This September, researchers and practitioners at The Patterson Institute for Integrative Oncology Research and The Centre for Health Innovation (CHI) attended The Society for Integrative Oncology (SIO)’s 20th annual conference in Banff, Canada.
SIO is a multidisciplinary professional organization for integrative oncology that includes a community of oncologists, nurses, naturopathic doctors (ND), and many other complementary and conventional healthcare providers. The mission of SIO is to advance evidence-based, integrative healthcare to improve the lives of people affected by cancer.
Figure 1. Photo taken in Banff, Alberta at the SIO conference. Left to right: Anne Pitman, Yoga Therapist, Mark Legacy, Research Coordinator, Dr. Erica Rizzolo, ND, research assistant, Dr. Julie Robinson, ND, research assistant.
The Patterson Institute and the CHI submitted four abstracts for the conference which were accepted as research poster presentations. Three of them were literature reviews about the use of intravenous (IV) vitamin C (IVC), IV alpha lipoic acid (ALA), and artemisinin and its derivatives. The other poster presented quality of life (QOL) data from the Canadian/US Integrative Oncology Study (CUSIOS), a large clinical study we have run which completed recruitment in 2020.
Literature reviews are conducted at The Patterson Institute to aide in the creation of monographs available to NDs, other healthcare professionals, and patients living with cancer. These monographs act as a resource for information on the existing evidence in cancer care. Regarding artemisinin and its derivatives in cancer care, there is still a lack of evidence on its effectiveness; however, they are generally safe with appropriate use. More research is needed to explore the potential for its use in cancer control. Similarly, there is insufficient evidence to comment on the efficacy of IV ALA in the context of cancer management, and more clinical research is needed. Regarding IVC, the collective results from 23 clinical trials demonstrate that IVC is generally safe and well tolerated with minimal and mild side effects. Some but not all studies have found benefits for QOL and symptom management alongside cancer treatment or as monotherapy. There is preliminary evidence that IVC given alongside conventional cancer treatments, such as surgery or chemotherapy, may improve tumor response or survival outcomes in advanced pancreatic cancer, non-small cell lung cancer, colorectal cancer, and ovarian cancer. More rigorous, larger, randomized trials are needed to confirm these results.
The clinical study CUSIOS was created in partnership with Bastyr University and is a North American-wide observational study exploring the impact of complementary care delivered by NDs for patients with advanced breast, colorectal, ovarian, and pancreatic cancer. Study objectives were to describe and analyze impacts on QOL, cancer-related costs, qualitative experiences, and survival outcomes. Results pertaining to QOL were presented at the SIO conference. Ninety-seven patients were included in the analysis. In summary, we observed continued improvements in QOL over time, and improvements in symptom burden at 3 months, which remained stable throughout the study. We cannot say for certain if these improvements were a result of naturopathic medicine, since there was no control group to compare these results to.
All four posters gained a lot of attention among attendees and sparked great discussion about integrative oncology research at The Patterson Institute and other projects. Special thanks to our research coordinator, Mark Legacy, and research assistant, Dr. Erica Rizzolo, ND, for putting these posters together and presenting them at the reception.
Overview of Conference Content
A wide range of topics related to integrative cancer care were showcased. One of the highlights was SIO’s new clinical practice guidelines for anxiety and depression, which were created in partnership with the American Society of Clinical Oncology (ASCO).
Drs. Suzie Zick, Linda Carlson, and Lynda Balneaves presented the latest clinical practice guideline developed by SIO and ASCO, “Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults with Cancer.” The guideline was developed by an expert panel, as well as methodology experts and patient advocate representatives. These guidelines present healthcare providers with evidence-based recommendations on integrative approaches to managing anxiety and depression in adults with cancer. Recommendations included mindfulness-based interventions, yoga, relaxation, music therapy, reflexology, and aromatherapy. If you wish to learn more, you can read the full publication here.
The conference also featured many keynote speakers. Dr. Donald Abrams spoke about his experience as a pioneer in integrative oncology, sharing how the field has changed over his years in-practice and what the challenges are for the future. Drs. Amanda Wurz, Jennifer Brunet, and Nicole Culos-Reed gave a three-part presentation on prescribing exercise in oncology. Topics covered included its role in pediatric oncology, physical activity interventions for cancer-related cognitive impairment, and a review of the community-based oncology exercise program “Exercise for cancer to Enhance Living Well,” a Canada-wide program for rural and remote cancer survivors. One of their takeaways was that a one-size-fits-all approach does not work, and individualized exercise recommendations are needed. Dr. Gregor Reid, the winner of the Dr. Rogers Prize for Excellence in Complementary and Alternative Medicine, presented on his ongoing research into how beneficial gut microbes can impact disease prevention and therapy, including some cancers.
Throughout the conference, three plenaries were held on traditional medicine and healing, trauma-informed integrative oncology, and psychedelics. The discussion on traditional medicine and healing spoke to working with Indigenous communities in cancer care, and the traumas experienced by First Nations people. The trauma discussion included a first-hand experience from a patient advocate, and the key principles of trauma-informed practice. Finally, the psychedelics plenary focused on psilocybin-assisted therapy in the context of advanced cancer and existential distress.
Every morning of the conference, a wellness session was held for any early risers wishing to start their day with some activity. The first morning attendees went on a hike to watch the sunrise. The second morning, the CHI’s yoga therapist and active member of SIO, Anne Pitman, led an “Embodied Yoga” class, which was a great way to wake up our bodies and begin the day feeling more grounded. Anne also acted as chair to the plenary on trauma-informed integrative oncology. In the afternoons, several breakout sessions were held for attendees to learn about more niche topics. There were a wide range of interesting subjects, including recent research on mind-body interventions, vitamins and nutrition, acupuncture in cancer care, exercise program interventions, and discussions on stool testing to guide treatment decisions and drug-herb interactions.
KNOW Integrative Oncology at SIO
The KNOW Integrative Oncology website is a not-for-profit database dedicated to supporting education, safety, and clinical decision-making about integrative cancer care. It offers current summaries on human studies involving cancer patients and various natural agents or nutritional interventions. KNOW’s Dr. Heather Wright, ND, FABNO, and Dr. Julie Robinson, ND, showcased the platform at the SIO conference.
Historically, SIO members enjoyed access to this database. However, due to financial restructuring within SIO, this access for members was set to be discontinued after October. This change caught many SIO members off guard, especially medical and radiation oncologists, who were the primary audience at the conference. These professionals were vocal about the database being a helpful tool for addressing questions related to natural therapies in cancer care.
One intriguing and frequently discussed topic during the demonstrations was the growing trend of patients self-prescribing natural agents and nutritional interventions. Practitioners often find themselves at a loss when encountering unfamiliar natural agents. KNOW was highlighted as a much-needed solution to bridge this gap, providing practitioners with valuable information on natural therapies in cancer care.
The SIO conference was an inspiring weekend for researchers and clinicians from various fields of integrative oncology to connect and discuss new and emerging research, gaps in the integrative healthcare system, and brainstorm ways we might be able to answer unmet needs in cancer care. It was also an opportunity to highlight the value of practitioner resources such as the KNOW database.
If you are someone effected by cancer, consider visiting SIO’s “Patients, Care Partners and Patient Advocates” page here. If wish to read more about ongoing research at The Patterson Institute, please visit us at: https://thechi.ca/research/. As of recent, you can now follow us for updates on Facebook and Instagram.