Medical cultures converge to form evidence-based integrative oncology program
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City of Hope received a $100M philanthropic gift to create a national integrative oncology program that will combine and optimize Eastern and Western medicine to improve outcomes and quality of life for patients with cancer and survivors.
The Cherng Family Center for Integrative Oncology, a first-of-its-kind program, aims to take a whole-patient approach to delivering high-quality integrative care that is backed by City of Hope’s research.
“We’re extremely grateful to Andrew and Peggy Cherng, the co-CEOs and co-founders of Panda Express and the Panda Charitable Family Foundation, for their profound generosity,” Edward S. Kim, MD, MBA, vice physician-in-chief and professor in the department of medical oncology and therapeutics research at City of Hope National Medical Center, told Healio.
“Integrative oncology is a holistic approach that treats the mind, body and soul through traditional Chinese medicine and other Eastern treatment techniques,” Kim — a Healio | HemOnc Today Associate Medical Editor — added. “The purpose of this center is to interweave these types of treatments and techniques with Western medicine. We believe this is the optimal way to treat the whole person.”
Three pillars of care
City of Hope’s integrative oncology program, which will be introduced across City of Hope’s locations, comes at a time of increased interest in integrative medicine as an evidence-based approach to cancer care and management. In 2022, ASCO and Society of Integrative Oncology (SIO) jointly published guidelines recommending integrative medicine for the management of cancer-associated pain. Earlier this year the two organizations released additional joint guidelines on the use of integrative medicine to manage anxiety and depression in adults with cancer.
Richard T. Lee, MD, a clinical professor at City of Hope and Cherng Family directors chair for Center for Integrative Oncology, served as part of the team that developed the ASCO/SIO pain management guidelines.
“We are seeing higher levels of evidence supporting the use of integrative therapies — such as mind/body medicine, relaxation therapies, acupuncture and massage — to help patients with symptoms of anxiety and depression,” Lee told Healio. “We are still in the early stages, though. We need to conduct more randomized, controlled trials and higher-level clinical research that demonstrates the benefits, as well as the potential risks of these therapies for cancer patients.”
The integrative medicine center will focus on three key pillars: education, clinical care and conducting key research, Lee said.
“We’ll be looking at natural products for drug discovery — we’ve been innovators in this area,” he said. “We also want to do clinical research that demonstrates the value of meditation, acupuncture and massage. These are all areas we want to investigate.”
Evidence-based services
The integrative oncology program — which is currently being piloted at City of Hope’s Orange County and Los Angeles campuses — offers services that include acupuncture and mind/body medicine, Lee said. Meditation, mindfulness and other relaxation approaches are key components of the program, which will add oncology massage services in the coming months, he added.
“We also have an integrative oncology consultation service, which is where I see patients and answer their questions around a particular holistic or integrative approach,” Lee said. “These patients might have a variety of questions related to herbs, supplements or other approaches they may have read about.”
Patients also benefit from group programs such as yoga, meditation, mind/body services, tai chi and qigong, with plans to expand these services further.
“I think the fact that we’re doing this at an establishment like City of Hope — a top 10 cancer center in the country — adds a lot of credibility to this project, especially with a leader like Richard Lee, who has secured grants from the NCI to study different integrative techniques,” Kim said. “It legitimizes the fact that we want to rigorously study this and bring level I evidence out to the public so people will understand that there is legitimacy behind it.”
The right time and place
As City of Hope works to interweave integrative medicine into the standard of care for people with cancer, Lee acknowledged that some skeptics remain within the medical establishment.
“Anytime there is a new way of thinking, or a paradigm shift, there are always going to be some individuals who might have some concerns and doubts about these kinds of approaches,” Lee said. “Generally, when I talk to my colleagues who might have these concerns, there are a few things I like to keep in mind.”
Lee said he emphasizes how addressing all aspects of patient health can improve their overall care plan. Additionally, he said he assures doubtful colleagues that City of Hope’s center will focus on evidence-based care.
“There are high-quality randomized controlled trials of mindfulness-based stress reduction and acupuncture,” he said. “There are large, phase 3 trials of oncology massage showing a real benefit. So, we’re going to focus on the evidence, focus on the high-quality research. It really helps bridge that gap.”
Kim said bridging this gap was a driving force behind the Cherng family’s vision for the center, adding that integrative medicine is something patients are interested in and want to discuss with their provider.
“Right now, data will tell us that about 40% of patients who have cancer will use integrative therapies, and some of them don’t even feel comfortable telling their physicians about it,” he said, “I think Andrew and Peggy [Cherng] really felt that not only was this the right time to bring this initiative forward, but that City of Hope was absolutely the right place to do it.”
Kim added that some of the most established cancer treatments may have once been viewed with skepticism.
“If I told you 30 years ago, we were going to study tree bark as an anticancer therapeutic, you might have had the same response,” he said. “Now, we call that paclitaxel and docetaxel, two of the most common drugs used across cancer therapies.”
Building the future
The Cherng Family Center is also dedicated to growing the workforce of future integrative oncologists through education and training programs. Over the next year, City of Hope plans to introduce one of the first integrative oncology fellowships to be developed and led by oncologists.
“We wanted to establish a fellowship for oncologists, whether they are medical oncologists, radiation oncologists or surgical oncologists,” Lee said. “We also want to train nurses, nurse practitioners and the City of Hope staff, as well as those outside City of Hope.”
In October 2024, City of Hope Orange County will host the SIO’s international conference in Costa Mesa, California.
“This conference brings in hundreds of participants and attendees from all over the world,” Lee said. “That will be one of the major educational initiatives we’ll be implementing.”
These educational initiatives will be aimed at teaching clinicians and cancer centers to establish their own integrative oncology programs.
“It’s very important for City of Hope, as well as the Cherng family, that we help establish the next generation of integrative oncologists,” Kim said, “We don’t want City of Hope to have the only large, evidence-based center. We want others to establish their own centers, so that patients everywhere can receive this type of care.”
Reference:
- City of Hope receives $100 million gift to create first-of-its-kind national integrative oncology program (press release) Available at: https://www.cityofhope.org/city-hope-receives-100-million-gift-create-first-its-kind-national-integrative-oncology-program. Published Sept. 12, 2023. Accessed Oct. 18, 2023.
For more information:
Edward S. Kim, MD, MBA, FACP, FASCO, and Richard T. Lee, MD, can be reached at City of Hope Orange County Lennar Foundation Cancer Center, 1000 Five Point, Irvine, CA 92618; email: edwkim@coh.org, richlee@coh.org.
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