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Providing integrative care in the pre-chemotherapy setting: a pragmatic controlled patient-centered trial with implications for supportive cancer care

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Context and objectives

To examine the impact of a complementary/integrative medicine (CIM) program on quality of life (QoL)-related concerns among patients scheduled for chemotherapy for breast and gynecologic cancer.

Methods

Chemotherapy-naïve patients were referred by their oncology healthcare professional to an integrative oncology program, where CIM is provided as part of palliative/supportive care. CIM treatments were tailored to patients’ preferences and leading concerns, and for most included acupuncture and mind–body–spirit modalities, which were usually co-administered in the week preceding the first chemotherapy cycle. Patients attending the program were considered part of the treatment group; those who chose to receive only standard supportive care as controls. Assessment of quantitative outcomes was conducted during the week before chemotherapy; at 24 h before and after the treatment; and at 1 week post treatment. For this purpose, the Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Well-being questionnaire (MYCAW) were used. Qualitative assessment was based on short narratives at the end of the follow-up MYCAW questionnaire, which were analyzed with ATLAS.Ti software for systematic coding.

Results

Of the 55 patients referred, 31 (56%) underwent CIM treatments, with 24 controls. Both groups had similar baseline demographic and cancer-related characteristics. QOL-related outcomes were significantly less impaired following CIM treatments for ESAS fatigue scores (P = 0.013), depression (P = 0.005), and feeling of well-being (P = 0.027); and MYCAW scores for well-being (P = 0.005) and emotional distress (P = 0.02). Qualitative analysis detected both specific and non-specific effects of the CIM treatment regimen, most describing a reduction in pre-chemotherapy anxiety.

Conclusion

A patient-tailored CIM program, initiated within a week of the first chemotherapy cycle, may help reduce the severity of fatigue, depression, and impaired well-being among patients with breast and gynecological cancers.

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Acknowledgements

We would like to thank Ms. Ronit Leiba for her assistance in statistical analysis.

Funding

This study was not funded by any source.

Author information

Author notes

  1. Eran Ben-Arye and Hadeel Dahly are regarded as co-first authors based on their equal contribution to this study.

Authors and Affiliations

  1. Integrative Oncology Program, The Oncology Service and Lin Medical center, Clalit Health Services, 35 Rothschild St., Haifa and Western Galilee District, Haifa, Israel

    Eran Ben-Arye & Jamal Dagash

  2. Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    Eran Ben-Arye & Hadeel Dahly

  3. Department of Sociology and Anthropology, Western Galilee Academic College, Galilee, Israel

    Yael Keshet

  4. Palliative Care–Home Care Hospice, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel

    Jamal Dagash

  5. Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel

    Noah Samuels

Authors
  1. Eran Ben-Arye
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  2. Hadeel Dahly
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  3. Yael Keshet
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  4. Jamal Dagash
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  5. Noah Samuels
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Corresponding author

Correspondence to Eran Ben-Arye.

Ethics declarations

Conflict of interest

Eran Ben-Arye declares that he has no conflict of interest. Hadeel Dahly declares that she has no conflict of interest. Yael Keshet declares that she has no conflict of interest. Jamal Dagash declares that he has no conflict of interest. Noah Samuels declares that he has no conflict of interest.

Ethical approval

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.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

The research was conducted as part of the second author’s research project in the Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

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Ben-Arye, E., Dahly, H., Keshet, Y. et al. Providing integrative care in the pre-chemotherapy setting: a pragmatic controlled patient-centered trial with implications for supportive cancer care. J Cancer Res Clin Oncol 144, 1825–1833 (2018). https://doi.org/10.1007/s00432-018-2700-y

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  • DOI: https://doi.org/10.1007/s00432-018-2700-y

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