Breaking Bad News

Block, Keith I.; Bugno, Terrence J.; Collichio, Frances A.; Geffen, Jeremy R.; Schapira, Lidia

doi:10.1177/1534735403251273

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…Recommendations for fish intake were followed, and refined foods were nearly eliminated while red meats were avoided entirely. Adherence to supplement exercise and mind‐spirit regimens was high (12).…”

Section: Discussionmentioning

confidence: 99%

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Survival Impact of Integrative Cancer Care in Advanced Metastatic Breast Cancer

Block¹,

Gyllenhaal²,

Tripathy³

et al. 2009

The Breast Journal

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Integrative cancer treatment is of substantial interest to many cancer patients. Research is needed to evaluate the effects of integrative treatment on patient outcomes. We report survival data for a consecutive case series of advanced metastatic breast cancer patients who received a comprehensive clinical program combining conventional treatments with nutrition and supplementation, fitness and mind-spirit instruction at the Block Center for Integrative Cancer Treatment. Treatment outcomes using integrative care for this disease have not previously been documented; survival data will thus contribute to decisions concerning future research directions and design. Ninety consecutive patients with metastatic breast cancer diagnosed during 1984-1997 who received chemotherapy at the integrative cancer center were included. Prognostic factors, treatments and survival from onset of metastases were determined from analysis of scans, labs, pathology and medical records. The log-rank test and Cox proportional hazards analyses were used, and a Kaplan-Meier curve was calculated. All patients had metastatic disease at baseline, 96% were relapsed and 52% had received prior chemotherapy for metastatic disease. Median age at onset of metastasis was 46 years. Median survival was 38 months (95% CI 27,48). Published literature on populations with somewhat more favorable prognostic factors treated in conventional clinics showed median survivals of 20 to 23 months. Through the 1990s, median survival reported in metastatic breast cancer trials or observations generally ranged from 12 to 24 months. Five-year survival was 27% for Center versus 17% for comparison patients. Despite a higher proportion of younger and relapsed patients, survival of metastatic breast cancer patients at the Center was approximately double that of comparison populations and possibly even higher compared to trials published during this period. Explanations for the advantage relative to conventional treatment alone may include the nutritional, nutraceutical, exercise and psychosocial interventions, individually or in combination; self-selection of patients cannot be ruled out. Further research to evaluate the impact of integrative breast cancer treatment on survival is warranted.

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Section: Discussionmentioning

confidence: 99%

“…The BCICT emphasizes a life‐affirming, hope‐based orientation in cancer treatment (11,12). Conventional, experimental, off‐label and integrative treatments are provided, grounded in clinical and literature‐based assessment of safety, efficacy and mode of action.…”

Section: Methodsmentioning

confidence: 99%

Survival Impact of Integrative Cancer Care in Advanced Metastatic Breast Cancer

Block¹,

Gyllenhaal²,

Tripathy³

et al. 2009

The Breast Journal

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“…Family stresses and tensions can also intensify patient unease; for example, family conflicts over treatment decisions involving CAM and cancer have been discussed in the literature. 57 While supporting the patient with a full complement of care, the cancerdirected OHE should also offer services to family members and others acting as primary caregivers to patients with cancer.…”

Section: Family and Other Supportive Elementsmentioning

confidence: 99%

The Role of Optimal Healing Environments in Patients Undergoing Cancer Treatment: Clinical Research Protocol Guidelines

Block¹,

Block²,

Gyllenhaal³

2004

The Journal of Alternative and Complementary Medicine

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Integrative cancer care (ICC) is the treatment of patients with cancer, under physician supervision, with appropriate conventional treatments in a healing context based on insights from research on nutrition, biochemistry, exercise, and psycho-oncology. It uses validated techniques and practitioners of complementary and alternative medicine (CAM), and strategies for enhancing treatment and side-effect management such as chronomodulated chemotherapy, therapies to reduce treatment resistance, and innovative assessments for individualizing treatment plans. The elements of ICC align well with the concepts of optimal healing environments (OHE). Expectations of well-being are fostered; transformative self-care practices are common therapeutic tools; development of healing presence among staff and therapeutic alliances with patients are emphasized; instruction in health-promoting behavior is standard; and collaborative integration of CAM in the practice is typical. Based on the authors' clinical experience, an OHE for patients with cancer is described and suggestions for meaningful research are identified. S-157

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Recapturing the Patient’s Voice

Block

2005

Integr Cancer Ther

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Breaking Bad News

Cited by 3 publications

References 2 publications

Survival Impact of Integrative Cancer Care in Advanced Metastatic Breast Cancer

Survival Impact of Integrative Cancer Care in Advanced Metastatic Breast Cancer

The Role of Optimal Healing Environments in Patients Undergoing Cancer Treatment: Clinical Research Protocol Guidelines

Recapturing the Patient’s Voice

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