Wellness for Cancer Initiative

2024 Trends

TREND 1:
With Wellness Centers Focused on Longevity, the Impact of Cancer and Its Treatments Need to be a Consideration

Longevity is a big topic in the wellness industry. Many health and wellness centers offer advanced testing, imaging and daily monitoring of vitals to determine areas that can be improved. Research has shown that “the effects of cancer and its treatment are associated with the late occurrence of additional comorbidities that happen earlier or more frequently in cancer survivors compared to cancer-free individuals.”1 This is often known as accelerated aging. Cancer treatments, for example, can affect many vitals, such as heart rate variability. If the health practitioner is focused on longevity, it is important that they interpret the client’s data and gain an understanding of the client’s full health history–and place it in proper context–before measuring them against general population numbers.  While the lifestyle intervention may be the same or similar to non-cancer-affected individuals, the root cause of the health measurement is not necessarily the same. Current research is exploring the effectiveness of proactive lifestyle strategies and pharmacological interventions to slow down or potentially reverse the aging process. Lifestyle strategies include prehabilitation, dietary adjustments like caloric restriction and rehabilitation programs. According to PubMed, the use of senolytics (a class of drugs that selectively clear senescent cells, which are said to accumulate with ageing) includes both pharmacological and natural occurring (e.g., quercetin). Ultimately, these interventions are aimed to address health span and lifespan. Further research will be of paramount importance as the number of cancer survivors continues to grow. 

Sources: 

• Bhatia R, Holtan S, Jurdi NE, Prizment A, Blaes A. Do Cancer and Cancer Treatments Accelerate Aging? Curr Oncol Rep. 2022 Nov;24(11):1401-1412. doi: 10.1007/s11912-022-01311-2. Epub 2022 Jul 7. PMID: 35796942; PMCID: PMC9606015. 

TREND 2:
Wellness Centers Focus on Longevity: Some Are Considering Early Cancer Detection Tests

The medical industry has made remarkable advancements in the treatment of cancers, including precision medicine (targeted therapies) and CAR T cell therapies. The field of oncology is also witnessing a remarkable transformation with the introduction of cancer early detection tests, including the promising multi-cancer early detection (MCED) tests. Several wellness centers and wellness conferences have discussed the role of early cancer detection tests. Our trends two years ago pointed to the promising GALLERI test as an example. This year’s trend is an addendum to that trend.  

The Emerging Landscape of Early Cancer Detection Tests
The field of oncology is witnessing a transformation with the introduction of cancer early detection tests, including the promising MCED tests. These advancements aim to overhaul traditional cancer screening methods by providing a broader, more efficient and potentially more effective approach to identifying cancer early through the detection of circulating tumor DNA from a wide variety of cancers in a non- or minimally invasive manner. 

What are MCED? 
Multi-Cancer Early Detection tests are groundbreaking in the realm of oncology, capable of detecting multiple types of cancers before symptoms manifest. Utilizing cutting-edge technologies, such as next-generation sequencing and liquid biopsies, MCED tests analyze samples for molecular signs of cancer, offering a new frontier in early diagnosis and significantly boosting early diagnosis rates across multiple types of cancer. 

The Benefits 
MCED tests herald a considerable promise for enhancing cancer survival rates via early detection, providing the opportunity for treatments to start sooner when the cancer is more manageable. By screening for various cancers through a single test, MCEDs can simplify the detection process, potentially streamline healthcare workflows, and offer a more cost-effective solution than conventional screening methods targeting one cancer at a time. 

The Harms
Despite their potential, MCEDs come with their share of concerns, including the risks of yielding false positives that can lead to unnecessary stress, anxiety and invasive follow-up procedures for individuals. Additionally, the possibility of false negatives may delay essential treatment. Concerns also extend to the risk of overdiagnosis, possibly resulting in the treatment of cancers that may not pose a significant threat to health and the potential to exacerbate healthcare inequalities. 

Wellness Centers Must Consider
For wellness centers and spas considering the inclusion of MCED tests among their offerings, it’s paramount to ensure informed decision-making processes for clients through detailed consultations with genetic counselors and specialist oncologists. An interdisciplinary approach, integrating expert interpretation of test results and establishing a protocol for managing false positives and educating clients about overdiagnosis, can mitigate potential harms and bolster the efficacy and relevance of MCED tests in the health and wellness industry. Collaboration with oncologists is crucial to providing comprehensive, accurate and responsible care, ultimately enhancing the value of cancer screening services in these settings. 

Variables to Address If Considering Cancer Screening Tests 

• Ensure Informed Decision-Making: Prior to undergoing MCED tests, individuals should engage in comprehensive consultations with genetic counselors and specialist oncologists. This step is crucial to fully understanding the test results’ benefits, limitations and potential implications. 
• Integrate Expert Interpretation: To avoid misinterpretation of MCED test results, it’s essential that these tests are interpreted by healthcare professionals with expertise in cancer genetics. Accurate interpretation is key to making informed healthcare decisions. 
• Adopt a Holistic Approach: Spas and wellness centers offering MCED tests must actively partner with medical facilities to ensure a holistic approach toward client health. This partnership should facilitate access to medical consultation and counseling, blending wellness with medical vigilance. 
• Address False Positives Proactively: Institutions offering MCED tests should establish protocols for managing false positives, including clear guidelines for follow-up procedures. This reduces unnecessary anxiety and invasive follow-up for clients. 
• Educate on Overdiagnosis: Clients should be educated about the phenomenon of overdiagnosis through MCED tests. Understanding that not all detected abnormalities may lead to serious health issues is important for informed decision-making. 

Importance of Alliance with Oncologists for Wellness Centers
Wellness centers conducting MCED screenings should prioritize establishing an alliance with oncologists rather than relying solely on the healthcare providers within the resort. This strategic partnership is crucial in ensuring that clients are supported throughout the screening process and provided with accurate and comprehensive information from the outset. Oncologists bring specialized knowledge and experience that are indispensable for interpreting MCED test results accurately and advising on the best course of action. This alliance ensures that clients receive guidance grounded in oncology expertise, facilitating informed decision-making and support through any necessary medical interventions. In essence, by collaborating closely with oncologists, wellness centers can enhance the effectiveness, reliability and overall value of their cancer screening services, positioning client wellbeing and proper care at the forefront of their operations. 

Sources: 

• Multi-Cancer Early Detection: The New Frontier in Cancer Early Detection, Carmen E. Guerra, Prateek V. Sharma, Brenda S. Castillo, Annual Review of Medicine 2024 75:1, 67-81 

TREND 3:
Cancer Health & Wellness Coaching Are Growing in Cancer Care

Health coaching is beginning to emerge as a vital component of integrative medicine, playing a pivotal role in cancer prevention and aiding individuals in navigating the complex landscape of cancer diagnosis, treatment and recovery. It serves to enhance the quality of life and, in certain instances, contribute to improved clinical outcomes for those affected by cancer. A cancer health and wellness coach is a professional dedicated to working with individuals either directly as a client or in conjunction with a healthcare professional or hospital, providing support throughout their cancer journey. These coaches often work in conjunction with a team of medical doctors, dietitians, nutritional therapists, psychologists or counselors. Their role complements that of the traditional healthcare team by focusing on lifestyle factors that bolster overall health, wellness and wellbeing.  

The primary objective of cancer health and wellness coaching is to empower individuals to take an active role in their care, making informed decisions that resonate with their unique circumstances and personal preferences. This self-empowering approach is centered around translating and personalizing generic lifestyle advice often provided by health professionals. Cancer health and wellness coaches emphasize the importance of aligning their support with the individual’s wishes, circumstances, preferences, needs, values and cultural background, ensuring a compassionate, dignified and respectful support system. 

One of the initial steps in cancer health and wellness coaching involves helping individuals recognize and believe in their daily actions’ influence on their care and outcomes. Coaches work on establishing a personal connection, focusing on the individual as a unique entity seeking to improve their cancer journey through sustainable lifestyle changes across six pillars: physical, emotional, spiritual, social, intellectual and occupational. 

Highlighting the efficacy of health coaching, clinical data points to significant benefits such as improved physical activity levels, reduction in cholesterol, levels, better self-management, reduced diabetes risk, decreased hospitalization rates and alleviation in pain severity. Specifically for cancer patients, health coaching offers personalized support that enhances understanding of their condition, builds self-efficacy, encourages the adoption of healthier habits and aids in reframing negative patterns to boost overall wellbeing.   

The American College of Lifestyle Medicine’s (ACLM) Compendium of Health and Wellness Coaching and its 2019 Addendum underscore the effectiveness of health coaching as a behavior change methodology. This body of evidence supports the application of health coaching in the prevention and treatment of various conditions, including diabetes, hypertension, heart disease, and, notably, cancer, among other chronic disorders.  

Sources:

• Julie Bach, Cancer Health & Wellness Coach, Educator of Cancer Health & Wellness Coaching 
• https://www.oncio.org/blog/blog-post-what-is-health-coaching
• https://osarahealth.com/healthcoaches 

TREND 4:
National Cancer Institute (NCI) Continues to Fund Exercise and Nutrition Interventions to Improve Cancer Treatment-Related Outcomes  

The newest lifestyle and survivorship research is being conducted at Sylvester Comprehensive Cancer Center, which is part of the University of Miami Miller School of Medicine. It aims to explore the effects of nutrition and exercise on cancer therapy and its outcomes. These efforts seek to understand how integrating lifestyle medicine into clinical practice can enhance cancer care.  

Spearheaded by Tracy E. Crane, PhD, RDN, who co-leads the Cancer Control Program and directs lifestyle medicine, prevention and digital health at Sylvester, the initiative is poised to revolutionize how patients receive care by incorporating nutrition and exercise support seamlessly into their treatment plans. That being said, other cancer treatment centers across the US and around the world are also pursuing integrated wellness-medical treatment plans.  

Dr. Crane and her team are considered at the forefront of leveraging digital health and technology solutions developed within her lab to integrate lifestyle medicine into clinical settings effectively. Their work is instrumental in ensuring that every cancer patient benefits from tailored nutrition and exercise recommendations, which could play a pivotal role in improving therapy outcomes. By using digital technology, the team aims to make lifestyle medicine an integral part of every patient’s cancer care regimen, emphasizing the potential of technology in facilitating this groundbreaking approach. 

Sylvester Comprehensive Cancer Center has taken a significant step forward by participating in the Exercise and Nutrition Interventions to Improve Cancer Treatment-related Outcomes (ENICTO) in Cancer Survivors consortium, funded by the National Cancer Institute (NCI). This study is one of the consortium’s four trials and is poised to contribute to and benefit from shared knowledge and practices in enhancing the efficacy of cancer treatments through lifestyle interventions. 

Sylvester is also collaborating with Yale researchers on the Trial of Exercise and Lifestyle in Women with Ovarian Cancer. This study seeks to ascertain whether lifestyle interventions can assist patients in completing their chemotherapy regimens, potentially opening new avenues for improving treatment adherence and outcomes. Such collaborative efforts underline the critical importance of lifestyle factors in complementing traditional cancer treatments.

Additionally, Dr. Crane and colleagues are deeply involved in the Lifestyle Intervention of Food and Exercise for Lymphoma Survivors (LIFE-L) trial. This trial examines whether adopting the Mediterranean diet and engaging in regular exercise could enhance chemotherapy completion rates among lymphoma patients.  

These initiatives underscore a holistic approach to cancer care, emphasizing the synergistic role of nutrition and exercise in supporting cancer therapy and potentially improving the lives of those affected by cancer. 

Sources: 

• https://news.med.miami.edu/nutrition-exercise-and-cancer-outcomes/ 

 

TREND 5:
Studies Examine Feasibility and Clinical Utility of Utilizing Handheld Devices to Detect Breast Cancer  

Breast cancer, the most common cancer globally, exhibits a stark contrast in detection and survival rates between high-income countries (HICs) and lower- and middle-income countries (LMICs). While HICs often detect breast cancer early, leading to survival rates of 80%-90%, LMICs face late detection due to inadequate clinical evaluation and screening infrastructures, resulting in a 40%-60% survival rate. This disparity emphasizes the urgent need for accessible screening methods in LMICs, where more than half of global breast cancer incidences occur. 

To address this gap, the Intelligent Breast Exam (iBE) device was developed and approved by the US Food and Drug Administration in 2013. This innovative, handheld device offers a cost-effective, portable solution for breast examinations without the need for radiation, relying instead on sensors to electronically palpate the breast tissue and identify abnormal tissue elasticity indicative of potential malignancies. The device’s piezoelectric finger (PEF) measures tissue compression, highlighting differences in tissue elasticity which could point to the presence of a lesion. It presents findings in a straightforward manner, using color-coded 3D maps to distinguish between normal tissue and suspicious areas without necessarily necessitating professional interpretation. 

Further enhancements in its technology led to the second-generation iBE system, which includes a Dynamic Co-Planar Capacitive Sensor (DCPC Sensor) and a mobile application, iBreastExam Connect, that facilitates the documentation and sharing of up to 10,000 breast examinations for efficient comparison of results over time. 

In LMICs, the limited access to healthcare facilities, shortage of trained providers and prevalent cultural and psychosocial barriers significantly contribute to the late detection and higher mortality rates associated with breast cancer. The iBE device emerges as a promising tool for early screening and triaging, potentially mitigating these challenges by enabling early detection without the need for expensive, conventional diagnostic imaging. This innovative approach could be pivotal in reducing the global health disparities in breast cancer mortality and incidence, particularly benefiting LMICs with resource-limited settings. 

Sources:  

• ”Can the Clinical Utility of iBreastExam, a Novel Device, Aid in Optimizing Breast Cancer Diagnosis? A Systematic Review. JCO Global Oncolology, 2023 by American Society of Clinical Oncology. https://ascopubs.org/doi/10.1200/GO.23.00149 

TREND 6:
Early Diagnostic Testing for Ovarian Cancer Using AI and Imaging Enhancements  

AI-Powered Early Diagnostic Test 
Researchers are developing an early diagnostic test for ovarian cancer through the application of AI technology. This innovation aims to address the challenges of early detection, as currently, only 20% of ovarian cancers are diagnosed early. The lack of early symptoms and effective screening tests similar to those for breast and cervical cancers contributes to late diagnoses, often when the disease has advanced to critical intra-abdominal organs.  

FDA-Approved “Glowing Tumor” Imaging Drug
The FDA has approved a novel imaging drug, known as Cytalux, which makes ovarian cancer cells “glow” during surgery, improving the accuracy of tumor identification and removal. This breakthrough, pioneered by surgeons at the University of Pennsylvania, along with their extensive research in targeted imaging technologies for various cancers, significantly enhances surgical precision. By illuminating tumors, surgeons can identify and resect cancerous lesions that would otherwise be missed, improving patient outcomes. This approach has been tested in a multi-center Phase 3 study, showing promising results in detecting cancerous lesions not found through traditional methods. 

Sources: 

• https://research.gatech.edu/researchers-leverage-ai-develop-early-diagnostic-test-ovarian-cancer
• www.pennmedicine.org/news/news-releases/2021/november/fda-approves-glowing-tumor-imaging-drug-to-better-identify-ovarian-cancer-cells