The growing demand for integrative cancer services highlights significant deficiencies in
patient care. Many individuals are forced to seek unverified or potentially harmful treatments without adequate medical oversight, often relying on dubious advice from insufficiently qualified practitioners. This issue is compounded by the limitations of traditional research methods, particularly gold standard randomised controlled trials (RCTs), which are resource-intensive and time-consuming—averaging £1.6 billion and taking 7 to 10 years to develop a single drug. Additionally, securing funding for prospective studies assessing the safety and efficacy of off-label medication in oncology is challenging.

To address these issues, we propose a dual strategy focused on:

1. Establishing reliable clinical services that specialise in integrative oncology, offering
evidence-based treatment protocols and tailored guidance to meet individual patient
needs. By emphasising metabolic oncology, practitioners can optimise patient
outcomes while ensuring care remains safe and credible.

2. Gathering pluralistic evidence and triangulating data on established medications,
concentrating on treatment efficacy rather than the already established safety profiles.
Recognising that real-world assessments of safety and efficacy often face confounding
factors—such as immortal time bias, lead time bias, and patient selection bias—we advocate for comprehensive, longitudinal data collection. This approach will utilise molecular testing of circulating tumour cells and analyse biomarkers linked to metabolic optimisation and cancer outcomes, moving beyond traditional time-to-event analyses. Collaborating with public health authorities and NHS clinical units will facilitate access to a more representative patient population, enhancing the robustness of our research.

In summary, integrating such research initiatives with clinical service provision can bridge existing gaps in cancer care, ultimately improving patient outcomes through a deeper understanding of treatment efficacy.