Society for Integrative Oncology Is Helping to Advance Evidence-Based, Comprehensive Integrative Health Care

A Conversation With Heather Greenlee, ND, PhD

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Heather Greenlee, ND, PhD

Heather Greenlee, ND, PhD, was named President of the Society for Integrative Oncology (SIO) at the organization’s 10th International Conference in October. Dr. Greenlee is Assistant Professor in the Department of Epidemiology at the Mailman School of Public Health at Columbia University in New York. Dr. Greenlee’s research focuses on the use of lifestyle modifications and complementary and integrative medicine for breast cancer prevention and control.

Before becoming President of the SIO, Dr. Greenlee served on its executive committee. She has received research funding from the National Institutes of Health (NIH) and is a member of SWOG (formerly the Southwest Oncology Group).

The ASCO Post talked with Dr. Greenlee about the goals she hopes to accomplish over the next year as President of SIO and the biggest challenges she faces.

Main Objectives

Please describe SIO’s mission.

The mission of the Society for Integrative Oncology is to advance evidence-based, comprehensive integrative health care to improve the lives of people affected by cancer. We want to be the leading go-to organization for developing and cultivating the research behind integrative oncology. Our main objective is not just to encourage new high-quality research, but also to disseminate that research to everyone who needs the information, including other researchers, oncologists, patients, and patient advocates.

Short- and Long-Term Goals

What are some goals you hope to accomplish over the next year?

Recently, we held a strategic planning meeting with all of the past presidents of SIO as well as our current and outgoing board members. During that meeting, we discussed our long-term goal—to be recognized as the leading international resource and science-based professional organization in the field of integrative oncology. One of the key methods to accomplish that is for SIO to partner with other major oncology organizations, such as ASCO, through participation in their meetings as well as inviting them to participate in our annual conference.

For example, this year we invited leaders from the American Society of Preventive Oncology (ASPO) to give a presentation on cancer survivorship research. And next year, we will have a session at ASPO’s conference on integrative oncology research. We are also planning to make presentations at the Oncology Nursing Society’s 2015 Annual Congress. Many of these groups are conducting research in integrative medicine, and we want to partner with them.

Another goal is to publish new clinical practice guidelines for specific cancers. To date, SIO has published four different practice guidelines. Two were on the general use of integrative therapies in oncology settings and two were specifically for the management of patients with lung cancer.

The next set of guidelines will focus specifically on the use of integrative therapies during breast cancer treatment for symptom management, to prevent and ameliorate treatment toxicities, and to improve quality of life. We will use the strictest standards established by ASCO and the Institute of Medicine for evaluating interventions and clinical strategies.

Perception Issues

What are some of SIO’s biggest challenges?

There needs to be a paradigm shift in some institutions and medical communities, to recognize the potential benefit of an integrative approach to cancer care. The field of integrative oncology isn’t going away, and we need to educate providers and researchers about integrative medicine’s role in cancer care.

It is also important to understand that SIO is not interested in promoting “alternative” cancer care. Integrative oncology combines the best of conventional approaches to cancer treatment with the best evidence-based integrative therapies. We want to advance the science.

Growing Field

Is the amount of integrative medicine research in cancer care growing?

The field is definitely growing. Within the National Institutes of Health, both the National Cancer Institute (NCI) and National Center for Complementary and Alternative Medicine (NCCAM) invest a significant amount of resources to studying integrative oncology.

A great deal of integrative oncology research focuses on symptom management. For example, our research group at Columbia University is conducting clinical trials using acupuncture to help with aromatase inhibitor–induced joint pain. We are also studying the use of dietary supplements to prevent and/or treat chemotherapy toxicities.

Obstacles to Implementation

What are the biggest impediments to the use of integrative medicine in oncology?

There are several. The first is that a great deal of research still needs to be conducted to identify which integrative practices work, how they work, and what the best doses are, and to determine whether they are safe.

In addition, most health-care professionals lack knowledge about the potential benefits and risks of integrative medicine, so we have to do a better job of educating oncologists, nurses, and primary care physicians on the use of integrative medicine in clinical care. We also have to do a better job of educating patients about integrative medicine. There is a lot of misunderstanding and misinformation about integrative care and about what it can and cannot do. The new SIO guidelines will summarize the existing scientific evidence for integrative practices in specific cancers and will highlight where the knowledge gaps exist.

Ongoing Progress

What progress have you seen over the past decade in advancing complementary medicine in oncology care, and what do expect to see in the future?

The research base in integrative medicine has certainly grown, as has the amount of funding for research. The development and implementation of integrative services and integrative programs for cancer survivors within cancer centers across the country and internationally are also growing.

Ten years ago, there weren’t many cancer survivorship programs. Now such programs exist almost everywhere, and integrative oncology is a key component in many of them.

Both research and clinical care are being conducted via interdisciplinary teams. In the future, we will see more of that interdisciplinary research, which will lead to the best science to inform evidence-based practice. ■

Disclosure: Dr. Greenlee reported no potential conflicts of interest.