title: Quality of life-related outcomes from a patient-tailored integrative medicine program: experience of Russian-speaking patients with cancer in Israel.
abstract: Complementary/integrative medicine (CIM) is increasingly being integrated with standard supportive cancer care. The effects of CIM on quality of life (QOL) during chemotherapy need to be examined in varied socio-cultural settings. We purpose to explore the impact of CIM on QOL-related outcomes among Russian-speaking (RS) patients with cancer.
  
  
  
  RS patients undergoing chemotherapy receiving standard supportive care were eligible. Patients in the treatment arm were seen by an integrative physician (IP) and treated within a patient-tailored CIM program. Symptoms and QOL were assessed at baseline, at 6, and at 12 weeks with the Edmonton Symptom Assessment Scale (ESAS), the Measure Yourself Concerns and Wellbeing (MYCAW) questionnaire, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).
  
  
  
  Of 70 patients referred to the treatment arm, 50 (71.4 %) underwent IP assessment and CIM treatments. Of 51 referred to the control arm, 38 (76 %) agreed to participate. At 6 weeks, CIM-treated patients reported improved ESAS scores for fatigue (P = 0.01), depression (P = 0.048), appetite (P = 0.008), sleep (P < 0.0001), and general wellbeing (P = 0.004). No improvement was observed among controls. Between-group analysis found CIM-treated patients had improved sleep scores on ESAS (P = 0.019) and EORTC (P = 0.007) at 6 weeks. Social functioning improved between 6 and 12 weeks (EORTC, P = 0.02), and global health status/QOL scale from baseline to 12 weeks (EORTC, P = 0.007).
  
  
  
  A patient-tailored CIM treatment program may improve QOL-related outcomes among RS patients undergoing chemotherapy. Integrating CIM in conventional supportive care needs to address cross-cultural aspects of care.
  
  
  
  The study protocol was registered at ClinicalTrials.gov ( https://clinicaltrials.gov/ct2/show/NCT01860365 ).
authors.affiliation: Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Ilanit Shalom
authors.initials: IS
authors.lastname: Sharabi
authors.affiliation: Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Anna
authors.initials: A
authors.lastname: Levin
authors.affiliation: Department of Internal Medicine, and Integrative Medicine Service, Bnai-Zion Hospital, Haifa, Israel; The Department for Complementary Medicine, Law and Ethics, The International Center for Health, Law and Ethics, Haifa University, Haifa, Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Schiff
authors.affiliation: Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel.|Tal Center for Integrative Medicine, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Noah
authors.initials: N
authors.lastname: Samuels
authors.affiliation: Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel.|Social-Work Service, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Olga
authors.initials: O
authors.lastname: Agour
authors.affiliation: Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Yehudith
authors.initials: Y
authors.lastname: Tapiro
authors.affiliation: Department of Eretz Israel Studies, University of Haifa, Haifa, Israel.
authors.forename: Efraim
authors.initials: E
authors.lastname: Lev
authors.affiliation: Israel Center for Disease Control, Israel Ministry of Health, Jerusalem, Israel.|School of Public Health, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.
authors.forename: Lital
authors.initials: L
authors.lastname: Keinan-Boker
authors.affiliation: Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, 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.|Clalit Health Services, Haifa and Western Galilee District, Israel. eranben@netvision.net.il.|The Oncology Service, Lin Medical Center, 35 Rothschild St., Haifa, Israel. eranben@netvision.net.il.
authors.forename: Eran
authors.initials: E
authors.lastname: Ben-Arye
mesh_terms: D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D055048:Integrative Medicine / Q000379:methods*; D007557:Israel; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D063189:Symptom Assessment; D016896:Treatment Outcome
keywords: Chemotherapy; Complementary and alternative medicine; Cross-cultural; Integrative medicine; Quality of life; Supportive care