Mao Jun J, Pillai Geetha Gopalakrishna, Andrade Carlos Jose, Ligibel Jennifer A, Basu Partha, Cohen Lorenzo, Khan Ikhlas A, Mustian Karen M, Puthiyedath Rammanohar, Dhiman Kartar Singh, Lao Lixing, Ghelman Ricardo, Cáceres Guido Paulo, Lopez Gabriel, Gallego-Perez Daniel F, Salicrup Luis Alejandro
Bendheim Integrative Medicine Center, Memorial Sloan Kettering Cancer Center, New York, New York.
Traditional, Complementary and Integrative Medicine Unit, Service Delivery and Safety Department, World Health Organization, Geneva, Switzerland.
CA Cancer J Clin. 2022 Mar;72(2):144-164. doi: 10.3322/caac.21706. Epub 2021 Nov 9.
The increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low- and middle-income countries (LMICs) when it comes to receiving evidence-based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence-based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence-informed, patient-centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment-related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence-based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence-informed, and culturally sensitive cancer care.
癌症发病率和死亡率的上升对全球当前的癌症护理服务构成了挑战,在获得循证癌症预防、治疗、姑息治疗和康复护理方面,低收入和中等收入国家(LMICs)受到的影响尤为严重。LMICs的患者通常依赖传统、补充和整合医学(TCIM),这种医学更熟悉、成本更低且广泛可得。然而,传统医学和TCIM之间的影响范围和紧张关系可能会进一步扰乱循证癌症护理的努力。整合肿瘤学提供了一个框架,用于研究并将安全、有效的TCIM与传统癌症治疗相结合,有助于弥合提供循证、以患者为中心护理方面的医疗差距。这个不断发展的领域采用生活方式调整、身心疗法(如针灸、按摩、冥想和瑜伽)以及天然产品来改善癌症患者的症状管理和生活质量。基于对癌症控制全球挑战和整合肿瘤学现状的综述,作者建议:1)对TCIM提供者进行教育并将其纳入癌症控制工作队伍,以促进降低风险和具有文化特色的健康生活方式;2)开发并测试TCIM干预措施,以解决癌症症状或治疗相关的不良反应(如疼痛、失眠、疲劳);3)传播并实施基于证据的TCIM干预措施,作为全面姑息治疗和康复护理的一部分,以便所有文化背景的患者都能带着尊严、活力,体面地与癌症共存或战胜癌症。在一个统一的框架下,将传统医学和TCIM结合起来,整合肿瘤学可能会为世界各地的公民提供安全、有效、循证且具有文化敏感性的癌症护理。
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