Complementary and Alternative Medicine Use in Individuals Presenting for Care at a Comprehensive Cancer Center

Complementary and alternative medicine use in patients before and after a cancer diagnosis

Background

Cancer patients are increasingly seeking out complementary and alternative medicine (cam) and might be reluctant to disclose its use to their oncology treatment team. Often, cam agents are not well studied, and little is known about their potential interactions with chemotherapy, radiation therapy, or biologic therapies, and their correlations with outcomes. In the present study, we set out to determine the rate of cam use in patients receiving treatment at a Northern Ontario cancer centre.

Methods

Patients reporting for treatment at the Northeast Cancer Centre (necc) in Sudbury, Ontario, were asked to complete an anonymous questionnaire to assess cam use. Changes in cam use before, compared with after, diagnosis were also assessed.

Results

Patients in Northern Ontario reported significant cam use both before and after diagnosis. However, as a function of the cam type, cam use was greatly enhanced after cancer diagnosis. For example, the number of patients who reported use of biologic products increased to 51.8% after a cancer diagnosis from 15.6% before a cancer diagnosis. Patients reported much smaller changes in the use of alternative medical systems or spiritual therapy after diagnosis. Vitamin use was reported by 66% of respondents, and the number of different cams used correlated significantly with the reported number of vitamins used.

Conclusions

Use of cam, particularly biologic products, increased significantly after a cancer diagnosis. Further studies are required to examine the effect of cam use on the efficacy and safety of cancer therapies.

Anticancer drug discovery from Chinese medicinal herbs

Cancer is still presenting a serious threat to human health worldwide. The understanding of the complex biology of cancer and the development of oncotherapy have led to increasing treatment approaches such as targeted therapy and immunotherapy. Chinese medicinal herbs have attracted considerable attention due to their potential anticancer effects. Some natural products or formulae from Chinese medicinal herbs with directly or indirectly anticancer effects have been reported. In this article, we summarized the current progression on development of anticancer drugs from Chinese medicinal herbs, toward providing ideas for further development and application of Chinese medicinal herbs in cancer therapy.

The perceptions and experiences of osteopathic treatment among cancer patients in palliative care: a qualitative study

PURPOSE

This research aimed to explore the perceptions and experiences of cancer patients receiving osteopathic treatment as a complementary therapy when it is used in addition to conventional treatment for cancer pain.

METHODS

This qualitative study employed semi structured interviews of cancer patients in a palliative care unit in Lyon, France, who received treatment from an osteopath alongside their conventional cancer treatment. We analysed data using grounded theory and qualitative methods.

RESULTS

We interviewed 16 patients. The themes identified through the analysis included a low awareness of osteopathy among the population and an accompanying high level of misconceptions. The benefits of osteopathy were described as more than just the manual treatments with participants valuing osteopathy as a holistic, meditative, and non-pharmaceutical approach. Participants also described the osteopathic treatments as assisting with a range of cancer-related health complaints such as pain, fatigue, and sleep problems. Offering osteopathic treatment at an accessible location at low or no cost were identified by participants as enablers to the continued use of osteopathy.

CONCLUSIONS

The findings of this study provides preliminary data which suggests, when delivered alongside existing medical care, osteopathy may have health benefits for patients with complex conditions such as cancer.

Acupuncture versus medication for pain management: a cross-sectional study of breast cancer survivors

AIM OF THE STUDY

Breast cancer survivors who take aromatase inhibitors (AI) often suffer from chronic pain. Emerging evidence supports the use of acupuncture as an effective pain management strategy for this condition, but its acceptability among cancer survivors is unknown. We evaluated breast cancer survivors' preferences for acupuncture as compared with medication use and identified factors predictive of this preference.

METHODS

We conducted a cross-sectional study among breast cancer survivors who were currently, or had been, taking an AI. The primary outcome was degree of preference for acupuncture as compared with medication for pain management. We conducted multivariate logistic regression analyses to evaluate the effects of socioeconomic status (SES) factors and health beliefs on treatment preference.

RESULTS

Among 592 participants, 160 (27.0%) preferred acupuncture, 153 (25.8%) preferred medication and 279 (47.1%) had no clear preference. In a multivariate analysis that only included SES, higher education and white race were significantly associated with greater preference for acupuncture. When health beliefs were added, SES effects were attenuated, while greater expectation of acupuncture's effect, lower perceived barriers to its use, higher social norm (endorsement from family members and healthcare professionals) related to acupuncture and higher holistic health beliefs were associated with greater preference for acupuncture.

CONCLUSION

We found similar rates of preference for acupuncture versus medication among breast cancer survivors for pain management. Specific attitudes and beliefs predicted such preferences, highlighting the importance of a patient-centred approach to align patient beliefs and preferences with therapeutic options for more effective pain management.

TRIAL REGISTRATION NUMBER

NCT01013337; Results.

Open to Exploration? Association of Personality Factors With Complementary Therapy Use After Breast Cancer Treatment

Purpose: Many cancer survivors seek complementary therapies (CTs) to improve their quality of life. While it is well-known that women who are younger, more highly educated, and have higher incomes are more likely to use CTs, individual differences such as personality factors have been largely unexplored as predictors of CT use. Methods: In a secondary analysis of a larger study, 270 women with stage I to III breast cancer completed self-report measures of demographic and illness-related information, personality variables, and use of several different types of CTs. A series of logistic regression models were used to explore whether demographic, illness-related, and personality variables predicted different types of CT use. Results: Prior relationships between education and CT use were replicated. There were no significant relationships between illness-related variables and different types of CT use. Of the 5 personality factors, only openness to experience was a significant predictor of multiple types of CT use. Conclusions: Openness to experience may represent an individual difference variable that predicts CT use among cancer survivors. CTs themselves may represent a form of intellectual curiosity and novelty seeking. Further studies are needed to replicate and examine the generalizability of the relationship between openness to experience and CT use in oncology populations.

Hand Massage for Cancer Patients Undergoing Chemotherapy as Outpatients: A Pilot Study

CONTEXT

There are no studies on the effect of volunteer-provided hand massage in a busy chemotherapy outpatient practice.

OBJECTIVE

To assess the feasibility of introducing hand massage therapy into an outpatient chemotherapy unit and to evaluate the effect of the therapy on various symptoms experienced by cancer patients.

DESIGN

A pilot, quasi-experimental, pretest-posttest study.

SETTING

Chemotherapy outpatient clinic of a large tertiary care academic medical center.

PATIENTS/PARTICIPANTS

Forty chemotherapy outpatients.

INTERVENTION

After being approached by a trained volunteer from a hand massage team, patients consented to receive a 20-minute hand massage before chemotherapy that was individualized according to patient preference and expressed needs.

MAIN OUTCOME MEASURES

The visual analog scale (VAS) was used to measure pain, fatigue, anxiety, muscular discomfort, nervousness, stress, happiness, energy, relaxation, calmness, and emotional well-being (on a scale from 0-10) before and after the intervention; a satisfaction survey was administered after the therapy. Patients' demographic data were summarized with descriptive statistics, and VAS total scores were compared between groups at each time point with the two-group t test. Feasibility was evaluated from the number of patients who were approached, received a hand massage, and completed the study surveys.

RESULTS

Of the 40 participants, 19 were men (mean age, 59.5 years). Significant improvement after hand massage was indicated by VAS scores for fatigue, anxiety, muscular discomfort, nervousness, stress, happiness, energy, relaxation, calmness, and emotional well-being (P < .05). Pain scores also improved, but the difference was not statistically significant (P = .06). All patients indicated that they would recommend hand massage to other patients, and 37 were interested in receiving it during their next chemotherapy treatment.