Abstract
This systematic review set out to summarize the research literature describing integrative oncology programs. Searches were conducted of 9 electronic databases, relevant journals (hand searched), and conference abstracts, and experts were contacted. Two investigators independently screened titles and abstracts for reports describing examples of programs that combine complementary and conventional cancer care. English-, French-, and German-language articles were included, with no date restriction. From the articles located, descriptive data were extracted according to 6 concepts: description of article, description of clinic, components of care, administrative structure, process of care, and measurable outcomes used. Of the 29 programs included, most were situated in the United States (n = 12, 41%) and England (n = 10, 34%). More than half (n = 16, 55%) operate within a hospital, and 7 (24%) are community-based. Clients come through patient self-referral (n = 15, 52%) and by referral from conventional health care providers (n = 9, 31%) and from cancer agencies (n = 7, 24%). In 12 programs (41%), conventional care is provided onsite; 7 programs (24%) collaborate with conventional centres to provide integrative care. Programs are supported financially through donations (n = 10, 34%), cancer agencies or hospitals (n = 7, 24%), private foundations (n = 6, 21%), and public funds (n = 3, 10%). Nearly two thirds of the programs maintain a research (n = 18, 62%) or evaluation (n = 15, 52%) program. The research literature documents a growing number of integrative oncology programs. These programs share a common vision to provide whole-person, patient-centred care, but each program is unique in terms of its structure and operational model.
Highlights
Cancer patients worldwide are increasingly combining complementary health care interventions such as acupuncture, massage therapy, and naturopathic medicine with conventional treatments such as chemotherapy, radiation, and surgery
53 articles describing 29 examples of integrative oncology programs were included in the review (Figure 1)
Our review suggests that distinct integrative oncology models are operating within England and the United States, with few published examples from other countries to be able to draw reliable comparisons
Summary
Cancer patients worldwide are increasingly combining complementary health care interventions such as acupuncture, massage therapy, and naturopathic medicine with conventional treatments such as chemotherapy, radiation, and surgery. Sagar and Leis describe integrative oncology as both a science and a philosophy that recognizes the complexity of care for cancer patients and that provides a multitude of evidence-based approaches to accompany conventional therapies and to facilitate health[9]. In 2009, the Society for Integrative Oncology published practice guidelines, representing evidencebased recommendations for the treatment of common problems encountered by cancer patients[6]. The guidelines are based on a summary and critical analysis of manuscripts and textbook chapters on complementary and integrative medicine in oncology and have proved useful for health professionals in providing evidencebased and patient-centred advice to individual patients. Integrative practice requires that a number of interdisciplinary professionals practice alongside each other and, ideally, communicate in nonhierarchical and respectful ways to further the goals of treating the whole person and of promoting health[10]. The literature contains many reports that document examples of integrative oncology practice, and yet that literature has not been reviewed and summarized
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