Skip to main content
Top
Published in: Journal of Cancer Research and Clinical Oncology 7/2017

01-07-2017 | Original Article – Clinical Oncology

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

Authors: Ilanit Shalom-Sharabi, Noah Samuels, Ofer Lavie, Efraim Lev, Lital Keinan-Boker, Elad Schiff, Eran Ben-Arye

Published in: Journal of Cancer Research and Clinical Oncology | Issue 7/2017

Login to get access

Abstract

Context and objectives

This study was conducted to assess the impact of a patient-tailored complementary/integrative medicine (CIM) program on gastro-intestinal (GI) symptoms and other concerns in female patients with breast/gynecological cancer undergoing chemotherapy.

Methods

Patients with breast/gynecological cancer reporting GI-related concerns were referred to an integrative physician (IP) consultation. The treatment group included patients agreeing to attend the consultation; controls those who did not. The Edmonton Symptom Assessment Scale (ESAS) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were administered at baseline and at 6 weeks. Adherence to integrative care (AIC) was defined as attending ≥4 CIM treatments, with ≤30 days between each session.

Results

Of 496 patients approached, 289 reported GI-related concerns. Optimal assessment at baseline and 6 weeks was achieved in 117 patients in the treatment arm, with 86 adhering to the CIM program (AIC subgroup); and in 89 of controls. EORTC scores improved more significantly in the treatment arm for appetite (P = 0.018), fatigue (P = 0.026), cognitive functioning (P < 0.001) and emotional functioning (P = 0.002); and ESAS scores for pain (P = 0.038), anxiety (P = 0.016), and sleep (P = 0.001). EORTC scores improved more significantly in the AIC group for global health status/QOL (P = 0.041), physical functioning (P = 0.004), role functioning (P = 0.011), appetite (P = 0.019), and fatigue (P = 0.001); and ESAS scores for pain (P = 0.048), fatigue (P = 0.011), drowsiness (P = 0.035), and appetite (P = 0.002).

Conclusion

The integration of CIM may improve chemotherapy-related GI and other QOL-related concerns in patients with breast and gynecological cancer, with greater benefit observed in adherent patients.
Literature
go back to reference Aaronson N, Ahmedzai S, Bergman B, Bullinger M et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality of life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376CrossRefPubMed Aaronson N, Ahmedzai S, Bergman B, Bullinger M et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality of life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376CrossRefPubMed
go back to reference Ben-Arye E, Schiff E, Shapira C, Frenkel M, Shalom T, Steiner M (2012) Modeling an integrative oncology program within a community-centered oncology service in Israel. Patient Educ Couns 89(3):423–429CrossRefPubMed Ben-Arye E, Schiff E, Shapira C, Frenkel M, Shalom T, Steiner M (2012) Modeling an integrative oncology program within a community-centered oncology service in Israel. Patient Educ Couns 89(3):423–429CrossRefPubMed
go back to reference Ben-Arye E, Schiff E, Zollman C, Heusser P, Mountford P, Frenkel M, Bar-Sela G, Lavie O (2013) Integrating complementary medicine in supportive cancer care models across four continents. Med Oncol 30(2):511CrossRefPubMed Ben-Arye E, Schiff E, Zollman C, Heusser P, Mountford P, Frenkel M, Bar-Sela G, Lavie O (2013) Integrating complementary medicine in supportive cancer care models across four continents. Med Oncol 30(2):511CrossRefPubMed
go back to reference Ben-Arye E, Aharonson ML, Schiff E, Samuels N (2015a) Alleviating gastro-intestinal symptoms and concerns by integrating patient-tailored complementary medicine in supportive cancer care. Clin Nutr 34(6):1215–1223CrossRefPubMed Ben-Arye E, Aharonson ML, Schiff E, Samuels N (2015a) Alleviating gastro-intestinal symptoms and concerns by integrating patient-tailored complementary medicine in supportive cancer care. Clin Nutr 34(6):1215–1223CrossRefPubMed
go back to reference Ben-Arye E, Samuels N, Schiff E, Raz OG, Sharabi IS, Lavie O (2015b) Quality-of-life outcomes in patients with gynecologic cancer referred to integrative oncology treatment during chemotherapy. Support Care Cancer 23(12):3411–3419CrossRef Ben-Arye E, Samuels N, Schiff E, Raz OG, Sharabi IS, Lavie O (2015b) Quality-of-life outcomes in patients with gynecologic cancer referred to integrative oncology treatment during chemotherapy. Support Care Cancer 23(12):3411–3419CrossRef
go back to reference Ben-Arye E, Samuels N, Schiff E, Raz OG, Sharabi IS, Lavie O (2015c) Quality-of-life outcomes in patients with gynecologic cancer referred to integrative oncology treatment during chemotherapy. Support Care Cancer 23(12):3411–3419CrossRef Ben-Arye E, Samuels N, Schiff E, Raz OG, Sharabi IS, Lavie O (2015c) Quality-of-life outcomes in patients with gynecologic cancer referred to integrative oncology treatment during chemotherapy. Support Care Cancer 23(12):3411–3419CrossRef
go back to reference Ben-Arye E, Schiff E, Silbermann M, Agbarya A, Bar-Sela G (2015d) Perceptions of complementary medicine integration in supportive cancer care of Arabs and Jews in Israel: a cross-cultural study. J Pain Symptom Manag 49(5):871–877CrossRef Ben-Arye E, Schiff E, Silbermann M, Agbarya A, Bar-Sela G (2015d) Perceptions of complementary medicine integration in supportive cancer care of Arabs and Jews in Israel: a cross-cultural study. J Pain Symptom Manag 49(5):871–877CrossRef
go back to reference Bruera E, Kuehn N, Miller M, Selmser P, Macmillan K (1991) The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliative Care 7(2):6–9. Bruera E, Kuehn N, Miller M, Selmser P, Macmillan K (1991) The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliative Care 7(2):6–9.
go back to reference Keshet Y, Schiff E, Samuels N, Ben-Arye E (2015) Giving voice to cancer patients: assessing non-specific effects of an integrative oncology therapeutic program via short patient narratives. Psychooncology 24(2):169–174CrossRefPubMed Keshet Y, Schiff E, Samuels N, Ben-Arye E (2015) Giving voice to cancer patients: assessing non-specific effects of an integrative oncology therapeutic program via short patient narratives. Psychooncology 24(2):169–174CrossRefPubMed
go back to reference Lesi G, Razzini G, Musti MA, Stivanello E, Petrucci C, Benedetti B, Rondini E, Ligabue MB, Scaltriti L, Botti A, Artioli F, Mancuso P, Cardini F, Pandolfi P (2016) Acupuncture as an integrative approach for the treatment of hot flashes in women with breast cancer: a prospective multicenter randomized controlled trial (AcCliMaT). J Clin Oncol 34(15):1795–1802CrossRefPubMed Lesi G, Razzini G, Musti MA, Stivanello E, Petrucci C, Benedetti B, Rondini E, Ligabue MB, Scaltriti L, Botti A, Artioli F, Mancuso P, Cardini F, Pandolfi P (2016) Acupuncture as an integrative approach for the treatment of hot flashes in women with breast cancer: a prospective multicenter randomized controlled trial (AcCliMaT). J Clin Oncol 34(15):1795–1802CrossRefPubMed
go back to reference Minchom A, Punwani R, Filshie J, Bhosle J, Nimako K, Myerson J, Gunapala R, Popat S, O’Brien ME (2016) A randomised study comparing the effectiveness of acupuncture or morphine versus the combination for the relief of dyspnoea in patients with advanced non-small cell lung cancer and mesothelioma. Eur J Cancer 61:102–110CrossRefPubMed Minchom A, Punwani R, Filshie J, Bhosle J, Nimako K, Myerson J, Gunapala R, Popat S, O’Brien ME (2016) A randomised study comparing the effectiveness of acupuncture or morphine versus the combination for the relief of dyspnoea in patients with advanced non-small cell lung cancer and mesothelioma. Eur J Cancer 61:102–110CrossRefPubMed
go back to reference Molassiotis A, Bardy J, Finnegan-John J, Mackereth P, Ryder DW, Filshie J, Ream E, Richardson A (2012) Acupuncture for cancer-related fatigue in patients with breast cancer: a pragmatic randomized controlled trial. J Clin Oncol 30(36):4470–4476CrossRefPubMed Molassiotis A, Bardy J, Finnegan-John J, Mackereth P, Ryder DW, Filshie J, Ream E, Richardson A (2012) Acupuncture for cancer-related fatigue in patients with breast cancer: a pragmatic randomized controlled trial. J Clin Oncol 30(36):4470–4476CrossRefPubMed
go back to reference Oldenmenger W, de Raaf P, de Klerk C, van der Rijt C (2012) Cut points on 0–10 numeric rating scales for symptoms included in the edmonton symptom assessment scale in cancer patients: A systematic review. J Pain Symp Manag. doi:10.1016/j.jpainsymman.2012.06.007 Oldenmenger W, de Raaf P, de Klerk C, van der Rijt C (2012) Cut points on 0–10 numeric rating scales for symptoms included in the edmonton symptom assessment scale in cancer patients: A systematic review. J Pain Symp Manag. doi:10.​1016/​j.​jpainsymman.​2012.​06.​007
go back to reference Palmer JB, Lane D, Mayo D, Schluchter M, Leeming R (2015) Effects of music therapy on anesthesia requirements and anxiety in women undergoing ambulatory breast surgery for cancer diagnosis and treatment: a randomized controlled trial. J Clin Oncol 33(28):3162–3168CrossRefPubMed Palmer JB, Lane D, Mayo D, Schluchter M, Leeming R (2015) Effects of music therapy on anesthesia requirements and anxiety in women undergoing ambulatory breast surgery for cancer diagnosis and treatment: a randomized controlled trial. J Clin Oncol 33(28):3162–3168CrossRefPubMed
go back to reference Pedersen CG, Christensen S, Jensen AB, Zachariae R (2009) Prevalence, socio-demographic and clinical predictors of post-diagnostic utilisation of different types of complementary and alternative medicine (CAM) in a nationwide cohort of Danish women treated for primary breast cancer. Eur J Cancer 45(18):3172–3181CrossRefPubMed Pedersen CG, Christensen S, Jensen AB, Zachariae R (2009) Prevalence, socio-demographic and clinical predictors of post-diagnostic utilisation of different types of complementary and alternative medicine (CAM) in a nationwide cohort of Danish women treated for primary breast cancer. Eur J Cancer 45(18):3172–3181CrossRefPubMed
go back to reference Rithirangsriroj K, Manchana T, Akkayagorn L (2015) Efficacy of acupuncture in prevention of delayed chemotherapy induced nausea and vomiting in gynecologic cancer patients. Gynecol Oncol 136(1):82–86CrossRefPubMed Rithirangsriroj K, Manchana T, Akkayagorn L (2015) Efficacy of acupuncture in prevention of delayed chemotherapy induced nausea and vomiting in gynecologic cancer patients. Gynecol Oncol 136(1):82–86CrossRefPubMed
go back to reference Roila F, Herrstedt J, Aapro M, Gralla RJ, Einhorn LH, Ballatori E, Bria E, Clark-Snow RA, Espersen BT, Feyer P, Grunberg SM, Hesketh PJ, Jordan K, Kris MG, Maranzano E, Molassiotis A, Morrow G, Olver I, Rapoport BL, Rittenberg C, Saito M, Tonato M, Warr D, ESMO, MASCC Guidelines Working Group (2010) Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol 21(Suppl 5):v232–v243 Roila F, Herrstedt J, Aapro M, Gralla RJ, Einhorn LH, Ballatori E, Bria E, Clark-Snow RA, Espersen BT, Feyer P, Grunberg SM, Hesketh PJ, Jordan K, Kris MG, Maranzano E, Molassiotis A, Morrow G, Olver I, Rapoport BL, Rittenberg C, Saito M, Tonato M, Warr D, ESMO, MASCC Guidelines Working Group (2010) Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol 21(Suppl 5):v232–v243
go back to reference Sawada NO, Zago MM, Galvão CM, Cardozo FM, Zandonai AP, Okino L, Nicolussi AC (2010) The outcomes of visualization and acupuncture on the quality of life of adult cancer patients receiving chemotherapy. Cancer Nurs 33(5):E21–E28PubMed Sawada NO, Zago MM, Galvão CM, Cardozo FM, Zandonai AP, Okino L, Nicolussi AC (2010) The outcomes of visualization and acupuncture on the quality of life of adult cancer patients receiving chemotherapy. Cancer Nurs 33(5):E21–E28PubMed
go back to reference Sharabi IS, Levin A, Schiff E, Samuels N, Agour O, Tapiro Y, Lev E, Keinan-Boker L, Ben-Arye E (2016) Quality of life-related outcomes from a patient-tailored integrative medicine program: experience of Russian-speaking patients with cancer in Israel. Support Care Cancer 24(10):4345–4355CrossRefPubMed Sharabi IS, Levin A, Schiff E, Samuels N, Agour O, Tapiro Y, Lev E, Keinan-Boker L, Ben-Arye E (2016) Quality of life-related outcomes from a patient-tailored integrative medicine program: experience of Russian-speaking patients with cancer in Israel. Support Care Cancer 24(10):4345–4355CrossRefPubMed
go back to reference Weeks LC, Seely D, Balneaves LG, Boon HS, Leis A, Oneschuk D, Sagar SM, Verhoef MJ (2013) Canadian integrative oncology research priorities: results of a consensus-building process. Curr Oncol 20(4):e289–e299CrossRefPubMedPubMedCentral Weeks LC, Seely D, Balneaves LG, Boon HS, Leis A, Oneschuk D, Sagar SM, Verhoef MJ (2013) Canadian integrative oncology research priorities: results of a consensus-building process. Curr Oncol 20(4):e289–e299CrossRefPubMedPubMedCentral
go back to reference Witt CM, Außerer O, Baier S, Heidegger H, Icke K, Mayr O, Mitterer M, Roll S, Spizzo G, Scherer A, Thuile C, Wieser A, Schützler L (2015) Effectiveness of an additional individualized multi-component complementary medicine treatment on health-related quality of life in breast cancer patients: a pragmatic randomized trial. Breast Cancer Res Treat 149(2):449–460CrossRefPubMed Witt CM, Außerer O, Baier S, Heidegger H, Icke K, Mayr O, Mitterer M, Roll S, Spizzo G, Scherer A, Thuile C, Wieser A, Schützler L (2015) Effectiveness of an additional individualized multi-component complementary medicine treatment on health-related quality of life in breast cancer patients: a pragmatic randomized trial. Breast Cancer Res Treat 149(2):449–460CrossRefPubMed
Metadata
Title
Effect of a patient-tailored integrative medicine program on gastro-intestinal concerns and quality of life in patients with breast and gynecologic cancer
Authors
Ilanit Shalom-Sharabi
Noah Samuels
Ofer Lavie
Efraim Lev
Lital Keinan-Boker
Elad Schiff
Eran Ben-Arye
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 7/2017
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-017-2368-8

Other articles of this Issue 7/2017

Journal of Cancer Research and Clinical Oncology 7/2017 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.