title: Effect of a patient-tailored integrative medicine program on gastro-intestinal concerns and quality of life in patients with breast and gynecologic cancer.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Integrative Oncology Program, The Oncology Service and Lin Medical center, Clalit Health Services, Haifa and Western Galilee District, 35 Rothschild St., Haifa, Israel.
authors.forename: Ilanit
authors.initials: I
authors.lastname: Shalom-Sharabi
authors.affiliation: Integrative Oncology Program, The Oncology Service and Lin Medical center, Clalit Health Services, Haifa and Western Galilee District, 35 Rothschild St., Haifa, Israel.|Tal Center for Integrative Oncology, Sheba Medical Center, Institute of Oncology, Tel Hashomer, Israel.
authors.forename: Noah
authors.initials: N
authors.lastname: Samuels
authors.affiliation: Department of Obstetrics and Gynecology, Gynecologic Oncology Service, Carmel Medical Center, Haifa, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Lavie
authors.affiliation: Department of Eretz Israel Studies, University of Haifa, Haifa, Israel.
authors.forename: Efraim
authors.initials: E
authors.lastname: Lev
authors.affiliation: Faculty of Social Welfare and Health Sciences, School of Public Health, University of Haifa, Haifa, Israel.|Israel Center for Disease Control, Israel Ministry of Health, Haifa, Israel.
authors.forename: Lital
authors.initials: L
authors.lastname: Keinan-Boker
authors.affiliation: Department of Internal Medicine, and the Integrative Medicine Service, Bnai-Zion Hospital, 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, 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.|Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel. eranben@netvision.net.il.
authors.forename: Eran
authors.initials: E
authors.lastname: Ben-Arye
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy; D000529:Complementary Therapies / Q000379:methods; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000628:therapy*; D005833:Genital Neoplasms, Female / Q000188:drug therapy; D006801:Humans; D055048:Integrative Medicine / Q000379:methods*; D008875:Middle Aged; D010349:Patient Compliance; D011788:Quality of Life
chemical_list: D000970:Antineoplastic Agents
keywords: Breast cancer; Chemotherapy; Complementary medicine; Integrative medicine; Quality of life; Supportive care