{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:06:16Z","timestamp":1779080776845,"version":"3.51.4"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Bladder cancer, particularly in older adults, poses significant therapeutic challenges due to its high recurrence rates, metastatic potential, and the toxicity associated with standard treatments. This case report describes a 75-year-old male with advanced muscle-invasive urothelial carcinoma of the bladder, exhibiting metastases to the prostate and lymph nodes. Following intolerance to conventional palliative chemotherapy, the patient underwent a structured integrative oncology protocol (systemic cancer therapies combined with adjuvant complementary therapies) that combined metabolic therapies, oncothermia, high-dose intravenous vitamin C, targeted nutraceutical supplementation, acupuncture, laser therapy, diet therapy, and yoga-based interventions. After initial metabolic optimization, an oral chemotherapy regimen comprising Afatinib, Axitinib, Relugolix, and Abiraterone was initiated. The patient demonstrated excellent tolerance to treatment, significant symptomatic relief, normalization of cancer-related biomarkers, and marked metabolic response with stable residual metabolic activity on PET-CT within six months. Quality of life measures improved substantially, and prognostic indices, including the Chuang Survival Score, reflected enhanced survival potential. This report underscores the potential of systemic cancer therapies along with integrative oncology to improve clinical outcomes, mitigate treatment-related toxicity, and enhance quality of life in advanced bladder cancer. While the findings are encouraging, they warrant validation through larger, controlled studies to better define the role of integrative approaches within the contemporary oncology framework.<\/jats:p>","DOI":"10.3389\/fonc.2026.1755406","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T04:17:26Z","timestamp":1779077846000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrative oncology along with systemic cancer therapies in advanced bladder and prostate cancer: metabolic optimization guiding the shift from palliative care to clinical remission \u2013 a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Pradeep","family":"M. K. Nair","sequence":"first","affiliation":[{"name":"Department of Integrative Oncology, Mirakle Integrated Health Centre","place":["Pollachi, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayyappan","family":"Palanisamy","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology, Mirakle Integrated Health Centre","place":["Pollachi, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sivaranjani","family":"Sekar","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology, Mirakle Integrated Health Centre","place":["Pollachi, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanmugam","family":"Sudarshan","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology, Mirakle Integrated Health Centre","place":["Pollachi, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elangovan","family":"Karthika","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology, Mirakle Integrated Health Centre","place":["Pollachi, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muniappan","family":"Devibala","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology, Mirakle Integrated Health Centre","place":["Pollachi, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maruthanayagam","family":"Saranya","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology, Mirakle Integrated Health Centre","place":["Pollachi, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thangavelu","family":"Ramasamy","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology, Mirakle Integrated Health Centre","place":["Pollachi, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manickam","family":"Mahalingam","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology, Mirakle Integrated Health Centre","place":["Pollachi, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.4103\/IJC.IJC_351_18","article-title":"Bladder cancer demographics and outcome data from 2013 at a tertiary cancer hospital in India","volume":"56","author":"Prakash","year":"2019","journal-title":"Indian J Cancer"},{"key":"B2","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1016\/J.JURO.2017.04.086","article-title":"Treatment of non-metastatic muscle-invasive bladder cancer: Aua\/Asco\/Astro\/Suo guideline","volume":"198","author":"Chang","year":"2017","journal-title":"J Urol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.25259\/IJMS_159_2020","article-title":"Urinary bladder cancer and its associated factors \u2013 An epidemiological overview","volume":"73","author":"Mishra","year":"2021","journal-title":"Indian J Med Sci"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000000078","article-title":"The burden of bladder cancer care: direct and indirect costs","volume":"24","author":"Mossanen","year":"2014","journal-title":"Curr Opin Urol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"88","DOI":"10.4103\/INJMS.INJMS_108_19","article-title":"Worldwide incidence and mortality of bladder cancer and human development index: An ecological study","volume":"11","author":"Goodarzi","year":"2020","journal-title":"Indian J Med Specialities"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/FONC.2024.1455022","article-title":"Beyond genetics: Integrative oncology and the metabolic perspective on cancer treatment","volume":"14","author":"Mk Nair","year":"2024","journal-title":"Front Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/FENDO.2025.1693142","article-title":"Decoding metabolic dysfunction in cancer: foundations for early detection and personalized therapeutics","volume":"16","author":"Nair","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2407-12-539","article-title":"Integrative oncology for breast cancer patients: Introduction of an expert-based model","volume":"12","author":"Dobos","year":"2012","journal-title":"BMC Cancer"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/FRESC.2023.1248981","article-title":"Editorial: Integrative oncology treatments in rehabilitation for cancer patients: challenges and unmet needs in cancer rehabilitation","volume":"4","author":"Oh","year":"2023","journal-title":"Front Rehabil Sci"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2022.10.026","article-title":"Content validity of the EORTC quality of life questionnaire QLQ-C30 for use in cancer","volume":"178","author":"Cocks","year":"2023","journal-title":"Eur J Cancer"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-005-0834-3","article-title":"Edmonton symptom assessment scale: Italian validation in two palliative care settings","volume":"14","author":"Moro","year":"2006","journal-title":"Supportive Care Cancer"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2003.11.008","article-title":"Prediction of survival in terminal cancer patients in Taiwan: Constructing a prognostic scale","volume":"28","author":"Chuang","year":"2004","journal-title":"J Pain Symptom Manage"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(99)00229-4","article-title":"Measurement of clinical and subclinical tumour response using [18F]- fluorodeoxyglucose and positron emission tomography: Review and 1999 EORTC recommendations","volume":"35","author":"Young","year":"1999","journal-title":"Eur J Cancer"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12955-020-01580-0","article-title":"Chemotherapy use and quality of life in cancer patients at the end of life: An integrative review","volume":"18","author":"Akhlaghi","year":"2020","journal-title":"Health Qual Life Outcomes"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/8814878","article-title":"Modulated electrohyperthermia: A new hope for cancer patients","volume":"2020","author":"Alshaibi","year":"2020","journal-title":"BioMed Res Int"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1080\/15368370902724633","article-title":"Oncothermia treatment of cancer: From the laboratory to clinic","volume":"28","author":"Andocs","year":"2009","journal-title":"Electromagn Biol Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3390\/NU13030735","article-title":"High-dose vitamin C in advanced-stage cancer patients","volume":"13","author":"Zasowska-Nowak","year":"2021","journal-title":"Nutrients"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1080\/15384047.2017.1394538","article-title":"Modulating secreted components of tumor microenvironment: A masterstroke in tumor therapeutics","volume":"19","author":"Patel","year":"2017","journal-title":"Cancer Biol Ther"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.7759\/CUREUS.77005","article-title":"Oncothermia and integrative medicine-a novel paradigm for infratentorial meningioma management: A case report with one-year follow-up","volume":"17","author":"Nair","year":"2025","journal-title":"Cureus"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.7759\/CUREUS.66492","article-title":"Integrative oncology for high-grade glioma: A case report on the combined effects of oncothermia and complementary therapies","volume":"16","author":"Nair","year":"2024","journal-title":"Cureus"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/J.HMEDIC.2024.100113","article-title":"Usefulness of a pragmatic integrative medicine approach in the management of breast cancer: A case series with literature review","volume":"7","author":"Nair","year":"2024","journal-title":"Med Rep"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1093\/NUTRIT\/NUX012","article-title":"Possible role of diet in cancer: systematic review and multiple meta-analyses of dietary patterns, lifestyle factors, and cancer risk","volume":"75","author":"Grosso","year":"2017","journal-title":"Nutr Rev"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/J.CCELL.2020.04.005","article-title":"Dietary approaches to cancer therapy","volume":"37","author":"Tajan","year":"2020","journal-title":"Cancer Cell"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/FNUT.2025.1640092","article-title":"Synergistic power of functional foods and exercise in colorectal cancer control: targeting metabolism, mitochondrial function, redox homeostasis, exercise performance, neuroimmune signaling, and brain-gut axis crosstalk","volume":"12","author":"Cheng","year":"2025","journal-title":"Front Nutr"},{"key":"B25","doi-asserted-by":"publisher","first-page":"45","DOI":"10.4103\/0973-6131.43541","article-title":"Modulation of immune responses in stress by yoga","volume":"1","author":"Arora","year":"2008","journal-title":"Int J Yoga"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1177\/15347354241302072","article-title":"Systematic review and meta-analysis of acupuncture for modulation of immune and inflammatory markers in cancer patients","volume":"23","author":"Liu","year":"2024","journal-title":"Integr Cancer Ther"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3390\/CANCERS14194780","article-title":"Review of under-recognized adjunctive therapies for cancer","volume":"14","author":"Money","year":"2022","journal-title":"Cancers (Basel)"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1755406\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T04:17:29Z","timestamp":1779077849000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1755406\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":27,"alternative-id":["10.3389\/fonc.2026.1755406"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1755406","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]},"article-number":"1755406"}}