Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Integrative oncology — strong science is needed for better patient care

Nature Reviews Cancer volume 15, page 165 (2015)Cite this article

Subjects

Access through your institution
Buy or subscribe

We read David Gorski's Opinion article on integrative oncology (Integrative oncology: really the best of both worlds? Nature Rev. Cancer 14, 692–700 (2014)1 with both interest and dismay. We firmly agree with Gorski that all forms of medical practice should be based on evidence supporting safety and efficacy. In addition, we concur that the field of integrative oncology encompasses a wide range of therapeutic approaches that vary in their level of evidence. However, we are concerned that Gorski's article selectively focuses on practices with the weakest mechanistic evidence base (for example, homeopathy and reiki) and, by doing so, ignores the current body of evidence that demonstrates where integrative oncology can be the most useful.

In oncology, integrative therapies are often used and tested in conditions that are not well-controlled by conventional approaches (for example, fatigue, pain and anxiety). Poor control of cancer symptoms and side effects of treatment are associated with non-adherence or discontinuation of standard oncology treatments2,3,4, which can decrease cancer survival5. Patients and clinicians need clear guidance on which integrative approaches can be useful to manage and control cancer-related symptoms.

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Gorski, D. Integrative oncology: really the best of both worlds? Nature Rev. Cancer 14, 692–700 (2014).

    Article  CAS  Google Scholar 

  2. Kidwell, K. M. et al. Patient-reported symptoms and discontinuation of adjuvant aromatase inhibitor therapy. Cancer 120, 2403–2411 (2014).

    Article  Google Scholar 

  3. Walker, M. S. et al. Early treatment discontinuation and switching in first-line metastatic breast cancer: the role of patient-reported symptom burden. Breast Cancer Res. Treat. 144, 673–681 (2014).

    Article  CAS  Google Scholar 

  4. Chim, K. et al. Joint pain severity predicts premature discontinuation of aromatase inhibitors in breast cancer survivors. BMC Cancer 13, 401 (2013).

    Article  Google Scholar 

  5. Hershman, D. L. et al. Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer. Breast Cancer Res. Treat. 126, 529–537 (2011).

    Article  CAS  Google Scholar 

  6. Greenlee, H. et al. Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J. Natl Cancer Inst. Monogr. 50, 346–358 (2014).

    Article  Google Scholar 

  7. Institute of Medicine.Clinical Practice Guidelines We Can Trust (The National Academies Press, 2011).

  8. Grade definitions. U.S. Preventive Services Task Force [online], (2014).

  9. Mao, J. J. et al. Complementary and alternative medicine use among cancer survivors: a population-based study. J. Cancer Surviv. 5, 8–17 (2011).

    Article  Google Scholar 

  10. John, G. et al. Costs associated with complementary and alternative medicine use among cancer survivors in the United States: results from the 2012 National Health Interview Survey. J. Altern. Complement. Med. 20, A4 (2014).

    Article  Google Scholar 

Download references

Author information

Author notes

  1. Heather Greenlee, Suzanna M. Zick, David Rosenthal, Lorenzo Cohen, Barrie Cassileth and Debu Tripathy: H.G. is the Immediate Past President of the Society for Integrative Oncology, S.Z. currently serves as the President, and all other authors are Past Presidents of the Society.

Authors and Affiliations

  1. Heather Greenlee is at the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.,

    Heather Greenlee

  2. Department of Family Medicine, University of Michigan, Ann Arbor, 48109, Michigan, USA

    Suzanna M. Zick

  3. Harvard Medical School and the Dana-Farber Cancer Institute, Boston, 02115, Massachusetts, USA

    David Rosenthal

  4. Departments of General Oncology and Behavioural Science, University of Texas MD Anderson Cancer Center, Houston, 77030, Texas, USA

    Lorenzo Cohen

  5. Memorial Sloan Kettering Cancer Center, New York, 10021, New York, USA

    Barrie Cassileth

  6. Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, 77030, Texas, USA

    Debu Tripathy

Authors
  1. Heather Greenlee
    View author publications

    Search author on:PubMed Google Scholar

  2. Suzanna M. Zick
    View author publications

    Search author on:PubMed Google Scholar

  3. David Rosenthal
    View author publications

    Search author on:PubMed Google Scholar

  4. Lorenzo Cohen
    View author publications

    Search author on:PubMed Google Scholar

  5. Barrie Cassileth
    View author publications

    Search author on:PubMed Google Scholar

  6. Debu Tripathy
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Heather Greenlee.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Greenlee, H., Zick, S., Rosenthal, D. et al. Integrative oncology — strong science is needed for better patient care. Nat Rev Cancer 15, 165 (2015). https://doi.org/10.1038/nrc3822-c1

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/nrc3822-c1

This article is cited by

Search

Advanced search

Quick links

Nature Briefing: Cancer

Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.

Get what matters in cancer research, free to your inbox weekly. Sign up for Nature Briefing: Cancer