Risk Management & Treatment

Palliative care and integrative medicine

Palliative care is an area of medicine focused on quality of life issues for patients and their families facing life-threatening illness. Integrative medicine is a combination of traditional medicine and complementary medicine to treat the whole person; mind, body and spirit. 

Palliative care

Palliative care specialists address a broad range of issues, including: 

  • support for family members and caregivers
  • pain and symptom management
  • nutritional support
  • emotional distress
  • financial issues
  • end of life issues

Although palliative care may address end of life issues for patients with serious illness, it is different from hospice care. Palliative care is available at any stage of a serious illness, including during active treatment. Hospice refers to a special type of palliative care to maintaining comfort in people towards the end of their lives. People with serious illness are often referred to hospice care if they have decided to discontinue active treatment, and they are expected to six months or less. 

The National Comprehensive Cancer Network (NCCN) has guidelines for palliative care, which includes: 

  • All cancer patients should be screened for palliative care needs at their initial visit, at appropriate intervals, and as clinically indicated. 
  • Patients/families/caregivers should be informed that palliative care is an integral part of their comprehensive cancer care. 
  • Palliative care specialists should be readily available to provide consultation or direct care to patients/families/caregivers and/or health care professionals who request or require their expertise. 

The American Society of Clinical Oncologists (ASCO) recommends that all patients with advanced cancer receive a palliative care plan within eight weeks of their diagnosis. Other recommendations include: 

  • Patients with advanced cancer should receive dedicated palliative care services early in the disease course and while undergoing treatment. 
  • Providers may refer caregivers of patients with early or advanced cancer to palliative care services. 

Integrative medicine 

Integrative medicine is a combination of traditional medicine and complementary medicine to treat the whole person; mind, body and spirit. The National Center for Complementary and Integrative Health (NCCIH) is a branch of the National Institutes of Health. They advise that people learn about the benefits, risks and scientific evidence before pursuing any complementary or integrative product or practice. This is particularly important for people who are thinking about taking supplements that have not been prescribed by their doctor. 

The NCCN has guidelines on the use of dietary supplements:

  • Taking dietary supplements is not recommended for most cancer survivors unless a patient has a known nutritional deficit, an inadequate diet or other indication (for example, osteoporosis).
  • Little data exist to support the use of vitamins or other dietary supplements for the purposes of cancer control, recurrence or prevention.
  • Taking vitamin supplements does not replace the need for a healthy diet. Patients should try to get nutrients from the foods they eat and the beverages they drink.
  • People should tell their doctors about any supplements that they are taking. 

The Society for Integrative Oncology (SIO) guidelines recommend the following evidence-based guidelines for integrative therapies:

  • Music therapy, meditation, stress management, and yoga for anxiety/stress reduction.
  • Meditation, relaxation, yoga, massage and music therapy for depression/mood disorders.
  • Meditation and yoga to improve overall quality of life.
  • Acupressure and acupuncture for reducing chemotherapy-induced nausea and vomiting.
finding-experts

Most hospitals and cancer centers offer palliative care as part of their patient services. Some centers also offer integrative care. It's important to share any symptoms, distress or other physical or emotional concerns with your health care team and ask about referrals to appropriate specialists to address these issues. The following websites may also help you locate palliative and integrative care specialists in your area. 

Finding a palliative care specialist

  • GetPalliativeCare.org is a service provided by the Center to Advance Palliative Care (CAPC).

Finding an integrative care specialist

paying-for-service

Insurance coverage of integrative and complementary therapies varies based on the insurance plan and the type of care or product being used. Some cancer centers may offer free classes (e.g., yoga or mindfulness) or services (e.g., consultation with a nutritionist) as part of their care. In general, insurance companies will only cover therapies shown by research to be safe, effective and medically necessary.

Private insurance, Medicare and Medicaid will often pay for some palliative care services. Coverage varies depending on the insurance plan and the type of service being provided. 

clinical-trials

Open to people diagnosed with different types of cancer

Breast cancer

Gastrointestinal cancer

Prostate cancer

Open to high risk people   

Last updated March 11, 2020