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Integrative medicine

Integrative medicine in oncology is responsible for the mind, state of mind and other needs of the patient during cancer treatment, with the aim of improving their quality of life. Learn more
Integrative medicine

Cancer treatment goes beyond fighting the disease. In parallel with the elimination of cancer cells, it is necessary to take care of the patient’s mind, spirit and the rest of the body. In addition, family members and close friends who are following the good and bad news of the consultations, the chemotherapy and radiotherapy sessions and their possible adverse effects and supporting the recovery from the surgeries need support, precisely to be able to move forward on this journey.

This is where integrative medicine in oncology comes in. This practice comprehensively addresses patient care, through the proposal to include complementary therapies to the traditional therapies used against cancer, such as surgery, chemotherapy and radiotherapy, among others. The purpose of integrative oncology is to optimize quality of life, mitigating the physical and emotional effects that may involve this period of the patient’s life and those around them.

All possibilities of complementary therapies are considered in integrative medicine, including those put into practice by professionals who are not doctors. Here, the multidisciplinary team that is so much talked about when it comes to cancer treatment gains a new dimension, with the integration of physical educators, holistic therapists, specialists in the human body and even artists.

Importance of integrative medicine during cancer treatment

There are many benefits of integrative medicine during cancer treatment. Among them, the following stand out:

  • Helps to alleviate the physical adverse effects of chemotherapy and radiotherapy, such as nausea, pain and fatigue;
  • Helps to alleviate the emotional exhaustion caused by cancer treatment, such as the symptoms of anxiety and depression that may manifest after the diagnosis;
  • Helps to regulate the patient’s sleep pattern, which may be modified both by the action of medications and treatments and by the emotional factor;
  • Gives the patient tools to build a self-healing capacity that he may not even know he has;
  • Allows the patient to look inside himself and see the many nuances of the cancer treatment he is undergoing; and
  • Provides quality of life in advanced and incurable cancer cases.

What integrative medicine includes in the routine during cancer treatment

There are many modalities of complementary therapies to cancer treatment. The important thing when choosing them is to respect the moment of the patient and their companions, in addition to taking into account their physical aptitudes. The aim is to build up the quality of life and the comfort of the cancer patient.

Although healing is not the goal of adopting integrative medicine, some of the activities can impact on a lower risk of cancer recurrence, especially those that include physical exercise and positive changes in daily eating habits.

Learn about the main modalities of integrative medicine in oncology below:

Meditative techniques – Allows cancer patients to look within and better perceive their body and health, understand and welcome their anxieties. The following are the most important techniques are:

Mindfulness – is a state in which qualities of attention to the present moment and self-compassion are trained through challenging experiences. Although not a practice related to religious beliefs, it is based on the fundamental principles of Buddhist meditations: Paying attention intentionally, being in the present moment and not judging. Studies on the impact of a stress reduction program using the Mindfulness-Based Stress Reduction (MBSR) method, applied for eight weeks in cancer patients, revealed a decrease in sleep disturbances and a significant decrease in stress, mood disorders, fatigue and conditions such as pain, stress, anxiety, depression and eating disorders. Through mindfulness training, we begin to perceive thoughts, bodily sensations and emotions as they occur, without reacting automatically or habitually. With this, we learn to make more conscious, practical choices and to deal positively with everyday challenges. The programs help patients with anxiety, depression, chronic illness and pain, excessive tiredness and lack of purpose. The professional responsible for running the program is usually a psychologist, but people with a variety of other backgrounds can specialize in mindfulness and perform this role; and

Yoga – physical, mental and spiritual practice that originated in India and whose name means “to unite”, symbolizing the union of the body and consciousness. It combines meditation and stretching (and, if possible, strength exercises) movements, improving breathing, concentration and muscle tone. The UN (United Nations) recognizes yoga as an effective tool to deal with stress and uncertainty and to maintain physical well-being, and the WHO (World Health Organization) mentions in its “Global Action Plan on Physical Activity 2018-2030” yoga as a means of improving health. It is usually guided by a physical educator or physical therapist.

Energetic practices – They serve to reorganize physical and, mainly, emotional energies, in addition to providing a body self-perception and relief from pain and discomfort caused by cancer treatment. The following are the main ones:

• Tai chi chuan – Chinese martial art in which simple, low-speed movements are performed with the aim of improving physical and mental health. It does not require special preparation and can be performed anywhere. With breathing techniques and the need for attention to movements, it balances pressure and blood circulation, reduces stress, increases energy and the ability to concentrate, as well as stretches muscles, improves flexibility and balance. Your instructor should be a physical educator or physical therapist;

Reiki – a technique of Japanese origin that works physical, emotional, mental and spiritual energy through the gentle touch of the hands. Its main benefits are relaxation and relief from symptoms such as stress, anxiety, insomnia, nausea, pain and fatigue. It must be performed by a therapist specialized in the technique;

Acupuncture – Traditional Chinese medicine technique that works the balance of vital energy in all 12 meridians of the human body. It has analgesic and anti-inflammatory action and, in oncology, helps to relieve pain, symptoms of depression and anxiety and adverse reactions to conventional treatments, such as nausea and fatigue. It must be performed by a professional with specific training in acupuncture; and

Shiatsu – ancient massage, of oriental origin, recognized as a therapy for over 70 years in Japan. The technique is performed by placing light pressure on the entire body, stimulating and sedating specific points, according to the patient’s needs. It works stress, muscle aches, headaches, weaknesses and the digestive and circulatory systems. It must be performed by a professional specialized in the modality.

Artistic techniques – For patients who have an affinity for the arts, two techniques can be integrated into cancer treatment to work with emotions and energies. They are the following:

Music Therapy – technique that uses the elements of music (sound, rhythm, melody and harmony) and movements to open channels of communication and produce therapeutic, prophylactic and rehabilitation effects in patients, helping them to restore their functions and achieve a better integration between body and mind. It must be performed by a music therapist – there are university courses open to all professionals, and those who normally adhere to it are pedagogues, psychologists and musicians; and

Art therapy – psychology technique that works with the exploration, expression and communication of aspects that the patient does not consciously express, giving the specialist tools to assist in the search for emotional and social well-being during cancer treatment. Painting, clay art, collage, dance and performing arts are some of the modalities that can be used – they are chosen according to the individual’s profile. It must be performed by a psychologist.

Sensory techniques – The senses are worked in search of relaxation, relief from symptoms of stress, anxiety, nausea, insomnia and the patient’s physical and mental balance. The most common modalities are the following:

Aromatherapy – as the name suggests, it uses the aroma of essential oils to minimize pain and stress, improve mood and, in the specific case of cancer patients, alleviate adverse effects of chemotherapy and radiotherapy, such as nausea, loss of appetite and vomiting. The oils can be used directly on the body, through massages, or in the environment, in diffusers. It must be guided by an aromatherapist with specific training in the technique, who will choose essential oils according to the characteristics and needs of each individual; and

Chromotherapy – uses colors to help the body in the search for health restoration. Red, orange, yellow, green, blue, indigo and violet are used in light frequencies to stimulate the organism. It can be applied at the time of chemotherapy and radiotherapy sessions and must be controlled by a professional specialized in the technique.

Chiropractic – WHO-recognized healthcare technique dedicated to the diagnosis, treatment and prevention of neuro-musculoskeletal system problems (joints, muscles, tendons, bones, nerves and other structures). Manual techniques are used to adjust these problems, decrease pain, and reduce the risk of injury.

Chiropractic helps the cancer patient to maintain control of their movements and feel less pain resulting from drug treatment and should be performed by a chiropractor with higher chiropractic education.

Osteopathy – According to the WHO, osteopathy is a diagnostic and therapeutic method that uses manual contact to achieve the structural and functional integrity of the organism with the relationship between body, mind and spirit, in health and in disease, assisting in the intrinsic tendency of the body to find its own cure. It must be performed by a health professional with higher specialization in Osteopathy, according to the guidelines of the AOB (Brazilian Association of Osteopaths) and the Federal Council of Physiotherapy and Occupational Therapy.

Which doctors should advise on integrative medicine during cancer treatment

The multidisciplinary team led by the clinical oncologist has all the necessary elements to indicate which therapies can be part of the integrative medicine program of that patient and their regular companions (be they family or close friends).

This is because these professionals, due to their daily routine, understand the context of the treatment in a comprehensive way and understand which practices can benefit the patient and their companions the most.

Ideally, integrative medicine therapies should be offered in the clinical unit where the oncological treatment is being carried out, but in some cases there may be referral to external referenced services.

It is essential to clarify that none of this is a mandatory part of the treatment. The patient and the people around him are heard and, through dialogue, a consensus is reached on the best complementary strategies to be incorporated in the care of that individual and his support network (family/friends). Technical support comes from the team, but the patient is the protagonist of their treatment.

Dr. Luciana Landeiro, coordinator of the Research Center and clinical oncologist at the Bahia Oncology Center (NOB)/Oncoclínicas Group.