comparison group is almost always “usual care.” Thus,
any benefit in anxiety, feelings of depression, or qual-
ity of life cannot be ascribed to the specific interven-
tion used. Benefits could be due simply to increased
time spent with a caring professional, supportive con-
versations between the integrative therapy practi-
tioner and the patient, or other non-specific effects.
Third,and related to the above, there is the issue
of transparency and patient decision-making. It is
unclear if and how information about the limited ef-
fectiveness of many of the integrative therapies is pre-
sented to patients, allowing them to choose therapies
that might be most effective for them, or if indeed,
they weigh the cost-benefit (e.g., chances of decreased
anxiety vs. time away from family) and decide that no
intervention is their best option. Patients have a right
to know the potential effectiveness of their surgery, ra-
diation, and chemotherapy treatments. Likewise, they
have a right to know the supportive evidence for inter-
ventions that may impact their quality of life.
Fourth,the point is often made that patients are
“demanding” such integrative services. However, pa-
tients did not demand such services until advocates
filled their heads with silly nonsense about practices
such as invisible energy fields and “healing touch.”
Cancer centers should not initiate or continue these
practices because their patients fall victim to the rec-
ommendations of alternative practitioners.
Integrative oncology supporters often tout “the
whole person” approach to treatment their practices
support. If this is the case, we should not simply bow to
patient demands. If patients demanded medical treat-
ment that was not consistent with good evidence, it is
doubtful that oncologists would provide it since the ev-
idence would not indicate benefit. Major cancer cen-
ters should not provide services without evidence of
benefit and should clearly not do so simply to “keep
up with the Jones’s” or for the positive financial impact
these services might provide on a fee-for-service basis.
Fifth, it is unclear who is “minding the store.” That
is, who is monitoring the provision of services to en-
sure that only integrative therapies with solid evidence
for specific outcomes are utilized? The Society of Inte-
grative Oncology is clearly a promoter of integrative
therapies and supports any number of such that clearly
have no reasonable biological basis (e.g., “healing
touch,” homeopathy), so they clearly cannot assume
the role of guardian of science-based medicine. The
claim that practices well within the medical main-
stream (exercise, nutritional consultations) are
“integrative” brings more acceptance to “integrative
therapy.” With this acceptance, it is not unreasonable
to believe that homeopathy, chiropractic, naturopathic
medicine, or aromatherapy will be provided (and per-
haps already are) in major cancer centers. As noted
previously, many of the practices included in the study
lack solid evidence of effectiveness. The promotion of
such therapies by these centers does not provide a great
deal of confidence that cancer “quackery” will not con-
tinue to breach the walls of what are supposed to bevolume 25 number 1 2020 W W W. S K E P T I C. C O M 3 7Illustration by Anna Maltese