Guidance for establishing an integrative oncology service in the Australian healthcare setting—a discussion paper
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There is an obvious mismatch between the high reported rates of use of traditional and complementary medicines (T&CM) by Australian cancer patients and cancer survivors and the low numbers of Australian cancer services integrating T&CM. An estimated 65% of Australian cancer patients use at least one form of T&CM. Over half use T&CM in conjunction with conventional cancer therapy. Yet, less than 20% of Australian hospital cancer care facilities provide access to T&CM. This compares to around 70% of UK cancer care facilities offering at least one T&CM therapy. Barriers to developing integrative oncology services include determining an appropriate service model and revenue structure; concerns with ethical and legal issues such as regulations and credentialing; and inadequate high-quality scientific evidence demonstrating safety and effectiveness, including concerns about the possibility of adversely affecting chemotherapy or radiotherapy treatment. This paper aims to provide general guidance and practical strategies for those seeking to develop integrative oncology services in Australian cancer care facilities.
KeywordsIntegrative oncology Cancer care facilities Australian hospitals Complementary medicine Integrative medicine
The authors would like to thank the assistance provided by the centres mentioned in this paper.
Compliance with ethical standards
The authors have full control over the data used in preparing this manuscript and agree to the journal reviewing the data if required.
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Horneber M, Bueschel G, Dennert G, Less D, Ritter E, Zwahlen M (2012) How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis. Integr Cancer Ther 11(3):187–203Google Scholar
- 3.Parliament of Australia Senate Community Affairs References Committee (2005) The cancer journey: informing choice. Commonwealth of Australia, CanberraGoogle Scholar
- 10.NCCAM (2001) Can alternative medicine be integrated into mainstream care. UK, LondonGoogle Scholar
- 11.Cohen MH, Hrbek A, Davis RB, Schachter SC, Kemper KJ, Boyer EW et al (2005) Emerging credentialing practices, malpractice liability policies, and guidelines governing complementary and alternative medical practices and dietary supplement recommendations: a descriptive study of 19 integrative health care centers in the United States. Arch Intern Med 165(3):289–296CrossRefPubMedGoogle Scholar
- 13.NHS (2015) Enhanced supportive care: integrating supportive care in oncology. Gateways, UK. https://www.england.nhs.uk/wp-content/uploads/2016/03/ca1-enhncd-supprtv-care-guid.pdf
- 15.Greenlee H, DuPont-Reyes MJ, Balneaves LG, Carlson LE, Cohen MR, Deng G, et al. (2017). Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA: A Cancer Journal for CliniciansGoogle Scholar
- 20.Olver I, Robotin M (2012) Perspectives on complementary and alternative medicines. Imperial College Press, LondonGoogle Scholar
- 21.CATAG (2013) Rethinking medicines decision-making in Australian hospitals: guiding principles for the quality use of off-label medicines. Council of Australian Therapeutic Advisory Groups, AustraliaGoogle Scholar
- 23.Scott C (2012) The Dr Dorothea Sandars and Irene Lee Churchill Fellowship to study the integration of complementary and supportive therapies with conventional medical care for people with cancer—USA, UKGoogle Scholar
- 25.Weir M (2011) Law and ethics in complementary medicine: a handbook for practitioners in Australia and New Zealand. Allen and Unwin, AustraliaGoogle Scholar
- 34.WHO (2003) WHO guidelines. World Health Organisation, GenevaGoogle Scholar
- 38.Herman PM, Poindexter BL, Witt CM, Eisenberg DM (2012) Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations. BMJ Open 2(5). https://doi.org/10.1136/bmjopen-2012-001046
- 40.Johnson JR, Crespin DJ, Griffin KH, Finch MD, Dusek JA (2014) Effects of integrative medicine on pain and anxiety among oncology inpatients. J Natl Cancer Inst Monogr 50(330):e337Google Scholar
- 42.Sagar SM (2008) How do we evaluate outcome in an integrative oncology program? Curr Oncol (Toronto, Ont) 15(Suppl 2):s78–s82Google Scholar
- 43.Vohra S, Cvijovic K, Boon H, Foster BC, Jaeger W, LeGatt D et al (2012) Study of Natural Health Product Adverse Reactions (SONAR): active surveillance of adverse events following concurrent natural health product and prescription drug use in community pharmacies. PLoS One 7(9):e45196CrossRefPubMedPubMedCentralGoogle Scholar
- 44.Haroon M, Ranmal R, McElroy H, Dudley J (2015) Developing clinical guidelines: how much rigour is required? Arch Dis Child Educ Pract Ed 100(2):89–96Google Scholar
- 47.Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, Rogak L, Bennett AV, Dueck AC, Atkinson TM (2015) Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol 34(6):557–565Google Scholar
- 49.Witt CM, Ausserer O, Baier S, Heidegger H, Icke K, Mayr O et al (2015) Effectiveness of an additional individualized multi-component complementary medicine treatment on health-related quality of life in breast cancer patients: a pragmatic randomized trial. Breast Cancer Res Treat 149(2):449–460CrossRefPubMedGoogle Scholar
- 55.Polley M, Frenkel M, Balneaves L, Zollman C, Seely D, Abrams D, et al. Developing guidelines for the collection of patient outcomes data in clinical integrative oncology settings. Abstract 60. Presented November 15, 2015. SIO 12th International Conference; 15 November; Boston, USA2015Google Scholar
- 56.Girgs A, Delaney G, Miller A (2015) Utilising eHealth to support survivorship care. Cancer Forum 39(2):86–89Google Scholar
- 57.Lim E, Vardy JL, Oh B, Dhillon HM (2017) Integration of complementary and alternative medicine into cancer-specific supportive care programs in Australia: a scoping study. Asia Pac J Clin Oncol 13(1):6–12Google Scholar