Chapter 6: Integrative oncology, MBIs Flashcards
Alternative vs Complementary Medicine
Alternative - used instead of mainstream, Western medicine
Complementary - used in additional to mainstream medicine
CAM
“Complementary & Alternative Medicine,” most commonly used in publishings
Define “allopathic” medicine
Conventional medicine
Define “Integrative Medicine”
A more recent term that emphasizes the integration of conventional practices + complementary or alternative practices that are safe and evidence-based in efficacy
The heart of IM is the focus on the WHOLE PERSON and their environment
IM = whole health
The NIH classifies complementary health approaches into these 2 categories…
- Biological products
- Mind-body practices
T/F: Biological products (special diets, supplements) are less commonly used than mind-body interventions among cancer & cancer survivors in the US
FALSE - more common use of biological products
Define “Whole Medical Systems”
Traditionally characteristic of traditional, ancient cultures
They encompass mind-body approaches, biologically based, and energy-based approaches
i,e, Traditional Chinese Medicine
What are 3 types of alternative “Whole Medical Systems”
- Traditional Chinese Medicine - uses acupuncture, tai chi, music, biological products
- Ayurveda - Indian belief based on finding the perfect balance of nature elements and the human body. Includes meditation & yoga.
- Homeopathy - biologically based, using diluted natural substances to heal
Define “qi”
Pronounced “chi”
Part of chinese medicine, acupuncture & acupressure help more qi through the body
4 components of meditation
- Quiet, relatively distraction-free area
- Comfortable posture
- Focus of attention
- Judgement-free attitude towards thoughts that arise
Define Mindfulness-Based Stress Reduction (MBSR)
6-8 week mindfulness-based meditation program. Goal is to increase mindfulness in day to day life. Created by Jon Katbat Zinn
Define Qi Gong
Various ways to move qi throughout, into, or out of the body. Incorporates movement, meditation, breathing, massage
Define Tai Chi
A martial arts practice that involves qi gong
What fraction of the US population uses some type of CAM (biological or MBI)?
1/3
What percentage of US adults with cancer have used CAM within the past year?
35.3% (slightly higher than average)
Higher amongst breast cancer
What are the 3 most commonly used MBIs?
- Deep breathing
- Meditation
- Yoga
What are the 3 most common MBIs offered at cancer centers?
- Accupuncture
2/3 (tied): Meditation & yoga
Which BMI group is most likely to use CAM?
Overweight (compared to normal, underweight, or obese)
T/F: The use of CAM is most common among young adult women
True
Most common in 20-30 y/o & > 60 years
Most common in highly educated, widowed, retired
What is the most-likely proposed mechanism of effectiveness for MBIs?
Management of both negative mental and biological impacts of stress
Stress can inhibit immune system & increase inflammation
Has both top down (contemplative like deep breathing U& meditation) & bottom up impacts on stress
The stress response involves the ________________ nervous system
Autonomic (part of the peripheral nervous system)
“involuntary”
Sympathetic vs Parasympathetic nervous system
Sympathetic = fight or flight
*chronic activation = increased inflammation
Parasympathetic = rest & digest
*activation = decreased inflammation
Vagus nerve
Found in neck, activation reduces stress (i.e. top down MBIS)
HPA axis
Hypothalamic-pituitary-adrenal (HPA) axis
(think cortisol) - activation increases stress
Evidence Grades by the Society for Integrative Oncology for therapies on breast Cancer
Grade A - recommended, high certainty of substantial benefit. Provide and recommend.
Grade B - recommend. either high to moderate certainty regarding moderate to substantial benefit. Offer and provide.
Grade C - recommend selectively. individualize using judgement and pt preference. There is at least moderate evidence that the net benefit is small.
What grade is acupuncture for use with antiemetic drugs to help control chemo-induced nausea & vomiting?
Grade B
What grade is acupuncture for
-reducing stress/anxiety
-reducing hot flashes
-reducing cancer-related pain
-reducing cancer fatigue
-reducing mood disturbances
Grade C
Limitations regarding acupuncture research
Inadequate descriptions regarding the interventions including specific points used and if it was carried out according to TCM theory
The SIO qualifies the evidence for qigong as an intvervention to improve _______________ for people with breast cancer as grade C
QOL
2 goals of meditation
- Cultivate awareness
- Monitor one’s thoughts with openness
The effects of meditation & MBSR for reducing anxiety, mood disturbances, and depressive symptoms are considered grade ___________
A
______ yoga is the most common in the US/canada and forms the basis for all classic approaches to yoga
Hatha
Emphasizes postures & breathing
Grade for yoga on reduced anxiety, mood disturbances, and depressive symptoms
B
Grade for yoga on reduced fatigue
C
T/F: Yoga therapist credential requires less training than yoga teacher credential
False. Yoga therapists dedicate their practice as a healing art *at least 800 hours)
This lineage of yoga is most ideal for people with cancer d/t focusing on people with imbalances
Yoga Therapy
Define Yin Yoga
Poses help for 3-5 minutes to strengthen connective tissue
Define Bikram
Hot yoga
Define Vinyasa
“Flow Yoga” - different from hatha where poses are 1 at a time
Define Restorative Yoga
Modifies poses to allow those with cancer or other medical conditions to practice yoga with modifications
Define Viniyoga
Therapeutic yoga tailored to individuals with an emphasis on breath
Define Kundalini
Meditation focused on spiritual awakening which includes movement
Define Kripalu
Inquiry-based yoga focusing on highlighting awareness and accepting sensations/thoughts
thing “crippling” thoughts
Define Iyengar
A hatha-style yoga with an emphasis on precise structural alignment, such as for therapeutic reasons (i.e. legs up the wall for edema reduction)
Define Ashtanga
“Flow yoga” but the same poses are repeated each class
Define Anusara
A wholistic approach to yoga focusing on traditional yogurt roots including spiritual growth + hatha poses
What are 3 types of yoga therapy?
- Restorative yoga
- Iyengar (i.e. feet up wall)
- Yiniyoga (individulized, breath)
