I’ve written about so-called “integrative medicine” in the past, and my conclusion was that it is largely a Trojan horse intended to exempt certain alternative therapies from rigorous scientific scrutiny and gain mainstream acceptance without appropriate evidence of safety and efficacy. This is accomplished partly by muddying the waters of what “alternative” and conventional therapies are, claiming certain perfectly ordinary science-based practices such as exercise and a healthy diet are “alternative,” and then using the good data for these to imply that all integrative therapies are equally legitimate. Integrative medicine is largely a marketing concept designed to gradually erode skepticism of unproven and implausible methods without actually demonstrating their value scientifically.
There is an interesting and thoughtful discussion of the specific variety of this phenomenon known as “integrative oncology,” in the current issue of Nature (free with registration). Since the same kinds of language and arguments presented for integrative oncology in humans crop up in veterinary oncology fairly often, this article seems quite pertinent to veterinary medicine.
I encourage anyone interested to read the full article, but here are a few selections:
Integrative oncology is often touted as being useful for relieving symptoms, rather than as a primary treatment for the actual cancer. Unfortunately, a closer examination of many CAM modalities indicates that the vast majority of them rest on principles that, from a strictly basic science standpoint, range from highly implausible to virtually impossible — some rest on principles whose precepts violate well-established laws of physics and chemistry and/or are rooted in pre-scientific vitalism (such as homeopathy and energy medicine…In CAM, as in science-based medicine, prior plausibility is no guarantee of positive results, but prior probabilities that are as close to zero as those of homeopathy are a good guarantee of negative results.
To the extent that conventional medicine might underemphasize non-pharmaceutical health-promoting activities, such as lifestyle interventions and nutrition, integrative oncology could be argued to be useful in its reintroduction of an emphasis on consuming a balanced diet, exercising, and doing things that promote general wellness, some of which could conceivably at least improve the quality of life in cancer patients, if not their overall chances of surviving their disease. However, this reintroduction is not without a price, and it is questionable whether the claimed benefits are worth this price.
Integrative oncology integrates unscientific practices into science-based medicine, and, worse, the non-biologically based subdivisions of CAM is so pervasive, so embedded in the very fabric of integrative oncology, that it opens the door to clinical trials of dubious efficacy and the wasting of time and resources.
…in its current form at least, integrative medicine integrates a great deal of pseudoscience and bad science with science-based oncology.
It does not need to be this way…practicing truly holistic oncology does not require rejecting science and embracing pseudoscience. It is possible to introduce scientifically supportable elements of CAM, such as certain dietary and lifestyle interventions, into oncology as science- and evidence-based supportive modalities There should be no such thing as alternative or integrative medicine. There should only be medicine with strong evidence supporting efficacy and safety. Unfortunately, most of what is being ‘integrated’ with science-based medicine in integrative oncology is either unproven or has been proven not to work. Patients with cancer deserve better.