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Integrative oncology — strong science is needed for better patient care

Nature Reviews Cancer volume 15, pages 165–166 (2015)Cite this article

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When reading the response to my recent Opinion article (Integrative oncology: really the best of both worlds? Nature Rev. Cancer 14, 692–700 (2014))1 by the Society for Integrative Oncology (SIO; Integrative oncology — strong science is needed for better patient care. Nature Rev. Cancer http://dx.doi.org/10.1038/nrc3822-c1 (2015))2, it became apparent to me that although we agree that “strong science” is needed for better patient care, we disagree strongly about what constitutes strong science with respect to integrative oncology. I was, however, gratified to see that the SIO conceded that homeopathy and reiki are integrative modalities with the “weakest mechanistic evidence base”. Unfortunately, the SIO seems to have missed my point, as evidenced by the accusation that I “selectively” focused on these two modalities. As I described in the article1 and elsewhere3, there was a clear reason for focusing on these treatments, which was to illustrate how integrative oncology frequently discounts infinitesimally low prior plausibility and how that oversight leads to the integration of pseudoscience into oncology.

Moreover, contrary to what is implied in the SIO's response, reiki and homeopathy are far from irrelevant to the practice of integrative oncology. Reiki, in particular, is offered to cancer patients in many academic medical centres (for example, the Cleveland Clinic4), among them US National Cancer Institute (NCI)-designated comprehensive cancer centres (for example, the University of Arizona5,6 and the Dana Farber Cancer Institute7,8), even though, when boiled down to its essence, it is faith healing that substitutes Eastern mysticism — the 'universal source' for a Christian belief (God) as the source of healing. Naturopathy, which embraces many unscientific and pseudoscientific treatments9,10, is increasingly accepted as a part of integrative oncology, and naturopaths have their own oncology specialty — namely, naturopathic oncology11. Of note, naturopaths are eligible to join the SIO12. Perhaps the SIO is unaware that homeopathy is an integral component of naturopathy, with accredited naturopathy colleges devoting considerable curricular time to it, and that newly minted naturopaths are tested on homeopathy in their licensing examination (which is set by the North American Board of Naturopathic Examiners)13. Indeed, one of the co-authors of the SIO's recently published clinical guidelines14 for patients with breast cancer is a naturopath and principal investigator of a clinical trial (ClinicalTrials.gov identifier NCT01983592) of homeopathic treatment for chemotherapy-induced fatigue.

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Change history

  • 17 March 2015

    This reply to an item of correspondence originally stated that M.D. Anderson Cancer Center offers reiki to patients. However, following publication it was brought to our attention that M.D. Anderson Cancer Center no longer offers reiki, and so we have corrected the sentence online to remove any reference to M.D. Anderson Cancer Center.

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Authors and Affiliations

  1. David H. Gorski is at the Michael and Marian Ilitch Department of Surgery, USA; and the Molecular Therapeutics Program and Department of Oncology, Wayne State University School of Medicine, 6C University Health Center, 4201 St. Antoine Street, Detroit, Michigan 48201, Barbara Ann Karmanos Cancer Institute, 4100 John R Street, Detroit, Michigan 48201, USA.,

    David H. Gorski

  2. and the Molecular Therapeutics Program and Department of Oncology, Barbara Ann Karmanos Cancer Institute, 4100 John R Street, Detroit, Michigan 48201, USA.,

    David H. Gorski

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Correspondence to David H. Gorski.

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The corresponding author is the chair of the board of directors of the Society for Science-Based Medicine, an organization dedicated to promoting a strong scientific basis for medicine, and the managing editor of the Science-Based Medicine weblog.

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Gorski, D. Integrative oncology — strong science is needed for better patient care. Nat Rev Cancer 15, 165–166 (2015). https://doi.org/10.1038/nrc3822-c2

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