July 14, 2025 • 22 mins
Integrative oncology blends conventional cancer treatments with supportive therapies like nutrition, acupuncture, and mind-body practices to improve patient outcomes and quality of life. This episode outlines what pharmacists need to know about the principles of integrative medicine, how to evaluate evidence-based resources, and counseling tips for guiding patients through safe, effective complementary options. Tune in to strengthen your ability to support cancer patients with credible, compassionate, and comprehensive care.
HOST
Joshua Davis Kinsey, PharmD
VP, Education
CEimpact
GUEST
Ginger Blackmon, PharmD
Associate Director of Clinical Initiatives
NCODA
Joshua Davis Kinsey and Ginger Blackmon have no relevant financial relationships to disclose.
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CPE INFORMATION
Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:
1. Define integrative oncology and identify its role in supporting patients undergoing conventional cancer treatment.
2. Describe how pharmacists can evaluate and counsel on evidence-based complementary therapies used in integrative oncology.
0.05 CEU/0.5 Hr
UAN: 0107-0000-25-257-H01-P
Initial release date: 7/14/2025
Expiration date: 7/14/2026
Additional CPE details can be found here.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome back to the Game Changers Clinical
Conversations podcast.
I'm your host, josh Kinsey, ifyou're just joining us or even
if you tuned in last time.
We're continuing our compellingconversation on integrative
oncology with our guest, gingerBlackman.
In our first episode, gingershared her powerful personal
story and helped us understandthe role of integrative oncology
(00:20):
in supporting the whole patient, not just treating the disease.
We explored how complementarytherapies like aromatherapy,
meditation, music therapy andeven exercise can be safely used
alongside conventionaltreatments to improve quality of
life, clinical outcomes andempower patients throughout
their cancer journey.
(00:41):
Now, in part two, we're divingdeeper into specific strategies
pharmacists can use to guide andsupport patients who are
exploring integrative approachesbacked by evidence and clinical
guidelines.
So let's pick up right where weleft off and continue this
important discussion on howintegrative oncology is changing
the way we care for ourpatients with cancer.
(01:01):
All right, so, deidre, let'smove into talking about access
and equity.
As we learned that, not learned.
We know that those things are.
They affect all of our patients, right as far as social
determinants of health andthings like that.
So how specifically, are theykind of incorporated into this
(01:22):
integrative oncology mindset?
Are they kind of incorporatedinto this?
Speaker 2 (01:24):
integrative oncology mindset.
So I will say, as far as accessis concerned and cost, I think
is a huge player hereUnfortunately, a lot of the
services while beneficial, andthere are some like exercise-
again.
You can do that at no cost Likego outside your door If, if you
live in a safe area where youcan walk, and that's that's one
(01:45):
thing where I have read thatit's kind of sad that some of
the malls are closing um,because you know that's where a
lot of people went, you know youwould see people would go to
the mall and do power walkers,yeah, yeah um, but you know you
can find ways to exercise forfree pretty easily.
But again, if you wanted to dostrength training and you wanted
(02:06):
to have that gym and someone todirect you, like a trainer is
not having that guidance is notcheap.
but also like acupuncture Um,there are some, there are some
insurances who are covering it,but a lot don't.
Um massage same.
But those therapies,unfortunately, when you're
(02:26):
already maybe paying hugeco-pays for your treatment, even
if you're not, they're notcheap and if they're not covered
by your insurance, then a lotof patients just are going to
have to forego because it's likewell, I can pay for my meds and
I can eat, or I can go getacupuncture I can pay for my
meds and I can eat or I can goget acupuncture.
So I don't have a solution forthat.
(02:48):
I would love to.
I think maybe some somenonprofit something.
I dream up, but with coverservices for the patients, but
right now, or maybe actuallypolicy changes too for insurance
companies.
Speaker 1 (03:03):
Yeah, but for now, you know, you know there is that
is something to to know aboutand consider is the fact that a
lot of these things, as we'vetalked about, are complementary
to, you know, the prescribedmedications and whatnot, and so
therefore they're, they may verywell not be covered, you know,
even just we were talking about,you know, it's easy to go
outside your door, and then wewere talking about, well, if,
(03:24):
what if it's easy to go outsideyour door?
And then we were talking about,well, what if it's not safe?
But you know, if you thinkabout, even too, if it's someone
, you know, if it's someone whohas transportation insecurities
and it's winter and they can't,even if it is safe, they can't
go outside their door becausethey live somewhere where
there's always a foot of snow onthe ground, but then they can't
be driven to the local gym orwhatever, but then they can't be
(03:47):
driven to the local gym orwhatever.
So you know, I think there's alot of things like that, and you
know we've talked about beforehow pharmacists can really play
a part in that and help toconnect them to the right
resources, and you all haveheard me plug many times my
listeners how we've talked aboutcommunity health workers and
cross-training our techniciansas community health workers,
which will help connect to theresources that are in the
(04:08):
community to help solve some ofthese.
You know food and travel,insecurities and things like
that.
So there are things that for youto be aware of as a pharmacist.
Even you know like, oh,someone's going to go get
acupuncture.
I can't help if they can'tafford it.
Well, maybe you could, becauseif you have the connections in
the community, you may be ableto.
(04:28):
You know what if there is anonprofit in your community, or
what if there is a local churchthat has funds for cancer care
or things like that?
So so, yeah, definitely,definitely some opportunities to
you at least need to be awareof this as a pharmacist and
understand that sometimes accessis difficult for patients and
this could be a place where youcan make connections and help.
(04:48):
So, yeah, I love that, yes,yeah.
So let's talk about then.
We've talked about some of theactual, what I would call
components of integrativeoncology and, just to review
those again mental healthsupport, pain management, cancer
related fatigue and some of thethings that will kind of help
with that.
Using exercise boldly astreatment we talked about that
(05:11):
at length and, I think, justsuch great information there.
And then we talked aboutvitamin D, some of the other
herbal medications and where tofind details and specifics about
those.
We won't mention all of thosein general.
And then the fact that we needto be sure, you know, we're
aware that access and equity tothese things is not always.
It's not always across theboard and easy to gain access
(05:31):
and equity too.
So, opportunity-wise, let'ssummarize some of the
opportunities that we have as apharmacist to help in this space
, or the opportunities and thepluses of if that's a word, is
that a word Pluses?
Yeah, it is now Positiveattributes, the opportunities
and the pluses of.
If that's a word, is that aword Pluses?
Speaker 2 (05:50):
Yeah, positive attributes of integrative
oncology, so I'll let you kindof take it there.
So I mean, I think as apharmacist even it gives you the
opportunity to help a patientpersonalize their care, kind of
take some control over theircare and advocate for themselves
, of take some control overtheir care and advocate for
themselves, and then also givesyou a chance to support the
patient holistically, so notjust physically but again total,
(06:14):
mind, body, spirit, everything.
I think you can leverage yourrole and again you mentioned
text, I love that but to guideevidence based intervention.
So maybe if they're consideringand I think that's where it
like about herbs and things likethat come in If they're
considering one thing, you maybe able to steer them away, like
(06:38):
listen to what they have to say.
Speaker 1 (06:41):
Yep.
Speaker 2 (06:41):
Give them like.
This is not what I wouldrecommend and this is why.
But maybe then, like you couldsay but instead, what if you?
Speaker 1 (06:49):
try this Yep, give an alternative.
And that goes back to what wetalked about earlier with don't
just put your foot down and sayno.
I mean that's.
We know that from you, knowparenting 101, like the minute
you say absolutely not, you willnever.
That's when your child's goingto do it, you know.
And then they're not going totell you Exactly and then you're
never going to know that theydid it again or whatever.
(07:10):
So so, yeah, I think that'salso just super important to to
reiterate the fact that don'tjust say no, don't do that Like,
don't listen to that orwhatever.
Give an alternative.
Have you know, know where to go, find more details, find the
evidence-based interventionsthat you know have proven
outcomes, and then recommendthose to the patient, as opposed
(07:32):
to just saying no, becauseagain they're going to.
Your patient will take that asgreat advice, and then they're
going to come to you next timeand say, hey, you helped me, you
know before, let's talk aboutthis now.
I want your help on this.
So okay, and then, keeping onwith the opportunities, going
ahead, you were going to saysomething else you could
potentially help them improveadherence.
Speaker 2 (07:53):
So let's think about it.
If they like the aromataseinhibitor AIs, if they have pain
and that's a side effect, well,if you could help them with
acupuncture, that may help thembe able to stay on that.
Speaker 1 (08:05):
Stay on it.
Yeah, yeah.
Speaker 2 (08:16):
Again with with outcomes too.
Like we, I spoke extensively,probably too long, about the
colon cancer outcomes, but Ijust find like I think that's
great, that that's showing anactual overall, like survival,
benefit.
So just a way to and thenpatient satisfaction as well,
right, so if they have a betterquality of life and they feel
better, they're going to be moresatisfied with their care.
Speaker 1 (08:34):
Well, and I mean their life their life and we
just I mean we it's it's kind ofa circle.
We talked about how they'redepressed or anxious and you
know treating those things, andso, just in general, if you're
taking your med, because youfeel better when you take it,
and then it's doing its job, andthen you get a good report when
you go to the doctor that themeds doing its job, and so it
(08:57):
just it's a constant circle oflike, well then that makes you
feel better and you're going tocontinue to do what you were
doing and it's going to havebetter outcomes overall, and so
it's just a great, it's just ahuge cycle.
So I think it's important thatwe're touching on all of these
things.
I think it's important thatwe're touching on all of these
things.
So, with anything, there'schallenges, right, there's
things to overcome.
So we talked a little bit about, potentially, access and equity
(09:19):
.
So let's kind of dig a little,just as a reminder or fresher on
that, what are some of thosechallenges that we're going to
see with integrative oncology?
Speaker 2 (09:25):
So, again, the cost barrier I think, is one of the
number one things and just lackof reimbursement.
While there is some, it stillhas a long, long way to go from
companies, which I think is whythe evidence-based care is going
to be so important, because themore studies we have, and again
(09:48):
that gets us into anotherchallenge.
Is that evidence-based care forthis right.
So there are no pharmacompanies necessarily to fund a
lot of these studies because youknow it's not a drug.
And then also misinformation.
I think around like naturaltherapies and oh, like that
(10:11):
doesn't have evidence, or usingsomething natural that really
maybe you shouldn't be usingcompared with some of these
things that are evidence-basedand have that information to
back them.
Speaker 1 (10:25):
Right, right, yeah, and I think that gets back into
that whole.
You know the misinformationlike I heard it on the morning
talk show or I heard it.
You know as a, as aninfomercial or whatever, and and
again, that's where we aspharmacists really have to step
up and be that expert for them.
Speaker 2 (10:40):
So yeah, I think that that also leads us to one other
challenge, though, that goesaround with, or goes along with,
misinformation is the need forclinician education.
So what we're doing here today,educating pharmacists, but
educating even oncologists,social workers, other staff, on
(11:01):
what is evidence based, all ofthese things that we've talked
about today and then havingstandardized pathways where you
can implement some of thesethings, then having standardized
pathways where you canimplement some of these things
and, like you said, knowingwhere to find them and knowing
the reputable resources to sendpeople to as well.
Speaker 1 (11:22):
Yeah, so we've kind of talked about those
cornerstone pieces ofintegrative oncology.
We've kind of looked at whatall those look like, how
pharmacists can interplay witheach of those individually in a
sense in some way, whether it beinformation or counseling or
actually choosing the supplementto use or the inhalation or
whatever.
So how can we, other than justknowing which ones of our
(11:47):
patients have been diagnosedwith cancer, how can we
determine from even that pool ofpeople, who is going to benefit
from this, this type ofintegrative support?
Like, how can we identify thoseindividuals?
Speaker 2 (11:59):
Well, I mean, my first response is to say I think
everyone everyone would benefit.
Speaker 1 (12:03):
I was kind of hoping that would be your response.
Speaker 2 (12:05):
I knew it would be yeah.
It's everybody.
But also just just asking aquestion too Like we've always
you know some other things withlike using marijuana or CBD.
We've always said, like if youdon't ask you're never going to
know.
But if you ask if they're usingthis, then a lot of times
they'll say yes.
But I think you can ask, like,have you tried?
(12:26):
Are you exercising?
Like, have you tried anyinterventions?
That go alongside your therapythat might be able to help with
your quality of life.
Speaker 1 (12:35):
Did you know that there's evidence to support?
You know an exercise regimen.
Have you looked into that?
Is that?
Do you need support with that?
You know, like again, do youneed help getting to the gym or
whatever?
Yeah, so, yeah, that's great.
Yeah, so, yeah, that's great.
So, in general and you know,thinking across multiple levels
of care, so as a pharmacistbeing in care or in inpatient,
(13:05):
or community or whateverobviously in inpatient, and
probably even in care a littlebit more, we know more when a
patient is being treated,especially if it's in, if we're
in care in an oncology clinic orwhatever.
And you know, oftentimes in thecommunity setting we don't know
when a patient is necessarilybeing treated with cancer unless
they tell us.
But we do know and we've hadother episodes on this before
some of the supportive carethings that our oncology
(13:27):
patients are going to be on.
So those are some of the thingsto look out for as well.
So, nausea and vomiting meds,steroids potentially if you
don't, if you don't see another,you know potential indication
for use of steroids, you knowthings like that.
So that's, those are other waysin which we can kind of
determine which patients youknow may be, may benefit from
(13:47):
this type of care.
So okay, so then let's go into.
I just want to review andremind everyone about the
trusted resources and referrals.
So if you can just review thoseagain the ones that you
mentioned where you would go toget herb information, that kind
of stuff, the databases, becauseagain, we want to be sure that
we're giving our patientsevidence-based content and not
(14:10):
just what we've heard about orwhatever.
So just review those for us ifyou don't mind.
Speaker 2 (14:15):
Yeah, so the two, the two.
I think where I would start isagain the Society for
Integrative Oncology and lookingat those guidelines that they
developed in accordance withASCO.
So those are going to be againsome of the basic, pretty,
pretty easy things that you cando, but they are evidence based.
And then the About Herbswebsite I would, anything herbal
(14:37):
, I would definitely go there.
Speaker 1 (14:39):
Go to that one.
Yeah, that's free.
They have an app as well, but Iwas just fixing to ask is it
subscription based or is itsomething that's just free?
Speaker 2 (14:46):
Well, it's free for everyone and it has a patient
can also utilize it.
Wow, ok, that's great, great tofor everyone.
And it has a patient facinglike a patient can also utilize
it.
Speaker 1 (14:52):
Wow.
Okay, that's great, great toknow and I loved you mentioned
earlier and I didn't really harpon it then.
But I want to bring it back up.
Collaborating as a pharmacist Ithink that's a big role too,
because don't assume that ifyou're on board with integrative
oncology, that the patient'soncology team is on board with
it.
So there might be instanceswhere you're having to
(15:15):
collaborate and educate theoncology team.
Is that right?
Is that a fair point?
Speaker 2 (15:20):
Absolutely yes.
I think that is again wheremaking sure that health care
providers are educated on this,but anytime making sure that
you're communicating with theirteam.
I know at Encoda our big pushis for medically integrated
pharmacy, so most of our membersare part of those oncology
(15:40):
practices.
So a pharmacy that's either inan academic or community
oncology.
But if you're in the communitylike make sure, if maybe you
don't have the direct line ofcommunication with that
patient's oncologist, but makesure, maybe maybe you don't have
the direct line ofcommunication with that
patient's oncologist, but makesure, maybe you tell the patient
like hey, can you make sure andlet your team know that you're
doing this, let your oncologistknow or your pharmacist at the
(16:03):
oncology clinic know, and maybeprovide them with a way for them
to contact you too if they haveany questions.
But I think making sure thatline is open and that everyone
knows what the patient is doing.
Speaker 1 (16:16):
It's great, yeah, great point.
And then you mentioned usingthose survivorship visits or
counseling points as a gatewayfor this.
So those are if you can justspeak to that really quickly
just as a.
Those are opportunities inwhich you can kind of join in
the conversation with thepatient as a pharmacist, are
opportunities in which you cankind of join in the conversation
with the patient as apharmacist.
Speaker 2 (16:34):
So, yes, yes, and I will say, like, survivorship and
this will be, hopefully youwill do another podcast, because
that's another topic that isvery close to my heart, but
hopefully, um, there will bemore coming on this.
But survivorship, I mean startsfrom like when, from diagnosis,
so you're in survivorship.
It doesn't necessarily meanyou've completed treatment Um,
(16:56):
but there is a huge, growing,thank goodness population of
people who have completedtreatment and will continue to
have visits um with providers,and I think that's a great.
At times they may be left withside effects or they might be on
the AI for five or 10 yearsafter they're visiting your
pharmacy.
There's another way to identifythem.
(17:17):
You know, if they're getting anaromatase inhibitor, um, you
likely know that.
That's probably why, um so, inthose visits to your pharmacy,
even to pick to pick up, pick,pick that up if they tell you
they're having a side effect, orif they come to you with any
issues.
It's a great opportunity totalk to them.
Speaker 1 (17:38):
Yeah, and, like you said, just the fact that you
have either are going through orhave gone through cancer
treatment and survive, that inand of itself is, you know, the
depression or the anxiety oflike is it coming back, or you
know when's it coming back, orwhatever.
Like you know, those are stillopportunities for us to see
(17:59):
those patients and we talkedabout how depression and anxiety
can be treated with severalthings and you know there's
evidence to show for that.
So, again, I think I guess whatwe're reiterating is it doesn't
stop with during treatment.
Like this can go on post andthis can be, you know, with your
patient afterward for years.
Speaker 2 (18:17):
I mean after the anxiety of like is it coming
back?
Speaker 1 (18:21):
Yep.
Speaker 2 (18:23):
It's the gift that keeps on giving.
Speaker 1 (18:26):
Yep, unfortunately, so Okay.
Well, ginger, if you could sumup integrative oncology in like
a sentence, what would you sayit is?
Speaker 2 (18:34):
So I would say that it bridges the gap between
symptom control and empowerment.
So, and really really, like wesaid earlier, it's really about
treating the person and not justthe disease.
Speaker 1 (18:47):
Yeah, yeah.
So it's taking off our reallysmart hats of treating the
disease which is what we're alsogood at doing and determining
the right regimen and the rightdose and the right length of
therapy, and all that.
And it's really just thinking,you know, being patient centric
for a little bit and just reallylooking at all of the issues
that they're going through.
So, yeah, it's more than justkilling the cancer.
(19:10):
Like you know, we have to makesure the patient is taken care
of too.
So that's great.
So a question I ask everyone atthe end of the podcast is
what's the game changer here?
So, in other words, what is theone key thing that you want to
leave with our listeners forthis two-part episode on
integrative oncology?
Speaker 2 (19:33):
two-part episode on integrative oncology.
So I would say that integrativeoncology transforms cancer
treatment by making patientsactive participants and offering
safe, evidence-informed toolsthat can enhance outcomes.
Speaker 1 (19:45):
Yeah, that's great, that's great.
Well, we encourage allpharmacists and oncology teams
to explore and advocate forintegrative interventions at
your practice sites and withyour patients.
You know, again, these arerooted in evidence.
Like we're not going to besharing anything with you unless
it's evidence-based.
And so you know, integrativeoncology is growing.
(20:08):
It's an ever-growing field.
I feel like it's just going tocontinue to explode as more and
more people really kind of latchonto it and we see that the
outcomes continue to get betterand better and we're going to
just see more and more peopleutilizing it in care.
So we encourage you, as apharmacist, to determine where
you best fit in this space andto be there for your patients,
(20:30):
whether you're heavily involvedalready with oncology care and
you're dealing with theday-to-day, or whether you are a
community pharmacist and youare looking for those
individuals that are fightingcancer or in survivorship mode
and you're helping to supportthem with this integrative care.
So with that, Ginger, thank youso much for joining us for
(20:51):
these episodes.
This content is so good and Ifeel like it's just.
It's a growing space and it'sthings that we don't all.
We didn't learn about a lot ofthis in school and I dare say
that they're even probably notstill learning about it, even
though there are some gettingout sooner than 20 years ago,
like us.
But I think it's just, it's aspace that you know.
(21:14):
That's what we're here for.
We're here to give continuingeducation on things that are
important and pertinent andrelevant to your practice.
So thank you for giving of yourtime.
I know this is a reallypassionate subject for you, so
I'm just so grateful to have youon with us to discuss these
things.
Speaker 2 (21:30):
It is Well.
Thank you so much for having me.
It's been a lot of fun andyou've been a pleasure, as I
knew you would be to work with,and it's been really just great
to be able to talk about it andhopefully again get more of our
love, our community pharmacists.
You and I both have our startand our background there.
(21:50):
I know you did in a hometownpharmacy and I worked in one
from when I was 16, a localindependent, but love our
community pharmacists and justhope that this gives them an
area where they can be anadvocate for their patients.
Speaker 1 (22:03):
Yeah, where they can actually be.
Yeah, they can feel likethey're really involved with
this cancer team.
So, yeah, that's great.
That's great.
Well, if you're a CE plansubscriber, be sure to claim
your CE credit for this episodeof Game Changers by logging in
at CEimpactcom and, as always,have a great week and keep
learning.
I can't wait to dig intoanother game changing topic with
(22:24):
you all next week.
Welcome back to the Game Changers Clinical
Conversations podcast.
I'm your host, josh Kinsey, ifyou're just joining us or even
if you tuned in last time.
We're continuing our compellingconversation on integrative
oncology with our guest, gingerBlackman.
In our first episode, gingershared her powerful personal
story and helped us understandthe role of integrative oncology
(00:20):
in supporting the whole patient, not just treating the disease.
We explored how complementarytherapies like aromatherapy,
meditation, music therapy andeven exercise can be safely used
alongside conventionaltreatments to improve quality of
life, clinical outcomes andempower patients throughout
their cancer journey.
(00:41):
Now, in part two, we're divingdeeper into specific strategies
pharmacists can use to guide andsupport patients who are
exploring integrative approachesbacked by evidence and clinical
guidelines.
So let's pick up right where weleft off and continue this
important discussion on howintegrative oncology is changing
the way we care for ourpatients with cancer.
(01:01):
All right, so, deidre, let'smove into talking about access
and equity.
As we learned that, not learned.
We know that those things are.
They affect all of our patients, right as far as social
determinants of health andthings like that.
So how specifically, are theykind of incorporated into this
(01:22):
integrative oncology mindset?
Are they kind of incorporatedinto this?
Speaker 2 (01:24):
integrative oncology mindset.
So I will say, as far as accessis concerned and cost, I think
is a huge player hereUnfortunately, a lot of the
services while beneficial, andthere are some like exercise-
again.
You can do that at no cost Likego outside your door If, if you
live in a safe area where youcan walk, and that's that's one
(01:45):
thing where I have read thatit's kind of sad that some of
the malls are closing um,because you know that's where a
lot of people went, you know youwould see people would go to
the mall and do power walkers,yeah, yeah um, but you know you
can find ways to exercise forfree pretty easily.
But again, if you wanted to dostrength training and you wanted
(02:06):
to have that gym and someone todirect you, like a trainer is
not having that guidance is notcheap.
but also like acupuncture Um,there are some, there are some
insurances who are covering it,but a lot don't.
Um massage same.
But those therapies,unfortunately, when you're
(02:26):
already maybe paying hugeco-pays for your treatment, even
if you're not, they're notcheap and if they're not covered
by your insurance, then a lotof patients just are going to
have to forego because it's likewell, I can pay for my meds and
I can eat, or I can go getacupuncture I can pay for my
meds and I can eat or I can goget acupuncture.
So I don't have a solution forthat.
(02:48):
I would love to.
I think maybe some somenonprofit something.
I dream up, but with coverservices for the patients, but
right now, or maybe actuallypolicy changes too for insurance
companies.
Speaker 1 (03:03):
Yeah, but for now, you know, you know there is that
is something to to know aboutand consider is the fact that a
lot of these things, as we'vetalked about, are complementary
to, you know, the prescribedmedications and whatnot, and so
therefore they're, they may verywell not be covered, you know,
even just we were talking about,you know, it's easy to go
outside your door, and then wewere talking about, well, if,
(03:24):
what if it's easy to go outsideyour door?
And then we were talking about,well, what if it's not safe?
But you know, if you thinkabout, even too, if it's someone
, you know, if it's someone whohas transportation insecurities
and it's winter and they can't,even if it is safe, they can't
go outside their door becausethey live somewhere where
there's always a foot of snow onthe ground, but then they can't
be driven to the local gym orwhatever, but then they can't be
(03:47):
driven to the local gym orwhatever.
So you know, I think there's alot of things like that, and you
know we've talked about beforehow pharmacists can really play
a part in that and help toconnect them to the right
resources, and you all haveheard me plug many times my
listeners how we've talked aboutcommunity health workers and
cross-training our techniciansas community health workers,
which will help connect to theresources that are in the
(04:08):
community to help solve some ofthese.
You know food and travel,insecurities and things like
that.
So there are things that for youto be aware of as a pharmacist.
Even you know like, oh,someone's going to go get
acupuncture.
I can't help if they can'tafford it.
Well, maybe you could, becauseif you have the connections in
the community, you may be ableto.
(04:28):
You know what if there is anonprofit in your community, or
what if there is a local churchthat has funds for cancer care
or things like that?
So so, yeah, definitely,definitely some opportunities to
you at least need to be awareof this as a pharmacist and
understand that sometimes accessis difficult for patients and
this could be a place where youcan make connections and help.
(04:48):
So, yeah, I love that, yes,yeah.
So let's talk about then.
We've talked about some of theactual, what I would call
components of integrativeoncology and, just to review
those again mental healthsupport, pain management, cancer
related fatigue and some of thethings that will kind of help
with that.
Using exercise boldly astreatment we talked about that
(05:11):
at length and, I think, justsuch great information there.
And then we talked aboutvitamin D, some of the other
herbal medications and where tofind details and specifics about
those.
We won't mention all of thosein general.
And then the fact that we needto be sure, you know, we're
aware that access and equity tothese things is not always.
It's not always across theboard and easy to gain access
(05:31):
and equity too.
So, opportunity-wise, let'ssummarize some of the
opportunities that we have as apharmacist to help in this space
, or the opportunities and thepluses of if that's a word, is
that a word Pluses?
Yeah, it is now Positiveattributes, the opportunities
and the pluses of.
If that's a word, is that aword Pluses?
Speaker 2 (05:50):
Yeah, positive attributes of integrative
oncology, so I'll let you kindof take it there.
So I mean, I think as apharmacist even it gives you the
opportunity to help a patientpersonalize their care, kind of
take some control over theircare and advocate for themselves
, of take some control overtheir care and advocate for
themselves, and then also givesyou a chance to support the
patient holistically, so notjust physically but again total,
(06:14):
mind, body, spirit, everything.
I think you can leverage yourrole and again you mentioned
text, I love that but to guideevidence based intervention.
So maybe if they're consideringand I think that's where it
like about herbs and things likethat come in If they're
considering one thing, you maybe able to steer them away, like
(06:38):
listen to what they have to say.
Speaker 1 (06:41):
Yep.
Speaker 2 (06:41):
Give them like.
This is not what I wouldrecommend and this is why.
But maybe then, like you couldsay but instead, what if you?
Speaker 1 (06:49):
try this Yep, give an alternative.
And that goes back to what wetalked about earlier with don't
just put your foot down and sayno.
I mean that's.
We know that from you, knowparenting 101, like the minute
you say absolutely not, you willnever.
That's when your child's goingto do it, you know.
And then they're not going totell you Exactly and then you're
never going to know that theydid it again or whatever.
(07:10):
So so, yeah, I think that'salso just super important to to
reiterate the fact that don'tjust say no, don't do that Like,
don't listen to that orwhatever.
Give an alternative.
Have you know, know where to go, find more details, find the
evidence-based interventionsthat you know have proven
outcomes, and then recommendthose to the patient, as opposed
(07:32):
to just saying no, becauseagain they're going to.
Your patient will take that asgreat advice, and then they're
going to come to you next timeand say, hey, you helped me, you
know before, let's talk aboutthis now.
I want your help on this.
So okay, and then, keeping onwith the opportunities, going
ahead, you were going to saysomething else you could
potentially help them improveadherence.
Speaker 2 (07:53):
So let's think about it.
If they like the aromataseinhibitor AIs, if they have pain
and that's a side effect, well,if you could help them with
acupuncture, that may help thembe able to stay on that.
Speaker 1 (08:05):
Stay on it.
Yeah, yeah.
Speaker 2 (08:16):
Again with with outcomes too.
Like we, I spoke extensively,probably too long, about the
colon cancer outcomes, but Ijust find like I think that's
great, that that's showing anactual overall, like survival,
benefit.
So just a way to and thenpatient satisfaction as well,
right, so if they have a betterquality of life and they feel
better, they're going to be moresatisfied with their care.
Speaker 1 (08:34):
Well, and I mean their life their life and we
just I mean we it's it's kind ofa circle.
We talked about how they'redepressed or anxious and you
know treating those things, andso, just in general, if you're
taking your med, because youfeel better when you take it,
and then it's doing its job, andthen you get a good report when
you go to the doctor that themeds doing its job, and so it
(08:57):
just it's a constant circle oflike, well then that makes you
feel better and you're going tocontinue to do what you were
doing and it's going to havebetter outcomes overall, and so
it's just a great, it's just ahuge cycle.
So I think it's important thatwe're touching on all of these
things.
I think it's important thatwe're touching on all of these
things.
So, with anything, there'schallenges, right, there's
things to overcome.
So we talked a little bit about, potentially, access and equity
(09:19):
.
So let's kind of dig a little,just as a reminder or fresher on
that, what are some of thosechallenges that we're going to
see with integrative oncology?
Speaker 2 (09:25):
So, again, the cost barrier I think, is one of the
number one things and just lackof reimbursement.
While there is some, it stillhas a long, long way to go from
companies, which I think is whythe evidence-based care is going
to be so important, because themore studies we have, and again
(09:48):
that gets us into anotherchallenge.
Is that evidence-based care forthis right.
So there are no pharmacompanies necessarily to fund a
lot of these studies because youknow it's not a drug.
And then also misinformation.
I think around like naturaltherapies and oh, like that
(10:11):
doesn't have evidence, or usingsomething natural that really
maybe you shouldn't be usingcompared with some of these
things that are evidence-basedand have that information to
back them.
Speaker 1 (10:25):
Right, right, yeah, and I think that gets back into
that whole.
You know the misinformationlike I heard it on the morning
talk show or I heard it.
You know as a, as aninfomercial or whatever, and and
again, that's where we aspharmacists really have to step
up and be that expert for them.
Speaker 2 (10:40):
So yeah, I think that that also leads us to one other
challenge, though, that goesaround with, or goes along with,
misinformation is the need forclinician education.
So what we're doing here today,educating pharmacists, but
educating even oncologists,social workers, other staff, on
(11:01):
what is evidence based, all ofthese things that we've talked
about today and then havingstandardized pathways where you
can implement some of thesethings, then having standardized
pathways where you canimplement some of these things
and, like you said, knowingwhere to find them and knowing
the reputable resources to sendpeople to as well.
Speaker 1 (11:22):
Yeah, so we've kind of talked about those
cornerstone pieces ofintegrative oncology.
We've kind of looked at whatall those look like, how
pharmacists can interplay witheach of those individually in a
sense in some way, whether it beinformation or counseling or
actually choosing the supplementto use or the inhalation or
whatever.
So how can we, other than justknowing which ones of our
(11:47):
patients have been diagnosedwith cancer, how can we
determine from even that pool ofpeople, who is going to benefit
from this, this type ofintegrative support?
Like, how can we identify thoseindividuals?
Speaker 2 (11:59):
Well, I mean, my first response is to say I think
everyone everyone would benefit.
Speaker 1 (12:03):
I was kind of hoping that would be your response.
Speaker 2 (12:05):
I knew it would be yeah.
It's everybody.
But also just just asking aquestion too Like we've always
you know some other things withlike using marijuana or CBD.
We've always said, like if youdon't ask you're never going to
know.
But if you ask if they're usingthis, then a lot of times
they'll say yes.
But I think you can ask, like,have you tried?
(12:26):
Are you exercising?
Like, have you tried anyinterventions?
That go alongside your therapythat might be able to help with
your quality of life.
Speaker 1 (12:35):
Did you know that there's evidence to support?
You know an exercise regimen.
Have you looked into that?
Is that?
Do you need support with that?
You know, like again, do youneed help getting to the gym or
whatever?
Yeah, so, yeah, that's great.
Yeah, so, yeah, that's great.
So, in general and you know,thinking across multiple levels
of care, so as a pharmacistbeing in care or in inpatient,
(13:05):
or community or whateverobviously in inpatient, and
probably even in care a littlebit more, we know more when a
patient is being treated,especially if it's in, if we're
in care in an oncology clinic orwhatever.
And you know, oftentimes in thecommunity setting we don't know
when a patient is necessarilybeing treated with cancer unless
they tell us.
But we do know and we've hadother episodes on this before
some of the supportive carethings that our oncology
(13:27):
patients are going to be on.
So those are some of the thingsto look out for as well.
So, nausea and vomiting meds,steroids potentially if you
don't, if you don't see another,you know potential indication
for use of steroids, you knowthings like that.
So that's, those are other waysin which we can kind of
determine which patients youknow may be, may benefit from
(13:47):
this type of care.
So okay, so then let's go into.
I just want to review andremind everyone about the
trusted resources and referrals.
So if you can just review thoseagain the ones that you
mentioned where you would go toget herb information, that kind
of stuff, the databases, becauseagain, we want to be sure that
we're giving our patientsevidence-based content and not
(14:10):
just what we've heard about orwhatever.
So just review those for us ifyou don't mind.
Speaker 2 (14:15):
Yeah, so the two, the two.
I think where I would start isagain the Society for
Integrative Oncology and lookingat those guidelines that they
developed in accordance withASCO.
So those are going to be againsome of the basic, pretty,
pretty easy things that you cando, but they are evidence based.
And then the About Herbswebsite I would, anything herbal
(14:37):
, I would definitely go there.
Speaker 1 (14:39):
Go to that one.
Yeah, that's free.
They have an app as well, but Iwas just fixing to ask is it
subscription based or is itsomething that's just free?
Speaker 2 (14:46):
Well, it's free for everyone and it has a patient
can also utilize it.
Wow, ok, that's great, great tofor everyone.
And it has a patient facinglike a patient can also utilize
it.
Speaker 1 (14:52):
Wow.
Okay, that's great, great toknow and I loved you mentioned
earlier and I didn't really harpon it then.
But I want to bring it back up.
Collaborating as a pharmacist Ithink that's a big role too,
because don't assume that ifyou're on board with integrative
oncology, that the patient'soncology team is on board with
it.
So there might be instanceswhere you're having to
(15:15):
collaborate and educate theoncology team.
Is that right?
Is that a fair point?
Speaker 2 (15:20):
Absolutely yes.
I think that is again wheremaking sure that health care
providers are educated on this,but anytime making sure that
you're communicating with theirteam.
I know at Encoda our big pushis for medically integrated
pharmacy, so most of our membersare part of those oncology
(15:40):
practices.
So a pharmacy that's either inan academic or community
oncology.
But if you're in the communitylike make sure, if maybe you
don't have the direct line ofcommunication with that
patient's oncologist, but makesure, maybe maybe you don't have
the direct line ofcommunication with that
patient's oncologist, but makesure, maybe you tell the patient
like hey, can you make sure andlet your team know that you're
doing this, let your oncologistknow or your pharmacist at the
(16:03):
oncology clinic know, and maybeprovide them with a way for them
to contact you too if they haveany questions.
But I think making sure thatline is open and that everyone
knows what the patient is doing.
Speaker 1 (16:16):
It's great, yeah, great point.
And then you mentioned usingthose survivorship visits or
counseling points as a gatewayfor this.
So those are if you can justspeak to that really quickly
just as a.
Those are opportunities inwhich you can kind of join in
the conversation with thepatient as a pharmacist, are
opportunities in which you cankind of join in the conversation
with the patient as apharmacist.
Speaker 2 (16:34):
So, yes, yes, and I will say, like, survivorship and
this will be, hopefully youwill do another podcast, because
that's another topic that isvery close to my heart, but
hopefully, um, there will bemore coming on this.
But survivorship, I mean startsfrom like when, from diagnosis,
so you're in survivorship.
It doesn't necessarily meanyou've completed treatment Um,
(16:56):
but there is a huge, growing,thank goodness population of
people who have completedtreatment and will continue to
have visits um with providers,and I think that's a great.
At times they may be left withside effects or they might be on
the AI for five or 10 yearsafter they're visiting your
pharmacy.
There's another way to identifythem.
(17:17):
You know, if they're getting anaromatase inhibitor, um, you
likely know that.
That's probably why, um so, inthose visits to your pharmacy,
even to pick to pick up, pick,pick that up if they tell you
they're having a side effect, orif they come to you with any
issues.
It's a great opportunity totalk to them.
Speaker 1 (17:38):
Yeah, and, like you said, just the fact that you
have either are going through orhave gone through cancer
treatment and survive, that inand of itself is, you know, the
depression or the anxiety oflike is it coming back, or you
know when's it coming back, orwhatever.
Like you know, those are stillopportunities for us to see
(17:59):
those patients and we talkedabout how depression and anxiety
can be treated with severalthings and you know there's
evidence to show for that.
So, again, I think I guess whatwe're reiterating is it doesn't
stop with during treatment.
Like this can go on post andthis can be, you know, with your
patient afterward for years.
Speaker 2 (18:17):
I mean after the anxiety of like is it coming
back?
Speaker 1 (18:21):
Yep.
Speaker 2 (18:23):
It's the gift that keeps on giving.
Speaker 1 (18:26):
Yep, unfortunately, so Okay.
Well, ginger, if you could sumup integrative oncology in like
a sentence, what would you sayit is?
Speaker 2 (18:34):
So I would say that it bridges the gap between
symptom control and empowerment.
So, and really really, like wesaid earlier, it's really about
treating the person and not justthe disease.
Speaker 1 (18:47):
Yeah, yeah.
So it's taking off our reallysmart hats of treating the
disease which is what we're alsogood at doing and determining
the right regimen and the rightdose and the right length of
therapy, and all that.
And it's really just thinking,you know, being patient centric
for a little bit and just reallylooking at all of the issues
that they're going through.
So, yeah, it's more than justkilling the cancer.
(19:10):
Like you know, we have to makesure the patient is taken care
of too.
So that's great.
So a question I ask everyone atthe end of the podcast is
what's the game changer here?
So, in other words, what is theone key thing that you want to
leave with our listeners forthis two-part episode on
integrative oncology?
Speaker 2 (19:33):
two-part episode on integrative oncology.
So I would say that integrativeoncology transforms cancer
treatment by making patientsactive participants and offering
safe, evidence-informed toolsthat can enhance outcomes.
Speaker 1 (19:45):
Yeah, that's great, that's great.
Well, we encourage allpharmacists and oncology teams
to explore and advocate forintegrative interventions at
your practice sites and withyour patients.
You know, again, these arerooted in evidence.
Like we're not going to besharing anything with you unless
it's evidence-based.
And so you know, integrativeoncology is growing.
(20:08):
It's an ever-growing field.
I feel like it's just going tocontinue to explode as more and
more people really kind of latchonto it and we see that the
outcomes continue to get betterand better and we're going to
just see more and more peopleutilizing it in care.
So we encourage you, as apharmacist, to determine where
you best fit in this space andto be there for your patients,
(20:30):
whether you're heavily involvedalready with oncology care and
you're dealing with theday-to-day, or whether you are a
community pharmacist and youare looking for those
individuals that are fightingcancer or in survivorship mode
and you're helping to supportthem with this integrative care.
So with that, Ginger, thank youso much for joining us for
(20:51):
these episodes.
This content is so good and Ifeel like it's just.
It's a growing space and it'sthings that we don't all.
We didn't learn about a lot ofthis in school and I dare say
that they're even probably notstill learning about it, even
though there are some gettingout sooner than 20 years ago,
like us.
But I think it's just, it's aspace that you know.
(21:14):
That's what we're here for.
We're here to give continuingeducation on things that are
important and pertinent andrelevant to your practice.
So thank you for giving of yourtime.
I know this is a reallypassionate subject for you, so
I'm just so grateful to have youon with us to discuss these
things.
Speaker 2 (21:30):
It is Well.
Thank you so much for having me.
It's been a lot of fun andyou've been a pleasure, as I
knew you would be to work with,and it's been really just great
to be able to talk about it andhopefully again get more of our
love, our community pharmacists.
You and I both have our startand our background there.
(21:50):
I know you did in a hometownpharmacy and I worked in one
from when I was 16, a localindependent, but love our
community pharmacists and justhope that this gives them an
area where they can be anadvocate for their patients.
Speaker 1 (22:03):
Yeah, where they can actually be.
Yeah, they can feel likethey're really involved with
this cancer team.
So, yeah, that's great.
That's great.
Well, if you're a CE plansubscriber, be sure to claim
your CE credit for this episodeof Game Changers by logging in
at CEimpactcom and, as always,have a great week and keep
learning.
I can't wait to dig intoanother game changing topic with
(22:24):
you all next week.
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