Toward Comprehensive Cancer Care

Abstract

William James pointed out a pattern in the development of ideas that has, I feel, some relevance to the progress of scientific study of integrative cancer care. New ideas, James said, are initially regarded as untrue. Once their truth can’t be denied, they’re dismissed as unimportant. And after they’ve been proved to be important, they are trivialized as no longer new. The articles in this section offer evidence of both the validity of an integrative approach to cancer treatment and its growing importance. They were presented at the Center for Mind-Body Medicine’s fifth international conference, “Comprehensive Cancer Care 2003: Integrating Complementary and Alternative Therapies” (CCC2003). They include a summing up of our knowledge about several complementary and alternative medicine (CAM) approaches, studies of the possible efficacy of two, and a detailed protocol for examining another. Each begins with observations about, or scientific analysis of, an approach that has been called “alternative,” and each points effectively toward its integration: the ways that herbs may be combined with pharmacologic agents, or mind-body approaches with conventional care; how what we call good care can be realized through a holistic approach grounded in selfawareness and self-care. Since its creation in 1991, the Center for MindBody Medicine has been concerned with helping people to understand and help themselves, combining the wisdom of ancient healing with the precision of modern science, helping clinicians and patients to know about and use what works with the fewest side effects, and the integrity, the wholeness, of clinicians and patients. Our cancer conferences are designed to bring together clinicians and researchers from all the worlds of health care and to invite patients and policy makers as well as professionals to participate in the dialogue. We sit together to take a thoughtful, open-minded, and critical look at what works and what doesn’t in CAM and how those approaches that work can be used for the benefit of all people with cancer and their families. Our CancerGuides training, which grew out of the conference, is designed to equip oncology and other health professionals and patient advocates to help people with cancer to make the wisest decisions about which therapies to use and to work with them supportively, consistently, lovingly, to create programs of integrative care. The articles in this section reflect our program’s intention and mark some of the signposts in the development of integrative cancer care. I believe each one makes its points with modest assurance and each reflects the principles, as well as the practice, of integrative care. Mary Johnson’s article, which was given as a keynote address at CCC2003, reminds us that the care of the person is central not only to the work of oncology nurses but to of all of us who work with and hope to be helpful to other people. That care, she would have us remember, needs always be grounded in the openness and awareness of the person offering the care. As well as helping patients to deal with their challenges, we need to address our own: the full range of emotions that arise in caring for others who are seriously ill and the complexities and conundrums of simply being human ourselves. Johnson makes the point that all care is manifested in specific ways and through a variety of modalities. Joel Marcus and his colleagues’ article on hypnosis and Janice Post-White and associates’ on massage therapy and healing touch deal with some of the modalities that are becoming central to integrative care. The article by Marcus and colleagues presents an overview of the principles of hypnosis and its power to alleviate the pain and suffering of the cancer process and the side effects of its treatments. Hypnosis, at least the more modern “permissive” hypnosis that we associate with the name of its great pioneer, Milton Erickson, MD, is deeply individual: it uses each person’s experience, including the crisis of having cancer, to open possibilities. When we enter the trance state, Marcus emphasizes, we find that our minds are far more capable of transforming our psychological Gordon