Psychiatry News Archive Featured in the Media JeffNEWS

Traditionally, many physicians have had some difficulties advocating the use of complementary and alternative medicine (CAM) in treating cancer for a variety of reasons, including a lack of scientific evidence. But a specialist in the field at Thomas Jefferson University Hospital in Philadelphia contends that doctors could be missing out on a potential opportunity.

As the number of cancer survivors continues to climb, physicians need to be more open to discussing the potential use of mind-body therapies, such as various stress-reduction techniques, which are increasingly popular and the use of which in some cases is supported by scientific evidence, says Daniel Monti, M.D., director of the Jefferson-Myrna Brind Center of Integrative Medicine at Thomas Jefferson University Hospital. Many have been found to help with quality of life issues, from stress to pain to coping with a cancer diagnosis.

Writing online in the journal Cancer, Dr. Monti, associate professor of Psychiatry and Human Behavior and Emergency Medicine at Jefferson Medical College of Thomas Jefferson University and the Kimmel Cancer Center at Jefferson suggests that physicians should talk to patients about the potential use of such therapies. Such dialogue, he says, may then “enable the physician and patient to have a more meaningful discussion of things in general and broaden the scope of the relationship.”

“If we look at mind-body therapy as a reasonable platform for patients and doctors to discuss cancer and even recommend things that have an evidence base – stress reduction for improved quality of life, for example, it then can open up broader discussions for other CAM modalities,” Dr. Monti says.

Surveys indicate that while patients in general are drawn in increasing numbers to CAM, they tend not to tell their doctors about it because they perceive doctors as being uncomfortable with it. One problem is that physicians often are unaware of scientific evidence supporting the effectiveness of some mind-body therapies.  

Dr. Monti maintains that many physicians are missing an important point. “There’s a patient-doctor communication and relationship gap,” he says. A recent study showed that the patient-doctor relationship can be somewhat lacking in empathy. “Most oncologists are very caring people, but I don’t think they always know what to recommend for patients’ psychosocial needs. There are therapies that are evidence-based and which enable the oncologist to be more open-minded to consider these things as options.

“At Jefferson, this is happening more and more. A grant funded by the National Cancer Institute looks at diverse ways to support patients such as mindfulness meditation and creative expression – specific skills that help patients achieve a better quality of life.

“We’re not saying that cancer patients should be encouraged to take shark cartilage to cure their cancer,” Dr. Monti says. “We’re saying, ‘Let’s meet the patients halfway by offering to discuss safe and potentially helpful CAM modalities (mind-body therapies), which could create the space for patients to talk about other types of CAM therapies they are considering.’ Doctors tend not to think about encouraging patients in this way, but patients are looking for ways to cope with the difficulties of having a cancer diagnosis and this provides a platform to address CAM modalities and concerns about things a little less safe. The cancer patient who wants to go on a vegan diet for its “healthful effects” may not know that although it could be great for the heart, there are cautions to consider for someone in the early stages of cancer treatment,” he says.