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Freeman JQ, Sheade JB, Zhao F, Olopade OI, Huo D, Nanda R. Racial differences in familiarity, interest, and use of integrative medicine among patients with breast cancer. Breast Cancer Res Treat 2024; 207:343-359. [PMID: 38748087 PMCID: PMC11297149 DOI: 10.1007/s10549-024-07363-1] [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: 01/29/2024] [Accepted: 04/24/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE Integrative medicine (IM) has received the American Society of Clinical Oncology's endorsement for managing cancer treatment-related side effects. Little is known about racial differences in familiarity, interest, and use of IM among patients with breast cancer. METHODS Patients with breast cancer enrolled in the Chicago Multiethnic Epidemiologic Breast Cancer Cohort were surveyed regarding familiarity, interest, and use of acupuncture, massage, meditation, music therapy, and yoga. Familiarity and interest, measured by a 5-point Likert scale, was modeled using proportional odds. Use was self-reported, and modeled using binary logistic regression. RESULTS Of 1,300 respondents (71.4% White and 21.9% Black), Black patients were less likely than White patients to be familiar with acupuncture (aOR 0.60, 95% CI 0.41-0.87); there were no racial differences in familiarity with massage, meditation, music therapy, and yoga. While there were no differences in interest in acupuncture between Black and White patients (aOR 1.12, 95% CI 0.76-1.65), Black patients were more interested in massage (aOR 1.86, 95% CI 1.25-2.77), meditation (aOR 2.03, 95% CI 1.37-3.00), music therapy (aOR 2.68, 95% CI 1.80-3.99), and yoga (aOR 2.10, 95% CI 1.41-3.12). Black patients were less likely than White patients to have used acupuncture (aOR 0.49, 95% CI 0.29-0.84); but there were no racial differences in use of massage, meditation, music therapy, and yoga. CONCLUSION Black patients expressed more interest in IM than their White counterparts; there were no racial differences in IM use, except lower acupuncture use among Black patients. A breast program focused on equity should provide access to these services for patients with breast cancer.
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Affiliation(s)
- Jincong Q Freeman
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
- Cancer Prevention and Control Program, UChicago Medicine Comprehensive Cancer Center, Chicago, IL, USA
- Center for Health and the Social Sciences, The University of Chicago, Chicago, IL, USA
| | - Jori B Sheade
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, IL, USA
- Department of Hematology and Medical Oncology, Lake Forest Hospital Cancer Center, Northwestern Medicine, Lake Forest, IL, USA
| | - Fangyuan Zhao
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | - Olufunmilayo I Olopade
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, IL, USA
- Center for Clinical Cancer Genetics & Global Health, The University of Chicago, Chicago, IL, USA
| | - Dezheng Huo
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
- Center for Clinical Cancer Genetics & Global Health, The University of Chicago, Chicago, IL, USA
| | - Rita Nanda
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, IL, USA.
- Center for Clinical Cancer Genetics & Global Health, The University of Chicago, Chicago, IL, USA.
- Department of Medicine, The University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
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Ng JY, Kochhar J, Cramer H. Oncology researchers' and clinicians' perceptions of complementary, alternative, and integrative medicine: an international, cross-sectional survey. Support Care Cancer 2024; 32:615. [PMID: 39196463 PMCID: PMC11358342 DOI: 10.1007/s00520-024-08785-9] [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: 03/03/2024] [Accepted: 08/02/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND Complementary, alternative, and integrative medicine (CAIM) has become an increasingly popular supportive therapy option for patients with cancer. The objective of this study was to investigate how researchers and clinicians in the oncology field perceive CAIM. METHODS We conducted an online, anonymous, cross-sectional survey for researchers and clinicians who have published their work in oncology journals that are indexed in MEDLINE. The link to the survey was sent to 47, 991 researchers and clinicians whose contact information was extracted from their publications. The survey included various multiple-choice questions, and one open-ended question at the end to allow for any additional comments. RESULTS 751 respondents completed the survey, and they mostly identified themselves as researchers (n = 329, 45.13%), or as both researchers and clinicians (n = 332, 45.45%) in the field of oncology. Over half of the respondents perceive mind-body therapies (n = 354, 54.97%) to be the most promising CAIM category with regards to the prevention, treatment, and/or management of diseases related to oncology, and many respondents agreed that most CAIM therapies are safe (n = 218, 37.39%), and that clinicians should receive training on CAIM therapies via formal (n = 225, 38.59%) and supplemental education (n = 290, 49.83%). However, many respondents were unsure when asked if most CAIM therapies are effective (n = 202, 34.77%). CONCLUSIONS The findings from this study demonstrated great current interest in the use of CAIM in oncology. This information can serve as a foundation for conducting additional research and creating customized educational materials for researchers and clinicians in oncology.
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Affiliation(s)
- Jeremy Y Ng
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany.
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany.
| | - Jassimar Kochhar
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - Holger Cramer
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
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Sun X, Huang W, Yin D, Zhao X, Cheng X, Zhang J, Hao Y. Nicotinamide riboside activates SIRT3 to prevent paclitaxel-induced peripheral neuropathy. Toxicol Appl Pharmacol 2024; 491:117066. [PMID: 39128506 DOI: 10.1016/j.taap.2024.117066] [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: 04/23/2024] [Revised: 07/27/2024] [Accepted: 08/07/2024] [Indexed: 08/13/2024]
Abstract
Paclitaxel (PTX) is a microtubule stabilizer that disrupts the normal cycle of microtubule depolymerization and repolymerization, leading to cell cycle arrest and cancer cell death. It is commonly used as a first-line chemotherapeutics for various malignancies, such as breast cancer, non-small cell lung cancer, and ovarian cancer. However, PTX chemotherapy is associated with common and serious side effects, including chemotherapy-induced peripheral neuropathy (CIPN). As cancer treatment advances and survival rates increase, the impact of CIPN on patients' quality of life has become more significant. To date, there is no effective treatment strategy for CIPN. Surtuin3 (SIRT3) is a nicotinamide adenine dinucleotide (NAD+) dependent protein deacetylase located on mitochondria. It transfers the acetyl group of the lysine side chain of acetylated substrate proteins to NAD+, producing deacetylated proteins to regulate mitochondrial energy metabolic processes. SIRT3 has been found to play an important role in various diseases, including aging, neurodegenerative diseases, cancer, heart disease, metabolic diseases, etc. However, the role of SIRT3 in CIPN is still unknown. This study found for the first time that activating SIRT3 helps to improve paclitaxel-induced CIPN. Nicotinamide riboside (NR) can protect dorsal root ganglion (DRG) mitochondria against oxidative damage caused by paclitaxel through activating SIRT3-MnSOD2 and SIRT3-Nrf2 pathway. Moreover, NR can enhance the anticancer activity of paclitaxel. Together, our research provides new strategy and candidate drug for the treatment of CIPN.
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Affiliation(s)
- Xiaohan Sun
- School of Pharmacy, Shenzhen University Medical School, Shenzhen University, Shenzhen 518055, China
| | - Weiting Huang
- School of Pharmacy, Shenzhen University Medical School, Shenzhen University, Shenzhen 518055, China
| | - Dejin Yin
- School of Pharmacy, Shenzhen University Medical School, Shenzhen University, Shenzhen 518055, China
| | - Xi Zhao
- School of Pharmacy, Shenzhen University Medical School, Shenzhen University, Shenzhen 518055, China
| | - Xiaoling Cheng
- School of Pharmacy, Shenzhen University Medical School, Shenzhen University, Shenzhen 518055, China
| | - Jin Zhang
- School of Pharmacy, Shenzhen University Medical School, Shenzhen University, Shenzhen 518055, China.
| | - Yue Hao
- School of Pharmacy, Shenzhen University Medical School, Shenzhen University, Shenzhen 518055, China.
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Colacurci N, Filardi PP, Chiantera A, Colao A, Pasqualetti P, Lenzi A. Sharing the multidisciplinary clinical approach to peri- and postmenopausal women: A Delphi consensus among Italian gynecologists, endocrinologists, and cardiologists for an integrated and optimal approach to clinical practice. Int J Gynaecol Obstet 2024; 166:682-691. [PMID: 38404042 DOI: 10.1002/ijgo.15448] [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: 12/21/2023] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE The critical phase of perimenopausal period is marked by a reduction in estrogen levels, leading to various clinical issues (vasomotor and neurodegenerative symptoms, increased osteoporosis risk and cardiovascular risk). These complex clinical scenarios pose challenges to clinicians in providing the right support for diagnosis and treatment. A group of Italian cardiologists, endocrinologists, and gynecologists conducted a survey among expert colleagues to assess consensus on controversial issues and best practices for screening and treating peri- and postmenopausal women. METHODS The Delphi methodology was used to analyze responses from a qualitative expert panel comprising 25 cardiologists, 25 endocrinologists, and 25 gynecologists, selected nationwide. Two consecutive questionnaires were proposed between February and May 2023. Agreement among experts was assessed following the Delphi method as developed by the RAND Corporation. RESULTS The results of this Delphi Consensus have been shared by the leading scientific societies: Italian Society of Cardiology, Italian Society of Endocrinology, Italian Society of Gynecology and Obstetrics, and Italian Hospital Obstetricians Gynecologists Association. CONCLUSIONS The experts highlighted comorbidities and hormone deprivation as crucial clinical problems to be evaluated in perimenopausal women, requiring investigation from cardiovascular and endocrinologic perspectives to assess cardiovascular risk, involving the use of BMI, standard blood samples, endocrine-metabolic tests, and lifestyle assessment, particularly in women with higher cardiovascular and metabolic risks candidates for hormone replacement therapy (HRT). The experts also agreed on the benefits of HRT in improving lipid metabolism and reducing insulin resistance, thereby mitigating the metabolic risks associated with menopause. However, this therapy should be tailored considering individual women's comorbidities and thrombotic risk.
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Affiliation(s)
- Nicola Colacurci
- Department of Obstetrics and Gynecology, Italian Society of Gynecology and Obstetrics, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pasquale Perrone Filardi
- Department of Advanced Biomedical Sciences, Italian Society of Cardiology, Federico II University of Naples, Naples, Italy
| | - Antonio Chiantera
- Italian Hospital Obstetricians Gynecologists Association, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Endocrinology, Diabetology and Andrology Unit, Italian Society of Endocrinology, Federico II University of Naples, Naples, Italy
| | - Patrizio Pasqualetti
- Department of Public Health and Infectious Disease, Sapienza Rome University, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza Rome University, Rome, Italy
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Blockhuys S, Wittung-Stafshede P. Yoga as a Complementary Therapy for Cancer Patients: From Clinical Observations to Biochemical Mechanisms. Complement Med Res 2024:1-13. [PMID: 38991506 DOI: 10.1159/000540213] [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: 02/14/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Integrative oncology combines conventional and complementary, or integrative, therapies for a holistic treatment of cancer patients. Yoga is increasingly used as a complementary therapy for cancer patients, but there is no direct evidence for its effect on cancer pathophysiology like tumor response, or patient outcome like overall survival. SUMMARY In this narrative review, we present in detail published studies from randomized clinical trials on complementary yoga therapy for cancer patients, including details about the biochemical mechanisms involved. Medicinal hatha yoga with breathing, postures, meditation, and relaxation enhances the quality of life of cancer patients by providing both psychological and physiological health benefits, highlighting the interconnectedness of mind and body. Yoga therapy reduces stress levels improving heart rate variability, leading to changes in hormonal regulation (e.g., cortisol), reduced oxidative stress, and improved immune function with reduced inflammation. Still, the biochemical effects of yoga on the cancer disease itself are unrevealed. KEY MESSAGES More clinical and basic research is needed for further establishment of yoga as complementary therapy in oncology.
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Affiliation(s)
- Stéphanie Blockhuys
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Messeha SS, Zarmouh NO, Maku H, Gendy S, Yedjou CG, Elhag R, Latinwo L, Odewumi C, Soliman KFA. Prognostic and Therapeutic Implications of Cell Division Cycle 20 Homolog in Breast Cancer. Cancers (Basel) 2024; 16:2546. [PMID: 39061186 PMCID: PMC11274456 DOI: 10.3390/cancers16142546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Cell division cycle 20 homolog (CDC20) is a well-known regulator of cell cycle progression. Abnormal expression of CDC20 leads to mitotic defects, which play a significant role in cancer development. In breast cancer (BC), CDC20 has been identified as a biomarker that has been linked to poor patient outcomes. In this study, we investigated the association of CDC20 with BC prognosis and immune cell infiltration by using multiple online databases, including UALCAN, KM plotter, TIMER2.0, HPA, TNM-plot, bc-GenExMiner, LinkedOmics, STRING, and GEPIA. The results demonstrate that BC patients have an elevated CDC20 expression in tumor tissues compared with the adjacent normal tissue. In addition, BC patients with overexpressed CDC20 had a median survival of 63.6 months compared to 169.2 months in patients with low CDC20 expression. Prognostic analysis of the examined data indicated that elevated expression of CDC20 was associated with poor prognosis and a reduction of overall survival in BC patients. These findings were even more prevalent in chemoresistance triple-negative breast cancer (TNBC) patients. Furthermore, the Gene Set Enrichment Analysis tool indicated that CDC20 regulates BC cells' cell cycle and apoptosis. CDC20 also significantly correlates with increased infiltrating B cells, CD4+ T cells, neutrophils, and dendritic cells in BC. In conclusion, the findings of this study suggest that CDC20 may be involved in immunomodulating the tumor microenvironment and provide evidence that CDC20 inhibition may serve as a potential therapeutic approach for the treatment of BC patients. In addition, the data indicates that CDC20 can be a reliable prognostic biomarker for BC.
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Affiliation(s)
- Samia S. Messeha
- College of Science and Technology, Florida A&M University, Tallahassee, FL 32307, USA; (S.S.M.); (C.G.Y.); (R.E.); (L.L.)
- College of Pharmacy & Pharmaceutical Sciences, Institute of Public Health, Florida A&M University, New Pharmacy Building, 1520 ML King Blvd, Tallahassee, FL 32307, USA
| | - Najla O. Zarmouh
- Faculty of Medical Technology-Misrata, Libyan Ministry of Technical & Vocational Education, Misrata LY72, Libya;
| | - Henrietta Maku
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX 77030, USA;
| | - Sherif Gendy
- School of Allied Health Sciences, Florida A&M University, Tallahassee, FL 32307, USA;
| | - Clement G. Yedjou
- College of Science and Technology, Florida A&M University, Tallahassee, FL 32307, USA; (S.S.M.); (C.G.Y.); (R.E.); (L.L.)
| | - Rashid Elhag
- College of Science and Technology, Florida A&M University, Tallahassee, FL 32307, USA; (S.S.M.); (C.G.Y.); (R.E.); (L.L.)
| | - Lekan Latinwo
- College of Science and Technology, Florida A&M University, Tallahassee, FL 32307, USA; (S.S.M.); (C.G.Y.); (R.E.); (L.L.)
| | - Caroline Odewumi
- College of Science and Technology, Florida A&M University, Tallahassee, FL 32307, USA; (S.S.M.); (C.G.Y.); (R.E.); (L.L.)
| | - Karam F. A. Soliman
- College of Pharmacy & Pharmaceutical Sciences, Institute of Public Health, Florida A&M University, New Pharmacy Building, 1520 ML King Blvd, Tallahassee, FL 32307, USA
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Bourgognon F, Bechet D, Huin-Schohn C, Strelow A, Demarche L, Guillou M, Adam V, Fall E, Omorou AY. A mixed method feasibility and acceptability study of a flexible intervention based on acceptance and commitment therapy for patients with cancer. Front Psychol 2024; 15:1409308. [PMID: 39021646 PMCID: PMC11252038 DOI: 10.3389/fpsyg.2024.1409308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Propose This study aimed to propose an innovative, open, and circular program that combines acceptance and commitment therapy (ACT) and mindfulness practices. We assessed its feasibility, acceptability, and first signs of its effect on psychological wellbeing in cancer support treatment. Methods A single-center, single-arm, uncontrolled study was performed. Forty adult patients with non-metastatic prostate or breast cancer, newly diagnosed or undergoing treatment (chemotherapy, radiotherapy, hormone therapy), were recruited. Three cycles of three MAEva program sessions (MAEva: Mindfulness meditation, Acceptance, and Commitment to values program) over nine consecutive weeks were proposed. During the total of 12 weeks of follow-up, after attending the first session, patients were free to attend subsequent sessions. Results Adherence to the study was high, with participation in an average of 6.8 out of nine sessions. A total of eight patients attended all sessions over the three cycles, and 90% participated in at least one cycle. Furthermore, attendance was associated with a statistically significant improvement in Quality of Life (QoL). Each additional session was associated with a mean increase in overall QoL score of more than one point (β = 1.09 [0.13; 2.04], p = 0.02). The fatigue dimensions decreased with session attendance: physical (β = -2.24 [-3.63; -0.85]), emotional (β = -2.60 [-4.11; -1.09]), and interference with daily life (β = -2.33 [-3.95; -0.72]). The qualitative section demonstrated that patients learned skills and shared their ability to "let go". Patients rated the degree of importance of the program at 8.36/10 (SD ± 1.64). Conclusion This study highlights the feasibility and acceptability of an original program that combines ACT and mindfulness practices in cancer patients. Future studies are required to demonstrate the efficacy of the MAEVA program. The MAEva pilot study is registered with ClinicalTrials.gov under the identifier NCT04751201. Clinical trial registration https://classic.clinicaltrials.gov/ct2/show/NCT04751201, identifier [NCT04751201].
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Affiliation(s)
- François Bourgognon
- Department of Supportive Care in Oncology, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | - Denise Bechet
- Departement of Clinical Research, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | - Cécile Huin-Schohn
- Departement of Clinical Research, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | | | - Laëtitia Demarche
- Department of Supportive Care in Oncology, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | - Mireille Guillou
- Department of Supportive Care in Oncology, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | - Virginie Adam
- Department of Supportive Care in Oncology, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | - Estelle Fall
- Université de Lorraine, Inserm, INSPIIRE, Nancy, France
| | - Abdou Yacoubou Omorou
- Université de Lorraine, Inserm, INSPIIRE, Nancy, France
- CIC-1433 Clinical Epidemiology, Nancy, France
- The French National Platform Quality of Life and Cancer, Nancy, France
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Theunissen I, Bagot JL. Supportive cancer care: is integrative oncology the future? Curr Opin Oncol 2024; 36:248-252. [PMID: 38842016 DOI: 10.1097/cco.0000000000001027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
PURPOSE OF REVIEW Nearly half of cancer patients use complementary therapies alongside the conventional cancer treatment. This clinical reality is a challenge for the medical team mainly to guarantee patient's safety. The evolution from Supportive Care to Integrative oncology is taking shape. RECENT FINDINGS Integrative oncology, a new field in cancer care, combines conventional supportive care and validated complementary approaches. The first part of this review is to highlight the process of validation of one of the most popular complementary medicines among European cancer patients: homeopathy. It seems to be a well tolerated and useful complementary approach in integrative cancer care. The second part shows through the example of stage IV lung cancer the transition from conventional supportive care to integrative oncology with a benefit for their quality of life and survival. SUMMARY The future of supportive cancer care seems to lead towards a move from coexistence of conventional care and complementary approaches to a combination of both in integrative oncology. This would require new skills among caregivers, specific academic training and adapted studies. Further research is needed to highlight the benefits in the specific field of integrative cancer care.
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Rogge AA, Helmer SM, Icke K, Witt CM. Effects of training oncology physicians advising patients on complementary and integrative therapies on patient-reported outcomes: 2-year follow-up of the multi-center, cluster-randomized KOKON-KTO study. Cancer Med 2024; 13:e70008. [PMID: 39031953 PMCID: PMC11259559 DOI: 10.1002/cam4.70008] [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: 03/12/2024] [Revised: 06/22/2024] [Accepted: 06/30/2024] [Indexed: 07/22/2024] Open
Abstract
PURPOSE Many cancer patients wish for complementary and integrative medicine (CIM) consultations led by their oncology physician. Within the KOKON-KTO study, oncology physicians in the intervention group were trained in a blended learning to provide CIM consultations to their cancer patients in addition to distributing a leaflet about CIM websites. Control oncology physicians only distributed the leaflet. The training showed positive effects on the patient-level. As of now, no consistent evidence exists on the long-term effects of such one-time-only CIM consultation during cancer treatment. METHODS In the KOKON-KTO follow-up study, cancer patients previously participating in the KOKON-KTO study (intervention group:IG and control group: CG) received, at least 24 months later, a follow-up questionnaire by post, evaluating long-term effects of the KOKON-KTO consultation using the measures provided in the original study (patient-physician communication (EORTC-QLQ-COMU2), satisfaction with cancer treatment (PS-CaTE), CIM disclosure with healthcare provider (HCP), and need for CIM consultation during cancer therapy). RESULTS In total, 102 cancer patients participated in the follow-up study (IG n = 62; CG n = 40). The overall reponse rate was around 36% (IG: 48.4%; CG: 23.7%). In the follow-up study, differences between groups had increased and were still shown (EORTC-QLQ-COMU26, 0-100 point scale, ≥10-point-group difference) in some subscales: patient's active behavior (in means; IG:73.6 (95% CI, 63.8-83.5); CG:61.1 (95% CI, 52.4-69.8)); clinician-patient relationship (IG:80.9 (95% CI, 71.8-90.0); CG:68.7 (95% CI, 59.3-78.0)). For some outcomes, differences decreased over time (e.g., EORTC-QLQ-COMU26 subscales "takes into account patient's preference" and "corrects misunderstandings"). More patients in the CG used CIM without oncology physicians' knowledge (IG: 13.7%, CG: 24.0%). CONCLUSION This study presents first findings that one-time-only CIM consultations may enhance patient-physican relationship and CIM disclosure long-term. To further support cancer patients' in their wish for CIM consultations, training programs should provide oncology physicians with CIM competencies for different cancer stages including cancer survivors.
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Affiliation(s)
- Alizé A. Rogge
- Department of Psychosomatic Medicine, Center for Patient‐Centered Outcomes ResearchCharité–Universitätsmedizin BerlinBerlinGermany
| | - Stefanie M. Helmer
- Institute of Health and Nursing ScienceCharité–Universitätsmedizin BerlinBerlinGermany
- Institute of Public Health and Nursing ResearchUniversity of BremenBremenGermany
| | - Katja Icke
- Institute for Social Medicine, Epidemiology and Health EconomicsCharité–Universitätsmedizin BerlinBerlinGermany
| | - Claudia M. Witt
- Institute for Social Medicine, Epidemiology and Health EconomicsCharité–Universitätsmedizin BerlinBerlinGermany
- Institute for Complementary and Integrative MedicineUniversity Zurich and University Hospital ZurichZurichSwitzerland
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Giordano F, Rutigliano C, Ugolini C, Iacona E, Ronconi L, Raguseo C, Perillo T, Rosa A, Santoro N, Testoni I. Effect of Music Therapy on Chemotherapy Anticipatory Symptoms in Adolescents: A Mixed Methods Study. J Pain Symptom Manage 2024; 68:e62-e74. [PMID: 38679306 DOI: 10.1016/j.jpainsymman.2024.04.019] [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: 12/19/2023] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION This study explores the feasibility and effects of music therapy on anticipatory nausea and vomiting, stress, pain and quality of life in adolescents undergoing chemotherapy. METHODS This is a single group, quasi-experimental study using pre/post-test design. Participants received four individual sessions of music therapy (MT), led by a certified music therapist. State-Trait-Anxiety Inventory Y-1, and a 0-4 Likert scale for pain, nausea and vomiting were recorded. Heart rate variability (LF/HF) was collected during sessions. PedsQL was collected before and at the end of the trial. Semi-structured interviews were conducted with participants. RESULTS A significant reduction in anxiety, nausea and vomiting, both pre-post single sessions and between different sessions, was observed. A significant increase in LF/HF and PedsQL scores was observed. Relevant themes also emerged from interviews. CONCLUSION Results support the feasibility of introducing music therapy with adolescents undergoing chemotherapy. Perceived stress and psychological/physical wellbeing were improved in participants.
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Affiliation(s)
- Filippo Giordano
- Department of Precision and Regenerative Medicine and Ionian Area (F.G.), University of Bari, Bari, Italy; Pediatric Hemathology-Oncology Unit (F.G., C.R., C.R., A.R., N.S.), University Hospital of Bari, Bari, Italy.
| | - Chiara Rutigliano
- Pediatric Hemathology-Oncology Unit (F.G., C.R., C.R., A.R., N.S.), University Hospital of Bari, Bari, Italy
| | - Caterina Ugolini
- Department of Philosophy (C.U., E.I., I.T.), Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padua, Italy
| | - Erika Iacona
- Department of Philosophy (C.U., E.I., I.T.), Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padua, Italy
| | - Lucia Ronconi
- Computer and Statistical Services, Multifunctional Pole of Psychology (L.R.), University of Padua, Padua, Italy
| | - Celeste Raguseo
- Pediatric Hemathology-Oncology Unit (F.G., C.R., C.R., A.R., N.S.), University Hospital of Bari, Bari, Italy
| | - Teresa Perillo
- Pediatric Hemathology-Oncology Unit (F.G., C.R., C.R., A.R., N.S.), University Hospital of Bari, Bari, Italy
| | - Angarano Rosa
- Pediatric Hemathology-Oncology Unit (F.G., C.R., C.R., A.R., N.S.), University Hospital of Bari, Bari, Italy
| | - Nicola Santoro
- Pediatric Hemathology-Oncology Unit (F.G., C.R., C.R., A.R., N.S.), University Hospital of Bari, Bari, Italy
| | - Ines Testoni
- Department of Philosophy (C.U., E.I., I.T.), Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padua, Italy
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11
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Carlson LE, Tripathy D, Zick SM, Balneaves LG, Lee RT, Greenlee H. The Society for Integrative Oncology-American Society of Clinical Oncology Joint Guidelines on Integrative Therapies for Symptom Management-Overview and Key Recommendations. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:596-601. [PMID: 39052420 DOI: 10.1089/jicm.2024.0452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Affiliation(s)
- Linda E Carlson
- Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Debu Tripathy
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Suzanna M Zick
- Departments of Family Medicine and Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | | | - Richard T Lee
- Departments of Supportive Care Medicine and Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Heather Greenlee
- Public Health Sciences and Clinical Research Divisions, Fred Hutchinson Cancer Center, Seattle, WA, USA
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12
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Hoenders R, Ghelman R, Portella C, Simmons S, Locke A, Cramer H, Gallego-Perez D, Jong M. A review of the WHO strategy on traditional, complementary, and integrative medicine from the perspective of academic consortia for integrative medicine and health. Front Med (Lausanne) 2024; 11:1395698. [PMID: 38933107 PMCID: PMC11201178 DOI: 10.3389/fmed.2024.1395698] [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: 03/04/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Despite important progress in modern medicine, widely regarded as an indispensable foundation of healthcare in all highly advanced nations and regions, not all patients respond well to available treatments in biomedicine alone. Additionally, there are concerns about side effects of many medications and interventions, the unsustainable cost of healthcare and the low resolution of chronic non-communicable diseases and mental disorders whose incidence has risen in the last decades. Besides, the chronic stress and burnout of many healthcare professionals impairs the therapeutic relationship. These circumstances call for a change in the current paradigm and practices of biomedicine healthcare. Most of the world population (80%) uses some form of traditional, complementary, and integrative medicine (T&CM), usually alongside biomedicine. Patients seem equally satisfied with biomedicine and T&CM, but in the field of T&CM there are also many challenges, such as unsupported claims for safety and/or efficacy, contamination of herbal medicines and problems with regulation and quality standards. As biomedicine and T&CM seem to have different strengths and weaknesses, integration of both approaches may be beneficial. Indeed, WHO has repeatedly called upon member states to work on the integration of T&CM into healthcare systems. Integrative medicine (IM) is an approach that offers a paradigm for doing so. It combines the best of both worlds (biomedicine and T&CM), based on evidence for efficacy and safety, adopting a holistic personalized approach, focused on health. In the last decades academic health centers are increasingly supportive of IM, as evidenced by the foundation of national academic consortia for integrative medicine in Brazil (2017), the Netherlands (2018), and Germany (2024) besides the pioneering American consortium (1998). However, the integration process is slow and sometimes met with criticism and even hostility. The WHO T&CM strategies (2002-2005 and 2014-2023) have provided incipient guidance on the integration process, but several challenges are yet to be addressed. This policy review proposes several possible solutions, including the establishment of a global matrix of academic consortia for IM, to update and extend the WHO T&CM strategy, that is currently under review.
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Affiliation(s)
- Rogier Hoenders
- Dutch Consortium for Integrative Care and Health, Center for Integrative Psychiatry, Lentis, Groningen, The Netherlands and Faculty of Religion, Culture and Society, University of Groningen, Groningen, Netherlands
| | - Ricardo Ghelman
- Brazilian Academic Consortium for Integrative Health and Department of Medicine on Primary Care, Faculty of Medicine Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caio Portella
- Brazilian Academic Consortium for Integrative Health and Universidade de São Paulo, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, São Paulo, Brazil
| | - Samantha Simmons
- Academic Consortium for Integrative Medicine and Health, Lake Oswego, OR, United States
| | - Amy Locke
- Academic Consortium for Integrative Medicine and Health and Department of Family and Preventive Medicine University of Utah Health, Salt Lake City, UT, United States
| | - Holger Cramer
- Academic Consortium for Traditional & Integrative Medicine and Health, Germany and Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany and Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - Daniel Gallego-Perez
- Physical Medicine and Rehabilitation Department University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Miek Jong
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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13
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Gowin K, Muminovic M, Zick SM, Lee RT, Lacchetti C, Mehta A. Integrative Therapies in Cancer Care: An Update on the Guidelines. Am Soc Clin Oncol Educ Book 2024; 44:e431554. [PMID: 38820485 DOI: 10.1200/edbk_431554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
INTRODUCTION ASCO and the Society for Integrative Oncology have collaborated to develop guidelines for the application of integrative approaches in the management of anxiety, depression, fatigue and use of cannabinoids and cannabis in patients with cancer. These guidelines provide evidence-based recommendations to improve outcomes and quality of life by enhancing conventional cancer treatment with integrative modalities. METHODS All studies that informed the guideline recommendations were reviewed by an Expert Panel which was made up of a patient advocate, an ASCO methodologist, oncology providers, and integrative medicine experts. Panel members reviewed each trial for quality of evidence, determined a grade quality assessment label, and concluded strength of recommendations. RESULTS Strong recommendations for management of cancer fatigue during treatment were given to both in-person or web-based mindfulness-based stress reduction, mindfulness-based cognitive therapy, and tai chi or qigong. Strong recommendations for management of cancer fatigue after cancer treatment were given to mindfulness-based programs. Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial. The recommended modalities for managing anxiety included Mindfulness-Based Interventions (MBIs), yoga, hypnosis, relaxation therapies, music therapy, reflexology, acupuncture, tai chi, and lavender essential oils. The strongest recommendation in the guideline is that MBIs should be offered to people with cancer, both during active treatment and post-treatment, to address depression. CONCLUSION The evidence for integrative interventions in cancer care is growing, with research now supporting benefits of integrative interventions across the cancer care continuum.
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Affiliation(s)
- Krisstina Gowin
- Division of Hematology Oncology, Department of Medicine, University of Arizona, Tucson, AZ
| | - Meri Muminovic
- Department of Hematology-Oncology, Memorial Cancer Institute, Memorial Healthcare System, Miami, FL
| | - Suzanna M Zick
- Family Medicine and Nutritional Sciences, University of Michigan, Ann Arbor, MI
| | - Richard T Lee
- Departments of Supportive Care Medicine and Medical Oncology, City of Hope Comprehensive Cancer Center, Irvine, CA
| | - Christina Lacchetti
- Senior Clinical Practice Guidelines Methodologist, American Society of Clinical Oncology, Alexandria, VA
| | - Ashwin Mehta
- Memorial Division of Integrative Medicine, Memorial Healthcare System, Hollywood, FL
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Mao H, Jin M, Xie L, Mao N, Shen X, Chen J, Chen X, Mao JJ, Shen X. Infrared laser moxibustion for cancer-related fatigue in breast cancer survivors: a randomized controlled trial. Breast Cancer Res 2024; 26:80. [PMID: 38773552 PMCID: PMC11110353 DOI: 10.1186/s13058-024-01838-1] [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: 06/14/2023] [Accepted: 05/13/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a pervasive, persistent, and distressing symptom experienced by cancer patients, for which few treatments are available. We investigated the efficacy and safety of infrared laser moxibustion (ILM) for improving fatigue in breast cancer survivors. METHODS A three-arm, randomized, sham-controlled clinical trial (6-week intervention plus 12-week observational follow-up) was conducted at a tertiary hospital in Shanghai, China. The female breast cancer survivors with moderate to severe fatigue were randomized 2:2:1 to ILM (n = 56) sham ILM (n = 56), and Waitlist control (WLC)(n = 28) groups. Patients in the ILM and sham ILM (SILM) groups received real or sham ILM treatment, 2 sessions per week for 6 weeks, for a total of 12 sessions. The primary outcome was change in the Brief Fatigue Inventory (BFI) score from baseline to week 6 with follow-up until week 18 assessed in the intention-to-treat population. RESULTS Between June 2018 and July 2021, 273 patients were assessed for eligibility, and 140 patients were finally enrolled and included in the intention-to-treat analysis. Compared with WLC, ILM reduced the average BFI score by 0.9 points (95% CI, 0.3 to 1.6, P = .007) from baseline to week 6, with a difference between the groups of 1.1 points (95% CI, 0.4 to 1.8, P = .002) at week 18. Compared with SILM, ILM treatment resulted in a non-significant reduction in the BFI score (0.4; 95% CI, -0.2 to 0.9, P = .206) from baseline to week 6, while the between-group difference was significant at week 18 (0.7; 95% CI, 0.2 to 1.3, P = .014). No serious adverse events were reported. CONCLUSION While ILM was found to be safe and to significantly reduce fatigue compared with WLC, its promising efficacy against the sham control needs to be verified in future adequately powered trials. TRIAL REGISTRATION Clinicaltrials.gov: NCT04144309. Registered 12 June 2018.
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Affiliation(s)
- Huijuan Mao
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China
| | - Ming Jin
- Shanghai University of Traditional Chinese Medicine, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, 110 Ganhe Road, Shanghai, 200437, China
| | - Lulu Xie
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China
| | - Ni Mao
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China
| | - Xubo Shen
- Shanghai University of Traditional Chinese Medicine, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, 110 Ganhe Road, Shanghai, 200437, China
| | - Junchao Chen
- Institute of Disciplinary Science, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China
| | - Xuefen Chen
- School of Public Health, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China
| | - Jun J Mao
- Bendheim Integrative Medicine Center, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Xueyong Shen
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China.
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15
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Coles CE, Earl H, Anderson BO, Barrios CH, Bienz M, Bliss JM, Cameron DA, Cardoso F, Cui W, Francis PA, Jagsi R, Knaul FM, McIntosh SA, Phillips KA, Radbruch L, Thompson MK, André F, Abraham JE, Bhattacharya IS, Franzoi MA, Drewett L, Fulton A, Kazmi F, Inbah Rajah D, Mutebi M, Ng D, Ng S, Olopade OI, Rosa WE, Rubasingham J, Spence D, Stobart H, Vargas Enciso V, Vaz-Luis I, Villarreal-Garza C. The Lancet Breast Cancer Commission. Lancet 2024; 403:1895-1950. [PMID: 38636533 DOI: 10.1016/s0140-6736(24)00747-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/18/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Affiliation(s)
| | - Helena Earl
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Benjamin O Anderson
- Global Breast Cancer Initiative, World Health Organisation and Departments of Surgery and Global Health Medicine, University of Washington, Seattle, WA, USA
| | - Carlos H Barrios
- Oncology Research Center, Hospital São Lucas, Porto Alegre, Brazil
| | - Maya Bienz
- Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - David A Cameron
- Institute of Genetics and Cancer and Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Wanda Cui
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Prudence A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Reshma Jagsi
- Emory University School of Medicine, Atlanta, GA, USA
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA; Tómatelo a Pecho, Mexico City, Mexico
| | - Stuart A McIntosh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Kelly-Anne Phillips
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | | | | | - Jean E Abraham
- Department of Oncology, University of Cambridge, Cambridge, UK
| | | | | | - Lynsey Drewett
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | | | - Farasat Kazmi
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | | | | | - Dianna Ng
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Szeyi Ng
- The Institute of Cancer Research, London, UK
| | | | - William E Rosa
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | | | | | | | | | | | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
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16
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Kwon KK, Lacey J, Kerin-Ayres K, Heller G, Grant S. Acupuncture for the treatment of the pain-fatigue-sleep disturbance-numbness/tingling symptom cluster in breast cancer survivors: a feasibility trial. Support Care Cancer 2024; 32:332. [PMID: 38713422 PMCID: PMC11076364 DOI: 10.1007/s00520-024-08529-9] [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: 10/04/2023] [Accepted: 04/27/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE Breast cancer survivors following disease-modifying treatment frequently experience multiple-concurrent symptoms (Jansana et al. in Int J Cancer 149(10):1755 1767, 2021), negatively impacting their quality of life and increasing the risk of polypharmacy (Alwhaibi et al. in J Oncol Pharm Pract 26(5):1052 1059, 2020). This study evaluates the feasibility and acceptability of acupuncture for the management of the pain-fatigue-sleep disturbance-numbness/tingling symptom cluster in breast cancer survivors, and investigates relationships between the symptom cluster and Traditional Chinese Medicine (TCM) syndrome diagnosis. METHODS This was a single-arm, pre-test/post-test feasibility trial conducted at Chris O'Brien Lifehouse Hospital, Australia. Breast cancer survivors who completed treatment and experienced clinically significant levels of two or more symptoms (pain, fatigue, sleep disturbance, numbness/tingling) were eligible to participate in the individualized, pragmatic 6-week acupuncture intervention. The primary outcome was feasibility and acceptability. Effectiveness was explored using a symptom cluster mean score. RESULTS Twenty women enrolled in the study over an 11-week period and 90% completed the study. Most women agreed or completely agreed that acupuncture was feasible (85%), acceptable (90%), and appropriate (90%). Both mean and composite symptom cluster scores were significantly reduced (p < 0.001), as were individual symptom scores in fatigue (p < 0.001), sleep disturbance (p = 0.04), and numbness/tingling (p = 0.01). TCM syndromes most closely associated with this symptom cluster were Spleen qi deficiency and Heart fire. No adverse events were reported. CONCLUSION This study demonstrated that acupuncture was safe and feasible, justifying a powered randomized control trial. Preliminary findings suggest beneficial effects of acupuncture for the management of the pain-fatigue-sleep disturbance-numbness/tingling symptom cluster for women with breast cancer. TCM syndromes identified in this trial may be used to guide acupuncture treatment protocols. CLINICAL TRIAL REGISTRATION This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000590763) on 21 April 2022.
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Affiliation(s)
- Ki Kyung Kwon
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
- Chris O'Brien Lifehouse Hospital, Camperdown, NSW, Australia.
| | - Judith Lacey
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- Chris O'Brien Lifehouse Hospital, Camperdown, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | - Kim Kerin-Ayres
- Chris O'Brien Lifehouse Hospital, Camperdown, NSW, Australia
| | - Gillian Heller
- Chris O'Brien Lifehouse Hospital, Camperdown, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | - Suzanne Grant
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- Chris O'Brien Lifehouse Hospital, Camperdown, NSW, Australia
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17
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He Z, Xing L, He M, Sun Y, Xu J, Zhuang H, Guo R, Chen H, Wu K, Dong Q, Yin G, Zhang J, Yu S, Wang X, Zhao R, Qin D. Best acupuncture method for mammary gland hyperplasia: Evaluation of randomized controlled trials and Bayesian network meta-analysis. Heliyon 2024; 10:e28831. [PMID: 38638998 PMCID: PMC11024574 DOI: 10.1016/j.heliyon.2024.e28831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/20/2024] Open
Abstract
Objective To evaluate the effectiveness of different acupuncture treatments for mammary gland hyperplasia (MGH) using a network meta-analysis. Methods Several databases were searched without language restrictions from 2000 to February 2023, including PubMed, Embase, Web of Science, Cochrane Library, China Science and Technology Journal Database, China Biology Medicine Database, Wanfang Database, China National Knowledge Infrastructure Database, and other professional websites and gray literature. Inclusion criteria were adult women diagnosed with MGH; intervention measures included acupuncture and related therapies; the control group was treated with simple drugs; and the research type was a randomized controlled trial (RCT). The primary outcomes were treatment effectiveness and estradiol and progesterone levels. Secondary outcomes were breast lump size and visual analog scale (VAS) score of breast pain. Exclusion criteria were studies unrelated to MGH, incorrect study populations, control measures or interventions, incomplete data, non-RCTs, case reports, and animal experiments. Cochrane tools were used to assess the risk of bias. The R software (x64 version 4.2.1), Review Manager 5.3 software and STATA 16.0 software were used for data analysis. Results Following a rigorous screening process, data extraction, and quality assessment, 48 eligible RCTs encompassing 4,500 patients with MGH and 16 interventions were included. The results indicated that acupuncture, alone or in combination with traditional Chinese or Western medicine, had better therapeutic effects than conventional therapy. In terms of effectiveness, warm needle acupuncture was the best choice (94.6%). Bloodletting pricking was the most effective method (85.7%) for lowering progesterone levels. Bloodletting pricking was the most effective method (98.3%) for lowering estradiol levels. Manual acupuncture combined with traditional Chinese medicine was the most effective (74.5%) treatment to improve the size of the breast lump. Warm needle acupuncture was the most effective (69.8%) in improving the VAS score. Conclusion Acupuncture therapy was more effective in treating MGH than drug therapy alone, and warm needle acupuncture and bloodletting pricking were the two best options. However, larger sample sizes and high-quality RCTs are required.
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Affiliation(s)
- Zhe He
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Liwei Xing
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Ming He
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Yuhuan Sun
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Jinlong Xu
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Haina Zhuang
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Rui Guo
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Hongxi Chen
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Kenan Wu
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Qinzuo Dong
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Guochen Yin
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Junbao Zhang
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Shun Yu
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Xiaoyan Wang
- Department of Acupuncture and Moxibustion, Yuxi Traditional Chinese Medicine Hospital, 53 North Nie er Road, 653100, Yuxi, China
| | - Rong Zhao
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Dongdong Qin
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
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18
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Bahçacı U, Atasavun Uysal S, Erdogan İyigün Z, Ordu Ç, Soybir GR, Ozmen V. Progressive relaxation training in patients with breast cancer receiving aromatase inhibitor therapy-randomized controlled trial. PLoS One 2024; 19:e0301020. [PMID: 38635763 PMCID: PMC11025930 DOI: 10.1371/journal.pone.0301020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/07/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Aromatase inhibitors have positive impacts on the disease-free life of patients with breast cancer. However, their side effects, especially arthralgia, may be experienced by many patients. This study sought to assess the efficacy of Progressive Relaxation Exercises on the prevalent side effects of Aromatase Inhibitors in patients with breast cancer. MATERIALS AND METHODS This clinical trial was conducted with single-blind randomization at a physiotherapy department in a local hospital. Patients who received Aromatase Inhibitor were assigned at random to either the study or control group. The study group (n = 22) performed a Progressive Relaxation Exercises program four days a week for six weeks, while the control group (n = 22) received advice on relaxation for daily life. Data was collected before the intervention and after six weeks. The study's primary endpoint was the Brief Pain Inventory, which was used to measure pain severity. Secondary endpoints included assessments of quality of life and emotional status, which were measured using the Functional Assessment of Chronic Illness Therapy and Hospital Anxiety and Depression scales, respectively. RESULTS The study group exhibited a significant reduction in Pain Severity (p = 0.001) and Pain Interference (p = 0.012) sub-scores. Reduction in Pain Severity (p<0.001) and Patient Pain Experience (p = 0.003) sub-scores was also noted between the groups. Quality of Life and Emotional Status showed no significant variation both within and between the groups (p>0.05). CONCLUSION The study demonstrated that Progressive Relaxation Exercises caused a significant reduction in pain scores among Breast Cancer patients receiving Aromatase Inhibitors. While a decrease in pain during the 6-week period is valuable data, it is necessary to monitor the long-term effects of relaxation techniques.
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Affiliation(s)
- Umut Bahçacı
- Graduate School of Health Sciences, Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | | | | | - Çetin Ordu
- Department of Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Gürsel Remzi Soybir
- Department of General Surgery, Memorial Etiler Health Center, Istanbul, Turkey
| | - Vahit Ozmen
- Breast Health Center, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
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19
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Zhou X, Zhang J, Jiang L, Zhang S, Gu Y, Tang J, Pu T, Quan X, Chi H, Huang S. Therapeutic efficacy of acupuncture point stimulation for stomach cancer pain: a systematic review and meta-analysis. Front Neurol 2024; 15:1334657. [PMID: 38638316 PMCID: PMC11024429 DOI: 10.3389/fneur.2024.1334657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
Purpose In recent years, traditional Chinese medicine has received widespread attention in the field of cancer pain treatment. This meta-analysis is the first to evaluate the effectiveness and safety of acupuncture point stimulation in the treatment of stomach cancer pain. Methods For this systematic review and meta-analysis, we searched PubMed, Web of Science, Cochrane Library, Embase, WANFANG, China National Knowledge Infrastructure (CNKI), and Chinese Journal of Science and Technology (VIP) databases as well as forward and backward citations to studies published between database creation to July 27, 2023. All randomized controlled trials (RCTs) on acupuncture point stimulation for the treatment of patients with stomach cancer pain were included without language restrictions. We assessed all outcome indicators of the included trials. The evidence from the randomized controlled trials was synthesized as the standardized mean difference (SMD) of symptom change. The quality of the evidence was assessed using the Cochrane Risk of Bias tool. This study is registered on PROSPERO under the number CRD42023457341. Results Eleven RCTs were included. The study included 768 patients, split into 2 groups: acupuncture point stimulation treatment group (n = 406), medication control group (n = 372). The results showed that treatment was more effective in the acupuncture point stimulation treatment group than in the medication control group (efficacy rate, RR = 1.63, 95% CI 1.37 to 1.94, p < 0.00001), decreasing in NRS score was greater in acupuncture point stimulation treatment group than in the medication control group (SMD = -1.30, 95% CI -1.96 to -0.63, p < 0.001). Systematic Review Registration https://clinicaltrials.gov/, identifier CRD42023457341.
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Affiliation(s)
- Xuancheng Zhou
- Clinical Medical College, Southwest Medical University, Luzhou, China
| | - Jieying Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Lai Jiang
- Clinical Medical College, Southwest Medical University, Luzhou, China
| | - Shengke Zhang
- Clinical Medical College, Southwest Medical University, Luzhou, China
| | - Yuheng Gu
- Clinical Medical College, Southwest Medical University, Luzhou, China
| | - Jingyi Tang
- Clinical Medical College, Southwest Medical University, Luzhou, China
| | - Tong Pu
- College of Acupuncture and Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China
| | - Xiaomin Quan
- Beijing University of Chinese Medicine Second Affiliated Dong Fang Hospital, Beijing, China
| | - Hao Chi
- Clinical Medical College, Southwest Medical University, Luzhou, China
| | - Shangke Huang
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Grant SJ, Kay S, Lacey J, Kumar S, Kerin-Ayres K, Stehn J, Gonzalez M, Templeton S, Heller G, Cockburn J, Wahlroos S, Malalasekera A, Mak C, Graham S. Feasibility study of a multimodal prehabilitation programme in women receiving neoadjuvant therapy for breast cancer in a major cancer hospital: a protocol. BMJ Open 2024; 14:e080239. [PMID: 38508617 PMCID: PMC10961545 DOI: 10.1136/bmjopen-2023-080239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Neoadjuvant therapy has become a standard treatment for patients with stage II/III HER2 positive and triple negative breast cancer, and in well-selected patients with locally advanced and borderline resectable high risk, luminal B breast cancer. Side effects of neoadjuvant therapy, such as fatigue, cardiotoxicity, neurotoxicity, anxiety, insomnia, vasomotor symptoms, gastrointestinal disturbance as well as a raft of immune-related adverse events, may impact treatment tolerance, long-term outcomes, and quality of life. Providing early supportive care prior to surgery (typically termed 'prehabilitation') may mitigate these side effects and improve quality of life.During our codesign of the intervention, consumers and healthcare professionals expressed desire for a programme that 'packaged' care, was easy to access, and was embedded in their care pathway. We hypothesise that a multimodal supportive care programme including exercise and complementary therapies, underpinned by behavioural change theory will improve self-efficacy, quality of life, readiness for surgery and any additional treatment for women with breast cancer. We seek to explore cardiometabolic, residual cancer burden and surgical outcomes, along with chemotherapy completion (relative dose intensity). This article describes the protocol for a feasibility study of a multimodal prehabilitation programme. METHODS AND ANALYSIS This is a prospective, mixed-method, feasibility study of a multi-modal programme in a hospital setting for 20-30 women with breast cancer receiving neoadjuvant therapy. Primary outcomes are recruitment rate, retention rate, adherence and acceptability. Secondary outcomes include patient reported outcome measures (PROMs), surgical outcomes, length of stay, satisfaction with surgery, chemotherapy completion rates, changes in metabolic markers and adverse events. Interviews and focus groups to understand the experience with prehabilitation and different factors that may affect feasibility of the intervention . The output of this study will be a codesigned, evidence-informed intervention assessed for feasibility and acceptability by women with breast cancer and the healthcare professionals that care for them. ETHICS AND DISSEMINATION The study received ethics approval from the St Vincents Hospital HREC (HREC/2021/ETH12198). Trial results will be communicated to participants, healthcare professionals, and the public via publication and conferences. TRIAL REGISTRATION NUMBER ACTRN12622000584730.
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Affiliation(s)
- Suzanne J Grant
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Shelley Kay
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Judith Lacey
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Sanjeev Kumar
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Kim Kerin-Ayres
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Justine Stehn
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Maria Gonzalez
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Sandra Templeton
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Gillian Heller
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Jane Cockburn
- Patient Advocate, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Sara Wahlroos
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Ashanya Malalasekera
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- School of Medicine, University of Sydney SDN, Sydney, New South Wales, Australia
| | - Cindy Mak
- Surgical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Susannah Graham
- Surgical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
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21
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El-Khoury F, Mino JC, Deschamps N, Lopez C, Menvielle G, Dargent-Molina P. Effectiveness of a community-based multicomponent lifestyle intervention (the ADA programme) to improve the quality of life of French breast cancer survivors: protocol for a pragmatic cluster randomised trial and embedded qualitative study. BMJ Open 2024; 14:e081447. [PMID: 38485475 PMCID: PMC10941123 DOI: 10.1136/bmjopen-2023-081447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/27/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Breast cancer survivors (BCSs) are often faced with multiple mental and physical sequelae and are at increased risk of emotional distress, degraded health-related quality of life (HRQoL), chronic pain and fatigue.Physical activity is strongly associated with improved HRQoL and survival rates; however, adherence rates to recommendations for a healthy lifestyle are seldom satisfactory among BCSs. Also, few studies have examined the effectiveness of multicomponent and personalised interventions that integrate physical activity and motivational techniques to improve the HRQoL of BCS. METHOD AND ANALYSIS "Activité physique adaptée Doublée d'un Accompagnement d'après cancer" (ADA) is an integrated programme of physical activity enriched with a dietary and supportive care approach targeting BCS in the early post-treatment phase. The effectiveness of the ADA intervention will be evaluated using a cluster randomised controlled trial design with two arms (ADA programme vs usual care; 1:1 ratio).The ADA intervention aims to recruit 160 participants and will be implemented by Siel Bleu, a non-profit association specialised in health prevention via adapted physical activity. Measurements will be performed at baseline, 3, 6 and 12 months after the start of the intervention. The primary outcome will be participants' HRQoL, at 12 months measured by the Functional Assessment of Chronic Illness Therapy-Fatigue global score. Secondary outcome will include participants' physical, social, emotional and functional well-being. The effect of the intervention on physical activity level, motivation for physical activity, relation to food and self-efficacy will also be evaluated. ETHICS AND DISSEMINATION The study was approved by the 'CPP Paris XI' Institutional Review Board on 5 May 2022 (Ref no.: 21.04512.000048-22004). The study's findings will be shared through various channels, including academic publications, simplified reports for wider audiences and active engagement with medical and institutional organisations as well as patients' associations. TRIAL REGISTRATION NUMBER NCT05658341.
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Affiliation(s)
- Fabienne El-Khoury
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, Île-de-France, France
| | | | | | - Chloé Lopez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, Île-de-France, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, Île-de-France, France
- INSERM, Gustave Roussy Institute, University Paris Saclay, Unit Molecular Predictors and New Targets in Oncology, Villejuif, Île-de-France, France
| | - Patricia Dargent-Molina
- Université Paris Cité et Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, Île-de-France, France
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Fuller-Shavel N, Krell J. Integrative Oncology Approaches to Supporting Immune Checkpoint Inhibitor Treatment of Solid Tumours. Curr Oncol Rep 2024; 26:164-174. [PMID: 38194216 PMCID: PMC10890979 DOI: 10.1007/s11912-023-01492-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE OF REVIEW The goal of this review was to examine the role and practical applications of integrative oncology strategies in supporting immune checkpoint inhibitor (ICI) treatment of adult solid tumours. RECENT FINDINGS Beyond tumour-intrinsic factors, several patient-associated factors affect ICI response, including germline genetics, systemic inflammation, the gut microbiota, and diet. Current promising supportive interventions include a Mediterranean-style diet with over 20 g of fibre, regular exercise, use of live biotherapeutics, minimisation of PPI and antibiotic use, and ensuring vitamin D repletion, with many other integrative oncology approaches under study. Caution around medical cannabis use in patients on ICIs is advised due to previously documented adverse impact on overall survival, while VAE (Viscum album extract) therapy studies have not highlighted any safety concerns so far. With expanding ICI use, it is important to investigate and apply low-cost integrative oncology strategies to support better treatment outcomes and minimise adverse events. Further research may lead to pre-treatment assessment of both tumour and patient-associated biomarkers and personalised multimodal prehabilitation care plans, as well as on-treatment support with targeted nutrition, physical activity, and supplementation regimes, including both systemic inflammation and gut microbiome modulating strategies. Given the emerging understanding of chronic stress impact on ICI treatment outcomes, mind-body approaches require further investigation.
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Affiliation(s)
- Nina Fuller-Shavel
- Synthesis Clinic, Winchester, UK.
- British Society for Integrative Oncology (BSIO), Midhurst, UK.
- Oncio CIC, Stockbridge, UK.
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23
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Freeman JQ, Sheade JB, Zhao F, Olopade OI, Huo D, Nanda R. Racial differences in familiarity, interest, and use of integrative medicine among patients with breast cancer. RESEARCH SQUARE 2024:rs.3.rs-3909360. [PMID: 38352451 PMCID: PMC10862959 DOI: 10.21203/rs.3.rs-3909360/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Purpose Integrative medicine (IM) has received ASCO endorsement for managing cancer treatment-related side effects. Little is known about racial differences in familiarity, interest, and use of IM among breast cancer patients. Methods Breast cancer patients enrolled in the Chicago Multiethnic Epidemiologic Breast Cancer Cohort were surveyed regarding familiarity, interest, and use of IM: acupuncture, massage, meditation, music therapy, and yoga. Familiarity and interest, measured by a 5-point Likert scale, was modeled using proportional odds. Use was self-reported, modeled using binary logistic regression. Results Of 1,300 respondents (71.4% White and 21.9% Black), Black patients were less likely than White patients to be familiar with acupuncture (aOR 0.60, 95% CI: 0.41-0.87). While there was no differences in interest in acupuncture between Black and White patients (aOR 1.12, 95% CI: 0.76-1.65), Black patients were more interested in massage (aOR 1.86, 95% CI: 1.25-2.77), meditation (aOR 2.03, 95% CI: 1.37-3.00), music therapy (aOR 2.68, 95% CI: 1.80-3.99) and yoga (aOR 2.10, 95% CI: 1.41-3.12). Black patients were less likely than White to have used acupuncture (aOR 0.49, 95% CI: 0.29-0.84); but there were no racial differences in use of massage (aOR 0.83, 95% CI: 0.53-1.30), meditation (aOR 0.82, 95% CI: 0.47-1.43), music therapy (aOR 1.65, 95% CI: 0.82-3.32) and yoga (aOR 0.67, 95% CI: 0.37-1.20). Conclusion Black patients expressed more interest in IM than their White counterparts; there were no racial differences in IM use, except lower acupuncture use among Black patients. A breast program focused on equity should provide access to these services for breast cancer patients.
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Powers-James C, Morse M, Narayanan S, Ramondetta L, Lopez G, Wagner R, Cohen L. Integrative Oncology Approaches to Reduce Recurrence of Disease and Improve Survival. Curr Oncol Rep 2024; 26:147-163. [PMID: 38180690 DOI: 10.1007/s11912-023-01467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE OF REVIEW After a cancer diagnosis, patients ask what they can do in addition to the recommended treatments to increase their survival. Many turn to integrative medicine modalities and lifestyle changes to improve their chances of survival. Numerous studies have demonstrated that lifestyle changes can significantly improve survival rates for cancer patients. Less support exists for the use of natural products or supplements to improve cancer survival. In this manuscript, we review key findings and evidence in the areas of healthy eating habits, physical activity, stress management and social support, and sleep quality, as well as natural products and supplements as they relate to the cancer recurrence and survival. RECENT FINDINGS While more research is needed to fully understand the mechanisms underlying the associations between lifestyle changes and cancer survival, findings suggest that lifestyle modifications in the areas of diet, physical activity, stress management and social support, and sleep quality improve clinical cancer outcomes. This is especially true for programs that modify more than one lifestyle habit. To date, outside of supplementing with vitamin D to maintain adequate levels, conflicting conclusion within the research remain regarding the efficacy of using natural products or supplement to improve cancer recurrence of disease or cancer survival. A call for further research is warranted. Lifestyle screening and counseling should be incorporated into cancer treatment plans to help improve patient outcomes. While the scientific community strives for the pursuit of high-quality research on natural products to enhance cancer survival, transparency, dialogue, and psychological safety between patients and clinicians must continue to be emphasized. Proactive inquiry by clinicians regarding patients' supplement use will allow for an informed discussion of the benefits and risks of natural products and supplements, as well as a re-emphasis of the evidence supporting diet and other lifestyle habits to increase survival.
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Affiliation(s)
- Catherine Powers-James
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
| | - Meroë Morse
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Santhosshi Narayanan
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Lois Ramondetta
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Gabriel Lopez
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Richard Wagner
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
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Llamas DM, Langan JC. Alternative Mental Health Interventions for Hispanic Women With Breast Cancer: A State of the Science Review. HISPANIC HEALTH CARE INTERNATIONAL 2024:15404153231226390. [PMID: 38258294 DOI: 10.1177/15404153231226390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Introduction: Current disadvantages in accessing healthcare services, particularly mental health resources, result in increased psychological dysfunction among Hispanic women with advanced breast cancer. Little is known about using alternative nonpharmacological therapies for Hispanic women experiencing psychological distress secondary to a breast cancer diagnosis. This state-of-the-science paper synthesizes current culturally appropriate alternative therapies that effectively address depressive symptoms, anxiety, and psychological distress among Hispanic women with breast cancer (HWBC). Methods: The search criteria included published articles that used alternative interventions to address psychological needs among HWBC. Ten studies met the inclusion criteria. Results: Four alternative interventions were identified in the literature that significantly met the cultural mental health needs of HWBC. Mindfulness and technology use were the two interventions most studied in this review. Conclusion: Evidence indicates that alternative therapies for mental health improve overall quality of life. Further research to attenuate psychological distress is needed to meet mental health needs among HWBC. Innovative methods such as the use of technology and mindfulness as well as integrating personalized care are crucial to address the cultural needs of HWBC.
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Affiliation(s)
- Diana M Llamas
- Trudy Busch Valentine School of Nursing, Saint Louis University, Saint Louis, MO, USA
| | - Joanne C Langan
- Trudy Busch Valentine School of Nursing, Saint Louis University, Saint Louis, MO, USA
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Faravel K, Jarlier M, Meignant L, Thomaso M, Del Rio M, Jacot W, Stoebner A. Efficacy of a physiotherapy, yoga and patient education programme for patients with breast cancer and hormone therapy-induced pain: a multicentre randomised study protocol (SKYPE 2). BMJ Open 2024; 14:e075378. [PMID: 38191246 PMCID: PMC10806805 DOI: 10.1136/bmjopen-2023-075378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024] Open
Abstract
INTRODUCTION Osteoarticular pain is experienced by approximately 50% of patients with breast cancer under hormone therapy and can increase the risk of therapy discontinuation. Among complementary therapies, yoga has shown efficacy regarding reduction of fatigue, anxiety, pain due to hormone therapy and inflammation. Personalised patient education programmes increase engagement and motivation, and induce effective behavioural changes. The SKYPE programme, an integrated intervention combining physiotherapy, yoga and patient education, showed promising efficacy on hormone therapy-induced pain in a previous pilot study. In this study, we hypothesised that using theory-based patient education favour learning and practising 15 min of at-home yoga every day to decrease hormone therapy-induced pain. METHODS AND ANALYSIS This multicentre randomised study will assess the efficacy of the SKYPE programme on pain reduction compared with standard care in patients with breast cancer reporting osteoarticular pain due to hormone therapy. Main secondary objectives will describe pain evolution and characteristics, patient adhesion to yoga sessions and home practice, forward flexibility, quality of life, fatigue, anxiety and compliance to hormone therapy. Patients in the intervention group will participate in 1 weekly educational yoga session of 90 min for 6 weeks, supervised by physiotherapists (period 1). They will also perform daily at-home 15 min yoga sessions for 12 weeks, the total duration of the intervention (periods 1 and 2). Pain will be evaluated during physiotherapy check-ups at baseline (T0), at 6 weeks (T1) and at 12 weeks (T2). ETHICS AND DISSEMINATION This study was approved by the ethics committee (CPP Ile de France 8 on 22 June 2020). The results will be disseminated to patients and healthcare professionals, and published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT04457895.
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Affiliation(s)
- Kerstin Faravel
- Supportive Care, Montpellier Cancer Institute, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Marta Jarlier
- University of Montpellier, Montpellier, France
- Biometrics Unit, Montpellier Cancer Institute, Montpellier, France
| | - Laetitia Meignant
- University of Montpellier, Montpellier, France
- Clinical Research and Innovation, Montpellier Cancer Institute, Montpellier, France
| | - Muriel Thomaso
- Supportive Care, Montpellier Cancer Institute, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Maguy Del Rio
- University of Montpellier, Montpellier, France
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Montpellier Cancer Institute, Montpellier, France
| | - William Jacot
- Medical Oncology, Montpellier Cancer Institute, Montpellier, France
- INSERM U1194, Montpellier, France
| | - Anne Stoebner
- Supportive Care, Montpellier Cancer Institute, Montpellier, France
- INSERM UA11 IDESP, Montpellier, France
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Ben-Arye E, Mao J, Bruera E, Samuels N, Keshet Y, Lee RT, Ben-Yehuda D, Eisenberg E, Bar-Sela G, Shvartzman P, Balneaves LG, Shani M, Ellis M, Tripathy D, Ash S, Elis A, Vaknin Z, Ofir R, Schiff E. Challenges in Implementing Guideline on Integrative Oncology and Pain: The Israeli Perspective. J Pain Symptom Manage 2024; 67:69-76. [PMID: 37769821 DOI: 10.1016/j.jpainsymman.2023.09.022] [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: 07/01/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023]
Abstract
CONTEXT AND OBJECTIVES To explore the feasibility of implementing the joint guideline on integrative medicine for pain management in oncology, published by the Society for Integrative Oncology (SIO) and the American Society of Clinical Oncology (ASCO), for integrative oncology (IO) services in supportive and palliative care. METHODS A qualitative research methodology was co-designed by the SIO-ASCO guideline committee, with the Society for Complementary Medicine, Israel Medical Association (IMA). A questionnaire with five open-ended questions exploring barriers and enablers to implementing the guideline was distributed to chairs and board members of nine IMA-affiliated medical societies; four deans of Israeli medical schools; and nurses from the Israeli Society for Oncology Nursing. Respondent narratives were qualitatively analyzed using ATLAS.Ti software for systematic coding. RESULTS Questionnaires were completed by 52 physicians and nurses from medical oncology, hematology, gynecological oncology, pediatric oncology, palliative medicine, pain, family medicine, internal medicine, and integrative medicine. The SIO-ASCO guidelines were endorsed by nine IMA-affiliated societies. The domains identified included the importance of guideline implementation in clinical practice; barriers and facilitators to implementation; practical aspects required for this implementation (e.g., IO training); clinical indications for referral; budget-related issues; and clinical and administrative models enabling practical implementation of the guideline. CONCLUSION We found across-the-board consensus among the nine IMA-affiliated societies supporting the current guideline. This, while identifying potential facilitators and barriers in order to address the implementation of the SIO-ASCO guideline recommendations.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program (E.B-A), The Oncology Service; Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, Haifa, Israel; Ruth and Bruch Rappaport Faculty of Medicine (E.B-A., E.E.), Technion-Israel Institute of Technology, Haifa, Israel.
| | - Jun Mao
- ASCO Guideline on Integrative Medicine for Pain Management (J.M.); Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eduardo Bruera
- ASCO Guideline on Integrative Medicine for Pain Management (E.B.); MD Anderson Cancer Center, Houston, Texas, USA
| | - Noah Samuels
- Center for Integrative Complementary Medicine (N.S.), Shaarei Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Yael Keshet
- Department of Sociology (Y.K.), The Western Galilee College, Acco, Israel
| | - Richard T Lee
- City of Hope Comprehensive Cancer Center (R.T.L.), Duarte, California, USA
| | - Dina Ben-Yehuda
- Hadassah-Hebrew University Medical School (D.B-Y.), Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Elon Eisenberg
- Ruth and Bruch Rappaport Faculty of Medicine (E.B-A., E.E.), Technion-Israel Institute of Technology, Haifa, Israel; The Israel Pain Society (E.E.), Israel Medical Association, Israel
| | - Gil Bar-Sela
- Israeli Society of Clinical Oncology & Radiation Therapy (ISCORT) (G.B-S.), Israel Medical Association; Cancer Center, Emek Medical Center, Afula, Israel
| | - Pesach Shvartzman
- Israel Society for Palliative Medicine (P.S.), Israel Medical Association; Siaal Center for Community Research, Pain and Palliative Care Unit, Kappy and Eric Flanders National Palliative Care Resource Centre, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lynda G Balneaves
- College of Nursing, Faculty of Health Sciences (L.G.B.), University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michal Shani
- Israel Association of Family Physicians (M.S.), Israel Medical Association; Department of Family Medicine, Central District, Clalit Health Service, Rehovot, Israel; Sackler Faculty of Medicine (M.S.), Tel Aviv University, Tel Aviv, Israel
| | - Martin Ellis
- Israel Society of Hematology and Transfusion Medicine (M.E.), Israel Medical Association; Hematology Institute and Translational Hemato-Oncology Laboratory, Meir Medical Center, Israel
| | - Debu Tripathy
- Department of Breast Medical Oncology (D.T.), University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shifra Ash
- Israeli Society of Pediatric Hematology/Oncology (S.A.), Israel Medical Association; Department of Pediatric Hematology-Oncology, Rambam Medical Center, Haifa, Israel
| | - Avishay Elis
- Israel Society of Internal Medicine (A.E), Israel Medical Association; Department of Internal Medicine "C", Beilinson Hospital, Rabin Medical Center, Petah-Tikva, Israel
| | - Zvi Vaknin
- Israeli Society of Gynecologic Oncology (Z.V.), Israel Medical Association; Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center, Zerifin, Israel; Affiliated to the Sackler Faculty of Medicine (Z.V.), Tel Aviv University, Tel Aviv, Israel
| | - Ruth Ofir
- Israeli Oncology Nursing Society (R.O.), Department of Pediatric Hematology-Oncology, Rambam Medical Center, Haifa, Israel
| | - Elad Schiff
- The Society of Complementary Medicine (E.S.), Israel Medical Association; Department of Internal Medicine & Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel
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Huemer M, Graca S, Bitsche S, Hofmann G, Armour M, Pichler M. Mapping the clinical practice of traditional, complementary and integrative medicine in oncology in Western countries: A multinational cross-sectional survey. JOURNAL OF INTEGRATIVE MEDICINE 2024; 22:64-71. [PMID: 38199884 DOI: 10.1016/j.joim.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Many cancer patients seek adjunctive therapies to biomedical cancer treatments at some point of their disease trajectory. While acupuncture is increasingly recommended by leading oncological associations, limited evidence exists concerning the evidence-informed practice and adherence to current guidelines of traditional complementary and integrative medicine (TCIM) practitioners treating cancer patients. METHODS An international online-survey assessed the demographical data, clinical practice, and sources of information used by TCIM practitioners in Austria, Germany, United States of America, Australia, and New Zealand. RESULTS In total, 404 respondents completed the survey, of which 254 (62.9%) treated cancer patients. Most practitioners were acupuncturists and herbalists (57.1%), had (16.8 ± 9.9) years of clinical experience and see a median of 2 (1, 4) cancer patients per week. Breast cancer (61.8%) is the most common cancer type seen in TCIM clinics. Adjunctive TCIM treatments are frequently concurrent with the patient's cancer specific treatment (39.9%), which is also reflected by the main goal of a TCIM treatment to alleviate side effects (52.4%). However, only 28.0% of the respondents are in contact with the treating oncologist. According to the respondents, pain is most effectively treated using acupuncture, while herbal medicine is best for cancer-related fatigue. TCIM practitioners mostly use certified courses (33.1%) or online databases (28.3%) but often believe that experts are more reliable to inform their practice (37.0%) than research publications (32.7%). CONCLUSION Acupuncturists and herbalists commonly treat cancer patients. Most practitioners use TCIM as an adjunct to biomedicine as supportive care and use it largely in accordance with current oncological guidelines. PLEASE CITE THIS ARTICLE AS Huemer M, Graca S, Bitsche S, Hofmann G, Armour M, Pichler M. Mapping the clinical practice of traditional, complementary and integrative medicine in oncology in Western countries: A multinational cross-sectional survey. J Integr Med. 2024; 22(1): 64-71.
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Affiliation(s)
- Matthias Huemer
- Palliative Care Unit, Division of Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Sandro Graca
- Northern College of Acupuncture, York YO1 6LJ, United Kingdom; School of Health and Society, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, United Kingdom
| | - Sarah Bitsche
- Palliative Care Unit, Division of Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Guenter Hofmann
- Palliative Care Unit, Division of Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Mike Armour
- National Institute of Complementary Medicine Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia; Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia; Medical Research Institute of New Zealand, Wellington 6021, New Zealand
| | - Martin Pichler
- Palliative Care Unit, Division of Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; Translational Oncology, University Hospital of Augsburg, 86156 Augsburg, Germany
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Loy MH, Prisco L, Parikh C. Implementation of Virtual Integrative Oncology Shared Medical Appointment Series (VIOSMAS) Within Mixed Diagnosis Population. Integr Cancer Ther 2024; 23:15347354231223969. [PMID: 38243739 PMCID: PMC10799580 DOI: 10.1177/15347354231223969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 11/09/2023] [Accepted: 12/15/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Integrative oncology [IO] is sought-after by patients, endorsed by clinical guidelines, and valued within National Cancer Institute Centers. Shared Medical Appointments [SMA] leverage health education and social connection to deliver enhanced patient experience, population health, cost-reduction, and clinician well-being. Integrative Oncology Shared Medical Appointments increase access to integrative medicine but delivering these services via telehealth have not been evaluated. OBJECTIVE We created, and pilot tested a Virtual Integrative Oncology Shared Medical Appointment Series (VIOSMAS) to assess its feasibility, acceptability, and efficacy at an urban academic teaching hospital. METHODS The 7-session hour-long Living Well with and after Cancer series included didactics, multi-disciplinary experiential sessions, and group discussion. Topics included (1) Introduction, (2) Herbs/Botanicals/Fungi, (3) Mindful Movement, (4) Acupuncture, (5) Narratives and Nature, (6) Diet and Culinary Medicine, and (7) Vitamins/Supplements. Virtual visits via telehealth were offered to enhance patient participation during the pandemic. Outcome measures included recruitment, retention, pre/post-series patient survey and qualitative clinician feedback. RESULTS Between 9/2021 and 4/2023, 72 unique patients were recruited to 5 cohorts and had a total of 332 VIOSMAS visits. A total of 50 patients (69%) attended 4 or more of the 7-session series; 60 (83% were women); patients ranged in age from 28 to 93 years (median 66); 36 (50%) lived outside the city center; the most common cancer diagnoses were breast, lymphoma, and lung cancer. Patients were from diverse demographics. Pre-program, patients reported desiring assistance in addressing diverse symptoms including fatigue, insomnia, pain, gastrointestinal (GI) symptoms, anxiety, and depression. Post-series, patients reported that the VIOSMAS addressed their goals and symptoms; they also reported incorporating recommended lifestyle changes in diet, exercise, sleep, and stress management; they were satisfied with the number of sessions and telehealth format. The participating clinicians reported high levels of satisfaction with VIOSMAS. Revenue to the institution from VIOSMAS exceeded the revenue potential of equivalent time spent for individual visits while supporting extended physician-patient contact. CONCLUSION VIOSMAS is feasible for patients and clinicians, addresses patients' symptoms and questions about lifestyle and complementary therapies, and generates more revenue than individual visits. Larger implementation trials with appropriate comparison groups are recommended.
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Affiliation(s)
- Michelle H. Loy
- Cornell University, New York, NY, USA
- Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | | | - Chiti Parikh
- Cornell University, New York, NY, USA
- Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
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Von Reusner MJ, Märtens B, Barthel S, Weiser A, Ziert Y, Steinmann D, Babadağ-Savaş B. Interdisciplinary Integrative Oncology Group-Based Program: Evaluation of Long-Term Effects on Resilience and Use of Complementary and Alternative Medicine in Patients With Cancer. Integr Cancer Ther 2024; 23:15347354241269931. [PMID: 39155547 PMCID: PMC11331462 DOI: 10.1177/15347354241269931] [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] [Revised: 03/06/2024] [Accepted: 07/22/2024] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND Cancer often causes reduced resilience, quality of life (QoL) and poorer overall well-being. To mitigate these problems, complementary and alternative medicine (CAM) is widely used among patients with cancer. This study aimed to evaluate the long-term effects of an interdisciplinary integrative oncology group-based program (IO-GP) on the resilience and use of CAM in patients with cancer. METHODS This was a prospective, observational, single-center study. Resilience (RS-13), CAM usage (I-CAM-G), QoL (SF-12) and health-related lifestyle factor (nutrition, smoking, alcohol consumption and physical exercise) data were collected for 70 patients who participated in a 10-week IO-GP between January 2019 and June 2022 due to cancer. The IO-GP is offered at the setting of a university hospital and is open to adult patients with cancer. It contains elements from mind-body medicine and positive psychology, as well as recommendations on healthy diet, exercise and CAM approaches. Patients who completed the IO-GP at least 12 months prior (1-4.5 years ago) were included in this study. Statistical analysis included descriptive analysis and parametric and nonparametric tests to identify significant differences (P < .05). RESULTS Resilience increased significantly ≥12 months after participation in the IO-GP (n = 44, P = .006, F = 8.274) and had a medium effect size (r = .410). The time since the IO-GP was completed ("12-24 months," "24-36 months," and ">36 months") showed no statistically significant interaction with changes in resilience (P = .226, F = 1.544). The most frequently used CAM modalities within the past 12 months were vitamins/minerals (85.7%), relaxation techniques (54.3%), herbs and plant medicine (41.1%), yoga (41.4%) and meditation (41.4%). The IO-GP was the most common source informing study participants about relaxation techniques (n = 24, 64.9%), meditation (n = 21, 72.4%) and taking vitamin D (n = 16, 40.0%). Significantly greater levels of resilience were found in those practicing meditation (P = .010, d = -.642) or visualization (P = .003, d = -.805) compared to non-practitioners. CONCLUSION IO-GPs have the potential to empower patients with cancer to continue using CAM practices-especially from mind-body medicine-even 1 to 4.5 years after completing the program. Additionally, resilience levels increased. These findings provide notable insight into the long-term effects of integrative oncology interventions on resilience and the use of CAM, especially in patients with breast cancer.
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Affiliation(s)
| | - Bettina Märtens
- Department of Radiotherapy, Hannover Medical School, Hannover, Germany
- CCC Hannover (Claudia von Schilling Center), Klaus Bahlsen Center for Integrative Oncology, Hannover Medical School, Hannover, Germany
| | - Stephanie Barthel
- CCC Hannover (Claudia von Schilling Center), Klaus Bahlsen Center for Integrative Oncology, Hannover Medical School, Hannover, Germany
| | - Axel Weiser
- Quality Management, Hannover Medical School, Hannover, Germany
| | - Yvonne Ziert
- Institute of Biometrics, Hannover Medical School, Hannover, Germany
| | - Diana Steinmann
- Department of Radiotherapy, Hannover Medical School, Hannover, Germany
- CCC Hannover (Claudia von Schilling Center), Klaus Bahlsen Center for Integrative Oncology, Hannover Medical School, Hannover, Germany
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Ghosh P, Patari N, Manisha C, Basavan D, Petchiappan V, Justin A. Reversal mechanism of multidrug-resistant cancer cells by lectin as chemo-adjuvant and targeted therapy- a systematic review. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 123:155205. [PMID: 37980807 DOI: 10.1016/j.phymed.2023.155205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/04/2023] [Accepted: 11/08/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Cancer is characterized as the leading cause of death, and the susceptibility of cancer cells to develop resistance due to long-term exposure to complementary chemotherapeutic treatment is referred to as multidrug resistance cancer cells (MDRC), which is a significant obstacle in the treatment of malignancies. Since complementary medicine lost its effectiveness, the development of potential alternative and novel therapeutic approaches has been elevated to a top priority in recent years. In this context, a bioactive protein lectin from plant and animal sources exhibits an invaluable source of anticancer agents with vast therapeutic potential. PURPOSE This manuscript's primary purpose is to enlighten the evidence-based (from 1986 to 2022) possible molecular mechanism of alternative treatment approaches using lectins over the complementary medicines used for cancer treatment. METHODS The PRISMA rules have been followed properly and qualitative and quantitative data are synthesized systematically. Articles were identified based on Clinical and preclinical reports published on lectin that investigated the in-depth cellular mechanisms, of reverse drug integrative oncology, as a nano-carried targeted delivery. Articles were systematically screened from 1986 to 2022 and selected based on electronic database searches, Medline (PubMed), Google Scholar, Web of Science, Encyclopaedias, Scopus, and ClinicalTrials.gov database. RESULTS The search turned up 4,212 publications from 38 different nations, of which 170 reference articles were used in our analysis, in 16 combination therapy and their mode of action, and 27 clinical trial studies including dosage and mechanism of action were included. Reports from the 30 lectins belonging to 28 different families have been included. The reversal mechanism of lectin and alternative therapy against MDRC is critically screened and according to a few clinical and preclinical reports, lectin can suppress the overexpressing genes like P-53, EGFR, and P-gp, MRP, and ABC transporter proteins associated with intracellular transportation of drugs. Since, the drug efflux mechanism leads to MDRC, in this phenomenon, lectin plays a key role in reversing the efflux mechanism. Few preclinical reports have mentioned that lectin shows synergism in combination with complementary medicine and as a nano drug carrier helps to deliver to the targeted site. CONCLUSION We have discussed the alternative therapy using lectin and an in-depth insight into the reversal drug resistance mechanisms to combat MDRC cancer, enhance the efficacy, reduce toxicity and adverse events, and ensure targeted delivery, and their application in the field of cancer diagnosis and prognosis has been discussed. However, further investigation is necessary in drug development and clinical trials which could be helpful to elaborate the reversal mechanism and unlock newer treatment modalities in MDRC cancer.
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Affiliation(s)
- Puja Ghosh
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, Tamil Nadu 643 001, India
| | - Niloy Patari
- Lane Department of Computer Science and Electrical Engineering, West Virginia University, USA
| | - Chennu Manisha
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, Tamil Nadu 643 001, India
| | - Duraiswamy Basavan
- Department of Pharmacognosy, JSS College of Pharmacy, Najwal, Vijaypur, Jammu 184 120, India
| | - Velammal Petchiappan
- Department of General Medicine, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu 641 004, India
| | - Antony Justin
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, Tamil Nadu 643 001, India.
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Molassiotis A, Affronti ML, Fleury M, Olver I, Giusti R, Scotte F. 2023 MASCC/ESMO consensus antiemetic guidelines related to integrative and non-pharmacological therapies. Support Care Cancer 2023; 32:30. [PMID: 38102373 DOI: 10.1007/s00520-023-08225-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
PURPOSE Review the literature to propose suggestions or recommendations for controlling nausea and vomiting through integrative and non-pharmacological treatments for the MASCC/ESMO 2023 update of its antiemetic guidelines. METHODS The authors identified available systematic reviews and/or meta-analyses for 12 integrative therapies, including acupressure, acupuncture, auricular therapy, electrical stimulation of point PC6, ginger use (i.e., Zingiber officinale), guided imagery, hypnosis, inhalation aromatherapy, music therapy, food-based interventions, progressive muscle relaxation, and reflexology. Reviews were assessed for quality through the AMSTAR2 tool. A consensus committee reviewed recommendations as per MASCC/ESMO established processes. RESULTS Thirty-nine systematic reviews and/or meta-analyses were used. There were major methodological flaws for many of the trials used as the bases for the reviews. No recommendation for ingested ginger could be made because of conflicting evidence. Recommendations were possible for acupuncture/electroacupuncture treatments, food-based interventions, and progressive muscle relaxation training alone or combined with guided imagery. No recommendations could be reached for a number of food-based approaches, inhalation aromatherapy, hypnosis in adults, music therapy, and reflexology. CONCLUSION While a limited number of suggestions are provided, there is a need for significantly higher quality trials in many of the therapeutic approaches assessed, before stronger recommendations and a wider range of approaches are made.
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Affiliation(s)
- A Molassiotis
- College of Arts, Humanities & Education, University of Derby, Derby, UK.
| | | | - Mapi Fleury
- Department of Oncology, Faculty of Biology and Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Ian Olver
- University of Adelaide, Adelaide, South Australia, Australia
| | - Raffaele Giusti
- Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Florian Scotte
- Medical Oncology, Institute Gustave Roussy, Cedex, France
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Huemer M, Pansi A, Hofmann G, Terbuch A, Sciri E, Lipp R, Spiegelberg JA, Jahn-Kuch D, Pichler M. Symptom clusters associated with complementary and alternative medicine use by cancer patients: A cross-sectional study. PLoS One 2023; 18:e0294641. [PMID: 38096236 PMCID: PMC10721086 DOI: 10.1371/journal.pone.0294641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 10/04/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) is a commonly used approach among cancer patients, with a reported prevalence of 14.8 to 73.1% depending on multiple factors. Even though a typical patient-reported reason for using CAM is symptom control, no conclusive evidence could be established for specific symptoms being a predictor for CAM use. Symptom clusters are a novel approach for assessing a multidimensional symptom burden, reflecting the impact of diseases on the patient's quality of life and considering the tendency of symptoms to occur in groups. MATERIAL AND METHODS A single-center cross-sectional study on cancer patients during oncological or palliative care was conducted to identify socio-demographical and clinical characteristics, including symptom clusters of CAM users and non-users. Symptom clusters were defined using latent profile analysis, and multivariable analyses were performed to assess significant factors influencing CAM use. RESULTS Of 171 cancer patients in this study, 63.7% used CAM alongside oncological treatment or palliative care. The most common CAM therapies were biological and physical therapies, including homeopathy (30.3%), supplements (27.4%), herbs (26.6%), massage (24.8%), and acupuncture (22.0%). Four distinct symptom clusters were identified, of which the cluster drowsiness-depression-anxiety was associated with a 3.83-fold increased chance of using CAM compared to low-symptomatic cancer patients. Multivariate analysis did not show any additional significant predictors of socio-demographical factors. CONCLUSION Using the concept of symptom clusters revealed a significant predictor for CAM use, suggesting to be a more conclusive method for assessing symptom burden in cancer patients. In addition, understanding why and how cancer patients turn to CAM can enhance the quality of multidisciplinary communication about its use.
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Affiliation(s)
- Matthias Huemer
- Division of Oncology, Department of Internal Medicine, Palliative Care Unit, Medical University of Graz, Graz, Austria
| | - Anna Pansi
- Division of Oncology, Department of Internal Medicine, Palliative Care Unit, Medical University of Graz, Graz, Austria
| | - Guenter Hofmann
- Division of Oncology, Department of Internal Medicine, Palliative Care Unit, Medical University of Graz, Graz, Austria
| | - Angelika Terbuch
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Elisabeth Sciri
- Division of Oncology, Department of Internal Medicine, Palliative Care Unit, Medical University of Graz, Graz, Austria
| | - Rainer Lipp
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Jasmin Alija Spiegelberg
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Daniela Jahn-Kuch
- Division of Oncology, Department of Internal Medicine, Palliative Care Unit, Medical University of Graz, Graz, Austria
| | - Martin Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Thronicke A, Oei SL, Grieb G, Grabowski P, Roos J, Schad F. Self-Reported Baseline Quality of Life Mirrors Treatment-Specific Characteristics of Cancer Patients. Cancers (Basel) 2023; 15:5763. [PMID: 38136309 PMCID: PMC10742018 DOI: 10.3390/cancers15245763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Baseline quality of life (bQL) has been shown to be a predictor of the clinical outcome of oncological patients. The primary objective of the present study was to examine the role of bQL as a treatment predictor in oncological patients. METHODS In this prospective study, all-stage cancer patients registered in the Network Oncology registry were enrolled, and their bQL at diagnosis was evaluated. RESULTS Five hundred and thirty-eight oncological patients were eligible (median age 64 years). We show that survival-predicting bQL variables such as pain, low physical functioning or financial burden at tumor diagnosis were linked to lower systemic treatment (p = 0.03), reduced surgery (p = 0.007) or reduced oncological treatment compliance (0.01), respectively. Lastly, female gender and older cancer patients exhibited a tempered bQL. CONCLUSION Our study is one of the first to reveal that bQL at tumor diagnosis is significantly associated with the prediction of oncological treatment with distinctive age- and gender-related patterns. Our results emphasize the need to address the physical, psychosocial, and financial burden of cancer patients prior to their oncological treatment with respect to age and gender. The associations found here pave the way for early integration of patient-reported outcomes into oncological supportive concepts.
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Affiliation(s)
- Anja Thronicke
- Research Institute Havelhöhe gGmbH, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany; (A.T.)
| | - Shiao Li Oei
- Research Institute Havelhöhe gGmbH, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany; (A.T.)
| | - Gerrit Grieb
- Department of Plastic Surgery and Hand Surgery, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
| | - Patricia Grabowski
- Interdisciplinary Oncology and Palliative Care, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
| | - Juliane Roos
- Interdisciplinary Oncology and Palliative Care, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
| | - Friedemann Schad
- Research Institute Havelhöhe gGmbH, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany; (A.T.)
- Interdisciplinary Oncology and Palliative Care, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
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Peppercorn J, Miller EK, Hasselmo ME. Don't You Worry 'bout a Thing: Harnessing the Power of Music to Improve Emotional Health in Oncology. JCO Oncol Pract 2023; 19:1089-1091. [PMID: 37883731 DOI: 10.1200/op.23.00555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
In this editorial, Drs Peppercorn and noted neuroscientists Miller and Hasselmo comment on a recent randomized trial of music to reduce stress during infusion, noting that our understanding of the brain supports a unique and particularly effective role for music in improving mood and reducing distress for patients with cancer
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Affiliation(s)
- Jeffrey Peppercorn
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Earl K Miller
- The Picower Institute for Learning & Memory and Department of Brain & Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA
| | - Michael E Hasselmo
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
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Sasada S, Kondo N, Hashimoto H, Takahashi Y, Terata K, Kida K, Sagara Y, Ueno T, Anan K, Suto A, Kanbayashi C, Takahashi M, Nakamura R, Ishiba T, Tsuneizumi M, Nishimura S, Naito Y, Hara F, Shien T, Iwata H. Prognostic impact of adjuvant endocrine therapy for estrogen receptor-positive and HER2-negative T1a/bN0M0 breast cancer. Breast Cancer Res Treat 2023; 202:473-483. [PMID: 37688665 PMCID: PMC10564809 DOI: 10.1007/s10549-023-07097-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/14/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE Mammography screening has increased the detection of subcentimeter breast cancers. The prognosis for estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative T1a/bN0M0 breast cancers is excellent; however, the necessity of adjuvant endocrine therapy (ET) is uncertain. METHODS We evaluated the effectiveness of adjuvant ET in patients with ER-positive and HER2-negative T1a/bN0M0 breast cancer who underwent surgery from 2008 to 2012. Standard ET was administrated after surgery. The primary endpoint was the cumulative incidence of distant metastasis. All statistical tests were 2-sided. RESULTS Adjuvant ET was administered to 3991 (83%) of the 4758 eligible patients (1202 T1a [25.3%] and 3556 T1b [74.7%], diseases). The median follow-up period was 9.2 years. The 9-year cumulative incidence of distant metastasis was 1.5% with ET and 2.6% without ET (adjusted subdistribution hazard ratio [sHR], 0.54; 95% CI, 0.32-0.93). In multivariate analysis, the independent risk factors for distant metastasis were no history of ET, mastectomy, high-grade, and lymphatic invasion. The 9-year overall survival was 97.0% and 94.4% with and without ET, respectively (adjusted HR, 0.57; 95% CI, 0.39-0.83). In addition, adjuvant ET reduced the incidence of ipsilateral and contralateral breast cancer (9-year rates; 1.1% vs. 6.9%; sHR, 0.17, and 1.9% vs. 5.2%; sHR, 0.33). CONCLUSIONS The prognosis was favorable in patients with ER-positive and HER2-negative T1a/bN0M0 breast cancer. Furthermore, adjuvant ET reduced the incidence of distant metastasis with minimal absolute risk difference. These findings support considering the omission of adjuvant ET, especially for patients with low-grade and no lymphatic invasion disease.
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Affiliation(s)
- Shinsuke Sasada
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Naoto Kondo
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroya Hashimoto
- Core Laboratory, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuko Takahashi
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, 700-8558, Okayama, Japan
| | - Kaori Terata
- Department of Breast and Endocrine Surgery, Akita University Hospital, Akita, Japan
| | - Kumiko Kida
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Yasuaki Sagara
- Department of Breast and Thyroid Surgical Oncology, Social medical corporation Hakuaikai, Sagara Hospital, Kagoshima, Japan
| | - Takayuki Ueno
- Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keisei Anan
- Department of Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Akihiko Suto
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Chizuko Kanbayashi
- Department of Breast Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Mina Takahashi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Rikiya Nakamura
- Department of Breast Surgery, Chiba Cancer Center, Chiba, Japan
| | - Toshiyuki Ishiba
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Michiko Tsuneizumi
- Department of Breast Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Seiichiro Nishimura
- Department of Breast Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Yoichi Naito
- Department of General Internal Medicine, National Cancer Center Hospital East, Chiba, Japan
| | - Fumikata Hara
- Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, 700-8558, Okayama, Japan.
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Rajendran T. Music therapy in cancer care: unravelling the complexities in LMICs. Support Care Cancer 2023; 31:715. [PMID: 37991584 DOI: 10.1007/s00520-023-08188-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
The past decades have seen the field of oncology becoming far more receptive to integrative oncology. Music therapy has been used to mitigate symptoms and address psychosocial needs in people with cancer as an adjunct to the primary treatment. Providing patients access to sources of aesthetic support, like a deeply personal choice of musical playlist, may help cognitive recovery and elevate mood in patients undergoing treatment or recovery. Cancer care infrastructures around the world are heterogeneous and are more noticeable when it comes to evidence-based integrative oncology practices. In most lower and middle-income countries (LMICs), there is a complete absence of a professional body for music therapy, accredited training programs, and board-certified providers, as well as a lack of personalization in evidence-based approaches. The other critical challenge is the paucity of high-quality peer-reviewed randomized controlled trials evaluating indigenous music interventions. Developing high-quality, unbiased, blinded, randomized controlled trials using indigenous musical genres-based interventions is the best way by which we can find out the impact and potential of music in providing supportive care to cancer patients.
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Affiliation(s)
- Tara Rajendran
- Department of Music, Faculty of Fine Arts, Annamalai University, Annamalai Nagar, Chidambaram, Tamil Nadu, India, 608002.
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Smith KL, Tsai HL, Lim D, Wang C, Nunes R, Wilkinson MJ, Sheng JY, Couzi R, Fetting J, Riley C, Wolff AC, Santa-Maria CA, Papathakis K, Collins-Chase L, Hilton C, Thorner E, Montanari A, Ikejiani D, Snyder C, Stearns V. Feasibility of Symptom Monitoring During the First Year of Endocrine Therapy for Early Breast Cancer Using Patient-Reported Outcomes Collected via Smartphone App. JCO Oncol Pract 2023; 19:981-989. [PMID: 37733984 DOI: 10.1200/op.23.00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 04/07/2023] [Accepted: 08/18/2023] [Indexed: 09/23/2023] Open
Abstract
PURPOSE Treatment-associated symptoms drive early discontinuation of adjuvant endocrine therapy (ET) for breast cancer. We hypothesized that symptom monitoring with electronic patient-reported outcomes (ePROs) during adjuvant ET will enhance symptom detection, symptom management, and persistence. METHODS Eligible patients were initiating ET for stage 0-III breast cancer. Participants completed ePRO surveys via smartphone at baseline and 1, 3, 6, and 12 months. Measures included Patient-Reported Outcomes Measurement Information System Anxiety, Depression, Fatigue, and Vaginal Discomfort; plus Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events items assessing joint pain, hot flashes, vaginal dryness, concentration problems, and memory problems. Scores surpassing prespecified thresholds triggered alerts, and recommended symptom management pathways were provided to clinicians. The primary objective was to evaluate feasibility, assessed by survey completion rates, with targets of >65% for the baseline survey and ≥1 follow-up survey during the first 6 months. Secondary objectives included 12-month ET discontinuation rate (target: ≤15%), describing symptoms and evaluating pathway implementation. RESULTS Among 250 participants, 73.2% completed the baseline survey and 69.6% completed ≥1 follow-up survey during the first 6 months. Thirty-one percent of participants had ≥1 symptom alert at baseline and 74% had ≥1 symptom alert during follow-up. The proportions of participants for whom pathway-concordant symptom management was documented at each time point ranged from 12.8% to 36.6%. Twenty-eight participants (11.2%) discontinued ET by 12 months. CONCLUSION Symptom monitoring with ePROs during adjuvant ET is feasible. Despite infrequent documentation of pathway-concordant symptom management after symptom alerts, ePROs were associated with favorable short-term ET persistence.
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Affiliation(s)
- Karen Lisa Smith
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
- AstraZeneca, Gaithersburg, MD
| | - Hua-Ling Tsai
- Division of Biostatistics and Bioinformatics, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - David Lim
- Division of Biostatistics and Bioinformatics, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
- Division of Statistics Collaborative Inc, WCG, Washington, DC
| | - Chenguang Wang
- Division of Biostatistics and Bioinformatics, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
- Regeneron Pharmaceuticals, Tarrytown, NY
| | - Raquel Nunes
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
- AstraZeneca, Gaithersburg, MD
| | - Mary J Wilkinson
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jennifer Y Sheng
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rima Couzi
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
| | - John Fetting
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Carol Riley
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Antonio C Wolff
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Cesar A Santa-Maria
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Katie Papathakis
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Christie Hilton
- Division of Hematology and Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA
| | - Elissa Thorner
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Amanda Montanari
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Claire Snyder
- Johns Hopkins Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Vered Stearns
- Sidney Kimmel Comprehensive Cancer Center, Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD
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Shi Y, Nguyen T, Farrell M, Rodgers-Melnick S, Moss G, Kaiser C, Dusek JA, Mendiratta P, Adan F, Lee RT. Retrospective Outcomes of a New Acupuncture Service at a Comprehensive Cancer Center. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:674-682. [PMID: 37252748 DOI: 10.1089/jicm.2022.0709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Introduction: Among cancer centers, patients' interest in acupuncture is growing, in addition to clinical research in the intervention. Their National Cancer Institute-designated comprehensive cancer center piloted an acupuncture service. Their aim was to assess whether acupuncture impacted patient self-reported symptoms as delivered clinically and discuss their implementation strategy. Methods: Patients undergoing acupuncture at a comprehensive cancer center from June 2019 to March 2020 were asked to complete a modified Edmonton Symptom Assessment Scale (ESAS) before and after each session. The authors evaluated symptom changes after acupuncture in both outpatient and inpatient settings. A change of ≥1 U, on the 0-10 scale, was considered clinically significant. Results: Three hundred and nine outpatient and 394 inpatient acupuncture sessions were provided to patients at the comprehensive cancer center during this period, of which surveys from 186 outpatient (34 patients) and 124 inpatient (57 patients) sessions were available for analysis. The highest pretreatment symptoms reported by outpatients were neuropathy (5.78), pain (5.58), and tiredness (5.59). Outpatients receiving acupuncture reported clinically significant improvements in pain (ESAS score change of -2.97), neuropathy (-2.68), decreased lack of well-being (-2.60), tiredness (-1.85), nausea (-1.83), anxiety (-1.56), activities of daily living issues (-1.32), depression (-1.23), anorexia (-1.19), insomnia (-1.14), and shortness of breath (-1.14). The most severe pretreatment symptoms reported by inpatients were pain (6.90), insomnia (6.16), and constipation (5.44). Inpatients receiving acupuncture reported clinically significant improvements in anxiety (-3.69), nausea (-3.61), insomnia (-3.26), depression (-2.98), pain (-2.77), neuropathy (-2.68), anorexia (-2.20), constipation (-1.95), and diarrhea (-1.26). Conclusion: Both outpatient and inpatient participants in this pilot acupuncture program reported clinically significant improvements in symptoms after a single acupuncture treatment. Some differences between the outpatient and inpatient settings warrant further investigation.
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Affiliation(s)
- Yuming Shi
- Case Western Reserve University, Cleveland, OH, USA
| | - Thuy Nguyen
- University Hospitals Connor Whole Health, Cleveland, OH, USA
- Cleveland Clinic, Cleveland, OH, USA
| | | | - Samuel Rodgers-Melnick
- Case Western Reserve University, Cleveland, OH, USA
- University Hospitals Connor Whole Health, Cleveland, OH, USA
| | - Gabriel Moss
- Case Western Reserve University, Cleveland, OH, USA
| | | | - Jeffery A Dusek
- Case Western Reserve University, Cleveland, OH, USA
- University Hospitals Connor Whole Health, Cleveland, OH, USA
| | - Prateek Mendiratta
- Case Western Reserve University, Cleveland, OH, USA
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Francoise Adan
- Case Western Reserve University, Cleveland, OH, USA
- University Hospitals Connor Whole Health, Cleveland, OH, USA
| | - Richard T Lee
- Case Western Reserve University, Cleveland, OH, USA
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Integrative Medicine Program, Departments of Supportive Care Medicine and Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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Gerhardt S, Leerhøy B, Jarlbaek L, Herling S. Qualitative evaluation of a palliative care case management intervention for patients with incurable gastrointestinal cancer (PalMaGiC) in a hospital department. Eur J Oncol Nurs 2023; 66:102409. [PMID: 37742424 DOI: 10.1016/j.ejon.2023.102409] [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: 01/19/2023] [Revised: 06/21/2023] [Accepted: 08/30/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE Generalist palliative care in hospital departments largely lacks an overall structure to fully manage the symptom burden and support needs of patients with incurable gastrointestinal cancer. Palliative care case management interventions show promising results in reducing healthcare use and enhancing quality of life. Less is known about these interventions and their potential to improve the quality of generalist palliative care in hospital departments. The aim of this study was to explore patients' experience of a palliative care case management intervention (PalMaGiC) to acquire knowledge about its advantages and disadvantages and, if needed, adjust the intervention. METHODS Qualitative semi-structured interviews with patients (n = 14) with incurable gastrointestinal cancers of the oesophagus, pancreas, colon, or rectum were conducted and analysed using content analysis. Participants in the study were affiliated with PalMaGiC, an intervention in a gastroenterology department based on symptom assessment, care planning, care coordination, and needs-based follow-up. RESULTS Participants perceived the intervention as filling a gap and as a secure lifeline in the healthcare system since it provided 24-h access, a designated specialist nurse, and a patient-healthcare alliance. Using a needs-based approach, PalMaGiC changed the participants' focus from disease to quality of life. Participants requested more open dialog within complementary and alternative medicine, greater focus on promoting hope and using need assessment questionnaires differently in assessing symptoms and problems. CONCLUSION The PalMaGiC intervention can potentially meet the needs of patients requiring palliative care in hospital departments, but further development of the content and personalised approach is needed.
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Affiliation(s)
- Stine Gerhardt
- Digestive Disease Center, Copenhagen University Hospital - Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.
| | - Bonna Leerhøy
- Digestive Disease Center, Copenhagen University Hospital - Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark; Center for Translational Research, Copenhagen University Hospital - Bispebjerg, Nielsine Nielsensvej 4, 2400, Copenhagen, NV, Denmark.
| | - Lene Jarlbaek
- Danish Knowledge Centre for Rehabilitation and Palliative Care (REHPA), University of Southern Denmark, Vestergade 17, 5800, Nyborg, Denmark.
| | - Suzanne Herling
- The Neuroscience Center, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, København Ø, Copenhagen, Denmark.
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Carlson LE, Ismaila N, Addington EL, Asher GN, Atreya C, Balneaves LG, Bradt J, Fuller-Shavel N, Goodman J, Hoffman CJ, Huston A, Mehta A, Paller CJ, Richardson K, Seely D, Siwik CJ, Temel JS, Rowland JH. Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults With Cancer: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol 2023; 41:4562-4591. [PMID: 37582238 DOI: 10.1200/jco.23.00857] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/13/2023] [Indexed: 08/17/2023] Open
Abstract
PURPOSE To provide evidence-based recommendations to health care providers on integrative approaches to managing anxiety and depression symptoms in adults living with cancer. METHODS The Society for Integrative Oncology and ASCO convened an expert panel of integrative oncology, medical oncology, radiation oncology, surgical oncology, palliative oncology, social sciences, mind-body medicine, nursing, methodology, and patient advocacy representatives. The literature search included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2023. Outcomes of interest included anxiety or depression symptoms as measured by validated psychometric tools, and adverse events. Expert panel members used this evidence and informal consensus with the Guidelines into Decision Support methodology to develop evidence-based guideline recommendations. RESULTS The literature search identified 110 relevant studies (30 systematic reviews and 80 randomized controlled trials) to inform the evidence base for this guideline. RECOMMENDATIONS Recommendations were made for mindfulness-based interventions (MBIs), yoga, relaxation, music therapy, reflexology, and aromatherapy (using inhalation) for treating symptoms of anxiety during active treatment; and MBIs, yoga, acupuncture, tai chi and/or qigong, and reflexology for treating anxiety symptoms after cancer treatment. For depression symptoms, MBIs, yoga, music therapy, relaxation, and reflexology were recommended during treatment, and MBIs, yoga, and tai chi and/or qigong were recommended post-treatment. DISCUSSION Issues of patient-health care provider communication, health disparities, comorbid medical conditions, cost implications, guideline implementation, provider training and credentialing, and quality assurance of natural health products are discussed. While several approaches such as MBIs and yoga appear effective, limitations of the evidence base including assessment of risk of bias, nonstandardization of therapies, lack of diversity in study samples, and lack of active control conditions as well as future research directions are discussed.Additional information is available at www.asco.org/survivorship-guidelines.
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Affiliation(s)
- Linda E Carlson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | | | - Gary N Asher
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Chloe Atreya
- University of California San Francisco, San Francisco, CA
| | | | - Joke Bradt
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA
| | | | | | | | - Alissa Huston
- University of Rochester Medical Center, Rochester, NY
| | | | - Channing J Paller
- Sidney Kimmel Comprehensive Cancer Center, John Hopkins University, Baltimore, MD
| | | | - Dugald Seely
- University of Ottawa, Ottawa, ON, Canada
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Chelsea J Siwik
- Osher Center for Integrative Health, University of California, San Francisco, San Francisco, CA
| | - Jennifer S Temel
- Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Zhan D, Wang X, Zheng Y, Wang S, Yang B, Pan B, Wang N, Wang Z. Integrative dissection of 5-hydroxytryptamine receptors-related signature in the prognosis and immune microenvironment of breast cancer. Front Oncol 2023; 13:1147189. [PMID: 37795441 PMCID: PMC10546427 DOI: 10.3389/fonc.2023.1147189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/14/2023] [Indexed: 10/06/2023] Open
Abstract
Background Depression increases the risk of breast cancer recurrence and metastasis. However, there lacks potential biomarkers for predicting prognosis in breast cancer. 5-hydroxytryptamine (5-HT) plays a key role in the pathogenesis and treatment of depression. In this study, we developed a prognostic signature based on 5-HT receptors (5-HTRs) and elucidated its potential immune regulatory mechanisms for breast cancer prognosis. Methods Oncomine, GEPIA, UALCAN, cBioPortal, Kaplan-Meier plotter, and TIMER were used to analyze differential expression, prognostic value, genetic alteration, and immune cell infiltration of HTRs in breast cancer patients. The model training and validation assays were based on the analyses of GSE1456 and GSE86166. A risk signature was established by univariate and multivariate Cox regression analyses. The transwell assay was utilized to verify the effect of the 5-HTRs expression on breast cancer invasion. Effects of HTR2A/2B inhibitor on CD8+ T cell proliferation and infiltration as well as apoptosis of 4T1 cells in the tumor microenvironment were detected by flow cytometry and TUNEL assay. Zebrafish and mouse breast cancer xenografts were used to determine the effect of HTR2A/2B inhibitor on breast cancer metastasis. Results The expression levels of HTR1A, HTR1B, HTR2A, HTR2B, HTR2C, HTR4, and HTR7 were significantly downregulated in highly malignant breast cancer types. 5-HTRs were significantly associated with recurrence-free survival (RFS) in breast cancer patients. The genetic alteration of HTR1D, HTR3A, HTR3B, and HTR6 in breast cancer patients was significantly associated with shorter overall survival (OS). Finally, HTR2A and HTR2B were determined to construct the risk signature. The expression of HTR2A/2B was positively correlated with the infiltration of immune cells such as CD8+ T cells and macrophages. Furthermore, inhibition of HTR2A expression could suppress CD8+ T cell proliferation and enhance invasion and metastasis of breast cancer cells in both zebrafish and mice model. Conclusions The HTR2A/2B risk signature not only highlights the significance of HTRs in breast cancer prognosis by modulating cancer immune microenvironment, but also provides a novel gene-testing tool for early prevention of depression in breast cancer patients and lead to an improved prognosis and quality of life.
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Affiliation(s)
- Dandan Zhan
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xuan Wang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yifeng Zheng
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Shengqi Wang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Bowen Yang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Bo Pan
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Neng Wang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Integrative Medicine Research Center, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhiyu Wang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
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Murillo R, Pinto-Martínez N, Serrano N, Uribe C, Navarro E, Duque J, Yepes A, Olaya L, Mariño C, Morales OL, Erazo-Muñoz MA, Sánchez-Vega DC, Martínez-Ramos N. Use of complementary and alternative medicine by cancer patients in Colombia. BMC Complement Med Ther 2023; 23:321. [PMID: 37710213 PMCID: PMC10500828 DOI: 10.1186/s12906-023-04144-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/28/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND The use of complementary and alternative medicines (CAM) among cancer patients varies greatly. The available data suggest an increasing use of CAM over time and a higher prevalence in low- and middle-income countries. However, no reliable data are available from Latin America. Accordingly, we examined the prevalence of CAM use among cancer patients from six Colombian regions. METHODS We conducted a survey on cancer patients attending comprehensive cancer centres in six capital cities from different regions. The survey was designed based on a literature review and information gathered through focus groups on CAM terminology in Colombia. Independent random samples of patients from two comprehensive cancer centres in every city were obtained. Patients 18 years and older with a histopathological diagnosis of cancer undergoing active treatment were eligible. The prevalence of CAM use is reported as a percentage with the corresponding confidence interval. CAM types are reported by region. The sociodemographic and clinical characteristics of CAM users and non-users were compared using Chi square and t tests. RESULTS In total, 3117 patients were recruited. The average age 59.6 years old, and 62.8% were female. The prevalence of CAM use was 51.7%, and compared to non-users, CAM users were younger, more frequently women, affiliated with the health insurance plan for low-income populations and non-Catholic. We found no differences regarding the clinical stage or treatment modality, but CAM users reported more treatment-related side effects. The most frequent types of CAM were herbal products, specific foods and vitamins, and individually, soursop was the most frequently used product. Relevant variability between regions was observed regarding the prevalence and type of CAM used (range: 36.6% to 66.7%). The most frequent reason for using CAM was symptom management (30.5%), followed by curative purposes (19.5%). CONCLUSIONS The prevalence of CAM use among cancer patients in Colombia is high in general, and variations between regions might be related to differences in cultural backgrounds and access to comprehensive cancer care. The most frequently used CAM products and practices have little scientific support, suggesting the need to enhance integrative oncology research in the country.
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Affiliation(s)
- Raúl Murillo
- Hospital Universitario San Ignacio, Diagonal 70B 214 Este Apt 104, Bogotá, Colombia.
- Pontificia Universidad Javeriana, Bogotá, Colombia.
| | | | - Norma Serrano
- Hospital Internacional de Colombia-Fundación Cardiovascular, Bucaramanga, Colombia
| | - Claudia Uribe
- Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | | | - Jorge Duque
- Oncólogos Asociados de Imbanaco, Cali, Colombia
| | - Andrés Yepes
- Clínica de Oncología Astorga, Medellín, Colombia
| | - Laura Olaya
- Unidad Oncológica Surcolombiana, Neiva, Colombia
| | - Carolina Mariño
- Pontificia Universidad Javeriana, Bogotá, Colombia
- Universidad de Valencia, Valencia, Spain
| | - Olga Lucia Morales
- Hospital Universitario San Ignacio, Diagonal 70B 214 Este Apt 104, Bogotá, Colombia
- Pontificia Universidad Javeriana, Bogotá, Colombia
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Mentink M, Verbeek D, Noordman J, Timmer-Bonte A, von Rosenstiel I, van Dulmen S. The Effects of Complementary Therapies on Patient-Reported Outcomes: An Overview of Recent Systematic Reviews in Oncology. Cancers (Basel) 2023; 15:4513. [PMID: 37760483 PMCID: PMC10526744 DOI: 10.3390/cancers15184513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Many patients with cancer make use of complementary medicine alongside conventional medicine, but clinicians in oncology often lack the knowledge to adequately advise patients on the evidence base for complementary therapies. This study aims to provide an overview of recently published systematic reviews that assess the effects of complementary therapies on patient-reported health outcomes in patients with cancer. Systematic reviews, including a meta-analysis of at least two randomized controlled trials, were identified from the PubMed, Embase, Cochrane Library, CINAHL and PsycINFO databases. The methodological quality was assessed with AMSTAR 2. One hundred systematic reviews were included. The results suggest that several complementary therapies can improve health outcomes reported by patients with cancer, such as acupuncture to relieve pain, music interventions to reduce anxiety and yoga to improve cancer-related fatigue. The side effects related to complementary therapy use are generally mild. The results remain inconclusive for some intervention-outcome combinations. Many of the included systematic reviews insufficiently assessed the causes and impact of bias in their interpretation of the results. This overview of systematic reviews can support clinicians in counselling their patients on this topic and provide directions for future research and clinical practice guidelines in the field of complementary medicine.
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Affiliation(s)
- Marit Mentink
- Nivel (Netherlands Institute of Health Services Research), Otterstraat 118, 3512 CR Utrecht, The Netherlands; (J.N.); (S.v.D.)
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 21, 6525 EZ Nijmegen, The Netherlands
| | - Daniëlle Verbeek
- Praktijk Integratieve Oncologie, Heesterpoort 18, 9713 KZ Groningen, The Netherlands;
| | - Janneke Noordman
- Nivel (Netherlands Institute of Health Services Research), Otterstraat 118, 3512 CR Utrecht, The Netherlands; (J.N.); (S.v.D.)
| | - Anja Timmer-Bonte
- Department of Medical Oncology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands;
| | - Ines von Rosenstiel
- Department of Integrative Oncology, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands;
| | - Sandra van Dulmen
- Nivel (Netherlands Institute of Health Services Research), Otterstraat 118, 3512 CR Utrecht, The Netherlands; (J.N.); (S.v.D.)
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 21, 6525 EZ Nijmegen, The Netherlands
- Faculty of Caring Science, University of Borås, Work Life and Social Welfare, Allégatan 1, 501 90 Borås, Sweden
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Wode K, Sharp L, Fransson P, Nordberg JH. Communication About Complementary and Alternative Medicine When Patients Decline Conventional Cancer Treatment: Patients' and Physicians' Experiences. Oncologist 2023; 28:e774-e783. [PMID: 37071805 PMCID: PMC10485293 DOI: 10.1093/oncolo/oyad084] [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: 05/08/2022] [Accepted: 02/17/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) is a broad set of nonconventional practices used alongside or instead of conventional treatment: The latter poses obvious risks related to cancer prognosis. Patient-physician dialogue about CAM is crucial for patient safety and mutual trust. Little is known about communication in the rare situations when patients decline recommended cancer treatment and consider using CAM. The objective of this study was to explore patients' and physicians' experiences from situations when patients decline recommended cancer treatment and consider using CAM. MATERIALS AND METHODS Semi-structured interviews were carried out with 7 CAM-using cancer patients who had declined some or all conventional treatment as well as 10 physicians from oncology and palliative care. Framework analysis was used. RESULTS Regarding treatment choices, there was a dissonance between physicians' focus on medical reasoning and patients' expression of complex values. Physicians' difficulty in understanding patients' treatment decline was exacerbated when patients considered using CAM, impairing communication even further. Inequalities in roles resulting in power struggles risked pushing both parties toward extreme and inflexible standpoints. Despite these challenges regarding treatment choices and hierarchical roles, both parties considered open and respectful communication as crucial. CONCLUSIONS This study highlights the difficulty of shared decision-making in practice when patients' and physicians' views on treatment decisions deviate in clinically challenging situations. Our results point to a need to address the complexity of these situations, pay attention to patients' values, and improve knowledge among physicians about CAM.
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Affiliation(s)
- Kathrin Wode
- Department of Radiation Sciences/Oncology, Umeå University, Umeå, Sweden
- Regional Cancer Centre Stockholm Gotland, Stockholm, Sweden
- Department of Nursing, Umeå University, Sweden
| | - Lena Sharp
- Regional Cancer Centre Stockholm Gotland, Stockholm, Sweden
- Department of Nursing, Umeå University, Sweden
| | | | - Johanna Hök Nordberg
- Regional Cancer Centre Stockholm Gotland, Stockholm, Sweden
- Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Franco A, Magno S. The Breaking Point and Post-Traumatic Growth in Breast Cancer Survivors. Cancers (Basel) 2023; 15:4441. [PMID: 37760411 PMCID: PMC10527318 DOI: 10.3390/cancers15184441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Advancements in breast cancer survival rates make the issues of quality of life and psycho-physical wellbeing in survivors central goals of comprehensive care [...].
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Affiliation(s)
| | - Stefano Magno
- Breast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy;
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Samuels N, Cohen N, Katz D, Ben-Arye E. Identifying cultural, demographic, personal health and cancer-related barriers to integrative oncology care: a retrospective case-cohort study. J Cancer Res Clin Oncol 2023; 149:10143-10148. [PMID: 37264264 DOI: 10.1007/s00432-023-04912-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/20/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE Integrative oncology (IO) provides complementary and integrative medicine within conventional supportive and palliative cancer care. The present study set out to identify barriers to attending an integrative physician (IP) consultation, provided without charge within an IO treatment program. STUDY METHODS Electronic files of adult oncology patients undergoing chemotherapy were studied. Patient-related characteristics were examined to identify factors associated with attendance at the IP consultation: socio-demographic (age, gender, country of birth, place of residence, primary language spoken); health- related (BMI, smoking, independent functioning); and cancer- related (primary tumor site, localized vs. metastatic). RESULTS Only 257 of the 1912 patients studied (13.4%) attended the IP consultation, with female patients more likely to attend (p < 0.001), as well as younger patients (p = 0.002); those residing outside the Jerusalem municipality (p = 0.008); and patients whose primary language was Hebrew (p < 0.001). Non-smokers and functionally independent patients were also more likely to attend (p = 0.007 and 0.008, respectively), as were those diagnosed with breast/gynecological (p = 0.005) or gastrointestinal tumors (p = 0.002). Multivariate analysis showed a significantly greater likelihood of attending the consultation among females (OR 1.619, 95% CI 1.065-2.460; p = 0.024); younger patients (OR 1.019, 95% CI 1.007-1.031; p = 0.001); non-Arabic speakers (OR 8.220, 95% CI 3.310-20.413; p < 0.001); and patients diagnosed with a tumor other than lung cancer (OR 2.954, 95% CI 1.259-6.933; p = 0.013). CONCLUSION Further prospective research addressing socio-demographic, personal health- and cancer-related characteristics of oncology patients is needed to address potential barriers to the provision of IO care within a diverse, equitable and inclusive setting of care.
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Affiliation(s)
- Noah Samuels
- Center for Integrative Complementary Medicine, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, P.O.B. 3235, 9103102, Jerusalem, Israel.
| | - Neora Cohen
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniela Katz
- Integrated Oncology Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service, Lin Carmel, and Zebulun Medical Centers, Clalit Health Services, Haifa, Israel
- Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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de Vries M, Stewart T, Ireton T, Keelan K, Jordan J, Robinson BA, Dachs GU. Patients' and carers' priorities for cancer research in Aotearoa/New Zealand. PLoS One 2023; 18:e0290321. [PMID: 37607163 PMCID: PMC10443847 DOI: 10.1371/journal.pone.0290321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Discrepancies have been reported between what is being researched, and what patients/families deem important to be investigated. Our aim was to understand research priorities for those who live with cancer in Aotearoa/New Zealand, with emphasis on Māori. METHODS Adult outpatients with cancer and their whānau/family completed a survey (demographics, selecting keywords, free-text comments) at Christchurch hospital. Quantitative and qualitative data were evaluated using standard statistical and thematic analyses, respectively. RESULTS We recruited 205 participants, including both tūroro/patients (n = 129) and their whānau/family/carer (n = 76). Partnership with Māori health workers enabled greater recruitment of Māori participants (19%), compared to the proportion of Māori in Canterbury (9%). Cancer research was seen as a priority by 96% of participants. Priorities were similar between Māori and non-Māori participants, with the keywords 'Cancer screening', 'Quality of Life' and 'Development of new drugs' chosen most often. Free-text analysis identified three themes; 'Genetics and Prevention', 'Early Detection and Treatment', and 'Service Delivery', with some differences by ethnicity. CONCLUSIONS Cancer research is a high priority for those living with cancer. In addition, participants want researchers to listen to their immediate and practical needs. These findings may inform future cancer research in Aotearoa. MāORI TERMS AND TRANSLATION Aotearoa (New Zealand) he aha ō whakaaro (what are your thoughts) hui (gathering) mate pukupuku (cancer) mokopuna (descendent) Ōtautahi (Christchurch) rongoā (traditional healing) tāne (male) te reo (Māori language) Te Whatu Ora (weaving of wellness, Health New Zealand) tikanga (methods, customary practices) tūroro (patients) (alternative terms used: whānau affected by cancer or tangata whaiora (person seeking health)) wahine (female) Waitaha (Canterbury) whakapapa (genealogy) whānau ((extended) family, based on whakapapa, here also carer).
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Affiliation(s)
- Millie de Vries
- Mackenzie Cancer Research Group, Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand (NZ)
| | - Tiria Stewart
- Te Pūtahi Mātai Toto o Te Waipounamu, Christchurch Hospital, Christchurch, NZ (Nga Puhi, Ngāti Porou)
| | - Theona Ireton
- Māori Health Services, Christchurch Hospital, Te Whatu Ora, Waitaha/Canterbury, Christchurch, NZ (Ngā Wairiki, Ngāti Porou)
| | - Karen Keelan
- Te Aho o Te Kahu–Cancer Control Agency, Ministry of Health, NZ (Ngāti Porou)
| | - Jennifer Jordan
- Psychological Medicine, University of Otago, Christchurch, NZ
- Specialist Mental Health Service Clinical Research Unit, Te Whatu Ora, Waitaha/Canterbury, Christchurch, NZ
| | - Bridget A. Robinson
- Mackenzie Cancer Research Group, Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand (NZ)
- Canterbury Regional Cancer and Haematology Service, Te Whatu Ora, Waitaha/Canterbury, Christchurch, NZ
| | - Gabi U. Dachs
- Mackenzie Cancer Research Group, Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand (NZ)
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Cohen SA, Veleber S, Siman J, Guthrie KA, McMillen K, Heit M, Wadhera S, Daniels J, Hansen K, Jacoby M, Taromina K, Chin S, Romeo M, Langley BO, Coveler AL, Hannan LM, King G, Purcell T, Safyan RA, Shankaran V, Zhen DB, Chiorean EG, Greenlee H. Use of acupuncture with acupressure in addition to standard-of-care cryotherapy to decrease chemotherapy-associated neuropathy in patients with gastrointestinal malignancies receiving oxaliplatin-based chemotherapy: Study protocol for a randomized, controlled pilot and feasibility study. Contemp Clin Trials 2023; 131:107273. [PMID: 37380021 PMCID: PMC10527487 DOI: 10.1016/j.cct.2023.107273] [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: 04/01/2023] [Revised: 05/30/2023] [Accepted: 06/25/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Oxaliplatin is a key chemotherapeutic agent in the treatment of local and metastatic gastrointestinal (GI) malignancies. Dose density and treatment adherence can be limited by chemotherapy-induced peripheral neuropathy (CIPN). Early research suggests CIPN incidence and severity may be mitigated by acupuncture, but rigorous data in GI oncology patients is limited. Here, we describe the protocol of a randomized, waitlist-controlled pilot study testing the use of preemptive of acupuncture plus acupressure to decrease CIPN and chemotherapy-related toxicities. METHODS Patients with a GI malignancy (n = 56) with planned 5-fluorouracil (5-FU) and oxaliplatin IV (FOLFOX, FOLFIRINOX) every 2 weeks are being recruited. Additional concurrent anti-neoplastic agents may be used. Enrolled patients are randomized 1:1 to a 3-month intervention of Arm A: acupuncture with acupressure and standard-of-care treatment, or Arm B: standard-of-care alone. In Arm A, on days 1 and 3 of each chemotherapy cycle a standardized acupuncture protocol is administered and patients are taught self-acupressure to perform daily between chemotherapy treatments. Patients in both arms are given standard-of-care oral and peripheral (hands/feet) ice chip cryotherapy during oxaliplatin administration. CIPN and other symptoms are assessed at baseline, 6 weeks, and 3 months from registration. The primary endpoint is CIPN severity at 3 months (EORTC-CIPN 20). Additional endpoints evaluate CIPN incidence (CTCAE, Neuropen, tuning fork); incidence of pain, fatigue, nausea, oral dysesthesia, and anxiety; and feasibility (recruitment, retention, adherence, acceptability). If warranted, trial results will inform the design of a multi-center trial to expand testing of the intervention to a larger patient cohort.
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Affiliation(s)
- Stacey A Cohen
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA.
| | - Susan Veleber
- Integrative Medicine Program, Division of Supportive Care, Fred Hutchinson Cancer Center, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Center, USA
| | - Jonathan Siman
- Integrative Medicine Program, Division of Supportive Care, Fred Hutchinson Cancer Center, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Center, USA
| | | | - Kerry McMillen
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA
| | - Madilyn Heit
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Sonia Wadhera
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Jonathan Daniels
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Kjell Hansen
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Madeline Jacoby
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Katherine Taromina
- Integrative Medicine Program, Division of Supportive Care, Fred Hutchinson Cancer Center, USA
| | - Samantha Chin
- Integrative Medicine Program, Division of Supportive Care, Fred Hutchinson Cancer Center, USA
| | - Melissa Romeo
- Integrative Medicine Program, Division of Supportive Care, Fred Hutchinson Cancer Center, USA
| | - Blake O Langley
- Integrative Medicine Program, Division of Supportive Care, Fred Hutchinson Cancer Center, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Center, USA; Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA 98195, USA
| | - Andrew L Coveler
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Lindsay M Hannan
- Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Gentry King
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Tom Purcell
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Rachael A Safyan
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Veena Shankaran
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - David B Zhen
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - E Gabriela Chiorean
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA
| | - Heather Greenlee
- Clinical Research Division, Fred Hutchinson Cancer Center, 825 Eastlake Ave E, Seattle, WA 98109, USA; Division of Medical Oncology, University of Washington School of Medicine, USA; Integrative Medicine Program, Division of Supportive Care, Fred Hutchinson Cancer Center, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Center, USA
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50
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Phillips CS, Bockhoff J, Berry DL, Buchbinder E, Frazier AL, LaCasce A, Ligibel J, Luskin MR, Woods H, Knoerl R. Exploring Young Adults' Perspectives of Participation in a Mindfulness-Based Music Therapy Intervention Before and During the COVID-19 Pandemic. J Adolesc Young Adult Oncol 2023; 12:569-576. [PMID: 36752714 DOI: 10.1089/jayao.2022.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Purpose: To explore adolescent and young adults' (AYAs) experiences with participation in a mindfulness-based music therapy intervention during cancer treatment before and during the COVID-19 pandemic. Methods: Sixteen young adults (20-39 years old) who received cancer treatment and participated in a mindfulness-based music therapy intervention for anxiety and stress were interviewed using a semistructured interview guide. Interviews were audio recorded and transcribed verbatim. The interview guide contained prompts about reasons for joining the study, usual coping strategies, experience with the in-person and virtual delivery formats of the intervention, and suggestions for improvement. Themes were derived from the data using inductive content analysis methods. Results: Findings from the interviews included the following: (1) virtual group participants reported difficulty finding a private place to attend the intervention sessions, (2) participants experienced a sense of relaxation in response to intervention participation, (3) in-person group participants felt a sense of connection to the music and their family members who were present during the intervention, while virtual group participants felt a sense of connection to mindfulness, (4) virtual group participants reported that practicing music and mindfulness together was synergistic, and (5) in-person intervention delivery was preferred to virtual intervention delivery. Conclusion: This study provides insight into the contextual factors that impact satisfaction with the intervention and the effect of the intervention on anxiety and stress. Overall, while virtual mindfulness-based music therapy delivery may be more feasible, there are still important advantages to in-person delivery that should be considered in the design of future mindfulness-based music therapy interventions. ClinicalTrials.gov Identifier: NCT03709225.
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Affiliation(s)
- Carolyn S Phillips
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Julianna Bockhoff
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Donna L Berry
- Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, Washington, USA
| | - Elizabeth Buchbinder
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - A Lindsay Frazier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ann LaCasce
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jennifer Ligibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Marlise R Luskin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Heather Woods
- The Leonard P. Zakim Center for Integrative Therapies and Healthy Living, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Robert Knoerl
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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