How Integrative Oncology Can Help.

Optimize symptom management, address unmet needs, and facilitate positive behaviorial changes.

Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum and to empower people to prevent cancer and become active participants before, during, and beyond cancer treatment.”

- Advancing the Global Impact of Integrative Oncology, Journal of the National Cancer Institute monograph

More than a quarter of all cancer patients visit complementary and alternative medicine providers during treatment to manage common cancer-related symptoms and side effects. There is solid evidence showing that some complementary therapies can safely and effectively ease cancer-related symptoms. This blog describes some of the more commonly utilized modalities and what symptoms can be effectively addressed by them.

Acupuncture

Acupuncture is defined as the application of stimulation such as needling, moxibustion, cupping, and acupressure on specific sites of the body known as acupuncture points. Certified specialists who are trained and licensed in the practice of acupuncture can help with a variety of conditions. Cancer patients can use it for pain management, to help with nausea and vomiting, fatigue, symptoms of menopause whether natural or induced by chemotherapy including hot flashes, dry mouth, neuropathy, anxiety, insomnia and depression. The role of acupuncture in controlling pain, nausea and vomiting has been researched extensively, especially in breast cancer patients. Data shows that it is an effective modality for alleviating these symptoms. The most common barriers to using acupuncture for cancer patients are lack of knowledge about it, concerns about lack of insurance coverage, cost, and difficulty in finding qualified acupuncturists.

Massage Therapy

Massage is a modality used for pain relief through therapeutic touch. There are many styles of massage including Swedish, reflexology, neuromuscular therapy, myofascial release, shiatsu, and manual lymphatic drainage, or MLD. When performed by a qualified licensed massage therapist, massage helps reduce muscle soreness, stiffness, and spasms. It also promotes relaxation and improves circulation, as well as processes that can support recovery and healing. Clinical trials have shown that massage therapy helps reduce pain, anxiety, fatigue, and shortness of breath in cancer patients. It can ease the mind, help with sleep, reduce depression, and provide comfort. In addition, studies suggest that massage can reduce pain and anxiety related to medical procedures, including surgery.

Energy Therapy

This set of therapy programs is based on the belief that there are energy fields or a bio-field that flow through and around your body and are essential to the body’s basic composition. The energy therapies are based on the premise that physical, mental, emotional, and/or spiritual illness or injury will manifest in both the physical body and the bio-field. The goal of energy therapies is to restore the balance of energy to the bio-field, thus promoting good health, and general well-being. It should be noted that there is no accepted proof or way to quantify the bio-field and hence more studies need to be done to evaluate this modality. The more common types of energy therapy include:

• Reiki, which has the most spiritual focus of all of the energy therapies. Reiki practitioners believe that channelling spiritual energy through their hands can help in healing.

• Therapeutic Touch practitioners move their hands just above the body to find blockages, remove harmful energy and replace them with their own healthy energy.

• Healing Touch uses gentle touches on the body to help it heal its own energy fields.

Case reports and preliminary studies have been published supporting the benefit of energy therapies in cancer care for palliation of cancer symptoms and treatment-related side effects. Early indications show positive response leanings towards Reiki in cancer-related fatigue, anxiety, overall improvement in quality of life, and decreased pain, Therapeutic Touch for anxiety and Healing Touch for positively impacting mood disturbance, fatigue, nausea, pain, physical functioning and well-being.

Biofeedback Therapy

Biofeedback therapy is a way to help you learn to better control your body and your response to stress. In cancer patients, it can be used to manage anxiety, and stress. Cancer treatment can be incredibly stressful and fraught with anxiety, but biofeedback can help you learn to better control your body’s response to stress. During a biofeedback session, your therapist shows you different relaxation techniques including deep breathing, guided imagery, mindfulness meditation, progressive muscle relaxation and self-hypnosis.

Generally, a biofeedback therapist guides you through each treatment session. At the beginning of the session, your therapist places small electrodes on your skin to measure body functions like your heart rate, blood pressure and muscle tension. The information the electrodes gather is sent to a special machine that gives immediate feedback about your bodily functions. Knowing what’s going on inside your body in real-time helps you become more aware of your physiological response to certain stressors. This information can be used to help you control your responses to stress and promote natural relaxation. There is some early research that indicates these techniques can also help with chemotherapy-induced nausea. Research has shown that biofeedback can also be helpful if you are trying to regain urinary and bowel function after cancer surgery, especially if you experience incontinence. It can help muscle-strengthening exercises work better as well as retraining muscles after injury.

Yoga Therapy

Multiple studies have demonstrated the effectiveness of yoga therapy for symptom management in patients with cancer, including its potential to decrease fatigue, pain, anxiety, depression, and insomnia and improve flexibility, balance, mood, and overall quality of life. It is important to differentiate between yoga and yoga therapy. A general public yoga class can help ease everyday aches, pains, and mood complaints; however, a cancer yoga therapy session is tailored to the patient’s needs and addresses physical, mental, and emotional needs. Certified oncology yoga therapists can provide services to cancer patients in a variety of settings—from outpatient to inpatient.

These are a few of the options that are available for cancer patients that can make a big difference in the quality of their life as well as how they respond to treatment and deal with its side effects. As always, consult with your cancer care team prior to starting any of these integrative therapies to help optimize your care.

Unfortunately, challenges including lack of institutional resources and funding, knowledge of existing programs, demanding treatment schedules that leave little time for these programs, symptom and travel burdens, and lack of financial support or insurance coverage have impeded cancer patients from benefiting from integrated complementary modalities. Shining a light on the effectiveness of these complementary strategies and increasing access should be a priority for all cancer treatment centers.