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Integrative Cancer Care in an Academic Cancer Centre in the U.S.

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Integrating Wellness in Cancer Care - Toronto, Ontario - October 4, 2007 …

Integrating Wellness in Cancer Care - Toronto, Ontario - October 4, 2007


Gary Deng, MD, PhD
Integrative Medicine Service
Memorial Sloan-Kettering Cancer Center
New York, NY

Published in: Health & Medicine

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  • 1. Integrative Cancer Care in an Academic Cancer Centre in the U.S. Gary Deng, MD, PhD Integrative Medicine Service Memorial Sloan-Kettering Cancer Center New York, NY Integrating Wellness in Cancer Care Toronto, Ontario October 4, 2007 Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc .
  • 2. Overview
    • History
    • Clinical service
    • Research activity
    • Educational efforts
    • Future direction
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc .
  • 3. Memorial Sloan-Kettering Cancer Center Integrative Medicine Service Clinical Services Research Education & Training 212-639-4700 http://www.mskcc.org/mskcc/html/1979.cfm Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc .
  • 4. Clinical Services
    • Outpatient center
    • Inpatient treatment
    • Oncology clinic
    • Classes for employees
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc .
  • 5.
    • Acupuncture
    • Massage
    • Mind-body therapies
    • Exercise, fitness
    • Nutritional counseling
    MSKCC Integrative Medicine Clinic
    • 1429 First Avenue (74 th Street)
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc .
  • 6. Treatment Room of Integrative Medicine Outpatient Center Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc .
  • 7. Clinical Services
    • Clientele
      • Newly diagnosed cancer patients
      • Cancer patients undergoing treatment
      • Cancer survivors
    • Non-cancer patients
      • Employees
    • Interacting departments
      • Medical, surgical and radiation oncology
      • Pain and palliative care, psychiatry, physical medicine and rehabilitation, sexual health clinic, geriatric program, survivorship program
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc .
  • 8. Research Efficacy Safety harmful useless safe helpful safe insignificant with effects but also risk Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc .
  • 9. Active Symptom Control Trials at MSKCC
    • Cancer pain (massage)
    • Post-chemo fatigue (acupuncture)
    • Shoulder pain and dysfunction in H&N cancer (acupuncture)
    • Post-operative ileus (acupuncture)
    • Thoracotomy pain (acupuncture)
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 10. Completed Symptom Control Trials at MSKCC
    • Mood disturbance (music therapy)
    • Post-chemo fatigue (acupuncture)
    • Symptom control (massage)
    • Dyspnea (acupuncture)
    • Hot flashes (acupuncture)
    • Functional MRI (acupuncture)
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 11. Botanical Trials at MSKCC
    • Breast cancer (Maitake extract)
    • Solid tumor (Huanglian extract)
    • Lung cancer (JFK herbal formulation)
    • Hepatitic C (SST herbal formulation)
    • More Information:
      • 212-639-4700
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 12. MSKCC Research Center of Botanical Immunomodulators
    • Setting : One of the six Centers in the nation (NIH P50 Grant)
    • Theme : Immunomodulators and cancer
    • Study Agents : Echinacea, Astragalus, Turmeric, Maitake, Coriolus and other botanicals
    • Institutions : MSKCC, CUHK-ICM, Cornell, Rockefeller U.
    • Goals : to study the effects, mechanisms of action and active constituents of botanicals purported to boost the immune system for their potential application in prevention and treatment of cancer or infectious diseases
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc Botanical Research Center
  • 13. Immunomodulation
    • Facilitate antigen presentation
    • Improve innate immunity
    • Enhance antibody mediated cytotoxicity
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 14. MSKCC Integrative Oncology T32 Research Fellowship Training Program
    • Setting : The first of the kind program in the country
    • Funding : NIH T32 Grant
    • Goals : To foster the development of cross-trained young investigators in Integrative Medicine and Cancer Care
    • Candidate : MD or MD/PhD completing or having completed residency training in the U.S.
    • Program :
      • Three years of training
      • Core curriculum in Integrative Medicine and research methodology
      • Clinical practice
      • Laboratory and clinical research projects
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 15. Integrative Oncology Training Courses
    • Acupuncture for cancer patients
      • Level I, II, III, twice a year
    • Medical massage for cancer patients
      • Level I, II, twice a year
    • Integrative Oncology Summer Research Fellowship
      • Three medical students/year, NCI funded
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 16. www.mskcc.org/aboutherbs Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 17. MSKCC AboutHerbs Website
    • More than 220 monographs, updated monthly
    • More than 1.5 million hits per year
    • Cited in JAMA, Nature, Washington Post, Wall Street Journal
    • Named one of the top five websites in all of Medicine by Scientific American.
    • More hits than MSKCC home page
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 18. Integration with Mainstream Care
    • Clinical Practice
      • Review medical chart prior to providing treatment
      • Collaborate with members of the healthcare team
      • Document all treatment, response and plan in medical chart
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 19. Expertise of Therapists
    • Professional accreditation required
    • Hiring process individualized
    • Staff only with highly experienced clinicians with related work experience
    • Continually monitor practitioners and provide advanced training/education
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 20. Factors Helping to Ensure a Successful Program
      • Use evidence based therapies
      • Follow norms of clinical practice
      • Develop a strong administrative component
      • Maintain a professional image
      • Assure excellence of staff
      • Deliver superior service
      • Remain adaptable and responsive to client needs
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 21. Past Challenges and Our Approaches
    • Unfamiliarity
      • Give seminars, grand rounds, in-services, demonstrations
      • Write book chapters, reviews
      • Conduct join research
    • Skepticism
      • Establish trust and credibility
      • Have patients provide positive feedback
      • Conduct high quality research
      • Get NIH grants
      • Participate in institutional committees
    • Competition for resources
      • Provide value-added services
      • Elicit support from institutional leadership
      • Bring in external funding
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc
  • 22. Future Directions
      • Raise awareness among patients and health care professionals
      • Implement closer integration throughout a patient’s journey through cancer treatment and beyond
      • Develop more efficient and effective programs
      • Elevate the level of sophistication in research
    Published by Current Oncology and the Cancer Knowledge Network © 2011 Multimed Inc