Clinical research in complementary Oncology

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Integrative oncology intends to improve the overall wellbeing of people with cancer. This implies dealing with physical, emotional, mental, social, spiritual, and environmental factors, and demands the coordinated combination of conventional and complementary approaches. Therefore, integrative oncology is not to be confused with alternative medical care: the later intends to be applied in place of conventional medicine, while the former is to be used together with it. Integrative oncology has the potential to directly improve the overall welfare of cancer patients and survivors, and therefore the attention generated by this novel field has increased steadily in the last decade. Interestingly, quality of life improvements can also result in additional indirect benefits, such as decreased dose-reductions of conventional drugs and increased adherence to physician’s recommendations.

Most of the complementary approaches that can be coordinated with conventional oncology fall into two different broad categories: Natural Products (including herbs, mushrooms, vitamins, minerals, or probiotics) and Mind and Body Practices (like yoga, meditation, acupuncture, or osteopathy). Around 50% of patients with cancer in the US reported that they started taking new natural dietary supplements after being given their diagnosis, highlighting the wide spread of complementary health approaches in cancer patients and survivors.

Oncologists are often questioned about the effectiveness and safety of different complementary approaches, but usually lack the clinical evidence needed to provide solid advice. Absence of patient protection for complementary health solutions means that providers cannot afford the high costs associated with the development of clinical studies. Consequently, clinical research on these programs is in its early stages, although some studies have already shown promising results in managing symptoms and side effects of patients receiving conventional cancer treatment. Acupuncture may reduce treatment-related joint pain for breast cancer patients, mindfulness practice can reduce cortisol blunting during chemotherapy, and integrative medicine programs can improve the gastro-intestinal concerns and quality of life in patients with breast and gynecologic cancer, among other examples.

In MedSIR, we believe the generation of scientifically-robust clinical evidence on integrative oncology approaches is an unavoidable necessity, and a field that will experience significant growth in the near future. The design and development of strategic clinical trials in this area, even if they need to be supported by alternative sources of funding, will pave the road for the mainstream implementation of the integrative approaches that demonstrate potential to improve the lives of cancer patients and survivors.

Roldan Cortés, MedSIR.

References:

«Acupuncture May Reduce Joint Pain Caused by Breast Cancer Therapy», National Cancer Institute. [En línea]. Disponible en: https://www.cancer.gov/news-events/cancer-currents-blog/2018/acupuncture-aromatase-inhibitor-joint-pain. [Accedido: 24-abr-2018].
 
D. S. Black, C. Peng, A. G. Sleight, N. Nguyen, H.-J. Lenz, y J. C. Figueiredo, «Mindfulness practice reduces cortisol blunting during chemotherapy: A randomized controlled study of colorectal cancer patients», Cancer, vol. 123, n.o 16, pp. 3088-3096, ago. 2017.
 
M. Domnick, M. Domnick, K.-R. Wiebelitz, y A.-M. Beer, «Evaluation of the Effectiveness of a Multimodal Complementary Medicine Program for Improving the Quality of Life of Cancer Patients during Adjuvant Radiotherapy and/or Chemotherapy or Outpatient Aftercare», OCL, vol. 93, n.o 2, pp. 83-91, 2017.
 
I. Shalom-Sharabi et al., «Effect of a patient-tailored integrative medicine program on gastro-intestinal concerns and quality of life in patients with breast and gynecologic cancer», J Cancer Res Clin Oncol, vol. 143, n.o 7, pp. 1243-1254, jul. 2017.
 
C. J. Paller, S. R. Denmeade, y M. A. Carducci, «Challenges of conducting clinical trials of natural products to combat cancer», Clin Adv Hematol Oncol, vol. 14, n.o 6, pp. 447-455, jun. 2016.

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