Integrative Oncology Breast Cancer Clinical Practice Guidelines Published in JNCI Monographs

The Society for Integrative Oncology has published a first-of-its kind breast cancer clinical practice guidelines in the Journal of the National Cancer Institute Monographs coinciding with the 11th International Conference of the Society for Integrative Oncology held this week in Houston, Texas.

With over 80% of breast cancer patients using some form of integrative cancer therapy following diagnose, these timely guidelines will bring much needed clarity and support to women undergoing active cancer treatment.

Leading integrative oncology investigators from several major NCI-designated comprehensive cancer centers, as well as additional U.S. and Canadian institutions, evaluated over 80 various therapies and 30 interventions, (including: acupuncture, natural products, yoga, meditation), in terms of efficacy and safety.

Investigators also analyzed a group of nine biomedical publication databases comprising over 4,900 research articles pertaining to randomized controlled clinical trials from 1990 through 2013; including studies of women who had undergone standard of care therapies (i.e., surgery, chemotherapy, radiation therapy and hormonal therapy) with adjuvant integrative therapies. In the final analysis, 203 of these studies met the criteria for inclusion.

These guidelines provide an important tool for breast cancer patients and their clinicians as they make decisions on what integrative therapies to use and not use. The guidelines clearly demonstrate that clinicians and patients should adopt shared decision-making approaches when assessing the risk-benefit ratio for each therapy. It is important to personalize the recommendations based upon patients’ clinical characteristics and values. What’s right for one patient may be wrong for another”, said Heather Greenlee, ND, PhD, assistant professor of epidemiology at Columbia University’s Mailman School of Public Health and president of SIO.

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The monograph table of contents and all 15 articles, including contributions from NCCAM Director Josephine Briggs, MD and OCCAM Director Jeffrey D. White, can be accessed here.

Comment:

(Disclosure: I am a past SIO board member and current communications committee co-chair.)

Given that over 75% of breast cancer patients currently use complementary therapies following diagnosis, these highly effective clinical guidelines offer medical oncologists, physicians and practitioners across disciplines, and, just as importantly, patients and caregivers, an extremely useful tool.

Now, virtually any private practice oncologist, hospital or health system—especially those with minimal experience discussing or recommending integrative cancer therapies—should feel quite comfortable and confident in the quality and ratings of these core evidence-based modalities.

Congratulations to SIO and the team of researchers, evaluators and collaborating institutions for developing such a timely set of clinical guidelines rendering valuable support to millions of breast cancer patients through their cancer care journey.

The Breast Cancer Clinical Practice Guidelines can be found here.

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