Cancer-related Pain: An Integrative Approach - CancerChoices



Cancer-related Pain: An Integrative Approach

Cancer-related pain is common, especially in advanced cancer. It can be managed, often with relatively simple treatments such as oral pain medications. Many self-care practices and complementary therapies also address pain, and these may work in tandem with medications.

Pain at a glance

Between 50% and 70% of people with cancer report pain during cancer treatment, as well as about 65% of people with advanced disease.1Pujol LA, Monti DA. Managing cancer pain with nonpharmacologic and complementary therapies. Journal of the American Osteopathic Association. 2007 Dec;107(12 Suppl 7):ES15-21; van den Beuken-van Everdingen MH, de Rijke JM et al. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Annals of Oncology. 2007 Sep;18(9):1437-49. Controlling pain needs to be a priority. 

Keep in mind three important facts about cancer-related pain:

  1. Not all types of cancer or cancer treatments are linked with pain.   
  2. Cancer-related pain can be managed, often with therapies that are very simple to use.  
  3. Experts can help you if you are experiencing pain.

Uncontrolled pain greatly reduces your quality of life, wearing you down and making other issues seem worse. Pain may contribute to imbalances in body terrain › linked to cancer growth, such as changes in stress hormones and increased inflammation. Pain can also lead to worse cancer-related symptoms, such as depression, anxiety, sleep disturbance, and distress. People whose persistent cancer-related pain is controlled may even live longer than those with uncontrolled pain.2Zylla D, Steele G, Gupta P. A systematic review of the impact of pain on overall survival in patients with cancer. Supportive Care in Cancer. 2017 May;25(5):1687-1698; Quinten C, Coens C et al; EORTC Clinical Groups. Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncology. 2009 Sep;10(9):865-71; Efficace F, Bottomley A et al; EORTC Lung Cancer Group and Quality of Life Unit. Is a patient’s self-reported health-related quality of life a prognostic factor for survival in non-small-cell lung cancer patients? A multivariate analysis of prognostic factors of EORTC study 08975. Annals of Oncology. 2006 Nov;17(11):1698-704; Zheng J, He J et al. The impact of pain and opioids use on survival in cancer patients: results from a population-based cohort study and a meta-analysis. Medicine (Baltimore). 2020 Feb;99(9):e19306; de la O Murillo A, Torres AC et al. Association of pain with the presence of additional supportive care (SC) needs in patients with advanced cancer. Journal of Clinical Oncology. 2022 Jun 1;40(16_suppl):e24071-e24071.

Controlling cancer-related pain is both a science and an art. Seek professional help if needed. Specialists in cancer care are trained either to help you manage your pain or to refer you to pain experts, such as palliative care specialists. Help is available, and the first step is reporting your pain to your doctor. While addiction to opioids is a concern, it can often be prevented by following directions and getting medical supervision.

We strongly encourage you to let your doctor know as soon as possible if you are having moderate or severe pain that is not being managed well with the medications and therapies you have been using.  No one who cares about you wants you to suffer, alone and in silence. In fact, loneliness and lack of social support might make pain worse.3Pole L, Hepp N. How can Sharing Love and Support help you? What the research says. CancerChoices. February 10, 2024. So speak out, reach out, and let others be with you in and through your pain. Their presence with you is where comfort begins.

On this page

Pain: overview

What is pain?

One of the most important actions you can take to get your pain under control is telling your care team you have pain and describing where the pain is, how long it lasts, and what the pain feels like. These all influence how they treat your pain. Here are some terms that will help you and your cancer team understand your pain:

Reporting and describing your pain

Types of pain based on duration and timing

  • Acute pain is short-term and usually ends after the source of the pain is addressed and the painful area heals, for example, pain related to a surgical incision. 
  • Chronic intermittent pain is longer term but not constant or nearly constant, such as waking up daily with joint pain that goes away with movement.
  • Chronic persistent pain is present frequently or constantly throughout the day and persists beyond the time when a painful area is expected to heal.4Chronic Pain. Johns Hopkins Medicine. Viewed July 24, 2024. With persistent pain, the cause of the pain may not be resolvable. Many people with cancer fear that they will have persistent, intense pain, but such pain is not common except perhaps with advanced cancer.  
  • Incident pain is additional pain on top of the persistent pain and is caused by something you do or is done to you, such as a painful procedure or pain while riding in the car to treatments. If you have this type of pain, a short-acting pain medication and/or other therapy before the incident occurs could be helpful. Additional therapies may include using imagery or breathwork or acupressure before and during a brief, mildly painful procedure.

Keep  a record and tell your care team about the timing of the pain—when it happens, how long it lasts, and how long pain management measures last. If you describe persistent pain, for example, the key is to use medications, therapies, and practices on a regular schedule to bring pain down to a manageable level and keep it there. This might mean, for example, getting acupuncture on a regular basis, taking long-acting pain medications, or using your TENS unit routinely throughout the day.   

Types of pain based on location and cause

Showing where you are feeling pain and telling what it feels like is important for your medical team to correctly diagnose and treat it.  If you have pain from cancer in a bone, for example, you will usually be able to point to it. This type of local pain can usually be relieved with targeted local treatment such as radiation therapy or anti-inflammatory drugs that reduce swelling around the tumor.

  • Nociceptive pain is the most common type of pain among people with cancer, caused when body tissues are damaged.5Franks I. Nociceptive Pain. Healthline. January 28, 2024. Viewed July 23, 2024. There are two types of nociceptive pain:
    • Somatic pain occurs in a local area, such as bones, muscle, or skin, and may feel sharp or like aching, cramping, gnawing, or throbbing. 
    • Visceral pain is in internal organs and tissues and feels vague and diffuse, sometimes radiating to other areas such as your back, chest, jaw, or arms. This pain is often described as squeezing, dull aching, moving, twising, colicky, deep, or pressing.
  • Neuropathic pain is linked to nerve damage due to the cancer and/or treatments such as chemotherapy, radiotherapy, or surgery. With neuropathic pain, a tumor can be directly invading or pressing on nerves, or nerves can be injured by toxicity from chemotherapy or radiotherapy. Symptoms of high sensitivity (burning, tingling, electrical feeling) and symptoms of low sensitivity (numbness and muscle weakness) are both common with neuropathic pain.6Yoon SY, Oh J. Neuropathic cancer pain: prevalence, pathophysiology, and management. Korean Journal of Internal Medicine. 2018 Nov;33(6):1058-1069. For more information on managing this type of pain, see Neuropathy and other Neurological Symptoms ›

In sum, different approaches are used to manage acute, persistent, and incident  pain as well as nociceptive and neuropathic pain. Palliative care is one of the most useful approaches for managing persistent pain. Read more about Palliative Care in Cancer ›

What can cause or trigger pain? 

Pain is usually caused by tissue damage or nerve damage. Psychological status can also contribute to pain, such as with pain caused by nerve damage that becomes interconnected with fear, depression, stress, or anxiety.7Saling J. Pain Classifications and Causes: Nerve Pain, Muscle Pain, and More. Web MD. January 12, 2023. Viewed July 17, 2024.

Medical conditions

Pain has a bidirectional link to anxiety, depression, fatigue, sleep disruption, stress, and muscle tension.
  • Injury and inflammation: Injury is a common cause of pain. Pain can also be caused by inflammation, whether brought on by direct injury or not.8Totsch SK, Waite ME, Sorge RE. Dietary influence on pain via the immune system. Progress in Molecular Biology and Translational Science. 2015;131:435-69; Crane TE, Miller A, Skiba MB, Donzella S, Thomson CA. Association of chronotype and pain at baseline in ovarian cancer survivors participating in a lifestyle intervention (NRG/GOG 0225). Journal of Clinical Oncology. 2020;38(suppl) abstr 6018). 
  • Stress response: “A prolonged or exaggerated stress response may perpetuate cortisol dysfunction, widespread inflammation, and pain.”9Hannibal KE, Bishop MD. Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Physical Therapy. 2014 Dec;94(12):1816-25. 
  • Hormone imbalances: Hormone imbalances or deficiencies can contribute to pain and can serve as biomarkers for the presence of severe pain.10Tennant F. Hormone testing and replacement in pain patients made simple. Practical Pain Management. 2012;12(6); Tennant F. The physiologic effects of pain on the endocrine system. Pain and Therapy. 2013 Dec;2(2):75-86. Example: lower estrogen levels among premenopausal women is linked to increased pain and an increased risk of developing chronic pain due to impairment of pain pathways.11Henry NL, Conlon A et al. Effect of estrogen depletion on pain sensitivity in aromatase inhibitor-treated women with early-stage breast cancer. Journal of Pain. 2014 May;15(5):468-75. 
  • Depression: The relationship between pain and depression works in both directions—each can trigger and impact the other.12Theobald DE. Cancer pain, fatigue, distress, and insomnia in cancer patients. Clinical Cornerstone. 2004;6 Suppl 1D:S15-21. 

Medications and therapies

Conventional cancer treatments—chemotherapy, hormone therapy, radiation therapy, or surgery—can cause pain syndromes. For example, hormonal cancer treatments such as aromatase inhibitors are linked to joint pain.13Gragnolati AB. 9 Medications That Cause Joint and Muscle Pain. GoodRx Health. April 1, 2024. Viewed July 19, 2024; Paice JA, Portenoy R. Management of chronic pain in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. Journal of Clinical Oncology. 2016 Sep 20;34(27):3325-45. 

In addition to cancer treatments, other medications can cause pain or interfere with your pain treatment. For example, bisphosphonates which are prescribed for osteoporosis are linked to jaw and joint pain, and low-dose naltrexone will interfere with opioids. Consult your practitioner or pharmacist to see if any medications are contributing to your pain and to develop a plan to manage treatment-related pain.

Connections to cancer survival

Controlling cancer-related pain is linked to better survival,14Quinten C, Coens C et al; EORTC Clinical Groups. Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncology. 2009 Sep;10(9):865-71; Zheng J, He J et al. The impact of pain and opioids use on survival in cancer patients: results from a population-based cohort study and a meta-analysis. Medicine (Baltimore). 2020 Feb;99(9):e19306; de la O Murillo A, Torres AC et al. Association of pain with the presence of additional supportive care (SC) needs in patients with advanced cancer. Journal of Clinical Oncology. 2022 Jun 1;40(16_suppl):e24071-e24071; Efficace F, Bottomley A et al; EORTC Lung Cancer Group and Quality of Life Unit. Is a patient’s self-reported health-related quality of life a prognostic factor for survival in non-small-cell lung cancer patients? A multivariate analysis of prognostic factors of EORTC study 08975. Annals of Oncology. 2006 Nov;17(11):1698-704. as in advanced prostate cancer, for example.15Zylla D, Steele G, Gupta P. A systematic review of the impact of pain on overall survival in patients with cancer. Supportive Care in Cancer. 2017 May;25(5):1687-1698. People reporting pain with newly diagnosed metastatic solid tumors have shown a worse life expectancy than people not reporting pain.16de la O Murillo A, Torres AC et al. Association of pain with the presence of additional supportive care (SC) needs in patients with advanced cancer. Journal of Clinical Oncology. 2022 Jun 1;40(16_suppl):e24071-e24071. Because pain, advanced cancer, and pain medications each contribute to worse survival, we can’t conclude that reducing pain can by itself lead to better survival, but communicating pain and other symptoms to your cancer care team may lead to better survival among people with cancer.17Basch E, Deal AM et al. Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA. 2017 Jul 11;318(2):197-198. Reducing pain will certainly improve quality of life for anyone with advanced cancer.

Top evidence-based practices and therapies for managing pain 

If your pain is a symptom of other medical conditions such as those mentioned above, you may need to treat the underlying condition to address the cause of your pain.

SIO-ASCO clinical practice guideline recommendations

In 2022, the Society for Integrative Oncology and the American Society of Clinical Oncology published Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline ›

These recommendations are based on a rigorous review of 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 psychosocialtherapy, and acupuncture therapies with a high level of evidence. Most of these therapies are also recommended in other clinical practice guidelines for managing cancer-related pain.18NCCN Guidelines for Patients ® Survivorship Care for Cancer-Related Late and Long-Term Effects. National Comprehensive Cancer Network. 2024. Viewed July 2, 2024; Ge L, Wang Q et al; International Trustworthy Traditional Chinese Medicine Recommendations (TCM Recs) Working Group. Acupuncture for cancer pain: an evidence-based clinical practice guideline. Chinese Medicine. 2022 Jan 5;17(1):8; Lam WC, Zhong L et al. Hong Kong Chinese medicine clinical practice guideline for cancer palliative care: pain, constipation, and insomnia. Evidence-based Complementary and Alternative Medicine. 2019 Jan 22;2019:1038206; Ling CQ, Fan J et al; Chinese Integrative Therapy of Primary Liver Cancer Working Group. Clinical practice guidelines for the treatment of primary liver cancer with integrative traditional Chinese and Western medicine. Journal of Integrative Medicine. 2018 Jul;16(4):236-248; Greenlee H, DuPont-Reyes MJ et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA: A Cancer Journal for Clinicians. 2017 May 6;67(3):194-232 (this set of guidelines has been endorsed by the American Society of Clinical Oncology (ASCO): Lyman 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); Paice JA, Portenoy R et al. Management of chronic pain in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. Journal of Clinical Oncology. 2016 Sep 20;34(27):3325-45; Deng GE, Rausch SM et al. Complementary therapies and integrative medicine in lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May;143(5 Suppl):e420S-e436S; Deng GE, Frenkel M et al. Evidence-based clinical practice guidelines for integrative oncology: complementary therapies and botanicals. Journal of the Society for Integrative Oncology. 2009 Summer;7(3):85-120.

Different therapies are recommended for different types of pain, as shown in this table.

SIO-ASCO recommendations of complementary therapies for managing cancer-related pain

Other practices and therapies

Conventional therapies 

Various prescription drugs may help manage pain. Ask your doctor for recommendations, but also ask about side effects from their use. Many of the lifestyle practices and complementary therapies described on this page have fewer side effects than prescription drugs.

  • Opioids: In light of both benefits and risks of opioidschemicals that interact with opioid receptors on nerve cells in the body and brain to reduce the intensity of pain signals and feelings of pain. This class of drugs includes natural, synthetic, or semi-synthetic drugs such as oxycodone, hydrocodone, codeine, morphine, heroin, fentanyl, and many others.—including evidence of worse cancer survival19Budd K. Pain, the immune system, and opioimmunotoxicity. Reviews in Analgesia. 2004;8(1): 1-10.—integrative experts recommend they be used when necessary but in the smallest effective amount and, in the case of acute pain, for the shortest period possible. We encourage you to discuss opioid and non-opioid options such as ibuprofen (Motrin or Advil) or acetaminophen (Tylenol) with your healthcare practitioners to assess their use and safety.
  • Physical therapy and/or cold and heat are recommended to help manage some types of pain. Conventional treatments for skeletal pain might include a back brace or limited bed rest for acute vertebral compression, surgery, and radiofrequency ablationuse of heat to destroy tissue pressing on nerves. Heat and cold are used to manage musculoskeletal pain, and cold packs on hands and feet are also used to reduce neuropathic pain during some types of chemotherapy.20NCCN Guidelines for Patients ® Survivorship Care for Cancer-Related Late and Long-Term Effects. National Comprehensive Cancer Network. 2024. Viewed July 2, 2024.
  • Laxatives, enemas, and/or lots of fluids may be used to manage chronic pelvic pain.21NCCN Guidelines for Patients ® Survivorship Care for Cancer-Related Late and Long-Term Effects. National Comprehensive Cancer Network. 2024. Viewed July 2, 2024.

Lifestyle practices

We present practices backed by modestsignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently), goodsignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently), or strongconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) evidence of effectiveness. 

Complementary therapies 

We present additional therapies for reducing pain backed by modestsignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently), goodsignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently), or strongconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) evidence of effectiveness. 

For guidance in selecting and using complementary therapies, see Finding Integrative Oncologists and Other Practitioners ›

Supplements and natural products
Other complementary therapies

Healing stories

Helpful links

General

Tracking and reporting pain

For caregivers

Videos

Meditation and Cancer Pain

Thomas Smith, MD, Professor of Oncology, Johns Hopkins University School of Medicine and Director of Palliative Medicine, Johns Hopkins Medicine, discusses the role of meditation in supporting people living with cancer pain.

Play video

Managing Anxiety and Depression during Cancer Pain

Thomas Smith, MD, Professor of Oncology, Johns Hopkins University School of Medicine and Director of Palliative Medicine, Johns Hopkins Medicine, discusses the importance of screening for anxiety and depression in people experiencing cancer pain and how to help patients manage these conditions.

Play video

For healthcare professionals

Basic principles of managing persistent cancer pain

Oncologists and palliative medicine practitioners usually consider widely accepted management principles in developing a treatment plan for persistent pain.53Paice JA, Portenoy R et al. Management of chronic pain in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. Journal of Clinical Oncology. 2016 Sep 20;34(27):3325-45; WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. World Health Organization. January 2019. Viewed January 27, 2023. “Communicating an intent to control pain and stress early on and emphasizing the concern reassures both the patient and family. This includes active, concerned inquiry about pain, sleep, mental status, energy, and functional capability. Discussion should include family members as well as the patient.”54Chapman CR, Gavrin J. Suffering and its relationship to pain. Journal of Palliative Care. 1993;9(2):5-13.

To learn more about basic principles for managing persistent pain, download our guide ›

The Therapeutic Value of a Good Pain Assessment ›

A story for healthcare professionals

Managing pain and other symptoms concurrently

CancerChoices Senior Clinical Consultant Laura Pole, MSN, RN, OCNS, Palliative Care Educator/Consultant: Those of us involved in helping people with cancer manage their pain have long witnessed a connection between cancer-related pain and other symptoms. Usually, what we see is that if someone’s pain is poorly managed, especially for a long time, they feel more anxious, depressed, and fatigued. They don’t sleep well. Their physical function declines. They see their quality of life as poor. In turn, these other symptoms and problems worsen people’s perception of their pain.55Thielking PD. Cancer pain and anxiety. Current Pain and Headache Reports. 2003 Aug;7(4):249-61.

This becomes a vicious cycle. It’s imperative to directly treat the pain with effective pain management therapies—with this, the other related symptoms often improve. Though it’s also helpful to manage other symptoms that are linked to the pain, this should be in addition to, not in place of, pain treatments.56Cleeland CS. The impact of pain on the patient with cancer. Cancer. 1984 Dec 1;54(11 Suppl):2635-41; Thielking PD. Cancer pain and anxiety. Current Pain and Headache Reports. 2003 Aug;7(4):249-61.

Opioids for cancer pain management: fears about prescribing

CancerChoices Senior Clinical Consultant Laura Pole, MSN, RN, OCNS, Palliative Care Educator/Consultant: Every knowledgeable clinician caring for people with cancer pain knows that opioids are often necessary in treating moderate to severe persistent cancer-related pain. And most likely, if you prescribe opioids, you’re aware of the increasing scrutiny and restrictions as a backlash of the prescription and illicit drug abuse that has become known as the opioid epidemic.

A 2021 study found a dramatic decrease in opioid access among terminally ill cancer patients over a recent 10-year period. The authors link this worsening of end-of-life pain management to heightened opioid regulations.57Enzinger AC, Ghosh K et al. US trends in opioid access among patients with poor prognosis cancer near the end-of-life. Journal of Clinical Oncology. 2021 Sep 10;39(26):2948-2958. An excellent article in the Journal of Oncology Practice provides much needed perspective and guidance on balancing public health concerns, patient needs, and prescription oversight.58Page R, Blanchard E. Opioids and cancer pain: patients’ needs and access challenges. Journal of Oncology Practice. 2019;15:5:229-231.

To read the full commentary on this issue, including more recent practices being adopted by palliative care specialists, download our guide ›

Helpful links for professionals

Basic principles of managing persistent cancer pain 
Integrative cancer pain management
Managing pain and other symptoms concurrently

Authors

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Nancy Hepp, MS

Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Christine has a dynamic background in the life sciences, public health, and program operations. Her career began at the lab bench with a Gates Foundation-funded HIV Vaccine research group, which led her to graduate studies in public health epidemiology at UC Berkeley. Her research experience spans clinical epidemiology research to evaluating the impacts of community nutrition programs in Los Angeles, the Central Valley, and Oakland. Most recently she has worked in executive operations for a seed-stage venture capital firm based in San Francisco. Personally, Christine is passionate about holistic health and wellness. She is a clinical herbalist and Reiki master, and she has been practicing yoga for 15+ years. She brings a breadth of experiences to her work leading the CancerChoices program.

Christine Mineart, MPH CancerChoices Team

Reviewers

Miki Scheidel

Co-Founder and Creative Director
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Miki Scheidel is Co-founder and creative director of CancerChoices. She led the effort to transform Beyond Conventional Cancer Therapies, the prior version of CancerChoices, to its current form. Miki and her family were deeply affected by her father’s transformative experience with integrative approaches to metastatic kidney cancer. That experience inspires her work as president of the Scheidel Foundation and as volunteer staff at CancerChoices. She previously worked with the US Agency for International Development and Family Health International among other roles. She received her graduate degree in international development from Georgetown University, a graduate certificate in nonprofit management from George Mason University, and a Bachelor of Arts from Gettysburg College.

Miki Scheidel Co-Founder and Creative Director

Wayne B. Jonas, MD

Integrative physician and CancerChoices advisor
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Dr. Wayne B. Jonas is a practicing family physician, an expert in integrative health and healthcare delivery, and a widely published scientific investigator. Dr. Jonas is the executive director of Samueli Integrative Health Programs, an effort supported by Henry and Susan Samueli to increase awareness and access to integrative health and supporting the scientific investigation of healing processes in the areas of stress, pain, and resilience. Additionally, Dr. Jonas is a retired lieutenant colonel in the Medical Corps of the United States Army. From 2001 to 2016, he was president and chief executive officer of Samueli Institute, he was the director of the Office of Alternative Medicine at the National Institutes of Health (NIH) from 1995 to 1999, and prior to that served as the director of the Medical Research Fellowship at the Walter Reed Army Institute of Research. He is a Fellow of the American Academy of Family Physicians.

Dr. Jonas’s research has appeared in peer-reviewed journals such as the Journal of the American Medical AssociationNatural MedicineThe Journal of Family PracticeThe Annals of Internal Medicine, and The Lancet. His books include the 2018 best seller How Healing Works: Get Well and Stay Well Using Your Hidden Power to Heal.

Dr. Jonas received the 2015 Pioneer Award from the Integrative Healthcare Symposium, the 2007 America’s Top Family Doctors Award, the 2003 Pioneer Award from the American Holistic Medical Association, the 2002 Physician Recognition Award of the American Medical Association, and the 2002 Meritorious Activity Prize from the International Society of Life Information Science in Chiba, Japan.

Dr. Jonas’s view: “We know so little about the mystery of life and the body that we need to consider all systems and explanations for their wisdom.”

Wayne B. Jonas, MD Integrative physician and CancerChoices advisor

Last update: July 25, 2024

Last full literature review: August 2022

We are grateful to Dr. Giovanni Elias for his review of several sections of this handbook.

CancerChoices provides information about integrativein cancer care, a patient-centered approach combining the best of conventional care, self care, and evidence-informed complementary care in an integrated plan cancer care. We review 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 psychosocialtherapy, and acupuncture therapies and self carelifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

 

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