Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

All Conditions

Digestive System Diseases

Rare Diseases

Lung Neoplasms

Stomach Neoplasms

Esophageal Neoplasms

Stomach Cancer

Esophageal Cancer

Bone Density Conservation Agents

Micronutrients

All Drugs and Chemicals

Anti-Inflammatory Agents

Antineoplastic Agents

Antirheumatic Agents

Analgesics

Vitamins

Other Dietary Supplements

Herbal and Botanical

Vitamin D

Cholecalciferol

Curcumin

Ergocalciferols

Trace Elements

Hormones

Calcium

Calcium, Dietary

Anti-Inflammatory Agents, Non-Steroidal

Analgesics, Non-Narcotic

Enzyme Inhibitors

Vitamin D3

Calciferol

Whey Protein

Ergocalciferol

Vitamin D2

Participants in the Integrative arm will receive standard surgical and oncologic care at The Ottawa Hospital plus complementary care guided by a naturopathic doctor at The Centre for Health Innovation

Participants in the control arm will receive standard surgical and oncologic care at The Ottawa Hospital

1,000 - 10,000 units daily based on serum levels for the duration of the study

Vitamin D3 Drops

1.5g twice daily for the duration of the study

Coriolus Versicolor

3g once daily for the duration of the study

Trident SAP 66:33 Lemon

12 billion colony forming units daily during the peri-operative period (approximately 1 month pre and post-surgery)

Probiotic Pro12

1 scoop (22g) once daily during the peri-operative period (approximately 1 month pre and post-surgery) and during any adjuvant chemotherapy and radiation treatments

Provitalix Pure Whey Protein

1.2g twice daily after the peri-operative period. including during adjuvant chemotherapy and radiation

Theracurmin 2X

700 mg twice daily after the peri-operative period. Will not be given during adjuvant radiation or chemotherapy treatments.

Green Tea Extract

Based on the Mediterranean diet and lower glycemic index foods

Nutrition Recommendations

150 minutes moderate intensity aerobic exercise per week plus the addition of a resistance exercise program on 2 of those days

Physical Activity Recommendations

Activities with the intention of actively improving the participant's mental and emotional health

Psychological Recommendations

Anna Fazekas, MA, CCRP

Mark Legacy, BSc

Andrew Seely, MD, PhD, FRCSC

Dugald Seely, ND, MSc

Ellen Conte, ND

Tim Asmis, MD, FRCPC

Rebecca Auer, MD, FRCSC, FACS

Kednapa Thavorn, PhD

Dean Fergusson, PhD

Christian Finley, MD, FRCPC

Tim Ramsay, PhD

Salmaan Kanji, BSc, PharmD

Despite enormous advances in thoracic surgery and oncology, two critical issues concern patients undergoing curative-intent surgery for lung, gastric and esophageal cancer: first, a majority (\~60%) of patients experience minor and major adverse events occurring during and in the days following surgery; second, patients worry about the significant risk of cancer recurrence and mortality months to years after surgery. These issues, combined with side effects of chemotherapy and radiation, have detrimental effects on health-related quality of life (HRQoL). On a deeper level, there is the problem of an ongoing failure to integrate and evaluate the best of what complementary medicine has to offer surgical oncology care. Too many clinical trials focus on single agent therapies, rather than broad multi-faceted individualized and integrative care interventions that are used in real world settings.

The Thoracic POISE project has the overarching goal of improving care for thoracic cancer patients by impacting HRQoL, reducing surgical adverse events, prolonging overall survival and pioneering integrative care delivery.

The Thoracic Peri-Operative Integrative Surgical Care Evaluation Trial - Stage II

Pioneering Pre- and Post-Operative Integrative Care to Improve Thoracic Cancer Quality of Care - The Thoracic Peri-Operative Integrative Surgical Care Evaluation (POISE) Trial - Stage II

Measured by the number of people who are enrolled in the study compared to the total number screened.

Measured by the number of people who enrol in the study but subsequently withdraw. These numbers will be compared between arms.

Measured by the number of participants in the control arm who use the integrative interventions outlined in the protocol independent of a naturopathic doctor. Information on the number of supplements used and the length of use use will be collected at each standard of care visit.

Measured by the number of participants in the control arm who use the integrative interventions outlined in the protocol independent of a naturopathic doctor. Mediterranean diet scores (scale of 0-9) will be calculated in the control group using the Harvard Food Frequency Questionnaire to assess for changes over the 1 year follow up period.

Changes in physical activity will be monitored using the International Physical Activity Questionnaire, which is used to calculate total metabolic equivalent task (MET) minutes.

Measured by the number of participants in the control arm who perform activities in which the goal of the activity was to improve mental and emotional health.

Assessing the type and frequency of communications between research staff at The Ottawa Hospital (TOH) and the Centre for Health Innovation (CHI), as well as within TOH and the CHI through number of emails, phone calls, meetings (in-person or virtual) or any other communication method.

Measured by serum Interferon Gamma Levels

Evaluate the qualitative experience of care of participants in both arms through semi-structured interviews

Measured by serum C-Reactive Protein Levels

Measured by collecting a complete blood count with differential and comparing neutrophil and lymphocyte levels

Spots Global Cancer Trial Database for vitamin d3 drops