Objective: This study sought to describe changes in the
health-related quality of life (HRQOL) of women who do and do not seek
naturopathic oncology (NO) complementary and alternative medicine (CAM) care
during and immediately after breast cancer treatment, and to explore the
predictive role of NO CAM care, demographic characteristics, and involvement in
decision-making on HRQOL in breast cancer survivors. Methods:
Matched cohorts of breast cancer survivors who did and did not choose to
supplement their breast cancer treatment with NO care within 2 years of
diagnosis participated. NO users were identified through naturopathic doctors’
clinics and usual care (UC) controls with similar prognosis were identified
through a cancer registry. The registry provided information about all
participants’ age, race, ethnicity, marital status, stage of cancer at time of
diagnosis, date of diagnosis, and use of conventional medical treatments
(surgery, chemotherapy, radiation, and endocrine therapy). Data of participants’
self-reported involvement in decision-making and HRQOL were collected at study
enrollment and at 6-month follow-up. Results: At 6-month follow-up,
the NO patients reported significantly more involvement in decision-making about
care and better general health than did UC patients (P <
.05). Self-reported involvement in decision-making about cancer treatment was
associated with better role-physical, role-emotional, and social-functional
well-being (P < .05). Race, age, marital status, and
congruence of preferred and achieved levels of involvement also predicted
aspects of HRQOL in breast cancer survivors (P < .05).
Conclusions: Both NO CAM care and involvement in
decision-making about cancer treatment may be associated with better HRQOL in
breast cancer survivors.
Use of vitamin D supplements is nominally a complementary and alternative medicine (CAM) activity; however, some conventional doctors also encourage cancer patients to take supplemental vitamin D during and after breast cancer treatment. Epidemiological evidence suggests that solar exposure, through its influence on vitamin D blood levels, may prevent cancer and improve outcomes for diagnosed patients. 1,2 Thus far, the evidence for vitamin D's effectiveness in preventing cancer is mixed, 3,4 but studies have found evidence that low levels of vitamin D (25(OH)D) in the blood are associated with increased risk of recurrence and death in early-stage breast cancer patients. 5 Studies also found that women with breast cancer in the highest tertile of 25(OH)D blood levels have superior overall survival (OS), breast cancer-specific survival, and invasive disease-free survival compared with those with lower levels. 6 Other cohort examinations found higher blood levels of 25(OH)D associated with survival and lower recurrence rates, although the results have not always been statistically significant. 7-9 Systemically, vitamin D may influence breast cancer because activation of its receptor induces autophagy and an autophagic transcriptional signature in breast cancer cells that correlates with increased survival in patients and is
Patients' lay theories about the cause of their cancer may influence patient behavior and adjustment, they have also been found to differ substantially from scientific evidence of cancer risk factors. This report describes beliefs about genetic causes of breast cancer, among 522 recently diagnosed breast cancer survivors participating in an observational study. Patients were asked to respond to an open-ended question about the cause of their cancer. Causes mentioned included family history, genetics, lifestyle, reproductive and environmental factors, often in combination. Of particular interest we found in total, 31% of women described inheritable causes, including family history, genetics, and specific genes. Lay theories about cancer's cause appear to have evolved to include new information about breast cancer genetics including BRCA1/2, epigenetic influence, and other mutations. Other causes seen in prior reports are also described and were used in many cases in combination with genetic explanations. We present evidence that genetics and family history appear to be particularly satisfying answers to questions of cause for many women with breast cancer.These findings have implications for those seeking to educate and counsel breast cancer patients with and without a family history of cancer.
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