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Press release: Integrative Medicine Meeting 2018

Patient Needs and Medical Demands in Integrative Oncology:

a Global Overview

A unique platform for international scientific exchange and networking, the “Integrative Medicine Meeting” also measured the global acceptance of integrative medical concepts in oncology. Approximately 200 doctors and experts from all over the world attended. The four-day conference took place on the premises of the main sponsor, Helixor Heilmittel GmbH, for the fourth time. Despite country-specific differences in possibilities and needs, the participants and speakers shared a common goal: optimized care for cancer patients using effective, evidence-based methods of integrative oncology.

Dr. Gary Deng (MSKCC, New York, USA) one of the event’s two chairmen, came to Rosenfeld with encouraging news: After 20 years of ideals-driven work combining conventional oncology with evidence-based modalities of complementary medicine, guidelines for integrative oncology (breast cancer) have now been published for the first time1 and have even been adopted by the American Society of Clinical Oncology (ASCO)2. According to Dr. Deng, this guideline offers a good starting point for selecting modalities with a high level of evidence.

First guideline on integrative oncology

Integrative oncology is meanwhile widely accepted in the United States. Dr. Deng, MD, leads the Integrative Medicine Clinical Program at Memorial Sloan Kettering Cancer Center (MSKCC), where 50 staff members care for 30,000 cancer patients each year. Under these conditions, efficient scientific research on complementary oncological methods enjoys a solid foundation, says Dr. Deng, and the evidence base continues to grow. It was agreed that, in view of the diversity of methods in integrative medicine, this essential prerequisite should become reality worldwide. However, as the event’s chairmen – Dr. Deng and Prof. Dr. Roman Huber (Centre for Complementary Medicine, University Hospital Freiburg, Germany) – emphasized, case reports are also essential for scientific progress and optimized patient care. Prof. Huber mentioned, among other things, the CARE (CAse REporting) guideline, which helps to improve the completeness and transparency of published case reports.3

Good side-effect management results in good quality of life

Treatment results with complementary methods can sometimes seem miraculous: As an example, Dr. Eric Marsden (Vaughan, Canada) shared the therapeutic effect of exercise. The levels of effect are varied: prevention, side effect management (especially in terms of cancer-related fatigue [CRF]), improved quality of life, and life expectancy. Dr. Marsden cited a meta-analysis (68,000 cancer patients) which showed an exercise-associated reduction of cancer-specific mortality in the range of 28 – 44 %, and a reduction of recurrence rates by 25 – 48 %.4 Other integrative modalities now also show this level of evidence, though not on the basis of such large numbers. The guideline mentioned above lists three complementary modalities with the highest degree of evidence for several cancer-related symptoms (1. meditation for anxiety/stress reduction, 2. mindfulness-based relaxation for depression/mood disorders, and 3. meditation for quality of life). Other evidence-based modalities include mistletoe therapy, music therapy, stress management, yoga, acupuncture, and massage.

Mistletoe therapy: complementary modality with high level of evidence

Next to exercise, no other complementary therapy in oncology has been researched as intensively as the use of mistletoe extracts (Viscum album), which is why it was the subject of several conference lectures. Prof. Huber mentioned a Cochrane review which, as early as 2008, showed a significant improvement in quality of life (for breast cancer patients) achieved by administering mistletoe extracts in parallel to chemotherapy.5 Mistletoe extract was also demonstrated to significantly prolong overall survival rates for metastatic pancreatic cancer patients.6 This finding drew so much international attention that the Swedish Karolinska University is currently attempting to replicate the study.7 Dr. Friedemann Schad (Community Hospital Havelhoehe, Berlin, Germany) described one of the most costly problems with targeted therapies: significant non-adherence in long-term applications. Yet according to Dr. Schad, complementary mistletoe extracts administered during targeted therapy actually increase the probability of therapy adherence by 70 %, thanks to significantly reduced side effects.8 Ivelisse Page (Glyndon, USA) reported on the first US phase I study on the IV use of mistletoe extract in advanced solid tumors, at Johns Hopkins University in Baltimore (NCT 03051477). The impressive case reports of intratumoral off-label application of Viscum album were also discussed in a very lively manner.

Looking “outside the box”

North American oncologists reported significant success with intermittent fasting (repeated short-term fasting) in the treatment of CRF and other disease-/therapy-related side effects. In addition, a recent pilot study by Charité – Universitaetsmedizin Berlin showed that, in gynecological cancers, short-term fasting during chemotherapy reduced the side effects of treatment, without causing serious problems. The lecture program also included integrative methods that are not as widely established: Dr. Gurdev Parmar (Fort Langley, Canada) presented the results of an 8-year study on hyperthermia in 785 cancer patients with advanced metastatic disease. The treatment led to a better five-year survival rate over comparative data (study forthcoming). Finally, Dr. Friedrich Migeod (Bad Aibling, Germany) described how Helleborus niger (Christmas rose) can improve the course of lymphoma or carcinoma cases, especially with malignant breast, neck, and brain tumors, along with the importance of the extract in improving quality of life in palliative oncology.

The 4th Integrative Medicine Meeting was not only a time to listen, but also to join in the discussion and share best practices: Practical suggestions were presented, for example, in the workshops “Integrative Oncology: Principles & Practice” and “Mistletoe Therapy: Application in Practice” or a tour of the main sponsor Helixor Heilmittel GmbH. Guided tours in regional hospitals with an integrative medical focus were also offered. This “holistic” program not only fostered scientific networking, but encouraged considerations on joint projects in health policy. As one participant from Austria put it: “At the Integrative Medicine Meeting, international comparisons offered interesting insights that encouraged me to think ‘outside the box’ of my daily professional work and ultimately expanded my horizons”.

To be continued ...

Our goal is to promote integrative medicine worldwide, and you are welcome to join us for the next steps: preparations for the 5th Integrative Medicine Meeting are now underway. 20 years after the first use of the term “integrative oncology”, we now know that it describes many aspects of holistic, patient-centered cancer treatment, and represents the universal medicine of our time. For more information, and impressions of this year’s event, please visit: imm-

Press contact – do not name as author:

Helixor Heilmittel GmbH

Fischermuehle 1, 72348 Rosenfeld, Germany



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Dr. Gary Deng, MD, leads the Integrative Medicine Clinical Program at Memorial Sloan Kettering Cancer Center (MSKCC), New York. “We want to, and can, improve quality of life for our oncological patients.”

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Prof. Dr. Roman Huber, Centre for Complementary Medicine, University Hospital Freiburg: “Oncological patients have a high demand for integrative medical treatment options, which points to gaps in conventional cancer medicine.”

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Experts from 26 countries turned the 4th Integrative Medicine Meeting into a continuing education event that resonated deeply with participants.

Definition of integrative oncology (National Cancer Institute): Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum and to empower people to prevent cancer and become active participants before, during, and beyond cancer treatment.9

Literature:

1. Greenlee H, DuPont-Reyes MJ, Balneaves LG, Carlson LE, Cohen MR, Deng G, Johnson JA, Mumber M, Seely D, Zick SM, Boyce LM, Tripathy D: Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin. 2017 May 6;67(3):194-232.

2. Lyman GH, Greenlee H, Bohlke K, Bao T, DeMichele AM, Deng GE, Fouladbakhsh JM, Gil B, Hershman DL, Mansfield S, Mussallem DM, Mustian KM, Price E, Rafte S, Cohen L: Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline. J Clin Oncol. 2018 Sep 1;36(25):2647-2655.

3. Gagnier JJ, Riley D, Altman DG, Moher D, Sox H, Kienle G; CARE Group: Die Case Reporting (CARE) Guideline: Entwicklung einer konsensbasierten Leitlinie für die Erstellung klinischer Fallberichte. Dtsch Arztebl Int. 2013 Sep;110(37):603-8.

4. Cormie P, Zopf EM, Zhang X, Schmitz KH: The Impact of Exercise on Cancer Mortality, Recurrence, and Treatment-Related Adverse Effects. Epidemiol Rev. 2017 Jan 1;39(1):71-92.

5. Horneber MA, Bueschel G, Huber R, Linde K, Rostock M: Mistletoe therapy in oncology. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003297.

6. Tröger W, Galun D, Reif M, Schumann A, Stanković N, Milićević M: Viscum album [L.] extract therapy in patients with locally advanced or metastatic pancreatic cancer: a randomised clinical trial on overall survival. Eur J Cancer. 2013 Dec;49(18):3788-97.

7. Wode K: Mistletoe Therapy in Primary and Recurrent Inoperable Pancreatic Cancer (MISTRAL). Identifier: NCT02948309.

8. Thronicke A, Oei SL, Merkle A, Matthes H, Schad F: Clinical Safety of Combined Targeted and Viscum album L. Therapy in Oncological Patients. Medicines (Basel). 2018 Sep 6;5(3).

9. Witt CM, Balneaves LG, Cardoso MJ, Cohen L, Greenlee H, Johnstone P, Kücük Ö, Mailman J, Mao JJ: A Comprehensive Definition for Integrative Oncology. J Natl Cancer Inst Monogr. 2017 Nov 1;2017(52).

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