The Role of Integrative Medicine in Oncology: Expert Perspectives on Nutrition, Exercise, and Symptom Management

Integrative oncology is increasingly recognized as a vital component of comprehensive cancer care, focusing on the combination of conventional medical treatments with evidence-based complementary therapies to support the whole patient through their cancer journey.

In interviews with Oncology Nursing News, experts emphasize that this approach is a collaborative effort to mitigate adverse effects (AEs), improve treatment adherence, and enhance quality of life. At its heart, integrative oncology is evidence-based practice in action.

Dietary Change and Exercise

For many patients, lifestyle modifications represent a way to regain agency during treatment. However, clinicians must move beyond vague advice. Lillian Rodich, MPH, PA-C, who practices at Memorial Sloan Kettering Cancer Center (MSK), noted that patients often find general suggestions like "eat healthy" frustrating.

“One of the things that people say almost daily in clinic is, 'I can’t stand when somebody tells me just eat whatever you want. I want better guidelines,'” Rodich shared. She emphasized that providing specific goals, such as increasing fiber and decreasing processed meats, sets patients up for success.

Further, advising patients how to make these changes should be specific enough to give them a sense of what their daily intake should look like.

“Just telling someone to eat more, or to eat small meals many times throughout the day, that’s not specific enough for them,” said Rodich. “[Give] them little tidbits, little ideas, of how to sneak different things in to optimize calorie intake so that it all adds up at the end of the day, and how to optimize what their taste buds are wanting, since there are so many taste bud changes going on as well.”

Claudia Aguilar Clancy, MSN, RN, FNP-C, AOCNP, a nurse practitioner at Texas Oncology, highlighted the impact of movement. She cited a July 2025 meta-analysis published in The Lancet Public Health involving over 160,000 adults, which found that achieving 7000 steps per day significantly lowered all-cause mortality by approximately 47% (HR, 0.53; 95% CI, 0.46-0.60).¹

“It counts from when you wake up to when you go to sleep; all of that movement is critical,” Clancy explained, noting that this realistic goal often motivates patients who feel paralyzed by the traditional 10,000-step target.

David C. Leopold, MD, the immediate past medical director for Hackensack Meridian Integrative Health and Medicine, agreed that physical activity is paramount. From a dietary standpoint, he advocates for a plant-forward approach that avoids ultraprocessed foods and refined sugars, noting that the evidence clearly shows patients who adopt these habits do better.

At-Home Symptom Management and Honest Conversations With Patients

A critical role for oncology nurses and advanced practice providers (APPs) is maintaining open rapport regarding outside remedies. Rodich recommended using tools like MSK’s “About Herbs” app to bridge communication gaps.

“If someone comes to you and they say,...‘Should I take this?,’ you’re able to say, ‘I don’t know about it…. Let’s look it up together. It looks like it has an interaction with your chemotherapy; better not take it,’” Rodich suggested. “Now the patient and you have this great level of trust, and they’re more likely to discuss other things with you.”

Leopold warned that being overly dismissive can be counterproductive. “If it’s not frankly going to be dangerous to somebody, then you have to be very careful [about taking it away],” he said, explaining that his primary role is to keep patients engaged with the medical system rather than seeking unvetted care elsewhere.

The Evidence Is There

While some perceive integrative methods as anecdotal, Rodich, Leopold, and Clancy stressed the robust data supporting these interventions. Leopold pointed to research by Dean Ornish, MD, showing that comprehensive lifestyle changes can regulate over 500 genes in a way that results in a lower likelihood of cancer.²

“There’s not an absence of evidence; there’s an absence of people reading the evidence,” Leopold stated.

Rodich highlighted that the American Society of Clinical Oncology now recommends acupuncture as a first-line treatment option for joint pain related to aromatase inhibitors.

“This is one of the first times...where a holistic measure like this is a first-line treatment option, not somewhere down in the fine print,” she noted.

Similarly, Clancy emphasized that the 6 pillars of lifestyle medicine—nutrition, physical activity, stress management, sleep, social connection, and avoiding risky behaviors—are foundational evidence-based practices that align with American Cancer Society’s recommendations.

The Evolution of Integrative Oncology and Professional Paths Toward It

The field has evolved significantly over the last 2 decades. Leopold observed that nurse navigators have become pivotal in ensuring patients are aware of integrative services. He noted that early in his career, many oncologists told patients that diet did not matter, a misconception that has largely been debunked by current research.

For clinicians looking to specialize, several educational pathways exist. Rodich pointed to the University of Arizona fellowship and the Society for Integrative Oncology’s Integrative Scholars Program as valuable resources. Clancy, who is currently establishing the first APP integrative role at Texas Oncology, encourages peers to explore the American College of Lifestyle Medicine for evidence-based training.

Regardless of their formal title, nurses and APPs can act as “integrative champions” in any setting. As Leopold summarized, “Nursing is so key because nurses are there with the patient, so they get it. Nurses have always understood compassion and the healing relationship.”

When AEs become overwhelming for a patient, working with the patient to manage toxicities and maintain treatment adherence is crucial. Leopold helps his patients mitigate the toxicities of cancer treatment with evidence-based practices, including acupuncture for fatigue and stress management, physical activity, and dietary modifications.

“What I would always say to my patients is, ‘If I can get you to a place where these AEs are mitigated…will you stay on that medication?” said Leopold. “Well over 90% said, ‘Yes, I will.’”

When patients are given appropriate care, Leopold explained, they can adhere to treatment plans. According to Leopold, his patients often enter the integrative medicine clinic years into their cancer journey and wonder why they were not referred sooner.

“They would say…‘Why am I just ending up in your clinic now? I’ve been suffering for years with these [AEs],’” said Leopold. “I had a team of acupuncturists, mind-body specialists, and nutritionists, and [the patients] would feel better. They would feel better despite everything they were going through.”

As the clinicians working most closely with patients and keeping up with their AEs throughout the course of treatment, nurses play a key role in bringing comprehensive treatment to patients. Leopold emphasized that nurses and APPs are often the ones to bring the idea of acupuncture or other integrative interventions to a patient’s attention after seeing the success of the intervention in previous patients.

“Nursing is so key because nurses are there with the patient, so they get it. Nurses have always understood compassion and the healing relationship,” said Leopold. “Even something as simple as holding someone’s hand or being present can make such a massive difference.”

References

1. Ding D, Nguyen B, Nau T, et al. Daily steps and health outcomes in adults: a systematic review and dose-response meta-analysis. Lancet Public Health. 2025;10(8):e668-e681. doi:10.1016/S2468-2667(25)00164-1
2. Ornish D, Magbanua MJ, Weidner G, et al. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proc Natl Acad Sci U S A. 2008;105(24):8369-8374. doi:10.1073/pnas.0803080105