Quality-of-life outcomes in patients with gynecologic cancer referred to integrative oncology treatment during chemotherapy.
OBJECTIVE
Integrative oncology incorporates complementary medicine (CM) therapies in patients with cancer. We explored the impact of an integrative oncology therapeutic regimen on quality-of-life (QOL) outcomes in women with gynecological cancer undergoing chemotherapy.


METHODS
A prospective preference study examined patients referred by oncology health care practitioners (HCPs) to an integrative physician (IP) consultation and CM treatments. QOL and chemotherapy-related toxicities were evaluated using the Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Wellbeing (MYCAW) questionnaire, at baseline and at a 6-12-week follow-up assessment. Adherence to the integrative care (AIC) program was defined as ≥ 4 CM treatments, with ≤ 30 days between each session.


RESULTS
Of 128 patients referred by their HCP, 102 underwent IP consultation and subsequent CM treatments. The main concerns expressed by patients were fatigue (79.8%), gastrointestinal symptoms (64.6%), pain and neuropathy (54.5 %), and emotional distress (45.5%). Patients in both AIC (n = 68) and non-AIC (n = 28) groups shared similar demographic, treatment, and cancer-related characteristics. ESAS fatigue scores improved by a mean of 1.97 points in the AIC group on a scale of 0-10 and worsened by a mean of 0.27 points in the non-AIC group (p = 0.033). In the AIC group, MYCAW scores improved significantly (p < 0.0001) for each of the leading concerns as well as for well-being, a finding which was not apparent in the non-AIC group.


CONCLUSIONS
An IP-guided CM treatment regimen provided to patients with gynecological cancer during chemotherapy may reduce cancer-related fatigue and improve other QOL outcomes.
Integrative Oncology Program, The Oncology Service, Lin Medical Center, Western Galilee District, Clalit Health Services, 35 Rothschild St., Haifa, Israel. eranben@netvision.net.il.|Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. eranben@netvision.net.il.
Eran
E
Ben-Arye
Integrative Oncology Program, The Oncology Service, Lin Medical Center, Western Galilee District, Clalit Health Services, 35 Rothschild St., Haifa, Israel.|Tal Center for Integrative Medicine, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel.
Noah
N
Samuels
Department of Internal Medicine and Integrative Surgery Service, Bnai Zion Hospital, Haifa, Israel.
Elad
E
Schiff
Integrative Oncology Program, The Oncology Service, Lin Medical Center, Western Galilee District, Clalit Health Services, 35 Rothschild St., Haifa, Israel.
Orit Gressel
OG
Raz
Integrative Oncology Program, The Oncology Service, Lin Medical Center, Western Galilee District, Clalit Health Services, 35 Rothschild St., Haifa, Israel.
Ilanit Shalom
IS
Sharabi
Department of Obstetrics and Gynecology, Gynecologic Oncology Service, Carmel Medical Center, Haifa, Israel.
Ofer
O
Lavie
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data; D005221:Fatigue / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D055048:Integrative Medicine / Q000706:statistics & numerical data; D008875:Middle Aged; D059408:Pain Management / Q000379:methods / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D063189:Symptom Assessment; D016896:Treatment Outcome
Chemotherapy; Complementary medicine; Gynecologic oncology; Integrative medicine; Quality of life