Integrative Cancer Care: Focusing on the Person as Well as the Disease
To customize care for each patient, integrative oncology combines a range of treatment methods, from nutrition to counseling
Produced by Cancer Treatment Centers of America (CTCA)
When coping with a cancer diagnosis, patients are typically offered treatment options that include some combination of surgery, chemotherapy and radiation therapy.
Yet, even as the efficacy of these options improves, there’s a growing recognition that treatment efforts must go beyond attacking cancerous cells to address a patient’s broader needs. From emotional support to improved nutrition, a holistic approach to patient care may enhance quality of life during treatment, speed recovery and reduce the risk of side effects.
As our understanding of the importance of these secondary factors has grown, a new generation of integrative clinicians has emerged. Their mission is to create a well-rounded approach to cancer treatment that helps heal both the body and the mind.
Their resources include a mix of traditional methods including surgery, radiation and chemotherapy, as well as supplements, physical activity and psychosocial therapies. Food plays a major role, too.
“Nutrition is important in cancer care for three main reasons,” says Kalli Castille, director of nutrition and culinary services at Cancer Treatment Centers of America (CTCA). “It can reduce treatment side effects, enhance recovery and improve overall quality of life.”
Cancer can compromise a patient’s ability to fight off infections in two ways. The disease itself can impair the body’s defenses and treatments often have side effects that leave patients weaker.
For instance, depressed appetite — whether due to the cancer itself or resulting from chemotherapy — may diminish the intake of protein, a key ingredient to maintain immunity. Thus, monitoring protein consumption and adding healthful sources is a smart option.
Castille works with patients prior to treatment, recommending simple interventions in anticipation of the potential side effects of chemotherapy such as nausea, vomiting and constipation. Treatment-related nausea, for example, may be reduced with the consumption of simple foods, such as ginger and mint.
When the focus shifts to post-treatment survival, oncology rehabilitation begins early, with an assessment of the patient’s strength, range of motion and energy level to anticipate how well a patient may tolerate treatment.
“If someone has a high physical performance status, they may be able to move quickly from one procedure to the next,” Castille notes. “But someone with a lower status may need a break between treatments.”
“It’s very helpful to meet people before treatment begins,” says Karen Gilbert, national director of oncology rehabilitation at CTCA, “so we have a better concept of what they love and want to do.”
The recommended interventions depend on the patient, the type and stage of cancer, as well as the treatment plan. Some patients may benefit from physical exercise to boost their muscular strength before, during and after treatment. For others, massage and other hands-on physical therapies may reduce pain and stress. Or, for patients being treated for head and neck cancers that affect the ability to speak, a speech-language pathologist can help improve communication abilities.
Whatever rehabilitative measure is recommended, Gilbert always focuses on the patient. “We know you are your best resource to manage side effects both during and after treatment,” she tells them. “And we are going to make sure that resource is healthy and functioning.”
As with other integrative approaches to cancer care, naturopathic interventions aim to decrease side effects and improve quality of life.
“The goal of naturopathic medicine in cancer care is to help patients move through the process as gracefully as possible,” says Anthony Rutledge, a naturopathic practitioner at CTCA.
Trained with many of the same building blocks as general medical practitioners, naturopathic practitioners offer a complementary path in the care they provide after a diagnosis. “What sets naturopathy apart is the toolkit,” Rutledge says. His preferred tools include: vitamins; amino acids and minerals; hands-on therapy; and other non-medical therapies.
Naturopathic clinicians also offer an important informational resource for patients who have turned to “Dr. Google” to research remedies. “Just because something is natural doesn’t mean it’s harmless,” says Rutledge.
For example, curcumin is an active constituent of turmeric that may have anti-inflammatory effects, enhance chemotherapy and reduce skin issues resulting from radiation. But the way the liver metabolizes curcumin can interfere with drugs that are processed similarly.
“We have to balance the research with each patient’s treatment plan and individual needs,” says Rutledge.
Physically, integrative cancer can also focus pain management — including acupuncture — andchiropractic therapy.
A patient’s emotional needs should be a top priority, too. Hence, mind-body medicine, such as individual or family counseling, may help patients cope with the depression, fatigue, stress and sleeplessness that sometimes accompany cancer and its treatment.
Spiritual support is also important. Individual or group prayer or worship can helps cope with the challenges faced during treatment.
Integrative practitioners treat the whole patient, not just the tumor. And they strive to enhance the quality of their patients’ lives as they undergo treatment. “We partner with our patients,” says Gilbert, “and it’s a privilege to do so.”
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