A systematic review of integrative oncology programs

Abstract

Objective: This systematic review set out to summarize the research literature describing integrative oncology programs.

Methods: Searches were conducted of 9 electronic databases, relevant journals (hand searched), and conference abstracts, and experts were contacted. Two investigators independently screened titles and abstracts for reports describing examples of programs that combine complementary and conventional cancer care. English-, French-, and German-language articles were included, with no date restriction. From the articles located, descriptive data were extracted according to 6 concepts: description of article, description of clinic, components of care, administrative structure, process of care, and measurable outcomes used.

Results: Of the 29 programs included, most were situated in the United States (n = 12, 41%) and England (n = 10, 34%). More than half (n = 16, 55%) operate within a hospital, and 7 (24%) are community-based. Clients come through patient self-referral (n = 15, 52%) and by referral from conventional health care providers (n = 9, 31%) and from cancer agencies (n = 7, 24%). In 12 programs (41%), conventional care is provided onsite; 7 programs (24%) collaborate with conventional centres to provide integrative care. Programs are supported financially through donations (n = 10, 34%), cancer agencies or hospitals (n = 7, 24%), private foundations (n = 6, 21%), and public funds (n = 3, 10%). Nearly two thirds of the programs maintain a research (n = 18, 62%) or evaluation (n = 15, 52%) program.

Conclusions: The research literature documents a growing number of integrative oncology programs. These programs share a common vision to provide whole-person, patient-centred care, but each program is unique in terms of its structure and operational model.

Keywords: Complementary medicine; cancer; health systems; integrative medicine; integrative oncology; oncology; systematic review.

FIGURE 1

prisma diagram of article flow throughout the systematic review

Figure 2

Complementary therapies offered within integrative oncology programs. Other therapies offered within 2 or fewer programs, and not represented in this figure, include dance therapy, herbal medicine, integrative medicine consultations, life coaching, relationship counselling, naturopathic medicine, Pilates, biofeedback, sound therapy, machine therapy, chiropractic, electrochemical therapies, enemas, healing garden, hyperthermia, orthobionomy, physiotherapy, quartz crystal bowls, Tibetan bowls, special baths, and Traditional Chinese Medicine.

Figure 3

Components of care and organizational structure within integrative oncology programs. nr = not reported.