Integrative Oncology: A Holistic Approach To Cancer Care
Brian D. Lawenda, M.D.

Integrative oncology is a personalized and holistic approach to cancer care that takes into account each individual’s unique circumstances to customize treatment programs. It combines the appropriate conventional cancer treatments (for example: surgery, radiation, chemotherapy), complementary therapies (for example: acupuncture, massage, meditation) and behavioral/lifestyle education to help patients improve their quality of life (psychological, spiritual and physical), cancer outcomes and overall health. 
Integrative oncology is no longer an “alternative” approach to cancer care.  Increasingly, prestigious academic cancer centers (for example: Harvard, Memorial Sloan Kettering, MD Anderson, Duke, UCSF) are incorporating integrative oncology within their practice of taking care of patients living with and beyond cancer.
As an integrative oncologist, I commonly see patients who are interested in learning about what “other” things they can do to improve their chances of beating cancer.  The first thing I always clarify about integrative oncology is that it is not about treating cancer with complementary or alternative therapies (also known as “CAM” therapies.) In fact, it is about using various CAM therapies (such as: acupuncture, massage, yoga, natural botanical remedies, etc.) and recommending specific behavior and lifestyle changes to help our patients more comfortably tolerate the side effects of conventional treatment and the symptoms of the cancer itself. Integrative oncology recognizes the fact that when our patients are able to receive the entire prescribed course of cancer treatment they will achieve the best results.
During an integrative oncology encounter, in addition to the traditional medical history and physical, many other subjects are addressed that are very important to the holistic (whole) approach to cancer care. I spend time reviewing my patient’s diet, physical activity and psychological stress. These factors have been implicated in the development and progression of many cancers. Recent studies have suggested that when these lifestyle factors are optimized, significant improvements in outcomes have been reported (such as: improved survival, decreased risk of cancer recurrence, reduced symptoms and side effects.)
Optimizing nutrition and diet is a key component in integrative oncology, and is one of the many topics discussed during these encounters.  Increasingly, studies suggest that by eating a diet rich in foods containing a variety of natural anticancer compounds, as well as limiting consumption of specific types of fats and carbohydrates, an individual is creating an environment within their body that is not conducive to cancer development and growth.
There are literally thousands of natural compounds that have been discovered in various plants and other foods that, when taken for prolonged periods of time, may reduce the risk of cancer development and progression. Many of these natural products function in a similar manner as commonly prescribed drugs, and yet have a significantly lower risk of side effects. Consuming these substances as part of a whole foods diet is the most favorable way of obtaining their beneficial effects. **It is very important to inform your oncologist and surgeons about any vitamins or supplements you are taking, as these may alter the effectiveness of certain treatments, increase their toxicity or lead to complications (such as bleeding.)
Another key component of integrative oncology is stress reduction.  It is quite common to come down with a cold shortly after periods of high stress. Scientists believe that this is likely a result of naturally occurring stress hormones (like cortisol and epinephrine) causing a decrease in the strength of the immune system. Substantial evidence suggests that exposure to long periods of stress increases rates of cancer development and growth. A recent study reported that a group of breast cancer survivors who were taught stress reduction techniques had a lower risk of cancer recurrence and improved survival compared to survivors who did not receive this teaching.
Regardless of whether stress reduction techniques are able to improve cancer outcomes, there is no doubt that they can greatly improve quality of life. Stress reduction techniques can involve any of variety of effective options, such as massage therapy, meditation, guided imagery, yoga, cognitive based therapies, prayer, walking on the beach, and many others.
Following a diagnosis of cancer, it is not uncommon for patients to reduce their level of physical activity as a result of fatigue, discomfort or other side effects of treatment.  Unfortunately, decreasing physical activity may actually increase the risk of cancer recurrence or growth.  Physical activity has many positive effects on the mind and body (such as: a reduction in tumor growth factors, estrogen and free radical production; increases in immune function, improvements in sleep and fatigue, and reduction in anxiety and depression.)
If you choose to work with a fitness instructor or physical therapist, be sure to select one who is experienced in working with cancer patients. There are many forms of physical activity that can have great beneficial effects for individuals living with and beyond cancer (such as: yoga, tai chi, walking.) **It is important to discuss any changes in physical activity and exercise with your oncologist.
The integration of various CAM therapies, whole health systems (such as: traditional Chinese medicine and Ayurvedic medicine), conventional cancer treatments and behavioral/lifestyle changes is the realm of integrative oncology. Navigating the waters of this complex array of options can be confusing.  A visit to an integrative oncologist may be a helpful way to start this journey.
Brian D. Lawenda, M.D. graduated from Temple University School of Medicine and is a former resident at Harvard Medical School. Dr. Lawenda is experienced with the integration of complementary and alternative approaches to cancer treatment. He currently practices at Oncology Therapies of Vista. For further information, please call 760-599-9545.