title: Complementary and alternative medicine for cancer patients: results of the EPAAC survey on integrative oncology centres in Europe.
abstract: BACKGROUND
  The Region of Tuscany Health Department was included as an associated member in WP7 "Healthcare" of the European Partnership for Action Against Cancer (EPAAC), initiated by the EU Commission in 2009.
  
  
  OBJECTIVE
  The principal aim was to map centres across Europe prioritizing those that provide public health services and operating within the national health system in integrative oncology (IO).
  
  
  METHODS
  A cross-sectional descriptive survey design was used to collect data. A questionnaire was elaborated concerning integrative oncology therapies to be administered to all the national health system oncology centres or hospitals in each European country. These institutes were identified by convenience sampling, searching on oncology websites and forums. The official websites of these structures were analysed to obtain more information about their activities and contacts.
  
  
  RESULTS
  Information was received from 123 (52.1 %) out of the 236 centres contacted until 31 December 2013. Forty-seven out of 99 responding centres meeting inclusion criteria (47.5 %) provided integrative oncology treatments, 24 from Italy and 23 from other European countries. The number of patients seen per year was on average 301.2 ± 337. Among the centres providing these kinds of therapies, 33 (70.2 %) use fixed protocols and 35 (74.5 %) use systems for the evaluation of results. Thirty-two centres (68.1 %) had research in progress or carried out until the deadline of the survey. The complementary and alternative medicines (CAMs) more frequently provided to cancer patients were acupuncture 26 (55.3 %), homeopathy 19 (40.4 %), herbal medicine 18 (38.3 %) and traditional Chinese medicine 17 (36.2 %); anthroposophic medicine 10 (21.3 %); homotoxicology 6 (12.8 %); and other therapies 30 (63.8 %). Treatments are mainly directed to reduce adverse reactions to chemo-radiotherapy (23.9 %), in particular nausea and vomiting (13.4 %) and leucopenia (5 %). The CAMs were also used to reduce pain and fatigue (10.9 %), to reduce side effects of iatrogenic menopause (8.8 %) and to improve anxiety and depression (5.9 %), gastrointestinal disorders (5 %), sleep disturbances and neuropathy (3.8 %).
  
  
  CONCLUSIONS
  Mapping of the centres across Europe is an essential step in the process of creating a European network of centres, experts and professionals constantly engaged in the field of integrative oncology, in order to increase, share and disseminate the knowledge in this field and provide evidence-based practice.
authors.affiliation: Department of Research, Innovation and Human Resources, Regional Health Ministry of Region of Tuscany (Italy), Tuscan Network for Integrative Medicine, via T. Alderotti 26 N - 50100, Florence, Italy, retemedicinaintegrata@regione.toscana.it.
authors.forename: Elio
authors.initials: E
authors.lastname: Rossi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vita
authors.forename: Sonia
authors.initials: S
authors.lastname: Baccetti
authors.forename: Mariella
authors.initials: M
authors.lastname: Di Stefano
authors.forename: Fabio
authors.initials: F
authors.lastname: Voller
authors.forename: Alberto
authors.initials: A
authors.lastname: Zanobini
mesh_terms: D015670:Acupuncture Therapy / Q000706:statistics & numerical data; D001007:Anxiety / Q000628:therapy; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000379:methods*; D005006:Ethnicity; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D009369:Neoplasms / Q000628:therapy*; D010146:Pain; D059408:Pain Management; D008517:Phytotherapy / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States