Noah Samuels1, Eran Ben-Arye2,3, Yair Maimon4, Raanan Berger5. 1. Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center, 2 Derech Sheba Road, Tel-Hashomer, 52621, Ramat Gan, Israel. noah.samuels@sheba.health.gov.il. 2. Integrative Oncology Program, Oncology Service and Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel. 3. Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. 4. Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center, 2 Derech Sheba Road, Tel-Hashomer, 52621, Ramat Gan, Israel. 5. Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel.
Abstract
PURPOSE: To identify the unmonitored use of herbal medicine by female patients with breast cancer, examining the impact of an integrative physician (IP) consultation on this practice. METHODS: The files of 269 female patients with breast cancer following an IP consultation were surveyed retrospectively for use of herbal medicine for cancer-related goals. Expectations from the IP consultation and adherence to the IP-guided treatments were examined as well. RESULTS: Among the cohort, 111 (41.3%) reported using herbal medicine for cancer-related goals, unmonitored by their oncology healthcare professional. Factors predicting herbal medicine use were the adoption of dietary changes (odds ratio = 13.6, p < 0.001, CI 7.16-26.0) and the expectation that the IP consultation and treatments would address cancer-related goals (odds ratio = 3.29, p = 0.001, CI 1.64-6.6). Patients with metastatic disease were more likely to be using herbal medicine than non-users (34.5 vs. 22.8%; p = 0.088), as were those who had consulted with a complementary/alternative medicine practitioner (54.9 vs. 20.8%; p = 0.005). The IP advised 17 patients (15.3%) to stop taking specific herbal products due to safety-related concerns; and 10 patients to take dietary supplements for relief of specific symptoms. Herbal medicine users were less likely than non-users to adhere to the IP-recommended treatment program (34.7 vs. 48.3%; p = 0.037). CONCLUSIONS: Unmonitored use of herbal medicine by patients with breast cancer is more frequent among those adopting dietary changes for cancer-related goals. Integrative physicians provide evidence-based guidance on the safe and effective use of herbal products, and reframe patient expectations from cancer-related goals to reducing symptoms and improving quality of life.
PURPOSE: To identify the unmonitored use of herbal medicine by female patients with breast cancer, examining the impact of an integrative physician (IP) consultation on this practice. METHODS: The files of 269 female patients with breast cancer following an IP consultation were surveyed retrospectively for use of herbal medicine for cancer-related goals. Expectations from the IP consultation and adherence to the IP-guided treatments were examined as well. RESULTS: Among the cohort, 111 (41.3%) reported using herbal medicine for cancer-related goals, unmonitored by their oncology healthcare professional. Factors predicting herbal medicine use were the adoption of dietary changes (odds ratio = 13.6, p < 0.001, CI 7.16-26.0) and the expectation that the IP consultation and treatments would address cancer-related goals (odds ratio = 3.29, p = 0.001, CI 1.64-6.6). Patients with metastatic disease were more likely to be using herbal medicine than non-users (34.5 vs. 22.8%; p = 0.088), as were those who had consulted with a complementary/alternative medicine practitioner (54.9 vs. 20.8%; p = 0.005). The IP advised 17 patients (15.3%) to stop taking specific herbal products due to safety-related concerns; and 10 patients to take dietary supplements for relief of specific symptoms. Herbal medicine users were less likely than non-users to adhere to the IP-recommended treatment program (34.7 vs. 48.3%; p = 0.037). CONCLUSIONS: Unmonitored use of herbal medicine by patients with breast cancer is more frequent among those adopting dietary changes for cancer-related goals. Integrative physicians provide evidence-based guidance on the safe and effective use of herbal products, and reframe patient expectations from cancer-related goals to reducing symptoms and improving quality of life.
Entities:
Keywords:
Breast cancer; Complementary/integrative medicine; Herbal medicine; Herb–drug interaction; Safety
Authors: Cleora S Roberts; Frank Baker; Danette Hann; Joan Runfola; Cathy Witt; Jamie McDonald; Mary L Livingston; Jane Ruiterman; Rosemarie Ampela; Okrae C K Kaw; Chris Blanchard Journal: J Psychosoc Oncol Date: 2005
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