By Lynda G. Balneaves, RN, PhD
When patients or loved ones receive a cancer diagnosis, they often experience fear, worry, and a desire to do everything possible to increase the chance of survival. It is also a pivotal time for patients to assess their well-being and lifestyle and make positive changes. For many, complementary therapies become part of their cancer care journey. Internationally, 40% of patients with cancer have reported using complementary therapies to address cancer-related symptoms, improve the effectiveness of conventional treatments, and provide hope.
What Is Integrative Oncology?
Complementary therapies are non-mainstream health practices that are used together with conventional medical treatment. In contrast are alternative therapies, which are used in place of conventional medical treatment. Although only 3%–6% of patients report treating their cancer with alternative therapies, it is cause for concern when patients remove themselves from evidence-based treatments to pursue therapies about which little is known.
As the use of complementary therapies has grown, so too has the evidence regarding their safety and efficacy. This has given rise to the field of integrative oncology, what researchers have defined as “a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum.”
Role of Nurses in Integrative Oncology
The number of nurses whose clinical practice is focused on integrative oncology is increasing. Nurses with advanced training are part of interdisciplinary oncology care teams that triage and provide integrative care. Internationally, integrative oncology therapies that nurses may provide include massage, acupressure, and qigong.
At a more fundamental level, nurses play a key role in the assessment and documentation of oncology complementary therapy use. Ensuring that patients’ health records include all of the natural products and other modalities used is essential to the provision of safe and comprehensive care. Because patients may hesitate to disclose complementary therapy use, nurses should approach the topic in a nonjudgemental, patient-centered manner and explain the importance of the healthcare team being aware of all therapies being used for cancer and other health conditions.
Nurses are also a source of evidence-based information and decision support on oncology complementary therapies for patients struggling to make sense of the vast amount of literature available. Both general and oncology-specific integrative healthcare courses offer nurses and other health professionals the education and training required to support patients in making informed treatment decisions about complementary therapies. Nurses interested in integrative oncology have access to other resources, including the American Society of Clinical Oncology-endorsed integrative oncology guidelines for women with breast cancer. See sidebars for a list of specific programs and online resources.
As the field of integrative oncology evolves, new opportunities will emerge for nurses. Not only will they play an integral role in supporting informed treatment decisions and coordinating integrative oncology care plans, but their scope of practice may expand to include evidence-based complementary therapies. Nurse-led integrative oncology education and research programs will provide a valuable foundation for this exciting new frontier in cancer care.