On Target with Dr Akila Viswanathan - Integrative Oncology and Radiation Therapy for Seminars in Radiation Oncology

Where do you think the evidence is strongest today and where should we be appropriately cautious?

In the last 20 plus years, the field of integrated oncology has matured through a lot of rigorous research done by many teams.

I think where we now have a lot of strong evidence on exercise to improve both symptoms, functions, and cancer outcomes.

And we also have really important knowledge about nutrition, particularly for patients undergoing head and neck cancer or GI cancers.

Those may affect absorption nutrition.

I think that need to be integrated, right? And then therapies like acupuncture can be very effective for pain, for dry mouth in patients with head and neck cancer.

And therapies like yoga, meditation, tai chi, those mind-body therapies have a lot of strong evidence for fatigue, sleep, psychological distress.

And many of the therapy can be utilized not only during treatment, but also falling into survivorship.

So I do think the evidence base is growing.

In terms of where we really need to be cautious is dietary supplements and herbs.

And these are also an area of patient really have a lot

of

interest.

There's a lot of online information coming from whether social media, TikTok, influencers, A lot of the information, unfortunately, are anecdotal, so even completely wrong.

Patients really want to grab on everything that could potentially help them, right? So as integrated medicine providers or physicians, we need to really help to explain where incorporating those herb supplements can be okay or dangerous.

For example, there's some concerns about high-dose antioxidants, particularly in the setting of radiation.

active of the therapeutic effect of radiation.

So I think those areas we have to be particularly cautious.

Interesting.

You know, I think exercise and all that it entails is really such an important component of survivorship.

And it's nice to hear about the study that really showed an improvement in outcomes.

So exercise may be changing the definition of supportive care.

The article on physical activity makes a proactive argument that exercise should be viewed not as an optional wellness intervention, but as foundational to high quality cancer care.

The challenge trial adds an important survival signal.

Does this fundamentally change how we should think about exercise in patients receiving radiation therapy if they're able to exercise?

Where do you think the evidence is strongest today and where should we be appropriately cautious?

In the last 20 plus years, the field of integrated oncology has matured through a lot of rigorous research done by many teams.

I think where we now have a lot of strong evidence on exercise to improve both symptoms, functions, and cancer outcomes.

And we also have really important knowledge about nutrition, particularly for patients undergoing head and neck cancer or GI cancers.

Those may affect absorption nutrition.

I think that need to be integrated, right? And then therapies like acupuncture can be very effective for pain, for dry mouth in patients with head and neck cancer.

And therapies like yoga, meditation, tai chi, those mind-body therapies have a lot of strong evidence for fatigue, sleep, psychological distress.

And many of the therapy can be utilized not only during treatment, but also falling into survivorship.

So I do think the evidence base is growing.

In terms of where we really need to be cautious is dietary supplements and herbs.

And these are also an area of patient really have a lot

of

interest.

There's a lot of online information coming from whether social media, TikTok, influencers, A lot of the information, unfortunately, are anecdotal, so even completely wrong.

Patients really want to grab on everything that could potentially help them, right? So as integrated medicine providers or physicians, we need to really help to explain where incorporating those herb supplements can be okay or dangerous.

For example, there's some concerns about high-dose antioxidants, particularly in the setting of radiation.

active of the therapeutic effect of radiation.

So I think those areas we have to be particularly cautious.

Interesting.

You know, I think exercise and all that it entails is really such an important component of survivorship.

And it's nice to hear about the study that really showed an improvement in outcomes.

So exercise may be changing the definition of supportive care.

The article on physical activity makes a proactive argument that exercise should be viewed not as an optional wellness intervention, but as foundational to high quality cancer care.

The challenge trial adds an important survival signal.

Does this fundamentally change how we should think about exercise in patients receiving radiation therapy if they're able to exercise?