Dr. David Rosenthal Speaks about the Leonard P. Zakim Center
for Integrated Therapies

Dr. David Rosenthal is the Medical Director of the Leonard P. Zakim Center for Integrated Therapies at Dana-Farber Cancer Institute. He is also a professor of Medicine at Harvard Medical School and is affiliated with the Department of Medical Oncology at Dana-Farber. The Zakim Center is a powerful, living memorial to its namesake. A passionate civil rights leader, Lenny Zakim was also a cancer patient and NECCS member who believed in the use of complementary therapies to support conventional cancer treatments and survivorship. His dream was to make a potpourri of supportive therapies readily accessible and affordable to cancer patients and their family members while undergoing traditional therapy. Formally opened in November of 2001 and conveniently located near the first floor outpatient hematology clinic of the Dana-Farber, the Zakim Center is an innovative first step toward the realization of Lenny’s dream.

The following interview with Dr. Rosenthal was conducted by Inga Lennes, NECCS board member and medical intern at Beth Israel Deaconess Medical Center:

What are integrated (or complementary) therapies?
Integrated therapies are individual treatments that are used in addition to (or as a complement to) traditional cancer treatments such as chemotherapy and radiation. Acupuncture, yoga, and Reiki are a few of the complementary therapies offered at the Zakim Center. When patients integrate these therapies into their medical and surgical care, they are creating a more comprehensive treatment plan and helping their own bodies to regain health and vitality.

How does complementary care differ from traditional care?
Complementary care supports and encourages the body's natural mechanisms to recover from illness by addressing the needs of the mind, body, and spirit. Research has shown that stress reduction and pain management can lower blood pressure and heart rate, while improving circulation. This allows for greater delivery of oxygen and nutrients to body tissues, which in turn can promote more efficient recovery from trauma and illness.

How did you become interested in this area of medicine?
Two people have influenced the direction my career has taken. The first was my mentor from the old Boston City Hospital who taught me what it meant to be a good doctor – communication always came first! He always listened and touched patients.... The second person was my father, who was very active and participated in research studies on the elderly. He taught me that it is never too late to reinvent yourself and that you must always keep trying.

How did the Zakim Center come to fruition?
The Center actually developed before I arrived in November of 2000. It hadn’t opened its doors, but the concept was there and the vision was there. Lenny Zakim was struggling with multiple myeloma and significant pain. He began using acupuncture to help manage the pain. Zakim wondered why the Dana Farber did not offer acupuncture. So, he convinced the hospital to investigate and offer complementary therapies for patients. A task force was formed that led to the development of the Center.... Its goal is to integrate these services into the hospital setting.

How did you become involved with the Center?
I am a trained Hematologist-Oncologist and had been working at the American Cancer Society (ACS) where I chaired the advisory committee on complementary and alternative medicine. (ACS had published a guide for patients about complementary therapies based on the studies by Eisenberg and others which show that patients use CAM therapies as well as questionable over-the counter remedies.... Meanwhile, physicians did not know that their patients were doing this.).... I came to Dana-Farber in my current position because of my interests in alternative therapies and complementary medicine.

How have physicians’ attitudes changed since the Zakim Center was opened?
It is important for medical professionals to know about all the medical and complementary treatments their patients undergo so that they can guard against unsafe interactions and follow the effectiveness of the patient’s total treatment program. Since complementary therapies are a relatively new approach to health care, there is a broad range of reactions to them within the medical community. However, many doctors are becoming increasingly open to exploring the use of these therapies with their patients. The major focus of the Center has been on research, clinical services, and education. The educational component began first due to the work of the Complementary Therapies Task Force led by Lenny. The task force was instrumental in educating our physicians, providers and patients about herbal remedies, massage, acupuncture and nutrition. Physicians and nurses have become more aware of our referral guidelines and the services we offer. However, even now, many of our patients are self-referred. I regularly lecture to the medical faculty about our services. The Zakim Center also sponsors monthly complementary therapy lectures, produces fact sheets, and develops professional educational seminars.

Which services are most popular?
We started off with acupuncture, massage therapy and nutritional consulting. We now offer a full range of services that have been proven safe and effective in enhancing the physical, emotional, and psychological health of people living with cancer. However, by far the most popular service is nutritional consultation.... Also, we do about 120 acupuncture consultations a month. Two full-time, licensed acupuncturists work with us and we will need to hire a third.... Our staff is trained in both conventional and alternative cancer therapies. They will assist patients in the creation of individual treatment plans in consultation with their doctors.

When can patients receive treatments?
Our hours of service vary depending on the therapy. We make every effort to schedule appointments for times when patients are already coming to the hospital so they don't have to make separate trips.

How are the rates of payment determined?
All of our services are fee-for-service. Philanthropy helped get our clinical services going. The costs of our services are offset by the donations we receive, so patients pay below market price.... We will work with patients, including those who cannot afford any services, to find donations to cover the cost of their treatments....
Despite the documented benefits of some of these therapies, most insurance plans will not pay for them. Some of our services can be billed to health insurance, some are offered at no charge, and some have a reduced fee. We provide receipts so patients can submit them to their insurance companies for reimbursement. We encourage all patients to discuss their individual needs with us so we can work to help them, regardless of their financial situation or health care coverage.

Do you need to be a patient at the Dana-Farber to be seen at the Zakim Center?
Yes, we are trying to make the Center an integrated part of health care at the Dana-Farber. We rely on close communication and partnership with system physicians.

When should a patient or a survivor contact the Zakim Center for a consultation or therapies?
The Center is deliberately located in the Dana-Farber to make it accessible to patients when they come for their regular appointments. They can contact us at any time for a consultation.... We would like to integrate our treatment schedules into their regular appointments and we need to do more research on the timing of therapies like massage and acupuncture.

What research projects are active at the Center?
We are conducting a research project on music therapy in conjunction with the Berklee School of Music regarding the effect of music on breast cancer patients who are undergoing chemotherapy. We are looking for effects on quality of life. We are also in the second year of a pilot study on the role of acupuncture in helping pain and nausea in advanced cancers. Nutritionists are studying vitamins and minerals and their effect on mucositis in head and neck cancers.... Our multidisciplinary research committee is comprised of oncologists, nurses, biostatisticians, and dietitians who are committed to furthering knowledge about the effectiveness of complementary therapies. We feel it is essential to find treatments that are effective and that enhance quality of life. We are conducting clinical research trials to ensure that our patients receive the safest and most efficacious care possible.

For more information about The Zakim Center, complementary therapies, and/or suggested resources, check out the Center’s website http://www.dana-farber.org/pat/support/zakim_default.asp––or contact the clinic coordinator, Anne Doherty, (617) 632-3322, e-mail anne_doherty@dfci.harvard.edu.

Complementary and Alternative Medicine (CAM)
Do You Know?
Getting Started: Questions, Answers, Definitions and Some Advice...
Caregivers Corner: Nurse and Reiki Master, Pat Iyer, Is a Partner in Healing
Dr. David Rosenthal Speaks about the Zakim Center for Integrated Therapies
Chun-Han Zhu: Portrait of a Chinese Doctor
Creative Arts Are Complementary Therapies
In Her Own Words––Survivor Lynn Buckley Uses CAM Therapies
Diet & Cancer: Choosing Wisely to Live Well
Credits & Info