Use of complementary and alternative therapy by women...

Wed, 28 Jul 2010 12:05:00 -0500

Full Title: Use of complementary and alternative therapy by women in the first 2 years after diagnosis and treatment of invasive breast cancer OBJECTIVE:: Our aim was to document patterns of consultation with alternative practitioners, use of complementary and alternative medicine (CAM) commonly used to alleviate menopausal symptoms, and lifestyle changes made by women in the first 2 years after their diagnosis with invasive breast cancer. METHODS:: A total of 1,588 women in the MBF Foundation Health and Wellbeing After Breast Cancer Study completed both the enrollment questionnaire and the first follow-up questionnaire (FQ1), on average, 41 and 92 weeks after diagnosis, respectively. The Menopause Quality of Life Questionnaire and the Psychological General Wellbeing Index were included in the FQ1. Logistic regression analysis was used to examine characteristics associated with consulting a CAM practitioner or using CAMs. RESULTS:: At the time of completion of the FQ1, 16.4% of women had consulted a CAM practitioner and 10.6% reported using at least one CAM commonly used to alleviate menopausal symptoms. Women who consulted a CAM practitioner and women who were using at least one CAM at the time of completion of the FQ1 were, on average, younger and more educated and had a higher Menopause Quality of Life Questionnaire score than did women who did not. Of the women, 33.6% reported having made a dietary change, and the most common lifestyle change was an increase in physical activity, which was reported by 29.0% of women. CONCLUSIONS:: The frequency of use of CAMs in common usage for menopausal symptoms by women with breast cancer was lower than anticipated, increased with time from diagnosis, and is associated with more severe menopausal symptoms. Menopause. 2010 May 24. Davis SR, Lijovic M, Fradkin P, Bradbury J, La China M, Schwarz M, Bell RJ. From the 1Women's Health Program, Department of Medicine, Monash University, Alfred Hospital; 2Department of Medicine, Monash University, Alfred Hospital; and 3Alfred Health, Prahran, Victoria, Australia.

The Outcomes of Visualization and Acupuncture on the Quality of Life of Adult Cancer Patients...

Wed, 21 Jul 2010 12:04:00 -0500

Full Title: The Outcomes of Visualization and Acupuncture on the Quality of Life of Adult Cancer Patients Receiving Chemotherapy BACKGROUND:: The use of complementary and alternative medicine (CAM) to treat cancer patients has increased around the world, and its benefits have been described. These therapies represent an important theme in oncology and have been used in parallel with conventional therapies. OBJECTIVES:: This study aimed to assess the outcomes of using relaxation with visualization and acupuncture on the quality of life of cancer patients undergoing chemotherapy treatment and to compare these outcomes with patients who did not choose to receive the intervention. METHODS:: Participants chose to be in either the intervention group (IG) or control group (CG). They completed the Quality of Life Questionnaire-Core 30 at the start and end of chemotherapy. The IG was chosen by 38 patients with different types of cancer who completed weekly relaxation with visualization and acupuncture sessions, whereas the CG was composed of 37 patients who did not receive the intervention. RESULTS:: Statistically significant results evidenced an increase in global health and emotional and social functions and a decrease in fatigue and loss of appetite for the IG, and an increase in global health for the CG (P

Role of hypnosis and hypno-suggestions methods in the complex therapy of tumor patients

Thu, 15 Jul 2010 12:11:00 -0500

Besides more conventional tumor risks, depression and negative life events are significant risk factors in cancer here in Hungary, therefore oncopsychology is increasingly important. We discuss traumatizing effects of the diagnosis and invasive diagnostic and therapeutic procedures from the viewpoint of altered state of consciousness. During stress and hypnosis brain functioning is altered in a similar way, which can be seen both in the patient's symptoms and his/her physiological and neuroimaging findings. In trance state patients part from reality, they no longer communicate conventionally or maturely. Hypnosis is characterized not only by physical and mental changes, but important unique social interactions as well. These interactions affect the endocrine and immune system and the mental state of the patient, they strengthen and synchronize resources and help posttraumatic growth. Since in the stress induced spontaneous altered state of consciousness the susceptibility to suggestions is increased, suggestive communication can be used effectively and it can even result in formal hypnosis induction. Under the strong time and mental pressure characterizing the work of the oncologic departments, it might help the staff to improve the cooperation with the patient if staff members, physicians and nurses as well, are aware of the nature and the neurophysiologic background of the spontaneous trance state induced by the life-threatening diagnosis of cancer. Magy Onkol. 2010 Jun;54(2):153-60. Jakubovits E. Semmelweis Egyetem Egészségtudományi Kar Morfológiai és Fiziológiai Intézet 1088 Budapest Vas. u. 17. ELTE Pszichológiai Doktori Iskola Magatartáspszichológiai PhD Program Budapest.

Taiwanese adult cancer patients' reports of using complementary therapies

Wed, 14 Jul 2010 12:03:00 -0500

BACKGROUND: More information is needed by cancer clinicians regarding cancer patients' use of complementary and alternative medicine (CAM). OBJECTIVE: In this qualitative study, in-depth interviews were used to obtain the reports of adult cancer patients regarding their use of CAM. METHODS: Seven cancer patients (4 women, 3 men) who reported using CAM were recruited by snowball sampling. Content analysis was used to examine the interview transcriptions. RESULTS: Five themes and multiple categories were identified related to CAM use: (1) facing the challenges of cancer (I can't be defeated, need to cooperate with conventional medical treatment, rebuilding my confidence), (2) handling the physical and psychological distress of CAM use (extra loading due to the therapy, uncertainty and fear about the efficacy of CAM, being understood and supported, feeling guilty about being sick, (3) lifestyle disruption (altering social life, changing family living style), (4) having reasons for seeking other therapies (finding a way to cure the disease, boosting my immunity, improving my overall health status, and prolonging life and searching for peace of mind), and (5) unresolved practical concerns about CAM (finding an easy and effective way to practice CAM, needing CAM to be integrated into mainstream health care, and where to get the related information). CONCLUSION: Adult Taiwanese cancer patients who use CAM do experience burdens secondary to CAM use and prefer that oncology specialists be more informed about CAM. IMPLICATIONS FOR PRACTICE: Oncology specialists who know where adult cancer patients could obtain helpful information about CAM would help to decrease the burdens that patients who use CAM experience. Cancer Nurs. 2010 Jul-Aug;33(4):320-6. Lu JH, Tsay SL, Sung SC. Department of Nursing, Chang Gung Institute of Technology, Tao-Yuan, Taiwan.

Complementary medicine use in patients with head and neck cancer in Ireland

Wed, 07 Jul 2010 17:01:00 -0500

The objectives of the study were: first, to determine the prevalence of traditional medicine (TM) and complementary and alternative medicine (CAM) use in head and neck cancer patients in Ireland; second, to educate ourselves on the plethora of CAM/TM options available to patients outside the dominion of conventional medicine. The study design consisted of a cross-sectional survey carried out in three head and neck cancer centres. Self-administered questionnaires were distributed to 110 head and neck cancer patients attending the three cancer centres and data were collected for statistical analysis. A total of 106 patients completed the questionnaire; 21.7% of the participants used CAM/TM since their diagnosis with head and neck cancer. CAM/TM usage was higher in female (34.3%) than in male patients (16.2%). CAM/TM use was more common in the 41-50-year age group, in patients with higher educational levels and those holding strong religious beliefs, and also in married than single patients. The most common types of CAM/TM used were spiritual and laying on of hands. The most common reasons reported for using CAM/TM were to counteract the ill effects of treatment and increase the body's ability to fight cancer. Sources of information on CAM/TM were friends (65%), family (48%) and media (21%). This survey reveals a high prevalence of CAM/TM use in head and neck cancer patients, hence emphasising the need for otolaryngologists to educate themselves on the various therapies available to be able to provide informative advice. There is an urgent need for evidence-based investigation of various CAM/TM therapies currently offered to patients. Eur Arch Otorhinolaryngol. 2010 Aug;267(8):1291-7. Epub 2010 Mar 14. Amin M, Glynn F, Rowley S, O'Leary G, O'Dwyer T, Timon C, Kinsella J. Department of Otolaryngology, Head and Neck Cancer, St. James's Hospital, Dublin, Ireland. mohamin@rcsi.ie

From Cancer Patient to Respant

Mon, 28 Jun 2010 00:13:00 -0500

by Bernie Siegel, MD Unfortunately doctors and health professionals, in general, do not study success. We are far more likely to consider an unexpected recovery to be due to the treatment or a spontaneous remission. However, I have learned from my experience with patients and by asking them, "Why didn't you die when you were supposed to?" that they always had a story to tell. I can recall, as an intern, realizing that the seniors, with hip fractures, who were noisy and demanding didn't develop pneumonia and die while the submissive, quiet seniors who never raised their voice or caused a problem had a much higher mortality rate. [More]

Music's relevance for pediatric cancer patients

Sun, 09 May 2010 12:04:00 -0500

Full Title: Music's relevance for pediatric cancer patients: a constructivist and mosaic research approach PURPOSE: Music is important in most children's lives. To advance efficacious pediatric supportive care, it is necessary to understand young cancer patients' thoughts about music. Concern about inviting unwell children to express opinions has resulted in scant research examining their views. "Mosaic" research examines children's experiences through investigating multiple perspectives which inform a "co-constructed meaning." This study examines pediatric cancer patients' and their parents' perspectives about music and music therapy's role in the children's lives. MATERIALS AND METHODS: Children were receiving care at three hospitals with the Paediatric Integrative Cancer Service in Melbourne, Victoria, Australia. A constructivist research approach with grounded theory design was applied. Children up to 14 years old with cancer and parents participated. Data included transcripts from semi-structured research interviews and observations of children's music behaviors. Qualitative inter-rater reliability was integrated. Findings were compared with music therapists' perspectives examined elsewhere. RESULTS: Interviews were conducted with 26 patients, median age 5.7 years, and 28 parents. Data "saturation" was achieved. A substantive grounded theory emerged: Children's adverse cancer experiences are often alleviated by music usages. Broader family, social, and electronic musical interactions also promote children's resilience and "normal" development. Music therapy and associated programs often, but not always, alleviate children's distress. Positive effects may carry over into children's home lives and vicariously support families. CONCLUSIONS: Health professionals should consider ways to assist parents who are often using music to support children with cancer. Hospitals can promote pediatric cancer patients' resilience by providing music-based support services, including music therapy, and reducing unwanted stressful sounds. Support Care Cancer. 2010 Apr 28. O'Callaghan C, Baron A, Barry P, Dun B. Peter MacCallum Cancer Centre, Melbourne, Australia, clare.ocallaghan@petermac.org.

Mediators of a brief hypnosis intervention to control side effects in breast surgery patients

Thu, 04 Feb 2010 08:27:00 -0500

Full Title: Mediators of a brief hypnosis intervention to control side effects in breast surgery patients: Response expectancies and emotional distress. Objective: The present study was designed to test the hypotheses that response expectancies and emotional distress mediate the effects of an empirically validated presurgical hypnosis intervention on postsurgical side effects (i.e., pain, nausea, and fatigue). Method: Women (n = 200) undergoing breast-conserving surgery (mean age = 48.50 years; 63% White, 15% Hispanic, 13% African American, and 9% other) were randomized to a hypnosis or to an attention control group. Prior to surgery, patients completed assessments of hypothesized mediators (response expectancies and emotional distress), and following surgery, patients completed assessments of outcome variables (pain, nausea, and fatigue). Results: Structural equation modeling revealed the following: (a) Hypnotic effects on postsurgical pain were partially mediated by pain expectancy (p < .0001) but not by distress (p = .12); (b) hypnotic effects on postsurgical nausea were partially mediated by presurgical distress (p = .02) but not by nausea expectancy (p = .10); and (c) hypnotic effects on postsurgical fatigue were partially mediated by both fatigue expectancy (p = .0001) and presurgical distress (p = .02). Conclusions: The results demonstrate the mediational roles of response expectancies and emotional distress in clinical benefits associated with a hypnotic intervention for breast cancer surgical patients. More broadly, the results improve understanding of the underlying mechanisms responsible for hypnotic phenomena and suggest that future hypnotic interventions target patient expectancies and distress to improve postsurgical recovery. (PsycINFO Database Record (c) 2009 APA, all rights reserved). J Consult Clin Psychol. 2010 Feb;78(1):80-8. Montgomery GH, Hallquist MN, Schnur JB, David D, Silverstein JH, Bovbjerg DH. Integrative Behavioral Medicine Program.

Mind-Body Treatments for the Pain-Fatigue-Sleep Disturbance Symptom Cluster

Tue, 29 Dec 2009 00:00:00 -0500

Full Title: Mind-Body Treatments for the Pain-Fatigue-Sleep Disturbance Symptom Cluster in Persons with Cancer CONTEXT: Co-occurring pain, fatigue, and sleep disturbance comprise a common symptom cluster in patients with cancer. Treatment approaches that target the cluster of symptoms rather than just a single symptom need to be identified and tested. OBJECTIVE: To synthesize evidence regarding mind-body interventions that have shown efficacy in treating two or more symptoms in the pain-fatigue-sleep disturbance cancer symptom cluster. METHODS: A literature search was conducted using CINAHL, Medline, and PsychInfo databases through March 2009. Studies were categorized based on the type of mind-body intervention (relaxation, imagery/hypnosis, cognitive-behavioral therapy/coping skills training [CBT/CST], meditation, music, and virtual reality), and a preliminary review was conducted with respect to efficacy for pain, fatigue, and sleep disturbance. Mind-body interventions were selected for review if there was evidence of efficacy for at least two of the three symptoms. Forty-three studies addressing five types of mind-body interventions met criteria and are summarized in this review. RESULTS: Imagery/hypnosis and CBT/CST interventions have produced improvement in all the three cancer-related symptoms individually: pain, fatigue, and sleep disturbance. Relaxation has resulted in improvements in pain and sleep disturbance. Meditation interventions have demonstrated beneficial effects on fatigue and sleep disturbance. Music interventions have demonstrated efficacy for pain and fatigue. No trials were found that tested the mind-body interventions specifically for the pain-fatigue-sleep disturbance symptom cluster. CONCLUSIONS: Efficacy studies are needed to test the impact of relaxation, imagery/hypnosis, CBT/CST, meditation, and music interventions in persons with cancer experiencing concurrent pain, fatigue, and sleep disturbance. These mind-body interventions could help patients manage all the symptoms in the cluster with a single treatment strategy. J Pain Symptom Manage. 2009 Nov 7. Kwekkeboom KL, Cherwin CH, Lee JW, Wanta B. School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Is there a role for complementary therapy in the management of leukemia?

Thu, 03 Dec 2009 00:00:00 -0500

Patients with leukemia often seek additional treatments not prescribed by their oncologist in an effort to improve their cancer treatment outcome or to manage symptoms. Complementary therapies are used in conjunction with traditional cancer treatments to decrease symptoms and side effects associated with cancer or cancer treatment, and to improve patients' overall quality of life. Complementary therapies are distinct from so-called 'alternative' therapies, which are unproven, ineffective and may postpone or interfere with mainstream cancer treatment. Complementary therapies are pleasant, inexpensive, nonpharmacologic and effective. For patients with leukemia, the complementary therapies that are always appropriate include mind-body interventions, such as self-hypnosis, meditation, guided imagery and breath awareness. Massage and reflexology (foot massage) decrease symptoms with effects lasting at least 2 days following treatment. Acupuncture is very beneficial for symptom management without adverse consequences. Physical fitness with regular exercise and healthy dietary habits can significantly decrease side effects of cancer treatments and may prolong survival. Botanical extracts and vitamin supplements may interfere with active cancer treatments, and should be discussed with the oncologist or pharmacist before use. Expert Rev Anticancer Ther. 2009 Sep;9(9):1241-9. Wesa KM, Cassileth BR. Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, 1429 First Avenue, NY 10021, USA. wesak@mskcc.org

Systematic review of post-treatment psychosocial and behaviour change interventions

Mon, 21 Sep 2009 14:00:00 -0500

FULL TITLE: Systematic review of post-treatment psychosocial and behaviour change interventions for men with cancer Objectives: The psychosocial impacts of a cancer diagnosis include reduced quality of life, poorer inter-personal relationships, hopelessness and mental illness. Worse outcomes, including mortality rates have been found for single men with cancer compared with women and partnered men. The aim of this systematic review was to examine the effectiveness of post-treatment psychosocial and behaviour change interventions for adult men with cancer, in order to inform the development of an intervention. A focus on single men was intended.Methods: Ten databases were searched via Ovid and Web of Science. Papers were systematically extracted by title, abstract and full paper according to the inclusion/exclusion criteria. Full papers were assessed by two authors. Inclusion criteria: participants at any stage of a cancer diagnosis, >/=50% male and aged 18+; psychosocial and/or behavioural post-treatment interventions, using any format; a one-three level of evidence. Couple/carer/family interventions were excluded.Results: From 9948 studies initially identified, 11 were finally included in the review. They implemented cognitive behaviour therapy, hypnosis or psychoeducational interventions. All studies had some positive results, however, lack of reporting of intervention content and methodological issues limit the findings. No studies intervened with single men, and none provided comparative outcomes for marital status.Conclusions: Effectiveness of interventions was difficult to assess as, while all had benefits, their generalisability was limited due to methodological and reporting limitations. Improved reporting procedures are required to allow for replication. Copyright (c) 2009 John Wiley & Sons, Ltd. Psychooncology. 2009 Jul 9. Dale HL, Adair PM, Humphris GM. Department of Clinical Psychology, NHS Fife, Cupar, UK.

Complementary and alternative medical therapies used by children with cancer

Wed, 16 Sep 2009 01:47:00 -0500

Full Title: Complementary and alternative medical therapies used by children with cancer treated at an Italian pediatric oncology unit BACKGROUND: Research has identified a growing use of complementary and alternative medicines (CAM) in the pediatric oncology setting and health care professionals should consider how they might interact with and/or be used in lieu of conventional treatment. The present study was designed to establish the prevalence of CAM usage at an Italian pediatric oncology department, and the reasons why patients used these unconventional therapies. PROCEDURE: This was an observational study involving parents whose children were treated for tumors at the pediatric oncology unit of the Istituto Nazionale Tumori in Milano. Data were collected on their sociodemographic variables and their use of CAM by means of a self-administered questionnaire. RESULTS: We distributed 145 questionnaires and 97 of them (67%) were returned. Judging from this survey, 12.4% of the children used at least one type of CAM and homoeopathy was the most often used. Benefits were reported by 83% of parents. The most common reasons for using CAM were to reduce the side-effects of conventional therapies. The oncologists taking care of the patients were notified of the child's use of CAM in only one case. CONCLUSION: CAM were used not as a substitute but in addition to conventional treatments. In almost all cases, oncologists were not informed that a child was using CAM, posing a risk of any interaction with pharmacological treatments being inadequately understood. Pediatr Blood Cancer. 2009 Oct;53(4):599-604 Clerici CA, Veneroni L, Giacon B, Mariani L, Fossati-Bellani F. Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. carlo.clerici@unimi.it

Complementary and alternative medicine in patients with chronic lymphocytic leukemia

Fri, 11 Sep 2009 01:17:00 -0500

BACKGROUND: Despite the widespread use of complementary and alternative medicine (CAM) in the general population for the treatment of chronic diseases, only few data have been published for patients with leukemia. The aim of this survey was to study systematically the use of CAM in patients with chronic lymphocytic leukemia (CLL). PATIENTS AND METHODS: A structured questionnaire was sent to 247 CLL patients of all clinical stages and disease durations, treated and untreated. The questionnaire was returned anonymously by 87 patients (35%). RESULTS: Thirty-nine patients (44%) had used alternative treatments. No correlation was seen with educational level, gender, or previous or current chemotherapy. The most common alternative or complementary treatment modality was vitamin supplementation (26%), followed by mineral (18%), homeopathic (14%), and mistletoe therapy (9.2%). Some 21% of patients considered their alternative treatment as being successful. Most patients reported that they decided to use CAM after conducting a personal investigation and based on the information they found, without outside recommendations (59%). The majority of the patients used patient brochures about CLL as an important source of information (54%), followed by specific lectures (34%) or the internet (32%). CONCLUSION: Our data show that patients with CLL use a wide range of CAM, among them potentially harmful methods. Rational, evidence-based medical information about the effects and risks of CAM use should be made available through patient brochures distributed by patient organizations, through information events with lectures, or via the internet. Support Care Cancer. 2009 Jan;17(1):47-52. Epub 2008 May 6. Hensel M, Zoz M, Ho AD. Department of Medicine V, University of Heidelberg, Heidelberg, Germany. Hensel@mannheimer-onkologie-praxis.de

Systematic review of post-treatment psychosocial and behaviour change interventions for men...

Mon, 31 Aug 2009 05:00:00 -0500

Full Title: Systematic review of post-treatment psychosocial and behaviour change interventions for men with cancer. The psychosocial impacts of a cancer diagnosis include reduced quality of life, poorer inter-personal relationships, hopelessness and mental illness. Worse outcomes, including mortality rates have been found for single men with cancer compared with women and partnered men. The aim of this systematic review was to examine the effectiveness of post-treatment psychosocial and behaviour change interventions for adult men with cancer, in order to inform the development of an intervention. A focus on single men was intended. Methods: Ten databases were searched via Ovid and Web of Science. Papers were systematically extracted by title, abstract and full paper according to the inclusion/exclusion criteria. Full papers were assessed by two authors. Inclusion criteria: participants at any stage of a cancer diagnosis, >/=50% male and aged 18+; psychosocial and/or behavioural post-treatment interventions, using any format; a one-three level of evidence. Couple/carer/family interventions were excluded. Results: From 9948 studies initially identified, 11 were finally included in the review. They implemented cognitive behaviour therapy, hypnosis or psychoeducational interventions. All studies had some positive results, however, lack of reporting of intervention content and methodological issues limit the findings. No studies intervened with single men, and none provided comparative outcomes for marital status.Conclusions: Effectiveness of interventions was difficult to assess as, while all had benefits, their generalisability was limited due to methodological and reporting limitations. Improved reporting procedures are required to allow for replication. Copyright (c) 2009 John Wiley & Sons, Ltd. Psychooncology. 2009 Jul 9. Dale HL, Adair PM, Humphris GM. Department of Clinical Psychology, NHS Fife, Cupar, UK.

My Sister Myself

Sat, 01 Aug 2009 05:58:00 -0500

by Marta J. Luzim, MS On November 21, 2004, my sister Carla, at fifty-eight years of age died of breast cancer. When I was young I envied my sister's natural style and popularity. I wanted to hang out with her. I wanted to wear her mini skirts. I wanted to imitate the way she painted her eyes with bright blue eye shadow. My sister was a beautiful woman who rejected her own beauty. She had a passion for conversation and loved to give advice whether you wanted it or not. She wove her husband and three sons into a tight-knit family structure believing that they would never leave her. Eight years prior to her death her husband Larry died of leukemia. Before my sister's husband died Carla had a will to live. Afterwards, she slowly slid into a depression. Therapy, medication weren't able to help, nor did her affinity for shopping or her supportive family. [More]

International Hypnosis Research Institute - Cancer