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Boesenecker SJ, Mathies V, Buentzel J, Huebner J. How can counselling by family physicians on nutrition and physical activity be improved: trends from a survey in Germany. J Cancer Res Clin Oncol 2023; 149:3335-3347. [PMID: 35932301 PMCID: PMC10314832 DOI: 10.1007/s00432-022-04233-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/19/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Cancer and its therapy causes severe symptoms, most of which are amendable to nutrition and physical activity (PA). Counselling on nutrition and PA empowers patients to take part more actively in their treatment. Many cancer patients are yet in need of information on these topics. In this study, we investigate the perception of family physicians (FP) on nutrition and PA in cancer patient care and assess barriers and steps to improve their involvement in counselling on these topics. METHODS Based on qualitative content analysis of 5 semi-structured interviews with FP, a questionnaire was developed and completed by 61 German FP. RESULTS Most of the FP acknowledged the importance of nutrition and PA during (91.4%) and after (100%) cancer therapy. While many participants were involved in cancer patient care, 65.6% of FP viewed themselves as primary reference person to address these topics. However, a third (32.8%) of FP were unfamiliar with information thereof. Some were unsatisfied regarding timely updates on their patient's treatment course via discharge letters (25.0%) or phone calls (36.2%). FP would like to dedicate more consultation time addressing nutrition and PA than they currently do (p < 0.001). CONCLUSION Communication btween healthcare practitioners about mutual cancer patient's treatment must be improved, e.g. utilising electronic communication to quicken correspondence. Acquisition of information on nutrition and PA in cancer patient care needs to be facilitated for FP, approachable by compiling reliable information and their sources. Involvement of FP in structured treatment programs could benefit cancer patient care. TRIAL REGISTRATION NUMBER (May 7, 2021): 2021-2149-Bef.
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Affiliation(s)
- S J Boesenecker
- Clinic for Internal Medicine II, University Hospital, Bachstraße 18, 07743, Jena, Germany.
| | - V Mathies
- University Tumor Center, University Hospital, Jena, Germany
| | - J Buentzel
- Clinic for Otorhinolaryngology, Head Neck Surgery, Suedharz Klinikum, Nordhausen, Germany
| | - J Huebner
- Clinic for Internal Medicine II, University Hospital, Bachstraße 18, 07743, Jena, Germany
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Hack V, Josfeld L, Hübner J, Keinki C, Büntzel J. Decision-making by cancer patients and the role of a counselling facility for complementary and alternative medicine: a cohort study. J Cancer Res Clin Oncol 2023; 149:2903-2913. [PMID: 35819526 PMCID: PMC10314849 DOI: 10.1007/s00432-022-04178-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/27/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this cohort study was to gain insight on influencing factors on the decision-making process in conventional medicine compared to complementary and alternative medicine (CAM). METHODS A standardized questionnaire was distributed among cancer patients who attended the counselling facility for CAM of a German university hospital in 2020. RESULTS Fifty patients (30.3%) returned the questionnaire. After counselling on CAM, most patients made a decision in CAM but also in conventional medicine. Thus, the focus on informed decision-making during counselling on CAM had a strong effect on the decision-making process in conventional medicine. Patients reporting good support also reported making decisions together with physicians and relatives. Moreover, after counselling on CAM, patients reported being more satisfied with their decision in both settings afterwards. CONCLUSION Information on CAM which focuses on informed decision-making, supports patient's ability to understand and weigh risks and benefits of treatments, supports shared decision-making and enables patients to transfer these competences also to decisions on conventional medicine. So counselling on CAM may further decision-making competences in cancer patients. This encourages patients to engage in shared decision-making and increases patient's satisfaction with decisions.
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Affiliation(s)
- Vanessa Hack
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany.
- , Christeserstraße, 98547, Kühndorf, Germany.
| | - Lena Josfeld
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Jutta Hübner
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Christian Keinki
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Jens Büntzel
- Klinik für HNO-Erkrankungen, Südharzklinikum, Nordhausen, Germany
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Bauer-Büntzel C, Büntzel J, Zomorodbakhsch B, Keinki C. [Phytotherapy in uro-oncology]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:3-10. [PMID: 36445447 DOI: 10.1007/s00120-022-01979-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Complementary and alternative medicine (CAM) is used by about 40-90% of all patients with cancer. CAM also includes phytotherapy, which is considered to be a biologically based therapy. Depending on the survey, the users of phytotherapy account for up to 80%. The intention of the users is to fight cancer or to alleviate its symptoms. OBJECTIVES Frequently used phytotherapeutics with their level of evidence and possible pitfalls are presented in a narrative review. Special attention is given to the uro-oncological context. MATERIALS AND METHODS Popular phytotherapeutics (mistletoe, pomegranate, aloe vera, sage, ginger, ginseng) as well as three uronephrological plants (juniper, horsetail, bearberry) are classified and evaluated according to existing guidelines and by using a selective literature search. RESULTS A total of nine plants were considered. Currently, there is no sufficient evidence for the use of pomegranate or mistletoe for tumor therapy. Guideline recommendations for or against symptom-oriented use exist for ginger (nausea; may be used), ginseng (fatigue; may be used), aloe vera (radiation dermatitis, should not be recommend), and bearberry (recurrent cystitis, may be used). A small number of studies on other symptoms and medicinal plants could be found (e.g., ginger - xerostomia, aloe vera - constipation, sage - oral mucositis or sweating). CONCLUSIONS An integration of phytotherapeutic drugs into uro-oncological treatments concept can be considered. The benefits and risks of complementary herbal medicines (e.g., potential interactions with tumor therapy) must always be carefully weighed.
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Affiliation(s)
| | - Judith Büntzel
- Klinik für Hämatologie und Medizinische Onkologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | | | - Christian Keinki
- Medizinische Klinik II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.
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Witt CM, Balneaves LG, Carlson LE, Cohen M, Deng G, Fouladbakhsh JM, Kinney AY, Mehta A, Mailman J, Pole L, Rogge AA, O'Toole C, Zick SM, Helmer SM. Education Competencies for Integrative Oncology-Results of a Systematic Review and an International and Interprofessional Consensus Procedure. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:499-507. [PMID: 32783117 PMCID: PMC7876161 DOI: 10.1007/s13187-020-01829-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Integrative oncology is a burgeoning field and typically provided by a multiprofessional team. To ensure cancer patients receive effective, appropriate, and safe care, health professionals providing integrative cancer care should have a certain set of competencies. The aim of this project was to define core competencies for different health professions involved in integrative oncology. The project consisted of two phases. A systematic literature review on published competencies was performed, and the results informed an international and interprofessional consensus procedure. The second phase consisted of three rounds of consensus procedure and included 28 experts representing 7 different professions (medical doctors, psychologists, nurses, naturopathic doctors, traditional Chinese medicine practitioners, yoga practitioners, patient navigators) as well as patient advocates, public health experts, and members of the Society for Integrative Oncology. A total of 40 integrative medicine competencies were identified in the literature review. These were further complemented by 18 core oncology competencies. The final round of the consensus procedure yielded 37 core competencies in the following categories: knowledge (n = 11), skills (n = 17), and abilities (n = 9). There was an agreement that these competencies are relevant for all participating professions. The integrative oncology core competencies combine both fundamental oncology knowledge and integrative medicine competencies that are necessary to provide effective and safe integrative oncology care for cancer patients. They can be used as a starting point for developing profession-specific learning objectives and to establish integrative oncology education and training programs to meet the needs of cancer patients and health professionals.
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Affiliation(s)
- Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland.
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany.
| | - Lynda G Balneaves
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Linda E Carlson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Misha Cohen
- Chicken Soup Chinese Medicine, San Francisco, CA, USA
- American College of Traditional Chinese Medicine at California Institute of Integral Studies, San Francisco, CA, USA
| | - Gary Deng
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Anita Y Kinney
- Department of Epidemiology, School of Public Health and Rutgers, Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | | | | | - Laura Pole
- Smith Center for Healing and the Arts, Institute for Integrative Oncology Navigation, Washington, DC, USA
| | - Alizé A Rogge
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany
| | - Carole O'Toole
- Smith Center for Healing and the Arts, Washington, DC, USA
| | - Suzanna M Zick
- Department of Family Medicine and Nutritional Sciences Schools of Medicine and Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Stefanie M Helmer
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany
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Keinki C, Meyer H, Bozkurt G, Müller N, Römelt J, Müller UA, Hübner J. Salvation Expectations of Patients of Medicine, Complementary and Alternative Medicine and Religion. JOURNAL OF RELIGION AND HEALTH 2022; 61:601-615. [PMID: 32948977 PMCID: PMC8837522 DOI: 10.1007/s10943-020-01074-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Health and holistic quality of life, physical and emotional needs, somatic and spiritual aspects contain a comprehensive promise of healing. The aim of the current study is to measure the expectations of patients of medicine, alternative medicine and religion related to health and illness. The survey was carried out among 103 patients of a rural general practitioner from May to June 2013 and among 103 patients of the outpatient department for endocrinology and metabolic disease of the Jena University Hospital in 2013. All patients were asked by one interviewer (HM) on fears in relation to health/illness and expectations of help for its own life, medicine, alternative medicine and religion. The biggest fear of patients is "being in need of help of others." There is no significant difference between religious and non-religious patients. Overall, the expectations of medicine were significantly higher in all sectors than in alternative medicine or religion. Comparing alternative medicine and religion, the expectations of alternative medicine were significantly higher excluding consolation and inner peace. The expectations for medicine in general and for the physician are very high and comprehensive and go beyond diagnosis and realization of therapies. Patients expect hope, guidance, support, comfort, inner peace and advice most from medicine. This results in considerable challenges for the physician, especially in a healthcare system with limited resources and without suitable offers. There is an urgent need to integrate these requirements into daily routine.
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Affiliation(s)
- Christian Keinki
- Department of Hematology and Medical Oncology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
| | - Herbert Meyer
- Department Ethics and Moral Philosophy, University of Erfurt, Erfurt, Germany
| | - Gültekin Bozkurt
- Department of Hematology and Medical Oncology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Nicolle Müller
- FB Endocrinology, Department Internal Medicine III, Jena University Hospital, Jena, Germany
| | - Josef Römelt
- Department Ethics and Moral Philosophy, University of Erfurt, Erfurt, Germany
| | - Ulrich Alfons Müller
- Practice for Endocrinology and Diabetology, Centre for Ambulatory Medicine, Jena University Hospital, Jena, Germany
| | - Jutta Hübner
- Department of Hematology and Medical Oncology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
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Johannsen M, Stoll C, Raida M, van Oorschot B, Flörcken A. Supportive therapy and complementary medicine in renal cell carcinoma. World J Urol 2021; 40:2359-2371. [PMID: 34821959 DOI: 10.1007/s00345-021-03885-1] [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: 04/02/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE As part of the German interdisciplinary S3-guideline "Diagnosis, Treatment and Followup of Renal Cell Carcinoma", this article aimes to provide guidance regarding the use of supportive therapy and complementary medicine in patients with advanced or metastatic renal cell carcinoma. METHODS The German interdisciplinary S3-guidelines are national clinical practice guidelines that implement the highest methodological quality of evidence-based medicine. Recommendations and evidence-based statements are provided according to available evidence. RESULTS Supportive and palliative care are important areas of tumor treatment and require knowledge on the management of a variety of issues. This article outlines the management of tumor-related symptoms such as pain, undesired treatment-related effects, palliative care and end-of-life care in patients with renal cell carcinoma. CONCLUSION Patients with advanced or metastatic renal cell carcinoma should have access to supportive and palliative care according to their individual needs. There is very limited evidence regarding the impact of complementary medicine for the treatment of patients with renal cell carcinoma.
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Affiliation(s)
- M Johannsen
- Urology Practice Johannsen & Laux, Berlin and d-uo (Deutsche Uro-Onkologen), Berlin, Germany
| | - C Stoll
- Department of Oncology, Clinic Herzoghoehe, Bayreuth, Germany
| | - M Raida
- VAMED Rehabilitation Clinic Bergisch-Land, Wuppertal, Germany
| | - B van Oorschot
- Interdisciplinary Center for Palliative Medicine, Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
| | - A Flörcken
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
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7
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[Complementary medicine in uro-oncology]. Urologe A 2021; 60:953-962. [PMID: 34129061 DOI: 10.1007/s00120-021-01584-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 10/21/2022]
Abstract
Complementary and alternative medicine (CAM) is widespread in oncology patients with a user rate of approximately 40-50%. An accompanying supportive effect can arise through improved adherence, especially in long-term (e.g. endocrine) therapies through active patient involvement. When assessing the evidence on frequently requested methods, there is no high-quality evidence that homeopathy or anthroposophy leads to an improved prognosis. Mistletoe therapy can be considered to improve the quality of life, although the data quality is weak. In prostate cancer, pomegranate has an influence on the prostate-specific antigen. It is currently unclear whether this will also result in an improved prognosis. In contrast the evidence on selenium and vitamin D speaks in favor of integration into the aftercare concept. Supplementation is recommended after the serum level has been determined.
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von der Brelie C, Schatlo B, Bettag C, Rohde V. Safety aspects of opioid-naïve patients with high-grade glioma treated with D,L-Methadone: an observational case series. Neurosurg Rev 2020; 44:579-586. [PMID: 32060760 DOI: 10.1007/s10143-020-01250-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/22/2019] [Accepted: 01/20/2020] [Indexed: 12/31/2022]
Abstract
It was suggested that D, L-Methadone might improve the clinical course of glioma patients. Owing to massive press coverage, patients demand the prescription of D, L-Methadone, but regarding its adjunctive use in glioma therapy there is no standard medication plan. Furthermore, it is not known which side effects the administration of D, L-Methadone might harbor, especially if the patients are opioid-naïve and if D, L-Methadone therapy was managed by the patients themselves or their general practitioners. Opioid-naïve patients with high-grade glioma (new diagnosis or recurrent) receiving D, L-Methadone were included in this retrospective observational analysis. Side effects were assigned if the condition deteriorated in conjunction with the initiation of D, L-Methadone and resolved/ ameliorated after cessation of the intake/reduction of the dosage. Side effects were categorized according to the common toxicity criteria (CTC). Twenty-four patients were included. All patients were opioid-naïve and received D, L-Methadone from their general practitioners. Sixteen patients experienced side effects. The median dosage when side effects began to occur was 15.8 mg/ 24 h. Fatigue and mood changes were reported most frequently (14 of 24 patients). Five patients had severe side effects related to relatively high doses. In all cases, symptoms resolved after cessation or dose reduction. Our results show that D/L M intake lead to frequent occurrence of side effects in opioid-naïve patients especially when not handled with caution and close supervision. Patients, their relatives, their GPs and neuro-oncologists need to be informed about the broad spectrum of side effects in order to thoroughly counsel glioma patients.
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Affiliation(s)
- Christian von der Brelie
- Department of Neurosurgery, Georg August Universität of Göttingen, Robert-Koch-Strasse 40, 37075, Göttingen, Germany.
| | - Bawarjan Schatlo
- Department of Neurosurgery, Georg August Universität of Göttingen, Robert-Koch-Strasse 40, 37075, Göttingen, Germany
| | - Chistoph Bettag
- Department of Neurosurgery, Georg August Universität of Göttingen, Robert-Koch-Strasse 40, 37075, Göttingen, Germany
| | - Veit Rohde
- Department of Neurosurgery, Georg August Universität of Göttingen, Robert-Koch-Strasse 40, 37075, Göttingen, Germany
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Schallock H, Bartmann B, Keinki C, Huebner J. Online information on oncologists' and non-medical practitioners' websites in Germany: A critical comparison. PATIENT EDUCATION AND COUNSELING 2019; 102:2038-2048. [PMID: 31147090 DOI: 10.1016/j.pec.2019.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To survey websites of oncologists and non-medical practitioners (NMPs) in Germany regarding range of treated symptoms, diagnostic tools and therapies offered to cancer patients as well as the quality of websites. METHODS Analysis of 98 websites of oncologists and NMPs was conducted between April and July 2018 with a standardized tool. RESULTS Range of diagnostic and therapeutic methods was high and differed between both groups. Many NMPs (65.3%) intended to support conventional therapy rather than to treat cancer. Most oncologists (85.7%) did not mention the role of complementary and alternative medicine (CAM). Texts on oncologists' websites, showed high complexity according to readability analysis using LIX score as opposed to those on NMPs websites that showed medium complexity. Only small difference of quality of websites between both groups could be detected. CONCLUSION Methods not acknowledged by evidence-based medicine as well as methods at risk for interaction with conventional cancer therapy but also treatment offers with potential benefits for cancer patients were found on NMPs websites. PRACTICE IMPLICATIONS As evidence-based CAM methods can be a useful support of cancer treatment, risk of herb drug interactions can be minimized by oncologists offering reasonable CAM.
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Affiliation(s)
- Henriette Schallock
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Berit Bartmann
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Christian Keinki
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Jutta Huebner
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
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Yang W, Hao X, Qu J, Wang L, Zhang M, Jiang Y, Liu Y. Collaborative networks and thematic trends of research on the application of complementary and alternative medicine in cancer patients: A bibliometric analysis. Complement Ther Clin Pract 2019; 37:58-67. [PMID: 31487580 DOI: 10.1016/j.ctcp.2019.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND and purpose: Complementary and Alternative Medicine(CAM) has been greatly used in cancer patients. This research aimed to explore the research priorities of CAM for cancer patient's treatment. METHODS Web of Science(WoS), HistCite, BibExcel, GunnMap and VOSviewer were used to extract and visualize information. RESULTS 2768 articles published in 789 journals were indexed in the WoS from 1989 to 2018. The USA(n = 1009) and Technion-Israel Institute Technology(n = 58) were the most prolific country and institution, respectively. Keywords co-occurrence analysis indicated that the research hotspots around the world formed five clusters, so did the author co-citation analysis. The research priorities of the top-five countries, the top-three prolific authors and the co-citation core authors were also discussed, which reveals the differences and similarities among them. CONCLUSION This study delineates a framework for better understanding the situational use of CAM in cancer patients, which could help health care workers to prioritize and organize future research.
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Affiliation(s)
- Weimei Yang
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR China
| | - Xinying Hao
- College of Chemistry and Molecular Sciences, Wuhan University, Wuhan, 430072, PR China
| | - Jia Qu
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR China
| | - Lan Wang
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR China
| | - Meng Zhang
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR China
| | - Yun Jiang
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR China
| | - Yu Liu
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR China.
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Complementary medicine use during cancer treatment and potential herb-drug interactions from a cross-sectional study in an academic centre. Sci Rep 2019; 9:5078. [PMID: 30911084 PMCID: PMC6434040 DOI: 10.1038/s41598-019-41532-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 03/12/2019] [Indexed: 12/21/2022] Open
Abstract
Complementary medicine (CM) is used by one third to one half of cancer patients throughout the world. The objective of this study was to describe the prevalence of CM use and the potential for interactions with cancer treatments in an academic oncology centre. A cross-sectional study was conducted among patients undergoing current cancer treatment. Among 132 included patients, 56% had used CM since their cancer diagnosis and 45% were using CM during cancer treatment at the time of the survey. The main CM used were green tea (35%), herbal tea (35%), homeopathy (27%), dietary supplements (27%), and herbal medicines (27%). A small majority of patients (58%) spontaneously mentioned the use of CM to their oncologist. Of 42 identified combinations of concomitant use of biologically based CM and anticancer agents among the study patients, the potential for pharmacokinetic interactions of clinical relevance was not expected in 17 combinations (40%), hypothetical and deemed unlikely in 23 (55%), and of probable low clinical relevance in 2 (5%). Considering the high prevalence of CM use, active enquiries should be made by healthcare professionals to detect symptoms that may relate to CM tolerance and effects or that suggest interactions between CM and cancer treatments.
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Complementary medicine in radiation oncology : German health care professionals' current qualifications and therapeutic methods. Strahlenther Onkol 2018; 194:904-910. [PMID: 30073483 DOI: 10.1007/s00066-018-1345-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/19/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Recently, complementary and alternative medicine (CAM) has moved more into the focus, and cancer societies such as the German Cancer Society (Deutsche Krebsgesellschaft, DKG) have established working groups to develop a guideline for CAM. The present work aims to evaluate the acceptance of CAM in the whole radiation oncology community. METHODS We conducted an online survey on CAM and sent the modified questionnaire that was successfully distributed to all members of the Research Group on Gynecological Oncology (Arbeitsgemeinschaft Gynakologische Onkologie, AGO) of the DKG in 2014 to the members of the German Society of Radiation Oncology (Deutsche Gesellschaft für Radioonkologie und Strahlentherapie, DEGRO). The survey consisted of 17 questions regarding personal information and current CAM guidelines within the workplace/clinic. RESULTS A total of 143 members participated. Of these, 12% had some CAM qualification. For hematological cancer in 35% and in up to 76% for breast cancer, CAM treatment is offered in German radiation oncology facilities, mainly due to fatigue symptoms. CAM is part of routine treatment in 32.2%, 22.0% are planning to incorporate it. Most physicians advise patients to partake in sports activities and recommend dietary supplements and nutritional counseling. The cost of CAM treatment is fully covered in 9.8% of all participating facilities. CONCLUSION Today, CAM is integrated into cancer care; however, skepticism regarding its effect still exists. Evidence-based results must be generated to convince physicians of the effectiveness of CAM methods. CAM qualifications must be included in physicians' training to improve their understanding and counseling regarding CAM options in cancer care.
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Erickson N, Paradies K, Buchholz D, Huebner J. Nutrition care of cancer patients-A survey among physicians and nurses. Eur J Cancer Care (Engl) 2018; 27:e12855. [DOI: 10.1111/ecc.12855] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- N. Erickson
- Comprehensive Cancer Center; Ludwig-Maximilian-University Munich (CCC LMU); Munich Germany
| | - K. Paradies
- Working Group KOK (Conference of Oncological Nurses of the German Cancer Society); Berlin Germany
| | - D. Buchholz
- School for Dietetics; University Medical Center of the Johannes Gutenberg University Mainz; Mainz Germany
| | - J. Huebner
- Medizinische Klinik II; Universitätsklinikum Jena; Jena Germany
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Firkins R, Eisfeld H, Keinki C, Buentzel J, Hochhaus A, Schmidt T, Huebner J. The use of complementary and alternative medicine by patients in routine care and the risk of interactions. J Cancer Res Clin Oncol 2018; 144:551-557. [DOI: 10.1007/s00432-018-2587-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 01/16/2018] [Indexed: 10/18/2022]
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15
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Complementary and alternative medicine in radiation oncology. Strahlenther Onkol 2017; 193:419-425. [DOI: 10.1007/s00066-017-1101-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 01/06/2017] [Indexed: 01/23/2023]
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16
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Loquai C, Dechent D, Garzarolli M, Kaatz M, Kaehler KC, Kurschat P, Meiss F, Micke O, Muecke R, Muenstedt K, Stein A, Nashan D, Stoll C, Schmidtmann I, Huebner J. Use of complementary and alternative medicine: A multicenter cross-sectional study in 1089 melanoma patients. Eur J Cancer 2017; 71:70-79. [DOI: 10.1016/j.ejca.2016.10.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/01/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
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Use of complementary and alternative medicine by patients with cancer: a cross-sectional study at different points of cancer care. Med Oncol 2016; 33:78. [DOI: 10.1007/s12032-016-0790-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 06/04/2016] [Indexed: 10/21/2022]
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Schmidt A, Kowalski C, Pfaff H, Wesselmann S, Wirtz M, Ernstmann N. The Influence of Health Literacy on Information Needs Among Women Newly Diagnosed With Breast Cancer, With Special Reference to Employment Status. JOURNAL OF HEALTH COMMUNICATION 2015; 20:1177-84. [PMID: 26086892 DOI: 10.1080/10810730.2015.1018626] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Breast cancer is the most frequent type of malignancy among women throughout Germany. The present analysis aimed to identify information needs and aspects of health literacy in women of working age newly diagnosed with breast cancer. PIAT is a prospective multicenter cohort study in which patients were asked about their information needs at 3 assessment points: postoperatively, after 10 weeks, and after 40 weeks. The present analysis includes data from 1,344 female patients after the first assessment point. In addition to descriptive analyses, logistic regression analyses were calculated. Results of the study show that, in addition to sociodemographic characteristics, the level of health literacy and the employment status of the women who responded to the inquiry influence specific unmet information needs. Most frequently mentioned unmet information needs relate to supplementary naturopathy, nutrition, health-promoting measures, and working during breast cancer. Patients with breast cancer are often provided with large amounts of information during their hospital stay indicating this information is not targeted to patient needs and may be overwhelming. The results show that information on everyday life needs such as supplementary naturopathy were important for the sample newly diagnosed with breast cancer. Employed women in particular have questions regarding working during cancer or tax relief.
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Affiliation(s)
- Anna Schmidt
- a Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Science and Faculty of Medicine , University of Cologne , Cologne , Germany
| | | | - Holger Pfaff
- a Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Science and Faculty of Medicine , University of Cologne , Cologne , Germany
| | | | - Markus Wirtz
- c Institute for Psychology , University of Education , Freiburg , Germany
| | - Nicole Ernstmann
- a Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Science and Faculty of Medicine , University of Cologne , Cologne , Germany
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Huebner J, Ebel M, Muenstedt K, Micke O, Prott FJ, Muecke R, Hoppe A. A lecture program on complementary and alternative medicine for cancer patients--evaluation of the pilot phase. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:340-3. [PMID: 25056420 DOI: 10.1007/s13187-014-0706-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
About half of all patients with cancer use complementary or alternative medicine (CAM). In 2013, we started a lecture program for patients, followed by evidence-based recommendations on counseling on CAM. These recommendations have been published before by this working group. The aim of the program is to provide scientific facts on the most often used CAM methods in standardized presentations which help patients discuss the topic with their oncologists and support shared decision making. The article presents the evaluation of the pilot phase. Participants received a standardized questionnaire before the start of the lecture. The questionnaire comprises four parts: demographic data, data concerning experience with CAM, satisfaction with the lecture, and needs for further information on CAM. In 2013, seven lectures on CAM were given in cooperation with regional branches of the German Cancer Society in several German states. Four hundred sixty patients and relatives took part (75% females and 16% males). Forty-eight percent formerly had used CAM. Most often named sources of information on CAM were print media (48%) and the Internet (37%). Most participants rated additional written information valuable. About one third would like to have an individual consultation concerning CAM. A standardized presentation of evidence on CAM methods most often used, together with recommendations on the self-management of symptoms, is highly appreciated. The concept of a highly interactive lecture comprising is feasible and if presented in lay terminology, adequate. In order to give additional support on the topic, written information should be provided as the first step.
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Affiliation(s)
- J Huebner
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany,
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Münstedt K, Vogt T, Rabanus ME, Hübner J. Wishes and beliefs of cancer patients regarding counseling on integrative medicine. ACTA ACUST UNITED AC 2015; 9:416-20. [PMID: 25759624 DOI: 10.1159/000368428] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Today there is an agreement on how patients should be counseled regarding integrative medicine in oncology. In order to better meet the patients' demands, we investigated additional beliefs and wishes related to these topics. PATIENTS AND METHODS Patients in 2 locations were asked to complete an assessment form regarding their wishes in relation to counseling on integrative medicine. RESULTS Based on 404 returned assessment forms, we found that most patients wished to be counseled on integrative medicine by oncologists but also wanted to be treated by them with such methods. Oncologists received the best ratings regarding credibility, oncological competence, sympathy for patients, and honesty. Only with regard to time for patients did health practitioners receive better ratings. Physical exercise, balanced diets, and psycho-oncological support were the methods mainly recommended by physicians. Health practitioners mainly recommended taking mistletoe extracts, trace elements, and immunostimulants. CONCLUSION It may be hypothesized from this work that the physicians' leading role in promoting integrative medicine in the field of oncology - which contrasts with findings in other countries - is perhaps based on the patients' desire to be treated and counseled by physicians, especially oncologists.
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Affiliation(s)
- Karsten Münstedt
- Department of Obstetrics and Gynecology, Justus-Liebig-University of Giessen, Germany
| | - Tobias Vogt
- Department of Obstetrics and Gynecology, Justus-Liebig-University of Giessen, Germany
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Ebel MD, Rudolph I, Keinki C, Hoppe A, Muecke R, Micke O, Muenstedt K, Huebner J. Perception of cancer patients of their disease, self-efficacy and locus of control and usage of complementary and alternative medicine. J Cancer Res Clin Oncol 2015; 141:1449-55. [DOI: 10.1007/s00432-015-1940-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 02/12/2015] [Indexed: 11/30/2022]
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Huebner J, Prott FJ, Micke O, Muecke R, Senf B, Dennert G, Muenstedt K. Online survey of cancer patients on complementary and alternative medicine. Oncol Res Treat 2014; 37:304-8. [PMID: 24903760 DOI: 10.1159/000362616] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 03/27/2014] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Complementary and alternative medicine (CAM) is often used by cancer patients, yet, communication with the oncologist is poor. The objective of our study was to gather information on patients' usage of CAM, source of information, and aims, in order to derive strategies to improve the communication between physicians and patients on this topic. MATERIALS AND METHODS An online survey was conducted by linking a standardized questionnaire to the largest internet portal for cancer patients in Germany. The questionnaire addresses CAM usage, disclosure to physicians, source of information, objectives for using CAM, and perceived reasons for cancer. RESULTS Of 170 participants, 77% were currently using CAM. Disclosure to a physician was rather high with 63% having informed their oncologist. Asked whether the oncologist took time to discuss CAM, 74% answered 'no'. Most frequently used are biologically based therapies, relaxation techniques, prayer, and meditation. Most patients want to reduce side effects, boost their immune system, and get active. Almost half the participants had positive experiences with some type of CAM before they fell ill. CONCLUSION Understanding patients' concepts of the etiology of cancer and accepting their goals for using CAM may help oncologists communicate with their patients and guide them to a safe use of CAM.
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Affiliation(s)
- Jutta Huebner
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J. W. Goethe University, Frankfurt/M., Germany
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