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Lee RT, Kim E, Mendiratta P, Farrell M, Finklea S, Huang L, Trapl E, Gerson S, Cullen J. A survey of patients with cancer and oncology health-care professionals about cannabis use during treatment. J Natl Cancer Inst Monogr 2024; 2024:290-297. [PMID: 39108243 PMCID: PMC11303858 DOI: 10.1093/jncimonographs/lgae007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/08/2023] [Accepted: 02/13/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND This study characterizes patient and health-care professional perspectives regarding medical cannabis use at a National Cancer Institute-Designated Cancer Center. Data evaluated included the prevalence and patterns of and reasons for cannabis use. METHODS Patients with cancer undergoing treatment were recruited into a cross-sectional survey as part of a national National Cancer Institute-funded effort. Participants completed a survey about cannabis use, reasons for use, and types of cannabis. A health-care professional survey was also conducted to explore perspectives regarding patients' use of cannabis. RESULTS A total of 313 patients with cancer (mean [SD] age = 60.7 [12.8] years) completed the survey (43% response rate) between 2021 and 2022. Of the respondents, 58% were female; identified as White (61%) and Black (23%); and had diverse cancer diagnoses. Nearly half of respondents (43%) had previously used cannabis, one-quarter (26%) had used cannabis since their cancer diagnosis, and almost 1 in 6 (17%) were actively using cannabis at the time of survey completion. The most common modes of ingestion were gummies (33%) and smoking (30%). The most commonly reported reasons for use were insomnia (46%), pain (41%), and mood (39%). For the 164 health-care professionals who completed the survey (25% response rate), the majority agreed that cannabis use (72%) is safe and beneficial for patients (57%). Four in 10 (39%) health-care professionals felt comfortable providing guidance to patients about cannabis use; however, only 1 in 8 (13%) felt knowledgeable about the topic of cannabis. CONCLUSIONS Approximately one-sixth of patients with cancer receiving treatment actively use cannabis for management of various cancer symptoms. Perceptions about cannabis use and education varied widely among health-care professionals.
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Affiliation(s)
- Richard T Lee
- Departments of Supportive Care Medicine and Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
- Case Western Reserve University Comprehensive Cancer Center, Cleveland, OH, USA
| | - Elyssa Kim
- Departments of Supportive Care Medicine and Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Prateek Mendiratta
- Case Western Reserve University Comprehensive Cancer Center, Cleveland, OH, USA
- Department of Medicine, University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Megan Farrell
- Case Western Reserve University Comprehensive Cancer Center, Cleveland, OH, USA
| | - Shalena Finklea
- Case Western Reserve University Comprehensive Cancer Center, Cleveland, OH, USA
| | - Lauren Huang
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Erika Trapl
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Stanton Gerson
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jennifer Cullen
- Case Western Reserve University Comprehensive Cancer Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Ben-Arye E, Lopez AM, Daoud N, Zoller L, Walker E, Davidescu M, Shulman K, Gressel O, Stein N, Brosh S, Schiff E, Samuels N. Identifying Factors Associated With Disparities in Access to Integrative Oncology Program. J Pain Symptom Manage 2024; 68:10-21. [PMID: 38552747 DOI: 10.1016/j.jpainsymman.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/28/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
CONTEXT AND OBJECTIVES Cancer centers are increasingly providing complementary medicine as part of an emerging discipline termed 'integrative oncology' (IO). The present study explored factors associated with disparities in referral and adherence to a freely-provided IO program. METHODS The databases of three oncology centers in northern Israel were searched retrospectively for chemotherapy-treated oncology patients eligible for referral by their oncology healthcare professionals to an integrative physician (IP) consultation. Demographic and cancer-related variables associated with the referral, and attendance by patients at the consultation were identified, as was adherence to the 6-week IO treatment program (high adherence, attending ≥4 IO treatment sessions; low adherence, 0-3 sessions). RESULTS Of 4988 eligible patients, 1694 (34%) were referred to the IP consultation, with 1331 (78.6%) attending the consultation of which 766 (57.6%) were adherent to IO treatments. Multivariate analysis revealed lower referral rates among patients speaking primarily Arabic and Russian vs. Hebrew (OR = 3.0, 95% CI = 2.0-4.6, P < 0.0001); males vs. females (OR = 1.94, CI = 1.3-2.9, P = 0.001); those not reporting emotional distress (OR = 1.5, CI = 1.02-2.16, P = 0.037); and older age (OR = 1.04, CI = 1.03-1.06, P < 0.0001). Arabic and Russian-speaking patients were less likely to adhere to IO treatments (OR = 0.52, 95% CI = 0.32-0.83, P = 0.006). CONCLUSION Patients' ethno-national origin and immigration status (primary language, Arabic and Russian), male gender and older age were associated with lower rates of referral to and attendance of the IP consultation, with reduced adherence to weekly IO treatments. These findings require further study to identify barriers toward diversity, equity and inclusion in IO care, increasing awareness among healthcare professionals regarding the benefits of these services for improving patient wellbeing.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program (E.B.A., M.D.), The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, Haifa, Israel; Rappaport Faculty of Medicine (E.B.A., K.S., E.S.), Technion-Israel Institute of Technology, Haifa, Israel.
| | - Ana Maria Lopez
- Sidney Kimmel Medical College and Sidney Kimmel Cancer Center (A.M.L.), Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Nihaya Daoud
- School of Public health, Faculty of Health Sciences (N.D.), Ben-Gurion University of the Negev, Beer Sheba, Israel
| | - Lilach Zoller
- Haifa and Western Galilee District (L.Z.), Clalit Health Services, Haifa, Israel
| | | | - Michal Davidescu
- Integrative Oncology Program (E.B.A., M.D.), The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, Haifa, Israel
| | - Katerina Shulman
- Rappaport Faculty of Medicine (E.B.A., K.S., E.S.), Technion-Israel Institute of Technology, Haifa, Israel; The Oncology Service (K.S.), Lin and Zebulun Medical Centers, Clalit Health Services, Haifa, Israel
| | - Orit Gressel
- Integrative Oncology Program (E.B.A., M.D.), The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, Haifa, Israel
| | - Nili Stein
- Department of Community Medicine and Epidemiology (N.S.), Carmel Medical Center, Haifa, Israel
| | | | - Elad Schiff
- Rappaport Faculty of Medicine (E.B.A., K.S., E.S.), Technion-Israel Institute of Technology, Haifa, Israel; Department of Internal Medicine & Integrative Medicine Service (E.S.), Bnai-Zion, hospital, Haifa, Israel
| | - Noah Samuels
- Center for Integrative Complementary Medicine (N.S.), Shaarei Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Lapidari P, Djehal N, Havas J, Gbenou A, Martin E, Charles C, Dauchy S, Pistilli B, Cadeau C, Bertaut A, Everhard S, Martin AL, Coutant C, Cottu P, Menvielle G, Dumas A, Andre F, Michiels S, Vaz-Luis I, Di Meglio A. Determinants of use of oral complementary-alternative medicine among women with early breast cancer: a focus on cancer-related fatigue. Breast Cancer Res Treat 2021; 190:517-529. [PMID: 34559354 DOI: 10.1007/s10549-021-06394-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/11/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Despite the questionable effectiveness of oral complementary and alternative medicine (OCAM) in relieving cancer-related symptoms, including fatigue (CRF), many patients use it aiming to improve their quality of life. We assessed factors associated with OCAM use, focusing on CRF. METHODS Women with stage I-III breast cancer (BC) were included from CANTO (NCT01993498). OCAM use was defined as taking homeopathy, vitamins/minerals, or herbal/dietary supplements. Multivariable multinomial logistic regressions evaluated associations of CRF (EORTC QLQ-C30), patient, and treatment characteristics with OCAM use. RESULTS Among 5237 women, 23.0% reported OCAM use overall (49.3% at diagnosis, 50.7% starting post-diagnosis), mostly homeopathy (65.4%). Mean (SD) CRF score was 27.6 (24.0) at diagnosis and 35.1 (25.3) at post-diagnosis. More intense CRF was consistently associated with OCAM use at diagnosis and post-diagnosis [adjusted odds ratio (aOR) for 10-point increase 1.05 (95% Confidence interval 1.01-1.09) and 1.04 (1.01-1.09) vs. never use, respectively]. Odds of using OCAM at diagnosis were higher among older [for 5-year increase, 1.09 (1.04-1.14)] and more educated patients [college vs. primary 1.80 (1.27-2.55)]. Women with income > 3000 [vs. < 1500 euros/month, 1.44 (1.02-2.03)], anxiety [vs. not, 1.25 (1.01-1.54)], and those receiving chemotherapy [vs. not, 1.32 (1.04-1.68)] had higher odds of using OCAM post-diagnosis. CONCLUSION One-in-four patients reported use of OCAM. More severe CRF was consistently associated with its use. Moreover, older, better educated, wealthier, more anxious women, and those receiving chemotherapy seemed more prone to use OCAM. Characterizing profiles of BC patients more frequently resorting to OCAM may help deliver targeted information about its benefits and potential risks.
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Affiliation(s)
- Pietro Lapidari
- Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France.,Univesità Degli Studi di Pavia, Pavia, Italy
| | | | - Julie Havas
- Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - Arnauld Gbenou
- Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - Elise Martin
- Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - Cecile Charles
- Bordeaux Public Health, Université de Bordeaux, U1219, Bordeaux, France
| | - Sarah Dauchy
- Département Interdisciplinaire de Soins de Support aux Patients en Onco-hématologie, Gustave Roussy, Villejuif, France
| | | | | | - Aurélie Bertaut
- Centre Georges-François Leclerc, Methodology and Biostatistic Unit, Dijon, France
| | | | | | - Charles Coutant
- Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Paul Cottu
- Medical Oncology, Institut Curie, Paris, France
| | - Gwenn Menvielle
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Agnes Dumas
- ECEVE UMR 1123, Université de Paris, Paris, France
| | - Fabrice Andre
- Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - Stefan Michiels
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France.,Inserm, University Paris-Saclay, Labeled «Ligue Contre le Cancer», Oncostat U1018, Villejuif, France
| | - Ines Vaz-Luis
- Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - Antonio Di Meglio
- Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France.
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Wang S, Yang T, Qiang W, Shen A, Zhao Z, Liu X. Benefits of Dietary Management in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Nutr Cancer 2021; 74:1580-1592. [PMID: 34319187 DOI: 10.1080/01635581.2021.1957129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The World Cancer Research Fund/American Institute of Cancer Research recommendations include guidance on diet, nutrition, and weight management for people with cancer. However, for women diagnosed with breast cancer there is a lack of comprehensive analyses on the effects of dietary interventions. The purpose of this study was to investigate the impact of changes in dietary behavior and body composition on breast cancer development. A comprehensive and systematic literature search of 12 electronic databases was undertaken on January 27, 2021 to identify randomized controlled trials (RCTs) of dietary interventions for breast cancer. The Cochrane risk bias assessment tool was used to evaluate the quality of the trials identified with the data analyzed by Review Manager 5.3 software. The results showed that dietary interventions probably did not modify servings of fruit (P = 0.08), fat intake (P = 0.10), total cholesterol level (P = 0.82), body weight (P = 0.08), waist circumference (P = 0.15), or waist-to-hip ratio (P = 0.32). However, a significant reduction in body mass index (P = 0.03), and hip circumference (P = 0.03), and improvement in energy intake (P = 0.02), vegetable servings (P < 0.0001), and fiber intake (P < 0.00001) were observed. Future studies should investigate the benefits of exercise in combination with dietary interventions in breast cancer patients.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1957129.
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Affiliation(s)
- Shurui Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ting Yang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wanmin Qiang
- Nursing Department, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Aomei Shen
- Nursing Department, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Zihan Zhao
- Nursing Department, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Xiaofeng Liu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Paepke D, Wiedeck C, Hapfelmeier A, Kiechle M, Brambs C. Lifestyle modifications after the diagnosis of gynecological cancer. BMC WOMENS HEALTH 2021; 21:260. [PMID: 34182983 PMCID: PMC8240378 DOI: 10.1186/s12905-021-01391-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022]
Abstract
Background The influence of lifestyle factors on the quality of life, incidence and tumor recurrence has been evaluated in several studies and is gaining increasing importance in cancer research. However, the extent of the influence of such lifestyle factors on the quality of life of cancer patients remains largely unclear, as does the number of patients actually pursuing these lifestyle changes. The purpose of this study was to examine the prevalence and predictors of lifestyle changes in patients with gynecological cancer.
Methods The survey consisted of a pseudonymous questionnaire that was conducted from January to May 2014 via a telephone interview with 141 patients with a gynaecological malignancy who had undergone surgery at our Department of Gynaecology and Obstetrics. Lifestyle factors (diet, physical activity, stress level, alcohol and nicotine consumption) prior to and after the diagnosis of cancer were evaluated. Results 89% (n = 125) of the patients reported lifestyle changes after being diagnosed with cancer. There was a significant association between the implementation of lifestyle changes and age as well as the use of complementary medicine. Nutrition: 66% of the patients (n = 93) consumed more fruit and vegetables and 65% ate less meat (n = 92). Physical activity: 37% (n = 52) reported no change in their exercise routine, 36% (n = 51) described a decrease, 27% (n = 38) an increase in their physical activity. Subjective feeling of stress: 77% of the patients (n = 108) described a reduction in their perceived level of stress. Nicotine consumption: 63% (n = 12) of the 19 patients who were smokers at the time of the diagnosis quit or reduced smoking thereafter. Alcohol consumption: 47% (n = 61/129) of the patients reduced their alcohol consumption. Conclusions Most of the patients from our study group implemented lifestyle changes after being diagnosed with cancer. Prospective randomized trials are needed in order to determine the benefit of lifestyle changes (physical activity, dietary habits and stress reduction) for cancer survivors. The potential impact of lifestyle on the quality of life and the trajectory of the disease should be discussed with all oncological patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01391-5.
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Affiliation(s)
- Daniela Paepke
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany.
| | - Clea Wiedeck
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of Medical Informatics, Statistics and Epidemiology, School of Medicine, Technical University of Munich, Munich, Germany.,Institute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marion Kiechle
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany
| | - Christine Brambs
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany
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6
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Prevalence of the Use of Herbal Medicines among Patients with Cancer: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9963038. [PMID: 34055029 PMCID: PMC8149249 DOI: 10.1155/2021/9963038] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/01/2021] [Accepted: 05/08/2021] [Indexed: 12/24/2022]
Abstract
Background Although herbal medicines are used by patients with cancer in multiple oncology care settings, the magnitude of herbal medicine use in this context remains unclear. The purpose of this review was to establish the prevalence of herbal medicine use among patients with cancer, across various geographical settings and patient characteristics (age and gender categories). Methods Electronic databases that were searched for data published, from January 2000 to January 2020, were Medline (PubMed), Google Scholar, Embase, and African Index Medicus. Eligible studies reporting prevalence estimates of herbal medicine use amongst cancer patients were pooled using random-effects meta-analyses. Studies were grouped by World Bank region and income groups. Subgroup and meta-regression analyses were performed to explore source of heterogeneity. Results In total, 155 studies with data for 809,065 participants (53.95% female) met the inclusion criteria. Overall, the pooled prevalence of the use of herbal medicine among patients with cancer was 22% (95% confidence interval (CI): 18%–25%), with the highest prevalence estimates for Africa (40%, 95% CI: 23%–58%) and Asia (28%, 95% CI: 21%–35%). The pooled prevalence estimate was higher across low- and middle-income countries (32%, 95% CI: 23%–42%) and lower across high-income countries (17%, 95% CI: 14%–21%). Higher pooled prevalence estimates were found for adult patients with cancer (22%, 95% CI: 19%–26%) compared with children with cancer (18%, 95% CI: 11%–27%) and for female patients (27%, 95% CI: 19%–35%) compared with males (17%, 95% CI: 1%–47%). Conclusion Herbal medicine is used by a large percentage of patients with cancer use. The findings of this review highlight the need for herbal medicine to be integrated in cancer care.
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Youn J, Park S, Song S, Moon HG, Noh DY, Jung SY, Lee E, Kim Z, Youn HJ, Cho J, Yoo YB, Lee SK, Hyun T, Lee JE. Nutrient intakes from supplement and factors associated with supplement use among breast cancer survivors: A cross-sectional study. Eur J Cancer Care (Engl) 2021; 30:e13447. [PMID: 33774893 DOI: 10.1111/ecc.13447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/27/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE We investigated the contribution of supplement use to total nutrient intake, the prevalence of inadequate nutrient intake and the factors associated with supplement use among breast cancer survivors. METHODS A total of 701 Korean breast cancer survivors were included. We calculated the contribution of dietary supplements to total nutrient intake and the proportion of the population below the estimated average requirements (EARs) or exceeding the tolerable upper intake levels (ULs). Stepwise logistic regression was used to identify factors associated with dietary supplement use. RESULTS A total of 66.5% of the survivors used dietary supplements, with multivitamins and minerals being the most commonly consumed ones. The per cent contribution of supplement to the total intake was the highest for vitamin C. 28.2%-55.4% of the non-users consumed below the EAR of riboflavin, folate and calcium; 6.1%, 4.9% and 6.5% of the supplement users consumed above the UL of vitamins A and C, and iron, respectively. Supplement users had higher education levels or longer survival time. CONCLUSION 66.5% of Korean breast cancer survivors used dietary supplements. A higher education level or prolonged survival time was associated with higher use of dietary supplements.
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Affiliation(s)
- Jiyoung Youn
- Department of Food and Nutrition, Seoul National University, Seoul, Korea
| | - Sihyun Park
- Department of Food and Nutrition, Seoul National University, Seoul, Korea
| | - Sihan Song
- Department of Food and Nutrition, Seoul National University, Seoul, Korea
| | - Hyeong-Gon Moon
- Department of Surgery, Breast Care Center, Seoul National University Hospital, Seoul, Korea.,Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Young Noh
- Department of Surgery, Breast Care Center, Seoul National University Hospital, Seoul, Korea.,Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - So-Youn Jung
- Center for Breast Cancer, National Cancer Center, Research Institute and Hospital, Goyang, Korea
| | - Eunsook Lee
- Center for Breast Cancer, National Cancer Center, Research Institute and Hospital, Goyang, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hyun Jo Youn
- Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
| | - Jihyoung Cho
- Breast Endocrine Division, Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
| | - Young Bum Yoo
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Se Kyung Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Taisun Hyun
- Department of Food and Nutrition, Chungbuk National University, Cheongju, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, Seoul National University, Seoul, Korea.,Research Institute of Human Ecology, Seoul National University, Seoul, Korea
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8
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Mohty R, Savani M, Brissot E, Mohty M. Nutritional Supplements and Complementary/Alternative Medications in Patients With Hematologic Diseases and Hematopoietic Stem Cell Transplantation. Transplant Cell Ther 2021; 27:467-473. [PMID: 33839088 DOI: 10.1016/j.jtct.2021.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/27/2021] [Accepted: 03/07/2021] [Indexed: 11/25/2022]
Abstract
This perspective article discusses the various practices classified as complementary and alternative medicine (CAM) and reviews the benefits and uncertainties with respect to nutritional supplements in patients with hematological disease. It considers the high prevalence of CAM use especially among cancer survivors, particularly patients with hematologic malignancies and allogeneic stem cell transplant survivors, many of whom believe (because of extensive advertising) that supplements are anticancer/antitoxic agents, despite the paucity of evidence to support any benefit and the enormous cost to the individual. CAM constitutes various practices and nutritional behaviors including prayers, relaxation, spiritual healing, nutritional supplements, meditation, religious counseling, massage, and support groups. We highlighted the current literature regarding CAM practices and focused our discussion on the omnipresent nutritional supplements in particular to further expound on their benefits and adverse effects. As the number of survivors after HSCT increases over the next several years along with prevalence of CAM use, it becomes imperative to ascertain any beneficial potential, as well as toxicities associated with CAM use in this population.
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Affiliation(s)
- Razan Mohty
- American University of Beirut Medical Center, Hematology and Oncology division, Internal Medicine Department, Beirut Lebanon
| | - Malvi Savani
- Division of Hematology and Oncology, Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona
| | - Eolia Brissot
- APHP, Hôpital Saint Antoine, Service d'Hématologie Clinique et de Thérapie cellulaire, Paris, France; Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | - Mohamad Mohty
- APHP, Hôpital Saint Antoine, Service d'Hématologie Clinique et de Thérapie cellulaire, Paris, France; Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine (CRSA), Paris, France.
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9
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Abstract
Introduction Receiving a cancer diagnosis is an important moment in anyone’s life. Consequently, many patients are prepared to change their everyday habits and begin to look for advice from a wide range of sources. Women with breast cancer are particularly motivated and committed to making changes to their lifestyle and diet. The purpose of this study was to elucidate the changes in nutritional and other lifestyle habits following breast cancer diagnosis in Slovenia. A further goal was to estimate the proportion of breast cancer patients using dietary supplements and alternative diets or ascertain their desire to attend a consultation with a dietician. Methods A link to an online questionnaire was sent to the email addresses of members of Europa Donna and posted on their website (www.europadonna-zdruzenje.si) and Facebook page. Results A total of 102 patients were included in the study. We found that a majority of breast cancer patients changed their eating habits (68.6%) and/or physical activity level (53.9%) following diagnosis. On average, they increased their fruit and vegetable intake and reduced their intake of sugar, red meat and fat. Alternative diets were used by 29.4% of patients, with a high proportion of patients (75.5%) consuming dietary supplements. More than a half of the patients (69.6%) expressed a desire for a consultation with a dietician. Conclusions Nutritional support during cancer treatment is part of medical treatment and has an important role to play in secondary and tertiary cancer prevention activities. More dieticians should therefore be incorporated into the health system.
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10
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Leng J, Lei L, Lei SF, Zhu Z, Ocampo A, Gany F. Use of Traditional Chinese Herbal Medicine Concurrently with Conventional Cancer Treatment Among Chinese Cancer Patients. J Immigr Minor Health 2020; 22:1240-1247. [PMID: 32418000 PMCID: PMC8279391 DOI: 10.1007/s10903-020-01017-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the U.S. and Canada, Traditional Chinese Medicine (TCM) use has become increasingly common; Chinese immigrants have particularly high rates of TCM use. In this study, we used a cross sectional survey study design to assess the specific types of Traditional Chinese Herbal Medicine (TCHM) used, the concurrent use of TCHM and conventional cancer treatment, and communication with providers about TCHM use, among Chinese immigrant cancer patients in New York City (NYC). We surveyed 114 patients from several community and clinical settings in NYC. The mean age was 63, 59% were female, and 83% originated from mainland China. Breast (18%) and lung (21%) cancer were the most common cancer diagnoses, and 60% were receiving conventional cancer treatment at the time of the survey. 75% reported ever using TCHM since their most recent primary cancer diagnosis. 68% of those who used herbs reported concurrent use of TCHM with conventional cancer treatment. Only 13% of those who used herbs reported sharing TCHM use with a provider, and only 19% reported that a provider had ever discussed TCHM use with them. Our findings demonstrated an alarmingly high rate of concurrent use of TCHM and conventional cancer treatment and low rate of communication with providers about TCHM use. A wide variety of herbs were used, including those with potentially negative interactions with conventional treatment. This study highlights the urgent need for the development of interventions to assist providers and patients in improving communication around this important topic.
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Affiliation(s)
- Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
| | - Lei Lei
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Shu Fang Lei
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Zhiying Zhu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Alex Ocampo
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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Experiences of Advanced Breast Cancer Among Latina Immigrants: A Qualitative Pilot Study. J Immigr Minor Health 2020; 22:1287-1294. [PMID: 32876850 DOI: 10.1007/s10903-020-01069-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To explore the experiences of Latina immigrants with advanced breast cancer and their support networks. We conducted semi-structured interviews with low-income Latina immigrants with advanced breast cancer and their support networks (informal caregivers, physicians, and complementary medicine (CM) practitioners). Patient interviews explored patients' illness experience and end of life (EOL) concerns. Support network member interviews focused on the relationship of the interviewee with the patient and EOL conversations. Six authors independently coded transcripts and jointly conducted qualitative thematic analysis. 72 total interviews (13 patients, 12 informal caregivers, 6 CM practitioners, and 4 physicians) revealed two themes. (1) Staying positive was a primary patient coping mechanism. (2) Patients' language barriers and socioeconomic and immigration status posed challenges in participants' illness experience. Appropriately addressing language barriers and social context during medical visits is crucial for effective EOL care. Clinicians should consider patients' financial constraints and ensure support in applying for public benefits.
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Lee RT, Amico A, Malaka D, Lewin R, Cummings SA, Verp M, Patrick-Miller L, Bradbury AR, Olopade OI. Utilization of Complementary Alternative Medicine, Diet, and Exercise Among Women at High Risk for Developing Breast Cancer. Integr Cancer Ther 2020; 19:1534735420922610. [PMID: 32448019 PMCID: PMC7249552 DOI: 10.1177/1534735420922610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Women diagnosed as having a high risk for breast cancer
(HR-BC) often seek different health behaviors (HBs) such as complementary and
alternative medicine (CAM), diet, and exercise to improve their health and
cancer outcome. Methods: Women already enrolled in a multimodality
screening study for patients at HR-BC (gene mutation carrier or >20%
cumulative lifetime risk) were given a questionnaire to evaluate their use of
CAM therapies, diet, and exercise before and after a diagnosis of HR-BC.
Patients were also asked to complete the Short-Form 36, State-Trait Anxiety
Inventory, and Beck Depression Inventory. Results: A total of 134
(67%) subjects completed the survey from the original cohort. General
characteristics included a median age of 46 years (range = 24-73 years),
majority were White (91%), BRCA1/2 gene mutation carrier (49%),
and prior diagnosis of breast and/or ovarian cancer (30%). Almost all of the
patients reported a lifetime prevalence of any HB (97%) and CAM utilization
(91%). Subjects also had a high lifetime utilization of exercise (83%), herbs
and supplements(72%), and diet programs (58%). All of these HBs declined in
utilization after diagnosis of HR-BC by as much as 30%. After diagnosis of a
HR-BC, a personal history of breast and/or ovarian cancer was significantly
correlated with increased use of CAM (odds ratio [OR] = 5.9, P
< .01), herbs and supplements (OR = 4.3, P < .01), and
diet program (OR = 4.4, P < .01) in multivariate analysis.
Conclusions: HBs such as CAM, diet, and exercise are highly
prevalent among women with HR-BC, and the utilization of HB decreases
significantly after diagnosis of HR-BC.
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Affiliation(s)
- Richard T Lee
- Case Western Reserve University and University Hospitals, Cleveland, OH, USA
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Jones E, Nissen L, McCarthy A, Steadman K, Windsor C. Exploring the Use of Complementary and Alternative Medicine in Cancer Patients. Integr Cancer Ther 2019; 18:1534735419846986. [PMID: 31072149 PMCID: PMC7242794 DOI: 10.1177/1534735419846986] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In Australia, it is estimated that around 17% to 87% of cancer patients have used
one form of complementary therapy during their cancer treatment. There are
numerous reasons and contributing factors for cancer patients to consider using
complementary and alternative medicine (CAM). CAM information and products are
readily available. However, the level of evidence to support the benefits of use
in the cancer setting is limited, and the associated adverse effects and
interactions with conventional medicine may not be fully studied. Besides, not
all health professionals favor the concept of integrative health approaches, or
have the confidence in dealing with CAM due to a lack of knowledge and
standardization of practices. A thematic review of the literature was performed
on the main contributing factors to cancer patients’ use of CAM, as well as the
current issues that may be encountered by the patients and health
professionals.
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Affiliation(s)
- Ellen Jones
- 1 Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Lisa Nissen
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Carol Windsor
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
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Jones E, Nissen L, McCarthy A, Steadman K, Windsor C. Exploring the Use of Complementary and Alternative Medicine in Cancer Patients. Integr Cancer Ther 2019; 18:1534735419854134. [PMID: 31170844 PMCID: PMC6557018 DOI: 10.1177/1534735419854134] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In Australia, it is estimated that around 17% to 87% of cancer patients have used one form of complementary therapy during their cancer treatment. There are numerous reasons and contributing factors for cancer patients to consider using complementary and alternative medicine (CAM). CAM information and products are readily available. However, the level of evidence to support the benefits of use in the cancer setting is limited, and the associated adverse effects and interactions with conventional medicine may not be fully studied. Besides, not all health professionals favor the concept of integrative health approaches, or have the confidence in dealing with CAM due to a lack of knowledge and standardization of practices. A thematic review of the literature was performed on the main contributing factors to cancer patients’ use of CAM, as well as the current issues that may be encountered by the patients and health professionals.
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Affiliation(s)
- Ellen Jones
- 1 Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Lisa Nissen
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Carol Windsor
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
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15
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Kristoffersen AE, Stub T, Broderstad AR, Hansen AH. Use of traditional and complementary medicine among Norwegian cancer patients in the seventh survey of the Tromsø study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:341. [PMID: 31783842 PMCID: PMC6884826 DOI: 10.1186/s12906-019-2762-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/19/2019] [Indexed: 12/12/2022]
Abstract
Background Traditional and complementary medicine (T&CM) is commonly used by cancer patients in Northern Norway, in particular spiritual forms like traditional healing. T&CM is mainly used complementary to conventional cancer treatment and is rarely discussed with conventional health care providers, increasing the risk of negative interaction with conventional cancer care. The aim of this study was to investigate the use of T&CM among cancer patients in Tromsø, and to investigate the differences in T&CM use between people living with cancer, people with cancer previously, and people without a history of cancer. Method Data was drawn from the seventh survey of the Tromsø study conducted in 2015–2016. All inhabitants of Tromsø aged 40 and above were invited to participate (n = 32,591) of whom n = 21,083 accepted the invitation (response rate 65%). Data was collected thorough three self-administered questionnaires and a comprehensive clinical examination. Pearson chi-square tests, Fisher exact tests and one-way ANOVA tests were used to describe differences between the groups while binary logistic regressions were used for adjusted values. Results Eight percent of the participants (n = 1636) reported to have (n = 404) or have had (n = 1232) cancer. Of the participants with cancer at present 33.4% reported use of T&CM within the last year, 13.6% had consulted a T&CM provider, 17.9% had used herbal medicine/natural remedies and 6.4% had practiced self-help techniques. The participants with cancer at present were more likely to have visited a T&CM provider than participants with cancer previously (13.6% vs. 8.7%, p = 0.020). Among the participants with cancer at present, 6.4% reported to have consulted a TM provider, 5.8% had consulted an acupuncturist, while 4.7% had consulted other CM providers. Women were significantly more likely than men to have used acupuncture and self-help techniques. No significant gender differences were found regarding visits to other CM providers, TM providers nor use of herbal medicine/natural remedies. Conclusion The findings are in line with previous research suggesting that both men and women use TM complementary to other CM modalities outside the official health care system. As herbal medicine might interact with conventional cancer treatment, health care providers need to discuss such use with their patients.
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Cheng C, Bai J, Yang C, Li M, Inder K, Chan SW. Patients' experiences of coping with multiple chronic conditions: A qualitative descriptive study. J Clin Nurs 2019; 28:4400-4411. [DOI: 10.1111/jocn.15022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/04/2019] [Accepted: 08/04/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Cheng Cheng
- School of Nursing and Midwifery University of Newcastle Callaghan NSW Australia
- Department of Nursing Bengbu Medical College Bengbu Anhui China
| | - Jie Bai
- Department of Nursing Bengbu Medical College Bengbu Anhui China
| | - Cong‐Yan Yang
- Department of Nursing The First Affiliated Hospital of Bengbu Medical College Bengbu Anhui China
| | - Ming Li
- Department of Neurology The First Affiliated Hospital of Bengbu Medical College Bengbu Anhui China
| | - Kerry Inder
- School of Nursing and Midwifery University of Newcastle Callaghan NSW Australia
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Mwaka AD, Mangi SP, Okuku FM. Use of traditional and complementary medicines by cancer patients at a national cancer referral facility in a low-income country. Eur J Cancer Care (Engl) 2019; 28:e13158. [PMID: 31441575 DOI: 10.1111/ecc.13158] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/28/2019] [Accepted: 08/01/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim of this study was to describe use of traditional and complementary medicines (T&CM) and associated factors among patients with cancer. METHODS We conducted a cross-sectional study at the Uganda Cancer Institute (UCI) involving patients with selected solid tumours. Independent variables included age, sex, marital status, cancer site and stage. Main outcome variables were use and disclosure of use of T&CM. RESULTS The majority of participants were women (n = 352; 81.9%). Breast cancer (n = 312; 71.9%) was the predominant cancer type. 55.4% of participants (n = 240) self-reported use of T&CM. Among them, 68.3% (140/205) reported using them to treat/cure cancer, 35.6% (72/202) for strengthening the immune system and 31.2% (63/202) for management of pain. Patients with advanced stage cancers were more likely to be users compared with those in stage one. The majority (81.9%, 195/238) of T&CM users did not disclose use to their healthcare professionals. The main reasons for nondisclosure included lack of inquiry by clinicians (79.6%, 117/147) and fear of disapproval and/or rebuke (11.6%, 17/147). CONCLUSION Use of T&CM by patients with cancer under biomedical care is common but often undisclosed to the healthcare professionals.
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Affiliation(s)
- Amos Deogratius Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.,Cancer Awareness and Early Detection Coalition (CAEDCO), Kampala, Uganda
| | - Sabina Patrick Mangi
- Department of Medicine, St. Francis Hospital Nsambya, Kampala, Uganda.,Tosamaganga Council Designated Hospital, Iringa, Tanzania
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Puigpinós-Riera R, Castillo Gómez A, Romero Morales A, Aller M, Castells X, Sala M. [Social and clinical determinants of the use of health services in women with breast cancer (Cohort DAMA)]. GACETA SANITARIA 2018; 33:434-441. [PMID: 30031657 DOI: 10.1016/j.gaceta.2018.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To describe and analyse the factors associated with the use of health services (emergency departments, admissions and primary care) in women survivors of breast cancer diagnosed or treated in four university hospitals of Barcelona (Spain) between 2003 and 2013, within the framework of the Cohort DAMA project. METHOD Descriptive design nested in a mixed cohort (Cohort Dama). We obtained sociodemographic information and information on the use of health services through a questionnaire, and on the tumour from the clinical history. Logistic regression models were performed, calculating the odds ratio of the use of health services (emergency departments, hospital admissions and primary care) raw and adjusted (aOR) by diagnostic method, the characteristics of the tumour and of the women and their 95% confidence intervals. RESULTS The presence of chronic diseases was associated with greater use of the three levels of care. A disadvantaged economic level increases the risk of use of emergency departments and primary care but not of hospital admissions, while a higher tumour stage is associated with a greater risk of admission. By age, those under 50 had a higher risk of using emergency departments and admissions. CONCLUSIONS The factors associated with the use of health services differ according to the level of care (aOR: 3.53 emergency departments, 1.67 admissions, 3.89 primary care) and treatment-derived complications (aOR: 1.35 emergency departments, 1.43 primary care). The presence of chronic disorders, younger age, disadvantaged social class, increases the risk of using services more than the tumour stage and treatment-derived complications. Neither the diagnostic method nor the survival time, nor the use of non-conventional therapies influence this.
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Affiliation(s)
- Rosa Puigpinós-Riera
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut de Recerca Biomèdica Sant Pau, Barcelona, España.
| | - Adán Castillo Gómez
- Servei d'Epidemiologia i Avaluació, Institut Hospital del Mar d'Investigació Mèdica, Barcelona, España
| | - Anabel Romero Morales
- Servei d'Epidemiologia i Avaluació, Institut Hospital del Mar d'Investigació Mèdica, Barcelona, España; Red de Investigación de Servicios de Salud (REDISSEC), España
| | - Marta Aller
- Servei d'Epidemiologia i Avaluació, Institut Hospital del Mar d'Investigació Mèdica, Barcelona, España; Red de Investigación de Servicios de Salud (REDISSEC), España
| | - Xavier Castells
- Servei d'Epidemiologia i Avaluació, Institut Hospital del Mar d'Investigació Mèdica, Barcelona, España; Red de Investigación de Servicios de Salud (REDISSEC), España; Departament de Pediatria, Ginecologia i Obstetrícia i Medicina Preventiva i Salut Pública, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - María Sala
- Servei d'Epidemiologia i Avaluació, Institut Hospital del Mar d'Investigació Mèdica, Barcelona, España; Red de Investigación de Servicios de Salud (REDISSEC), España; Departament de Pediatria, Ginecologia i Obstetrícia i Medicina Preventiva i Salut Pública, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
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Akhtar K, Akhtar K, Rahman MM. Use of Alternative Medicine Is Delaying Health-Seeking Behavior by Bangladeshi Breast Cancer Patients. Eur J Breast Health 2018; 14:166-172. [PMID: 30123883 DOI: 10.5152/ejbh.2018.3929] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/03/2018] [Indexed: 11/22/2022]
Abstract
Objective Various treatment options including alternative medicine is available in underdeveloped countries which attracts easily the community with low profile. This study aimed to find perception of the use and mode use of alternative medicine (AM) by Bangladeshi Breast cancer patients which may influence timely treatment seeking. Materials and Methods A cross sectional study was performed to determine the spectrum in use of alternative medicine and compare the use of alternative medicine with their delay in presentation. Patients were selected randomly from July 2015-June 2016 in a specialized public cancer hospital of Dhaka city. Face to face interview was taken from diagnosed breast cancer patients, collected in pre-structured data sheet, SPSS was used for statical tests. Results Out of 200 respondents, about half of the respondents 46.5% (93) first sought help to alternative medicine. Most of them 86.02 %(80) preferred to use homeopathy. The mean duration of use alternative medicine was 2.9±4.7 months, mean patient delay was 4 months. Use of alternative medicine was found significantly (p<0.05) associated with patient delay (p=0.019), provider delay (p<0.0001), total delay (p<0.0001), use of homeopathy (p<0.0001) and residence (p=0.014). Logistic regression analysis showed that alternative medicine was 4 times more likely to cause delay help seeking (OR=4.353; 95% CI 2.2.7-8.587) p<0.0001. The co-efficient r was 0.488, p<0.0001 and there was a positive correlation among delay and duration of use of alternative medicine. Conclusion Seeking medical help other than orthodox available treatment leads to delayed presentation by the breast cancer patients.
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Affiliation(s)
- Khursheda Akhtar
- Department of Community Medicine, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh
| | - Khodeza Akhtar
- Department of Conservative Dentistry and Endodontics, Chittagong Medical College, Chittagong, Bangladesh
| | - M Mizanur Rahman
- Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
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Polite BN, Cipriano-Steffens TM, Hlubocky FJ, Jean-Pierre P, Cheng Y, Brewer KC, Rauscher GH, Fitchett GA. Association of externalizing religious and spiritual beliefs on stage of colon cancer diagnosis among black and white multicenter urban patient populations. Cancer 2018; 124:2578-2587. [PMID: 29579340 DOI: 10.1002/cncr.31351] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 02/25/2018] [Accepted: 02/27/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND This study explores whether externalizing religious and spiritual beliefs is associated with advanced-stage colon cancer at initial oncology presentation and whether this association is stronger for blacks than for whites. METHODS Patients who had newly diagnosed, invasive colon cancer were recruited at 9 sites in the Chicago metropolitan area. Eligible patients were non-Hispanic white or black, ages 30 to 79 years, and diagnosed with a primary invasive colon cancer. Patients were interviewed on prior screening and diagnosis. Social and attitudinal constructs were measured, including the God Locus of Health Control (GLHC) and Religious Problem Solving. The final response rate was 52% and included 407 patients. RESULTS The median age was 59 years (range, 30-79 years), and 51% of participants were black. Cancer stage was available for 389 (96%) patients and was divided between late stage (stages III-IV; 60%) and early stage (stages I-II; 40%). Multivariate analysis indicated that patients in the highest tertile of scores on the GLHC were more likely have an advanced stage of disease at presentation (odds ratio, 2.14; 95% confidence interval, 1.00-4.59; P = .05) compared with those in the lowest tertile. No significant interaction was identified between race and GLHC scores for stage at presentation (P = .78). CONCLUSIONS In a large sample of black and white individuals across diverse health care systems, higher scores on the GLHC predicted late disease stage at presentation. Although blacks had significantly higher GLHC scores, race was not associated with stage at presentation, nor was the association between GLHC and stage limited to blacks. Further work is needed to better understand this association and to develop interventions to better connect the religious and health care spheres. Cancer 2018;124:2578-87. © 2018 American Cancer Society.
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Affiliation(s)
- Blase N Polite
- Department of Medicine, University of Chicago, Chicago, Illinois
| | | | - Fay J Hlubocky
- Department of Medicine, University of Chicago, Chicago, Illinois
| | | | - Ying Cheng
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana
| | - Katherine C Brewer
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Garth H Rauscher
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - George A Fitchett
- Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois
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Complementary and alternative medicine (CAM) information and support needs of Chinese-speaking cancer patients. Support Care Cancer 2018; 26:4151-4159. [DOI: 10.1007/s00520-018-4288-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 05/21/2018] [Indexed: 10/14/2022]
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Latte-Naor S, Sidlow R, Sun L, Li QS, Mao JJ. Influence of family on expected benefits of complementary and alternative medicine (CAM) in cancer patients. Support Care Cancer 2018; 26:2063-2069. [PMID: 29368030 DOI: 10.1007/s00520-018-4053-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 01/15/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cancer patients often use complementary and alternative medicine (CAM) based on recommendations from family. However, the relationship between family endorsement of CAM and the patient's expectation of its benefits has never been quantified. METHODS Between 2010 and 2011, we conducted a cross-sectional survey study among patients with a diagnosis of cancer recruited from thoracic, breast, and gastrointestinal medical oncology clinics at a single academic cancer center. We performed multivariate linear regression analyses to evaluate the relationship between perceived family endorsement of and expected benefits from CAM, adjusting for covariates. RESULTS Among the 962 participants, 303 (31.3%) reported family endorsement of CAM use. Younger patients and those who had college or higher education were more likely to report family endorsement (both p < 0.05). Patients with family support had expectation scores that were 15.9 higher than patients without family support (coefficient 15.9, 95% CI 13.5, 18.2, p < 0.001). Participants with family encouragement of CAM use were also more likely to expect CAM to cure their cancer (12 vs. 37%) and prolong their life (24 vs. 61%). These relationships remained highly significant after adjusting for covariates). CONCLUSIONS Family endorsement of CAM use is strongly associated with patient expectation of its clinical efficacy, including expectations for cure and improved survival. These findings underscore the importance of including family in counseling and education on CAM use in order to achieve realistic patient expectations, maximize benefits, and avoid potential medical adverse effects through herb-drug interactions or rejections of conventional care.
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Affiliation(s)
- Shelly Latte-Naor
- Integrative Medicine Service, Division of Survivorship and Supportive Care, Bendheim Center for Integrative Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA.
| | - Robert Sidlow
- Integrative Medicine Service, Division of Survivorship and Supportive Care, Bendheim Center for Integrative Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Lingyun Sun
- Integrative Medicine Service, Division of Survivorship and Supportive Care, Bendheim Center for Integrative Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Qing S Li
- Integrative Medicine Service, Division of Survivorship and Supportive Care, Bendheim Center for Integrative Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Jun J Mao
- Integrative Medicine Service, Division of Survivorship and Supportive Care, Bendheim Center for Integrative Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
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Bao T, Li Q, DeRito JL, Seluzicki C, Im EO, Mao J. Barriers to Acupuncture Use Among Breast Cancer Survivors: A Cross-Sectional Analysis. Integr Cancer Ther 2018; 17:854-859. [PMID: 29338443 PMCID: PMC6142082 DOI: 10.1177/1534735418754309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Introduction: Increasing evidence suggests that acupuncture may be
helpful to manage common symptoms and treatment side effects among breast cancer
(BC) survivors. Acupuncture usage among BC survivors remains low with little
known about the barriers to its utilization. We evaluated perceived barriers to
acupuncture use among BC survivors and explored the sociodemographic variations
of such barriers. Methods: We conducted a cross-sectional analysis
at an urban academic cancer center on 593 postmenopausal women with a history of
stage I-III hormone receptor-positive BC who were taking or had taken an
aromatase inhibitor. We used the modified Attitudes and Beliefs about
Complementary and Alternative Medicine instrument to evaluate patients’
perceived barriers to acupuncture. Multiple linear regression analysis was
performed to determine sociodemographic factors associated with perceived
barrier scores. Results: The most common barriers were lack of
knowledge about acupuncture (41.6%), concern for lack of insurance coverage
(25.0%), cost (22.3%), and difficulty finding qualified acupuncturists (18.6%).
Compared with whites, minority patients had higher perceived barriers to use
acupuncture (β coefficient = 1.63, 95% confidence interval = 0.3-2.9,
P = .013). Patients with lower education had higher
barriers to use acupuncture (β coefficient = 4.23, 95% confidence interval =
3.0-5.4, P < .001) compared with patients with college
education or above. Conclusion: Lack of knowledge and concerns for
insurance coverage and cost are the common barriers to acupuncture use among BC
survivors, especially among minority patients with lower education. Addressing
these barriers may lead to more equitable access to acupuncture treatment for BC
survivors from diverse backgrounds.
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Affiliation(s)
- Ting Bao
- 1 Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Qing Li
- 1 Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | | | - Jun Mao
- 1 Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Use of Complementary and Alternative Medicine Among Iranian Cancer Patients in South of Iran. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017. [DOI: 10.5812/ijcm.7233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jones D, Cohen L, Rieber AG, Urbauer D, Fellman B, Fisch MJ, Nazario A. Complementary and Alternative Medicine Use in Minority and Medically Underserved Oncology Patients: Assessment and Implications. Integr Cancer Ther 2017; 17:371-379. [PMID: 29025275 PMCID: PMC6041918 DOI: 10.1177/1534735417735892] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction: Complementary and alternative medicine (CAM) use in minority and medically underserved oncology patients is not well documented. We assessed knowledge and utilization of CAM in a sample of these patients receiving treatment at an urban community hospital. Methods: Patients with cancer were interviewed using an electronic application that depicted specific CAM therapies. Patients were questioned on their knowledge and utilization of therapies, deterrents to use, and interest in using these therapies if they were made available. Results: Patients (n = 165) reported a high awareness and use of CAM therapies. CAM use was highest for prayer (85%), relaxation (54%), special diet (29%), meditation (19%), and massage (18%). Patients’ interest in using CAM was high for nearly all therapies. Lack of adequate knowledge and cost of use were reported as deterrents to use. Female patients reported higher use of aromatherapy relative to males (37.1% vs 19.4%, P = .02); those with higher education reported greater use of relaxation (60.8% vs 28.6%, P = .02); non-Hispanics reported higher use of relaxation relative to Hispanics (63.5% vs 44.2%, P = .03), and African American patients reported higher use of relaxation relative to White patients (69.2% vs 50%, P = .03). Conclusions: CAM use in minority and medically underserved cancer patients is common, but not professionally guided; thus, concerns remain regarding its safe use. Our data underscore the importance of patient-physician dialogue regarding CAM use in this patient population, and interest in access to the medically guided integration of evidence-based CAM therapies.
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Affiliation(s)
- Desiree Jones
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Desiree Jones, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 410, Houston, TX 77030, USA.
| | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alyssa G. Rieber
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Diana Urbauer
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bryan Fellman
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Arlene Nazario
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Porter D, Cochrane S, Zhu X. Current Usage of Traditional Chinese Medicine for Breast Cancer-A Narrative Approach to the Experiences of Women with Breast Cancer in Australia-A Pilot Study. MEDICINES 2017; 4:medicines4020020. [PMID: 28930235 PMCID: PMC5590056 DOI: 10.3390/medicines4020020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 04/10/2017] [Accepted: 04/10/2017] [Indexed: 01/06/2023]
Abstract
Background: The use of Traditional Chinese Medicine (TCM) by breast cancer patients is growing. Few studies have examined the complexity of breast cancer survivors' attitudes, lived experiences, barriers, and perceptions in using TCM as part of their treatment journey. This article examines breast cancer survivors' experiences, perceptions of, and benefits (or not) in using TCM. Methods: Qualitative research, using semi-structured interviews, was the chosen methodology. Results: Participants used TCM as a form of self-help and as a complement, not an alternative, to standard care. Overall, 100% of the participants used acupuncture, 62% used Chinese herbal medicine, 23% used Qigong, and 23% used Chinese dietary therapy. Participants reported perceived outcomes and health benefits from TCM usage ranging from increased coping mechanisms, relieving stress and side-effects of standard treatment, the desire to be pro-active in the treatment journey, and to have a locus of control. Some cited the need to have "time-out" and the therapeutic relationship with the practitioner as being important. Conclusion: There is a clear need to understand breast cancer survivors' needs for physical and psychological support as they aim to regain control over their life through their experience of illness. More studies are needed to measure and evaluate these outcomes and to help identify breast cancer survivors' healthcare seeking behaviours, during and after the acute treatment stage that addresses their physical, emotional, and spiritual needs. These results aim to inform future research design and evaluate and develop support services that are patient-centred and focus on whole health outcomes, shared decision-making, and quality of life.
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Affiliation(s)
- Dianna Porter
- National Institute of Complementary Medicine, Western Sydney University, Penrith 2751, Australia.
| | - Suzanne Cochrane
- National Institute of Complementary Medicine, Western Sydney University, Penrith 2751, Australia.
| | - Xiaoshu Zhu
- School of Science and Health, Western Sydney University, Penrith 2751, Australia.
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Khan TM, Jacob SA. Brief review of complementary and alternative medicine use among Malaysian women with breast cancer. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2017. [DOI: 10.1002/jppr.1254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tahir Mehmood Khan
- School of Pharmacy; Monash University Malaysia; Bandar Sunway Selangor Malaysia
| | - Sabrina Anne Jacob
- School of Pharmacy; Monash University Malaysia; Bandar Sunway Selangor Malaysia
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Panchuk RR, Skorokhyd NR, Kozak YS, Lehka LV, Chumak VV, Omelyanchik SN, Gurinovich VA, Moiseenok AG, Stoika RS. Antioxidants selenomethionine and D-pantethine decrease the negative side effects of doxorubicin in NL/Ly lymphoma-bearing mice. Croat Med J 2017; 57:180-92. [PMID: 27106359 PMCID: PMC4856192 DOI: 10.3325/cmj.2016.57.180] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Aim To investigate the potential tissue-protective effects of antioxidants selenomethionine and D-pantethine applied together with doxorubicin (Dx) on NK/Ly lymphoma-bearing mice. The impact of this chemotherapy scheme on animal survival, blood cell profile, hepatotoxicity, glutathione level, and activity of glutathione-converting enzymes in the liver was compared with the action of Dx applied alone. Methods The hematological profile of animals was studied by the analysis of blood smears under light microscopy. Hepatotoxicity of studied drugs was evaluated measuring the activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzymes, De Ritis ratio, and coenzyme A fractions by McDougal assay. Glutathione level in animal tissues was measured with Ellman reagent, and the activity of glutathione reductase, transferase, and peroxidase was measured using standard biochemical assays. Results D-pantethine (500 mg/kg) and, to a lower extent, selenomethionine (600 µg/kg) partially reduced the negative side effects (leukocytopenia and erythropenia) of Dx (5 mg/kg) in NK/Ly lymphoma bearing animals on the 14th day of their treatment. This increased animal survival time from 47-48 to 60+ days and improved the quality of their life. This ability of D-pantethine and selenomethionine was realized via hepatoprotective and immunomodulating activities. D-pantethine also restored the levels of acid-soluble and free CoA in the liver of tumor-bearing animals, while selenomethionine caused the recovery of glutathione peroxidase levels in the liver, which was significantly diminished under Dx treatment. Both compounds decreased glutathione level in the liver, which was considerably induced by Dx. Conclusions Antioxidants selenomethionine and D-pantethine partially reversed the negative side effects of Dx in NK/Ly lymphoma-bearing mice and significantly increased the therapeutic efficiency of this drug in tumor treatment.
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Affiliation(s)
- Rostyslav R Panchuk
- Rostyslav R. Panchuk, Institute of Cell Biology, National Academy of Sciences of Ukraine, Drahomanov Street 14/16, 79005, Lviv, Ukraine,
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Sarradon-Eck A, Bouhnik AD, Rey D, Bendiane MK, Huiart L, Peretti-Watel P. Use of non-conventional medicine two years after cancer diagnosis in France: evidence from the VICAN survey. J Cancer Surviv 2017; 11:421-430. [PMID: 28150122 DOI: 10.1007/s11764-017-0599-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/16/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study was to assess the use of non-conventional medicine (NCM) in a representative sample of French patients 2 years after cancer diagnosis. METHODS The study was based on data obtained in the VICAN survey (2012) on a representative sample of 4349 patients 2 years after cancer diagnosis. Self-reported data were collected at telephone interviews with patients. The questionnaire addressed the various types of non-conventional treatments used at the time of the survey. RESULTS Among the participants, 16.4% reported that they used NCM, and 45.3% of this group had not used NCM before cancer diagnosis (new NCM users). Commonly, NCMs used were homeopathy (64.0%), acupuncture (22.1%), osteopathy (15.1%), herbal medicine (8.1%), diets (7.3%) and energy therapies (5.8%). NCM use was found to be significantly associated with younger age, female gender and a higher education level. Previous NCM use was significantly associated with having a managerial occupation and an expected 5-year survival rate ≥80% at diagnosis; recent NCM use was associated with cancer progression since diagnosis, impaired quality of life and higher pain reports. CONCLUSION This is the first study on NCM use 2 years after cancer diagnosis in France. In nearly half of the NCM users, cancer diagnosis was one of the main factors which incited patients to use NCM. Apart from the NCM users' socioeconomic profile, the present results show that impaired health was a decisive factor: opting for unconventional approaches was therefore a pragmatic response to needs which conventional medicine fails to meet during the course of the disease. IMPLICATIONS FOR CANCER SURVIVORS Better information of patients and caregivers is needed to allow access to these therapies to a larger population of survivors.
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Affiliation(s)
- Aline Sarradon-Eck
- Aix Marseille Univ, INSERM, IRD, SESSTIM, "Economics & Social Sciences Applied to Health & Analysis of Medical Information", Marseille, France. .,Inst Paoli Calmettes, SESSTIM, Marseille, France.
| | - Anne-Déborah Bouhnik
- Aix Marseille Univ, INSERM, IRD, SESSTIM, "Economics & Social Sciences Applied to Health & Analysis of Medical Information", Marseille, France
| | - Dominique Rey
- Aix Marseille Univ, INSERM, IRD, SESSTIM, "Economics & Social Sciences Applied to Health & Analysis of Medical Information", Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Marc-Karim Bendiane
- Aix Marseille Univ, INSERM, IRD, SESSTIM, "Economics & Social Sciences Applied to Health & Analysis of Medical Information", Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Laetitia Huiart
- Aix Marseille Univ, INSERM, IRD, SESSTIM, "Economics & Social Sciences Applied to Health & Analysis of Medical Information", Marseille, France.,CHU de la Réunion, Unité de Soutien Méthodologique, Saint Denis, France.,CHU de la Réunion, INSERM, CIC 1410, Saint-Pierre, France
| | - Patrick Peretti-Watel
- Aix Marseille Univ, INSERM, IRD, SESSTIM, "Economics & Social Sciences Applied to Health & Analysis of Medical Information", Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
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Complementary and Alternative Medicine Use and Latina Breast Cancer Survivors' Symptoms and Functioning. Healthcare (Basel) 2016; 4:healthcare4040080. [PMID: 27809225 PMCID: PMC5198122 DOI: 10.3390/healthcare4040080] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 10/15/2016] [Accepted: 10/21/2016] [Indexed: 01/23/2023] Open
Abstract
Complementary and alternative medicine (CAM) is used widely in cancer populations, particularly among women, and has shown promise for addressing symptom and functioning outcomes. Few studies to date have evaluated CAM use and associations over time with symptoms and function among Latina breast cancer survivors. We administered a baseline (N = 136) and follow-up (n = 58) telephone survey in Spanish or English assessing Latina breast cancer survivor demographics, physical function, anxiety, depression, fatigue, satisfaction with social roles, and both CAM activities and devotional and spiritual practices. About one-third of our sample (35% baseline; 36% follow-up) reported using CAM (yoga, meditation, massage, or herbal/dietary supplements). We assessed devotional and spiritual practices separately from CAM (church attendance, prayer, religious groups, and reading devotional and religious texts); the majority of Latina survivors reported devotional and spiritual practices (80% baseline; 81% follow-up). At baseline, CAM demonstrated a positive association with better physical functioning and lower depression. In contrast, CAM use at the time of follow-up appeared to be related to lower levels of satisfaction with social roles and physical function. In longitudinal analyses, devotional and spiritual practices at baseline significantly predicted lower anxiety, depression, and fatigue at follow-up. Findings suggest CAM plays a complex and not always linear role in symptoms and function outcomes for Latina breast cancer survivors. These findings contribute to the literature on longitudinal CAM use and associations with symptom and functioning outcomes among Latina breast cancer survivors.
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Akpunar D, Bebis H, Yavan T. Use of Complementary and Alternative Medicine in Patients with Gynecologic Cancer: a Systematic Review. Asian Pac J Cancer Prev 2016; 16:7847-52. [PMID: 26625809 DOI: 10.7314/apjcp.2015.16.17.7847] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Research carried out with gynecologic cancer patients using CAM was reviewed to provide a source for discussing which CAM method is used for which purpose, patients' perceptions on the effects/side effects occurred during/after using CAM and their sources of information regarding CAM. MATERIALS AND METHODS This literature review was carried out for the period between January 2000 and March 2015 using Scopus, Dynamed, Med-Line, Science Direct, Ulakbim, Research Starters, Ebscohost, Cinahl Complete, Academic Onefile, Directory of Open Access Journals, BMJ Online Journals (2007-2009), Ovid, Oxford Journal, Proquest Hospital Collection, Springer-Kluwer Link, Taylor and Francis, Up To Date, Web Of Science (Citation Index), Wiley Cochrane-Evidence Base, Wiley Online Library, and Pub-Med search databases with "complementary and alternative medicine, gynecologic cancer" as keywords. After searching through these results, a total of 12 full length papers in English were included. RESULTS CAM use in gynecologic cancer patients was discussed in 8 studies and CAM use in breast and gynecologic cancer patients in 4. It was determined that the frequency of CAM use varies between 40.3% and 94.7%. As the CAM method, herbal medicines, vitamins/minerals were used most frequently in 8 of the studies. When the reasons why gynecologic cancer patients use CAM are examined, it is determined that they generally use to strengthen the immune system, reduce the side effects of cancer treatment and for physical and psychological relaxation. In this review, most of the gynecologic cancer patients perceived use of CAM as beneficial. CONCLUSIONS In order that the patients obtain adequate reliable information about CAM and avoid practices which may harm the efficiency of medical treatment, it is recommended that "Healthcare Professionals" develop a common language.
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Affiliation(s)
- Dercan Akpunar
- Public Health Nursing Department, Gulhane Military Medical Academy, Health Sciences Institution, Ankara, Turkey E-mail :
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A systematic review of yoga interventions as integrative treatment in breast cancer. J Cancer Res Clin Oncol 2016; 142:2523-2540. [PMID: 27630024 DOI: 10.1007/s00432-016-2269-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 09/08/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE Breast cancer is a significant public health problem all over the world. The treatment of breast cancer has many side effects. Yoga has been suggested as an integrative form of therapy for breast cancer. The purpose of this study was to systematically review yoga interventions for breast cancer and determine the efficacy of these interventions as integrative modalities of treatment in altering various outcomes related to breast cancer. METHODS Studies were included if (1) exclusively targeted breast cancer patients; (2) published between 2013 and May 2016; (3) written in the English language; (4) published in a peer-reviewed journals indexed in MEDLINE (PubMed), CINAHL, ERIC and Alt Health Watch; (5) they used any type of yoga as a part of or the whole intervention; and (6) utilized a quantitative design for evaluation. RESULTS A total of 23 interventions met the inclusion criteria. Majority of the studies had been done in USA (n = 9), followed by Germany (n = 3), India (n = 3) and Turkey (n = 2). One study each was from Australia, Canada, Iran, Taiwan, Poland, and UK. Twenty-two of the 23 interventions had statistically significant changes in studied outcome measures. CONCLUSIONS Despite the limitations of wide variabilities in sample size, lack of standardized approach in conducting yoga, multiplicity of outcome measures, varying durations of interventions and lack of using behavioral theories, yoga as an integrative form of therapy for breast cancer is a promising approach. More interventions utilizing yoga need to be tested.
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Hann D, Baker F, Denniston M, Entrekin N. Long-term Breast Cancer Survivors’ Use of Complementary Therapies: Perceived Impact on Recovery and Prevention of Recurrence. Integr Cancer Ther 2016; 4:14-20. [PMID: 15695473 DOI: 10.1177/1534735404273723] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective:Many cancer survivors use some form of complementary therapy (CT); this is particularly true for women with breast cancer. The majority of reports on CT use in women with breast cancer have focused on CT use during cancer treatment or within a year or two of treatment completion. The purpose of this study was to evaluate longertermbreast cancer survivors’ (average, 8.7 years) frequency of CT use and their beliefs about the role of CT in cancer recovery and the prevention of cancer recurrence, as well as the relationship of CT use with current life satisfaction. Methods: A mail survey was completed by 608 breast cancer survivors a minimum of 2 years after their most recent cancer diagnosis. Participants were contacted through the American Cancer Society Reach to Recovery program in Florida. The self-report questionnaire inquired about the use of various CTs, beliefs about CT, current life satisfaction, demographic characteristics, and cancer treatment history. Results: Most of the respondents were older than 50, were Caucasian, were married, had attended or completed college, and were at least 5 years after breast cancer treatment. The most commonly used CTs included exercise, vitamins, prayer/spiritual practice, support groups, humor, self-help books, and relaxation. These survivors used CT therapies because they wanted to play a more active role in their cancer recovery, to manage stress, and to maintain hope. A majority of them reported that they used CT to reduce the risk of cancer recurrence. Use of CT was not correlated with life satisfaction. Conclusions: Most of the breast cancer survivors in this study had used some form of CT since the time of their most recent cancer diagnosis and believed that such therapies could be of significant benefit, despite a lack of correlation between CT use and current life satisfaction. Many believed that use of CT may prevent cancer recurrence. It is important, therefore, to investigate the efficacy of variousCTs among longer-termcancer survivors, especially with regard to their potential in preventing cancer recurrence.
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Affiliation(s)
- Danette Hann
- American Cancer Society Behavioral Research Center, 1599 Clifton Road NE, Atlanta, GA 30329, USA.
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Abstract
The purposes of this study were to identify patterns of herbal product use for health promotion and self-care management among older African American women, to explore their use of herbal products to manage disease-specific symptoms, and to compare users of herbal products to nonusers. The sample consisted of 57 community-residing African American women age 65 years and older. Of the sample, 33% used herbal product(s) within the past year. Those who used herbal products perceived their overall health to be better than those who did not use herbal products. However, differences in demographic characteristics and locus of control between herbal users and nonusers were not significant. More than 40% of the herbals used were not discussed with health care providers. Most participants using herbals were mixing herbal, prescription, and overthe-counter products. Indiscriminate use of herbal products in combination with or in place of conventional medicines can be problematic and costly.
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Hann D, Allen S, Ciambrone D, Shah A. Use of Complementary Therapies During Chemotherapy: Influence of Patients’ Satisfaction With Treatment Decision Making and the Treating Oncologist. Integr Cancer Ther 2016; 5:224-31. [PMID: 16880427 DOI: 10.1177/1534735406291494] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The relationship between the use of complementary therapy (CT) and satisfaction with medical treatment decision making and with the treating oncologist was evaluated in a sample of 166 women who were undergoing an initial course of chemotherapy for early-stage breast cancer. At the beginning of chemotherapy, 39% indicated already trying CT and an additional 13% reported planning to try CT. These women mentioned a variety of vitamin, nutritional, herbal, physical, mental, and spiritual approaches. Four months later, when most patients had completed chemotherapy, more than half (53%) reported using CT, with another 8% planning to try it. Regression analysis controlling for psychosocial and medical variables revealed that women who were younger and less satisfied with their treatment decision-making experience were significantly more likely to use CT. When predicting use of CT at the conclusion of treatment, baseline utilization was the greatest predictor, but dissatisfaction with the oncologist was also a significant predictor. These findings suggest that patients who are dissatisfied with their medical care may be more likely to use CT during treatment. Further research is needed to elucidate the relationship between satisfaction with medical decision making and the patient-physician relationship to CT use among cancer patients. The findings also highlight the importance of good patient-physician communication about CT use throughout the cancer treatment experience.
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Affiliation(s)
- Danette Hann
- Advanced Research Corporation, St Petersburg, Florida 33701, USA.
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Lesson From Comparison of CAM Use by Women With Female-Specific Cancers to Others: It's Time to Focus on Interaction Risks With CAM Therapies. Integr Cancer Ther 2016; 6:313-44. [DOI: 10.1177/1534735407309257] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
There has been no examination as to whether the prevalence of complementary and alternative medicine (CAM) use, as well as personal factors associated with CAM use and predictive of CAM use for women with female-specific cancers, is similar to those in other diagnostic groups. The purpose of this review is to compare CAM use and personal factors associated with and predictive of CAM use by women with female-specific cancers to samples of other diagnostic groups. If it is the case that CAM use is similar across various types of samples, then it may be unnecessary to continue to study detailed CAM use by those in separate diagnostic groups and instead focus energies on the examination of CAM therapies that may have risks for interaction with conventional therapies, such as biologically based therapies. The researcher concludes that we are now in an era in which we need to use our restricted time, human resources, and finances to examine biologically based CAM use that may carry high risks for interactions or toxicities for specific groups under examination, rather than examine global CAM use, unless the situation warrants such all-inclusive study.
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Judson PL, Abdallah R, Xiong Y, Ebbert J, Lancaster JM. Complementary and Alternative Medicine Use in Individuals Presenting for Care at a Comprehensive Cancer Center. Integr Cancer Ther 2016; 16:96-103. [PMID: 27444312 PMCID: PMC5736072 DOI: 10.1177/1534735416660384] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Purpose: To define the use of complementary and alternative medicine (CAM) in individuals presenting for care at a comprehensive cancer center. Patients and Methods: A total of 17 639 individuals presenting to an NCI-designated Comprehensive Cancer Center (and consortium sites) completed a questionnaire regarding CAM use. Data were analyzed using the univariate χ2 test to assess CAM use associated with a number of variables, including cancer status, age, gender, marital status, ethnicity, race, employment, and education level. Results: Eighty-seven percent of individuals who completed the CAM survey acknowledged CAM therapy use within the previous 12 months. Of the 5 broad categories of CAM, the most commonly used were biologically based approaches (14 759/17 639 [83.67%]), mind-body interventions (4624/17 485 [26.45%]), manipulative and body-based therapies (3957/17 537 [22.56%]), alternative medical systems (429/15 952 [2.69%]), and energy therapies (270/15 872 [1.7%]). CAM use was more prevalent among women, non-Hispanics, Caucasians, patients 60 to 69 years of age, and those who are married, have a higher level of education, and are employed (P < .005). Conclusions: This is the largest report of CAM use in individuals presenting for care at a comprehensive cancer center. Our analysis revealed that a very high percentage of patients utilize CAM. Because many of these CAM interventions are not studied in oncology patients, additional research on safety, efficacy, and mechanisms of action are essential. Furthermore, it is important that oncologists understand CAM modalities and counsel their patients about their use.
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Affiliation(s)
- Patricia L Judson
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,2 Jordan Valley Cancer Center, West Jordan, UT, USA
| | - Reem Abdallah
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,3 American University of Beirut Medical Center, Beirut, Lebanon
| | - Yin Xiong
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Judith Ebbert
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Johnathan M Lancaster
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,4 Myriad Genetic Laboratories, Salt Lake City, UT, USA
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Marrie RA, Hadjimichael O, Vollmer T. Predictors of alternative medicine use by multiple sclerosis patients. Mult Scler 2016; 9:461-6. [PMID: 14582770 DOI: 10.1191/1352458503ms953oa] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To determine the frequency of alternative medicine use among multiple sclerosis (MS) patients, and the factors which predict such use. Methods: We examined 20778 MS patients enrolled in the North A merican Research C onsortium on Multiple Sclerosis (NARC O MS) Patient Registry, residing in the USA. We used demographic and clinical data to create multivariate logistic regression models for i) lifetime use of any alternative medicine, ii) lifetime use of any alternative provider (A P), and iii) lifetime use of each of the three most common A P. Results: 20387 patients provided data regarding alternative medicine use. Lifetime use of any alternative medicine was 54% and current use was 30%. C hiropractors (51%), massage therapists (34%), and nutritionists (24%) were the most commonly used A P. In all five models, use of alternative medicine was most strongly predicted by use of a conventional provider, and more modestly by disease factors indicating more severe or prolonged disease. Predictive power of the models was poor (c-index =0.62-0.68), despite good fits for the data. Conclusions: Demographic factors play only a minimal role in predicting the use of alternative medicine in this MS population while disease factors play a slightly stronger role. There must be other factors involved that may include accessibility, social acceptability and cultural factors. G iven the frequency of alternative medicine use by this patient population, further characterization of these factors is important.
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Affiliation(s)
- Ruth Ann Marrie
- Mellen Center for MS Treatment and Research, U10, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
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Bishop FL, Yardley L, Lewith GT. A Systematic Review of Beliefs Involved in the Use of Complementary and Alternative Medicine. J Health Psychol 2016; 12:851-67. [PMID: 17956965 DOI: 10.1177/1359105307082447] [Citation(s) in RCA: 188] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
People might be attracted to and use complementary and alternative medicines (CAM) because they hold beliefs that are congruent with CAM. This article collates, examines and synthesizes the evidence surrounding this hypothesis. Most studies are cross-sectional and focus on a limited number of beliefs. Multivariate studies suggest that beliefs related to control and participation, perceptions of illness, holism and natural treatments, and general philosophies of life predict CAM use when controlling for demographic and clinical factors. Further research should examine the robustness of these relationships in different illness groups and the prospective relationships among beliefs and CAM use over time.
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Affiliation(s)
- Felicity L. Bishop
- University of Southampton, University of Southampton, & University of Southampton Medical School
| | - Lucy Yardley
- University of Southampton, University of Southampton, & University of Southampton Medical School
| | - George T. Lewith
- University of Southampton, University of Southampton, & University of Southampton Medical School
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Shellman J. “Nobody Ever Asked Me Before”: Understanding Life Experiences of African American Elders. J Transcult Nurs 2016; 15:308-16. [PMID: 15359064 DOI: 10.1177/1043659604268961] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
With the unprecedented growth in the African American elderly population, there exists an urgent need to prepare nurses to deliver culturally competent care. The purpose of this study was to increase the knowledge available about the cultural heritage, worldviews, and life experiences of African American elders. Reminiscence interviews were conducted with African American elders living in a medium-sized northeast urban community. Data were analyzed using Spiegelberg’s phenomenological method. The following themes emerged: (a) nobody ever asked me before, (b) stories of discrimination, (c) coping with discrimination, (d) the hurt of discrimination, and (e) self-discoveries. Nurses, through the use of reminiscence, can gain insight into the cultural heritage, worldviews, and life experiences of African American elders and improve their ability to deliver culturally competent care to this population.
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Liu S, Qiu G, Louie W. Use of Mindfulness Sitting Meditation in Chinese American Women in Treatment of Cancer. Integr Cancer Ther 2016; 16:110-117. [PMID: 27252075 PMCID: PMC5736067 DOI: 10.1177/1534735416649661] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background. Very few studies have been conducted to examine the prevalence, frequency, perceived effectiveness, and possible influencing factors of use of meditation in patients with cancer. Objectives. To examine use of mindfulness sitting medication (MSM) in Chinese American women in treatment of cancer, its relationship to specific symptom distress, and possible influencing factors of MSM. Methods. Volunteer participants were recruited through the American Cancer Society support groups. The participants completed a demographic data form, a researcher-developed criteria and checklist for MSM, and the Memorial Symptom Assessment Scale–Short Form. Results. Eighty-nine Chinese American women with a mean age of 58 years completed the questionnaires. Twenty-one patients (24%) reported the use of MSM during active treatment of cancer. Patients who had higher education, better income, better English proficiency, and health insurance were more likely to use MSM. Patients who had more symptom distress also reported to use more MSM. Most patients (20/21) who used meditation considered it effective. After controlling other variables, better English proficiency, breast cancer, and higher symptom distress predicted the use of MSM in Chinese American women in treatment of cancer. Conclusions. About 24% of Chinese American women used MSM in the treatment of cancer and most of them considered it effective. Symptom distress and English proficiency levels predicted the use of MSM. Implications for Practice. Given the effectiveness of MSM, oncology nurses could recommend using MSM in Chinese American women in treatment of cancer, especially for patients who had higher symptom distress.
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Affiliation(s)
- Shan Liu
- 1 Adelphi University College of Nursing and Public Health, Garden City, NY, USA
| | - Guang Qiu
- 2 The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Wendy Louie
- 3 New York Presbyterian Queen Hospital, Flushing, NY, USA
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Changes in fat-soluble vitamin levels after gastrectomy for gastric cancer. Surg Today 2016; 47:145-150. [PMID: 27226020 DOI: 10.1007/s00595-016-1341-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 01/26/2016] [Indexed: 12/31/2022]
Abstract
Several authors have reported the relationship between gastric cancer risk and vitamins. However, there are few reports on fat-soluble vitamins after gastrectomy for gastric cancer. Fat malabsorption and suppression of food intake after gastrectomy for gastric cancer have been previously documented. Because of fat malabsorption and suppression of food intake, a potential deficiency in fat-soluble vitamins, such as vitamins A, D, E, and K, has been readily suggested. In about 20 % of patients, the serum vitamin E levels were decreased. Indeed, vitamin E deficiency is a common complication after gastrectomy. Continuous vitamin E deficiency could develop from neurological symptoms, i.e., peripheral neuropathy, limb or truncal ataxia. The total cholesterol level is associated with the vitamin E levels. However, the serum vitamin A levels were decreased in only 1.8 % of patients. In total gastrectomy cases, the serum vitamin A level may readily decrease. In contrast, 1,25(OH)2 vitamin D deficiency, which is the most active vitamin D metabolite, is rare. Additionally, vitamin K deficiency after gastrectomy has not been reported thus far. Evidence that serum fat-soluble vitamin levels may decrease after gastrectomy for gastric cancer has not been established yet. Future research must explore fat-soluble vitamin deficiency after gastrectomy.
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Acupoints Stimulation for Anxiety and Depression in Cancer Patients: A Quantitative Synthesis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:5645632. [PMID: 27118981 PMCID: PMC4828553 DOI: 10.1155/2016/5645632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 11/09/2015] [Accepted: 11/17/2015] [Indexed: 01/06/2023]
Abstract
This study aims at concluding the current evidence on the therapeutic effects of acupoints stimulation for cancer patients with anxiety and depression. Randomized controlled trials using acupoints stimulation for relieving anxiety and/or depression in cancer patients were searched, and 11 studies were finally included, of which eight trials compared acupoints stimulation with standard methods of treatment/care, and acupoints stimulation showed significantly better effects in improving depression than using standard methods of treatment/care. Four studies compared true acupoints stimulation with sham methods, and no significant differences can be found between groups for either depression or anxiety, although the pooled effects still favored true intervention. For the five studies that evaluated sleep quality, the results were conflicting, with three supporting the superiority of acupoints stimulation in improving sleep quality and two demonstrating no differences across groups. Acupoints stimulation seems to be an effective approach in relieving depression and anxiety in cancer patients, and placebo effects may partially contribute to the benefits. However, the evidence is not conclusive due to the limited number of included studies and the clinical heterogeneity identified among trials. More rigorous designed randomized, sham-controlled studies are necessary in future research.
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Polite BN, Cipriano-Steffens T, Hlubocky F, Dignam J, Ray M, Smith D, Undevia S, Sprague E, Olopade O, Daugherty C, Fitchett G, Gehlert S. An Evaluation of Psychosocial and Religious Belief Differences in a Diverse Racial and Socioeconomic Urban Cancer Population. J Racial Ethn Health Disparities 2016; 4:140-148. [DOI: 10.1007/s40615-016-0211-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 02/10/2016] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
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Akbari ME, Kashani FL, Ahangari G, Pornour M, Hejazi H, Nooshinfar E, Kabiri M, Hosseini L. The effects of spiritual intervention and changes in dopamine receptor gene expression in breast cancer patients. Breast Cancer 2015; 23:893-900. [PMID: 26597879 DOI: 10.1007/s12282-015-0658-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 10/30/2015] [Indexed: 01/11/2023]
Abstract
Breast cancer is the most common cancer in females in Iran and in most of the developed countries. Studies have shown that having chronic stress in individuals predisposes several types of cancer including breast cancer. Research results showed that spiritual factors correlate with indices of physical consequences such as heart disease, cancer, and death, so do psychiatric conditions and changes in receptor gene expression in depression, anxiety, and social dysfunction. Different studies demonstrated the role of neurotransmitters in occurrence and progression of cancers. They affected cells by their various types of receptors. An effective gene in mental and physical conditions is Dopamine receptor. Accordingly, the study was conducted to evaluate effects of psychotherapy (spiritual intervention) on changes in Dopamine receptor gene expressions in breast cancer patients. 90 female volunteers, including 30 healthy individuals and 60 diagnosed with breast cancer, considering exclusion criteria, were selected for the purpose of the study. The breast cancer patients were further categorized into experimental and control groups of 30 each. Blood samples were collected both prior to and following the spiritual intervention to analyze changes in their dopamine gene receptor expressions. We observed that DRD2-DRD4 in the control group (breast cancer patients) PBMC increased compared to healthy individuals. Also, DRD2-DRD4 in intervention group PBMC decreased compared to the control group and to even lower than those of healthy individuals. The findings were of great significance in management and treatment of cancer because they revealed the possibility of using alternative treatments (e.g., spiritual interventions) apart from conventional medical treatments.
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Affiliation(s)
- Mohammad Esmael Akbari
- Department of Surgical Oncology, Shahid Beheshti University of Medical Sciences (SBUMS), Cancer Research Center (CRC), Tehran, Iran
| | - Farah Lotfi Kashani
- Department of Psycho-oncology, Shahid Beheshti University of Medical Sciences (SBUMS), Cancer Research Center (CRC), Tehran, Iran
| | | | | | - Hessam Hejazi
- Department of Biology, Faculty of Science, Lorestan University, Khoramabad, Iran
| | - Elah Nooshinfar
- Department of Psycho-oncology, Shahid Beheshti University of Medical Sciences (SBUMS), Cancer Research Center (CRC), Tehran, Iran
| | - Mohsen Kabiri
- Department of Language, Aryanpour Institute, Tehran, Iran
| | - Leili Hosseini
- Department of Psycho-oncology, Shahid Beheshti University of Medical Sciences (SBUMS), Cancer Research Center (CRC), Tehran, Iran.
- Cancer Research Center, Shohada Hospital, Tajrish, Tehran, Iran.
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46
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Liu S, Sun Y, Louie W. Symptom distress and its association with traditional Chinese medicine use in Chinese American women with cancer. Oncol Nurs Forum 2015; 42:E24-32. [PMID: 25542331 DOI: 10.1188/15.onf.e24-e32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To identify symptom distress related to cancer for a group of Chinese American women in treatment, and to examine their use of various forms of traditional Chinese medicine (TCM) and their relationships to specific symptoms they identified. DESIGN Cross-sectional, correlational. SETTING American Cancer Society Asian Initiatives support groups in the state of New York. SAMPLE 97 Chinese American women residing in New York with a mean age of 57 years; the time since diagnosis of cancer ranged from two months to 24 years. The type of diagnosis for the majority of women was breast cancer. METHODS A self-reported questionnaire including a demographic data form, a researcher-developed checklist for types of TCM, and the Memorial Symptom Assessment Scale Short Form (MSAS-SF) were administered. The MSAS-SF has three subscales: global distress index, psychological symptom distress scale, and physical symptom distress scale. MAIN RESEARCH VARIABLES Symptoms, symptom distress, and types of TCM. The descriptive statistics and Mann-Whitney U tests were applied for data analysis. FINDINGS Chinese American women with cancer in treatment reported multiple symptoms, and the three MSAS-SF distress subscale scores indicated moderate symptom distress. Symptoms were positively associated with the use of TCM. CONCLUSIONS Chinese American women in treatment for cancer reported multiple symptoms and moderate symptom distress. Participants with specific symptoms tended to use specific forms of TCM. IMPLICATIONS FOR NURSING High prevalence of psychological symptoms for Chinese American women with cancer suggests that oncology nurses should work with mental health providers for symptom management of this population. Oncology nurses also need to stay informed of the growing body of evidence on the benefits of TCM for patients with cancer. Future studies should include an emphasis on the improvement in methodologic quality for studies that investigate using TCM in participants with cancer.
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Affiliation(s)
- Shan Liu
- College of Nursing and Public Health, Adelphi University, Garden City, NY
| | - Yiyuan Sun
- College of Nursing and Public Health, Adelphi University, Garden City, NY
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Ojukwu M, Mbizo J, Leyva B, Olaku O, Zia F. Complementary and Alternative Medicine Use Among Overweight and Obese Cancer Survivors in the United States. Integr Cancer Ther 2015; 14:503-14. [PMID: 26044767 DOI: 10.1177/1534735415589347] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of the study was to determine the prevalence of complementary and alternative medicine (CAM) use among US cancer survivors; examine whether use varies by underweight/normal weight, overweight, and obese body mass index status; determine reasons for use; and document disclosure rates of CAM use to medical professionals. METHODS Data for 1785 cancer survivors were obtained from the 2007 National Health Interview Survey and CAM supplement. The prevalence and associations of CAM use in the previous 12 months were compared among underweight/normal weight, overweight, and obese adult cancer survivors. RESULTS Nearly 90% of cancer survivors used at least one type of CAM therapy in the 12 months preceding the survey. Those who were overweight, but not obese, were more likely to use a CAM modality compared to normal/underweight respondents. Over two thirds (71%) reported using CAM therapy for general health and wellness and 39.3% used CAM because a health care provider recommended it. Disclosure rates of CAM use to conventional medical professionals varied widely by CAM modality. CONCLUSIONS An overwhelming majority of US cancer survivors use CAM for a variety of reasons. Overweight cancer survivors may be more likely to use CAM than those who are underweight, normal weight, or obese. Cancer survivors should be screened by medical providers for the use of CAM therapies; furthermore, prospective clinical research evaluating the efficacy and safety of biologically based CAM therapies, often used by cancer survivors, is important and necessary for the well-being of this population.
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Affiliation(s)
- Mary Ojukwu
- Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, Bethesda, MD, USA
| | | | - Bryan Leyva
- Process of Care Research Branch, National Cancer Institute, Bethesda, MD, USA
| | - Oluwadamilola Olaku
- Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, Bethesda, MD, USA Kelly Services Incorporated, Rockville, MD, USA
| | - Farah Zia
- Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, Bethesda, MD, USA
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Bauml JM, Chokshi S, Schapira MM, Im EO, Li SQ, Langer CJ, Ibrahim SA, Mao JJ. Do attitudes and beliefs regarding complementary and alternative medicine impact its use among patients with cancer? A cross-sectional survey. Cancer 2015; 121:2431-8. [PMID: 26011157 DOI: 10.1002/cncr.29173] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 11/01/2014] [Accepted: 11/03/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Complementary and alternative medicine (CAM) incorporates treatments used by cancer survivors in an attempt to improve their quality of life. Although population studies have identified factors associated with its use, to the best of the authors knowledge, assessment of why patients use CAM or the barriers against its use have not been examined to date. METHODS The authors conducted a cross-sectional survey study in the thoracic, breast, and gastrointestinal medical oncology clinics at an academic cancer center. Clinical and demographic variables were collected by self-report and chart abstraction. Attitudes and beliefs were measured using the validated Attitudes and Beliefs about CAM (ABCAM) instrument. This instrument divides attitudes and beliefs into 3 domains: expected benefits, perceived barriers, and subjective norms. RESULTS Among 969 participants (response rate, 82.7%) surveyed between June 2010 and September 2011, patient age ≤65 years, female sex, and college education were associated with a significantly greater expected benefit from CAM (P<.0001 for all). Nonwhite patients reported more perceived barriers to CAM use compared with white patients (P<.0001), but had a similar degree of expected benefit (P = .76). In a multivariate logistic regression analysis, all domains of the ABCAM instrument were found to be significantly associated with CAM use (P<.01 for all) among patients with cancer. Attitudes and beliefs regarding CAM explained much more variance in CAM use than clinical and demographic variables alone. CONCLUSIONS Attitudes and beliefs varied by key clinical and demographic characteristics, and predicted CAM use. By developing CAM programs based upon attitudes and beliefs, barriers among underserved patient populations may be removed and more patient centered care may be provided.
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Affiliation(s)
- Joshua M Bauml
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.,Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Philadelphia, Pennsylvania
| | - Sagar Chokshi
- Rowan University School of Osteopathic Medicine, Stratford, NJ
| | - Marilyn M Schapira
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Philadelphia, Pennsylvania.,Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Eun-Ok Im
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Susan Q Li
- Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Corey J Langer
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.,Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Said A Ibrahim
- Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Philadelphia, Pennsylvania.,Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jun J Mao
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Zhang F, Song X, Li L, Wang J, Lin L, Li C, Li H, Lv Y, Jin Y, Liu Y, Hu Y, Xin T. Polygala tenuifolia polysaccharide (PTP) inhibits cell proliferation by repressing Bmi-1 expression and downregulating telomerase activity. Tumour Biol 2014; 36:2907-12. [DOI: 10.1007/s13277-014-2920-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 11/28/2014] [Indexed: 02/04/2023] Open
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Williams PD, Lantican LS, Bader JO, Lerma D. Symptom monitoring, alleviation, and self-care among Mexican Americans during cancer treatment. Clin J Oncol Nurs 2014; 18:547-54. [PMID: 25253108 DOI: 10.1188/14.cjon.547-554] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Monitoring the occurrence and severity of symptoms among Mexican American adults undergoing cancer treatments, along with their self-care to alleviate symptoms, are understudied; the current study aimed to fill this gap in the literature. A total of 67 Mexican Americans receiving outpatient oncology treatments in the southwestern United States participated. Instruments included a patient-report checklist, the Therapy-Related Symptom Checklist (TRSC), the Symptom Alleviation: Self-Care Methods tool, and a demographic and health information form. At least 40% of participants reported the occurrence of 12 symptoms: hair loss, feeling sluggish, nausea, taste change, loss of appetite, depression, difficulty sleeping, weight loss, difficulty concentrating, constipation, skin changes, and numb fingers and toes. More than a third also reported pain, vomiting, decreased interest in sexual activity, cough, and sore throat. The helpful self-care strategies reported included diet and nutrition changes; lifestyle changes; and mind, body control, and spiritual activities. Patient report of symptoms during cancer treatments was facilitated by the use of the TRSC. Patients use symptom alleviation strategies to help relieve symptoms during their cancer treatment. The ability to perform appropriate, effective self-care methods to alleviate the symptoms may influence adherence to the treatment regimen.
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Affiliation(s)
- Phoebe D Williams
- School of Nursing, University of Kansas Medical Center in Kansas City
| | - Leticia S Lantican
- College of Health Sciences and the School of Nursing, University of Texas at El Paso
| | - Julia O Bader
- Statistical Consulting Lab, University of Texas at El Paso
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