This roundtable stems from a deep desire expressed by Carlos Chan when we first met, to create a space to give voice to people who have resorted to various approaches in the context of oncological illness, from conventional to complementary, following an Integrative Medicine logic, and have achieved different results, even in cases of advanced oncological diagnosis.
I feel very grateful for the path we have walked together and that he has been persistent in "crossing deserts in search of oases", in his own words. Bless you, Carlos, and the entire Dojo Team ☺
I also thank Vera Luís and Rute Silva for their contributions in this rewarding conversation.
You can listen to the Integrative Health audio (only available in Portuguese): A Discussion on Health in the First Person.
Integrative Health, a firsthand experience
The topic of this conversation - Integrative Health, a firsthand experience - focused on the discussion and description of options and strategies toward Integrative Medicine when dealing with oncological diseases. That is, human health viewed from various dimensions and needs in contrast to the solutions available in the healthcare system.
Based on statistical data and the demonstration of the predominance of medical strategies (medication, respiratory support, among others) in terms of healthcare, with examples from the advanced data revealed at the recent International Congress of Palliative Care, held in March 2024 in Castelo Branco, the lesser relevance given to other types of responses was discussed, such as nutritional support and social support in processes of mourning and/or spiritual guidance.
We reflected on questions like:
what does an integrative approach imply?
what characterizes the philosophy and approach of East Asian Medicine?
what kind of difficulties do people with oncological diseases face?
what kind of daily decisions most influence our well-being?
why is it important to embrace the spiritual dimension in the process?
Vera Luís, one of the contributors in this roundtable, emphasized the importance of people "not relying on a single solution and instead embracing various possibilities." Given how complex things get when living with an oncological disease, according to her experience, she considers that "there is no one answer, there are several dimensions," to meet our needs as "relational beings" and to improve quality of life.
Lifestyle
Reflecting on habits and routines, Vera emphasized that one of the changes she introduced and maintains in her lifestyle is regular physical exercise. In this vein, Rute Silva also testified to the importance of changes in dietary care in her recovery process. Both speakers focused on one of the major changes they made, which was how they experience time, with greater awareness of their presence, of self-care, and of the priorities they place at the centre of life.
The role of prevention in an integrative approach was discussed, and Carlos Chan added some hints to the group’s reflection from his experience in supporting these illnesses.
Some fears present in these processes were mentioned, which are magnified by the scarce information available regarding more personalised alternatives in care, as well as the impact of these experiences on the family unit.
Gaps in healthcare services
As explained by Rita Lança, one of the major gaps in healthcare services is the lack of continuity of family support, which includes connection with family/significant others as a care unit.
She noted that, outside of the type of support she provides as a Transition Doula, there are very few options available from home support services. For instance, the importance of facilitating family sessions was emphasized as a way to help deal with fears that arise in the face of new challenges, to clarify doubts, and to support decision-making.
Within the scope of the health system, family meetings are mainly informative. In reality, all family members are suffering, often in silence, with the intention of protecting each other.
Rita Lança used a metaphor to illustrate this challenge: each person has a piece of the puzzle. Only when they come together does the puzzle become complete.
Rute Silva emphasized that "the spiritual dimension of the process isn’t usually discussed. It is part of the process, it is more of a beautiful discovery." Vera expressed the importance of "being accompanied by someone who listens to you," in a context where there is space to talk about self-forgiveness, forgiveness, and daily reconnection practices.
Spiritual guidance
In the context of the spiritual guidance she provides, Rita Lança spoke of spiritual needs occurring during these processes, the consequences of these needs not being met, and the limited response from most services. Rita also made a brief introduction about spirituality and myths associated with spirituality/religion, with reference to daily contemplative practices.
Quoting Pablo D'Ors, "When we are still, we discover that we are restless," Rita said that we are in a "permanent gestation of ourselves". She spoke of the importance of "redefining ourselves through changes," beyond the "imposed speed" with which we are confronted in day-to-day life. She asked "what moments do we have throughout the day to reconnect with ourselves?".
Still within the context of spirituality, there was talk of suffering, compassion, gratitude, interconnection, with reference to the broad view of East Asian Medicine.
We ended the roundtable with contemplative hints from Tolentino de Mendonça (42nd Portuguese Congress of Cardiology), which Rita proposed.
Happy is he or she who makes the hearts of others their own. Some tasks that pave the necessary learning path to conquer happiness are:
reconciling with life;
loving it as it comes;
giving even that which we do not have;
being thankful for that which is not given to us;
taking care of what makes us happy.
Those who are happiest are the ones who are able to see more of a promise than an absence in the incomplete and unfinished.
But in that case, when can we expect happiness to manifest?
Taking care of what makes us happy, of joy, identifying the roots that tie joy to everyday life and taking care of them is where the path begins. Afterwards, it is necessary to take better care of lightness, a kind of transparency and gratitude, linked to the miracle of life that's present in every moment.
The little hopes, so often ignored by the ideology of happiness, are crucial in this process of gratitude that teaches us that the arduous fatigue of living and the shadow are not necessarily contrary to happiness but alternative paths, which, if followed and accepted as they come to us, can lead us to the indestructible experience of life.