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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 - PowerPoint PPT Presentation
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Overview of Integrative Medicine Program at MD Anderson Cancer Center
Richard T. Lee, MDAssistant Professor
Medical Director, Integrative Medicine Program
March 4, 2011
Overview of Integrative Medicine
Integrative Medicine Program at MD Anderson Cancer Center
Therapies of Interest
Objectives & Outline
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 - NCCAM1. 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
MD Anderson Cancer Center, 2000◦ ~450 patients
CAM Use Among Cancer Patients
Richardson et al. JCO 2000
2007 CAM Use in United States
Therapy Prevalence (%)
Natural Product 17.7%
Meditation 9.4%
Chiropractor 8.6%
Massage 8.3%
Yoga 6.1%
Acupuncture 1.4%
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.
Physical
Psycho-Spiritual
Social
Integrative Medicine Center Model
Health
Optimal Health
● Pharmacy
●Chemotherapy ●
Surgery ● Radiation
Physical● Nutrition
● Acupuncture
● Massage
● Exercise
● Rehabilitation
Psycho-Spiritual●
Chaplaincy
● Psychiatry
● Tai Chi
● Cognitive Behavior
● Meditation ● Yoga
Social
● Music Therapy
● Family/Friends
● Patient Advocacy
● Social Work
● Education
● Support Groups
● Integrative Oncology Consultation
Integrative Medicine Center Model
= Improved Clinical Outcomes
● Chaplaincy
● Nutrition
● Family/Friends
Physical
Psycho-Spiritual
Social
● Pharmacy
● Psychiatry
● Patient Advocacy
● Music Therapy
● Tai Chi
●Chemotherapy ●
Surgery ● Radiation
● Acupuncture
● Massage
● Exercise
● Rehabilitation
● Cognitive Behavior
● Meditation ● Yoga
● Social Work
● Education
● Support Groups
Integrative Medicine Center● Integrative Oncology
Consultation
Optimal Health
● Chaplaincy
● Nutrition
● Family/Friends
Physical
Psycho-Spiritual
Social
● Pharmacy
● Psychiatry
● Patient Advocacy
● Music Therapy
● Tai Chi
●Chemotherapy ●
Surgery ● Radiation
● Acupuncture
● Massage
● Exercise
● Rehabilitation
● Cognitive Behavior
● Meditation ● Yoga
● Social Work
● Education
● Support Groups
Integrative Medicine Center● Integrative Oncology
Consultation
Optimal Health
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 CareDiagnosis Surgery Chemotherapy Radiation
MeditationDiet & Exercise
AcupunctureMusic Therapy
Active TreatmentPrevention Survivors
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)
Pain (1A) Nausea (1A) Xerostomia (1B) Hot Flashes (1B) Fatigue (2C) Neuropathy (2C) Insomnia
Acupuncture
What is the best way to delivery acupuncture?
What points? How deep? How often? Is electroacupuncture really better? What about acupuncture is really working?
Acupunctre Research
Mushrooms◦ PSK, AHCC
Oleander
Mistletoe/Iscador
Milk Thistle
Does is work, how does it work, and does it interfere with treatment?
Natural Products of Interest
Thank You