Principles to Guide Integrative Oncology and the Development of an Evidence Base

Abstract

Background: Integrative oncology uses both conventional and complementary medicine to meet individual patients’ needs and focuses on the whole person. While the core principles of integrative oncology include individualization, holism, dynamism, synergism, and collaboration, the nature of evidence to guide the development of integrative oncology has been given little attention. Objectives: To 1) discuss the need for evidence to support the integration of complementary therapies for integrative oncology care; 2) emphasize that the evidence base needs to be valid and respect the underlying principles of individual complementary therapies and integrative oncology practice; and 3) suggest ways to begin developing that evidence base. Review and discussion: While evidence for the safety and efficacy seems paramount to support the individual integration of a complementary therapy into mainstream cancer care, the need for evidence to support the overall practice of integrative oncology has to be considered as well. We argue that developing an evidence base for integrative oncology requires a contextual and comprehensive research approach that assesses a range of outcomes over a suitable period of time that the patient and their family, in addition to health care providers, deem important. Conclusion: A whole systems framework to the development of the evidence base for integrative oncology can guide the development of evidence that respects the complex nature of many complementary and integrative practices and their underlying principles of care delivery. Keywords: Integrative oncology, evidence-based medicine, randomized controlled trials, whole systems research