Exploring the effectiveness of a patient‐tailored integrative oncology program on emotional distress during chemotherapy for localized cancer

Abstract

Study objective: There is a need to explore how patient-tailored integrative oncology (IO) programs reduce emotional distress. This study set out to bridge the IO research gap between non-specific, quality of life-related and specific emotionalrelated concerns in chemotherapy-treated patients. Methods: This pragmatic, prospective and preference-controlled study examined patients attending an integrative-physician consultation and weekly IO treatments during adjuvant/neo-adjuvant chemotherapy for localized cancer. Patients choosing to attend ≥4 IO sessions (highly adherent to integrative care, AIC) were compared to low AIC patients using the ESAS (Edmonton Symptom Assessment Scale) anxiety, depression and sleep; and the EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) emotional functioning scale, at baseline, 6 and 12 weeks. Emotional distress was assessed by ESAS anxiety and depression, considered as the primary study outcomes. Results: Of 439 participants, 260 (59%) were high-AIC and 179 low-AIC, both with similar baseline demographic and cancer-related characteristics. At 6 weeks, high-AIC patients reported greater improvement on ESAS sleep (p = 0.044); withingroup improvement on ESAS anxiety and; and EORTC emotional functioning. Compared with low-AIC, high-AIC patients showed greater improvement on ESAS depression (p = 0.022) and sleep (p = 0.015) in those with high baseline ESAS anxiety scores (≥7); and ESAS anxiety (p = 0.049) for patients moderately anxious (4-6) at baseline. Conclusions: High-AIC was associated with significantly reduced anxiety, depression and sleep severity at 6 weeks, especially those with high-to-moderate baseline anxiety levels. These findings reduce the research gap, suggesting specific emotional-related effects of IO.

Impact of acupuncture and integrative therapies on chemotherapy‐induced peripheral neuropathy: A multicentered, randomized controlled trial

“…The lack of a significantly greater improvement in overall QoL in the intervention arm contrasts with prior pragmatic trials which showed significantly greater improvement on EORTC‐reported functioning and symptom severity scales (e.g., anxiety, insomnia) with IO therapies 27,28 . The equivocal outcomes for QOL‐related outcomes in the present study may have resulted from the use of a protocolized CIPN‐directed CIM interventions, which focused more on relief of CIPN and less on general and holistic (e.g., overall well‐being) outcomes.…”

Acupuncture during gynecological oncology surgery: A randomized controlled trial assessing the impact of integrative therapies on perioperative pain and anxiety

“…Patients in the intervention arm of the study were treated with touch/relaxation therapies, including acupressure but excluding acupuncture. Acupressure points included Yin Tang and Pericard‐6, Neiguan ; gentle Tuina and Shiatsu foot massage including acupressure point Kidney‐1, Yongquan ); and breathing and relaxation exercises (e.g., guided imagery) 20 . IO treatments began within 3 hours before surgery and continued until the patient began undergoing general anesthesia and intubation.…”

Parasympathetic Versus Sympathetic Changes in Heart Rate Variability After a Multimodal Integrative Medicine Intervention for Frontline COVID-19 Personnel

“…IM treatments were individually tailored to the HCP’s concerns, in the same way that they are provided by the study practitioners in the integrative oncology setting. This approach takes into consideration the patient’s quality of life–related concerns, as well as their openness to undergo IM therapies that may be unfamiliar and with unknown effectiveness and safety (34). Each treatment session lasted approximately 20 to 30 minutes.…”