{'fraction_non_alphanumeric': 0.02524271844660194, 'fraction_numerical': 0.0013592233009708738, 'mean_word_length': 5.1030805687203795, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Why Integrative Therapies?

Over the past few months, I have found myself becoming uncomfortable with using the term complementary therapies to describe the range of therapies that are part of what is being called integrative medicine. The term integrative therapies, as used in the title of this journal, has a very different connotation than CAM practice. In this regard, my experience at the recent Society for Integrative Oncology meeting, held in early November in San Diego, California, brought some of these thoughts into sharper focus. A concept brought up by one speaker (and referred to by others) to describe the role of various types of therapies in integrative medicine was “feel better, live better, get better.” Therapies such as massage, yoga, stress reduction techniques, or strategies to reduce the side effects of conventional treatment seem to be classified under the “feel better” concept, with a suggestion that some things that make you feel better (such as antioxidants during cancer therapies) are somewhat inimical to getting better. Under “live better,” one could put the lifestyle therapies such as dietary changes and exercise, useful in their own right in terms of general improvement of health. However, this speaker felt that under the “get better” classification, only conventional therapies should be included. Thus, “complementary” therapies are placed in the “feel better” and “live better” categories but excluded from the “get better” category. Alternative therapies were excluded from the fold altogether, on the grounds that they simply do not work. Much of this classification is based on the lack of large-scale randomized, controlled trials that demonstrate that the various complementary therapies are able to prolong life after a cancer diagnosis. This concept is, exactly, what is causing my discomfort with the term complementary therapies. The therapies often termed complementary should not, I feel, be excluded from the process of getting cancer patients “better.” It is true that they can certainly be conceived of and used in a way that relegates them to nice, but perhaps not necessary, ways of improving quality of life (which is a wonderful goal, certainly, but definitely not the only one sought by most cancer patients with lifethreatening disease). In true integrative care, the complementary therapies are viewed and used specifically as means to contribute to the overall process of “getting better,” or at least maximizing the length of optimal-quality life as much as possible. For instance, Michelle Holmes (a very effective speaker at the Society meeting) recently analyzed prospective data from the Nurses’ Health Study on women who had stages I to III breast cancer. She reports that women who performed exercise equivalent to 3 to 5 hours a week of walking at a normal pace were only 50% as likely to die as were women who exercised less than 3 hours a week. While exercise would be classified under “living better,” it seems to me that this is a potentially very large contribution to “getting better” with several good side effects (better sleep, better weight control, less depression) and few negative ones (the occasional minor sports injury). If a new drug was found to reduce breast cancer mortality by 50% in early-stage studies, we can be sure that the publicity surrounding it would be deafening, which has not yet been the case with the results of Holmes. But say a patient has painful muscle contractions or strains from cancer-related anxiety or from improper exercise technique, which hinder her psychologically or physically from exercising. Addressing these through regular massage, yoga classes, or physical therapy may enable her to exercise more effectively and regularly, which then may contribute to her “getting better.” In this situation, complementary therapies are part of a continuum of therapies, all of which aim at getting the patient better. Therapies such as massage or yoga are not, frankly, ever likely to go through large-scale randomized trials that show they can contribute to increased survival through this continuum. Does that mean they have no part in getting patients better? On the contrary, they may indeed play a critical role in allowing the patient to continue exercising and thus ultimately contribute to survival. This example is just one of many possible illustrations of how therapies usually termed complementary or even alternative may contribute to getting cancer patients better, if they are used strategically as part of a comprehensive program to improve the survival, as well as the survivorship, of cancer patients. The name of this journal, Integrative Cancer Therapies, is thus in some ways a statement of our editorial position: the therapies discussed in these pages are ones that have, or may have, the potential to contribute to improving survival as well as quality of life of cancer patients, if they are integrated into a comprehensive and scientifically based program adapted to the needs of the patient’s disease, stage, and biological and social individuality. The individual therapies themselves may or Editorial