National Cancer Institute's support of research to further integrative oncology practice.

Abstract

In the United States, the term “integrative oncology” may be variably defined, but most definitions would include the idea and prac tice of adding complementary and alternative medicine (CAM) approaches to the range of therapeutic options provided to cancer patients in previously strictly conventional medical environments. This shift in practice has been paralleled and aided by a gradually evolving evidence-base established from the results of welldesigned and conducted research, often funded by the National Institutes of Health. Both the absolute and proportional sizes of the National Cancer Institute’s (NCI’s) CAM research portfolio grew substantially in the early 2000s reaching a peak in FY2004 ($128.7 million; 2.7% of NCI’s appropriations). Over the intervening decade, NCI has annually supported over 300 intramural and extramural projects with some component of CAM research, with research costs totaling 80–120 million dollars annually (1). The great majority of these projects explore aspects of basic science or clinical cancer research; however, NCI also supports research to improve communication about CAM issues (2). The NCI’s Physician’s Data Query program also provides summaries of the literature about several CAM interventions with separate formats developed for healthcare practitioners and for patients (3). NCI’s extramural research portfolio (ie, grants, cooperative agreements, contracts) includes projects addressing all phases of the cancer continuum and is distributed throughout several scientific programs within NCI. The field of cancer survivor ship touches on nearly all the aspects of cancer management and some of prevention as well, thus the great majority of NCI’s CAM research portfolio is relevant to it. This diverse portfolio includes both preclinical and clinical research exploring aspects of traditional medical systems (eg, traditional Chinese medicine [TCM]), exercise, mind-body interventions, manual therapies, various botanicals, and diet (from individual components to whole diet interventions). One major component of NCI’s clinical research activi