One Hand Cannot Clap—A Study of Arab Practitioners of Traditional and Complementary Medicine in Israel: Identifying Barriers to Integrative Oncology Care

Patient use of integrative oncology (the inclusion of nonconventional treatments alongside the conventional standard of care) continues to grow, with some studies showing its use in cancer patients to be as high as 91%. Naturopathic physicians are primary care providers who use integrative therapies to deliver patient-centred care. The Oncology Association of Naturopathic Physicians (oncanp) was formed in 2004 as a specialty association for naturopathic physicians providing integrative cancer care (nd oncs). Currently, the membership encompasses more than 400 naturopathic physicians and students, 115 of whom are board-certified Fellows of the American Board of Naturopathic Oncology. In 2016, oncanp established a committee comprising recognized experts in the field of naturopathic oncology to develop a Principles of Care (poc) guideline. The committee first undertook a review of existing standard-of-care and best-practice guidelines in the field of oncology and then adapted those concepts into a draft document. The draft document was then reviewed by naturopathic physicians, medical and radiation oncologists, naturopathic policy experts, and finally the oncanp membership at large. The poc document presented here provides clear guidelines for nd oncs on how best to deliver patient-centred care in the areas of assessment, treatment planning, care management, interprofessional collaboration, and survivorship care. This naturopathic oncology poc document can be a valuable resource for nd oncs and other oncology care providers to further an understanding of the naturopathic and integrative oncology care model and its potential for collaboration.

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Book Review Integrative Oncology: Incorporating Complementary Medicine into Conventional Cancer Care (Current Clinical Oncology.) Edited by Lorenzo Cohen and Maurie Markman. 216 pp., illustrated. Totowa, NJ, Humana Press, 2008. $79.95. 978-1-58829-869-0

New England Journal of Medicine ◽

10.1056/nejmbkrev59949 ◽

2008 ◽

Vol 359 (5) ◽

pp. 542-543 ◽

Cited By ~ 1

Author(s):

Donald I. Abrams

Keyword(s):

Complementary Medicine ◽

Clinical Oncology ◽

Cancer Care ◽

Integrative Oncology

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Development of a Pediatric Integrative Oncology Program: Pearls, Barriers, and Future Directions

10.21926/obm.icm.2101005 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Allison Ast ◽

Margaret Meyer ◽

R. Elyse Heidelberg ◽

Jennifer M. Allen ◽

Amy Ly ◽

...

Keyword(s):

Treatment Result ◽

Integrative Oncology ◽

Children With Cancer ◽

Initial Development ◽

Pediatric Hematology ◽

Pediatric Diseases ◽

Oncology Care ◽

Literature Base ◽

Facilitators And Barriers

Children with cancer can experience intense suffering. Currently, despite our best efforts, symptoms associated with both cancer and its treatment result in physical, psychological, and emotional discomfort that can be difficult to manage with traditional Western medicine alone. Developing integrative services within a pediatric hematology-oncology program may help improve cancer-related symptoms by combining different modalities targeting overall health with traditional oncology care. This study details the initial development of a Pediatric Integrative Oncology (PIO) program at St. Jude Children’s Research Hospital, which treats cancer and other catastrophic pediatric diseases. We highlight facilitators and barriers to integration of PIO. In addition, we advocate that PIO clinicians add to the growing literature base by sharing clinical and administrative experiences across institutions to support the long-term goal of developing specific guidelines that focus on using integrative modalities in children with cancer.

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Integrative oncology and complementary medicine cancer services in Australia: findings from a national cross-sectional survey

BMC Complementary and Alternative Medicine ◽

10.1186/s12906-018-2357-8 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 13

Author(s):

Caroline A. Smith ◽

Jennifer Hunter ◽

Geoff P. Delaney ◽

Jane M. Ussher ◽

Kate Templeman ◽

...

Keyword(s):

Complementary Medicine ◽

Integrative Oncology ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Cancer Services

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Integrative Oncology: Best of Both Worlds—Theoretical, Practical, and Research Issues

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/383142 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

Holger Cramer ◽

Lorenzo Cohen ◽

Gustav Dobos ◽

Claudia M. Witt

Keyword(s):

Complementary Medicine ◽

Health Care Professionals ◽

Complementary Therapies ◽

The United States ◽

Cancer Center ◽

Integrative Oncology ◽

Patient Centered ◽

Research Issues ◽

Medicine Research ◽

Evidenced Based

More and more cancer patients use complementary therapies. As the majority of patients do not disclose their use of complementary therapies to their oncologists, they expose themselves to possible detrimental effects from the therapies due to drug interactions. To meet the needs of patients and health care professionals on valid information on complementary therapies, the collaborative research project “Competence Network Complementary Medicine in Oncology—KOKON”, an interdisciplinary network for complementary medicine research in oncology, was established. Moreover, Integrative Oncology, a combination of conventional and evidenced-based complementary therapies delivered using a comprehensive approach, is now increasingly used in the United States and Europe. A variety of different Integrative Oncology models have been established worldwide including an expert-based model at the Kliniken Essen-Mitte, Essen, Germany and a patient-centered, evidenced-based approach at The University of Texas MD Anderson Cancer Center. Both models are briefly reviewed. More research is needed and Comparative Effectiveness Research that places strong emphasis on the comparison of different treatment options in usual care settings by including more heterogeneous patients, using less standardized treatment protocols, and measuring patient-centered outcomes would provide useful information for decision-making. To improve the quality of care and research in Integrative Oncology, sustainable financial models for Integrative Oncology and more funding for research are needed.

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Breast Cancer Integrative Oncology Care and Its Costs

Integrative Cancer Therapies ◽

10.1177/1534735416649034 ◽

2016 ◽

Vol 16 (1) ◽

pp. 85-95 ◽

Cited By ~ 12

Author(s):

Leanna J. Standish ◽

Fred Dowd ◽

Erin Sweet ◽

Linda Dale ◽

Morgan Weaver ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Early Stage ◽

Insurance Companies ◽

Quality Data ◽

First Year ◽

Breast Cancer Patients ◽

Integrative Oncology ◽

Body Therapy ◽

Oncology Care

Background. Naturopathic oncology in conjunction with conventional treatment is commonly referred to as integrative oncology (IO). Clinics directed by oncology board certified NDs (Fellows of the American Board of Naturopathic Oncology or FABNOs) provide high-quality data for describing IO therapies, their costs and measuring clinical outcomes. Purpose. To describe the types of IO therapies prescribed to breast cancer patients by ND FABNO physicians. Study participants (n = 324). Women who sought care at 1 of 6 naturopathic oncology clinics in Washington State were asked to enroll in a prospective 5 year observational outcomes study. Methods. Medical records were abstracted to collect treatment recommendations and cost data. Results. More than 72 oral or topical, nutritional, botanical, fungal and bacterial-based medicines were prescribed to the cohort during their first year of IO care. Trametes versicolor was prescribed to 63% of the women. Mind-body therapy was recommended to 45% of patients, and 49% received acupuncture. Also, 26% were prescribed injectable therapy, including mistletoe, vitamin B complex (12%), IV ascorbate (12%), IV artesunate (7%), and IV nutrition and hydration (4%). Costs ranged from $1594/year for early-stage breast cancer to $6200/year for stage 4 breast cancer patients. Of the total amount billed for IO care for 1 year for breast cancer patients, 21% was out-of-pocket. Conclusions. IO care for women with breast cancer consists of botanical and mushroom oral therapies, parenteral botanical and nutrient therapy, mind-body medicine and acupuncture. IO clinic visits and acupuncture are partially paid for by medical insurance companies.

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