Clinical Topics & News

A New Integrative Oncology Clinic at the Veterans Affairs Pittsburgh Healthcare System


 

Background

Prostate cancer is a common cancer among US veterans (31.8%). Radiation/chemotherapy effects (dry mouth, fatigue, neuropathy, gastrointestinal) are worsened by hormonal effects (hot flashes, weak bones, sexual dysfunction). Conventional treatments help symptoms (reactive) while integrative oncology proactively prevents them, links complementary with conventional care. Veterans are unfamiliar with integrative services. Office of Patient-Centered Care and Cultural Transformation awarded grant funding to build an Integrative Oncology-Prostate Cancer clinic. Goals: improve surgical outcomes, lessen chemotherapy/radiation side effects, boost morale, optimize post-therapy clinical outcomes over a 1-year period.

Objective

Evidence-based integrative therapies shift our focus from treating disease to treating the whole patient. Empowering veterans to take charge of their health improves health outcomes.

Methods

Identify veterans with prostate cancer and screen for symptoms (ie, anxiety, fatigue, depression, neuropathy, nausea, vomiting, diarrhea, anorexia, constipation, sexual dysfunction, insomnia). We will perform a personal health inventory (PHI), assess stress with a Perceived Stress Score (PSS), identify the patient’s mission, aspiration, and purpose (MAP). Other measures: PROMIS-10 (measures emotional, spiritual, social support, selfmanagement); OMPRACTICE-instant feedback; HOPE-FACT-spiritual test. Consults: psychology, acupuncture, nutrition, pharmacy, social work, chaplain, creative arts, music, dance, movement, reiki, yoga, qigong, Tai-chi, rehab, pre-habilitation.

Results

Recruitment began in June 2021; we have 37 enlisted patients, 5 battlefield acupuncturists, 1 reiki instructor, 1 hypnotist, 1 dance therapist, 1 massage therapist. Other services are available by referral. Weekly Integrative Oncology meetings: Two 90-minute clinics twice weekly.

Conclusions

Interest in integrative oncology is high. Abundant resources exist. We increased awareness and accessibility. Future plans: Assess program adherence, boost patient satisfaction, and enrolment.

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