Integrative Oncology

Integrative Oncology: Principles and Practice (edited by Mathew P. Mumber; Taylor & Francis, 2005) brings together resources and information for those interested in approaches additional to conventional cancer treatment.

(I just received my copy, having contributed a chapter co-authored with David S. Rosenthal, MD, Medical Director of the Zakim Center for Integrated Therapies at the Dana Farber Cancer Institute, on legal issues in integrative oncology). Having contributed to the book, I know that Dr. Mumber worked exhaustively on the research and editing.

The foreword by James S. Gordon, MD, founder and director of the Center for Mind-Body Medicine, notes that in the mid-1990's, 70% of all queries to the NIH Office of Alternative Medicine were about complementary and alternative medicine (CAM) for cancer. According to Dr. Gordon, Integrative Oncology offers "some of the most progressive and important thinking in the field," including models of integrative care, perspective from alternative healing systems, "clear summaries of research considerations," reviews of the contributions of CAM therapies to palliative care and to dealing with the side-effects of conventional care, and extensive references.

In the Introduction, Dr. Rosenthal describes "integrative oncology" (IO) as the "incorporation of complementary therapies (e.g., acupuncture, meditation, music therapy) with conventional cancer treatment." He discusses issues such as concern for drug-herb intersactions and for other interactions that could interfere with the effectiveness of conventional treatments, as well as other issues "that need to be addressed in order to provide optimal, comprehensive cancer care." He notes that both the oncologist and the patient must be alert to ensure that integartive therapies are providing "preventive and supportive care" and not being relied on as "cures" where conventional care is medically necessary. He also addresses the principles leading to wise treatment decisions in the hospital, ambulatory setting, or group practice, and mentions the new Society for Integrative Oncology as a forum for conversation.

Dr. Mumber later defines integrative oncology as "a comprehensive, evidence-based approach to cancer care that addresses all participants at all levels of their being and experience," and emphasizes four imporant mechanisms:

1. inclusion of all participants at all levels of their being;
2. a renewed focus on the guiding principles of medicine;
3. an expansion of the goals of intervention to include translational and transformational approaches and specific categories of preventive, supportive and antineoplastic care;
4. a focus on variable levels of evidence required for recommendations based upon the goals of a therapy and an individualized risk-benefit analysis.

The book goes on to canvass such matters as clinical research and evidence, physician training in integrative medicine, business assessment, clinical decision analysis, specific CAM modalities (for cancer prevention and supportive care), application to specific malignancies, and palliative and end-of-life care.

Dr. Mumber is a graduate of the University of Arizona Program in Integrative Medicine, working at the Harbin Clinic Radiation Oncology Center in Rome, Georgia.