NEW YORKA Memorial Sloan-Kettering Cancer Center public forum
held to introduce the public to the hospitals new complementary
medicine service drew repeated bursts of applause and expressions of
thanks from the patients, family, and community members who attended.
The audience not only heard from practitioners but also saw slides of
relaxing visual imagery, meditated to the sound of a crystal bowl rim
being rubbed, and listened to the music of a trio of music
I want to thank you for taking the initiative for supporting
what some people in the medical profession consider nonmedical,
said one man in the audience whose remarks were echoed by others.
Another person wondered if it was necessary to have cancer to take
advantage of the array of therapies available through Memorials
new Integrative Medicine Service. (The answer was no; the service is
also open to family members of cancer patients.)
The new services include massage, art, music and sound therapy,
acupuncture, hypnotherapy, meditation, guided imagery and
visualization, yoga, Tai Chi, nutritional counseling, and movement
therapies such as the Alexander Technique and Feldenkrais method.
They are available to inpatients, outpatients, and their families at
the hospital, and at two outpatient facilities. One of the
facilities, the new Outpatient Center for Integrative Medicine, also
takes cancer patients who are not receiving medical treatment at
Complementary therapies improve the quality of life,
Memorials new chief of Integrative Medicine, Barrie R.
Cassileth, PhD, told the forum. [See ONI, September, 1999, page 1,
for an interview with Dr. Cassileth.] Thats really the
role of complementary care. It relieves fear, stress, anxiety,
depression, and all these negative emotions.
The difference between complementary and alternative medicine, Dr.
Cassileth said, is that alternative therapies are unproved. But
complementary therapies such as meditation, biofeedback, and other
modalities have been shown to have a positive impact on physiological
and psychological states.
David Payne, PhD, staff psychologist with the Department of
Integrative Medicine, observed that the search for inner composure
goes back thousands of years. One of the enduring searches of
mankind is a search for equanimity, and thats what we intend to
work for in the area of mind-body medicine.
The underlying rationale behind the mind-body regimens, he said, is
that a calm mind equals a calm body. We know that calming the
mind can lead to a downward regulation of physiological parameters,
and it goes the other way. A calm body can equal a calm mind.
Therapies such as relaxation, meditation, and biofeedback are very
useful in handling pain and anxiety, which are often a part of the
Dr. Payne also noted that some patients fear that mind-body
techniques require them to give up control, but the reality is
otherwise. Many people who go through cancer treatment often
have a sense that they are out of control, that cancer, or the
physician, or life itself is driving the car. Yet, we know from
research that with the use of mind-body techniques, cancer patients
can gain a greater sense of control.
He cited the example of hypnosis. In order to undergo hypnosis,
people must be capable of focusing their attention rather than
letting it go. When people are in a hypnotic state, they
actually have greater ability to pay attention, and symptom
management is much more easily achieved.
Different Kinds of Massage
Wendy Miner, director of the Outpatient Center for Integrative
Medicine, talked about the use of massage with cancer patients.
The hospital offers many types, she said, including:
Shiatsu, a Japanese manual pressure technique that uses acupressure
points, gentle stretching, and joint rotation.
Swedish massage, which is designed to release chronic tension and
increase local blood circulation through the manipulation of soft
Reflexology, which focuses on specific pressure points on the hand
The type each patient receives is determined after an initial
consultation. For many of our patients, particularly those we
see in the hospital right after surgery, any kind of massage would be
very invasive, Ms. Miner said. But what we can do is
offer them reflexology, which is done on their feet, and they often
report that their first walk round the corridor is made much easier.
Some patients also elect to get massages while they receive
Music therapists also work with inpatients and outpatients. They give
weekly concerts at the hospital on each patient floor, and make
rounds with a violin, guitar, tape deck, or CD player, stopping in to
see patients in their rooms.
An audience member asked if Medicare or other insurers pay for these
complementary treatments. Dr. Cassileth answered that insurers
frequently will pay part of the cost of acupuncture and sometimes
massage in cases of cancer.
The list of covered complementary therapies will probably
grow, she said. Memorial Sloan-Kettering offers these
services on a fee-for-service basis, and it is up to the patient to