UVM Integrative Lecture Series: “Integrative Oncology: An Evolving Discipline”
Lecture Type: Online Video (Link Here)
Time: 63 minutes 44 seconds
Date: November 13, 2015
Speakers: David Rosenthal, M.D.
Topic: Integrative Oncology
Introduction
Dr. Rosenthal presents a lecture on using integrative medicine to treat patients with cancer for the University of Vermont Laura Mann Integrative Health Care Lecture Series. He combines conventional cancer care with complementary therapies through in-depth patient consultations.
Dr. David Rosenthal is a medical doctor who is board certified in internal medicine, hematology, and medical oncology. He received his medical degree (M.D.) from Tufts University School of Medicine and completed his residency at the Beth Israel Deaconess Medical Center and Boston City Hospital. He currently conducts research for the Dana-Farber Cancer Institute.
Read Dr. Rosenthal’s biography from the Dana-Farber Cancer Institute here.
You can view the lecture directly by clicking the link here.
You can download the PowerPoint presentation for this lecture by clicking the link here.
What is Integrative Oncology?
Dr. Rosenthal defines integrative oncology as the best combination of traditional and complementary medical therapies that optimize a person’s innate healing ability. This approach to care maximizes patient participation and empowerment and improves the patient-physician relationship through shared decision-making.
In clinical oncology visits, patients can ask questions about complementary or alternative therapies that they are interested in pursuing, for which integrative oncologists provide evidence-based recommendations.
As an integrative oncologist for the Zakim Center, Dr. Rosenthal offers such consultations for his patients. He also oversees the provision of affordable integrative services, such as acupuncture and nutrition, and conducts research for the Dana-Farber Institute.
There are several categories of complementary and alternative therapies. According to Dr. Rosenthal, there are 5 major categories. You can also view the image above to see some of the different therapies offered within these groupings.
Categories of CAM:
- Diet/ OTC Supplements/ Herbs/ Antioxidants
- Mind Body Medicine
- Physical Activity and Modified Exercise Programs
- Massage and Touch Therapies
- Acupuncture
One of the problems with integrative medical therapies is that there is a wide variety to choose from. For safe and efficacious therapies, the choice of therapy is largely left to patient preference. Healthcare providers must consider therapies that are culturally sensitive and fit within a patient’s lifestyle to improve outcomes.
In other cases, some therapies may be more specific to patient needs – such as reducing peripheral neuropathy induced by some cancer drugs. It is up to the physician and the healthcare team to determine the best treatment for the patient. Overall, these therapies are added to conventional treatment plans to improve quality of life from a physical, psychological, social, and spiritual standpoint.
Challenges in Integrative Oncology
Since this talk in 2015, some of the challenges discussed by Dr. Rosenthal in this lecture have been slowly addressed through research and the development of innovative solutions. Many healthcare professionals today acknowledge the potential benefits of integrating complementary therapies into conventional medicine across all specialties. Despite these improvements, there continue to be many challenges. Below are some of the issues highlighted by Dr. Rosenthal.
Cost
Many complementary therapies are not covered by insurance, therefore acting as a barrier to integration and utilization.
Physician Overwhelm
Doctors have limited time and resources to work with patients for extended periods. Integrative medicine requires a healthcare team to address the holistic needs of patients. This may include working with a primary care physician and/or a health coach who can spend more time with patients to determine their individual preferences and available resources.
Disclosure of Use
According to one paper by Richardson et. al cited by Dr. Rosenthal, “83% of patients across broad-spectrum of malignancies use CAM.” Despite this, many patients do not disclose their use to their doctors. This may lead to the utilization of ineffective therapies and therefore increased out-of-pocket costs, or it may even lead to interactions between conventional and alternative therapies.
Interactions
As alluded to above, not all complementary and alternative therapies are safe, especially for patients with cancer. Common herbal remedies may reduce the effectiveness of cancer drugs, therefore reducing the chances of survival. For example, St. John’s Wort interacts with the p450 system and increases the metabolism of certain cancer drugs. This means the drug will be excreted faster from the body. Other drugs may have direct toxic effects.
Delaying Treatment
Finally, patients who are diagnosed with cancer may delay life-saving treatment in pursuit of alternative medicine instead of working in partnership with conventional medicine. This may lead to cancer progressing to its later stages. If a patient later chooses to pursue traditional therapy it may be too late.
Resources for Patients and Physicians
Dr. Rosenthal provides an extensive resource list on the current research and recommendations on integrative therapies, drug-medication interactions, and more. Click the links below to explore!
Memorial Sloan-Kettering Cancer Center
The University of Texas MD Anderson Cancer Center
American Botanical Council
American Cancer Society
National Institutes of Health (NIH) National Center for Complementary and Integrative Health
Concluding Thoughts
Integrative oncology combines conventional and complementary therapies to support the healing of patients with cancer. Dr. Rosenthal uses an individualized approach to treat his patients to improve outcomes and quality of life. This lecture was filled with information and research on using complementary therapies in cancer treatment.
Check out the lecture video here.
Download the PowerPoint presentation here.
Visit the UVM Integrative Lecture Series home page here.
Citation
Rosenthal, D. (2015, November 13). [Lecture Recording]. University of Vermont Laura Mann Integrative Health Care Lecture Series. https://www.youtube.com/watch?v=T_Nz6KsvOOI
Disclaimer
This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. The publisher of this content does not take responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement, exercise or other lifestyle program.