Mapping of the centres across Europe is an essential step in the process of creating a European network of centres, experts and professionals constantly engaged in the field of integrative oncology, in order to increase, share and disseminate the knowledge in this field and provide evidence-based practice.

Background: According to the literature an increasing number of cancer patients demand for complementary therapies during their disease. Research has demonstrated that some of these therapies are effective and safe as adjunctive treatments in specific symptoms of these patients. Methods: The aims of the paper are to review the main and recent papers of international literature on the effectiveness of complementary medicine (CM) therapies on side effects of anti-cancer protocols and improvement in the quality of life of oncological patients, and to describe the integration of evidence-based acupuncture, herbal medicine and homeopathy treatments in Public Cancer Network of the region of Tuscany. Results: After the review of literature and the approval of a Regional Resolution, some CM will be introduced in Cancer Departments in Tuscany to additionally treat cancer-related symptoms and side effects of conventional cancer therapy: acupuncture for nausea and post-chemotherapy and post-surgery vomiting, pain, hot flashes of iatrogenic menopause, xerostomia; homeopathy for hot flashes of iatrogenic menopause and the side effects of radiotherapy; herbal medicine for cancer-related fatigue, nausea and vomiting, pain, mucositis, anxiety, and depression. Conclusions: The integration of evidence-based complementary treatments allows for an effective response to the demand coming from cancer patients and combines safety and equity of access in public health systems.

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Aim: To develop a systematic approach to detect and prevent clinical risks in complementary medicine (CM) and increase patient safety through the analysis of activities in homeopathy and acupuncture centres in the Tuscan region using a significant event audit (SEA) and failure modes and effects analysis (FMEA). Methods: SEA is the selected tool for studying adverse events (AE) and detecting the best solutions to prevent future incidents in our Regional Healthcare Service (RHS). This requires the active participation of all the actors and external experts to validate the analysis. FMEA is a proactive risk assessment tool involving the selection of the clinical process, the input of a multidisciplinary group of experts, description of the process, identification of the failure modes (FMs) for each step, estimates of the frequency, severity, and detectability of FMs, calculation of the risk priority number (RPN), and prioritized improvement actions to prevent FMs. Results: In homeopathy, the greatest risk depends on the decision to switch from allopathic to homeopathic therapy. In acupuncture, major problems can arise, mainly from delayed treatment and from the modalities of needle insertion. Conclusions: The combination of SEA and FMEA can reveal potential risks for patients and suggest actions for safer and more reliable services in CM.

Acupuncture in an integrated system that includes therapeutic techniques such as diet therapy and Tuina self-massage can be used to treat hot flushes and selected symptoms in postmenopausal women.

The healthcare programmes of the Region of Tuscany, Italy have contained references to various types of non-conventional medicine since 1996, and the last three Regional Health Plans have includes a chapter on non-conventional medicine that arguably represent the greatest degree of integration of such therapies in the public health care system achieved thus far in Italy. The Plan aims to guarantee definitive integration in the Regional Health Service of types of non-conventional medicine which are supported by a sufficient level of scientific evidence to allow them to be defined as forms of complementary medicine (acupuncture, herbal medicine, homeopathy and manual medicine). Moreover, in 2007 the Regional council of Tuscany, for the first time in Italy, approved a regional law disciplining the practice of complementary medicines on the part of doctors, dentists, Veterinarians and pharmacists.

Health is a fundamental human right which contributes to reducing poverty, and encourages social development, human safety, and economic growth. International initiatives have fallen far short of their goals. This paper describes collaboration between the region of Tuscany and Cuba, Western Sahara, Senegal and Serbia. These have introduced various forms of Complementary and Alternative Medicine, including homeopathy and Traditional Chinese Medicine into primary healthcare particularly obstetrics, and into veterinary medicine. Complementary and traditional medicine can represent a useful and sustainable resource in various fields of health care. Inclusion in the public health system must go hand in hand with scientific evaluation.

Complementary medicine (CM) is being increasingly used by citizens across Europe as a means to maintain their health and to treat illness and disease. In Italy the reform of Title V of the Italian Constitution allows each Region to decide how to put into practice and organize the Public Healthcare System. The agreement among the Italian National Government, the Regions, and the Provinces of Trento and Bolzano on the terms and requirements for the quality certification of training and practice of acupuncture, herbal medicine, and homeopathy by medical doctors and dentists, signed on February 2013, sets up rules for education and training in acupuncture, herbal medicine, homeopathy, homotoxicology, and anthroposophic medicine. Some regions, including Tuscany, have decided to include Complementary Medicine in their Essential Levels of Assistance, by creating some structures that integrate the health services into the public structures. The Homeopathic Clinic in Lucca, funded by the Tuscany Region, was established in 1998 as part of a pilot project aimed at assessing the feasibility of integrating complementary medicine into the public health care system. To date, over 4,000 patients have been consecutively visited at the Homeopathic Clinic in Lucca. Concomitantly, research into homeopathy effectiveness has been conducted on the whole sample and on specific groups of children, women or patients' parents as well. Studies were also performed on symptom reduction or resolution of atopic diseases, respiratory diseases, side effects of anticancer therapies in women. Other researches concerned cost/effectiveness of therapies, sociodemographic characteristics and compliance of patients, and risk management. The results demonstrate that homeopathy can effectively integrate or, in some cases, substitute allopathic medicine and that the Tuscan example can be useful to the development of national or European rules on CM utilization.