At the prompting of my sister, bless her heart, I am going to share this presentation I am giving to the University of Arizona’s Cancer Support Group. This is a group of doctors, social workers, nurses and research fellows that meet monthly to talk about all forms of cancer care and research. I was attending for over a year, trying to get my foot in the door. The U-of-A is building a new Cancer Hospital, and I want this to be an integrative hospital. Again I feel like I am pushing that glacier back up the hill.
I have heard from a fairly well placed individual that the individual that will be making the decision already has. He believes that acupuncture uses “dirty needles” and other such mis-perceptions. After 18 months I gave up and said “win some, loose some. I have other fish to fry” and went on with my adventures.
Last week I got an e-mail from the group saying they need a presenter for tomorrow. I explained my concerns and the doctor that I deal with (and is a proponent of integration) said “Why not address how to integrate the medicine in the Cancer center?” I said OK.
Below is a copy of my power-point presentation. I will bold the page headlines.Peaceful Mountain Acupuncture
Traditional Medicine for a Modern World
Walking on Two Legs
Integrating Two Paradigms
“Integrating alternative strategies at the Cancer Center”
• Master of Science in Oriental Medicine
– Southwest Acupuncture College, Albq, NM
• Diplomat of Acupuncture (NCCAOM)
– National Commission for Certification in Acupuncture and Oriental Medicine
• Licensed Acupuncturist (AZ #240)
• Faculty: Instructor and Clinical Supervisor Asian Institute of Medical StudiesObjectives
• Open a dialogue about how to integrate the two paradigms of medical treatment.
• Create an open forum where each system can support the work of the other system to create a synergistic treatment.Objectives
• Start an on-going discussion that is designed to support the patient in all phases of treatment.
– The root of our reasons for becoming doctors, nurses, etc is the desire to HELP our patients.
• Clearly state that each system has incredible power; my intention is to create a system where we can work together.NCCAM.NIH.GOV
• "The scientific evidence supporting use of electroacupuncture for relief of acute nausea following chemotherapy is very encouraging," said Marc Blackman, M.D., Director of NCCAM's Division of Intramural Research. NCCAM Goals
• Development of a Comprehensive, National Research Strategy for Complementary and Alternative Medicine
• Acknowledging the Growing Consumer Interest in CAM
• The establishment of NCCAM by the U.S. Congress was precipitated by a growing interest in CAM, and a common belief that various CAM therapies may play a role in improving health. In 1997, approximately 42 percent of U.S. healthcare consumers spent $27 billion on CAM therapies.Another Perspective
• Only by holding CAM modalities to the highest standards of evidence will we best facilitate the creation of an integrated healthcare delivery system in which conventional physicians and CAM practitioners work as an interdisciplinary team.
• As the Prince of Wales commented in 1998, "This isn't a question of orthodox medicine taking over, or of complementary and alternative medicine diluting the intellectual rigor of orthodoxy. It is about reaching across the disciplines to help and to learn from one another for the ultimate benefit of the patients you all serve." How widely is acupuncture used in the United States?
According to the 2002 National Health Interview Survey--the largest and most comprehensive survey of complementary and alternative medicine (CAM) use by American adults to date--an estimated 8.2 million U.S. adults had ever used acupuncture, and an estimated 2.1 million U.S. adults had used acupuncture in the previous year.How many trials have been done?
• A quick search of NCCAM.NIH.GOV finds at least 46 clinical trials involving acupuncture.
• Google “Scholar” listed 2,780 papers
• A search for “chemotherapy, Chinese Herbal Medicine” listed 2,700 papers.American Cancer Society
• Acupuncture May Ease Cancer Pain Study: Needles Helped When Drugs Failed
• 213 articles on their web site referencing acupuncture.American Cancer Society
• There is some evidence from randomized clinical trials that some Chinese herbs may contribute to longer survival rates, reduction of side effects, and lower risk of recurrence for some cancers, especially when combined with conventional treatment.
• 31 articles mentioning chemotherapy and Chinese Herbal MedicineWhere do we go from here?
• U-of-A is preparing to open the new Cancer Hospital.
• Start an ongoing discussion about how to integrate the two medical paradigms.
• What would that look like?
• Who needs to talk to who?
• How can anyone help get this moving?
• “Do not settle for the comfort of opinion without first experiencing the discomfort of genuine thought.”
John F. KennedyThe Next Step
– We all want our patients to have the best treatment experience possible
– With discussion we can learn how to integrate, how to evaluate and how to evolve our treatment plans
– Listen to one-another, ask questions. Do not accept the “status quo” Implement ChangeAn alternative Step
– By believing that this “new” idea is not worth trying without taking the time to truly investigate
– Instead of personally speaking to a person that has a different idea directly, defend your idea behind their back, without risk
– The defense of an unexamined idea will destroy the possibility of creating a new workable ideaThe Key
• This, as so many things in our lives, is ALL ABOUT RELATIONSHIPS.
• Between medical paradigms
• Between Doctors, Nurses, Patients, Researchers, Acupuncturists, Patients Families
• Relationships are DYNAMIC, always changing and never staticI am not saying:
• This is what has to happen
• This is the only way it can happen
• That it will be easy
• That there will not be HUGE challenges to face
• That it will make THE DIFFERENCE in every patientI AM SAYING
• This integration of medical paradigms can work
• This is “the next step” in many cases
• The potential benefit of trying this by far outweighs the risk of not trying it.
• We can each learn from one another, as well as from our patientsWhat do you want to happen?
Open a discussion with the group of individuals that has the power to make the decision to integrate CAM into the Cancer Center.
Create a way to integrate CAM at all levels of the treatment of cancer
We need to make this happen, but it cannot without your help and active participationMichael Clifford