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Complementary and alternative medicine in radiation oncology

Survey of patients’ attitudes

Komplementär- und Alternativmedizin in der Radioonkologie

Umfrage zur Patientenakzeptanz

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Abstract

Background

Complementary and alternative medicine (CAM) are gaining in importance, but objective data are mostly missing. However, in previous trials, methods such as acupuncture showed significant advantages compared to standard therapies. Thus, the aim was to evaluate most frequently used methods, their significance and the general acceptance amongst cancer patients undergoing radiotherapy (RT).

Methods

A questionnaire of 18 questions based on the categorical classification released by the National Centre for Complementary and Integrative Health was developed. From April to September 2015, all patients undergoing RT at the Department of Radiation Oncology, Technical University of Munich, completed the survey. Changes in attitude towards CAM were evaluated using the questionnaire after RT during the first follow-up visit (n = 31).

Results

Of 634 patients, 333 answered the questionnaire (52.5%). Of all participants, 26.4% used CAM parallel to RT. Before RT, a total of 39.3% had already used complementary medicine. The most frequently applied methods during therapy were vitamins/minerals, food supplements, physiotherapy/manual medicine, and homeopathy. The majority (71.5%) did not use any complementary treatment, mostly stating that CAM was not offered to them (73.5%). The most common reasons for use were to improve the immune system (48%), to reduce side effects (43.8%), and to not miss an opportunity (37.8%). Treatment integrated into the individual therapy concept, e.g. regular acupuncture, would be used by 63.7% of RT patients.

Conclusion

In comparison to other studies, usage of CAM parallel to RT in our department is considered to be low. Acceptance amongst patients is present, as treatment integrated into the individual oncology therapy would be used by about two-third of patients.

Zusammenfassung

Hintergrund

Komplementär- und alternativmedizinische Behandlungen (CAM) nehmen in vielen medizinischen Bereichen trotz oftmals fehlender objektiver Daten zu. In Therapiestudien zeigen Verfahren wie Akupunktur bereits einen Vorteil gegenüber Standardtherapien. Ziel war die Erfassung der meist gewählten CAM, ihr Stellenwert sowie die generelle Akzeptanz bei radioonkologischen Patienten.

Methoden

Ein Fragebogen mit 18 Fragen, basierend auf der kategorischen Einteilung des National Center for Complementary and Integrative Health, wurde entwickelt. Alle Patienten, die zwischen April und September 2015 an der Klinik für RadioOnkologie und Strahlentherapie des Klinikums rechts der Isar eine Strahlentherapie (RT) erhalten hatten, wurden evaluiert. Akzeptanzänderungen der Patienten hinsichtlich CAM wurden mit einem weiteren Fragebogen nach RT bei der ersten Nachsorgeuntersuchung ermittelt (n = 31).

Ergebnisse

Von 634 Patienten beantworteten 333 (52,5 %) den Fragebogen. Von allen Befragten nutzten 39,3 % CAM vor RT und 26,4 % während RT. Die häufigsten Methoden waren Vitamine/Mineralstoffe, Nahrungsergänzungsmittel, Physiotherapie/Manuelle Medizin und Homöopathie. Die Mehrheit (71,5 %) verneinte eine parallel laufende CAM. Grund dafür war bei 73,5 % aller Befragten das fehlende Angebot seitens der Ärzte. Beweggründe für den CAM-Gebrauch waren das Immunsystem zu verbessern (43,8 %), Therapienebenwirkungen zu verringern (43,8 %) und keine Chance auszulassen (37,8 %). Eine in das Therapiekonzept integrierte Behandlung wie z. B. Akupunktur würden 63,7 % (212/333) der RT-Patienten in Anspruch nehmen.

Schlussfolgerung

Im Studienvergleich zeigte sich, dass der CAM-Einsatz parallel zur RT an unserer Klinik gering ist. Eine Patientenakzeptanz ist vorhanden, da etwa zwei Drittel eine in das individuelle Therapiekonzept integrierte CAM nutzen würden.

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Authors and Affiliations

  1. Department of Radiation Oncology, Technische Universität München (TUM), Ismaninger Straße 22, 81675, München, Germany

    Sabrina Lettner,  Kerstin A. Kessel &  Stephanie E. Combs

  2. Institute of Innovative Radiotherapy (iRT), Helmholtz Zentrum München, Ingolstädter Landstraße 1, Neuherberg, Germany

    Kerstin A. Kessel &  Stephanie E. Combs

Authors
  1. Sabrina Lettner
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  2. Kerstin A. Kessel
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  3. Stephanie E. Combs
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Correspondence to Kerstin A. Kessel.

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Conflict of interest

S. Lettner, K.A. Kessel and S.E. Combs declare that they have no competing interests.

Ethical standards

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.

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Lettner, S., Kessel, K.A. & Combs, S.E. Complementary and alternative medicine in radiation oncology. Strahlenther Onkol 193, 419–425 (2017). https://doi.org/10.1007/s00066-017-1101-5

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