Integrative care. It is a patient-centered concept that is changing the way cancer is treated and can serve as a source of hope for some who suffer from cancer-related side effects due to their treatments.
While traditional treatments focus on fighting the disease, side effects and/or existing conditions may be managed with evidence-informed care therapies to help strengthen the body.
For people of faith; however, the words can sometimes feel like a threat to their belief systems.
But integrative care is simply a way of bringing together evidenced-informed therapies to treat people according to their own unique needs.
"The terms integrative medicine, as well as alternative medicine are used synonymously, and they are very different," said Clinical Director of Naturopathic Medicine, Christina Shannon, of Cancer Treatment Centers of America®(CTCA) at Midwestern Regional Medical Center. "An alternative approach refers to exactly that – an alternative to conventional medicine, not utilized with it. An integrative approach uses the best of conventional medicine combined with the best evidence-informed therapies for an integrative approach."
Integrative medicine has two components. On one level, conventional and advanced treatments, such as chemotherapy, surgery and immunotherapy, attack the cancer. At the same time, your care team may recommend an array of supportive care therapies, including nutrition therapy, naturopathic medicine, psychological counseling or chiropractic care, to help you manage the side effects of treatment. Each component is tailored to your individual needs, physically, emotionally and spiritually.
But, what does the data say about how integrative care may help patients in their fight against cancer?
One of the most important benefits of integrative care is feeling better throughout treatment. According to the 2007 National Health Interview Survey (NHIS), which included a comprehensive survey on the use of complementary health approaches by Americans, 65 percent of respondents who had ever been diagnosed with cancer had used complementary approaches, as compared to 53 percent of other respondents. Those who had been diagnosed with cancer were more likely than others to have used complementary approaches for general wellness, immune enhancement, and pain management.
"I should say that research is beginning to really show us that an integrative approach can improve patients’ quality of life," says Shannon. "So patients want to look at lifestyle factors, they want to look at botanical medicine, they want to use therapies they’re not necessarily familiar with, such as naturopathic medicine. But they want guidance, for sure."
Many patients, in fact, underestimate the role pain sometimes plays in the patient experience. Still, patients often are afraid to raise the topic of cancer-related pain with their doctors out of fear that pain management may take away from the direct treatment of the cancer itself.
"Patients need to understand that integrative offerings may be a way to manage their pain on a regular basis," says Dr. Raed Rahman, Medical Director of Pain Management and Interventional Pain Medicine Physician at our Chicago-area hospital. "There should be more than one option for your pain plan, not just strong pain medications, painkillers, and that’s it. Patients should have other options and be thoroughly evaluated."
Additional therapies may include massage therapy, psychiatry, physical therapy, chiropractic, speech therapy and, of course, connecting to faith. A patient’s physical, emotional and spiritual needs will determine the integrated plan designed specifically for them.
The integrative care model is new to many, and new is often intimidating. However, this approach offers hope.
"Many people hear the term, ‘mind-body medicine,’ and think of either something truly intimidating to their faith or something that threatens their relationship with God, and that is not at all what this program is about," said Corliss Ivy, Mind-Body Therapist at our Chicago-area hospital. "It’s another approach to health that centers on mental wellbeing. But at the core, it is about helping people take the best care of themselves as possible while they’re dealing with what could be one of the most stressful experiences of their lives."
Some of the treatment-related challenges patients may encounter include painful side effects, greater stress, malnourishment and worsening of other existing conditions. By not treating a patient as a whole person, they may have unique needs that are being unmet.
For those of us who cling to our faith in times of trouble, an integrative care plan builds spiritual growth into the care model, instead of serving in opposition to our belief system.
It is encouraging to note that some studies suggest the importance of a belief system in healing. Most notably, Dr. Harold Koenig of Duke University has focused much of his study in this area.
"A lot of research* talks about how people just do so much better when their belief system is honored and respected, and when they can practice it," says Rev. Drew Angus, Director of Spiritual Outreach at our Philadelphia hospital. "So supporting that helps people have a much better quality of life."
"The spiritual component is part of the integrative component," says Carolyn Lammersfeld, Vice President of Integrative Medicine at CTCA®. "It all works very closely together. I’ve called a chaplain when I’ve been with a patient and said, ‘Hey, can you come pray with this patient?’ Because right now, that’s more important than talking about nutrition."
Even those of strong faith don’t often think of their belief system being a part of their cancer care, per se. But embracing and putting into action those beliefs can add value to their whole-body wellness.
Not all hospitals and cancer centers offer an integrative treatment model so when undergoing cancer treatment, some patients often put together their own plan. While taking control of their health and their plan is a wonderful and empowering step to take, some missteps may happen along the way that could do more harm than good – so it is important to always seek professional medical guidance.
"Patients want individuals who will help them prevent or manage side effects, maintain their quality of life so they can hopefully continue working or enjoying their family, enjoy their life while they’re having cancer treatment," says Lammersfeld. "So, many individuals, if it’s not available where they’re receiving care, will try to put that team together by themselves, which may create all kinds of concerns. If they’re running to several different offices, and those individuals aren’t communicating, there’s a potential safety concern."
Transparency among all the physicians involved is key to a successful treatment plan. Healthy dialogue and shared information will help to see that patients are getting appropriate care.
"For example," adds Lammersfeld, "if an individual has bone metastases, it may not be safe for them to have a chiropractic adjustment, and so being able to talk with a chiropractor who is also aware of the patient’s cancer is crucial. Taking some supplements may be helpful, but other supplements may be dangerous and interact with medications."
Lammersfeld says even something as simple as a vitamin or a supplement that a patient read about online could diminish or have an adverse effect on a chemotherapy treatment. Keeping an open conversation with all health care providers will help patients protect their health and better manage side effects.
Integrative care offers another world of personalized options to cancer patients as they look for ways to improve treatment and lessen the pain and stress that the battle with cancer brings. By having all this care offered under one roof, patients are given another chance to reduce stress and take some of the onus off themselves, allowing them to focus on what is most important—their healing.
*Additional Research on Spirituality and Health
National Comprehensive Cancer Network (NCCN)
National Cancer Institute (NIH)
University of Maryland Medical Center
A fully ordained minister for more than 20 years, Rev. Percy McCray is a member of the United States Chaplains Association. He has been recognized as one of the "most influential African Americans in Lake County (IL)" by the People's Voice newspaper for his religious and leadership roles within the community. Also recognized as one of the most beloved Pastors of the Chicagoland area by the Defender newspaper.
In addition to his role as Director of Faith-Based Programs at CTCA, Rev. McCray helps lead Our Journey of Hope®, a cancer ministry training and support program.