By BETH RUDLOFF, MedSpeaks
Integrative Medicine is a popular term in healthcare today, but what does it really mean for cancer care? I spent some time with Diane Robinson, PhD, who runs the Integrative Medicine Department at the Orlando Health UF Health Cancer Center to discuss her thoughts on this important trend.
"Integrative Medicine to me means integrating an individual patient's care, anything and everything that will help them get better. Being integrative means you look at all aspects; it is truly the interaction of their goals and the goals of the medical team. It's not just about what the doctor thinks, but what the patient thinks as well." Why is this revolutionizing cancer care? Because Integrative Medicine techniques are shown to improve survival and lessen side effects of treatment. The National Cancer Institute even has an Office of Cancer Complementary and Alternative Medicine that provides information to practitioners as well as patients and caregivers.
It's not necessarily that we don't know what to do to be healthy (reduce stress, eat healthy, exercise, etc.), it is that we don't know how to incorporate health into our daily lives. Western medicine and its breakthroughs have brought us cures, but there remains management of symptoms and chronic conditions and those things modern medicine cannot do that have us looking for other solutions. Also, there is the aspect of continued compliance with healthy practices where integrative medicine shows promise. This is where Dr. Robinson is revolutionizing cancer care, as she is a critical part of the team at Orlando Health UF Health Cancer Center and involved in bringing these integrative services right into the traditional medical care facility. Dr. Robinson opened one of the first facility based Cancer Support Committees in 2014.
"We are doing our patients a disservice when we are not understanding the obstacles for them to get healthy and sometimes it can be unlikely things. If someone is not taking their medication because they need to pay for childcare, can we find a way to get them help for childcare? That to me is integrative medicine because you are reducing the stress that is getting in the way of getting them healthy or getting in the way of their treatment," says Robinson.
How did Dr. Robinson get involved in Integrative Medicine? "As a neuropsychologist, one of the prime topic areas that I was very fascinated about was psycho-neuro endocrinology and immunology. In those fields, we are looking at how people are psychologically impacted in the function of some major symptoms in the body. So, I can tell you that the more stressed you are, the more it affects the hypothalamic adrenal axis as well as cortisol and adrenaline and other neuro-hormonal catalysts through the system... I understood by what I was doing in my own research that how we think impacts our health down to the level where it changes functions in the brain. For example, my dissertation looked at how stress can impact cognitive aging...and that lead me to how stress can impact the immune function. My work at the VA looked at how veterans could cope with stress to have a better life. So as a neuropsychologist I was looking at ways to reach these veterans - I was sending them to go fishing, teaching them how to meditate, and then the opportunity came up to work with Orlando Health and it was too interesting to turn it down."
Interest in Integrative Medicine is growing; research continues to build supporting certain integrative strategies, development of integrative medicine solutions through the internet, smartphones, and apps opens access to these solutions and the lines between eastern and western medicine continue to blur.
How is this interest in integrative medicine being influenced by technology? Technology is opening up access for patients to integrative health concepts with apps being developed for certain techniques like mindfulness meditation, yoga, and nutrition. Is there a downside to the combination of technology and integrative medicine?
"My main concern (with) technology (is that) we are getting a huge amount of folks that will go online and will say 'here is a new integrative approach,' maybe under the title of alternative medicine. Because people aren't educated on good research and understand good research, they can get misled. People will sell all kinds of things under the integrative medicine umbrella that really aren't valid and are frankly quackery," said Robinson. In other words, not much integration of different techniques or solutions, not much in discussing what is empirically proven, very little linkage with western medicine and a great deal of advertising.
In contrast, a website that is widely used in the medical community is the Memorial-Sloan Kettering's "About Herbs." This website and app was developed by a pharmacist and botanical expert to assist patients in making an informed choice about the benefits of herbs as well as interactions and contraindications. For example, if you were interested in turmeric, you would be able to see its purported uses, how it works (or doesn't according to research studies), patient warnings, interactions and side effects. It is comprehensive, unbiased, clinically research-based, easy to use, and combined with traditional medical care. You can also download their app to take the information anywhere.
"It's important to work with the institutes...to get the research into the hands of the public. There is so much great research, but it takes 20-30 years to get into actual practice. Technology has the chance to make those statistics so much better."
Dr. Robinson is partnering with the physicians at Orlando Health UF Health Cancer Center to develop the research and the tools around integrative medicine in cancer care. For example, she has developed a cognitive-based training program for insomnia and wants to demonstrate its efficacy in cancer patients.
Some other ideas that come to mind:
- A search of symptoms and pressure points that can benefit from acupuncture.
- Restorative yoga poses that benefit specific symptoms for patients undergoing chemotherapy.
- A symptom list for a chronic disease with a listing of multiple and complementary integrative medicine approaches and how they may interact or support western approaches such as drugs or surgery
- A diary app to go with an integrative medicine instructional program to encourage but also to track and monitor its effects so that a patient can monitor whether the approach is beneficial or not.
Successful technology for integrative medicine needs to have the following:
- be specific for a targeted population,
- clinically sound and research based interventions,
- incorporate and acknowledge traditional medicine,
- accessibility with easy to understand information and instruction,
- embedded motivational theory/change management tools,
- tracking for compliance as well as monitoring results.
We need more of this technology to bridge complementary medicine and traditional medicine in order to revolutionize cancer care. This is innovation that can save lives and improve the lives of survivors.
Reprinted with permission from MedSpeaks.com