Integrative oncology is a rapidly emerging field. It might be defined as being the practice of bringing the expertise and wisdom of a myriad of approaches and disciplines together for the benefit of those with cancer.It describes a collaborative effort that integrates the practice of conventional medicine with traditional and complementary and alternative (CAM) therapies, which are attracting a growing number of patients diagnosed with cancer. Estimates are that up to 85 percent of cancer patients have considered CAM approaches.1
Dr. Ralph W. Moss, author of The Moss Reports, returned from the 40th annual meeting of the American Society for Clinical Oncology earlier this year. He has spent the past 30 years monitoring the field of oncology and investigating both conventional and CAM treatments. He feels that, given the evidence, Western medicine has failed in the war on cancer, and wrote, "You would think that in the face of this failure the oncology profession would be eager to reach out for new ideas and concepts. As I have shown throughout my career, there are abundant new ideas in the world of CAM. But instead of welcoming CAM, the oncology profession reacts to it as if it were a competitive challenge rather than an opportunity."2
Clifton Leaf, in Fortune magazine's March 20043 issue asks the question, "Have we made so little progress in the war on cancer?" He includes astonishing facts and statistics regarding cancer in the U.S., including:
- "More Americans will die of cancer in the next 14 months than have died from every war that the U.S. has fought ... combined."
- Even adjusting for age, the percentage of Americans dying from cancer is about the same as it was in 1971 (when Nixon declared the war on cancer) or even back in 1950! Meanwhile, age-adjusted deaths from heart disease have been slashed by 59 percent and from stroke by 69 percent during that same half-century.
- "The few dramatic breakthroughs (such as in Hodgkin's disease) mainly occurred in the early days of the war on cancer. There has been little substantial progress in recent decades...despite nearly ubiquitous claims to the contrary."
However, there has been some interest in and research money for acupuncture and Oriental medicine. The National Institutes of Health (NIH) awarded the first acupuncture specific grants in 1973. Since 1997, NIH funding for CAM research increased from $2 million in 1997 to $213 million in 2001. The Society of Acupuncture Research (SAR) promotes research in acupuncture and Oriental medicine, and was actively involved in the November 1997 Consensus Development Conference on Acupuncture, sponsored by the NIH. The panel concluded that, "...there is sufficient evidence of acupuncture's value to expand its use into conventional medicine and to encourage further studies of its physiology and clinical value."4
The American Cancer Society, on its Web site, states, "There is no scientific evidence that acupuncture is effective as a treatment for cancer, but it appears to be useful as a complementary method for relieving some symptoms related to cancer and other conditions. ... Acupuncture is an effective treatment for nausea caused by chemotherapy drugs and surgical anesthesia, and the treatment of dental pain following surgery. There is also some evidence that acupuncture may lessen the need for conventional pain-relieving drugs."
Since 1991, the National Cancer Institute (NCI) has been evaluating data from CAM practitioners who treat patients with cancer. The Best Case Series Program, as it is called, provides an independent review of medical records, primary source material and pathology, then gives an overall assessment of evidence of a therapeutic effect. Earlier this year, the NCI developed an e-mail survey, which was distributed to CAM practitioners who treat cancer patients. I participated in the survey that hoped to assess the interest and concerns regarding various CAM therapies in the care of cancer patients. NCI's Office of Cancer Complementary and Alternative Medicine (OCCAM)5 oversees the program. OCCAM, established in 1998, supports CAM cancer research and provides information about the diagnosis, prevention, and treatment of cancer and cancer-related symptoms and treatment side-effects to health providers and the general public.
In 1999, the NIH National Center for Complementary and Alternative Medicine (NCCAM)6 established a Cancer Advisory Panel for Complementary and Alternative Medicine (CAPCAM), which advises NCCAM about promising CAM approaches for the treatment of cancer patients. NCI and NCCAM are currently sponsoring or cosponsoring clinical trials examining the efficacy of CAM treatments for cancer.7 Some trials are studying the effects of CAM approaches used in conjunction with conventional treatments, while others compare CAM therapies with conventional treatments. For example, a current trial is evaluating the response of utilizing acupuncture to reduce the symptoms of advanced colorectal cancer. I recently had an opportunity to support the health of a patient with advanced colorectal cancer, with both acupuncture and Chinese herbal medicine, and found that most of the patient's symptoms were satisfactorily relieved, so I imagine the trial will lead to additional research and engender integrative and collaborative care.
- Kaptchuk TJ, Eisenberg DM. The persuasive appeal of alternative medicine. Ann Intern Med 1998;129:1061-1065.
- Ralph W. Moss, PhD. The Moss Reports Newsletter, June 13, 2004. www.cancerdecisions.com.
- Leaf, Clifton. Why we're losing the war on cancer. Fortune 2004;149(6):76-97.
- www.cancer.gov/occam. The OCCAM Clinical Trials Web page. Links are provided to the NCI's clinical trials databases at www.cancer.gov/occam/trials.html on the Internet.
- The NCCAM Clinical Trials Web page. Clinical trials can be searched by type of treatment or disease at http://nccam.nih.gov/clinicaltrials/ on the Internet.
- The NCI's PDQ® Clinical Trials Database. The PDQ Clinical Trials database can be searched at www.cancer.gov/search/clinical_trials/.
Click here for previous articles by Kabba Anand, DAc, LAc, Dipl. Ac., Dipl. CH.