Advancing the science of integrative oncology to inform patient-centered care for cancer survivors.

Abstract

Cancer survivors, millions in number, often struggle to manage the physical as well as emotional, social, and spiritual consequences of their cancer and its necessary conventional treatments (1). Many individuals, like Josh Mailman (2), choose to incorporate complementary and integrative medicine therapies such as meditation, acupuncture, yoga, and diet into their cancer treatment with the goal of gaining a sense of control and being more active participants in their care. By doing so, they seek to improve their outcomes, including reducing the side effects of conventional cancer treatments and improving their quality of life and survival. More than ever before, cancer survivors desire the evidence-based integration of complementary and integrative medicine into conventional cancer care not only to treat their cancer but also to help in the healing of mind, body, and spirit. The nascent field of integrative oncology focuses on conducting research, providing education, and delivering evidence-based clinical care to improve quality of life and clinical outcomes for people affected by cancer. Two of the leading organizations engaging researchers, clinicians, educators, and patient advocates in the field of integrative oncology are the Society for Integrative Oncology and the Consortium of Academic Health Centers for Integrative Medicine. The Society for Integrative Oncology is an international professional society, founded in 2003, with 426 individual members whose mission is to advance evidence-based, comprehensive integrative health care to improve the lives of people affected by cancer [www.integrativonc.org (3)]. Consortium of Academic Health Centers for Integrative Medicine was founded in 2002 and now includes 57 leading academic health centers and health systems in the United States and Canada as members (www.imconsortium. org). Consortium of Academic Health Centers for Integrative Medicine seeks to advance the principles and practices of integrative health care within academic institutions by supporting and mentoring academic leaders, faculty, and students to advance integrative health-care curricula, research, and clinical care; disseminating information on rigorous scientific research, educational curricula in integrative health, and sustainable models of clinical care; and working to inform health-care policy (4). The growth of integrative oncology as a scientific discipline is only possible via the visionary and strategic research funding support of the National Cancer Institute (5), National Center for Complementary and Alternative Medicine (6), and large national foundations such as the American Cancer Society (7). The collective effort from these organizations has not only created a cadre of fully committed and talented researchers engaged in the science of integrative oncology, but it has also increased our understanding of the benefits, harms, and mechanisms of integrative approaches for symptom management and wellness promotion in cancer survivors. This monograph, “The Role of Integrative Oncology for Cancer Survivorship,” spotlights original clinical and translational research including randomized clinical trials (8–11), observational research (12,13), and implementation science (14). The monograph encompasses a range of methodologies including integration of novel biomarkers (8) and individual differences such as expectancy (9) and preference (10) into clinical trial evaluation; use of electronic medical records to perform comparative effectiveness research in the real-world setting (13); and application of mixed-methods research to inform the translation of an effective intervention into the clinical setting (14). Further, two manuscripts focus on under-studied populations, pediatric (12) and African American (11) cancer survivors. Finally, the Society for Integrative Oncology breast cancer clinical guidelines systematically synthesize a large body of existing research to provide actionable information for clinicians and cancer survivors while identifying important gaps for future research (15). With health care’s growing emphasis on personalized medicine and patient-centered care, the role of integrative oncology alongside conventional cancer care becomes essential. With dedicated and coordinated efforts from researchers, clinicians, funders, and key societal stakeholders, we will increase the scientific understanding of integrative oncology and rapidly translate the science into evidence-based practices to improve the health and well-being of millions of cancer survivors. We hope this special monograph is one step forward in this direction as the field matures and becomes incorporated within the standard of care worldwide.