CEimpact Podcast

Optimizing Care with Integrative Oncology - Part TWO

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Integrative oncology blends conventional cancer treatments with supportive therapies like nutrition, acupuncture, and mind-body practices to improve patient outcomes and quality of life. This episode outlines what pharmacists need to know about the principles of integrative medicine, how to evaluate evidence-based resources, and counseling tips for guiding patients through safe, effective complementary options. Tune in to strengthen your ability to support cancer patients with credible, compassionate, and comprehensive care. 

HOST
Joshua Davis Kinsey, PharmD
VP, Education
CEimpact

GUEST
Ginger Blackmon, PharmD
Associate Director of Clinical Initiatives 
NCODA

Joshua Davis Kinsey and Ginger Blackmon have no relevant financial relationships to disclose.

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CPE INFORMATION
Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:
1. Define integrative oncology and identify its role in supporting patients undergoing conventional cancer treatment.
2. Describe how pharmacists can evaluate and counsel on evidence-based complementary therapies used in integrative oncology.

0.05 CEU/0.5 Hr
UAN: 0107-0000-25-257-H01-P
Initial release date: 7/14/2025
Expiration date: 7/14/2026
Additional CPE details can be found here.

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Speaker 1:

Welcome back to the Game Changers Clinical Conversations podcast. I'm your host, josh Kinsey, if you're just joining us or even if you tuned in last time. We're continuing our compelling conversation on integrative oncology with our guest, ginger Blackman. In our first episode, ginger shared her powerful personal story and helped us understand the role of integrative oncology in supporting the whole patient, not just treating the disease. We explored how complementary therapies like aromatherapy, meditation, music therapy and even exercise can be safely used alongside conventional treatments to improve quality of life, clinical outcomes and empower patients throughout their cancer journey.

Speaker 1:

Now, in part two, we're diving deeper into specific strategies pharmacists can use to guide and support patients who are exploring integrative approaches backed by evidence and clinical guidelines. So let's pick up right where we left off and continue this important discussion on how integrative oncology is changing the way we care for our patients with cancer. All right, so, deidre, let's move into talking about access and equity. As we learned that, not learned. We know that those things are. They affect all of our patients, right as far as social determinants of health and things like that. So how specifically, are they kind of incorporated into this integrative oncology mindset? Are they kind of incorporated into this?

Speaker 2:

integrative oncology mindset. So I will say, as far as access is concerned and cost, I think is a huge player here Unfortunately, a lot of the services while beneficial, and there are some like exercise- again. You can do that at no cost Like go outside your door If, if you live in a safe area where you can walk, and that's that's one thing where I have read that it's kind of sad that some of the malls are closing um, because you know that's where a lot of people went, you know you would see people would go to the mall and do power walkers, yeah, yeah um, but you know you can find ways to exercise for free pretty easily.

Speaker 2:

But again, if you wanted to do strength training and you wanted to have that gym and someone to direct you, like a trainer is not having that guidance is not cheap.

Speaker 2:

but also like acupuncture Um, there are some, there are some insurances who are covering it, but a lot don't. Um massage same. But those therapies, unfortunately, when you're already maybe paying huge co-pays for your treatment, even if you're not, they're not cheap and if they're not covered by your insurance, then a lot of patients just are going to have to forego because it's like well, I can pay for my meds and I can eat, or I can go get acupuncture I can pay for my meds and I can eat or I can go get acupuncture.

Speaker 2:

So I don't have a solution for that. I would love to. I think maybe some some nonprofit something. I dream up, but with cover services for the patients, but right now, or maybe actually policy changes too for insurance companies.

Speaker 1:

Yeah, but for now, you know, you know there is that is something to to know about and consider is the fact that a lot of these things, as we've talked about, are complementary to, you know, the prescribed medications and whatnot, and so therefore they're, they may very well not be covered, you know, even just we were talking about, you know, it's easy to go outside your door, and then we were talking about, well, if, what if it's easy to go outside your door? And then we were talking about, well, what if it's not safe? But you know, if you think about, even too, if it's someone, you know, if it's someone who has transportation insecurities and it's winter and they can't, even if it is safe, they can't go outside their door because they live somewhere where there's always a foot of snow on the ground, but then they can't be driven to the local gym or whatever, but then they can't be driven to the local gym or whatever. So you know, I think there's a lot of things like that, and you know we've talked about before how pharmacists can really play a part in that and help to connect them to the right resources, and you all have heard me plug many times my listeners how we've talked about community health workers and cross-training our technicians as community health workers, which will help connect to the resources that are in the community to help solve some of these. You know food and travel, insecurities and things like that.

Speaker 1:

So there are things that for you to be aware of as a pharmacist. Even you know like, oh, someone's going to go get acupuncture. I can't help if they can't afford it. Well, maybe you could, because if you have the connections in the community, you may be able to. You know what if there is a nonprofit in your community, or what if there is a local church that has funds for cancer care or things like that? So so, yeah, definitely, definitely some opportunities to you at least need to be aware of this as a pharmacist and understand that sometimes access is difficult for patients and this could be a place where you can make connections and help. So, yeah, I love that, yes, yeah.

Speaker 1:

So let's talk about then. We've talked about some of the actual, what I would call components of integrative oncology and, just to review those again mental health support, pain management, cancer related fatigue and some of the things that will kind of help with that. Using exercise boldly as treatment we talked about that at length and, I think, just such great information there. And then we talked about vitamin D, some of the other herbal medications and where to find details and specifics about those. We won't mention all of those in general. And then the fact that we need to be sure, you know, we're aware that access and equity to these things is not always. It's not always across the board and easy to gain access and equity too. So, opportunity-wise, let's summarize some of the opportunities that we have as a pharmacist to help in this space, or the opportunities and the pluses of if that's a word, is that a word Pluses?

Speaker 1:

Yeah, it is now Positive attributes, the opportunities and the pluses of. If that's a word, is that a word Pluses?

Speaker 2:

Yeah, positive attributes of integrative oncology, so I'll let you kind of take it there. So I mean, I think as a pharmacist even it gives you the opportunity to help a patient personalize their care, kind of take some control over their care and advocate for themselves, of take some control over their care and advocate for themselves, and then also gives you a chance to support the patient holistically, so not just physically but again total, mind, body, spirit, everything. I think you can leverage your role and again you mentioned text, I love that but to guide evidence based intervention. So maybe if they're considering and I think that's where it like about herbs and things like that come in If they're considering one thing, you may be able to steer them away, like listen to what they have to say.

Speaker 1:

Yep.

Speaker 2:

Give them like. This is not what I would recommend and this is why. But maybe then, like you could say but instead, what if you?

Speaker 1:

try this Yep, give an alternative. And that goes back to what we talked about earlier with don't just put your foot down and say no. I mean that's. We know that from you, know parenting 101, like the minute you say absolutely not, you will never. That's when your child's going to do it, you know.

Speaker 1:

And then they're not going to tell you Exactly and then you're never going to know that they did it again or whatever. So so, yeah, I think that's also just super important to to reiterate the fact that don't just say no, don't do that Like, don't listen to that or whatever. Give an alternative. Have you know, know where to go, find more details, find the evidence-based interventions that you know have proven outcomes, and then recommend those to the patient, as opposed to just saying no, because again they're going to. Your patient will take that as great advice, and then they're going to come to you next time and say, hey, you helped me, you know before, let's talk about this now. I want your help on this. So okay, and then, keeping on with the opportunities, going ahead, you were going to say something else you could potentially help them improve adherence.

Speaker 2:

So let's think about it. If they like the aromatase inhibitor AIs, if they have pain and that's a side effect, well, if you could help them with acupuncture, that may help them be able to stay on that.

Speaker 1:

Stay on it. Yeah, yeah.

Speaker 2:

Again with with outcomes too. Like we, I spoke extensively, probably too long, about the colon cancer outcomes, but I just find like I think that's great, that that's showing an actual overall, like survival, benefit. So just a way to and then patient satisfaction as well, right, so if they have a better quality of life and they feel better, they're going to be more satisfied with their care.

Speaker 1:

Well, and I mean their life their life and we just I mean we it's it's kind of a circle. We talked about how they're depressed or anxious and you know treating those things, and so, just in general, if you're taking your med, because you feel better when you take it, and then it's doing its job, and then you get a good report when you go to the doctor that the meds doing its job, and so it just it's a constant circle of like, well then that makes you feel better and you're going to continue to do what you were doing and it's going to have better outcomes overall, and so it's just a great, it's just a huge cycle. So I think it's important that we're touching on all of these things. I think it's important that we're touching on all of these things. So, with anything, there's challenges, right, there's things to overcome. So we talked a little bit about, potentially, access and equity. So let's kind of dig a little, just as a reminder or fresher on that, what are some of those challenges that we're going to see with integrative oncology?

Speaker 2:

So, again, the cost barrier I think, is one of the number one things and just lack of reimbursement. While there is some, it still has a long, long way to go from companies, which I think is why the evidence-based care is going to be so important, because the more studies we have, and again that gets us into another challenge.

Speaker 2:

Is that evidence-based care for this right. So there are no pharma companies necessarily to fund a lot of these studies because you know it's not a drug. And then also misinformation. I think around like natural therapies and oh, like that doesn't have evidence, or using something natural that really maybe you shouldn't be using compared with some of these things that are evidence-based and have that information to back them.

Speaker 1:

Right, right, yeah, and I think that gets back into that whole. You know the misinformation like I heard it on the morning talk show or I heard it. You know as a, as an infomercial or whatever, and and again, that's where we as pharmacists really have to step up and be that expert for them.

Speaker 2:

So yeah, I think that that also leads us to one other challenge, though, that goes around with, or goes along with, misinformation is the need for clinician education. So what we're doing here today, educating pharmacists, but educating even oncologists, social workers, other staff, on what is evidence based, all of these things that we've talked about today and then having standardized pathways where you can implement some of these things, then having standardized pathways where you can implement some of these things and, like you said, knowing where to find them and knowing the reputable resources to send people to as well.

Speaker 1:

Yeah, so we've kind of talked about those cornerstone pieces of integrative oncology. We've kind of looked at what all those look like, how pharmacists can interplay with each of those individually in a sense in some way, whether it be information or counseling or actually choosing the supplement to use or the inhalation or whatever. So how can we, other than just knowing which ones of our patients have been diagnosed with cancer, how can we determine from even that pool of people, who is going to benefit from this, this type of integrative support? Like, how can we identify those individuals?

Speaker 2:

Well, I mean, my first response is to say I think everyone everyone would benefit.

Speaker 1:

I was kind of hoping that would be your response.

Speaker 2:

I knew it would be yeah. It's everybody. But also just just asking a question too Like we've always you know some other things with like using marijuana or CBD. We've always said, like if you don't ask you're never going to know. But if you ask if they're using this, then a lot of times they'll say yes. But I think you can ask, like, have you tried? Are you exercising? Like, have you tried any interventions? That go alongside your therapy that might be able to help with your quality of life.

Speaker 1:

Did you know that there's evidence to support? You know an exercise regimen. Have you looked into that? Is that? Do you need support with that? You know, like again, do you need help getting to the gym or whatever? Yeah, so, yeah, that's great. Yeah, so, yeah, that's great.

Speaker 1:

So, in general and you know, thinking across multiple levels of care, so as a pharmacist being in care or in inpatient, or community or whatever obviously in inpatient, and probably even in care a little bit more, we know more when a patient is being treated, especially if it's in, if we're in care in an oncology clinic or whatever. And you know, oftentimes in the community setting we don't know when a patient is necessarily being treated with cancer unless they tell us. But we do know and we've had other episodes on this before some of the supportive care things that our oncology patients are going to be on. So those are some of the things to look out for as well. So, nausea and vomiting meds, steroids potentially if you don't, if you don't see another, you know potential indication for use of steroids, you know things like that. So that's, those are other ways in which we can kind of determine which patients you know may be, may benefit from this type of care.

Speaker 1:

So okay, so then let's go into. I just want to review and remind everyone about the trusted resources and referrals. So if you can just review those again the ones that you mentioned where you would go to get herb information, that kind of stuff, the databases, because again, we want to be sure that we're giving our patients evidence-based content and not just what we've heard about or whatever. So just review those for us if you don't mind.

Speaker 2:

Yeah, so the two, the two. I think where I would start is again the Society for Integrative Oncology and looking at those guidelines that they developed in accordance with ASCO. So those are going to be again some of the basic, pretty, pretty easy things that you can do, but they are evidence based. And then the About Herbs website I would, anything herbal, I would definitely go there.

Speaker 1:

Go to that one. Yeah, that's free. They have an app as well, but I was just fixing to ask is it subscription based or is it something that's just free?

Speaker 2:

Well, it's free for everyone and it has a patient can also utilize it. Wow, ok, that's great, great to for everyone. And it has a patient facing like a patient can also utilize it.

Speaker 1:

Wow. Okay, that's great, great to know and I loved you mentioned earlier and I didn't really harp on it then. But I want to bring it back up. Collaborating as a pharmacist I think that's a big role too, because don't assume that if you're on board with integrative oncology, that the patient's oncology team is on board with it. So there might be instances where you're having to collaborate and educate the oncology team. Is that right? Is that a fair point?

Speaker 2:

Absolutely yes. I think that is again where making sure that health care providers are educated on this, but anytime making sure that you're communicating with their team. I know at Encoda our big push is for medically integrated pharmacy, so most of our members are part of those oncology practices. So a pharmacy that's either in an academic or community oncology. But if you're in the community like make sure, if maybe you don't have the direct line of communication with that patient's oncologist, but make sure, maybe maybe you don't have the direct line of communication with that patient's oncologist, but make sure, maybe you tell the patient like hey, can you make sure and let your team know that you're doing this, let your oncologist know or your pharmacist at the oncology clinic know, and maybe provide them with a way for them to contact you too if they have any questions. But I think making sure that line is open and that everyone knows what the patient is doing.

Speaker 1:

It's great, yeah, great point. And then you mentioned using those survivorship visits or counseling points as a gateway for this. So those are if you can just speak to that really quickly just as a. Those are opportunities in which you can kind of join in the conversation with the patient as a pharmacist, are opportunities in which you can kind of join in the conversation with the patient as a pharmacist.

Speaker 2:

So, yes, yes, and I will say, like, survivorship and this will be, hopefully you will do another podcast, because that's another topic that is very close to my heart, but hopefully, um, there will be more coming on this. But survivorship, I mean starts from like when, from diagnosis, so you're in survivorship.

Speaker 2:

It doesn't necessarily mean you've completed treatment Um, but there is a huge, growing, thank goodness population of people who have completed treatment and will continue to have visits um with providers, and I think that's a great. At times they may be left with side effects or they might be on the AI for five or 10 years after they're visiting your pharmacy.

Speaker 2:

There's another way to identify them. You know, if they're getting an aromatase inhibitor, um, you likely know that. That's probably why, um so, in those visits to your pharmacy, even to pick to pick up, pick, pick that up if they tell you they're having a side effect, or if they come to you with any issues. It's a great opportunity to talk to them.

Speaker 1:

Yeah, and, like you said, just the fact that you have either are going through or have gone through cancer treatment and survive, that in and of itself is, you know, the depression or the anxiety of like is it coming back, or you know when's it coming back, or whatever. Like you know, those are still opportunities for us to see those patients and we talked about how depression and anxiety can be treated with several things and you know there's evidence to show for that. So, again, I think I guess what we're reiterating is it doesn't stop with during treatment. Like this can go on post and this can be, you know, with your patient afterward for years.

Speaker 2:

I mean after the anxiety of like is it coming back?

Speaker 1:

Yep.

Speaker 2:

It's the gift that keeps on giving.

Speaker 1:

Yep, unfortunately, so Okay. Well, ginger, if you could sum up integrative oncology in like a sentence, what would you say it is?

Speaker 2:

So I would say that it bridges the gap between symptom control and empowerment. So, and really really, like we said earlier, it's really about treating the person and not just the disease.

Speaker 1:

Yeah, yeah. So it's taking off our really smart hats of treating the disease which is what we're also good at doing and determining the right regimen and the right dose and the right length of therapy, and all that. And it's really just thinking, you know, being patient centric for a little bit and just really looking at all of the issues that they're going through. So, yeah, it's more than just killing the cancer. Like you know, we have to make sure the patient is taken care of too. So that's great. So a question I ask everyone at the end of the podcast is what's the game changer here? So, in other words, what is the one key thing that you want to leave with our listeners for this two-part episode on integrative oncology?

Speaker 2:

two-part episode on integrative oncology. So I would say that integrative oncology transforms cancer treatment by making patients active participants and offering safe, evidence-informed tools that can enhance outcomes.

Speaker 1:

Yeah, that's great, that's great. Well, we encourage all pharmacists and oncology teams to explore and advocate for integrative interventions at your practice sites and with your patients. You know, again, these are rooted in evidence. Like we're not going to be sharing anything with you unless it's evidence-based. And so you know, integrative oncology is growing. It's an ever-growing field. I feel like it's just going to continue to explode as more and more people really kind of latch onto it and we see that the outcomes continue to get better and better and we're going to just see more and more people utilizing it in care. So we encourage you, as a pharmacist, to determine where you best fit in this space and to be there for your patients, whether you're heavily involved already with oncology care and you're dealing with the day-to-day, or whether you are a community pharmacist and you are looking for those individuals that are fighting cancer or in survivorship mode and you're helping to support them with this integrative care. So with that, Ginger, thank you so much for joining us for these episodes.

Speaker 1:

This content is so good and I feel like it's just. It's a growing space and it's things that we don't all. We didn't learn about a lot of this in school and I dare say that they're even probably not still learning about it, even though there are some getting out sooner than 20 years ago, like us. But I think it's just, it's a space that you know. That's what we're here for. We're here to give continuing education on things that are important and pertinent and relevant to your practice. So thank you for giving of your time. I know this is a really passionate subject for you, so I'm just so grateful to have you on with us to discuss these things.

Speaker 2:

It is Well. Thank you so much for having me. It's been a lot of fun and you've been a pleasure, as I knew you would be to work with, and it's been really just great to be able to talk about it and hopefully again get more of our love, our community pharmacists. You and I both have our start and our background there. I know you did in a hometown pharmacy and I worked in one from when I was 16, a local independent, but love our community pharmacists and just hope that this gives them an area where they can be an advocate for their patients.

Speaker 1:

Yeah, where they can actually be. Yeah, they can feel like they're really involved with this cancer team. So, yeah, that's great. That's great. Well, if you're a CE plan subscriber, be sure to claim your CE credit for this episode of Game Changers by logging in at CEimpactcom and, as always, have a great week and keep learning. I can't wait to dig into another game changing topic with you all next week.