A study by Terri Crudup and her colleagues was published by the online Journal of Oncology in January of 2022. The study examined the relationship between patient survival and the treating hospitals’ use of integrative therapies. While some studies have looked at the subjective wellbeing of patients using some of these therapies, this study is the first to look at institutional endorsement of integrative therapies and patient survivorship.

In this study, patients in hospitals that had low- to mid-level use of integrative therapies had triple the 5-year survivorship of those treated at institutions that had low level use of integrative therapies. Significantly, patients treated in hospitals with high levels of integrative therapies had a 48% increase in 5-year survivorship.

The theory

A cancer diagnosis impacts the whole person, affecting not just physical wellbeing. It also creates a cascade of emotional and mental health correlates. Additionally, it often prompts a spiritual crisis. It makes sense, then, that integrative therapies are popular among cancer patients. Integrative therapy is the term used for the combination of complementary and lifestyle therapies with conventional medical treatment.

Some of the most popular integrative approaches include nutrition counseling, exercise counseling, massage therapy and support groups. Others include meditation, biofield therapies, and physical practices like yoga and chi gong. However, without institutional involvement, these therapies are difficult for patients to find and to afford. Patient demand alone might not be enough to enroll other hospitals into the integrative world – but research like this might.

The study setup

Participants: The study included 172 patients, treated by 103 oncologists from 103 institutions. All patients were adult women. They had been treated for breast cancer in 2013 and 2014. Among the women in the study, the median age was 51. Finally, eight percent of participants had metastatic disease.

Scoring system for institutional involvement in integrative therapies: The researchers identified 12 therapies that are popular among breast cancer patients, listed below. Then they questioned providers about their institutional involvement on three metrics:

  1. First, educate: increase patient knowledge of integrative therapy
  2. Secondly, support: recommend, provide access to integrative therapy
  3. Thirdly, provide: institution covers partial or full cost of integrative therapy

Integrative therapies included in the study

  • Nutrition consultation or program
  • Exercise consultation or program
  • Patient support groups or patient-survivor pairing
  • Spiritual services
  • Psycho-oncology support
  • Massage therapy
  • Meditation or mindfulness
  • Yoga
  • Acupuncture or acupressure
  • Music or art therapy
  • Reiki, Healing Touch, Therapeutic Touch
  • Tai chi or chi gong
  • Study results

Study results

As noted in the beginning of this article, patients in hospitals that had just a low- to mid-level use of integrative therapies had triple the 5-year survivorship of those treated at institutions that had low involvement of integrative therapies. This was based on multivariate analysis (see below). Here is the breakdown:

5-year survivorship by level of institutional involvement

  • low cohort: 89%
  • low-mid cohort: 96%
  • mid-high cohort: 96%, and
  • high cohort: 95%

Considering other factors (multivariate modeling)

Increased odds of 5-year survivorship include:

  • An older age at diagnosis (66–76),
  • Having a PPO insurance plan,
  • Being treated in an academic setting, and
  • Being treated by an institution with a low-mid or mid-high integrative involvement score.

Of note

You may have noticed that the increase in survivorship among patients of hospitals with low- to mid-level involvement with integrative therapies was quite high. In contrast, however, the incremental benefit for patients treated at institutions with high-level involvement was relatively low. The authors not that this might be due to increased illness among people seeking treatment centers that offer these services.

Also, interestingly, a 2018 study published in the Journal of the National Cancer Institute found that people who used alternative therapies had worse outcomes than those who followed conventional medical practices. Alternative medicine is exactly that: an alternative to the conventional practice. The current study is quite different in that this examined the integrative model.

Why this study matters

This study adds to the growing body of evidence supporting the use of integrative therapies. Indeed, these therapies offer a sense of safety and increase wellbeing among patients. However, they are more than feel-good therapies. The results of this study suggest that in fact, they impact survivorship.