Abstract
Research on the long-term effects of complementary and integrative medicine (CIM) is limited. In this study, we explore the impact of a CIM intervention on gastro-intestinal (GI)-related concerns in patients with breast/gynecological cancer undergoing chemotherapy. Patients reporting chemotherapy-related GI concerns were referred by their cancer care providers to a CIM consultation and treatments and assessed at baseline and at 12 weeks. The following tools were used: Edmonton Symptom Assessment Scale (ESAS), Measure Yourself Concerns and Wellbeing (MYCAW) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The intervention group was subdivided according to adherence to the integrative care program (AIC), defined as attending ≥4 CIM treatments with ≤30 days between each session. Controls chose not to undergo the CIM consultation or treatments. Of 289 patients reporting GI-related concerns, 42 were treated with CIM and optimally assessed (intervention arm; AIC = 33), as were 32 of controls. ESAS scores for appetite and nausea improved more significantly in the intervention group, more so in the AIC subgroup (appetite, p = 0.025; nausea, p = 0.033). MYCAW scores for GI-related concerns also improved in the intervention group, again more so in the adherent subgroup. EORTC scores improved more significantly with respect to global health (p = 0.021) and cognitive functioning (p = 0.031) in the intervention group, when compared to controls. The integration of a 12-week CIM intervention in conventional supportive cancer care may reduce nausea and improve appetite in patients with breast/gynecological cancer undergoing chemotherapy.
References
Steinbach S, Hummel T, Böhner C, Berktold S, Hundt W, Kriner M, Heinrich P, Sommer H, Hanusch C, Prechtl A, Schmidt B, Bauerfeind I, Seck K, Jacobs VR, Schmalfeldt B, Harbeck N. Qualitative and quantitative assessment of taste and smell changes in patients undergoing chemotherapy for breast cancer or gynecologic malignancies. J Clin Oncol. 2009;27(11):1899–905.
Morita T, Fujimoto K, Namba M, Sasaki N, Ito T, Yamada C, Ohba A, Hiroyoshi M, Niwa H, Yamada T, Noda T. Palliative care needs of cancer outpatients receiving chemotherapy: an audit of a clinical screening project. Support Care Cancer. 2008;16(1):101–7.
Boltong A, Aranda S, Keast R, Wynne R, Francis PA, Chirgwin J, Gough K. A prospective cohort study of the effects of adjuvant breast cancer chemotherapy on taste function, food liking, appetite and associated nutritional outcomes. PLoS ONE. 2014;9(7):e103512.
Efficace F, Biganzoli L, Piccart M, Coens C, Van Steen K, Cufer T, Coleman RE, Calvert HA, Gamucci T, Twelves C, Fargeot P, Bottomley A, EORTC-BCG-IDBBC-NDDG. Baseline health-related quality-of-life data as prognostic factors in a phase III multicentre study of women with metastatic breast cancer. Eur J Cancer. 2004;40(7):1021–30.
Lee CK, Stockler MR, Coates AS, Gebski V, Lord SJ, Simes RJ, Australian New Zealand Breast Cancer Trials Group. Self-reported health-related quality of life is an independent predictor of chemotherapy treatment benefit and toxicity in women with advanced breast cancer. Br J Cancer. 2010;102(9):1341–7.
Jatoi A, Windschitl HE, Loprinzi CL, Sloan JA, Dakhil SR, Mailliard JA, Pundaleeka S, Kardinal CG, Fitch TR, Krook JE, Novotny PJ, Christensen B. Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. J Clin Oncol. 2002;20(2):567–73.
Guo L, Bai SP, Zhao L, Wang XH. Astragalus polysaccharide injection integrated with vinorelbine and cisplatin for patients with advanced non-small cell lung cancer: effects on quality of life and survival. Med Oncol. 2012;29(3):1656–62.
Kienle GS, Kiene H. Influence of Viscum album L (European mistletoe) extracts on quality of life in cancer patients: a systematic review of controlled clinical studies. Integr Cancer Ther. 2010;9(2):142–57.
Ben-Arye E, Aharonson ML, Schiff E, Samuels N. Alleviating gastro-intestinal symptoms and concerns by integrating patient-tailored complementary medicine in supportive cancer care. Clin Nutr. 2015;34(6):1215–23.
Shalom-Sharabi I, Samuels N, Lavie O, Lev E, Keinan-Boker L, Schiff E, Ben-Arye E. Effect of a patient-tailored integrative medicine program on gastro-intestinal concerns and quality of life in patients with breast and gynecologic cancer. J Cancer Res Clin Oncol. 2017;143(7):1243–54.
Bruera E, Kuehn N, Miller M, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991;7(2):6–9.
Paterson C, Thomas K, Manasse A, Cooke H, Peace G. Measure Yourself Concerns and Wellbeing (MYCaW): an individualised questionnaire for evaluating outcome in cancer support care that includes complementary therapies. Complement Ther Med. 2007;15(1):38–45.
Aaronson N, Ahmedzai S, Bergman B, Bullinger M, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality of life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365–76.
Sharabi IS, Levin A, Schiff E, Samuels N, Agour O, Tapiro Y, Lev E, Keinan-Boker L, Ben-Arye E. Quality of life-related outcomes from a patient-tailored integrative medicine program: experience of Russian-speaking patients with cancer in Israel. Support Care Cancer. 2016;24(10):4345–55.
Ben-Arye E, Samuels N, Schiff E, Raz OG, Sharabi IS, Lavie O. Quality-of-life outcomes in patients with gynecologic cancer referred to integrative oncology treatment during chemotherapy. Support Care Cancer. 2015;23(12):3411–9.
Mao H, Mao JJ, Guo M, Cheng K, Wei J, Shen X, Shen X. Effects of infrared laser moxibustion on cancer-related fatigue: a randomized, double-blind, placebo-controlled trial. Cancer. 2016;122(23):3667–72.
Song QH, Xu RM, Zhang QH, Ma M, Zhao XP. Relaxation training during chemotherapy for breast cancer improves mental health and lessens adverse events. Int J Clin Exp Med. 2013;6(10):979–84.
Mustian KM, Sprod LK, Janelsins M, Peppone LJ, Palesh OG, Chandwani K, Reddy PS, Melnik MK, Heckler C, Morrow GR. Multicenter, randomized controlled trial of yoga for sleep quality among cancer survivors. J Clin Oncol. 2013;31(26):3233–4.
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We would like to thank Ms. Ronit Leiba for her assistance in the statistical analysis of the data.
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Ilanit Shalom-Sharabi, Dr. Noah Samuels and Prof. Eran Ben-Arye contributed to conception and design of the study, acquisition of the data, analysis and interpretation of the data, drafting the article and revising it critically for important content and final approval of the version to be submitted. Prof. Lital Keinan-Boker, Prof. Ofer Lavie and Prof. Efraim Lev helped in conception and design of the study, drafting the article and revising it critically for important content and final approval of the version to be submitted.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
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Shalom-Sharabi, I., Keinan-Boker, L., Samuels, N. et al. Effect of a 12-week integrative oncology intervention on gastro-intestinal concerns in patients with gynecological and breast cancer undergoing chemotherapy. Med Oncol 34, 155 (2017). https://doi.org/10.1007/s12032-017-1016-0
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DOI: https://doi.org/10.1007/s12032-017-1016-0