Guest Editor’s Note: Although many cancer centers recognize the value of integrative therapies in oncologic care, cancer prevention, its treatment, and survivorship care continue to pose a challenge in many low- and middle-income countries. In this article, Alejandro Salicrup, PhD, highlights the proceedings from the 2020 Trans-NCI-NIH Conference to discuss the global perspective surrounding the role of integrative medicine in the cancer continuum and to further integrative oncology research.
Alejandro Salicrup, PhD
The Center for Global Health and the Office of Cancer Complementary and Alternative Medicine, Division of Cancer Treatment and Diagnosis of the National Cancer Institute (NCI), and National Institutes of Health (NIH) hosted the Trans-NCI-NIH Conference on International Perspectives on Integrative Medicine for Cancer Prevention and Cancer Patient Management. The virtual conference was held October 27–30, 2020, with 700 participants from around the globe. The main aims of the conference were to: (1) discuss the integration of traditional, complementary, and alternative medicine with conventional cancer prevention and treatment approaches; and (2) explore approaches for strengthening integrative oncology research in low- and middle-income countries. This conference is the first known forum to explicitly address the challenges and opportunities surrounding integrative medicine in low- and middle-income countries.
The conference began with keynote speakers, including the Director of the NCI Ned Sharpless, MD, and additional NCI senior leaders. Dr. -Alejandro Salicrup identified the charge of the audience and reinforced the conference objectives, purpose, and the importance of the forum. To address each aim, the conference agenda contained 10 sessions held with 42 presenters. The agenda with the name and institutions of all speakers as well as the conference proceedings and recordings are available at the following website: cam.cancer.gov/news_and_events/integrative_medicine.htm. Each session of the conference is briefly described below.
Challenges of Cancer Prevention, Therapy, and Survivorship in Low- and Middle-Income Countries.
Partha Basu, PhD, from the International Agency for Research on Cancer (IARC/WHO), discussed the pillars of traditional and complementary medicine (eg, the use of natural products, lifestyle modifications, and mind-body -practices). Further, he examined the role of integrative oncology in the cancer care continuum and opportunities to improve care from prevention through survivorship and end of life. In addition, Dr. Basu highlighted the challenges and advantages of integrative oncology in low- and middle-income countries and offered an implementation -roadmap.
The Role of Integrative Cancer Therapy, Prevention, and Management in Global Health, Moderators: Paul Jacobsen, PhD, and Jun Mao, MD, MSCE.
Lorenzo Cohen, PhD, and Geetha Gopalakrishna Pillai, MD, highlighted the importance of prevention, risk factors, global burden of cancer, health disparities in low- and middle-income countries, synergy, traditional and complementary medicine approaches, and implementing effective policies to combat cancer.
Challenges and Clashes of Worldviews and Circles of Influence of Western Medicine and Traditional Medical Systems, Moderators: Jeffrey D. White, MD, and K.S. Dhiman, PhD.
Dr. Geetha -Gopalakrishna Pillai; Carlos Jose Andrade, PhD; and Bhushan Patwardhan, PhD, emphasized cultural differences; bridging traditional, complementary, and Western medicine; health-care budgets; Ayurveda; colocation; communication; collaboration; and change.
Research- and Evidence-Based Integrative Oncology for Cancer Prevention and Treatment, Moderators: Paige Green, PhD, MPH, and Jun Mao, MD, MSCE.
Jennifer Ligibel, MD, and Karen Mustian, PhD, MPH, discussed integrative oncology research examples, challenges related to clinical trials, the importance of rigorous research, and lessons learned.
Understanding the Pharmacology of Traditional Medicine, Moderators: Ikhlas Khan, PhD, and Emmeline Edwards, PhD.
Carla Holandino Quaresma, PhD; Chrisna Gouws, PhD; Susana Fiorentino, PhD; and Pamela Weathers, PhD, provided an overview of natural products such as antitumoral agents, phytotherapy, pharmacology and mechanisms, along with relevant clinical trial findings.
Regional Approaches: Integration of Traditional Chinese Medicine With Western Medicine for Cancer Treatment and Prevention and Related Research, Moderators: Libin Jia, MD, and Lixing Lao, MD, PhD.
Li Feng, MD; Yang Yufei, LAc, MS; and Wei Hou, PhD, discussed traditional Chinese medicine practices, herbal medicines, research studies, international collaborations, and health-system practices.
Regional Approaches: Integration of Ayurveda With Western Medicine for Cancer Treatment and Prevention and Related Research, Moderators: Dr. K.S. Dhiman and Ram Manohar, PhD.
Ram Manohar, PhD and Narendra Bhatt, PhD, shared Ayurvedic techniques and practices and the AYUSH health system in India. In addition, they discussed how Ayurveda may aid in the prevention and early diagnosis of cancer, drug discovery, and reduce the cost and time of treatment.
Brazilian and Latin American Approaches to Integrative Oncology and Related Research, Moderators: Dr. Alejandro Salicrup and Daniel Miele Amado, MS.
Ricardo Ghelman, MD, PhD; Dr. Carlos Jose Andrade; and Paulo Caceres Guido, PharmD, highlighted research studies, health systems in -Brazil, mindfulness practices, cancer burden in South America, herbal extracts used for treatment, and the national policy of integrated health in Brazil.
Examples of Partnerships to Enhance Integrative Oncology Research in Low- and Middle-Income Countries, Moderators: Drs. Alejandro Salicrup and Daniel Gallego, PhD.
Libin Jia, MD; Jeffrey Buchsbaum, MD, PhD; William Folk, PhD; Gabriel Lopez, MD; Ricardo Ghelman, MD, PhD; and Natalia Aldana, MD, MSc, shared examples of collaborative partnerships (eg, NCI cancer research collaborations with India and China, the Traditional, Complementary, and Integrative Medicine Network for the Americas; ongoing international projects; and the International Center for Indigenous Phytotherapy Studies that collaborates with institutions in Africa and Asia).
Potential Mechanisms for Strengthening Integrative Oncology Research in Lower- and Middle-Income Countries, Moderators: Satish Gopal, MD, MPH, and Dr. Alejandro Salicrup.
Avraham Rasooly, PhD; Sudha Sivaram, DrPH, MPH; Paige Green, PhD; Della White, PhD; Marya Levintova, PhD; Dr. Partha Basu; Dr. Geetha Gopalakrishna Pillai; Dr. Wei Hou; Roger Chammas, MD, PhD; and Dr. K.S. Dhiman discussed some of the current available funding at the national and regional levels as well as the need to offer financial support for global research, improve research by developing a roadmap and designing appropriate studies, and international funding opportunities.
In addition to the oral sessions, this conference also featured 48 posters comprising 5 categories: (1) pharmacology of traditional medicine; (2) global use of natural products in cancer management; (3) global approaches of integrative oncology; (4) global integrative oncology: use in cancer prevention; and (5) global integrative oncology: use in cancer treatment. Posters are available for viewing on the conference website at events.cancer.gov/cgh/iio/poster.
More on the Conference
During the 4-day conference, attendees heard from presenters from across the globe (eg, China, India, France, Switzerland, Tanzania, Kenya, Ghana, South Africa, Colombia, Brazil, Peru, Chile, and Argentina). The topics discussed included research gaps, challenges, and opportunities pertaining to integrative oncology in low- and middle-income countries.
Ten major themes were derived from the conference: natural products (Ayurveda and herbal medicines), collaboration, improving quality of life, research in low- and middle-income countries, prevention, conventional medicine (eg, radiation, chemotherapy), traditional Chinese medicine, training, mind-body therapies (eg, yoga, hypnosis, mindfulness, meditation), and funding. These themes encompass what is working well, what needs improvement, and the future direction of the field.
The conference provided opportunities for attendees to exchange information, learn about partnerships and connections, and continue the conversation following the conference. In the evaluation survey after the conference, 97% of attendees reported extreme satisfaction with the conference, 99% found the conference useful, and 99% reported an increase in knowledge of global integrative oncology.
The 2020 Trans-NCI-NIH conference was successful in broadening and advancing the knowledge of integrative medicine in the field of international oncology. To further develop the field, conference planners intend to explore the potential mechanisms at the NIH and other organizations to promote research on global integrative oncology and to enhance existing programs.
DISCLOSURE: Dr. Salicrup reported no conflicts of interest.
Acknowledgments: We thank our partners: NCI’s Division of Cancer Control and Population Sciences, NIH’s National Center for Complementary and Integrative Health, NIH’s Fogarty International Center, World Health Organization; International Agency for Research on Cancer, Brazilian Academic Consortium for Integrative Health, Brazil National Cancer Institute, China Academy of Chinese Medical Sciences, Central Council for Research in Ayurvedic Sciences–Indian Ministry of AYUSH, and the Society for Integrative Oncology.
Dr. Salicrup is Senior Advisor for Global Health Research, Center for Global Health & Office of Cancer Complementary & Alternative Medicine (OCCAM), Division of Cancer Treatment & Diagnosis, National Cancer Institute, National Institutes of Health.