with stress management techniques such as yoga and meditation, the benefit is greater and some studies have shown a reduction in the risk of cancer death by as much as 50%. Psychological wellbeing in the form of group support has also been shown to reduce death from cancer, whereas social isolation and loneliness can have the opposite effect, increasing the risk of premature death between 3 and 10-fold. The above activities are also helpful in preventing cardiovascular diseases and diabetes, hence improving population health.
As cancer specialists, we have a duty to provide evidence-based treatments to our patients to treat the cancer effectively and such a mainstream approach is the recommended one, never to be replaced by alternative therapies alone.
As health professionals, we have a duty to treat our patients as whole persons, optimising their body and mind health to help them cope with cancer treatment, enabling better treatment outcomes and preventing illness. We also have a duty to improve population health through preventative medicine and health promotion.
Looking into the future, the inclusion of Integrative Medicine into the medical and nursing undergraduate curricula globally can increase knowledge and skill in the field. It can also lead to more systematic approach to Real-World data collection, clinical research and evidence generation about how Integrative Medicine works and for whom.
The evolution of this shift in clinical mindset and practice is the formation of a Personalised Healthcare Model and improved Population Health.