Integrative oncology: evolution, framework, and future directions.

Over the past several decades, cancer treatment has evolved from a discipline centered almost exclusively on tumor-directed modalities to one that increasingly acknowledges the complex interplay of biological, behavioral, psychosocial, spiritual, cultural, and environmental factors that shape patient outcomes. This shift has set the stage for the rise of integrative oncology: an evidence-informed, patient-centered approach that combines mind-body practices, natural products, and lifestyle strategies with conventional cancer treatment to enhance wellbeing, manage symptoms, and improve quality of life across the cancer continuum. Although rooted in long-standing healing traditions, integrative oncology emerged as a modern clinical and scientific field in response to patient needs, health-belief models, growing research evidence, and recognition of the limitations of a purely biomedical framework. There is also a need to mitigate the risks associated with unmonitored "alternative medicine" use and to ensure that trained healthcare professionals foster open, non-judgmental, evidence-based, patient-centered discussions regarding the use of integrative modalities in high-risk oncology and surgical settings. The formation of the Society for Integrative Oncology, development of evidence-informed clinical guidelines, and increasing adoption within major cancer centers have collectively advanced the discipline and established standards for safe and effective care. As the field matures, challenges remain including disparities in access, gaps in education, and the need for rigorous whole-systems research. This introductory manuscript to the special issue outlines the historical trajectory, scientific foundations, clinical models, and future opportunities that define integrative oncology today and its potential to transform cancer care.