Integrative Medical Systems in Practice in the US and Canada

Not all oncologists practice integrative oncology, nor do all integrative medicine physicians receive training in or provide cancer care. Some noted medical doctors who administer conventional cancer treatments using an integrative oncology approach include BCCT Advisors Keith Block, MD, and Donald Abrams, MD.

Integrative oncology is not currently a specialty certification, but in many countries, including the US and Canada, licensing boards and/or certifications exist for many of the disciplines of integrative oncology practitioners.

BCCT recommends finding providers who have received the required credentials of their field (licensure and/or certification) and who have received specialty training in cancer care as appropriate for their field. Some examples:

• Massage therapists are licensed and can also be trained in an accredited program to practice oncology massage.
• Board certified physicians practicing integrative medicine are considered “qualified medical specialists in the practice of integrative medicine. Completing the integrative medicine board certification indicates mastery of the specialty experience and knowledge as well as a professional commitment to adhere to the ABPS Medical Code of Ethics.”²

If you are unable to find an integrative oncologist, look for a conventional oncologist that's open to integrative approaches, perhaps on a team with a naturopath or functional medicine practitioner.

States differ on which board agencies they approve. All states accept certification from the American Board of Medical Specialties, although state medical boards can impose additional requirements for state certification. Not all states accept certification from the American Board of Physician Specialties.

Neither the American Board of Medical Specialties nor the American Osteopathic Association has an Integrative Medicine Board, and thus physicians are not certified in integrative medicine through an ABMS or AOA board (physicians practicing integrative medicine may still be certified through another specialty in these boards). The American Board of Physician Specialties lists an Integrative Medicine Board.

ABPS provides public access to check on the certification of a physician, although users must have a physician’s name and cannot search in their area or state for a physician. See the Public Inquiries section on the ABPS database page.

More Information

• National Center for Complementary and Integrative Health: Credentialing, Licensing, and Education

NDs promote and teach health-related behaviors and may recommend specific supplements or nutritional programs in an individualized treatment approach. Among integrative medical systems, naturopathic oncology stands out in developing a national/international evidence-informed training system for physicians.

Naturopathic oncologists work both in hospital oncology settings and in private practices, bringing their perspective and experience to aid oncology treatment teams that seek the best positive outcomes for their patients. Doctors who specialize in naturopathic oncology understand both the standard treatments employed by medical oncologists and how best to work in a collaborative model of cancer co-treatment. They often help patients maintain their oncology treatment regimens and provide vital support for reducing side effects of those treatments. Oncology Naturopaths are aware of the multitude of ‘alternative therapies’ promoted to cure cancer and work to educate patients on evidence-based treatment modalities. Cancer Treatment Centers of America, a mainstream group, employs naturopathic oncologists among their team members.

The designation “FABNO” after a physician’s name indicates she or he is a fellow of the American Board of Naturopathic Oncology (ABNO), which oversees board certification in naturopathic oncology. These physicians have met standards established for advanced experience and knowledge in cancer care and are eligible for board certification in naturopathic oncology.⁴

In addition to general licensing requirements, each state or province may have further requirements for licensure. The scope of practice for naturopathic physicians varies between states or provinces. In several states and provinces which do not yet license naturopathic physicians, “legal provisions still allow naturopathic doctors to consult with patients, making recommendations and suggestions based on prior diagnosis.”⁵

Non-accredited naturopathic training is available that does not meet the requirements for certification as a naturopathic physician or doctor. Unfortunately, graduates of this training may still call themselves “naturopaths”, leading to great confusion among patients and the general public. If you choose to add a naturopathic physician to your team, we at BCCT encourage you to look for a licensed naturopathic physician or naturopathic doctor—a licensed professional who has completed a medical education program and passed board certification—rather than simply a “naturopath.” See the directories below as a starting place for a search.

Strong Naturopathic Physician Training Programs

The Council on Naturopathic Medical Education approves and accredits naturopathic medical programs. These are listed on their Accredited Programs page.

Strong Naturopathic Physician Communities in the USA

In general, the largest cities in states that license naturopathic doctors have strong, established communities, with the strongest in those cities that also have a naturopathic medical school, such as Seattle, Portland and Phoenix. Large numbers of naturopathic doctors are found throughout California, Arizona, Washington state, Oregon and the New England states. Emerging communities are being established in the Midwest. The Southeastern US has the lowest concentration of naturopathic doctors.

• American Association of Naturopathic Physicians: Regulated States & Regulatory Authorities
• Natural Solutions for Digestive Health: Are Naturopathic Doctors Real Doctors?
• Council on Naturopathic Medical Education:
• Frequently asked questions
• Accredited Programs
• Links to Other Organizations and Helpful Web Sites
• World Naturopathic Federation: About Naturopathy
• Naturopathic Doctor Development Center: What You Ought to Know about Naturopathic Doctors
• Fleming SA, Gutknecht NC. Naturopathy and the primary care practice. Primary Care. 2010 Mar;37(1):119–136.
• Daily Show with Chris Sawyer: Jen Green

Built on the vision of Susan and Dr. Jeffrey Bland in the early 1990s, the Institute for Functional Medicine promotes a clinical practice approach based on the influence of epigenetic factors— environmental factors includeing diet and nutrition, toxics and lifestyle choices that influence the activation or expression of genes, but that do not cause mutations—on the development of chronic diseases.⁷

According to Mark Hyman, MD:

The future of cancer care must use medicine’s understanding of the mechanisms of disease and we must use this information to create physiologic and metabolic balance, to design treatments that support and enhance normal physiology. The future of cancer care lies not in finding the best cocktail of chemotherapeutic agents, the right dose of radiation, or a new surgical technique, (all of which are still important and will continue to be refined) but in finding the right way to personalize treatment according to the individual imbalances in each person.⁸

While functional medicine is an integrative care system based on restoring the function and health of underlying organ systems, it doesn’t address cancer specifically, nor has the Institute of Functional Medicine offered a recent training module on an FM approach to cancer. However, many FM physicians do treat cancer patients. If you are currently under the care of or considering care from an FM physician, you might inquire about their knowledge and experience and approach to working with people with cancer.

If the functional medicine approach resonates with you, consider working with a functional medicine physician in concert with your primary oncology physicians to support your physiologic and metabolic balance both during and after cancer treatment. Many functional medicine physicians practice primary care and would be able to address your general health as well as health problems unrelated to cancer. See further information about functional medicine practitioners in our Clinics/Clinicians section (under development).

More Information

• Dr. Hyman: 5 Strategies to Prevent and Treat Cancer
• Jeannine Walston: Functional Medicine and Cancer
• Cleveland Clinic: Why Choose the Center for Functional Medicine
• Foundation for Alternative and Integrative Medicine: Fatty Acids and Prostate Cancer Risk
• Personalized Lifestyle Medicine Institute: Cancer, the Tumor Microenvironment, and Personalized Lifestyle Medicine

Anthroposophic medicine is an integrative treatment system based on a holistic understanding of man and nature and of disease and treatment. Multimodal in practice, it builds on a concept of four levels of formative forces and on the model of a three-fold human constitution. Anthroposophic health care is provided by medical doctors, therapists, and nurses and is integrated with conventional medicine in large hospitals and medical practices. It uses these components:¹¹

• Medicines derived from plants, minerals, and animals
• Art therapy
• Eurythmy therapy, an exercise therapy involving cognitive, emotional, and volitional elements
• Rhythmical massage
• Counseling
• Psychotherapy
• Specific nursing techniques such as external embrocation, a liquid rubbed onto the body to reduce pain or stiffness in muscles

Mistletoe (Iscador), one of the natural products used for cancer, “originated within anthroposophic medicine. It is one of the most commonly prescribed complementary cancer therapies in central Europe and has been investigated intensely.”¹²

When BCCT director Michael Lerner visited anthroposophic hospitals in Germany and Switzerland, he noted that they combined an efficient and effective use of conventional medicine for cancer with intensive use of naturopathic, homeopathic and anthroposophic remedies. The anthroposophic hospitals are widely known and admired in Germany and are frequently used by Germans with life-threatening cancer diagnoses. The hospitals are aesthetically beautiful; with a strong emphasis on treatments that will enable the patient to make the best possible use of his life; and nursing and medical care are strikingly humane by American standards.¹³

Anthroposophic Medicine in North America: More Information

• Rudolf Steiner Health Center in Ann Arbor, Michigan: a therapy and training center for chronic illnesses
• Physicians in North America practice anthroposophic medicine, some of whom have completed a certification process. Lists of providers:
• Physicians' Association for Anthroposophic Medicine: PAAM Directory of Providers
• Association of Anthroposophic Medicine & Therapies in America: Directory