Patients, as primary stakeholders in their own well-being, are increasingly showing a deep interest in holistic approaches to cancer care that go beyond traditional medical treatments. Growing evidence supports this interest, showing that certain comprehensive and integrative approaches can improve quality of life and survival outcomes. The attitude of oncologists is evolving in the same direction, but with less urgency than that of our patients.
We recently conducted parallel surveys of oncologists and cancer patients and found that patients wanted complementary therapies, such as nutrition and exercise counseling, mindfulness, meditation and yoga , and that they wanted options presented to them at the start of their cancer journey. Patients are seeking oncologists and care centers to proactively support their quest for integrative care with conversations, advice and access to therapies.
Two-thirds of patients said they wanted to discuss complementary therapies – such as nutritional advice, exercise, massage or meditation support – before traditional cancer treatments began, while a similar proportion of oncologists say they postpone conversations about these services until later in treatment. process, probably when necessary to mitigate side effects. About a third of oncologists still think patients are not interested in complementary therapies, while only 13% of patients told us they are. Patients want a care team that proactively supports complementary therapies early in their cancer treatment journey.
We now know much more about the biology of cancer, and we know that it is more complex than we once thought. The development and progression of cancer involves the immune system, genetics, environment and the gut microbiome, which is influenced by the food we eat. Science shows the benefits of holistic approaches, such as exercise and stress management, but clinical practice has not caught up. Oncologists are beginning to realize this and are wondering how to put this science into practice. That means looking at the evidence for what works beyond treatments that aim to kill just the cancer cell.
Put it into practice
Doctors are increasingly forced to do more in less time. A discussion about whole-person care seems like one more thing to fit into a frustratingly limited time with patients. Cancer care teams are trained to focus on treating the tumor and want to accomplish this important task, which is itself a complicated process. There are, however, ways to strengthen support for integrative approaches in practice while respecting other requirements of the team's role in care delivery. First, make sure there is space and permission for patients to discuss integrative care. We know patients are interested and want to be able to talk to their doctor, if possible. It is therefore important to allow time to do this, upon admission. Benefit from the support of your team to support you. Once the conversation begins, team members, such as nurse practitioners and physician assistants, can play an important role in providing information and connecting patients to services; Resources are available at many cancer centers to coordinate this care.
Patients need to know what services are available that might benefit them and that you support them. Complementary care was more widely available in health centers than the patients in our survey seemed to understand. Nearly 96 percent of oncologists said some sort of complementary therapy was offered by their facility, with nutritional counseling and patient support groups being the most common. Yet patients are often unaware of these resources. Despite the lack of awareness, patients also say they are increasingly thinking about their options when choosing a cancer center. Overall, 55 percent of patients said they would have chosen a health system that offered more complementary therapies if they had the choice again, a substantial increase from 40 percent a year ago. . Administrators and providers should recognize the importance of making these services routine and easily accessible. Hospitals and cancer centers can leverage this information to align their offerings with patient preferences, strengthening their appeal to people seeking holistic care.
Cost and coverage of complementary therapies present additional barriers, requiring a systems approach to address these concerns. By advocating for the inclusion of these services in comprehensive cancer care programs and working with administrators to navigate reimbursement options, oncologists can help overcome financial barriers that hinder access to such therapies. and ultimately help our patients.
Training of doctors
More resources than ever are now available to provide physicians with information about integrative therapies. The Society for Integrative Oncology recently partnered with the American Society of Clinical Oncology to develop clinical practice guidelines evaluating the evidence for interventions such as massage, hypnosis, music therapy, acupuncture and yoga therapy in specific circumstances such as cancer pain. Oncologists can review what is recommended in these guidelines and then work with hospital administrators to make these offerings routine at your facility.
The tide of support for global oncology is turning. While integrating complementary therapies into cancer care requires a mindset shift and a commitment to early and open communication, we have the opportunity to change care delivery. By taking a holistic approach, we can transform cancer care into a more comprehensive, person-centered experience that addresses not just the tumor but the whole person from the start of their journey.
Wayne B. Jonas is a family doctor. Alyssa McManamon is a doctor in hematology-oncology.