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Integrative oncology: Addressing the global challenges of cancer prevention and treatment.
Literature Information
| DOI | 10.3322/caac.21706 |
|---|---|
| PMID | 34751943 |
| Journal | CA: a cancer journal for clinicians |
| Impact Factor | 232.4 |
| JCR Quartile | Q1 |
| Publication Year | 2022 |
| Times Cited | 152 |
| Keywords | alternative, and integrative medicine, cancer prevention, complementary, global health |
| Literature Type | Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review |
| ISSN | 0007-9235 |
| Pages | 144-164 |
| Issue | 72(2) |
| Authors | Jun J Mao, Geetha Gopalakrishna Pillai, Carlos Jose Andrade, Jennifer A Ligibel, Partha Basu, Lorenzo Cohen, Ikhlas A Khan, Karen M Mustian, Rammanohar Puthiyedath, Kartar Singh Dhiman, Lixing Lao, Ricardo Ghelman, Paulo Cáceres Guido, Gabriel Lopez, Daniel F Gallego-Perez, Luis Alejandro Salicrup |
TL;DR
This research highlights the challenges faced by low- and middle-income countries (LMICs) in cancer care, where patients often turn to traditional, complementary, and integrative medicine (TCIM) due to its accessibility and cost-effectiveness. The authors advocate for the integration of TCIM with conventional oncology to enhance evidence-based cancer care, improve symptom management, and promote culturally sensitive approaches, ultimately aiming to provide comprehensive and dignified care for cancer patients globally.
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alternative · and integrative medicine · cancer prevention · complementary · global health
Abstract
The increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low- and middle-income countries (LMICs) when it comes to receiving evidence-based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence-based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence-informed, patient-centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment-related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence-based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence-informed, and culturally sensitive cancer care.
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Primary Questions Addressed
- How can integrative oncology specifically address the cultural barriers faced by patients in low- and middle-income countries?
- What are the most effective lifestyle modifications recommended in integrative oncology for cancer prevention and treatment?
- How do mind and body therapies like acupuncture and meditation compare in efficacy to conventional treatments for cancer symptoms?
- What strategies can be employed to educate traditional, complementary, and integrative medicine providers about evidence-based cancer care?
- In what ways can integrative oncology improve the quality of life for cancer survivors in diverse cultural contexts?
Key Findings
Research Background and Objectives
The increasing incidence and mortality of cancer present significant challenges to cancer care delivery worldwide, particularly in low- and middle-income countries (LMICs). Patients in these regions often turn to traditional, complementary, and integrative medicine (TCIM) due to its accessibility and lower costs. This study aims to explore the integration of TCIM with conventional cancer treatments through the lens of integrative oncology, emphasizing the need for evidence-based, patient-centered care that respects cultural practices.
Main Methods/Materials/Experimental Design
The authors conducted a comprehensive review of existing literature on cancer care in LMICs and the role of integrative oncology. The approach involved identifying the barriers to effective cancer treatment and exploring the potential of TCIM to complement conventional methods.
Key Results and Findings
- Challenges Identified: The review highlighted significant barriers in cancer care, including lack of resources, cultural differences, and reliance on non-evidence-based practices.
- TCIM Potential: TCIM has been shown to improve symptom management and quality of life for cancer patients, addressing issues like pain, insomnia, and fatigue.
- Integrative Oncology Framework: The authors propose a cohesive framework that combines conventional and TCIM practices to enhance patient care.
Main Conclusions/Significance/Innovation
Integrative oncology represents a promising approach to cancer care, particularly in LMICs, by:
- Providing a structured method to incorporate TCIM with conventional treatments.
- Promoting culturally sensitive care that respects patients' preferences and beliefs.
- Encouraging the development of evidence-based TCIM interventions to improve patient outcomes and quality of life.
Research Limitations and Future Directions
- Limitations: The review is primarily qualitative and may not capture all quantitative aspects of TCIM efficacy. There is also a lack of standardized protocols for integrating TCIM into conventional cancer care.
- Future Directions:
- Further research is needed to evaluate the effectiveness of specific TCIM interventions in clinical settings.
- Development of training programs for TCIM providers to work collaboratively with conventional healthcare teams.
- Ongoing dissemination of successful TCIM practices to ensure they are culturally relevant and widely adopted in cancer care.
Summary Table
| Aspect | Details |
|---|---|
| Research Focus | Integration of TCIM with conventional cancer treatment in LMICs |
| Key Methods | Literature review, identification of barriers, exploration of TCIM |
| Major Findings | TCIM improves symptom management; significant barriers to care in LMICs |
| Conclusions | Integrative oncology can enhance patient-centered care and cultural sensitivity |
| Limitations | Qualitative focus, lack of standardized protocols |
| Future Directions | Evaluate TCIM efficacy, develop training for providers, disseminate successful practices |
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- Immortal Time Bias-Corrected Effectiveness of Traditional Chinese Medicine in Non-Small Cell Lung Cancer (C-EVID): A Prospective Cohort Study. - Xing Zhang;Qiujun Guo;Conghuang Li;Rui Liu;Tao Xu;Zhichao Jin;Yupeng Xi;Yinggang Qin;Weidong Li;Shuntai Chen;Ling Xu;Lizhu Lin;Kang Shao;Shenyu Wang;Ying Xie;Hong Sun;Ping Li;Xiangyang Chu;Kequn Chai;Qijin Shu;Yanqing Liu;Yue Zhang;Jiaqi Hu;Bolun Shi;Xiwen Zhang;Zhenhua Zhang;Juling Jiang;Shulin He;Jie He;Mingxi Sun;Ying Zhang;Meiying Zhang;Honggang Zheng;Wei Hou;Baojin Hua - Frontiers in oncology (2022)
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