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Effect of a patient-tailored integrative medicine program on gastro-intestinal concerns and quality of life in patients with breast and gynecologic cancer

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.

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Acknowledgements

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

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Corresponding author

Correspondence to Eran Ben-Arye.

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Funding

This study was not funded by any source.

Conflict of interest

Ilanit Shalom-Sharabi declares that she has no conflict of interest. Noah Samuels declares that he has no conflict of interest. Ofer Lavie declares that he has no conflict of interest. Efraim Lev declares that he has no conflict of interest. Lital Keinan-Boker declares that she has no conflict of interest. Elad Schiff declares that he has no conflict of interest. Eran Ben-Arye 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.

Informed consent

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

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Shalom-Sharabi, I., Samuels, N., Lavie, O. et al. 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 143, 1243–1254 (2017). https://doi.org/10.1007/s00432-017-2368-8

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Keywords

  • Integrative medicine
  • Breast cancer
  • Complementary medicine
  • Chemotherapy
  • Quality of life
  • Supportive care