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Abstract
In Australia, it is estimated that around 17% to 87% of cancer patients have used
one form of complementary therapy during their cancer treatment. There are
numerous reasons and contributing factors for cancer patients to consider using
complementary and alternative medicine (CAM). CAM information and products are
readily available. However, the level of evidence to support the benefits of use
in the cancer setting is limited, and the associated adverse effects and
interactions with conventional medicine may not be fully studied. Besides, not
all health professionals favor the concept of integrative health approaches, or
have the confidence in dealing with CAM due to a lack of knowledge and
standardization of practices. A thematic review of the literature was performed
on the main contributing factors to cancer patients’ use of CAM, as well as the
current issues that may be encountered by the patients and health
professionals.
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Affiliation(s)
- Ellen Jones
- 1 Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Lisa Nissen
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Carol Windsor
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
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2
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Abstract
In Australia, it is estimated that around 17% to 87% of cancer patients have used one form of complementary therapy during their cancer treatment. There are numerous reasons and contributing factors for cancer patients to consider using complementary and alternative medicine (CAM). CAM information and products are readily available. However, the level of evidence to support the benefits of use in the cancer setting is limited, and the associated adverse effects and interactions with conventional medicine may not be fully studied. Besides, not all health professionals favor the concept of integrative health approaches, or have the confidence in dealing with CAM due to a lack of knowledge and standardization of practices. A thematic review of the literature was performed on the main contributing factors to cancer patients’ use of CAM, as well as the current issues that may be encountered by the patients and health professionals.
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Affiliation(s)
- Ellen Jones
- 1 Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Lisa Nissen
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Carol Windsor
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
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Egger S, Hughes S, Smith DP, Chambers S, Kahn C, Moxey A, O'Connell DL. Factors associated with the use of complementary and alternative medicines for prostate cancer by long-term survivors. PLoS One 2018; 13:e0193686. [PMID: 29513724 DOI: 10.1371/journal.pone.0193686] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Objective To assess whether the use of complementary and alternative medicines therapies (CAMs) for prostate cancer and/or its treatment side effects by long-term survivors is associated with selected socio-demographic, clinical, health-related quality-of-life (HRQOL) and/or psychological factors. Design, setting and participants The Prostate Cancer Care and Outcomes Study (PCOS) is a population-based cohort study of men with prostate cancer who were aged less than 70 years at diagnosis in New South Wales, Australia. Included in these analyses were men who returned a 10-year follow-up questionnaire, which included questions about CAM use. Methods Validated instruments assessed patient’s HRQOL and psychological well-being. Poisson regression with robust variance estimation was used to estimate the adjusted relative risks of current CAM use for prostate cancer according to socio-demographic, clinical, HRQOL and psychological factors. Results 996 of 1634 (61%) living PCOS participants completed the 10-year questionnaire. Of these 996 men, 168 (17%) were using CAMs for prostate cancer and 525 (53%) were using CAMs for any reason (including prostate cancer). Those using CAM for prostate cancer were more likely to be regular or occasional support group participants (vs. no participation RR = 2.02; 95%CI 1.41–2.88), born in another country (vs. Australian born RR = 1.59; 95%CI 1.17–2.16), have received androgen deprivation treatment (ADT) since diagnosis (RR = 1.60; 95%CI 1.12–2.28) or in the past two years (RR = 2.34; 95%CI 1.56–3.52). CAM use was associated with greater fear of recurrence (RR = 1.29; 95%CI 1.12–1.48), cancer-specific distress (RR = 1.15; 95%CI 1.01–1.30), cancer-specific hyperarousal (RR = 1.17; 95%CI 1.04–1.31), cancer locus of control (RR = 1.16; 95%CI 1.01–1.34) and less satisfaction with medical treatments (RR = 0.86; 95%CI 0.76–0.97), but not with intrusive thinking, cognitive avoidance, depression, anxiety or any HRQOL domains. Conclusions In this study, about one in six long term prostate cancer survivors used CAMs for their prostate cancer with use centred around ADT, country of birth, distress, cancer control, fear of recurrence and active help seeking.
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Er O, Mistik S, Ozkan M, Ozturk A, Altinbas M. Factors Related to Complementary/Alternative Medicine use among Cancer Patients in Central Anatolia. Tumori 2018; 94:833-7. [DOI: 10.1177/030089160809400610] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background We aimed to evaluate the prevalence of and factors related to the use of complementary/alternative medicine among cancer patients undergoing or following conventional treatment at the Erciyes University Oncology Hospital in Central Anatolia. Study Design and Patients Face-to-face interview and a questionnaire were carried out with cancer patients attending the outpatient clinic of Medical Oncology. Questionnaire items included patients’ demographic data, treatment, use of complementary/alternative medicine and possible related factors. Multivariate analysis was performed to compare the factors related to use of complementary/alternative medicine. Results A total of 268 consecutive cancer patients were enrolled in the study. Overall, 43% of the patients were using or had used complementary/alternative medicine. Totally, 90% of the patients using complementary/alternative medicine utilized herbs, and most of the herbs used were stinging nettle. Nearly half of the patients using complementary/alternative medicine (46.1%) were aiming to fight the disease. Among users, nearly half of them regarded the method used as effective and 54 (50.5%) suggested the use of complementary/alternative medicine to other patients. Only 23.1% of the patients discussed the use of complementary/alternative medicine with their physician. In logistic regression analysis, younger age, higher educational status, advanced stage of the disease, longer duration of the disease and current treatment status were significantly associated with the use of complementary/alternative medicine. In our regression model, the predictivity rate of these variables was 72.2% for use of complementary/alternative medicine according to the backward Wald test. Conclusions Use of complementary/alternative medicine among cancer patients in our center is modestly high, and the most common method is herbal therapy. Communication between the patient and the physician shouldbe improvedon this subject.
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Affiliation(s)
- Ozlem Er
- Department of Medical Oncology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Selcuk Mistik
- Department of Family Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Metin Ozkan
- Department of Medical Oncology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ahmet Ozturk
- Department of Biostatistics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Mustafa Altinbas
- Department of Medical Oncology, Erciyes University Medical Faculty, Kayseri, Turkey
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Lim E, Vardy JL, Oh B, Dhillon HM. Mixed Method Study to Investigate Models of Australian Integrative Oncology. J Altern Complement Med 2017; 23:980-988. [DOI: 10.1089/acm.2016.0378] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- EunJin Lim
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), Concord Clinical School, Sydney Medical School, The University of Sydney, NSW, Australia
| | - Janette L. Vardy
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), Concord Clinical School, Sydney Medical School, The University of Sydney, NSW, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Byeongsang Oh
- Northern Clinical School, Sydney Medical School, The University of Sydney, Royal North Shore Hospital, St. Leonards, NSW, Australia
| | - Haryana M. Dhillon
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, NSW, Australia
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Nielsen TK, Højgaard M, Andersen JT, Jørgensen NR, Zerahn B, Kristensen B, Henriksen T, Lykkesfeldt J, Mikines KJ, Poulsen HE. Weekly ascorbic acid infusion in castration-resistant prostate cancer patients: a single-arm phase II trial. Transl Androl Urol 2017; 6:517-528. [PMID: 28725594 PMCID: PMC5503969 DOI: 10.21037/tau.2017.04.42] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Ascorbic acid (AA) has in vivo cytotoxic properties at concentrations that can only be achieved through intravenous (IV) administration in humans. Treatment with intravenous AA is widely and increasingly used in complementary medicine despite a lack of clinical evidence for the efficacy of this treatment. METHODS This non-comparative, single-center, phase II trial included patients with chemotherapy-naïve, metastatic castration-resistant prostate cancer (mCRPC) from an outpatient clinic to evaluate the efficacy and safety of IV AA therapy. Patients received weekly infusions of AA (week 1, 5 g; week 2, 30 g; and weeks 3-12, 60 g) followed by efficacy evaluation at 12 weeks. The primary endpoint for efficacy was a 50% reduction in the prostate-specific antigen (PSA) level. The secondary endpoints included changes in health-related quality of life (HRQoL), biomarkers of bone metabolism, inflammation and bone scans. Clinicaltrials.gov identifier: NCT01080352. RESULTS Twenty-three patients were enrolled in this study, and 20 completed the efficacy evaluation at 12 weeks. The mean baseline PSA level was 43 µg/L. No patient achieved a 50% PSA reduction; instead, a median increase in PSA of 17 µg/L was recorded at week 12. Among the secondary endpoints, no signs of disease remission were observed. In total, 53 adverse events (AEs) were recorded. Eleven were graded as "serious". Three AEs were directly related to AA, and all of which were related to fluid load. CONCLUSIONS Infusion with 60 g of AA did not result in disease remission. This study does not support the use of intravenous AA outside clinical trials.
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Affiliation(s)
- Torben K Nielsen
- Department of Urology, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Højgaard
- Department of Urology, Copenhagen University Hospital, Herlev, Denmark
| | - Jon T Andersen
- Laboratory of Clinical Pharmacology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg, Frederiksberg, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital, Herlev, Denmark
| | - Bent Kristensen
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital, Herlev, Denmark
| | - Trine Henriksen
- Laboratory of Clinical Pharmacology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg, Frederiksberg, Denmark
| | - Jens Lykkesfeldt
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kári J Mikines
- Department of Urology, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik E Poulsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Laboratory of Clinical Pharmacology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg, Frederiksberg, Denmark
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Oh B, Eade T, Kneebone A, Pavlakis N, Clarke S, Eslick G, River J, Back M. Factors Affecting Whether Or Not Cancer Patients Consider Using Acupuncture. Acupunct Med 2017; 35:107-113. [DOI: 10.1136/acupmed-2016-011115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2016] [Indexed: 11/04/2022]
Abstract
Objective To explore the factors associated with utilisation of an acupuncture service in a tertiary oncology setting in an Australian public hospital. Method Cancer patients attending oncology clinics at a university teaching hospital were invited to participate in the evaluation of acupuncture services from June 2014 to May 2015. Patients had a prior diagnosis of cancer (albeit at different stages) and were planning to receive, or were already receiving, systemic and/or radiation cancer treatment. Results The majority (81%) of participants indicated that they would consider the use of acupuncture during their cancer treatment. The most common reasons given for not considering acupuncture included adequate control of symptoms already with medical treatment, inconvenient clinic timing, and needle phobia. The main reasons given for considering acupuncture use included its perceived capability of reducing fatigue, boosting energy levels, improving immune function, and reducing pain and anxiety. Patients considering acupuncture use also demonstrated significantly higher levels of stress (p<0.001), anxiety and depression (p<0.001), fatigue (p<0.001), and lower global quality of life (p<0.01) compared to those who were not considering acupuncture. Conclusions The findings show that demand for acupuncture by cancer patients is high. A substantial proportion of cancer patients intend to use acupuncture to manage cancer and/or cancer treatment-related symptoms. Discussion with patients about acupuncture and other complementary therapies during the consultation may improve cancer care.
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Affiliation(s)
- Byeongsang Oh
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas Eade
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew Kneebone
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Nick Pavlakis
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Stephen Clarke
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Guy Eslick
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Jo River
- Sydney Nursing School, University of Sydney, Camperdown, New South Wales, Australia
| | - Michael Back
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Humpel N, Jones SC. Development of a Comprehensive Questionnaire of Complementary and Alternative Medicine Use Among Cancer Patients and Survivors. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/1533210105283386] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to develop and pilot test a comprehensive measurement tool to quantify all aspects of complementary and alternative medicine (CAM) use among cancer survivors. Data are from 81 cancer patients and survivors with a mean age of 62 years and 77.2% women. CAMwas used by 63% of the sample. The most common CAM was regular exercise (50%), meditation (48.5%), and fresh fruit and vegetable juices (38.8%). The main motivations for using CAM were to boost the immune system and enhance quality of life. More than 65% had told a doctor they were using CAM. Reported benefits included feeling better, having more energy, and providing a distraction. The main sources of information were support groups (61.5%), books (50%), and friends (45.3%). Few participants used CAM to cure the cancer, and they had realistic expectations about benefits they may receive from using CAM. Further studies are needed with larger sample sizes to confirm whether findings can be generalized to the broader population of cancer patients and survivors.
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Affiliation(s)
| | - Sandra C. Jones
- Faculty of Health and Behavioural Sciences, Centre for Health Behaviour and Communication Research, University of Wollongong, Australia
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Abstract
In recent years, complementary and alternative medicine (CAM) has become popular with the general public. Many cancer patients use CAM, usually without their physicians’ knowledge. The importance of discussing CAM with cancer patients is increasingly acknowledged. Unfortunately, there is little information available about teaching and increasing physicians’ knowledge about these therapies. In a preliminary trial addressing this lack of information, a course about the role of CAM in the treatment of cancer was designed and administered to primary care physicians. The course evolved as a response to an interest that was acknowledged among practicing family physicians and residents. The course involved family physicians, patients, and CAM practitioners. The main focus of the course was to enhance physicians’ understanding and attentiveness to patients’ reasons for using CAM, as well as education about the variety of CAM practices patients are using. The course consisted of biweekly meetings in which practitioners and patients brought their experience and practice. The course outcome was evaluated with an analysis of precourse and postcourse questionnaires. After completing the course, the participants reported that they were more open and able to talk about CAM with their patients and that they felt more prepared to treat patients with cancer, in general. This introductory course appears to be a first step in bridging some of the gaps between the popularity of CAM among cancer patients and primary care physicians’ knowledge related to CAM in cancer care.
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Affiliation(s)
- Eran Ben-Arye
- Complementary and Traditional Medicine Unit, Department of Family Medicine, Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
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10
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Abstract
Objective Psychotherapy is a common non-pharmacological approach to help cancer patients in their psychological distress. The benefit of psychotherapies was documented, but the types of psychotherapies proposed are varied. Given that the previous literature review was a decade ago and no quantitative analysis was done on this topic, we again critically and systematically reviewed all published trials on psychotherapy in cancer patients. Method We identified 17 clinical trials on six types of psychotherapy for cancer patients by searching PubMed and EMBASE. Result There were four trials involved adjunct psychological therapy which were included in quantitative analysis. Each trial demonstrated that psychotherapy improved the quality of life and coping in cancer patients. There was also a reduction in distress, anxiety, and depression after a psychological intervention. However, the number and quality of clinical trials for each type of psychotherapy were poor. The meta-analysis of the four trials involved adjunct psychological therapy showed no significant change in depression, with only significant short-term improvement in anxiety but not up to a year-the standardized mean differences were -0.37 (95% confidence interval (CI) = -0.57, -0.16) at 2 months, -0.21 (95% CI = -0.42, -0.01) at 4 months, and 0.03 (95 % CI = -0.19, 0.24) at 12 months. Conclusion The evidence on the efficacy of psychotherapy in cancer patients is unsatisfactory. There is a need for more rigorous and well-designed clinical trials on this topic.
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Affiliation(s)
- Ng Chong Guan
- 1 Department of Psychological Medicine, University Malaya Medical Centre, Malaysia
| | - Salina Mohamed
- 2 Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Malaysia
| | - Lai Kian Tiah
- 3 Department of Psychology, HELP University, Malaysia
| | - Teoh Kar Mun
- 4 Faculty of Arts and Social Science, Universiti Tunku Abdul Rahman, Malaysia
| | - Ahmad Hatim Sulaiman
- 1 Department of Psychological Medicine, University Malaya Medical Centre, Malaysia
| | - Nor Zuraida Zainal
- 1 Department of Psychological Medicine, University Malaya Medical Centre, Malaysia
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Yeo Y, Park J, Roh S, Levkoff S. Use of electronic personal health records (PHRs) for complementary and alternative medicine (CAM) disclosure: Implications for integrative health care. Complement Ther Med 2016; 26:108-16. [PMID: 27261990 DOI: 10.1016/j.ctim.2016.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 03/03/2016] [Accepted: 03/05/2016] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES To test a hypothesis that patients' use of Internet-based personal health records (PHRs) will be positively related to their disclosure of their CAM use to medical doctors, controlling for covariates' effects (e.g., health, human capital, and demographics), and to examine the factors influencing patients' CAM use disclosures. DESIGN Cross-sectional survey. METHODS We analyzed data in a subsample of CAM users who used both the internet and healthcare services (n=1457) from the Health Information National Trends Survey, a nationally representative study of U.S. adults (≥18), by using a multivariate logistic analysis. RESULTS Among the subsample, 52.7% disclosed their use of CAM to their doctors and 19.3% used PHRs. Both the bivariate (64.1% vs. 35.9%, p<0.01) and multivariate (β=0.558, SE=0.220, OR=1.75, p<0.05) analyses revealed a positive relationship between PHR use and CAM use disclosure. Other significant factors for CAM use disclosure included being older, being a female, having insurance, and having regular source of care. Particularly, foreign-born adults had significantly lower odds of disclosing their CAM use than U.S.-born adults. CONCLUSIONS We found that patients' PHR use facilitated their disclosure of CAM use to medical doctors. To ensure integrative healthcare and integrative medicine in the healthcare sector and optimum care for patients, education for CAM users regarding PHR adoption is encouraged. Next-generation PHR designs should consider incorporating domains for CAM data that allow patients to store CAM data and also incorporating 'intelligent' PHRs, whose contents can be converted into the patient's first language.
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Affiliation(s)
- Younsook Yeo
- Department of Social Work, St. Cloud State University, St. Cloud, MN 56304, USA.
| | - Jisung Park
- Retirement Research Center at Samsung Life Insurance Co., Seoul 100-716, South Korea
| | - Soonhee Roh
- Department of Social Work, University of South Dakota, Sioux Falls, SD 57105, USA
| | - Sue Levkoff
- College of Social Work, University of South Carolina, Columbia, SC 29208, USA
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12
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Abstract
Aim. Numerous studies have demonstrated the high prevalence of complementary and alternative medicine (CAM) use in metropolitan cancer cohorts but few have been conducted in regional and remote populations. This study aimed to investigate the trends and regional variations in CAM use by cancer patients at a regional cancer care center in Toowoomba, South East Queensland, Australia. Methods. All English-speaking adult cancer patients attending the regional cancer care center were invited to participate. Eligible patients were provided a self-administered questionnaire that was developed based on published surveys. Ethics approval was obtained. Results. Overall 142 patients completed the questionnaire and 68% were currently or had previously used at least one form of CAM. CAM users and nonusers did not differ significantly by region, age, gender, time since diagnosis, income, town size, treatment intent, or metastases. CAM users were more likely to have a higher level of education. Concurrent CAM use with conventional treatment was reported by approximately half of respondents. The most common reason for CAM use was “to improve general physical well-being.” The most common sources of CAM information were family (31%) and friends (29%). Disclosure of CAM use to either the general practitioner or specialist was reported by 46% and 33% of patients, respectively. The most common reason for nondisclosure was “doctor never asked.” Conclusion. This study supports previous research that CAM use is as common in regional and remote areas as metropolitan areas. Nondisclosure of CAM use to health professionals was common. Future research needs to focus on strategies to improve communication between patients and health professionals about the use of CAM.
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Affiliation(s)
- Aimee Sullivan
- Toowoomba Hospital, Toowoomba, Queensland, Australia
- Prince of Wales Hospital, Sydney, New South Wales, Australia
- University of Tasmania, Hobart, Tasmania, Australia
| | - Peter Gilbar
- Toowoomba Hospital, Toowoomba, Queensland, Australia
- Department of Medicine (Rural Clinical School), The University of Queensland, Toowoomba, Queensland, Australia
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Bonacchi A, Toccafondi A, Mambrini A, Cantore M, Muraca MG, Focardi F, Lippi D, Miccinesi G. Complementary needs behind complementary therapies in cancer patients. Psychooncology 2015; 24:1124-30. [PMID: 25690807 DOI: 10.1002/pon.3773] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 01/14/2015] [Accepted: 01/20/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Although many studies indicate that the use of complementary and alternative medicine by cancer patients is common and widespread, few studies have focused on unmet needs of patients using complementary therapies (CTs). The aim of the present study was to evaluate, through a quantitative approach, possible associations between the use of CTs and the presence of specific unmet needs in cancer patients. METHODS In six Italian oncology departments, 783 patients were interviewed about CTs use and completed the Needs Evaluation Questionnaire. Patients included in the study had different primary tumor sites and were in different phases of the disease and care process. RESULTS At the time of the survey, 38.3% of patients were using one or more types of CTs. According to Needs Evaluation Questionnaire, the use of CTs was associated (p < .05) with the need to be more involved in therapeutic choices (40% vs. 31.7%), the need to have a better dialogue with clinicians (44.4% vs. 37.2%), and the need to have more economic-insurance information in relation to their illness (46.1% vs. 36.4%). Statistical significance was confirmed with multivariable analysis for the last two items, whereas three more needs were associated with the use of CTs after adjustment: to receive more explanation on treatments (46.8% vs. 41.0%), to receive more comprehensible information (38% vs. 31.9%), and to receive more attention from nurses (16% vs. 12.1%). CONCLUSIONS Our study shows interesting differences regarding perceived needs between cancer patients who use and who do not use CTs. Unmet needs that are more expressed in CTs users should be known and, when possible, could be taken into account to improve both psychosocial interventions in the context of conventional care process and the quality of the relationship between patient and medical and nursing staff.
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Affiliation(s)
- A Bonacchi
- Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy.,Centro Studi e Ricerca Synthesis, Florence, Italy
| | - A Toccafondi
- Centro Studi e Ricerca Synthesis, Florence, Italy
| | - A Mambrini
- Oncologia Medica AUSL 1, Massa Carrara, Italy
| | - M Cantore
- Oncologia Medica AUSL 1, Massa Carrara, Italy
| | - M G Muraca
- Centro Riabilitazione Oncologica, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
| | - F Focardi
- Oncologia Medica Aziendale AUSL 10, Florence, Italy
| | - D Lippi
- Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - G Miccinesi
- Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
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Edwards GV, Aherne NJ, Horsley PJ, Benjamin LC, McLachlan CS, McKay MJ, Shakespeare TP. Prevalence of complementary and alternative therapy use by cancer patients undergoing radiation therapy. Asia Pac J Clin Oncol 2014; 10:346-53. [DOI: 10.1111/ajco.12203] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Grace V Edwards
- Department of Radiation Oncology; North Coast Cancer Institute; Coffs Harbour New South Wales Australia
| | - Noel J Aherne
- Department of Radiation Oncology; North Coast Cancer Institute; Coffs Harbour New South Wales Australia
- Rural Clinical School Faculty of Medicine; University of New South Wales; Coffs Harbour New South Wales Australia
| | - Patrick J Horsley
- Department of Radiation Oncology; North Coast Cancer Institute; Coffs Harbour New South Wales Australia
| | - Linus C Benjamin
- Department of Radiation Oncology; North Coast Cancer Institute; Coffs Harbour New South Wales Australia
| | - Craig S McLachlan
- Rural Clinical School Faculty of Medicine; University of New South Wales; Coffs Harbour New South Wales Australia
| | - Michael J McKay
- Department of Radiation Oncology; North Coast Cancer Institute; Lismore New South Wales Australia
- Faculty of Medicine; University of Sydney; Sydney New South Wales Australia
| | - Thomas P Shakespeare
- Department of Radiation Oncology; North Coast Cancer Institute; Coffs Harbour New South Wales Australia
- Rural Clinical School Faculty of Medicine; University of New South Wales; Coffs Harbour New South Wales Australia
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Furzer BJ, Petterson AS, Wright KE, Wallman KE, Ackland TR, Joske DJL. Positive patient experiences in an Australian integrative oncology centre. Altern Ther Health Med 2014; 14:158. [PMID: 24886476 PMCID: PMC4032569 DOI: 10.1186/1472-6882-14-158] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 05/08/2014] [Indexed: 11/10/2022]
Abstract
Background The purpose of this study was to explore the experiences of cancer patients’ utilising complementary and integrative therapies (CIT) within integrative oncology centres across Western Australia. Methods Across four locations 135 patients accessed CIT services whilst undergoing outpatient medical treatment for cancer. Of the 135 patients, 66 (61 ± 12 y; female n = 45; male n = 21) agreed to complete a personal accounts questionnaire consisting of open-ended questions designed to explore patients’ perceptions of CIT. All results were transcribed into nVivo (v9) and using thematic analysis, key themes were identified. Results Of the 66 participants, 100% indicated they would “recommend complementary therapies to other patients” and 92% stated “CIT would play a significant role in their future lifestyle”. A mean score of 8 ± 1 indicated an improvement in participants’ perception of wellbeing following a CIT session. Three central themes were identified: empowerment, support and relaxation. Fourteen sub-themes were identified, with all themes clustered into a framework of multifaceted views held by cancer patients in relation to wellbeing, role of significant others and control. Conclusions Exploration of patients’ experiences reveals uniformly positive results. One of the key merits of the environment created within the centres is patients are able to work through their cancer journey with an increased sense of empowerment, without placing them in opposition to conventional medical treatment. In order to effectively target integrative support services it is crucial to explore the experiences of patients in their own words and use those forms of expression to drive service delivery.
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Sait KH, Anfinan NM, Eldeek B, Al-Ahmadi J, Al-Attas M, Sait HK, Basalamah HA, Al-Ama N, El Sayed ME. Perception of Patients with Cancer towards Support Management Services and Use of Complementary Alternative Medicine - a Single Institution Hospital-Based Study in Saudi Arabia. Asian Pac J Cancer Prev 2014; 15:2547-54. [DOI: 10.7314/apjcp.2014.15.6.2547] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mathew E, Muttappallymyalil J, Sreedharan J, John L, John J, Mehboob M, Mathew A. Self-Reported Use of Complementary and Alternative Medicine among the Health Care Consumers at a Tertiary Care Center in Ajman, United Arab Emirates. Ann Med Health Sci Res 2013; 3:215-9. [PMID: 23919193 PMCID: PMC3728866 DOI: 10.4103/2141-9248.113665] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Complementary and alternative medicine (CAM) covers a wide range of approaches, including herbal medicine, manual healing techniques, traditional therapies and mind-body interventions. CAM is widely used throughout the world to treat a variety of illnesses and to maintain health. Aim: Complementary and alternative medicine (CAM) is popular across the world, and is widely practiced. Utilization pattern and reasons for use and non-use among patients attending a tertiary care center are assessed in this study. Subjects and Methods: One hundred and thirty-five patients of different nationalities, above the age of 18 years, Gulf Medical College Hospital and Research Centre, Ajman, UAE, were interviewed using an open-ended structured questionnaire. In addition to socio-demographic characteristics, the acceptability, utilization pattern and reasons for use and non-use were elicited from the participants after obtaining consent from them. PASW 18 version was used to perform Chi-square test and descriptive statistics. Results: Among the 135 participants were 20-81 years old, those from the Far East used most 85.7% (6/7), then Pakistan 38.5% (15/39) and India 23% (16/70). The most common system used was homeopathy. Physicians advised 28.2% (11/39) of users, whereas others used non-medical information. Around 71.8% (28/39) reported good outcome for themselves and family; however, only 10% (4/39) recommended it to others. Most of the users, 75% (101/135), were not sure whether CAM was based on scientific evidence, while 18% (24/135) felt it was. Good previous experience and less treatment complications were the most common reasons for using CAM and non-use due to lack of knowledge or need. Conclusion: About one-third of the seekers of modern medicine care also use CAM, and mostly without physician advice; hence, the importance of discussing the same while taking the clinical history. In view of the belief that CAM has fewer side-effects, there is even more need for physician-initiated discussion.
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Affiliation(s)
- E Mathew
- Department of Community Medicine, Gulf Medical University, Ajman, UAE
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Raszeja VM, Jordens CFC, Kerridge IH. Survey of practices and policies relating to the use of complementary and alternative medicines and therapies in New South Wales cancer services. Intern Med J 2013; 43:84-8. [DOI: 10.1111/imj.12010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 09/09/2012] [Indexed: 11/28/2022]
Affiliation(s)
- V. M. Raszeja
- Centre for Values, Ethics and the Law in Medicine; School of Public Health; University of Sydney
| | - C. F. C. Jordens
- Centre for Values, Ethics and the Law in Medicine; School of Public Health; University of Sydney
| | - I. H. Kerridge
- Centre for Values, Ethics and the Law in Medicine; School of Public Health; University of Sydney
- Haematology Department; Royal North Shore Hospital; Sydney New South Wales Australia
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Davis EL, Oh B, Butow PN, Mullan BA, Clarke S. Cancer patient disclosure and patient-doctor communication of complementary and alternative medicine use: a systematic review. Oncologist 2012; 17:1475-81. [PMID: 22933591 DOI: 10.1634/theoncologist.2012-0223] [Citation(s) in RCA: 227] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To explore the nondisclosure of complementary and alternative medicine (CAM) use among cancer patients, including reasons for and outcomes from nondisclosure of CAM use, within the context of patient-doctor communication. METHOD A systematic review was conducted exploring investigations surrounding the communication of CAM use for patients with cancer published until August 2011. RESULTS A total of 21 studies were located, which reported a prevalence of CAM use among patients with cancer ranging between 11% and 95%; of these patients, 20% to 77% did not disclose their CAM use. The main reasons for nondisclosure were the doctor's lack of inquiry; patient's anticipation of the doctor's disapproval, disinterest, or inability to help; and patient's perception that disclosure of CAM use is irrelevant to their conventional care. There is some evidence to suggest that patient-doctor communication about the use of CAM was associated with an enhanced patient-doctor relationship and higher patient satisfaction. CONCLUSIONS Although the use of CAM by patients with cancer is high, patients frequently fail to disclose its use to their health professionals for reasons emanating from both sides of the dyadic patient-doctor relationship. Because a substantial proportion of patients with cancer may use CAM and there is potential for herb- or vitamin-drug interactions, further research in patient-doctor communication about CAM is necessary to maintain patient safety and wellbeing. The development of effective interventions to improve the disclosure of CAM use should be an integral part of this future research.
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Affiliation(s)
- Esther L Davis
- Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, New South Wales, Australia.
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Klafke N, Eliott J, Wittert G, Olver I. Prevalence and predictors of complementary and alternative medicine (CAM) use by men in Australian cancer outpatient services. Ann Oncol 2012; 23:1571-8. [DOI: 10.1093/annonc/mdr521] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Egan B, Gage H, Hood J, Poole K, McDowell C, Maguire G, Storey L. Availability of complementary and alternative medicine for people with cancer in the British National Health Service: Results of a national survey. Complement Ther Clin Pract 2012; 18:75-80. [DOI: 10.1016/j.ctcp.2011.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 09/25/2011] [Accepted: 11/05/2011] [Indexed: 10/14/2022]
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Horneber M, Bueschel G, Dennert G, Less D, Ritter E, Zwahlen M. How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis. Integr Cancer Ther 2011; 11:187-203. [PMID: 22019489 DOI: 10.1177/1534735411423920] [Citation(s) in RCA: 454] [Impact Index Per Article: 34.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND No comprehensive systematic review has been published since 1998 about the frequency with which cancer patients use complementary and alternative medicine (CAM). METHODS MEDLINE, AMED, and Embase databases were searched for surveys published until January 2009. Surveys conducted in Australia, Canada, Europe, New Zealand, and the United States with at least 100 adult cancer patients were included. Detailed information on methods and results was independently extracted by 2 reviewers. Methodological quality was assessed using a criteria list developed according to the STROBE guideline. Exploratory random effects metaanalysis and metaregression were applied. RESULTS Studies from 18 countries (152; >65 000 cancer patients) were included. Heterogeneity of CAM use was high and to some extent explained by differences in survey methods. The combined prevalence for "current use" of CAM across all studies was 40%. The highest was in the United States and the lowest in Italy and the Netherlands. Metaanalysis suggested an increase in CAM use from an estimated 25% in the 1970s and 1980s to more than 32% in the 1990s and to 49% after 2000. CONCLUSIONS The overall prevalence of CAM use found was lower than often claimed. However, there was some evidence that the use has increased considerably over the past years. Therefore, the health care systems ought to implement clear strategies of how to deal with this. To improve the validity and reporting of future surveys, the authors suggest criteria for methodological quality that should be fulfilled and reporting standards that should be required.
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Affiliation(s)
- Markus Horneber
- Department of Internal Medicine, Division ofOncology/Hematology, Klinikum Nuernberg, Nuernberg, Germany.
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Affiliation(s)
- Jane M. Beith
- Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Byeongsang Oh
- Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Amanda K. Hale
- Sydney Cancer Centre, Concord Hospital, Sydney, New South Wales, Australia
| | - Ramya Venkateswaran
- Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Weber D, Wheat JM, Currie GM. Integrative oncology in Australia. Chin J Integr Med 2011; 17:246-50. [DOI: 10.1007/s11655-011-0711-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Indexed: 10/18/2022]
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Damery S, Gratus C, Grieve R, Warmington S, Jones J, Routledge P, Greenfield S, Dowswell G, Sherriff J, Wilson S. The use of herbal medicines by people with cancer: a cross-sectional survey. Br J Cancer 2011; 104:927-33. [PMID: 21364591 DOI: 10.1038/bjc.2011.47] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: A large proportion of cancer patients are estimated to use herbal medicines, but data to substantiate this are lacking. This study aimed to investigate the prevalence of herbal medicine use among cancer patients in the West Midlands, and determine the characteristics predicting herbal medicine use. Methods: A cross-sectional survey of oncology patients (n=1498) being followed up at a hospital in Coventry was undertaken. Recipients were asked about herbal medicine use since their cancer diagnosis, and the association between sociodemographic and cancer-related characteristics and herbal medicine use was evaluated. Results: A total of 1134 responses were received (75.7%). The prevalence of herbal medicine use was 19.7% (95% CI: 17.4–22.1; n=223). Users were more likely to be affluent, female, and aged under 50 years. Usage increased with time since cancer diagnosis (X2 for trend=4.63; P=0.031). A validation data set, derived from a survey of oncology patients in Birmingham (n=541) with differing socioeconomic characteristics showed no significant difference in estimated prevalence (16.6% 95% CI: 11.9–22.2). Conclusion: A substantial number of people with cancer are likely to be taking herbal medicines. Understanding the self-medication behaviours of these individuals is essential if health-care professionals are to support treatment adherence and avoid unwanted pharmacological interactions.
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Oh B, Butow P, Mullan B, Beale P, Pavlakis N, Rosenthal D, Clarke S. The use and perceived benefits resulting from the use of complementary and alternative medicine by cancer patients in Australia. Asia Pac J Clin Oncol 2010; 6:342-9. [PMID: 21114784 DOI: 10.1111/j.1743-7563.2010.01329.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIM The use of complementary and alternative medicine (CAM) by cancer patients is growing. However, few studies have examined the perceived benefits and adverse effects resulting from the use of CAM by cancer patients. The aim of this study was to evaluate CAM use by cancer patients and to explore their perceptions of the benefit, safety and efficacy of CAM in general. METHODS Oncologists from three university teaching hospitals screened patients for eligibility. Eligible patients (N = 1323) were mailed a letter of invitation with a questionnaire between January and May 2008. RESULTS Overall 381 questionnaires were returned, showing that 65% of cancer patients used at least one form of CAM. Patients considered taking biological CAM before, during and after chemotherapy. Up to 90% of CAM users believed that CAM provided potential health benefits and less than 3% reported adverse effects experienced from the use of CAM. Most respondents (80%) believed CAM can provide health benefits even when efficacy has not been proven. Most patients (90%) believed that doctors should consider learning about CAM to provide appropriate advice to their cancer patients, and most (83%) indicated they would be happier to accept CAM if it was offered by the hospital. CONCLUSION A substantial portion of Australian cancer patients use CAM. Given the limited data on efficacy and safety for most CAM, it may be reasonable to offer CAM within the hospital environment so its use can be monitored and patients can receive more evidence-based care.
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Affiliation(s)
- Byeongsang Oh
- Department of Medicine, University of Sydney, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
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Abstract
BACKGROUND Complementary and alternative medicine (CAM) has been widely used in the general population and in patients with cancer. Female sex and advanced cancer are 2 reported factors contributing to CAM use. OBJECTIVE The aim of this study was to examine the patterns of CAM use among women with metastatic cancer. METHODS A total of 68 women were enrolled into this cross-sectional study. All participants were receiving conventional treatment in a single inpatient oncology center. Data were collected from the women through a face-to-face interview guided by a questionnaire. On the basis of women's responses, all participants were divided into 2 groups: CAM users and nonusers. RESULTS The 2 cancers most frequently diagnosed in these women were gastrointestinal cancer (36.8%) and breast cancer (33.8%). Of 68 women, 40 (58.8%) reported the use of at least 1 type of CAM therapy after the diagnosis of cancer. There were no significant differences in the sociodemographic and clinical characteristics between CAM users and nonusers (P > .05). The most frequently used CAM method was herbal therapy (34.6%) and the second was nutritional supplements (17.9%). A considerable proportion (60.0%) of CAM users had not discussed their CAM use with their physicians or nurses. Four (10%) patients reported an adverse effect due to CAM use. CONCLUSIONS Our findings indicate that Turkish women with metastatic cancer seek to use CAM, with a small minority being at risk of potential adverse effects of certain CAM products. IMPLICATIONS FOR PRACTICE Because of the high prevalence of CAM therapies among women with metastatic cancer, oncology specialists and nurses should increase their knowledge about CAM therapies. Nurses are in a position to provide knowledge and education about CAM therapies and to develop protocols and guidelines about CAM use for patients with cancer.
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Frenkel M, Cohen L, Peterson N, Palmer JL, Swint K, Bruera E. Integrative Medicine Consultation Service in a Comprehensive Cancer Center: Findings and Outcomes. Integr Cancer Ther 2010; 9:276-83. [DOI: 10.1177/1534735410378663] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives. This study portrays the characteristics of patients who attended an integrative oncology clinic at a large comprehensive cancer center and evaluated whether this service addressed patients’ concerns about complementary and integrative medicine (CIM). Methods. Patient information was collected prior to an integrative consultation, including demographics, previous use of CIM, and primary reason for requesting the consultation. Concerns and outcomes were measured using the Measure Yourself Concerns and Well-being (MYCaW) Scale at the consultation and then again at follow-up (6-12 weeks later). Patients met with a physician for an integrative consultation that included a discussion of nutrition, supplements, physical activity, useful complementary therapies, and the mind—body—spirit connection. Results. A total of 238 patients were referred for consultation regarding the integration of CIM into their care. The majority of participants were female (60%, n = 143), and the mean age was 56 years (range, 21-90 years), with all major cancer types represented. Patients’ leading concerns were related to “What else can I do?” and “How can I better cope?” Although distressed over these concerns at the initial consultation, intense distress (5-6 out of 6 on the MYCaW scale) was reduced to less than half (31%) by the follow-up visit. Additional qualitative data revealed that patients value the process of obtaining reliable information that empowers them to be more involved in managing their care. Conclusions. Integrative medicine consultations at a large comprehensive cancer center appear to provide some benefit in addressing patients’ concerns about CIM use.
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Juraskova I, Hegedus L, Butow P, Smith A, Schofield P. Discussing Complementary Therapy Use With Early-Stage Breast Cancer Patients: Exploring the Communication Gap. Integr Cancer Ther 2010; 9:168-76. [DOI: 10.1177/1534735410365712] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective. The current study aimed to (1) describe communication patterns between oncologists and breast cancer patients regarding the use of complementary and alternative medicine (CAM) and (2) assess the relationship between CAM discussions and anxiety levels. Methods. Interaction analysis of audiotaped initial consultations of 102 early-stage breast cancer patients with Australian and New Zealand oncologists was carried out. Preconsultation and postconsultation anxiety levels were assessed using the State-Trait Anxiety Inventory. Results. At least 1 instance of CAM discussion was found in 24 of the 102 consultations (24%). CAM discussions were mainly patient initiated (73%). The most common doctor’s response to a patient’s mention of CAM was encouragement (38%), although 23% of CAM references elicited a discouraging comment, and 20% were ignored. No patient demographics were significantly associated with CAM discussion. Patients who discussed CAM reported higher preconsultation and postconsultation anxiety levels than those who did not discuss CAM. Conclusions. CAM discussions during initial consultations between early-stage breast cancer patients and oncologists appear to be limited and linked with higher patient anxiety before and after the consultation. These findings indicate that doctors require further education about CAM therapies and supplements as well as guidance in how to raise and effectively discuss CAM issues with concern for their safety while balancing respect for the patients’ beliefs.
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Affiliation(s)
- Ilona Juraskova
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, NSW, Australia,
| | - Leonard Hegedus
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, NSW, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, NSW, Australia
| | - Allan Smith
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, NSW, Australia
| | - Penelope Schofield
- Supportive Care Research Group Education Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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Steinsbekk A, Adams J, Sibbritt D, Johnsen R. Complementary and alternative medicine practitioner consultations among those who have or have had cancer in a Norwegian total population (Nord-Trøndelag Health Study): prevalence, socio-demographics and health perceptions. Eur J Cancer Care (Engl) 2010; 19:346-51. [PMID: 19686272 DOI: 10.1111/j.1365-2354.2008.01049.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Steinsbekk
- Department of Public Health and General Practice Norwegian University of Science and Technology (NTNU), Trondheim, MTFS, Trondheim, Norway
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Mercurio R, Eliott JA. Trick or treat? Australian newspaper portrayal of complementary and alternative medicine for the treatment of cancer. Support Care Cancer 2009; 19:67-80. [PMID: 19943067 DOI: 10.1007/s00520-009-0790-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 11/11/2009] [Indexed: 11/29/2022]
Abstract
PURPOSE Many cancer patients within developed nations cite the media as informing their decisions to use complementary and alternative medicine (CAM). The present study describes (1) Australian newspaper coverage of CAM use for cancer between 1998 and 2007; (2) trends in reporting frequency and characteristics; and (3) how the Australian press framed stories on CAM use for cancer. MATERIALS AND METHODS This study is a content analysis featuring quantitative and qualitative techniques, the latter guided by 'media framing', of targeted newspaper articles. RESULTS One hundred nineteen articles focused on CAM use for the treatment of cancer were identified. Quantitative analysis found that biologically based CAMs were most frequently described and breast cancer most mentioned. Two thirds of all articles described CAM use in the context of a cure, with approximately half of these opposing this reason for use. Potential benefits of CAM were discussed more frequently than potential risks, and information on costs and how to access CAM were uncommon. Recommendations included advice to use complementary, not alternative therapies, yet advice to discuss CAM with a medical doctor was rare. Qualitative analysis found six CAM cancer-related frames, four in support of CAM use for cancer treatment. The dominant frame constructed CAM as legitimate tools to assist biomedicine (even to cure), with others depicting CAM as normal and necessary or as addressing limitations of biomedicine. Negative frames depicted CAM as questionable and risky practices and the industry/practitioners as possessing malevolent intent. CONCLUSION These findings have implications for biomedical practitioners attempting to determine, respect and assist patient choices about their treatment.
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Affiliation(s)
- Reegan Mercurio
- School of Psychology, The University of Adelaide, Level 4, Hughes Building, Adelaide, SA, 5005, Australia
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Oh B, Butow P, Mullan B, Clarke S, Beale P, Pavlakis N, Kothe E, Lam L, Rosenthal D. Impact of medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial. Ann Oncol 2009; 21:608-614. [PMID: 19880433 PMCID: PMC2826100 DOI: 10.1093/annonc/mdp479] [Citation(s) in RCA: 140] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Substantial numbers of cancer patients use complementary medicine therapies, even without a supportive evidence base. This study aimed to evaluate in a randomized controlled trial, the use of Medical Qigong (MQ) compared with usual care to improve the quality of life (QOL) of cancer patients. Patients and methods: One hundred and sixty-two patients with a range of cancers were recruited. QOL and fatigue were measured by Functional Assessment of Cancer Therapy—General and Functional Assessment of Cancer Therapy—Fatigue, respectively, and mood status by Profile of Mood State. The inflammatory marker serum C-reactive protein (CRP) was monitored serially. Results: Regression analysis indicated that the MQ group significantly improved overall QOL (t144 = −5.761, P < 0.001), fatigue (t153 = −5.621, P < 0.001), mood disturbance (t122 =2.346, P = 0.021) and inflammation (CRP) (t99 = 2.042, P < 0.044) compared with usual care after controlling for baseline variables. Conclusions: This study indicates that MQ can improve cancer patients’ overall QOL and mood status and reduce specific side-effects of treatment. It may also produce physical benefits in the long term through reduced inflammation.
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Affiliation(s)
- B Oh
- Department of Medicine, Concord Repatriation General Hospital, University of Sydney, Concord; Center for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney; Sydney Cancer Center, Concord Repatriation General Hospital.
| | - P Butow
- Center for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney
| | - B Mullan
- Center for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney
| | - S Clarke
- Department of Medicine, Concord Repatriation General Hospital, University of Sydney, Concord; Sydney Cancer Center, Concord Repatriation General Hospital
| | - P Beale
- Department of Medicine, Concord Repatriation General Hospital, University of Sydney, Concord; Sydney Cancer Center, Concord Repatriation General Hospital
| | - N Pavlakis
- Department of Medicine, Concord Repatriation General Hospital, University of Sydney, Concord; Department of Medical Oncology, Royal North Shore Hospital
| | - E Kothe
- School of Psychology, University of Sydney
| | - L Lam
- School of Medical Sydney, Notre Dame University, NSW, Australia
| | - D Rosenthal
- Dana-Faber Cancer Institute, Harvard Medical School, Boston, MA, USA
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Broom A. Intuition, subjectivity, and Le bricoleur: cancer patients' accounts of negotiating a plurality of therapeutic options. Qual Health Res 2009; 19:1050-1059. [PMID: 19638599 DOI: 10.1177/1049732309341190] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Cancer patients are now combining complementary and alternative medicine (CAM) with biomedical cancer treatments, reflecting an increasingly pluralistic health care environment. However, there has been little research done on the ways in which cancer patients juggle multiplicity in claims to expertise, models of disease, and therapeutic practice. Drawing on the accounts of cancer patients who use CAM, in this article I develop a conceptualization of therapeutic decision making, utilizing the notion of bricolage as a key point of departure. The patient accounts illustrate the "piecing together" (or bricolage) of therapeutic trajectories, drawing on intuitive, embodied knowledge, as well as formalized "objective" scientific expertise. Le bricoleur, as characterized here, actively mediates, rather than accepts or rejects CAM or biomedicine, and utilizes a combination of scientific expertise, embodied physicality, and social knowledge to make decisions and assess therapeutic effectiveness. Although these "border crossings" are potentially subversive of established biomedical expertise, the analysis also illustrates the structural constraints (and penalties) associated with bricolage, and furthermore, the interplay of a repositioning of responsibility with neoliberal forms of self-governance.
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Affiliation(s)
- Alex Broom
- University of Sydney, Sydney, New South Wales, Australia
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Abstract
AbstractThis brief review aims to discuss the various cellular immunological aspects and related mechanisms of the use of specific components from traditional herbal medicines. We begin with lessons learned from thalidomide as an effective single drug with multiple mechanisms of action to treat multiple myeloma. Examples of “supplements” or integrative therapy will be drawn from arsenic trioxide, medicinal mushrooms including Coriolus vesicular and Ganoderma lucidum, followed by the discussion of beta-glucans affecting various immunological important cellular subsets. Different classes of compounds may enhance distinct immune cell populations that might contribute to a multi-targeted holistic effects on anti-cancer treatment. Finally, we conclude by highlighting an herbal formulation PHY906 as a potential adjunct to chemotherapy that might become one of the first US Food and Drug Administration (FDA) approved oral herbal medicines for anti-cancer adjunct treatment.
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Weis J, Giesler JM. Subjective dimensions of patient competence: relationships with selected healthcare usage behaviors and general features of self-rated competence. Patient Educ Couns 2008; 73:511-518. [PMID: 18952394 DOI: 10.1016/j.pec.2008.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2007] [Revised: 06/04/2008] [Accepted: 07/04/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To introduce the concept of patient competence and provide additional information on the concurrent validity of a new self-rating measure of patient competence in the context of cancer employing healthcare usage behaviors and more general self-rated features of patient competence as criteria. METHODS Based on a multi-center sample of n=536 patients with cancer, bivariate correlations and multiple regressions were computed. RESULTS The competence subscale of striving for autonomous decisions emerged as significant, albeit weak predictor of having used professional psycho-social support (r=.31, beta=.28) and employing other complementary medicines (r=.28; B=.65) in relation to one's cancer. Problem-focused and emotion-focused competencies relate differently to different general features of self-rated competence like feeling informed and assertive or adapting well. CONCLUSION Additional support for the concurrent validity of the new self-rating measure of patient competence in the context of cancer has been found. Viewed in perspective, this measure may therefore provide a methodological basis to examine determinants and health effects of patient competence empirically. Nevertheless, further research on the conceptualization and measurement of patient competence appears necessary. PRACTICE IMPLICATIONS Having available measures of patients' specific competencies in the context of cancer will help identify their strength and weaknesses in dealing with life-threatening disease and enhance their coping resources.
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Affiliation(s)
- Joachim Weis
- Tumor Biology Center, Freiburg, Freiburg, Germany.
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Gage H, Storey L, McDowell C, Maguire G, Williams P, Faithfull S, Thomas H, Poole K. Integrated care: utilisation of complementary and alternative medicine within a conventional cancer treatment centre. Complement Ther Med 2008; 17:84-91. [PMID: 19185266 DOI: 10.1016/j.ctim.2008.09.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 09/16/2008] [Accepted: 09/16/2008] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To estimate the proportion of cancer outpatients who visit a Complementary and Alternative Medicine (CAM) unit that is located within a conventional cancer treatment centre; to compare the characteristics of CAM unit visitors with those of all outpatients; to monitor the demand for 20 CAM therapies delivered by professionals, and the use of the CAM unit for waiting, gathering information and informal support from volunteer staff. DESIGN Prospective, observational, over a six month period. SETTING CAM unit within a NHS cancer treatment centre. MAIN OUTCOME MEASURES Utilisation of the CAM unit for 20 complementary therapies, and for waiting, gathering information, informal support; characteristics of CAM users compared with those of all cancer outpatients attending the cancer centre; predictors of CAM therapy use and frequent use. RESULTS 761 (95% of those approached) people were recruited, 498 (65.4%) cancer patients, 202 (26.5%) relatives, 37 (4.8%) friends/carers, 24 (3.2%) staff. Women predominated (n=560, 73.6%). Of all outpatients attending the cancer centre, 498 (15.8%) visited the CAM unit, 290 (9.2%) accessed therapies. Compared to all outpatients, those visiting the CAM unit were: younger (mean 63.7 vs. 58.4 years), more likely to be female (57.9% vs. 78.7%), have breast (14.8% vs. 51.9%), gynaecological (5.0% vs. 9.1%) cancer, live in local postal district (57.3% vs. 61.6%). Significant predictors of therapy use and frequent visits were being a patient, female, higher education, living closer to the cancer centre. CONCLUSIONS Despite easy access to CAM therapies, a relatively small number of people regularly used them, whilst a larger number selectively tried a few. The integrated CAM unit meets a demand for information and informal support. The findings inform emerging policy on integrating CAM and conventional cancer treatment to address psychosocial needs of people with cancer. More research is needed on why people do not use integrated CAM services and how charges affect demand.
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Affiliation(s)
- Heather Gage
- Department of Economics, University of Surrey, Guildford GU2 7XH, United Kingdom
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Lemon J, Edelman S, Kidman AD. Perceptions of the “Mind-Cancer” Relationship Among the Public, Cancer Patients, and Oncologists. J Psychosoc Oncol 2003; 21:43-58. [DOI: 10.1300/j077v21n04_03] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Spadacio C, Barros NFD. [Use of complementary and alternative medicine by cancer patients: systematic review]. Rev Saude Publica 2008; 42:158-64. [PMID: 18200356 DOI: 10.1590/s0034-89102008000100023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2006] [Accepted: 11/10/2007] [Indexed: 11/22/2022] Open
Abstract
Interest in complementary and alternative medicine has increased, especially among oncology patients. A systematic literature review of the profile of patients who choose to use this type of medicine, as well as their motivations, was carried out on the PubMed database. For this search, the key words used were ?cancer and complementary alternative medicine? and ?oncology and complementary alternative medicine?, covering the period between 1995 and 2005. The selection criteria were the following: key words were present in the article title; article was written in either English, Portuguese, or Spanish; and study was performed with an adult population. From the 43 articles analyzed, it could be concluded that the use of complementary and alternative medicine is part of these patients? social scope. Moreover, its use plays an important role in the identity construction of cancer patients, helping them to make decisions related to conventional treatment.
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Affiliation(s)
- Cristiane Spadacio
- Programa de Pós-graduação em Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
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Oh B, Butow P, Mullan B, Clarke S. Medical Qigong for cancer patients: pilot study of impact on quality of life, side effects of treatment and inflammation. Am J Chin Med 2008; 36:459-72. [PMID: 18543381 DOI: 10.1142/s0192415x08005904] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Quality of life (QOL) of cancer patients is often diminished due to the side effects of treatment and symptoms of the disease itself. Medical Qigong (coordination of gentle exercise and relaxation through meditation and breathing exercise based on Chinese medicine theory of energy channels) may be an effective therapy for improving QOL, symptoms and side effects, and longevity of cancer patients. In this pilot study, the feasibility, acceptability, and impact of Medical Qigong (MQ) were evaluated on outcomes in cancer patients. Thirty patients diagnosed with heterogeneous cancers, were randomly assigned to two groups: a control group that received usual medical care and an intervention group who participated in a MQ program for 8 weeks in addition to receiving usual medical care. Randomization was stratified by completion of cancer treatment (n = 14) or under chemotherapy (n = 16). Patients completed measures before and after the program. Quality of life and symptoms were measured by the EORTC QLQ-C 30 and progress of disease by the inflammation biomarker (CRP: c-reactive protein) via a blood test was assessed. The MQ intervention group reported clinically significant improved global QOL scores pre- and post-intervention. The MQ intervention also reduced the symptoms of side effects of cancer treatment and inflammation biomarker (CRP) compare to the control group. Due to the small sample size, however, the results were not statistically significant between treatment and the control groups. Data from the pilot study suggest that MQ with usual medical treatment can enhance the QOL of cancer patients and reduce inflammation. This study needs a further investigation with a larger sample size.
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Affiliation(s)
- Byeongsang Oh
- School of Public Health, Faculty of Medicine, The University of Sydney, Camperdown, NSW 2006, Australia.
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PIRRI C, KATRIS P, TROTTER J, BAYLISS E, BENNETT R, DRUMMOND P. Use of complementary and alternative therapies by Western Australian cancer patients. Asia Pac J Clin Oncol 2008. [DOI: 10.1111/j.1743-7563.2008.00180.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Cancer is already a well-recognized global phenomenon. The traditional approaches to cancer therapy have been surgery, radiotherapy and chemotherapy. These modalities have shown considerable promise and presently form cornerstones of management of most malignancies. However, these conventional approaches have associated toxicities and suffer from limitations in curing advanced lesions. Complementary and alternative medicine (CAM), for reasons varying from cost to accessibility, has assumed significant importance in cancer therapy. In this article, we review the prominent modalities in CAM in present day cancer management and critically analyze their emerging potential into an evidence-based oncology practice.
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Affiliation(s)
- Anusheel Munshi
- Department of Radiation Oncology 120, Tata Memorial Hospital, Parel, Mumbai 400012, India.
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Kremser T, Evans A, Moore A, Luxford K, Begbie S, Bensoussan A, Marigliani R, Zorbas H. Use of complementary therapies by Australian women with breast cancer. Breast 2008; 17:387-94. [DOI: 10.1016/j.breast.2007.12.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Revised: 11/08/2007] [Accepted: 12/04/2007] [Indexed: 11/30/2022] Open
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Abstract
PURPOSE OF REVIEW The effect of psychotherapy on the survival of cancer patients has been debated for the past 20 years, mainly due to contradictory findings in the studies published so far. Several reviews have been published, almost all of which criticize the methods used in the studies. In 2007, three replication studies were published, which indicate that the hypothesis that psychotherapy prolongs life should be abandoned. The purpose of the present review of randomized studies of psychosocial intervention is to determine the strength of the evidence for enhanced survival after participation in psychosocial interventions. RECENT FINDINGS Three recently published replication studies, which addressed a number of the methodological flaws of earlier studies, did not report better survival among the patients receiving the intervention than among those in the control group. SUMMARY The hypothesis that psychotherapy enhances survival should be abandoned in the light of the latest replication studies, which show null results for improved survival after psychotherapy. The evidence to date points to a need for investigating the interactions between the medical, psychological, social and health behaviour components of intervention programmes, as recently published studies indicate reduced mortality among patients who engage in physical activity and change to a healthier diet.
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Armstrong TS, Gilbert MR. Use of complementary and alternative medical therapy by patients with primary brain tumors. Curr Neurol Neurosci Rep 2008; 8:264-8. [DOI: 10.1007/s11910-008-0040-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vickers AJ, Cassileth B. Principles of Complementary and Alternative Medicine for Cancer. Oncology. [DOI: 10.1007/0-387-31056-8_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Steuer-Vogt MK, Bonkowsky V, Scholz M, Fauser C, Licht K, Ambrosch P. [Influence of ML-1 standardized mistletoe extract on the quality of life in head and neck cancer patients]. HNO 2007; 54:277-86. [PMID: 16132877 DOI: 10.1007/s00106-005-1318-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND ML-1 standardized mistletoe extracts have been recommended for increasing the health-related quality of life in cancer patients. PATIENTS AND METHODS The EORTC questionnaire QLQ-C30((V2)) was given to a randomly chosen subgroup of 399 patients of a prospective, randomized, open, multi-center trial. A total of 200 patients from this trial were randomized for ML-1 treatment (1 ng/kg body weight ML-1 was injected subcutaneously twice weekly over a 60-week period. Treatment cycles of 12 weeks were followed by a break of 4 weeks (between weeks 12-16, 28-32, and 44-48)). The remaining 199 patients formed the control group. RESULTS Patients completed questionnaires before the start of their treatments at week 0 and continued until week 156. The compliance rate was high: 3611 questionnaires were available, which equals a median of nine longitudinal measurements per patient between weeks 0 and 156. Analysis did not indicate any improvement in the quality of life for either group. A significant decrease in quality of life, however, was seen in patients undergoing radiotherapy. In these patients, the global state of health was reduced and four symptom scales were significantly worse. CONCLUSION Our results demonstrated no improvement in the quality of life in head and neck cancer patients when treated with ML-1 extract.
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MESH Headings
- Adult
- Aged
- Antineoplastic Agents, Phytogenic/adverse effects
- Antineoplastic Agents, Phytogenic/standards
- Antineoplastic Agents, Phytogenic/therapeutic use
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Drug Administration Schedule
- Female
- Follow-Up Studies
- Humans
- Injections, Subcutaneous
- Male
- Middle Aged
- Otorhinolaryngologic Neoplasms/drug therapy
- Otorhinolaryngologic Neoplasms/psychology
- Otorhinolaryngologic Neoplasms/radiotherapy
- Phytotherapy/psychology
- Plant Extracts/adverse effects
- Plant Extracts/standards
- Plant Extracts/therapeutic use
- Plant Preparations/adverse effects
- Plant Preparations/standards
- Plant Preparations/therapeutic use
- Plant Proteins/adverse effects
- Plant Proteins/standards
- Plant Proteins/therapeutic use
- Prospective Studies
- Quality of Life/psychology
- Radiotherapy, Adjuvant
- Ribosome Inactivating Proteins, Type 2
- Surveys and Questionnaires
- Toxins, Biological/adverse effects
- Toxins, Biological/standards
- Toxins, Biological/therapeutic use
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Affiliation(s)
- M K Steuer-Vogt
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Klinikum rechts der Isar--Technische Universität München.
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Humpel N, Jones SC. Gaining insight into the what, why and where of complementary and alternative medicine use by cancer patients and survivors. Eur J Cancer Care (Engl) 2007; 15:362-8. [PMID: 16968318 DOI: 10.1111/j.1365-2354.2006.00667.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to gain a greater understanding of complementary and alternative medicine (CAM) use among cancer patients and survivors. Specific objectives included types used and timing, motivations for use and benefits received, sources of information on CAM and communication with doctors. Semi-structured in-depth interviews were conducted with 19 patients and survivors (mean age = 57 years). Findings on frequency and type of CAM use were consistent with previous studies. Additionally, we found that the main expected benefit from using CAM was to boost the immune system, that participants could not readily explain the nature of the benefits they received, that CAM practitioners and books were the main sources of CAM information, and that the majority reported some discussion of CAM with a doctor. A greater range of questions needs to be asked of cancer patients in future quantitative studies. Reasons for commencing and stopping use of CAM and the quality of the CAM information source will be imperative to uncover, especially as the Internet is increasing in importance as a source for health information.
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Affiliation(s)
- N Humpel
- Centre for Health Behaviour & Communication Research, Faculty of Health & Behavioural Sciences, University of Wollongong, NSW, Australia.
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