Integrative Care

Recommendation:

Many comprehensive cancer programs choose to offer Integrative Care Services, which include services above and beyond those services that are considered traditional Supportive Care Services. They are offered in support and as an adjuvant to services considered necessary in the provision of cancer care.

Overview

Comprehensive cancer care services (also known as supportive care services) include the following: social work, nutritional care, psychotherapy, spiritual care, and financial counseling. These are services are integral to successful provision of whole-patient cancer care. Integrative medicine services (sometimes referred to as complementary medicine services) aim to enhance the patient experience through such modalities as massage, Reiki, yoga, meditation, art therapy, acupuncture, cooking classes for healthful nutrition, and other services focused on improving the patient and/or caregiver's well-being and quality of life. Any such program must consider and use personalized evidence-based clinical care, combined with exceptional medical research and education, as the primary starting point. Any services provided must be scientifically validated and considered useful to the patient population being served. Integrative medicine should not be confused with alternative medicine, which may have no supportive scientific evidence and can even be harmful. The Society for Integrative Oncology (SIO) includes Clinical Practice Guidelines on its website.

Validation of integrative medicine practices includes the use of quantitative and qualitative data sets, randomized clinical trials (RCTs), and data reviews regarding efficacy safety. For example, integrative care services include nutritional care, including the use of herbs, minerals, vitamins, and supplements; music therapy; art therapy; acupuncture; meditation; massage;  yoga; spiritual care; and mindfulness-based stress reduction. Outcome measures for integrative therapy trials usually focus on reduction of treatment side effects and/or improvement in quality of life measures. All uses of complementary or integrative medicine should be done in concert with and under the direction of the patient’s oncologist.

Accreditation/Certification

Many integrative care areas have separate certifications and accreditations. Examples include:

Resources to Help

  • The Society for Integrative Oncology provides information for patients and professionals on advanced evidence-based, comprehensive, integrative health care to improve the lives of people affected by cancer.
  • National Center for Complementary and Integrative Health is the Federal Government's lead agency for scientific research on complementary and integrative health approaches. The mission of NCCIH is to define, through rigorous scientific investigation, the usefulness and safety of complementary and integrative health interventions and their roles in improving health and health care.
  • ConsumerLab provides independent testing, quality ratings and comparisons of hundreds of vitamins, supplements and other health products.
  • Health on the Net Foundation was founded to encourage the dissemination of quality health information for patients and professionals and the general public, and to facilitate access to the latest and most relevant medical data through the use of the internet.
  • American Botanical Council provides reliable, up-to-date information about herbs based on modern science and traditional wisdom. The publications are peer-reviewed, and include a vast selection of periodicals, books, monographs, safety reviews, continuing education materials and searchable online databases.
  • Cancer.net provides timely, comprehensive, oncologist-approved information from the American Society of Clinical Oncology (ASCO), with support from the Conquer Cancer Foundation. Cancer.Net brings the expertise and resources of ASCO to people living with cancer and those who care for and about them to help patients and families make informed health care decisions.
  • Oncolink started in 1994, Oncolink was the first cancer information website on the Internet and remains one of the largest. This award-winning site is maintained by a group of oncology healthcare professionals who understand the need of patients, caregivers and healthcare professionals.

Insurance Considerations

Most integrative care services are not covered under insurance. In many cases, comprehensive cancer centers choose to offer such services at no or reduced charge and seek the offset of the expense from community organizations and other local funding sources. Additionally, in many cases, practitioners of integrative services may choose to offer their services to oncology patients at no charge.

 
ACCC Member Program: LSU Health Feist-Weiller Cancer Center, Shreveport, Louisiana

The Feist-Weiller Cancer Center developed the Arts in Medicine (AIM) program with the goal of improving the patient experience and to support a “healing environment” of care. Launched in 2002 and staffed by faculty spouses and volunteers, the program today is part of the cancer center’s Integrative Oncology Program. This unique art program offers patients the opportunity to work with a palette of color and a paintbrush while they receive IV chemotherapy or other treatment(s). Cancer patients receiving treatment in the inpatient or outpatient setting can participate—no prior experience is required.

The AIM program offers the opportunity to create a reproduction of a classic work of art using a paint-by-grid method, work with the program’s coordinating artist to paint an original piece of art, or create a piece of wearable art, such as a pin. Completed paintings are displayed in the hallways, clinics, and lobbies of the Feist-Weiller Cancer Center, where the artwork can be enjoyed by family, friends, and staff. Anecdotally, cancer center staff has heard from patients and families that the opportunity to paint or create a work of art can reduce stress and provide a new dimension of comfort for patients. Read the full story.