Objectives. This study portrays the characteristics of patients who attended an integrative oncology clinic at a large comprehensive cancer center and evaluated whether this service addressed patients' concerns about complementary and integrative medicine (CIM). Methods. Patient information was collected prior to an integrative consultation, including demographics, previous use of CIM, and primary reason for requesting the consultation. Concerns and outcomes were measured using the Measure Yourself Concerns and Well-being (MYCaW) Scale at the consultation and then again at follow-up (6-12 weeks later). Patients met with a physician for an integrative consultation that included a discussion of nutrition, supplements, physical activity, useful complementary therapies, and the mind-body-spirit connection. Results. A total of 238 patients were referred for consultation regarding the integration of CIM into their care. The majority of participants were female (60%, n = 143), and the mean age was 56 years (range, 21-90 years), with all major cancer types represented. Patients' leading concerns were related to "What else can I do?" and "How can I better cope?" Although distressed over these concerns at the initial consultation, intense distress (5-6 out of 6 on the MYCaW scale) was reduced to less than half (31%) by the follow-up visit. Additional qualitative data revealed that patients value the process of obtaining reliable information that empowers them to be more involved in managing their care. Conclusions. Integrative medicine consultations at a large comprehensive cancer center appear to provide some benefit in addressing patients' concerns about CIM use.

In this study, we found that activism was a major theme that was independently observed in both Israel and the U.S.A. This has implications for health care providers to facilitate patient engagement in the care and treatment of their disease. Further research on this phenomenon is needed.

The significance of patient-doctor relationship in cancer survival requires further research. This research is especially important as it adds to the current trend of patient centered care and points to the added value of relationship between health providers and patients. This relationship, as perceived by these exceptional patients, can be a factor that adds to improved survival in cancer care.

The importance of connections in these illness narratives was richly illustrated. These issues often are overlooked in clinical settings; yet they are of crucial importance to the health and well-being of the patients.

e20581 Background: Increased numbers of cancer patients are searching for additional options outside of their conventional medical care to improve their clinical outcome, quality of life, and overall wellbeing. Complementary and integrative medicine (CIM)) is one of the main options that patients are incorporating. The objectives of this study were to assess the outcome and value of an integrative medicine clinical consultation. Methods: Patients attending academic integrative medicine clinic evaluated their concerns and wellbeing using the Measure Yourself Concerns and Wellbeing (MYCaW) scale, a validated tool assessing outcome of complementary consultation for cancer patients. Prior to each visit patients completed the MYCaW and listed their two main concerns, the severity of the concern (0 = does not bother me at all to 6 = bothers me greatly), and their wellbeing (0 = as good as can be to 6 = as bad as can be). All patients met with a physician who provided an integrative consultation that included discussion of nutrition, supplements, exercise, useful complementary therapies, and the mind-body-spirit connection. At the follow up visit (usually 2–3 months later) patients completed the MYCaW to evaluate if the initial concerns were met. Results: Oncologists in the cancer center referred 197 patients for consultation about the integration of complementary medicine to their care. The majority of the participants were female (n=121), mean age was 56, range 21–90. Patients had been using a large range of CIM therapies including nutritional supplements (n=144), dietary changes (n=36), and acupuncture (n=33). The leading diagnosis was breast cancer followed by prostate cancer, but all major cancer diagnoses were represented. The leading concerns were related to “What else can I do?” and “How can I better cope?” From pre to post there was a reduction in severity of the concerns scores in 79% of patients, no change for 8%, and an increase for 13% (mean pre = 4.6; mean post = 2.6). For the question of Well being there was a reduction for 49%, no change for 32%, and an increase for 18% of the patients (mean pre = 2.5; mean post = 1.82). Conclusions: Integrative medicine consultations for cancer patients appear to be a valuable service that addresses patients’ main concerns and improves well being. No significant financial relationships to disclose.