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Overview of Integrative Medicine Program at MD Anderson Cancer Center. Richard T. Lee, MD Assistant Professor Medical Director, Integrative Medicine Program March 4, 2011. Objectives & Outline. Overview of Integrative Medicine Integrative Medicine Program at MD Anderson Cancer Center
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Overview of Integrative Medicine Program at MD Anderson Cancer Center Richard T. Lee, MD Assistant Professor Medical Director, Integrative Medicine Program March 4, 2011
Objectives & Outline • Overview of Integrative Medicine • Integrative Medicine Program at MD Anderson Cancer Center • Therapies of Interest
Complementary and Alternative Medicine (CAM) • National Center for Complementary and Alternative Medicine (NCCAM) – National Institutes of Health (NIH) • Office of Alternative Medicine (1991) • Definition • A group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.
Categories of CAM - NCCAM 1. Alternative Medical Systems • Traditional Chinese medicine, homeopathic, naturopathic 2. Mind-Body Interventions • Meditation, prayer, mental healing, music therapy 3. Biologically Based Therapies • Dietary supplements, herbal products, shark cartilage 4. Manipulative and Body-Based Methods • Chiropractic, osteopathic, massage, manipulation 5. Energy Therapies • Qi gong, Reiki, therapeutic touch, magnetic fields
CAM Use Among Cancer Patients • MD Anderson Cancer Center, 2000 • ~450 patients Richardson et al. JCO 2000
The Difference Between Alternative, Complementary, and Integrative • Alternative medicine is used in place of conventional medicine. • Complementary medicine is used together with conventional medicine. • Integrative medicine is used together with conventional medicine in a deliberate manner that is personalized, evidence-based, and safe.
The practice of medicine that reaffirms the importance of the relationship between practitioner and patient • Focuses on the whole person • Informed by evidence • Makes use of all appropriate therapeutic approaches, providers, and disciplines to achieve optimal health and healing
Integrative Medicine Center Philosophy The Integrative Medicine Center aims to work collaboratively with the oncology team to build a comprehensive and integrative care plan that is personalized, evidence-based, and safe with the goal of improving clinical outcomes.
Integrative Medicine Center Model Physical Health Psycho-Spiritual Social
Integrative Medicine Center Model ● Integrative Oncology Consultation ● Nutrition ●Chemotherapy Physical ● Exercise ● Surgery ● Rehabilitation ● Radiation ● Pharmacy ● Acupuncture ● Patient Advocacy ● Massage Optimal Health = Improved Clinical Outcomes ● Psychiatry ● Social Work ● Cognitive Behavior ● Family/Friends Psycho-Spiritual Social ● Support Groups ● Chaplaincy ● Education ● Meditation ● Yoga ● Music Therapy ● Tai Chi
Integrative Medicine Center ● Integrative Oncology Consultation ● Nutrition ●Chemotherapy Physical ● Surgery ● Exercise ● Rehabilitation ● Radiation ● Pharmacy ● Acupuncture ● Patient Advocacy ● Massage Optimal Health ● Psychiatry ● Social Work ● Cognitive Behavior ● Family/Friends Psycho-Spiritual Social ● Support Groups ● Chaplaincy ● Education ● Meditation ● Yoga ● Music Therapy ● Tai Chi
Integrative Medicine Center ● Integrative Oncology Consultation ● Nutrition ●Chemotherapy Physical ● Exercise ● Surgery ● Rehabilitation ● Radiation ● Pharmacy ● Acupuncture ● Patient Advocacy ● Massage Optimal Health ● Psychiatry ● Social Work ● Cognitive Behavior ● Family/Friends Psycho-Spiritual Social ● Support Groups ● Chaplaincy ● Education ● Meditation ● Yoga ● Music Therapy ● Tai Chi
Integrative Medicine Last 12 years… • Over 60,000 clinical encounters involving over 22,000 individuals • 50% were patients • Massage – 16,596 • Music Therapy – 6,780 • Yoga – 5,838 • Acupuncture – 4,803 • Consultations (FY ‘10) – 500+
When to Refer?Continuum of Cancer Care Diagnosis Surgery Chemotherapy Radiation Active Treatment Prevention Survivors Meditation Diet & Exercise Acupuncture Music Therapy
Oncology Massage Therapy • Mood Disturbance (1C) • Anxiety • Depression • Pain (1C) • Neuropathy
Mind-Body Practices • Stress (1B) • Pain • Mood Disturbance (1B) • Anxiety • Quality of Life (1B) • Insomnia (1B)
Music Therapy • Stress (1B) • Mood Disturbance (1B) • Anxiety • Quality of Life (1B)
Acupuncture • Pain (1A) • Nausea (1A) • Xerostomia (1B) • Hot Flashes (1B) • Fatigue (2C) • Neuropathy (2C) • Insomnia
Acupunctre Research • What is the best way to delivery acupuncture? • What points? • How deep? • How often? • Is electroacupuncture really better? • What about acupuncture is really working?
Natural Products of Interest • Mushrooms • PSK, AHCC • Oleander • Mistletoe/Iscador • Milk Thistle • Does is work, how does it work, and does it interfere with treatment?