title: Breast Cancer Integrative Oncology Care and Its Costs.
abstract: Naturopathic oncology in conjunction with conventional treatment is commonly referred to as integrative oncology (IO). Clinics directed by oncology board certified NDs (Fellows of the American Board of Naturopathic Oncology or FABNOs) provide high-quality data for describing IO therapies, their costs and measuring clinical outcomes.
  
  
  
  To describe the types of IO therapies prescribed to breast cancer patients by ND FABNO physicians. Study participants (n = 324). Women who sought care at 1 of 6 naturopathic oncology clinics in Washington State were asked to enroll in a prospective 5 year observational outcomes study.
  
  
  
  Medical records were abstracted to collect treatment recommendations and cost data.
  
  
  
  More than 72 oral or topical, nutritional, botanical, fungal and bacterial-based medicines were prescribed to the cohort during their first year of IO care. Trametes versicolor was prescribed to 63% of the women. Mind-body therapy was recommended to 45% of patients, and 49% received acupuncture. Also, 26% were prescribed injectable therapy, including mistletoe, vitamin B complex (12%), IV ascorbate (12%), IV artesunate (7%), and IV nutrition and hydration (4%). Costs ranged from $1594/year for early-stage breast cancer to $6200/year for stage 4 breast cancer patients. Of the total amount billed for IO care for 1 year for breast cancer patients, 21% was out-of-pocket.
  
  
  
  IO care for women with breast cancer consists of botanical and mushroom oral therapies, parenteral botanical and nutrient therapy, mind-body medicine and acupuncture. IO clinic visits and acupuncture are partially paid for by medical insurance companies.
authors.affiliation: 1 Bastyr University Research Institute, Kenmore, WA, USA.
authors.forename: Leanna J
authors.initials: LJ
authors.lastname: Standish
authors.affiliation: 1 Bastyr University Research Institute, Kenmore, WA, USA.
authors.forename: Fred
authors.initials: F
authors.lastname: Dowd
authors.affiliation: 1 Bastyr University Research Institute, Kenmore, WA, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Sweet
authors.affiliation: 1 Bastyr University Research Institute, Kenmore, WA, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Dale
authors.affiliation: 1 Bastyr University Research Institute, Kenmore, WA, USA.
authors.forename: Morgan
authors.initials: M
authors.lastname: Weaver
authors.affiliation: 1 Bastyr University Research Institute, Kenmore, WA, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Osborne
authors.affiliation: 2 Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: M Robyn
authors.initials: MR
authors.lastname: Andersen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000191:economics* / Q000628:therapy*; D005260:Female; D006801:Humans; D000073196:Integrative Oncology / Q000191:economics*; D008875:Middle Aged; D009324:Naturopathy / Q000191:economics*; D011446:Prospective Studies; D014861:Washington
keywords: breast cancer; community oncology care; costs; integrative oncology care; naturopathic medicine