The integrative care model is rooted in a biopsychosocial approach. Integrative is a term which refers to increasing the harmony and coherence of your whole being, and integrative care is therefore focused on the person, not on either the disease or a therapy. It is provided collaboratively by a health team comprising physicians, psychologists, physiotherapists, acupuncturists, and meditation, nutrition, and floral therapy. Previous studies have demonstrated that interventions based on the integrative care model improved womens lifestyle and quality of life. Our aim was to describe the use of complementary and alternative medicine (CAM) alongside traditional medicine among women with sleep conditions in our Womens Sleep Disorders Integrative Treatment Outpatient Clinic. We are sharing our experiences and clinical practice as the model we developed seems to have both physical and psychological benefits for women with sleep problems. We discuss the wide range of benefits that result from this type of complex intervention, and the contextual factors that may influence these benefits. This will inform future practitioners and we hope to contribute to quantitative research in the clinical setting. The study highlights the importance of treating sleep complaints with a caring relationship and a CAM approach, alongside conventional medicine. Exploration of the lived experience of CAM and its meaning enables healthcare professionals to gain insights into the patients needs, preferences, and values. Gynecologists, clinicians, and health care providers should support and guide patients in their decision to use CAM by providing evidence-based and comprehensive advice on the potential benefits, risks and related safety issues of this approach.

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Landoni F, Maneo A, Colombo A, Cormio G, Placa F, Nava S, Rossi R, Mangioni C. Concurrent carboplatin/5-FU and radiotherapy for locally advanced cervical carcinoma. Int J Gynecol Cancer 1997; 7: 471-476.Despite innovative techniques in radiotherapy delivery no significant improvement in survival rates for cervical carcinoma has been achieved during the last few decades. Concurrent chemoradiation (CR) is one of the several avenues being explored to improve these results.Forty-seven women with locally advanced (IB2-IVA) squamous cell carcinoma of the uterine cervix were treated with CR, comprising a combination of external and intracavitary radiation along with three cycles of 5-FU and carboplatin.Treatment was well tolerated with 81% of the patients completing the CR protocol as planned. Acute toxicity was severe but manageable: 16 patients (34%) experienced grade 3-4 acute toxicity. Late morbidity occurred in 15% of the patients. Overall response rate was 88%. At a median follow-up time of 19 months (range 12-59) 62% of the patients are alive without disease and 18% are dead of disease. Actuarial two-year survival rate for the whole group of patients is 64%.Concomitant carboplatin/5-FU and radiotherapy is a safe and tolerable mean of treatment for locally advanced cervical cancer. The true advantage for survival, however, can be demonstrated only after completion of randomized trials comparing CR with conventional radiation therapy.

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