Brief History of Medicine:Brief History of Medicine:
A patient goes to his doctor and he says,
"Doc, I have an earache."
In 1000 B.C., the doctor replies,
"Here, eat this root."
In 1000 A.D., the doctor replies,
A patient goes to his doctor and he says,
"Doc, I have an earache."
In 1000 B.C., the doctor replies,
"Here, eat this root."
In 1000 A.D., the doctor replies,
"That root is heathen. Say this prayer."
In 1850 A.D., the doctor says,
"That prayer's superstition. Drink this potion."
In 1950 A.D., the doctor says,
"That poison is snake oil. Swallow this pill."
In 2000 A.D., the doctor says,
"That pill is artificial. Here, eat this root."
"That root is heathen. Say this prayer."
In 1850 A.D., the doctor says,
"That prayer's superstition. Drink this potion."
In 1950 A.D., the doctor says,
"That poison is snake oil. Swallow this pill."
In 2000 A.D., the doctor says,
"That pill is artificial. Here, eat this root."
Integrative OncologyIntegrative Oncology
COMPREHENSIVE CANCER CARECOMPREHENSIVE CANCER CARE
Integrating Alternative, Complementary and Conventional Therapies
for
Integrating Alternative, Complementary and Conventional Therapies
for
•Complementary medicine = used together with conventional medicine
•Alternative medicine = used in place of conventional medicine
Integrative medicine = combines
•Complementary medicine = used together with conventional medicine
•Alternative medicine = used in place of conventional medicine
Integrative medicine = combines Integrative medicine = combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.
Integrative medicine = combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.
Integrative medicine
•combines conventional medicine, which primarily investigates and treats physical symptoms, with complementary practices that include the inner healing processes of mind and spirit
Integrative medicine
•combines conventional medicine, which primarily investigates and treats physical symptoms, with complementary practices that include the inner healing processes of mind and spiritof mind and spirit
•supports the body’s healing abilities through nutrition, physical activity, relaxation, and social and spiritual connections
CTCA
of mind and spirit
•supports the body’s healing abilities through nutrition, physical activity, relaxation, and social and spiritual connections
CTCA
Exploratory Survey Among Cancer Patients at the
UP-PGH Cancer Institute – Use of CAM
•Including prayer/ psychosocial support,
99% of the patients use CAM,
Exploratory Survey Among Cancer Patients at the
UP-PGH Cancer Institute – Use of CAM
•Including prayer/ psychosocial support,
99% of the patients use CAM, 99% of the patients use CAM,
with an overlap use 2-3 CAM types
•Excluding prayer/ psychosocial support, 81% use CAM
•The patients’ demographic or clinical profile showed no
correlation with CAM use
•36% of the patients consulted a CAM provider
99% of the patients use CAM,
with an overlap use 2-3 CAM types
•Excluding prayer/ psychosocial support, 81% use CAM
•The patients’ demographic or clinical profile showed no
correlation with CAM use
•36% of the patients consulted a CAM provider
Why Patients Use CAM - Results of a National Study
John A. Astin, PhD
JAMA. 1998;279:1548-1553.
Conclusion:— Along with being more educated and reporting poorer health status, the majority of CAM users appear to be doing so not so much as a result of
Why Patients Use CAM - Results of a National Study
John A. Astin, PhD
JAMA. 1998;279:1548-1553.
Conclusion:— Along with being more educated and reporting poorer health status, the majority of CAM users appear to be doing so not so much as a result of users appear to be doing so not so much as a result of being dissatisfied with conventional medicine but largely because they find these health care alternatives to be more congruent with their own values, beliefs, and philosophical orientations toward health and life.
users appear to be doing so not so much as a result of being dissatisfied with conventional medicine but largely because they find these health care alternatives to be more congruent with their own values, beliefs, and philosophical orientations toward health and life.
Filipino Cancer Patients’ Perception of Filipino Cancer Patients’ Perception of CAM vs CONV Cancer TreatmentCAM vs CONV Cancer Treatment
Weighted meansWeighted means pp--valuevalueCONVCONV CAMCAM
Prevents spread of cancerPrevents spread of cancer 4.524.52 2.982.98 0.000.00
Cures cancerCures cancer 4.484.48 3.133.13 0.000.00
Relieves symptomsRelieves symptoms 4.324.32 3.143.14 0.000.00
Assists body’s natural forces to healAssists body’s natural forces to heal 4.224.22 3.643.64 0.000.00
Complementary Medicine Use
Among Filipino Cancer Patients
(UP-PGH Medical Oncology Study Group, 2005)
Assists body’s natural forces to healAssists body’s natural forces to heal 4.224.22 3.643.64 0.000.00
Easy to understand how they workEasy to understand how they work 4.104.10 3.413.41 0.280.28
Prevents recurrence of cancerPrevents recurrence of cancer 4.094.09 3.253.25 0.000.00
Gives feeling of selfGives feeling of self--control over cancercontrol over cancer 3.723.72 3.423.42 0.000.00
SafeSafe 3.703.70 3.693.69 0.950.95
Improves quality of lifeImproves quality of life 3.703.70 3.563.56 0.280.28
Weakens body’s natural reservesWeakens body’s natural reserves 3.643.64 2.872.87 0.030.03
Have side effectsHave side effects 3.573.57 2.892.89 0.000.00
Boosts immune systemBoosts immune system 3.343.34 3.523.52 0.000.00
Reduces chance that the other therapy will Reduces chance that the other therapy will workwork
3.083.08 2.872.87 0.130.13
Rank Mean Filipino Cancer Patients’ Reason for CAM Use
3.37 To stabilize present condition
Complementary Medicine Use
Among Filipino Cancer Patients
(UP-PGH Medical Oncology Study Group, 2005)
4.00 To boost immune system
4.14 To aid conventional treatment
4.18 To treat cancer
4.31 To improve quality of life
4.64 To have a control over life
5.19 To treat side effects of conventional medicine
6.29 To compensate for failed conventional medicine
answers the patients’ question
“What else can I do?”
answers the patients’ question
“What else can I do?”
important role of
SELF CARE
in cancer care. ..
important role of
SELF CARE
in cancer care. ..
•38% of the patients disclosed to their doctors that they
were using a CAM remedy
•Among these doctors:
•20% advised their continued use
•25% advised possible adverse effects from CAM use
Reason for NonReason for Non--disclosure to disclosure to PhysiciansPhysicians
%%
The doctor did not askThe doctor did not ask 7474
Patient is not sure if CAM will help at Patient is not sure if CAM will help at allall
2020
The doctor may prohibit use or may The doctor may prohibit use or may disagree with patientdisagree with patient
99
The doctor may not understand The doctor may not understand patient’s usepatient’s use
88
The doctor may stop treating patient The doctor may stop treating patient 44
As Oncologists, As Physicians to these Cancer Patients –
We must be enlighten more than our patients…
to be able to understand…
to be able to Prescribe or Not Integrative Medicine….
Cancer Treatment Centers of America offers the most sophisticated forms of surgery, radiation, and chemotherapy in combination with complementary therapies that include; nutrition, spiritual support, mind-body medicine, and naturopathic medicine…
Mission
Cancer Treatment Centers of America
CTCA is the HOME of integrative and
Mission
Cancer Treatment Centers of America
CTCA is the HOME of integrative and CTCA is the HOME of integrative and compassionate cancer care.
We never stop searching for and providing powerful and innovative therapies to
treat the whole person, improve quality of life and restore hope.
CTCA is the HOME of integrative and compassionate cancer care.
We never stop searching for and providing powerful and innovative therapies to
treat the whole person, improve quality of life and restore hope.
Naturopathic
MedicineSurgical Oncology
Pastoral careMedical Oncology
Integrative Care Model
Patient and
Radiation Oncology
NutritionMotion for Life
Mind-Body
Medicine
Patient and
Family
Planned Team Interaction
Team Cases Review 3x weekly
Surgical, Medical, Radiation Oncologists
Medical Specialists
Naturopathic Physicians
NutritionistsNutritionists
Mind-Body Medicine Therapists
Physical Therapists
Pain Specialists
Nurse Case Managers
Pastoral Care/Social Services
CAM Modalities Used by Filipino Cancer PatientsCAM Modalities Used by Filipino Cancer Patients %%
Prayer by self, prayer by others, vitamins, exercisePrayer by self, prayer by others, vitamins, exercise 7474--100%100%
Herbal, vegetarian diet, cleansing/ detoxifying dietHerbal, vegetarian diet, cleansing/ detoxifying diet 5050--64%64%
Toning or pyramid power, iridology, vacuum cupping, Toning or pyramid power, iridology, vacuum cupping, reflexology, therapeutic massage,reflexology, therapeutic massage, acupunctureacupuncture
3838-- 48%48%
Vegan/ macrobiotic diet, psychotherapy, tai chi, Vegan/ macrobiotic diet, psychotherapy, tai chi, hypnosis, pranic healing, shark cartilage,hypnosis, pranic healing, shark cartilage, acupressure, acupressure, music therapymusic therapy
1515--30%30%
Chiropractic/ osteopathic, journaling, melatonin, Chiropractic/ osteopathic, journaling, melatonin, immune therapy, bioelectromagnetic, chelationimmune therapy, bioelectromagnetic, chelation
<10%<10%
Clinical Nutrition:
That "food is the best medicine" is a cornerstone of naturopathic practice.
Clinical Nutrition:
That "food is the best medicine" is a cornerstone of naturopathic practice.
Naturopathic Doctors use diet, natural hygiene, fasting, and nutritional supplementation in their practice.
Naturopathic Doctors use diet, natural hygiene, fasting, and nutritional supplementation in their practice.
Why should we integrate NUTRITION?Why should we integrate NUTRITION?
It has a tremendous effect on patients well being and quality of lifeIt has a tremendous effect on patients well being and quality of lifebeing and quality of life
It may affect their ability to tolerate treatment side effects
They have the tendency to change their diet and have demonstrated a willingness to make significant changes
being and quality of life
It may affect their ability to tolerate treatment side effects
They have the tendency to change their diet and have demonstrated a willingness to make significant changes
Why should we integrate NUTRITION?Why should we integrate NUTRITION?
An important component of the holistic approach to cancer care.
It may affect the tumor’s response to treatment and thereby affect treatment
An important component of the holistic approach to cancer care.
It may affect the tumor’s response to treatment and thereby affect treatment treatment and thereby affect treatment outcome.
It is important in cancer prevention. Obesity is a risk factor for cancer, regardless of the content of one’s diet.
Caution against baseless and potentially harmful alternative diets for cancer patients.
treatment and thereby affect treatment outcome.
It is important in cancer prevention. Obesity is a risk factor for cancer, regardless of the content of one’s diet.
Caution against baseless and potentially harmful alternative diets for cancer patients.
Oriental Medicine:
An important understanding of the unity of
the body and mind and adds to the Western understanding of physiology
Oriental Medicine:
An important understanding of the unity of
the body and mind and adds to the Western understanding of physiology
Acupuncture provides a method of Acupuncture provides a method of Acupuncture provides a method of
treatment that can unify and harmonize the
imbalances present in disease conditions,
which in turn stimulates the immune system
and the healing response
Acupuncture provides a method of
treatment that can unify and harmonize the
imbalances present in disease conditions,
which in turn stimulates the immune system
and the healing response
Acupuncture- pain control
nausea/vomiting (11 RCT’s)
fatigue
immunomodulation
radiation induced xerostomia
Acupuncture- pain control
nausea/vomiting (11 RCT’s)
fatigue
immunomodulation
radiation induced xerostomiaxerostomia
hiccups
anxiety
xerostomia
hiccups
anxiety
Ginger- reduces nausea/vomitingGinger- reduces nausea/vomiting
Qi gong- reduces fatigue
increases immunity
Qi gong- reduces fatigue
increases immunity
Mind-Body-Spirit Interventions
Uses a variety of techniques designed to enhance the mind's capacity to affect bodily function and symptoms.
Some techniques have become mainstream (e.g., patient support groups and cognitive-behavioral
Mind-Body-Spirit Interventions
Uses a variety of techniques designed to enhance the mind's capacity to affect bodily function and symptoms.
Some techniques have become mainstream (e.g., patient support groups and cognitive-behavioral patient support groups and cognitive-behavioral therapy).
Other mind-body techniques - meditation, prayer, mental healing, and therapies that use creative outlets such as art, music, or dance.
patient support groups and cognitive-behavioral therapy).
Other mind-body techniques - meditation, prayer, mental healing, and therapies that use creative outlets such as art, music, or dance.
MindBodySpirit Medicine
is the HEART of Cancer Care
Regardless of the kind or stage of illness, the human being who has cancer is CENTRAL
MindBodySpirit Medicine
is the HEART of Cancer Care
Regardless of the kind or stage of illness, the human being who has cancer is CENTRAL
It is a crucial part of the cancer patient’s answer to “What else can I do?”
Importance of acting on one’s own behalf
It is a crucial part of the cancer patient’s answer to “What else can I do?”
Importance of acting on one’s own behalf
Mind Body connection Cancer and the Mind
Psychoneuroimmunology
Mind Body connection Cancer and the Mind
Psychoneuroimmunology
“ I found in the (cancer) patients a clear pattern of great
crises, grave depressive afflictions, profound mourning, and all the sad emotions which have prolonged repercussions…you can see in the patients prolonged
“ I found in the (cancer) patients a clear pattern of great
crises, grave depressive afflictions, profound mourning, and all the sad emotions which have prolonged repercussions…you can see in the patients prolonged repercussions…you can see in the patients prolonged and silent sorrow without the release of sobs and tears.”
– E. Foque, MD 1931
repercussions…you can see in the patients prolonged and silent sorrow without the release of sobs and tears.”
– E. Foque, MD 1931
Woody Allen’s wisdom
In the movie Manhattan, he has just been dumped by his girlfriend, Diane Keaton, who started a relationship with his best friend.
Woody Allen’s wisdom
In the movie Manhattan, he has just been dumped by his girlfriend, Diane Keaton, who started a relationship with his best friend.
Keaton: “Why don’t you get angry so that we can get it out in the open? “Keaton: “Why don’t you get angry so that we can get it out in the open? “
Allen: “ I don’t get angry, OK? I mean, I have a tendency to internalize. That’s one of my problems. I—I grow a tumor instead.”
Allen: “ I don’t get angry, OK? I mean, I have a tendency to internalize. That’s one of my problems. I—I grow a tumor instead.”
Testing Woody’s Hypothesis
CAN THE MIND PLAY A ROLE IN CANCER RISK?
5 of 9 prospective studies show significant link between
Testing Woody’s Hypothesis
CAN THE MIND PLAY A ROLE IN CANCER RISK?
5 of 9 prospective studies show significant link between 5 of 9 prospective studies show significant link between non-expression of emotions and cancer risk
Only 2 of 9 reveal association between depression and cancer
5 of 9 prospective studies show significant link between non-expression of emotions and cancer risk
Only 2 of 9 reveal association between depression and cancer
Social factors and life events identified in 3 studies:
Social isolation
Lack of parental affection in childhood
Poor “relationship potential’
Social factors and life events identified in 3 studies:
Social isolation
Lack of parental affection in childhood
Poor “relationship potential’Poor “relationship potential’
Maternal death in childhood
Strongest data is for non expression or repression of emotions
Poor “relationship potential’
Maternal death in childhood
Strongest data is for non expression or repression of emotions
Basis: Psychoneuroimmunology, Psychobiology
Stress, ANS and Cancer
Basis: Psychoneuroimmunology, Psychobiology
Stress, ANS and CancerStress, ANS and Cancer
Perception influences Neurophysiology
Emotions influence Neurophysiology
Stress, ANS and Cancer
Perception influences Neurophysiology
Emotions influence Neurophysiology
Mind Body Spirit approaches:
Self Awareness- expressive writing, drawings, movement and dance
Relaxation- music therapy, hypnosis, guided
Mind Body Spirit approaches:
Self Awareness- expressive writing, drawings, movement and dance
Relaxation- music therapy, hypnosis, guided Relaxation- music therapy, hypnosis, guided imagery
Meditation- concentrative, awareness, expressive
Group Support
Relaxation- music therapy, hypnosis, guided imagery
Meditation- concentrative, awareness, expressive
Group Support
Group Support
the research is as good as that for many standard treatments
other supports:
individual counseling
family and friends
Group Support
the research is as good as that for many standard treatments
other supports:
individual counseling
family and friendsfamily and friendsfamily and friends
“One of the most difficult of all things to endure for a
crow, a raven, a wolf, or a human is to feel alone and
separated from one’s own kind. A sense of belonging is
one of the most universal of all feelings.”
-Lawrence Kilham, 1989
“One of the most difficult of all things to endure for a
crow, a raven, a wolf, or a human is to feel alone and
separated from one’s own kind. A sense of belonging is
one of the most universal of all feelings.”
-Lawrence Kilham, 1989
Prayer and Spirituality-
remote, intercessory prayer, distant healing
Prayer and Spirituality-
remote, intercessory prayer, distant healing
“A sense of spirituality can help you realize that you’re not alone, and that you can turn to a larger force for help, support or comfort.”
“A sense of spirituality can help you realize that you’re not alone, and that you can turn to a larger force for help, support or comfort.”
Should we integrate the Biologically Based Therapies?Should we integrate the Biologically Based Therapies?
•Vitamins (A,C,E)
•Minerals (selenium)
•Hormones (melatonin)
•Enzymes
•Vitamins (A,C,E)
•Minerals (selenium)
•Hormones (melatonin)
•Enzymes
•Phytonutrients: garlic, green tea, grape seed extract, flavonoids, isoflavones, resveratrol, chorella, spirulina, mushroom extracts
•Essential fatty acids
•Probiotics, amino acids
•Accessory nutrients (co Q10, whey prot, bee propolis, shark liver oil)
•Phytonutrients: garlic, green tea, grape seed extract, flavonoids, isoflavones, resveratrol, chorella, spirulina, mushroom extracts
•Essential fatty acids
•Probiotics, amino acids
•Accessory nutrients (co Q10, whey prot, bee propolis, shark liver oil)
It is important to distinguish – between:
•Complementary therapies that are used alongside conventional medicine for symptom management &
QoL versus
•Alternative therapies that are used instead of oncologic therapy for the purposes of cancer cure
It is important to distinguish – between:
•Complementary therapies that are used alongside conventional medicine for symptom management &
QoL versus
•Alternative therapies that are used instead of oncologic therapy for the purposes of cancer cure
SUPPORT/ COMPLEMENTARY/ INTEGRATIVE
NOT
THERAPEUTIC/ ALTERNATIVE FOR CURE
SUPPORT/ COMPLEMENTARY/ INTEGRATIVE
NOT
THERAPEUTIC/ ALTERNATIVE FOR CURE
ALTERNATIVE CANCER CURES – DISPROVENVickens, A (Memorial Sloan Kettering Cancer Center).
CA Cancer J Clin 2004; 54:110-118
ALTERNATIVE CANCER CURES – DISPROVENVickens, A (Memorial Sloan Kettering Cancer Center).
CA Cancer J Clin 2004; 54:110-118
•Livingston-Wheeler
•Di Bella Multitherapy
•Antineoplastons
•Livingston-Wheeler
•Di Bella Multitherapy
•Antineoplastons
•Mega Vit C
•Hydralazine sulfate
•Laetrile
•Psychotherapy
•Mega Vit C
•Hydralazine sulfate
•Laetrile
•Psychotherapy
Supplement Contraindications and Drug Interactions:
•Folic acid vs Methotrexate- activity depends on reduced
folates to damage DNA
•Soy genistein vs Paclitaxel- may interfere with drug
efficacy
Supplement Contraindications and Drug Interactions:
•Folic acid vs Methotrexate- activity depends on reduced
folates to damage DNA
•Soy genistein vs Paclitaxel- may interfere with drug
efficacyefficacy
•High dose Vit E vs Doxorubicin- may increase drug
uptake and toxicity
efficacy
•High dose Vit E vs Doxorubicin- may increase drug
uptake and toxicity
Manipulative and Body-Based Methods
based on manipulation and/or movement of one or more parts of the body;
include chiropractic or osteopathic manipulation, and massage.
Manipulative and Body-Based Methods
based on manipulation and/or movement of one or more parts of the body;
include chiropractic or osteopathic manipulation, and massage.
“May the work of your hands be a sign
of gratitude and reverence to the human
condition”
– Mahatma Ghandi
“May the work of your hands be a sign
of gratitude and reverence to the human
condition”
– Mahatma Ghandi
Research on Massage
Quality of Life- improved mood and sense of well
being
Anxiety and Pain- relaxation, reduced pain
Post Surgery and Massage- less anxiety, depression,
less pain medication, improved bowel
function, sleep, shorter hospital stay
Research on Massage
Quality of Life- improved mood and sense of well
being
Anxiety and Pain- relaxation, reduced pain
Post Surgery and Massage- less anxiety, depression,
less pain medication, improved bowel
function, sleep, shorter hospital stayfunction, sleep, shorter hospital stay
Side effects of Chemotherapy- decreased nausea
and vomiting, diarrhea, less fear, greater
sense of control
function, sleep, shorter hospital stay
Side effects of Chemotherapy- decreased nausea
and vomiting, diarrhea, less fear, greater
sense of control
Research on Massage
Coping with cancer
Depression- improved mood, decreased depression
Research on Massage
Coping with cancer
Depression- improved mood, decreased depressionDepression- improved mood, decreased depression
Fatigue
Lymphedema
Depression- improved mood, decreased depression
Fatigue
Lymphedema
“Massage therapy is not contraindicated in cancer
patients, massaging a tumor is – but there is great deal
more to a person than their tumor.”
-Bernie Siegel, MD
“Massage therapy is not contraindicated in cancer
patients, massaging a tumor is – but there is great deal
more to a person than their tumor.”
-Bernie Siegel, MD
Cautions and Contraindications:
Blood clots (DVT)
Cautions and Contraindications:
Blood clots (DVT)Blood clots (DVT)
Thrombocytopenia
Avoid fragile or broken skin
Don’t do deep traumatic massage
Not on the site of the tumor
Not near radioactive implants
Blood clots (DVT)
Thrombocytopenia
Avoid fragile or broken skin
Don’t do deep traumatic massage
Not on the site of the tumor
Not near radioactive implants
Energy Therapies
Involve the use of energy fields, the normal self healing capacity of the body
Biofield therapies
Examples include qi gong, Reiki, and
Energy Therapies
Involve the use of energy fields, the normal self healing capacity of the body
Biofield therapies
Examples include qi gong, Reiki, and Examples include qi gong, Reiki, and Therapeutic Touch
Bioelectromagnetic-based therapies
Examples include qi gong, Reiki, and Therapeutic Touch
Bioelectromagnetic-based therapies
Research:
RCT’s for Healing Touch and Therapeutic Massage
Non randomized controlled study for Reiki
Effects on: Quality of Life
Research:
RCT’s for Healing Touch and Therapeutic Massage
Non randomized controlled study for Reiki
Effects on: Quality of Life
Pain
Vitality
Physical Functioning
Fatigue
Anxiety/Stress/Relaxation
Pain
Vitality
Physical Functioning
Fatigue
Anxiety/Stress/Relaxation
Integration into Clinical Practice…WHY?
Improved patient well being during
treatment
Increased acceptance of treatment
Integration into Clinical Practice…WHY?
Improved patient well being during
treatment
Increased acceptance of treatment
Increased patient satisfaction Increased patient satisfaction
Exercise
A. Measurable Benefits: Improve mood and QOL
Enhance Immunity
Reduce symptoms
Increase Longevity
Exercise
A. Measurable Benefits: Improve mood and QOL
Enhance Immunity
Reduce symptoms
Increase LongevityIncrease Longevity
Decrease Risk
B. Immeasurable Blessings:
Moving beyond self limiting
thoughts
Getting back to your life
Increase Longevity
Decrease Risk
B. Immeasurable Blessings:
Moving beyond self limiting
thoughts
Getting back to your life
Talking with patients about Integrative Medicine:
Concentrate
Getting Better vs. Feeling Better
Talking with patients about Integrative Medicine:
Concentrate
Getting Better vs. Feeling BetterGetting Better vs. Feeling Better
Acknowledge the emotion
Explore, validate, empathize
Never argue with the patient
Getting Better vs. Feeling Better
Acknowledge the emotion
Explore, validate, empathize
Never argue with the patient
ITEM MINUTES PRICE
Nutrition initial consult 85 $175
follow up consult 55 $125
Guided Imagery 50 $60
Yoga 50 $75
Qi Gong 50 $100Qi Gong 50 $100
Massage Deluxe 80 $100
Full 50 $75
Hot Stone 80 $120
Lymphatic 80 $120
“Complementary medicine is here to stay.
It is no longer an option to ignore it or treat it as something outside the
“Complementary medicine is here to stay.
It is no longer an option to ignore it or treat it as something outside the something outside the normal processes of
medicine and science. “
- Wayne B. Jonas, MD
Journal of American Medical Association
Formerly of the National Institutes of Health
something outside the normal processes of
medicine and science. “
- Wayne B. Jonas, MD
Journal of American Medical Association
Formerly of the National Institutes of Health
Medical spa
comprehensive medical and wellness care in an environment which integrates spa services, as well as conventional and complementary therapies and treatments
Medical spa
comprehensive medical and wellness care in an environment which integrates spa services, as well as conventional and complementary therapies and treatments