Integrative Cancer Care: How Far We’ve Come!

It was a very significant event when the American Society for Clinical Oncology (ASCO) endorsed the Society for Integrative Oncology (SIO) clinical practice guidelines for breast cancer. ASCO is the leading organization of its kind. SIO is the leading organization of its kind. Historically, these two organizations, both committed to quality oncology care, did not share the same view or value of weaving the best conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy cancer care with the best complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture approaches.

Now, many factors including the growing evidence base for complementary therapies and patient interest and demand, seem to be bringing ASCO and SIO closer to working on a common goal of providing person-centered care in a more integrativein cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan way. Is this endorsement of the SIO guidelines a game-changer? We have reason to hope so.

The June 2018 Journal of Clinical Oncology headline reads: Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline. Leading conventional and integrative oncology clinicians and researchers, such as Gary Lyman, MD; Gary Deng, MD; Heather Greenlee, ND, PhD; Lorenzo Cohen, PhD, summarize: “The ASCO Expert Panel determined that the recommendations in the SIO guideline—published in 2017—are clear, thorough, and based on the most relevant scientific evidence [italics added]. ASCO endorsed the guideline with a few added discussion points.”¹Lyman GH, Greenlee H et al. Integrative therapies during and after breast cancer treatment: ASCO endorsement of the SIO clinical practice guideline. Journal of Clinical Oncology. 2018 Sep 1;36(25):2647-2655.

Big deal

This is a big deal for several reasons:

First, if the field of truly integrative oncology care is to advance, it’s vital that seminal professional associations for clinical oncologists, such as ASCO, recognize and acknowledge the value and credibility of evidence-based complementary cancer therapies. ASCO’s endorsement of the SIO guidelines do just that. This should encourage patients and integrative care clinicians to open dialogue with conventional oncologists about integrating complementary approaches.

Second, it is a remarkable accomplishment for integrative oncology to demonstrate to ASCO’s satisfaction that there is quality evidence to support integrating certain complementary therapies into conventional care. This shows that the field of integrative oncology is reaching a stage in its evolution where it has a compelling evidence base for some complementary therapies.

Third, respected integrative oncology clinicians and researchers, like Wayne Jonas, MD, and Donald Abrams, MD, are able to articulate the usefulness of evidence-informed complementary therapies. These are therapies that may realistically never be tested in rigorous randomized controlled clinical trials, either because pharmaceutical companies have no financial incentive to test them or because their complexity does not allow for a controlled study design. But they should not be overlooked—they may bring great benefits to many with cancer.

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