How to Talk to Your Care Team About Integrative Oncology Therapies

Patients are increasingly more involved in their healthcare decisions, and physicians are becoming more understanding that patients want to be involved in their healthcare decisions. Research shows that when patients are more involved in their healthcare decisions, it can increase their quality of life. Healthcare is an art and science, and part of that art is the collaboration between the physician and the patient. Like any relationship, there needs to be mutual trust, respect, and communication in order for the relationship to thrive. 

If you've recently been diagnosed with cancer, you may be seeking integrative, functional, or complementary medicine. Approximately 85% of cancer patients are using integrative or functional medicine alongside their diagnosis– by way of supplements, dietary changes, intravenous therapies, or acupuncture, to name a few. Many patients wonder, "if I seek evidence-based integrative medicine, should I tell my medical oncologist about it?" The answer is YES! Let's explore why and how. 

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What is Integrative Oncology?

The terms integrative and functional can sometimes be confusing. Integrative medicine speaks to the collaboration among healthcare modalities. Functional medicine focuses on a root cause analysis of a condition and a tailored treatment plan. Thus, integrative oncology integrates different healthcare modalities (functional medicine, Traditional Chinese Medicine, naturopathic medicine, Ayurveda, exercise science, and nutrition) alongside conventional oncology (chemotherapy, surgery, radiation, and immunotherapy.)

Integrative oncology aims to improve patient outcomes, decrease side effects, and increase the quality of life. Additionally, integrative oncology focuses on the safety and effectiveness of implementing integrative medicine alongside oncology treatments. For example, those trained in integrative oncology can answer the questions like, "is it safe for antioxidants to be taken during radiation? Are chemotherapy and IV Vitamin C synergistic? Is acupuncture helpful for chemotherapy-induced peripheral neuropathy?" 

For Practitioners: How To Talk To Your Care Team About Integrative Oncology Therapies

Healthcare providers are increasingly overworked and spread thin. It is unanimous that both healthcare providers and patients feel they need more time during office visits. Therefore, when you meet with your medical oncologist, it may feel less important to let them know about the acupuncturist you are seeing or the new supplement you are taking. So how can we foster interprofessional communication and collaboration? 

One suggestion is to ask each care team member to fax their chart notes to each other. Chart notes act as documentation of what happened during the office visit. They also allow the practitioner to explain the thinking behind their treatment recommendations. As a patient, you are in the driver's seat. You have the most information on a) how you are feeling, b) who you are seeing, and c) whether certain treatment recommendations are working. 

While it may be wishful thinking to have all of your providers get on the phone to talk about your care, it is possible to have them at least read what each provider is thinking regarding clinical courses and recommendations. Let's dive into some of the various specialties that can enhance your care team. 

Functional Medicine Practitioners

Functional medicine doctors are experts at root cause medicine. In oncology, functional medicine doctors can take a thorough history and understand what led up to your diagnosis. Perhaps you had been diagnosed with an autoimmune condition five years prior to being diagnosed with cancer. Maybe you experienced trauma in childhood and have a high adverse childhood experience (ACE) score. Both of those things can increase your risk of developing cancer.

A functional medicine practitioner can help put the story together and perhaps shed some light on the epigenetic risk factors. While your medical oncology team is focusing on treating the cancer, your functional medicine team can be addressing anything in the background that may increase the risk of recurrence. Functional medicine can also be very helpful in treating related side effects. For example, if you are experiencing chemotherapy-induced nausea, a functional medicine practitioner can suggest dietary and supplement strategies to minimize nausea. 

Acupuncturist

Acupuncture is an incredibly helpful tool in the setting of oncology. In fact, the word "tumor" was found on a 3500-year-old oracle-bone inscription in China. Acupuncture is helpful for general well-being during cancer treatment and treatment-related side effects. There is ample research showing that acupuncture can be helpful for treatment related to fatigue, nausea, peripheral neuropathy, pain, and anxiety. Many major hospitals and academic centers have acupuncturists on staff who can treat you before you go in for chemotherapy, surgery, or radiation. 

Chiropractors

Pain is a very common side effect during cancer treatment. The pain can either be medication related or post-operative. Unfortunately, more than 50% of cancer patients complain of moderate to severe pain. The options for pain management are limited, as many patients can become dependent on opioids. Chiropractors can be helpful with alternative ways to manage pain. After a thorough evaluation and assessment, a chiropractor can assess whether soft tissue manipulation, physiotherapy, prescriptive exercise, massage, or ergonomic counseling could be helpful for pain management. 

Integrative Nutritionist 

Fortunately, nutritionists and dieticians are increasingly becoming part of oncology care teams. These nutritionists are specifically trained in helping oncology patients through treatment and after. A nutritionist can take a look at your current diet and make personalized suggestions for ways to meet your dietary goals during treatment. As weight loss is common in those with cancer, it is crucial to maintain and improve muscle mass during chemotherapy. Nutritionists can also work with family members and caregivers who may be preparing meals at home to ensure they feel confident cooking for their loved ones. 

For Patients: How To Talk To Your Care Team About Integrative Oncology Therapies

For patients who have been diagnosed and are looking to assemble an integrative oncology care team, you’ve come to the right spot. First off, find a practitioner trained in integrative oncology. This practitioner may be a board certified naturopathic oncologist (FABNO) or an Institute for Functional Medicine (IFM) practitioner specializing in oncology. This practitioner can act as your "integrative oncology quarterback" and help coordinate care between your other practitioners (acupuncturist, chiropractor, nutritionist, massage therapist, etc.) and your medical oncology team. This practitioner can also help guide you on evidenced-informed integrative medicine specific to your diagnosis. 

Summary

Fortunately for patients, there is a growing number of integrative oncology programs. Hospitals are adding more and more integrative oncology modalities to their in-house integrative medicine centers, increasing accessibility for patients. There is a demand from patients to have more comprehensive, collaborative oncology treatments. There is also a growing number of research studies and methods to evaluate how integrative oncology can impact a patient's overall outcome. Many of these studies are underway and will provide us with more definitive answers. For now, patients shouldn't shy away from asking their care team to communicate.