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Volume 17, Issue 2, September 2009
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Coordinator's Message Integrative Oncology Nursing: Inspire, Initiate, and Influence Change
Greetings to all Complementary and Integrative Therapies SIG members! Thank you for a successful yearly meeting at Congress. We welcomed our new Coordinator-Elect Judith Fouladbakhsh, PhD, APRN, BC, AHN-BC, CHTP, and new Co-Editor Georgia Decker, APRN, ANP-BC, CN®, AOCN®. Judi is a complementary and alternative medicine (CAM) consultant and assistant professor at Wayne State University in Detroit, MI. Judi will begin her “Coordinator-Elect” column in the next issue. Georgia Decker is the immediate past ONS president, founder of Integrative Care in Albany, NY, former editor of the Clinical Journal of Oncology Nursing column—“Integrative Care,” and editor of An Introduction to Complementary and Alternative Therapies (1999). This issue is filled with exciting information. A review article in Integrative Medicine: A Clinician’s Journal caught my attention recently. The article, “Anxiety and Depression: It All Starts With Stress” was written by a naturopathic physician. A close connection exists between anxiety and depression, and for some people, if they have one symptom, they may have the other as well. Stress comes in many forms, and the body’s response can be both helpful and harmful. A mind-body approach that is rapidly gaining attention, clinical use, and a literature base is mindfulness-based stress reduction (MBSR). MBSR may help a broad range of individuals, including ourselves and our patients. In the “Cancer Complementary and Alternative Medicine Practice” article of this newsletter, the tenets of MBSR, its clinical use, and helpful resources are summarized. Labels, labels, labels . . . Have you found yourself reading more labels lately? What really is in this cereal, this medicine, this loaf of bread? In the “Cancer Complementary and Alternative Medicine Tools” article, Georgia Decker will refresh our memory on what to look for in “How to Read a Label.” The Office of Dietary Supplements has a series of new resource materials that will be announced in this article as well. The Practice of Integrative Medicine: A Legal and Operational Guide, the Journal of Complementary and Integrative Medicine, and the Natural Medicine Journal are reviewed in our “Cancer Complementary and Alternative Medicine Education” article. See what resources exist for your unit, clinic, school, or hospital to put into immediate use! Looking for CAM modalities that are under study now? Are you curious about results of closed cancer CAM clinical trials? The National Cancer Institute displays these trials in an easy-to-access, frequently-updated format. See the “Cancer CAM Research” article to find out how to access the use of CAM modalities for cancer treatment and symptom management. How far have you traveled in the world? Have you ever been to Tanzania? SIG and long-time ONS member Denise Murray Edwards, ARNP, BC, MA, M.Ed, MTS, shares her journey to Tanzania in “Member Highlights.” The SIG leadership encourages you to join in the activities and share what you have learned in cancer CAM. And don’t forget to take some time out this summer to de-stress! Reference Wilson, D. (2009). Anxiety and depression: It all starts with stress. Integrative Medicine: A Clinician’s Journal, 8(3), 42–45. |
Colleen O. Lee, MS, CRNP, AOCN®
The Complementary and Integrative Therapies SIG Newsletter is produced by members of the Complementary and Integrative Therapies SIG and ONS staff and is not a peer-reviewed publication. |
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Special Interest Group Newsletter September 2009 |
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About Our SIG
Click here to read the minutes from this meeting. The Complementary and Integrative Therapies SIG began in 1992 and now has over 400 members who have interest and expertise in a vast array of complementary, alternative, and integrative therapies. The goals of the SIG are as follows.
Check out the SIG membership chart. How do I network in the SIG?
How can I become more connected in the SIG?
If you are interested in serving in the SIG, contact Coordinator Colleen O. Lee, MS, CRNP, AOCN®.
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Our annual SIG Planning/Networking meeting was held Thursday, April 30, 2009, from 5–6:30 pm.| |
Special Interest Group Newsletter September 2009 |
Cancer Complementary and Alternative Medicine Practice
Mindfulness meditation is a self-regulatory approach to stress reduction and emotion management as practiced in mindfulness-based stress reduction (MBSR). Mindfulness is a state in which an individual is very aware of the present moment by paying attention to breathing, sights, sounds, and sensations or thoughts and feelings. Growing interest in the use of MBSR reflects a desire for a more “whole” approach to cancer treatment with respect to the relationship between social, psychological, and physiological health (Grossman, Niemann, Schmidt, & Walach, 2004). Mindfulness does not require a great deal of physical effort for the novice, and it has been shown to be helpful to patients who have cancer and other medical conditions. Mindfulness can bring about relaxation, although relaxation is not the main goal. Mindfulness differs from cognitive-behavioral therapy in that it does not attempt to distract or to reframe the stimuli. Rather, the main goal is the development of a stable nonreactive awareness of the stimuli and a return to the physical experience of breathing or other body sensations.
MBSR can lead to a gradual conversion than can strengthen and enhance the life experience of individuals with cancer (Ott, Norris, & Bauer-Wu, 2006).
A Mindfulness Meditation Professional Society The Center for Mindfulness in Medicine, Health Care, and Society (CFM) was established in 1995 by Jon Kabat-Zinn, PhD. The Center is a natural outgrowth of the acclaimed Stress Reduction Clinic founded in 1979 at the UMass Medical School. The Center serves a broad international constituency and is the oldest and largest academic medical center-based stress reduction program in the world. Mindfulness Meditation Research Two published meta-analyses detail MBSR research.
Sample Clinical Trial Involving Mindfulness Medication Mindfulness Meditation in Bone Marrow Transplantation
Read more information about this trial in the listing in cancer.gov. For more general information, check out the NCCAM Meditation Backgrounder.
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Colleen O. Lee, MS, CRNP, AOCN®| |
Special Interest Group Newsletter September 2009 |
Cancer Complementary and Alternative Medicine Tools  Georgia Decker, APRN, ANP-BC, CN®, AOCN® Reading a food or dietary supplement label can feel like life’s greatest mystery. Consumers, including healthcare professionals and patients with cancer, are frequently confused by food and dietary supplement labels. It can be difficult to make sense of the information provided on a label. Frequently asked questions include: What does “natural” mean? “Organic?” “Certified organic?” What is a serving size? What is RDA? Or RDI? What are other ingredients? The U.S. Congress passed the Dietary Supplement Health and Education Act (DSHEA) in 1994. The DSHEA included an expanded definition of dietary supplements and dietary ingredients and required specific information for ingredient and nutrition labeling. The term dietary supplement goes beyond essential nutrients and includes herbs, fish oils, enzymes, glandulars, and combination items, as defined by the DSHEA. This act allows for a variety of acceptable statements and claims and product labels, excluding claims concerning the use of supplements to diagnose, prevent, treat, or cure specific diseases. The DSHEA also mandates that retail establishments make third party materials available to help consumers understand health-related benefits and risks associated with dietary supplements. This information cannot be brand specific and may not include promotional materials. Current product labels provide information based on serving size. The advantage of this is that it makes comparison of products easier when the serving sizes are the same. However, serving sizes are not standardized. Also, when purchasing herbs and dietary supplements purity is a concern, and labels should be checked for preservative content. When a person receives a diagnosis of cancer, friends and family want to be of assistance. Often these well-meaning friends and family members bring supplements that they believe will be of help to the person recently diagnosed. Supplements believed to boost the immune system, fight cancer cells, and aid in relaxation and sleeping are common choices. Resources for assisting patients in understanding what is contained in a food, supplement, or herb are accessible in a Clinical Journal of Oncology Nursing Integrated Care column: How to Read Food and Dietary Supplement Labels.
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Special Interest Group Newsletter September 2009 |
Office of Dietary Supplements Update 
Georgia Decker, APRN, ANP-BC, CN®, AOCN® The mission of the Office of Dietary Supplements (ODS) is to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, stimulating and supporting research, disseminating research results, and educating the public to foster an enhanced quality of life and health for the U.S. population. The ODS was created in 1995 within the Office of Disease Prevention (ODP), Office of the Director (OD), National Institutes of Health. The ODS has developed fact sheets on a variety of nutrients and other dietary supplement ingredients directed primarily to healthcare providers and researchers. The sheets provide detailed overviews of ingredients, information of their associations with various health outcomes, and extensive lists of references. Dietary Supplement Fact Sheets You Are Invited To Share! My Integrative Oncology Nursing Practice:
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Special Interest Group Newsletter September 2009 |
Cancer Complementary and Alternative Medicine Education 
Georgia Decker, APRN, ANP-BC, CN®, AOCN® Journal of Complementary and Integrative Medicine (JCIM)
Database Highlights: Natural Standard The Natural Standard (NS) Web site states that it was founded by clinicians and researchers to provide high quality, evidence-based information about complementary and alternative therapies. This international multidisciplinary collaboration now includes contributors from more than 100 academic institutions. NS is impartial and not supported by any interest group, professional organization, or product manufacturer. A research team systematically gathers scientific data and expert opinions for each therapy covered by NS. Validated rating scales are used to evaluate the quality of available evidence. Information is incorporated into comprehensive monographs. These monographs undergo blinded editorial and peer review before they are included in databases and are intended to facilitate clinical decision making. The Web site provides access to demonstrations, audio/podcasts, news and events, and Webinars. Some of the databases include the following.
Some of the Webinars include video (requires Adobe Flash Player) and printable handouts (PDFs) (“Webinar” tab is on the left side)
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Special Interest Group Newsletter September 2009 |
Patient Education 
Colleen O. Lee, MS, CRNP, AOCN® The National Cancer Institute (NCI) has a long history indicative of its interest in the scientific evaluation of complementary and alternative modalities (CAM) in cancer. As a result of the interest in CAM within the NCI, the Office of Cancer Complementary and Alternative Medicine (OCCAM) was created by NCI senior leadership in 1998. The OCCAM coordinates and enhances activities of the NCI in CAM research as it relates to the prevention, diagnosis, and treatment of cancer, cancer-related symptoms, and side effects of conventional cancer treatment. In fiscal year 2007, the NCI sponsored about $121,932,765 in CAM-related research. These dollars represent greater than 461 projects in the form of cooperative agreements, grants, supplements, or contracts. The Health Information section on the OCCAM Web site provides helpful resources for patients and healthcare professionals looking for information about cancer and CAM including definitions, databases, publications, and links to trustworthy Web sites. One popular example is the awarding winning publication Thinking about CAM: A Guide for People with Cancer. Patients and healthcare providers can download the document as a PDF and/or order a free print copy. Have you read a cancer CAM text that you would like to share with the SIG? Please submit your review. You are welcome to use a similar format as seen above or as seen in each issue of the Oncology Nursing Forum.
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Special Interest Group Newsletter September 2009 |
Professional Development
The Fellowship in Integrative Medicine at the Arizona Center for Integrative Medicine (ACIM) is a 1,000 hour, two-year distance learning program created by Andrew Weil, MD, in 2000 and is designed for physicians, nurse practitioners, and physician assistants. The Arizona Center defines integrative medicine (IM) as healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle while emphasizing the therapeutic relationship and making use of all appropriate therapies. Their stated mission is to lead the transformation of healthcare by creating, educating, and actively supporting a community of professionals who embody the philosophy and practice of IM. Since its inception, the ACIM has focused its efforts on education, clinical care, and research with the primary emphasis on education.
An overview of programs, tuition, and additional eligibility information is available.
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Georgia Decker, APRN, ANP-BC, CN®, AOCN®| |
Special Interest Group Newsletter September 2009 |
Cancer Complementary and Alternative Medicine Research
Looking for complementary and alternative medicine (CAM) modalities that are under study now in clinical trials settings for cancer prevention, symptom management, or treatment? Are you curious about results of closed cancer CAM clinical trials? The National Cancer Institute’s (NCI’s) Office of Cancer Complementary and Alternative Medicine (OCCAM) displays these trials in an easy-to-access, frequently-updated format. CAM clinical trials are added daily to NCI's PDQ® comprehensive cancer database. View CAM clinical trials by the following groupings.
Cancer CAM Clinical Trials by Cancer Type (Active Trials)
Cancer CAM Clinical Trials by Symptom or Side Effect (Active Trials)
All Cancer CAM Clinical Trials
Featured CAM Clinical Trials
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Colleen O. Lee, MS, CRNP, AOCN®| |
Special Interest Group Newsletter September 2009 |
Member Highlights 
Denise Murray Edwards, ARNP, BC, MA, M.Ed, MTS Being part of a palliative care project in Tanzania, the fifth poorest nation on earth, was an experience that may take years to integrate. This project receives its funding from a non-government organization, the American International Health Alliance. Before I left for Tanzania, I had heard the phrase, “life-changing event.” While there, I participated in the home visiting segment of an ongoing palliative care and AIDS project. Now that I’m back in Iowa, I find it hard to fully capture the incredible warmth, openness, and caretaking that our team experienced from the local people we were there to assist. Our six-member team consisted of project leader, Philip Latessa (Associate Director of Global Health at Des Moines University), Yogesh (Yogi) Shaw, MD, Tim Ihrig, MD (senior resident in palliative care), Mary Engstrom (former teacher), Todd Byerly (Tanzanian coordinator for the project), and me. I have chosen to focus mainly on our first home visit that began with a lunch with one of the palliative care teams. Each team received classroom instruction and a small stipend. We listened to the data regarding types of illness, age, care given, frequency of visits in English, and with an interpreter in Swahili. Being "fed" lunch was significant to these workers who have very little protein in their diets; their plates were heaped with food and refilled. For some, it was the only meal of the day. Following lunch, the six of us were draped in kanga, a local cloth that most people wear. The cloth is beautifully colored and was wrapped Masai style for the men (like a toga) and for the women like a skirt with a shawl and perhaps a head covering. Everyone wanted to go on the first home visit, but space was limited so we crushed three people in front and ten on bench seats in the back. Soon, Yogi had everyone singing hymns in Swahili as we bumped up the narrow, red dirt road that clung to the side of the mountain. The Iowans soon picked up the “Bwana Jesu” chorus and we were quite connected by the time we stopped after fifteen minutes to climb another twenty minutes up a steep vertical trail. The palliative care worker (PCW) would have walked or bicycled the entire distance for each of his or her visits. The mud brick hut had two small rooms without mirrors, water, or electricity. The mother and her daughter were happy to see us and clearly felt comfortable with the PCW. The mother had a leg ulcer that extended from knee to ankle. Her daughter had AIDS, and the teenage granddaughter was the caretaker. She planted the vegetable and flower gardens and managed the chickens, which supplied the protein for their diet. Only acetaminophen and a non-steroid anti-inflammatory drug were available for pain, and one important goal of the project was to bring morphine to this area. We had only ourselves on this day, and I had my hands. With this patient, and all subsequent patients, I performed Reiki and Healing Touch which I felt were wonderful resources in an area where so few tangible ones exist. The daughter needed to be seen at the hospital and lacked funds for transportation. Our team supplied the funds and handed the PCW enough to take care of expenses. What was so meaningful was the response of the economically poor and underpaid PCW’s who accompanied us. Each of them offered their coins as well. We took their pictures and showed them immediately, and this was an unexpected surprise for them. Copies will accompany the next team in March so the patients and workers can have a photo to keep. This was especially significant for a young woman seen later that afternoon with an untreatable shoulder cancer who was near death. Later, as we slowly started back down the mountain on foot, we came to a very slippery place. The women on either side of me just reached out and took my hands to keep me steady. That expression of assistance was such a metaphor for our whole experience. One of our drivers told us that Tanzania is a very poor country so they have to get along and help each other; they cannot afford to focus on differences. They have much to teach us. If you would like to learn more about Denise’s trip, please feel free on contact her. Reference Hibdon, S.S. (2005). Biofield considerations in cancer treatment. Seminars in Oncology Nursing, 21(3), 196–200.
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Special Interest Group Newsletter September 2009 |
Conference Highlights
The goal of the conference was to provide a single event that would attract a significant accumulation of cutting-edge, peer-reviewed science and discussion in the field of complementary and integrative medical research. The conference benefited from collaboration with many professional organizations, publishers, and granting agencies that focus on aspects in the field. Events throughout the four-day meeting were designed to foster the development of new collaborations and to strengthen existing partnerships. A major highlight of the conference was the special session, “Integrative Medicine in Cancer Care” moderated by Moshe Frenkel, MD, from the University of Texas at MD Anderson Cancer Center (UT MDACC). Dr. Frenkel addressed the overriding themes within the field, namely, the challenges associated with a cancer diagnosis, conventional and complementary approaches to treatment, status of research funding, common issues in clinical settings when conducting research, and the various models of integrative oncology practices. Some of the speakers addressed specific topics.
The IO forum ended with a question-and-answer session inviting audience participation. For more information about the conference please check out the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) and the North American Research Conference on Complementary and Integrative Medicine. Did you know?
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Integrative Medicine in Cancer Care | |
Special Interest Group Newsletter September 2009 |
Wanted! Your Expertise!
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Share your expertise in the Complementary and Integrative Therapies SIG Newsletter. We are looking for articles on integrating care into practice. This includes practical experience as well as research summaries—500–1000 words, APA style references. We need your submissions now! | |
Special Interest Group Newsletter September 2009 |
ONS Article of Interest Check out the Oncology Nursing Forum (ONF) for an interesting article about complementary and integrative therapies.
For access to the full-text version of this and other ONF articles, visit the Publications area of the ONS Web site.
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| Special Interest Group Newsletter September 2009 |
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Membership Information SIG Membership Benefits
Join a Virtual Community A great way to stay connected to your SIG is to join its Virtual Community. It’s easy to do so. All you will need to do is
Subscribe to Your SIG’s Virtual Community Discussion Forum
Participate in Your SIG’s Virtual Community Discussion Forum
Sign Up to Receive Your SIG’s Virtual Community Announcements
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| Special Interest Group Newsletter September 2009 |
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Complementary & Integrative Therapies SIG Officers
Know someone who would like to receive a print copy of this newsletter? ONS Membership/Leadership Team Contact Information Angie Stengel, MS, CAE, Director of Membership/Leadership Diane Scheuring, MBA, CAE, CMP, Manager of Member Services Carol DeMarco, Membership/Leadership Specialist The Oncology Nursing Society (ONS) does not assume responsibility for the opinions expressed and information provided by authors or by Special Interest Groups (SIGs). Acceptance of advertising or corporate support does not indicate or imply endorsement of the company or its products by ONS or the SIG. Web sites listed in the SIG newsletters are provided for information only. Hosts are responsible for their own content and availability. Oncology Nursing Society
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