Outlook: Newsletter of the Society of Behavorial Medicine

A Conversation about the Intersection of Integrative Medicine and Psycho-Oncology with Jun Mao, Chief of Integrative Medicine at Memorial Sloan Kettering Cancer Center

Kristen E. Riley, PhD, Complementary and Integrative Medicine SIG member

Jun J. Mao, MD, MSCE
Jun J. Mao, MD, MSCE

The Society of Behavioral Medicine's Complementary and Integrative Medicine Special Interest Group (CIM SIG) recently interviewed Jun J. Mao, MD, MSCE, chief of Integrative Medicine at Memorial Sloan Kettering Cancer Center.

The CIM SIG talked with Dr. Mao about his ongoing research at the intersection of integrative medicine and psycho-oncology, including yoga, acupuncture, and tai chi interventions.

CIM: Can you tell us about a few of your current studies at Memorial Sloan Kettering Cancer Center?

Mao: “Well, I have been at Memorial Sloan Kettering Cancer Center (MSK) for about 10 months now, after 12 years at University of Pennsylvania, so we are getting some exciting projects going. We are beginning a Patient-Centered Outcomes Research Institute-funded study comparing acupuncture to Cognitive Behavioral Therapy for Insomnia for insomnia in cancer survivors. We will also collect qualitative data from participants about their preferences and clinical experiences with these interventions. It is the first trial that has ever compared these approaches.

“We also have a large outcome focused study. MSK were innovators of using integrative medicine for cancer care—they were one of the first—so we have a large amount of patients, about 20,000 a year, utilizing our services. It is important to understand who is using the services, how this impacts their health, side effects, and psychosocial outcomes, and any barriers to use. We are learning what is happening in the real world and how to bring these services to patients in their time of need.”

CIM: How is studying integrative medicine within psycho-oncology helpful?

Mao: “I think there is a lot of synergy between cancer care and integrative medicine. Integrative medicine is relationship centered and emphasizes the mind-body connection, implicitly through practices like acupuncture, or more explicitly with yoga therapies, which require the participant to use body and mind simultaneously. I think integrative medicine causes patients to be thoughtful about this mind body connection and take more ownership of their health. You can consider seeking acupuncture or yoga a health behavior; integrative medicine may lead patients to be more motivated to engage in health behaviors or a more healthy lifestyle overall. There is also a great sense of self-discovery in these practices, which people find helpful for creating a healthier lifestyle, which is helpful for cancer care and survivorship.”

CIM: Some physicians and psychotherapists are hesitant to recommend CIM to their patients, especially as this field of research is burgeoning; what would you say to these practicing clinicians?  

Mao: “I think related to any healthcare practice, providers need to find solutions for his or her patients; as we know, different approaches work for different patients. There has been research for 10 to 15 years suggesting that yoga, acupuncture, and meditation may decrease distress, depression, anxiety, and pain. Also, the word complementary means that these therapies can complement mainstream interventions. Additionally, sometimes mainstream therapies don’t work well, or don’t work at all; patient care is not one size fits all. It may be helpful to try some of these complementary or alternative practices under the appropriate supervision. It is important to understand the limitations of the burgeoning research, while at the same time being open to trying something new. This is the focus of patient centered decision making.”

CIM: What advice would you give to researchers in health psychology? Where does the field of complementary and alternative medicine, especially within the context of psycho-oncology, need to go next?

Mao: “I think complementary and alternative medicine therapies are practices based on thousands of years of practice and experience. Health psychology and behavioral medicine fields also have many years of practice and strong supporting research. It will be useful and important to continue to bring these two fields together. We can use health psychology knowledge to understand the mechanisms and moderators of integrative medicine to advance this field. Many integrative medicine practices, including yoga, massage, and meditation, can be considered health behaviors. We need rigorous behavioral medicine theory and strategies to improve or knowledge and understanding of them. I think implementation of these practices into medical and primary care settings, as well as examining barriers to their use, will be important research to conduct moving forward. There many psychologists already bridging the gaps between integrative medicine and health psychology/behavioral medicine.

“If practitioners (health behavior researchers, psychologists, medical doctors, oncologists, nurses, massage therapists, yoga therapists, integrative medicine practitioners) want to get involved in more integrative medicine and cancer care research, to advance research and care in this field, I am also the chief of the Society for Integrative Oncology.” Find more information online.