Integrative oncology is an evolving evidence-based specialty providing whole-person care by combining conventional approved cancer treatments with integrative and complementary therapies that best serve the needs of patients based on their diagnosis, prognosis, treatment history, and individual preferences. The field, which is now an important part of cancer care, struggled for decades to gain recognition, led by pioneers such as Barrie Cassileth, PhD, who was Founder and Chief of Memorial Sloan Kettering Cancer Center’s Integrative Medicine Service and the Laurance S. Rockefeller Chair in Integrative Medicine.
Career of Service Begins in College
DR. CASSILETH was born in Philadelphia, which she described as a wonderful place to grow up, full of opportunities and rich in art and history. After graduating from high school, she went to Bennington College in Vermont, majoring in social sciences. “It was a cauldron of intellectual freedom. My years there largely molded my career,” Dr. Cassileth said.
While at Bennington, Dr. Cassileth borrowed an old truck from the school and spent a year in the small backwater town of Pownal. “It hadn’t changed much in more than a century,” Dr. Cassileth said. Full of the Bennington spirit—which requires students to direct the course of their own education— she established herself in the close-knit, cloistered community of Pownal, teaching art and music in the town’s one-room schoolhouse.
Interaction With Dying Patients Guides Career
THAT WAS A GREAT EXPERIENCE, as were subsequent years at Albert Einstein University for an MS in psychology. Her prior plans to attend medical school shifted early in her third year of college, “when I hurried to complete my college degree early to marry my fiancé, a college senior then off to medical school and a PhD in medical sociology at the University of Pennsylvania,” she revealed. “I did my dissertation at the UPenn [University of Pennsylvania] Comprehensive Cancer Center’s Inpatient unit for leukemia patients. At that time, we did a poor job managing adult leukemia,” shared Dr. Cassileth. However, her clinical interaction with dying cancer patients had a deep effect on her career, and she wrote several journal articles based on her experiences as well as her first book, The Cancer Patient: Social and Medical Aspects of Care. “Even more important, the foundation of learning and knowledge was firmly embedded in me while at UPenn,” said Dr. Cassileth.
“Complementary modalities can control many symptoms and enhance quality of life with safe, noninvasive, nontoxic interventions in which patients themselves can play an active role.”— Barrie Cassileth, PhD
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After receiving her PhD, Dr. Cassileth remained at the UPenn Cancer Center as Assistant Professor, teaching medical sociology. However, after much discussion with the cancer center’s director, Dr. Cassileth took a turn into uncharted territory, which, in a sense, shaped her future career as a trailblazer in oncology. “I ended up initiating what I believe was the first palliative care program in the academic setting in the United States.”
To accomplish this, Dr. Cassileth pooled the University’s collective resources, including a large number of graduate students, and created novel programs, known collectively as psychosocial programs. One of her highpoint projects was conducting the first national survey of cancer patients’ use of complementary and alternative therapies. The results of the survey were enlightening. “The research showed that cancer patients were using a wide array of therapies on their own, some ineffective and potentially harmful, others very helpful,” explained Dr. Cassileth She added: “I also led studies of the clinical effects of these therapies.”
Dr. Cassileth had years of productive research in which she and her associates developed prototypic clinical and research programs in patient and family support, medical education, home care and hospice, and the complementary therapies that now comprise integrative medicine.
Long divorced from her former husband, the father of her three children, she moved to North Carolina in 1992, where she was appointed Consulting Professor of Community and Family Medicine at Duke. “It was a rewarding time,” she noted, “during which I created and served through 1995 as the first editor of the Duke Cancer Report and Adjunct Professor of Oncology at the University of North Carolina at Chapel Hill.”
Memorial Sloan Kettering Calls
IN 1999, Dr. Cassileth was recruited by Memorial Sloan Kettering Cancer Center (MSK) in New York to create what it termed an “Integrative Medicine” program, which has served since as an international prototype. “I also agreed to numerous requests to assist the development of such programs around the world. My strong belief in the necessity of helping patients and family members, as well as physicians and staff, participate in cancer research spurred me on. It was always clear that patients and family members need more than excellent surgery, chemotherapy, radiation, and all the new treatments. Top-notch cancer care, including the now-accessible complementary modalities, is a vastly updated new world,” said Dr. Cassileth.
“It was always clear that patients and family members need more than excellent surgery, chemotherapy, radiation, and all the new treatments.”— Barrie Cassileth, PhD
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Dr. Cassileth credits Laurance S. Rockefeller, the philanthropist and long-time supporter of MSK, for convincing the Sloan Kettering leadership that an integrative medicine program was needed at MSK. While at MSK, Dr. Cassileth promoted research of complementary therapies as the founding President of the International Society for Integrative Oncology and as a founding member of the advisory council to the National Institutes of Health (NIH) Office of Alternative Medicine, now the National Center for Complementary and Alternative Medicine.
Having served as Director of the first National Cancer Institute (NCI) T32 training program in Integrative Oncology for Physicians, Dr. Cassileth headed one of the six NIH T32-supported NIH Botanical Research Centers, which addressed the study of immunomodulators. “I spearheaded research and published extensively on the evidence-based application of complementary therapies, new ways to reduce physical and emotional pain in cancer. The now international, research-based blooming of integrative oncology helps patients and their families live well, physically and emotionally, during and beyond the struggle of cancer,” said Dr. Cassileth.
New Era in Oncology
FOR DR. CASSILETH, integrative medicine reflects the new era of oncology, one in which our increasing survival rates permit attention to survivor needs. Physical and emotional sequelae of treatment now are important emphases. She stressed that many cancer patients use complementary and alternative therapies. Patients appear increasingly willing to discuss the use of these remedies, especially when asked by their oncologists. “To encourage open communication of use of complementary and alternative modalities by their patients, oncologists should be knowledgeable about the most commonly used remedies or at least be able to direct patients to reliable sources of information,” said Dr. Cassileth.
“Complementary modalities can control many symptoms and enhance quality of life with safe, noninvasive, nontoxic interventions in which patients themselves can play an active role,” said Dr. Cassileth.
Dr. Cassileth recently retired from her position as Chief of Integrative Medicine Service at MSK. She has since traded the East Coast for the West Coast and now resides in Southern California to be near her children and grandchildren. Still active, she maintains many of her relationships with the colleagues and friends she has made along the way of her career in oncology, one that left the field a better place for patients with cancer. ■
DISCLOSURE: Dr. Cassileth reported no conflicts of interest.