Patients with cancer are increasingly seeking ways to improve their quality of life during and after treatment. In response to these needs, Thomas Jefferson University Hospital launched an Integrative Oncology Program in October 2025. While patients often come looking for guidance on nutrition, lifestyle changes, or symptom management, we quickly learned that many are searching for something deeper: support in navigating the unexpected physical, emotional, and social effects of cancer and its treatment.
Why We Created the Program
The program was developed by Nathan Handley, MD, MBA, Melissa Denton, and myself, an oncology social worker, all with advanced training in integrative oncology. Together, we sought to create a program that would provide evidence-based guidance around nutrition, physical activity, stress management, and other integrative approaches, while creating space for conversations that are often difficult to have during typical oncology visits.
The inspiration for the program came not only from professional training and clinical experience, but also from a patient living with ovarian cancer. Before supporting the program philanthropically, she volunteered to become our first patient, helping shape the patient experience while advocating for broader access to integrative oncology services.
Assessments and Referrals
Many referrals come from oncology providers seeking a trusted resource for patients interested in nutrition, supplements, lifestyle changes, and other integrative approaches. Unlike many oncology visits, which are understandably constrained by time, our initial consultations last 90 minutes to 2 hours. Prior to each appointment, patients complete a comprehensive assessment exploring symptom burden, nutrition, sleep, movement, relationships, spirituality, and readiness for change. We also ask questions such as, When did you last feel well? What are your priorities? What would help you feel whole? These conversations help us understand not only a patient’s diagnosis, but also the goals and values that shape their experience.
What Patients Are Really Telling Us
During the program’s first eight months, from October 2025 through May 2026, we completed 26 new patient consultations and seven follow-up visits. Patients most commonly sought guidance related to nutrition, symptom management, fatigue, sleep concerns, stress management, and integrative approaches to care.
One of the most important lessons from our first year has been that patients rarely present with a single concern. What begins as a discussion about symptom management often becomes a conversation about identity, relationships, uncertainty, and the challenge of adapting to life after cancer.
Many patients describe feeling unprepared for the unexpected long-term effects of cancer and treatment. Fatigue, sleep disruption, changes in relationships, and fear of recurrence often persist long after treatment ends and can be difficult to navigate alone.
The questions we ask in integrative oncology are often the same questions oncology social workers have asked for years: What matters most to you? What is getting in the way of your well-being? What strengths and supports can help you move forward? By bringing together medical, nutritional, and psychosocial expertise, we can better understand patient-defined goals and develop recommendations that reflect what they identify as most important.
What Matters Most
One patient with advanced cholangiocarcinoma came to our program seeking guidance regarding nutrition and symptom management. She had already received excellent support from her oncology team, including assistance with transportation and financial concerns. What emerged during our visit, however, was a desire to focus on something different: strengthening communication with her husband, creating meaningful experiences with her family, and considering the legacy she hoped to leave for her 10-year-old twins.
The team was able to address several goals simultaneously. Dr. Handley reviewed concerns about symptoms and supplement questions, while our dietitian recommended a Mediterranean-style eating pattern and strategies to help manage ongoing diarrhea. As our conversations continued, her priorities became increasingly focused on connection and quality of life. Although disease progression ultimately prevented participation in a Meaning-Centered Psychotherapy group, she and her family were able to take a much-needed vacation together, an experience that aligned closely with her values.
Her story reminded our team that patients are often seeking more than symptom relief. They are seeking opportunities for connection, meaning, and quality of life.
Expanding Access and Looking Ahead
Access remains one of the greatest challenges in integrative oncology. During the program’s first year, philanthropic support expanded access for patients who otherwise could not have participated while also helping establish the program.
As the program enters its second year, Dr. Handley will join the cancer center full-time as an integrative oncologist and survivorship physician. This expansion reflects the growing need for integrative oncology services and will allow philanthropic resources to be redirected toward services that are often not covered by insurance, including mindfulness-based stress reduction programs, acupuncture, supplements, specialized testing, and other supportive interventions.
During our first year, patients taught us that integrative oncology is about far more than nutrition or lifestyle recommendations. Our patients came seeking answers about symptoms, but often revealed concerns about relationships, identity, meaning, and the unexpected long-term effects of cancer and treatment. Helping patients identify what matters most to them, and supporting their ability to live well despite cancer, may be the most important intervention of all.
