"It's not just about treating the cancer. It's also about how the person is coping, what side effects they may have from the disease itself or from the treatment, and how those symptoms make their life harder to manage," she says. "Treating the whole person is a really important part of cancer care."
These symptoms can be caused by a variety of internal and external sources, and Dr. Chiaramonte says it's important to get to the root of the cause of the symptom to better treat the patient.
"We hear the patient's symptoms then make an evidence-supported treatment plan that's different for every person, based on what their symptom is and why we think their symptom is happening," she explains.
For example, one person may not be sleeping well because of a physical reaction to chemotherapy. Another may not be getting good sleep because their mind is filled with anxious thoughts about their diagnosis.
Dr. Chiaramonte says there are three main causes of symptoms, and the Integrative Medicine Program makes it easier for patients to get an evidence-based, effective treatment plan and to receive those treatments at the Sandra & Malcolm Berman Cancer Institute at GBMC.
"We pull out all the causes and then address them with the treatment that is likely to work on that particular person, and often it's not just one cause," she explains.
The mind-body connectionThe sympathetic nervous system directs our body's "fight or flight" response, which can be caused by both external factors and our own thoughts.
"Because the mind and body are connected, our anxious thinking can generate the 'fight-or-flight' response, and that can result in all kinds of physical symptoms, including increased pain, palpitations, changes in GI function, sleep, and nausea," Dr. Chiaramonte says.
According to Dr. Chiaramonte, there are a variety of ways to help decrease the sympathetic nervous response system, including craniosacral therapy (a light-touch manual therapy technique that works to balance and facilitate healing in the body) and massage. These methods reduce patients' anxiety.
Cancer treatment symptomsIt's no secret that chemotherapy and radiation can be taxing on the body. Nausea, fatigue, and neuropathy (nerve pain caused by damaged nerves) are just some of the side effects of cancer treatments that integrative modalities can help alleviate.
"Some energy medicine has been shown to help chemo-induced peripheral neuropathy," Dr. Chiaramonte says. "Many people come in with fatigue, usually from a combination of poor sleep and treatments. Acupuncture, meditation and guided imagery, reiki (a stress reduction and relaxation technique involving a trained practitioner), and yoga have all been shown to help fatigue."
Physical painDr. Chiaramonte reiterates that the Integrative Palliative Medicine Program is just that: an integrative medicine program and not an alternative to standardized cancer care.
"I treat pain with medicines, with different kinds of opiates and complementary medications," she says. "But acupuncture has been shown to decrease pain. Meditation and guided imagery have been shown to decrease pain. Reiki has been shown to decrease pain. Depending on the person, we may use multiple modalities to help them manage their pain."
Massage is also an oft-used modality for physical pain.
"Often, when something hurts in our body, the muscles around it contract and tighten to try to protect it, and over time it can become the actual contraction of the muscle that hurts, not necessarily the underlying factor," Dr. Chiaramonte says.
She explains this can also tie into the mind-body connection because "if you're generating a lot of anxious thinking, you're more likely to continue to have this muscle tension, and massage can help."
Integrative treatment plans will vary by patient, which Dr. Chiaramonte says is the key to taking care of the mind, body, and spirit of every individual.
"We find out the 'why' behind each patient's symptoms, pull out the causes, and then come up with a plan for that particular patient, using all the tools that work."