Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Advancing the Global Impact of Integrative Oncology

Advancing the Global Impact of Integrative Oncology Cancer is a global disease. In 2015, there were 17.5 million cancer cases and 8.7 million cancer deaths worldwide (1). By 2020, these numbers are expected to rise to 21.7 million new cases and 13 million deaths (2). With 16% of all deaths due to cancer in 2015, it is the second leading cause of death worldwide, and the past decade has seen a 33% increase in the number of cancer cases globally, due in large part to population aging and growth (1). From Cameroon to England, China to the Middle East, in our wealthiest and poorest countries, cancer is present; it does not discriminate. People throughout the world employ a variety of strategies to cope with the physical, emotional, and spiritual impact of cancer. In recent years, the field of integrative oncology has emerged as a scientific discipline to carefully research and bring together evidence-based complementary/traditional medicine therapies and conventional cancer treatment to address the diverse needs of cancer patients and their families. Many complementary therapies, such as acupuncture, yoga, and natural products originated from regions outside of North America thousands of years ago and are used extensively in their countries of origin today. For example, in China the use of Traditional Chinese Medicine (TCM) herbal therapies in cancer patients exceeds 80% (3). Despite such wide empirical use, rigorous research in this area remains limited. Because of the many barriers in language, culture, regulatory environments, and funding mechanisms, much is “lost in translation.” The clinical wisdom of the East is unknown to the West, while the experimental rigor of the West remains poorly integrated into the research enterprises of the East. However, there are indications that this is changing. In 2015, Professor Youyou Tu in China received the Nobel Prize for her impactful work on the herbal extract artemisinin for malaria (4), inspiring researchers in the field to apply rigorous methods to their research in integrative medicine, and further indicating the rise of this important emerging field. In the United States, the Memorial Sloan Kettering Cancer Center established its Integrative Medicine Service in 1999. Soon, other leaders in cancer care, such as the University of Texas MD Anderson Cancer Center and the Dana-Farber Cancer Center were forming dedicated programs focused on integrating complementary therapies into cancer care. Over the past several years, the presence of integrative medicine at US National Cancer Institute (NCI)–designated cancer centers has increased greatly, with the majority of centers now offering some form of integrative treatment (5). Established in 2003, the Society for Integrative Oncology (SIO) is an international, multidisciplinary, and interprofessional organization that seeks to advance evidence-based, comprehensive, integrative health care to improve the lives of people affected by cancer (www.integrativonc.org). Today, SIO has nearly 500 members representing 21 countries. In this special Journal of the National Cancer Institute monograph, we present a collection of original research and perspective manuscripts to highlight both the challenges and opportunities for advancing the global impact of integrative oncology. On the research path, it is essential to confront the vast global disparities that exist in cancer care and the role that effective integration of allopathic and traditional medicine can play to address these imbalances (6). Recognizing this need, in concert with the steadily increasing growth and impact of our field around the globe, a group of multidisciplinary scholars propose a long-needed definition of “integrative oncology” to give this field a focus and clarity, no matter what language we speak (7). From here, we move to the Middle East, where a group of clinician researchers from five countries are collaborating to advance the practice of integrative oncology (8). We then consider a global overview of the integrative oncology activities in pediatric units of low- and middle-income countries (9); learn about the findings of a prospective cohort study on Chinese colorectal cancer patients and their use of traditional Chinese herbal medicine (10); visit the United Kingdom to learn about “whole person” oncology (11); and appreciate the growth of integrative medicine in leading NCI Comprehensive Cancer Centers in the United States (5). We then turn to specific evidence-based approaches to improve integrative oncology clinical care, including comprehensive lifestyle changes to optimize cancer prevention and outcomes (12); mind-body therapies for managing distress (13); and the role of physical activity along the cancer care continuum (14). To accelerate the pace of evidence generation for patients and health care providers, we highlight important research methods: a new paradigm of comparative effectiveness research to evaluate real-world outcomes (15); the patient perspective to inform design and conduct in patient-centered outcomes research (16); and a report on the development and validation of a patient-reported outcome tool for use with Traditional Chinese Medicine (17). We conclude the monograph with three papers from the NCI, whose vision and leadership paves the way to advance comprehensive cancer care, including integrative oncology via rigorous research. The NCI has established a long-term collaboration with the China Academy of Chinese Medical Sciences for a number of basic natural product research projects, coordinated by the Office of Cancer Complementary and Alternative Medicine (18). Recently, NCI organized two separate workshops and presented white papers on cancer Complementary and Alternative Medicine therapeutics research (19) and oncology acupuncture for symptom management (20). The leading investigators and scholars in the field presented on the state of science, challenges, and opportunities, in addition to making recommendations for advancing rigorous integrative oncology research. With the publication of this special JNCI monograph, we hope to promote global collaborations among researchers, clinicians, funders, patient advocates, and key societal stakeholders. Together, we can accelerate the pace of discovery and translation to enhance the evidence-informed growth of integrative oncology and alleviate suffering from cancer worldwide. Funding Dr. Mao is funded in part by a National Cancer Institute grant to the Memorial Sloan Kettering Cancer Center (grant number P30-CA008748) and by the Laurance S. Rockefeller Fund. References 1 Global Burden of Disease Cancer Collaboration , Fitzmaurice C, Allen C, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: A systematic analysis for the Global Burden of Disease Study . JAMA Oncol. 2017 ; 3 4 : 524 – 548 . Google Scholar Crossref Search ADS PubMed WorldCat 2 American Cancer Society . Global Facts and Figures . 3rd ed. Atlanta : American Cancer Society ; 2015 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 3 Sun L , Yang Y, Vertosick E, Jo S, Sun G, Mao JJ. Do perceived needs affect willingness to use Traditional Chinese Medicine for survivorship care among chinese cancer survivors? A cross-sectional survey . J Global Oncol. 2017 ; in press. OpenURL Placeholder Text WorldCat 4 Nobelprize.org. Youyou Tu - facts. http://www.nobelprize.org/nobel_prizes/medicine/laureates/2015/tu-facts.html Accessed March 1, 2017. 5 Yun H , Sun L, Mao JJ. Growth of integrative medicine at leading cancer centers between 2009 and 2016: A systematic analysis of NCI-designated comprehensive cancer center websites . J Natl Cancer Inst Monogr. 2017 ; 2017 52 : 29 – 32 . Google Scholar Crossref Search ADS WorldCat 6 Trimble EL , Rajaraman P. Integrating traditional and allopathic medicine: An opportunity to improve global health in cancer . J Natl Cancer Inst Monogr. 2017;2017(52):9–10. OpenURL Placeholder Text WorldCat 7 Witt CM , Balneaves LG, Cardoso MJ, et al. A comprehensive definition for integrative oncology . J Natl Cancer Inst Monogr. 2017;2017(52):3–8. OpenURL Placeholder Text WorldCat 8 Ben-Arye E , Samuels N, Daher M, et al. Integrating complementary and traditional practices in Middle-Eastern supportive cancer care . J Natl Cancer Inst Monogr. 2017;2017(52):11–14. OpenURL Placeholder Text WorldCat 9 Ladas EJ , Marjerrison S, Arora B, et al. Traditional and complementary medicine in pediatric oncology and low-middle income countries: Recommendations from the International Society of Pediatric Oncology (SIOP), T&CM Collaborative . J Natl Cancer Inst Monogr. 2017;2017(52):15–18. OpenURL Placeholder Text WorldCat 10 Xu Y , Mao JJ, Sun L, et al. Association between use of Traditional Chinese Medicine herbal therapy and survival outcomes in patients with stage II and III colorectal cancer: A multicenter prospective cohort study . J Natl Cancer Inst Monogr. 2017;2017(52):19–25. OpenURL Placeholder Text WorldCat 11 Zollman C , Walther A, Seers H, Jolliffe R, Polley M. Integrative whole person oncology care in the UK . J Natl Cancer Inst Monogr. 2017;2017(52):26–28. OpenURL Placeholder Text WorldCat 12 Cohen L , Jefferies A. Comprehensive lifestyle change: Harnessing synergy to improve cancer outcomes . J Natl Cancer Inst Monogr. 2017;2017(52):33–36. OpenURL Placeholder Text WorldCat 13 Carlson LE. Distress management through mind-body therapies in oncology . J Natl Cancer Inst Monogr. 2017;2017(52):37–40. OpenURL Placeholder Text WorldCat 14 Brown JC , Ligibel JA. The role of physical activity in oncology care . J Natl Cancer Inst Monogr. 2017;2017(52):41–42. OpenURL Placeholder Text WorldCat 15 Witt CM , Herman PM, Tunis S. Effectiveness research in integrative oncology . J Natl Cancer Inst Monogr. 2017;2017(52):43–45. OpenURL Placeholder Text WorldCat 16 MacLeod J , Wolff E, McAllister A, Mao JJ, Garland SN. Including the patient voice in patient-centered outcomes research in integrative oncology . J Natl Cancer Inst Monogr. 2017;2017(52):46–47. OpenURL Placeholder Text WorldCat 17 Li Z , Shi Q, Jia L, et al. Validation and application of the MD Anderson Symptom Inventory for Traditional Chinese Medicine (MDASI-TCM) . J Natl Cancer Inst Monogr. 2017;2017(52):48–57. OpenURL Placeholder Text WorldCat 18 Jia L , Lin H, Oppenheim J, et al. US National Cancer Institute–China collaborative studies on Chinese medicine and cancer . J Natl Cancer Inst Monogr. 2017;2017(52):58–61. OpenURL Placeholder Text WorldCat 19 Xi D , Bao T, Chen Q, et al. State of the science: Cancer complementary and alternative medicine therapeutics research—NCI strategic workshop highlights of discussion report . J Natl Cancer Inst Monogr. 2017;2017(52):62–67. OpenURL Placeholder Text WorldCat 20 Zia FZ , Olaku O, Bao T, et al. The National Cancer Institute’s Conference on Acupuncture for Symptom Management in Oncology: State of the science, evidence, and research gaps . J Natl Cancer Inst Monogr. 2017;2017(52):68–73. OpenURL Placeholder Text WorldCat © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JNCI Monographs Oxford University Press

Advancing the Global Impact of Integrative Oncology

Mao, Jun, J.
JNCI Monographs , Volume 2017 (52) – Nov 1, 2017
Download PDF
2 pages

Loading next page...
 
/lp/oxford-university-press/advancing-the-global-impact-of-integrative-oncology-G8CS4iAztB

References (34)

Publisher
Oxford University Press
Copyright
© The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
ISSN
1052-6773
eISSN
1745-6614
DOI
10.1093/jncimonographs/lgx001
Publisher site
See Article on Publisher Site

Abstract

Cancer is a global disease. In 2015, there were 17.5 million cancer cases and 8.7 million cancer deaths worldwide (1). By 2020, these numbers are expected to rise to 21.7 million new cases and 13 million deaths (2). With 16% of all deaths due to cancer in 2015, it is the second leading cause of death worldwide, and the past decade has seen a 33% increase in the number of cancer cases globally, due in large part to population aging and growth (1). From Cameroon to England, China to the Middle East, in our wealthiest and poorest countries, cancer is present; it does not discriminate. People throughout the world employ a variety of strategies to cope with the physical, emotional, and spiritual impact of cancer. In recent years, the field of integrative oncology has emerged as a scientific discipline to carefully research and bring together evidence-based complementary/traditional medicine therapies and conventional cancer treatment to address the diverse needs of cancer patients and their families. Many complementary therapies, such as acupuncture, yoga, and natural products originated from regions outside of North America thousands of years ago and are used extensively in their countries of origin today. For example, in China the use of Traditional Chinese Medicine (TCM) herbal therapies in cancer patients exceeds 80% (3). Despite such wide empirical use, rigorous research in this area remains limited. Because of the many barriers in language, culture, regulatory environments, and funding mechanisms, much is “lost in translation.” The clinical wisdom of the East is unknown to the West, while the experimental rigor of the West remains poorly integrated into the research enterprises of the East. However, there are indications that this is changing. In 2015, Professor Youyou Tu in China received the Nobel Prize for her impactful work on the herbal extract artemisinin for malaria (4), inspiring researchers in the field to apply rigorous methods to their research in integrative medicine, and further indicating the rise of this important emerging field. In the United States, the Memorial Sloan Kettering Cancer Center established its Integrative Medicine Service in 1999. Soon, other leaders in cancer care, such as the University of Texas MD Anderson Cancer Center and the Dana-Farber Cancer Center were forming dedicated programs focused on integrating complementary therapies into cancer care. Over the past several years, the presence of integrative medicine at US National Cancer Institute (NCI)–designated cancer centers has increased greatly, with the majority of centers now offering some form of integrative treatment (5). Established in 2003, the Society for Integrative Oncology (SIO) is an international, multidisciplinary, and interprofessional organization that seeks to advance evidence-based, comprehensive, integrative health care to improve the lives of people affected by cancer (www.integrativonc.org). Today, SIO has nearly 500 members representing 21 countries. In this special Journal of the National Cancer Institute monograph, we present a collection of original research and perspective manuscripts to highlight both the challenges and opportunities for advancing the global impact of integrative oncology. On the research path, it is essential to confront the vast global disparities that exist in cancer care and the role that effective integration of allopathic and traditional medicine can play to address these imbalances (6). Recognizing this need, in concert with the steadily increasing growth and impact of our field around the globe, a group of multidisciplinary scholars propose a long-needed definition of “integrative oncology” to give this field a focus and clarity, no matter what language we speak (7). From here, we move to the Middle East, where a group of clinician researchers from five countries are collaborating to advance the practice of integrative oncology (8). We then consider a global overview of the integrative oncology activities in pediatric units of low- and middle-income countries (9); learn about the findings of a prospective cohort study on Chinese colorectal cancer patients and their use of traditional Chinese herbal medicine (10); visit the United Kingdom to learn about “whole person” oncology (11); and appreciate the growth of integrative medicine in leading NCI Comprehensive Cancer Centers in the United States (5). We then turn to specific evidence-based approaches to improve integrative oncology clinical care, including comprehensive lifestyle changes to optimize cancer prevention and outcomes (12); mind-body therapies for managing distress (13); and the role of physical activity along the cancer care continuum (14). To accelerate the pace of evidence generation for patients and health care providers, we highlight important research methods: a new paradigm of comparative effectiveness research to evaluate real-world outcomes (15); the patient perspective to inform design and conduct in patient-centered outcomes research (16); and a report on the development and validation of a patient-reported outcome tool for use with Traditional Chinese Medicine (17). We conclude the monograph with three papers from the NCI, whose vision and leadership paves the way to advance comprehensive cancer care, including integrative oncology via rigorous research. The NCI has established a long-term collaboration with the China Academy of Chinese Medical Sciences for a number of basic natural product research projects, coordinated by the Office of Cancer Complementary and Alternative Medicine (18). Recently, NCI organized two separate workshops and presented white papers on cancer Complementary and Alternative Medicine therapeutics research (19) and oncology acupuncture for symptom management (20). The leading investigators and scholars in the field presented on the state of science, challenges, and opportunities, in addition to making recommendations for advancing rigorous integrative oncology research. With the publication of this special JNCI monograph, we hope to promote global collaborations among researchers, clinicians, funders, patient advocates, and key societal stakeholders. Together, we can accelerate the pace of discovery and translation to enhance the evidence-informed growth of integrative oncology and alleviate suffering from cancer worldwide. Funding Dr. Mao is funded in part by a National Cancer Institute grant to the Memorial Sloan Kettering Cancer Center (grant number P30-CA008748) and by the Laurance S. Rockefeller Fund. References 1 Global Burden of Disease Cancer Collaboration , Fitzmaurice C, Allen C, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: A systematic analysis for the Global Burden of Disease Study . JAMA Oncol. 2017 ; 3 4 : 524 – 548 . Google Scholar Crossref Search ADS PubMed WorldCat 2 American Cancer Society . Global Facts and Figures . 3rd ed. Atlanta : American Cancer Society ; 2015 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 3 Sun L , Yang Y, Vertosick E, Jo S, Sun G, Mao JJ. Do perceived needs affect willingness to use Traditional Chinese Medicine for survivorship care among chinese cancer survivors? A cross-sectional survey . J Global Oncol. 2017 ; in press. OpenURL Placeholder Text WorldCat 4 Nobelprize.org. Youyou Tu - facts. http://www.nobelprize.org/nobel_prizes/medicine/laureates/2015/tu-facts.html Accessed March 1, 2017. 5 Yun H , Sun L, Mao JJ. Growth of integrative medicine at leading cancer centers between 2009 and 2016: A systematic analysis of NCI-designated comprehensive cancer center websites . J Natl Cancer Inst Monogr. 2017 ; 2017 52 : 29 – 32 . Google Scholar Crossref Search ADS WorldCat 6 Trimble EL , Rajaraman P. Integrating traditional and allopathic medicine: An opportunity to improve global health in cancer . J Natl Cancer Inst Monogr. 2017;2017(52):9–10. OpenURL Placeholder Text WorldCat 7 Witt CM , Balneaves LG, Cardoso MJ, et al. A comprehensive definition for integrative oncology . J Natl Cancer Inst Monogr. 2017;2017(52):3–8. OpenURL Placeholder Text WorldCat 8 Ben-Arye E , Samuels N, Daher M, et al. Integrating complementary and traditional practices in Middle-Eastern supportive cancer care . J Natl Cancer Inst Monogr. 2017;2017(52):11–14. OpenURL Placeholder Text WorldCat 9 Ladas EJ , Marjerrison S, Arora B, et al. Traditional and complementary medicine in pediatric oncology and low-middle income countries: Recommendations from the International Society of Pediatric Oncology (SIOP), T&CM Collaborative . J Natl Cancer Inst Monogr. 2017;2017(52):15–18. OpenURL Placeholder Text WorldCat 10 Xu Y , Mao JJ, Sun L, et al. Association between use of Traditional Chinese Medicine herbal therapy and survival outcomes in patients with stage II and III colorectal cancer: A multicenter prospective cohort study . J Natl Cancer Inst Monogr. 2017;2017(52):19–25. OpenURL Placeholder Text WorldCat 11 Zollman C , Walther A, Seers H, Jolliffe R, Polley M. Integrative whole person oncology care in the UK . J Natl Cancer Inst Monogr. 2017;2017(52):26–28. OpenURL Placeholder Text WorldCat 12 Cohen L , Jefferies A. Comprehensive lifestyle change: Harnessing synergy to improve cancer outcomes . J Natl Cancer Inst Monogr. 2017;2017(52):33–36. OpenURL Placeholder Text WorldCat 13 Carlson LE. Distress management through mind-body therapies in oncology . J Natl Cancer Inst Monogr. 2017;2017(52):37–40. OpenURL Placeholder Text WorldCat 14 Brown JC , Ligibel JA. The role of physical activity in oncology care . J Natl Cancer Inst Monogr. 2017;2017(52):41–42. OpenURL Placeholder Text WorldCat 15 Witt CM , Herman PM, Tunis S. Effectiveness research in integrative oncology . J Natl Cancer Inst Monogr. 2017;2017(52):43–45. OpenURL Placeholder Text WorldCat 16 MacLeod J , Wolff E, McAllister A, Mao JJ, Garland SN. Including the patient voice in patient-centered outcomes research in integrative oncology . J Natl Cancer Inst Monogr. 2017;2017(52):46–47. OpenURL Placeholder Text WorldCat 17 Li Z , Shi Q, Jia L, et al. Validation and application of the MD Anderson Symptom Inventory for Traditional Chinese Medicine (MDASI-TCM) . J Natl Cancer Inst Monogr. 2017;2017(52):48–57. OpenURL Placeholder Text WorldCat 18 Jia L , Lin H, Oppenheim J, et al. US National Cancer Institute–China collaborative studies on Chinese medicine and cancer . J Natl Cancer Inst Monogr. 2017;2017(52):58–61. OpenURL Placeholder Text WorldCat 19 Xi D , Bao T, Chen Q, et al. State of the science: Cancer complementary and alternative medicine therapeutics research—NCI strategic workshop highlights of discussion report . J Natl Cancer Inst Monogr. 2017;2017(52):62–67. OpenURL Placeholder Text WorldCat 20 Zia FZ , Olaku O, Bao T, et al. The National Cancer Institute’s Conference on Acupuncture for Symptom Management in Oncology: State of the science, evidence, and research gaps . J Natl Cancer Inst Monogr. 2017;2017(52):68–73. OpenURL Placeholder Text WorldCat © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Journal

JNCI Monographs – Oxford University Press

Published: Nov 1, 2017

There are no references for this article.