Ilanit Shalom-Sharabi1, Noah Samuels1,2, Ofer Lavie3, Efraim Lev4, Lital Keinan-Boker5,6, Elad Schiff7, Eran Ben-Arye8,9,10. 1. Integrative Oncology Program, The Oncology Service and Lin Medical center, Clalit Health Services, Haifa and Western Galilee District, 35 Rothschild St., Haifa, Israel. 2. Tal Center for Integrative Oncology, Sheba Medical Center, Institute of Oncology, Tel Hashomer, Israel. 3. Department of Obstetrics and Gynecology, Gynecologic Oncology Service, Carmel Medical Center, Haifa, Israel. 4. Department of Eretz Israel Studies, University of Haifa, Haifa, Israel. 5. Faculty of Social Welfare and Health Sciences, School of Public Health, University of Haifa, Haifa, Israel. 6. Israel Center for Disease Control, Israel Ministry of Health, Haifa, Israel. 7. Department of Internal Medicine, and the Integrative Medicine Service, Bnai-Zion Hospital, Haifa, Israel. 8. Integrative Oncology Program, The Oncology Service and Lin Medical center, Clalit Health Services, Haifa and Western Galilee District, 35 Rothschild St., Haifa, Israel. eranben@netvision.net.il. 9. Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. eranben@netvision.net.il. 10. Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel. eranben@netvision.net.il.
Abstract
CONTEXT AND OBJECTIVES: This study was conducted to assess the impact of a patient-tailored complementary/integrative medicine (CIM) program on gastro-intestinal (GI) symptoms and other concerns in female patients with breast/gynecological cancer undergoing chemotherapy. METHODS: Patients with breast/gynecological cancer reporting GI-related concerns were referred to an integrative physician (IP) consultation. The treatment group included patients agreeing to attend the consultation; controls those who did not. The Edmonton Symptom Assessment Scale (ESAS) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were administered at baseline and at 6 weeks. Adherence to integrative care (AIC) was defined as attending ≥4 CIM treatments, with ≤30 days between each session. RESULTS: Of 496 patients approached, 289 reported GI-related concerns. Optimal assessment at baseline and 6 weeks was achieved in 117 patients in the treatment arm, with 86 adhering to the CIM program (AIC subgroup); and in 89 of controls. EORTC scores improved more significantly in the treatment arm for appetite (P = 0.018), fatigue (P = 0.026), cognitive functioning (P < 0.001) and emotional functioning (P = 0.002); and ESAS scores for pain (P = 0.038), anxiety (P = 0.016), and sleep (P = 0.001). EORTC scores improved more significantly in the AIC group for global health status/QOL (P = 0.041), physical functioning (P = 0.004), role functioning (P = 0.011), appetite (P = 0.019), and fatigue (P = 0.001); and ESAS scores for pain (P = 0.048), fatigue (P = 0.011), drowsiness (P = 0.035), and appetite (P = 0.002). CONCLUSION: The integration of CIM may improve chemotherapy-related GI and other QOL-related concerns in patients with breast and gynecological cancer, with greater benefit observed in adherent patients.
CONTEXT AND OBJECTIVES: This study was conducted to assess the impact of a patient-tailored complementary/integrative medicine (CIM) program on gastro-intestinal (GI) symptoms and other concerns in female patients with breast/gynecological cancer undergoing chemotherapy. METHODS:Patients with breast/gynecological cancer reporting GI-related concerns were referred to an integrative physician (IP) consultation. The treatment group included patients agreeing to attend the consultation; controls those who did not. The Edmonton Symptom Assessment Scale (ESAS) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were administered at baseline and at 6 weeks. Adherence to integrative care (AIC) was defined as attending ≥4 CIM treatments, with ≤30 days between each session. RESULTS: Of 496 patients approached, 289 reported GI-related concerns. Optimal assessment at baseline and 6 weeks was achieved in 117 patients in the treatment arm, with 86 adhering to the CIM program (AIC subgroup); and in 89 of controls. EORTC scores improved more significantly in the treatment arm for appetite (P = 0.018), fatigue (P = 0.026), cognitive functioning (P < 0.001) and emotional functioning (P = 0.002); and ESAS scores for pain (P = 0.038), anxiety (P = 0.016), and sleep (P = 0.001). EORTC scores improved more significantly in the AIC group for global health status/QOL (P = 0.041), physical functioning (P = 0.004), role functioning (P = 0.011), appetite (P = 0.019), and fatigue (P = 0.001); and ESAS scores for pain (P = 0.048), fatigue (P = 0.011), drowsiness (P = 0.035), and appetite (P = 0.002). CONCLUSION: The integration of CIM may improve chemotherapy-related GI and other QOL-related concerns in patients with breast and gynecological cancer, with greater benefit observed in adherent patients.
Entities:
Keywords:
Breast cancer; Chemotherapy; Complementary medicine; Integrative medicine; Quality of life; Supportive care
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