Integrative Oncology in Practice: Moving the SIO-ASCO Guidelines From Evidence to Implementation

The Society for Integrative Oncology (SIO) and the American Society of Clinical Oncology (ASCO) collaboratively developed evidence-based guidelines supporting selected integrative therapies for common cancer-related symptoms, specifically pain, cancer-related fatigue, depression, and anxiety. Despite growing evidence supporting their use, implementation in routine oncology practice remains limited. In this review, we summarize the SIO-ASCO guidelines and examine barriers to their implementation in clinical settings. We then explore strategies to improve guideline adherence using a "carrot and stick" framework that combines incentive-based approaches with accountability mechanisms. Finally, we present practical strategies to integrate the SIO-ASCO guidelines into routine clinical care. We conclude by discussing future directions for implementing integrative oncology in real-world clinical settings. These approaches aim to overcome the barriers associated with guideline adoption in clinical practice, supporting the widespread use of evidence-based integrative therapies across academic and community settings, improving patient symptom management and quality of life, and ensuring equitable access to integrative therapies for all patients. Together, these efforts will help to establish integrative oncology as a standard part of routine cancer care.