The oncological patient in the field of tension between scientific standards and practical individualization in oncology A plea for an integrative oncology

Background The evidence-based medicine (EbM) founded by D. Sackett relies on three pillars. By focussing solely on external evidence in guidelines there is a danger of "tyranny of medicine", especially in oncology. Question What should an EbM based on all three pillars look like in oncology? Results The terms personalized and individualized medicine in oncological treatment are equally misleading for patients and doctors and usually do not mean the consideration of the personal and individual levels of the patient. A proposal is given for the introduction of a new term, "stratified medicine", which includes the biological, personal and individual levels of oncological treatment. Scientific standards which are based only on external evidence (guidelines) conflict with practical individualization of the patient in treatment conceptualization. Criteria for an assessment of the therapeutic benefit for the patient are presented. The multilayered nature of human beings requires an appropriate complementarity in treatment conception. Conclusion Integrative medicine includes the three pillars of EbM, the complementarity of the patient and the various medical conceptions (pathogenesis, salutogenesis; biopsychosocial model, humanism etc.) and makes an essential contribution to patient orientation in oncology.