Integrating Wellness Into the Management of Patients With Cancer

Gary Deng, MD, PhD, Memorial Sloan Kettering Cancer Center, New York, NY, highlighted the importance of cancer wellness and explained how to incorporate integrative medicine into the management of patients with cancer, at the 2023 Great Debates and Updates in Gastrointestinal Cancers meeting in Chicago.

Transcript:

 Hi, my name is Gary Deng. I'm the medical director for Integrative Medicine at Memorial Sloan Kettering Cancer Center in New York City. Today at the 2023 Great Debates & Updates in Gastrointestinal Malignancies meeting in Chicago, I'm going to talk about a topic that's not often talked about in oncology CMEs, which is cancer wellness.

What do I mean by cancer wellness? A lot of cancer patients, in addition to getting anti-cancer therapeutics like chemo, radiation, surgery, they also want to do of other things themselves to make their body feel stronger, their quality of life better, and not necessarily just using drugs. There are many other things they can use, self-care techniques, nutritional measures, stress reduction, et cetera. This is the area where I've been working on for 20 years. Specifically at this event, I'm going to talk about the pillars for cancer wellness, which includes nutrition, exercise, stress management, sleep and circadian rhythm, which is often overlooked, social and supportive social environment, and joy and meaning in life.

These are the things that often give patients meaning and help them go through the cancer treatment journey in a more positive way. Also, a lot of cancer survivors have the long-term side effect from treatment, and they worry, they gain wait, they cannot sleep, they have chronic fatigue. And if you work them up, there's nothing you can put your finger on. But there are a lot of things they can do with non-drug therapy, non-pharmacological therapies, and this is the area we focus on, such as meditation training, acupuncture, use of nutritional approach, exercise program, and so on.

When we are actually doing this in a day-to-day practice, we work together with the oncology team in an interdisciplinary manner. In fact, our service, the integrated medicine service at Sloan Kettering, we've gotten referral from all oncologists, oncological surgeons, radiation oncologists within our hospital, and we also work closely with supportive care, palliative care people, psychiatry, physical medicine and social work, nutrition service and so on.

It is important to incorporate this as part of their overall cancer care package. And our mission in our service is to make integrated medicine part of standard cancer care, and we can only do that as a team, so we can all work together to support our patients.

One of the questions we often get is about the accessibility, because some of the things we do sounds more like a luxury, and it's not covered by insurance. What we're trying to do is use technology, especially now, you can scale up. For example, we give lectures, and we have courses, demonstration. These are online things that the unit cost is actually pretty low. We teach patients how to manage their stress, how to do meditation through online programs. In addition, we do research to look at what's the best way to deliver these things in a large scale with a low unit cost.

The same accessibility question exists with nutrition. Of course, people always think, “oh, healthy foods are expensive. You have to buy organic. You have to go to Whole Foods.” Actually, that's a misconception, and in coaching our patients, we tell them how to use what they currently have access to and still eat healthy. All you have to do is to make some conscientious choices when you do grocery shopping. It's not that hard, but a lot of people don't know. So that's also a big part of us to reduce healthcare disparity and make this wellness accessible to every patient.

In this talk, I'm going to talk about some of the scientific evidence. Of course, we don't have time to talk about everything. I will also go into the details on some of the specific examples that patients can do. And more importantly, I'm going to talk about how to inspire and guide the patient so they can take more control in their own health, which is very empowering for them. And this way, they'll be more compliant with treatment, in their oncology treatment, and they live a happier life and are in a more robust physical shape and stronger mental state.

Source:

Deng G. “The Pillars of Cancer Wellness.” Presented at: Great Debates and Updates in Gastrointestinal Malignancies; March 30-April 1; Chicago, IL