Integrating Complementary Medicine in Support Programming for Gynecologic Oncology Patients

Gynecologic cancer prevalence has grown significantly over the past decade. In 2022, the American Cancer Society reported ovarian and uterine cancers as the 5th and 6th leading causes of cancer related death in females [1]. Cancer has been shown to negatively impact the psychosocial well-being of a patient as a result of the emotional and physical demands of diagnosis and treatment. In tandem with standard medical treatment, alternative medicine practices have shown significant improvement in the overall quality of life of cancer patient’s [2]. Further, literature has shown an increasing number of cancer patients requesting complementary therapy practices during diagnosis and treatment. In a recent online survey of Mount Sinai Tisch Cancer Center patient’s preferences for amenities for a new hospital, patient responses demonstrated the increased need for alternative medicine approaches to patient care. Patient responses indicated massage, reiki, meditation/ mindfulness, and acupuncture as top choices for hospital amenities. Outside of structured survey responses, these needs are often revealed in assessments completed by the medical and social work teams. In an attempt to address the holistic needs of gynecologic oncology patients throughout the Mount Sinai Health System social workers are fortunate to be able to refer patients to the Woman-to- Woman Program.

Woman to Woman was founded at Mount Sinai in 2003 by an ovarian cancer survivor. The Woman-to-Woman program’s goal is to lessen the isolation gynecologic cancer patients feel and to bolster the spirits of those who might otherwise face treatment alone. At Mount Sinai Hospital Woman to Woman has 39 survivor volunteers who provide peer mentoring for those in treatment from diagnosis throughout treatment and beyond. We have a robust financial assistance program and in 2022 we gave 231 individuals $63,748 in grants. With funding and support from the Ovarian Cancer Research Alliance (OCRA), Woman to Woman has now expanded to dozens of sites throughout the country.

In response to the COVID-19 pandemic, in April 2020 Woman to Woman established our virtual education and support program. The goal was to foster community and support the psychological, emotional and spiritual needs for those facing gynecologic cancer. When developing our online program, it was imperative to offer a mix of support groups and educational groups with a focus on complementary medicine. Based upon positive feedback, we slowly grew the virtual presence and currently offer an average of 11 groups monthly. In 2022, Woman to Woman offered 143 virtual support groups attended by 2,141 patients.

In 2022, Woman to Woman shared a program questionnaire with our mailing list of 800 patients assessing their experience with our virtual offerings and needs for future programming. When asked what types of groups and topics they would like to see offered (participants could choose more than one answer), 76.2% asked for information about coping strategies and 61.9% requested education about wellness. Research and education were both requested by 52.4% of the participants. Based on the feedback of our patients, we have incorporated integrative and complementary medicine presentations on topics such as, Lymphatic Health, Medical Marijuana, Nutrition and Gut Health, and Healthy Living. Topics have also included Food as Medicine, Reducing Toxicity, Cultivating Healthy Self-Esteem, Pelvic Floor Therapy and How to Boost Your Immune System.

Recently, we began offering multiple series with three-part sessions with a focus on complementary medicine topics in order to allow for deeper exploration on each topic. Workshops have included Energy Healing, Self-Care Tool Kit, Wellness Challenge, Finding Meaning in Life and Peace in Death, Manifesting the Life You Want through Vision Boards, Finding Happiness and Tapping. We also hold two educational conferences each year in the fall and spring which we call the Woman-to-Woman Reunion. The topic of our spring 2022 reunion was All About Herbs where an integrative medicine specialist spoke about the healing properties of herbs, how they could be used as supplements and in cooking to promote health and wellness. We were also joined by urban farmers who spoke about the benefits of growing your own herb garden and led a live planting demonstration. Because we understand how different cancer journeys can be, we have a range of groups for specific communities, including young persons, Latinos, LGBTQIA+ individuals, long-term survivors, newly diagnosed individuals, those dealing with COVID-19 and cancer, those experiencing recurrences, and more. We also offer a bi-monthly spirituality group led by a Mount Sinai Hospital chaplain which began in November 2021.

Woman to Woman also supports holistic patient care, by sponsoring a massage therapy program for inpatients to promote relaxation, offer symptom relief, enhance comfort and decrease stress. Since the massage therapy program’s inception in 2017, we have offered 1,439 massages to gynecologic cancer patients and their caregivers. In honor of Gynecologic Cancer Awareness Month, in September 2023 our young adult program Woman to Woman We’re Too Young for This, will resume in person gatherings. The goal of the program is to connect, empower and educate young adults impacted by gynecologic cancer while meeting outside of the medical center. The monthly gatherings will be centered on integrative medicine where participants can learn relevant information and have hands-on experiences such as engaging in reiki sessions, acupuncture and yoga.

As demonstrated in the breadth of programming, Woman to Woman has been an invaluable addition to the supportive services of Mount Sinai gynecologic oncology patients. The program has adapted to the needs of the patients by providing holistic and complementary medicine approaches to care. As complementary medicine services continue to grow, greater evidence of its clinical significance in cancer symptom management is revealed. This, along with the growing patient demand and desire for alternative therapy approaches, demonstrates the ongoing need for hospital administrators to incorporate funding for these services and embed them in routine cancer care. Current challenges that patient’s face are insurance coverage of complementary health approaches. In a study comparing the 2002 NHIS data on acupuncture, chiropractic, and massage to that of 2012, rates of all three approaches rose, yet the increase was much more pronounced among those who did not have any health insurance [3]. Medicare Part A and Part B do not normally cover most holistic medicine therapies, while Medicaid programs typically provide coverage for at least one alternative therapy. These insurance barriers further demonstrate the importance of partnership with community resources such as Woman to Woman, who work to offer these alternative approaches at no cost to the patients. The Woman-to-Woman programmatic response to the growing patient demand and desire for complementary therapy approaches demonstrated that these services are actively sought out by patient’s and can be implemented virtually. Virtual programming allows for greater accessibility of complementary and alternative medicine approaches to gynecologic cancer care in the greater population. It is our belief that focusing on expanding the availability of complementary and alternative medicine approaches to gynecologic cancer care in the greater population, should be a common goal.

None.

Authors declare no conflict of interest.

1. American Cancer Society (2022) American Cancer Society Cancer Facts & Figured 2022.
2. Rossi E, Di Stefano M, Firenzuoli F, Monechi M, Baccetti S (2017) Add-On Complementary Medicine in Cancer Care: Evidence in Literature and Experiences of Integration. Medicines (Basel) 4(1): 5.
3. Nahin RL, Barnes PM, Stussman BJ (2016, January). Insurance coverage for complementary health approaches among adult users.: United States, 2002 and 2012. NCHS Data Brief 235: 1-8.