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INTRODUCTION

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Integrative medicine seeks to merge conventional medicine and complementary therapies in a manner that is comprehensive, personalized, evidence-based, and safe in order to achieve optimal health and healing. Although applying the concept of integrative medicine to cancer care is still in its formative years, a number of comprehensive cancer centers in the United States are trying to put this concept into practice under the term integrative oncology. As a result of this growing interest in integrative medicine in cancer care, the National Cancer Institute formed the Office of Cancer Complementary and Alternative Medicine (OCCAM), the American Cancer Society (ACS) dedicated a portion of its Web site to assessment of complementary therapies, the Consortium of Academic Centers for Integrative Medicine created an oncology working group, and the Society for Integrative Oncology (SIO) was formed. The SIO mission is to study and facilitate cancer treatment and recovery through the use of integrated complementary therapeutic options, including natural and botanical products, nutrition, acupuncture, massage, mind–body therapies, and other complementary modalities (www.integrativeonc.org). This chapter will review the role of integrative oncology in cancer care with an emphasis on a comprehensive approach, an overview of the evidence, educational resources to guide health care providers and patients, and guidelines for creating a comprehensive, integrative treatment plan for cancer patients.

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DEFINITIONS

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Complementary and alternative medicine (CAM) has been defined by the National Center for Complementary and Alternative Medicine (NCCAM)1 and major US surveys as "… diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional medicine." Although evidence may exist for some of these modalities, it may not be sufficient to bring them into the realm of conventional medicine, and other CAM modalities may have no scientific support for their use. Strictly speaking, alternative medicine by definition is when a patient makes use of a nonconventional treatment modality in place of conventional medicine whether or not there is evidence for its efficacy. Complementary medicine, on the other hand, is when a patient makes use of a CAM modality in combination with conventional medicine.

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The terms alternative, complementary, and conventional focus on types of treatment modalities. In the last few years, the term integrative medicine or complementary and integrative medicine (CIM) has become more prevalent in medical settings. CIM is more about a philosophy of medical practice that merges both conventional and complementary medicine. The Consortium of Academic Health Centers for Integrative Medicine2 has defined this term as "the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing." In this way, integrative medicine makes use of both conventional and complementary treatment modalities using an interdisciplinary approach to health care. Practitioners of all disciplines should ...

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