Integrative oncology programs and expert guidelines
At a glance
Integrative oncology programs and expert guidelines are an additional source of information when deciding on your overall cancer care approach. Published research is limited, incomplete, and at times conflicting. It can also be overwhelming and written with a vocabulary and acronyms unfamiliar to many readers. Experts may be able to fill in a few gaps and interpret research for you.
Clinical practice guidelines bring together experts to review research evidence on a therapy or set of therapies. They are written to guide health professionals regarding which treatments and therapies to offer to their patients. As a result, they are typically more conservative than expert programs. If you wish to use only therapies with stronger evidence of benefit, these guidelines will be good sources of information for you.
Integrative oncology programs have been created by one or more integrative experts, drawing on training and published research as well as their experience from decades of clinical practice. These programs are published in books or articles which you can buy or perhaps access through your local library.
These programs and approaches share knowledge and experience not available from research studies. They package together conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy care, self carelifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress, and 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 care into a cohesive program or approach. If you are a person with cancer wanting to explore all options, you will likely find these published programs and approaches very helpful.
New information about cancer care and therapies is published very frequently. Programs and guidelines start going out of date as soon as they are published. Consider the publication date of guidelines and programs when evaluating them, especially if you find more recent evidence in our therapy reviews.
Why seek integrative oncology programs and expert guidelines?
Medical research is an ongoing process. Even with hundreds of thousands of studies published, we are far from knowing all we need to know about any therapy—its medical benefits, safety profile, interactions with other treatments, application among different types of cancer, and more. The language of research studies can also be difficult to understand for someone with no medical or research background.
Expert recommendations and programs summarize and interpret research findings for you if you don’t want to or can’t read hundreds or even thousands of studies yourself. Expert programs can also can give further information from experience.
The expert guidance on this site comes in three types. You’ll find one or more of these types of recommendation or advice on the “expert” page within every therapy review and self-care practice.
Clinical practice guidelines are the result of expert review of the research evidence available when the guidelines were written. They typically review each therapy in isolation and do not offer a program approach. To use a recipe analogy, these guidelines evaluate only the individual “ingredients” of cancer care and do not typically evaluate how to mix them together or what happens when you do, although some may include interactions with chemotherapy and other conventional treatments.
Published protocols, programs, and approaches from integrative oncologists draw from decades of clinical practice of integrative oncology. These experts share their experience and observations, often packaging many therapies and approaches into a comprehensive program. These programs are the “recipes” that guide how and when to combine individual therapies. Programs may include conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy care, self carelifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress, and 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 care in any combination.
Expert commentary includes notes and comments from many CancerChoices advisors, invited experts, and others who have written on a topic and whose advice is relevant to our readers.
Clinical practice guidelines
Guidelines are usually created by a panel of experts looking at all the evidence related to a therapy. They are written to guide health professionals regarding which treatments and therapies to offer to their patients. As a result, they are typically conservative, requiring a high level of evidence behind a therapy to recommend that health providers include it in a treatment plan. Because of this, guidelines may not include cutting-edge therapies and those with less rigorous—but promising—evidence.
Guidelines typically do not recommend therapies that have only preliminary or modest evidence supporting their use. Many guidelines categorize their recommendations into various levels such as these.
|Grade A||Recommend to offer/provide this therapy to patients|
High certainty that the net benefit is substantial
|Grade B||Recommend to offer/provide this therapy; high certainty that the net benefit is moderate|
Moderate certainty that the net benefit is moderate to substantial
|Grade C||Recommend to offer/provide this therapy for selected patients, depending on individual circumstances|
At least moderate certainty that the net benefit is small
|Grade D||Discourage the use of this therapy|
Moderate or high certainty that the therapy has no net benefit
|Grade H||Discourage the use of this therapy|
Moderate or high certainty that the harms outweigh the benefits
Guidelines identify and describe generally recommended treatment approaches. They are not presented as a substitute for the advice of a physician or other knowledgeable healthcare professional or practitioner.
Guidelines we reference
Within our therapy reviews and self-care handbooks, we summarize what these and several other guidelines recommend or conclude about use of each therapy or practice.
Published integrative oncology programs, protocols and approaches
Throughout the CancerChoices site, we refer to integrative oncology programs and protocolsa package of therapies combining and preferably integrating various therapies and practices into a cohesive design for care published by several leaders in integrative cancer care. We do not recommend specific integrative programs or protocols but provide information for you to evaluate with your healthcare team.
Lise Alschuler, ND, FABNO, and Karolyn Gazella
Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010
Alschuler LN, Gazella KA. The Definitive Guide to Thriving after Cancer: A Five-Step Integrative Plan to Reduce the Risk of Recurrence and Build Lifelong Health. Berkeley, California: Ten Speed Press. 2013.
Naturopathic oncologist Lise Alschuler and integrative health writer Karolyn Gazella published two books that include detailed sections describing integrative approaches in cancer. These approaches may be used for certain cancer types, or along with certain conventional therapy treatments, or for particular conditions such as insulin resistance. The book includes a discussion of and the evidence behind the use of herbs and supplements, diet, lifestyle and other integrative therapies for each cancer/treatment/condition. A section of the book provides commonly used dosages and special considerations for the various herbs and supplements described in the book.
Keith Block, MD
Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Care. New York: Bantam Dell. 2009.
The Block Program has recommendations for people who are at different places along the cancer continuum:
- Those who’ve been recently diagnosed
- Those in treatment
- Those who’ve concluded treatment and need to remain vigilant to prevent recurrence
Descriptions of optimal lifestyle practices, innovative approaches to conventional diagnostics, and conventional treatment administration are included, as well as information on supplement/nutraceutical support.
Raymond Chang, MD, FACP
Chang R. Beyond the Magic Bullet: The Anti-Cancer Cocktail. New York: Square One Publishers. 2012.
Integrative medicine physician Raymond Chang, MD, FACP, describes a “new therapy based on the knowledge that certain off-label drugs, nutrients, and therapies are each somewhat effective against cancer. By combining these therapeutic agents into a ‘cocktail’, [often along with conventional cancer treatment], doctors have found that they can attack the cancer all at once, on many different levels and at several different angles, with the goal of overwhelming the disease.” Dr. Chang discusses the effectiveness of the cocktail and provides an examination of the most valuable agents available. In some cases he describes commonly used dosages.
Lorenzo Cohen, PhD, and Alison Jefferies, MEd
Cohen L, Jefferies A. Anticancer Living: Transform Your Life and Health with the Mix of Six. New York: Viking. 2018.
Lorenzo Cohen is director of the Integrative Medicine Program at The University of Texas MD Anderson Cancer Center. He and healthcare educator Alison Jefferies introduce the concept of the Mix of Six.
They make a case that building social and emotional support; managing stress; improving sleep, exercise, and diet; and minimizing exposure to environmental toxins work together to promote an optimal environment for health and well-being. While each plays an independent role, the synergy created by all six factors can radically transform health, delay or prevent many cancers, support conventional treatments, and significantly improve quality of life. Anticancer Living provides a guide to wellness based on scientific findings and clinical trials.
Jeremy Geffen, MD
Geffen J. The Seven Levels of Healing. Audio CD – 2002
Geffen J. The Journey Through Cancer: An Oncologist’s Seven-Level Program for Healing and Transforming the Whole Person. New York, New York: Three Rivers Press. 2006.
Geffen J. The Seven Levels of Healing. Presented at Cancer as a Turning Point Conference in Seattle, Washington in 2006.
Jeremy Geffen was a renowned integrative oncologist who developed a healing program based on what he calls The Seven Levels of Healing. It is a program of body, mind, heart, and spirit for healing and transforming the whole person.
Gerald Lemole, MD; Pallav Mehta, MD; and Dwight McKee, MD
Lemole G, Mehta P, McKee D. After Cancer Care: The Definitive Self-Care Guide to Getting and Staying Well for Patients with Cancer. New York, New York: Rodale, Inc. 2015.
Integrative oncologists Gerald Lemole, Pallav Mehta and Dwight McKee give information on “how to maintain physical health after cancer treatment―with chapters on epigeneticschanges in organisms caused by modification of gene expression rather than alteration of the genetic code itself; epigenetic changes are caused by turning genes ‘on’ or ‘off’ or altering their function in other ways, but not through mutations, nutrition, and exercise―as well as emotional health through stress management techniques.” These doctors present easy-to-incorporate lifestyle changes to help you “turn on” hundreds of genes that fight cancer, and “turn off” the ones that encourage cancer, while recommending lifestyle approaches to address each type. In addition, they describe supplements to help prevent relapse.
Barbara MacDonald, ND, LAc
MacDonald B. The Breast Cancer Companion—A Complementary Care Manual: Third Edition. Self-published. 2016.
In the third edition of her book, naturopathic physician Barbara MacDonald provides information about breast cancer, its conventional treatment, and natural approaches to enhancing treatment, managing side effects, reducing risk of recurrence, and healthy living after cancer treatment is completed. This book would be useful for other cancer care clinicians as well as patients. It includes dosage and administration information about natural products. The appendix contains a number of patient handouts, such as preparing for breast cancer surgery with naturopathic medicine.
Lee B. Colorectal Cancer: FOLFOX/FOLFIRI and Supportive natural therapies. Marsden Centre for Excellence in Integrative Medicine.
This protocol from Becky Lee, ND, provides information regarding combining FOLFOX/FOLFIRI and supportive natural therapies in treating colorectal cancer.
Neil McKinney, BSc, ND
McKinney N. Naturopathic Oncology, Fourth Edition. Victoria, BC, Canada: Liaison Press. 2020.
In his third edition book, naturopathic physician Neil McKinney, BSc, ND, has compiled integrative naturopathic oncology interventions for cancer care. Useful for clinicians and patients, this book includes descriptions and uses of many natural and complementary protocols for cancer in general and for specific cancers. It also includes information on integrative support during conventional cancer treatment.
Ornish Diet and Lifestyle Modification Program (for prostate cancer)
Cardiologist Dean Ornish, MD, has adapted his Ornish Heart Disease Reversal Program for use by men with prostate cancer. The program includes nutrition, fitness, stress management, and love and support.
Gurdev Parmar, ND, FABNO, and Tina Kaczor, ND, FABNO
Parmar G, Kaczor T. Textbook of Naturopathic Oncology: A Desktop Guide of Integrative Cancer Care. 1st edition. Medicatrix Holdings Ltd. 2020.
Naturopathic oncologists Parmar and Kaczor provide information on the treatment of 24 cancers, plus the most effective treatments of the most common symptoms affecting cancer patients while they undergo chemotherapy, radiotherapy, or surgery. The book includes a chapter on advanced treatments including hyperthermia, intravenous Vitamin C, mistletoe, and repurposed drugs in oncology.
David Servan-Schreiber, MD, PhD
Servan-Schreiber D. Anticancer: A New Way of Life. New York: Penguin Books. 2009.
In his book, Dr. Servan-Schreiber provides tips on how people living with cancer can fight it and how healthy people can prevent it. It combines memoir with concise explanations of what makes cancer cells thrive and what inhibits them. Servan-Schreiber draws on both conventional and alternative ways to slow and prevent cancer. This book is the basis of the Anticancer Lifestyle Program.
Traditional medicine systems from every inhabited continent have their own philosophies and medicinal plants and therapies.
Find more information about traditional medicine and where to find practitioners in this handbook.
Further recommended resources
Keep reading about how to integrate your choices
Explore your choices
Choices in treatment
|1||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.|