Integrative approaches to gynecological cancer

Patients with gynecological cancer often present with quality-of-life (QoL)-related needs, many of which are unmet by conventional medical care. Integrative gynecological oncology (IGO) programs provide evidence- and guideline-based complementary and integrative medicine (CIM) therapies for QoL-related concerns in perioperative, adjuvant/neo-adjuvant/palliative/end-of-life and survivorship settings of care. In this way, CIM treatments have been shown to increase patient adherence to their anticancer regimen, with significant implications for treatment-related outcomes. Ideally, IGO programs are codesigned with the patient and include one or more CIM modalities such as acupuncture, manual and movement therapies, mind-body modalities, herbal and dietary supplements, and lifestyle modification coaching, within a broad and personalized bio-psycho-social-spiritual context of patient-centered care. This chapter presents an overview of the research published to date on the impact of IGO treatments for pain (cancer-related; perioperative) and chemotherapy-induced peripheral neuropathy; gastrointestinal symptoms (chemotherapy-induced nausea and vomiting; perioperative discomfort and dysfunction; postradiation diarrhea); anxiety and depression (perioperative; during chemotherapy and radiation treatments); cancer-related fatigue and sleep disturbances; and issues related to body image, sexual function, and pelvic wellness. Further research is still needed, with randomized controlled trials examining the role of CIM in the care of patients with gynecological cancer.