Barrie Cassileth, pioneer of integrative cancer care, dies at 83

Dr. Cassileth was the founder and longtime chief of the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center in New York and argued from the 1970s onward for what is often called a “whole-person” approach to medical care.

Practitioners of integrative medicine, Dr. Cassileth emphasized, do not seek to replace traditional treatments such as chemotherapy, radiation and surgery with “alternative” medicine.

“There are no viable alternatives to mainstream cancer care,” she told USA Today in 2013. “We work very hard to dissuade patients who want to go that way, because they are going to die.”

The purpose of integrative medicine, rather, is to complement traditional treatment with practices such as massage, acupuncture and herbal therapy that have been shown to help relieve pain, decrease stress or otherwise improve quality of life.

Dr. Cassileth eschewed diets and other so-called “natural cures” that purport to cleanse the body of toxins — regimens she described as “reminiscent of religious purification rituals” — and denounced as “grotesquely outrageous” the practice of enticing patients into unscientific alternatives to more rigorously tested treatments for their disease.

The reality remained, however, that many afflictions cannot be entirely cured by conventional medicine, and many treatments, however successful, are often accompanied by burdensome side effects. It was there, in those spaces that conventional medicine could not reach, that she argued that practices such as meditation, guided imagery, self-hypnosis and music therapy, as well as acupuncture and massage, could make a meaningful difference.

Especially for cancer patients undergoing chemotherapy and radiation, “the now international, research-based blooming of integrative oncology helps [them] and their families live well, physically and emotionally, during and beyond the struggle of cancer,” she told a publication of the American Society of Clinical Oncology in 2017.

Dr. Cassileth did not dispute the existence of what is often called the mind-body connection, which is offered to explain, for example, how relaxation techniques might alleviate pain and thus reduce the amount of pain medication a patient must take.

She did, however, caution patients and practitioners from attributing more to the mind-body connection than could be scientifically substantiated. In particular, she resisted the notion that the attitude patients adopted toward their illness, whether optimistic or pessimistic, has any measurable impact on its outcome.

For every cancer patient who holds onto a positive attitude and survives, Dr. Cassileth said, she could offer the example of 200 others who did the same and died.

“If a patient believes that he or she is dying because of inability to change a negative mental attitude,” she told the New York Times in 1989 when such an argument was applied to AIDS patients, the “belief may cruelly load the patient with an unwarranted sense of guilt.”

Barrie Joyce Rabinowitz was born in Philadelphia on April 22, 1938. Her parents owned and operated a custom kitchen shop.

Dr. Cassileth studied social sciences at Bennington College in Vermont, where she spent a year in the town of Pownal teaching art and music in a one-room schoolhouse. The mother of two of her students was suffering from terminal cancer.

“I helped in her care, doing whatever small things I could,” Dr. Cassileth told the publication Oncology News in an interview. “When she died, the overall experience had a profound affect on me.”

Dr. Cassileth graduated from Bennington in 1959 and pursued graduate studies that ultimately took her to the University of Pennsylvania, where she received a doctorate in medical sociology in 1978.

In the early years of her career, she taught at the University of Pennsylvania cancer center, where she started a palliative care program as well as undertaking research about complementary and alternative treatments in cancer therapy.

“The research showed that cancer patients were using a wide array of therapies on their own, some ineffective and potentially harmful, others very helpful,” Dr. Cassileth told Oncology News.

She continued her research and work at the University of North Carolina, Duke University and Harvard University before Memorial Sloan Kettering recruited her in 1999. She retired from the cancer center in 2016.

Dr. Cassileth’s marriages to Peter Cassileth and H. Taylor Vaden ended in divorce. Her husband Richard Cooper, a hematologist and oncologist, died in 2016 after eight years of marriage.

Survivors include three children from her first marriage, Jodi Cassileth Greenspan of New York City and Wendy Cassileth and Gregory Cassileth, both of Los Angeles; a sister; a brother; and six grandchildren.

Dr. Cassileth was an editor of books including “The Cancer Patient: Social and Medical Aspects of Care” (1979) and the author of the volumes “The Alternative Medicine Handbook” (1998) and “The Complete Guide to Complementary Therapies in Cancer Care” (2011).

Among other appointments, she was the founding president of the Society for Integrative Oncology and director of the National Cancer Institute’s first physician training program in integrative oncology.

“It was always clear that patients and family members need more than excellent surgery, chemotherapy, radiation, and all the new treatments,” Dr. Cassileth said. “Top-notch cancer care, including the now-accessible complementary modalities, is a vastly updated new world.”






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