Integrative cancer care in a certified Cancer Centre of a German Anthroposophic hospital

Thronicke, Anja; Oei, Shiao Li; Merkle, Antje; Herbstreit, Cornelia; Lemmens, H. P.; Grah, Christian; Kröz, Matthias; Matthes, Harald; Schad, Friedemann

doi:10.1016/j.ctim.2018.03.012

Cited by 18 publications

(23 citation statements)

References 38 publications

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“…On the contrary, hospitals expenditures per day of each hospitalization were higher in the V group compared to the C group. is can be explained by the application of several Anthroposophic add-on complementary therapies (beyond add-on VA therapy) [29,30]. However, compared to earlier studies on pancreatic carcinoma, our data indicate less visits and shorter hospitalization time of the total observed mPC cohort in our study, reflecting current real-life treatment of pancreatic cancer patients as they lie shorter and most of the preparations are increasingly performed in an ambulant setting [31].…”

Section: Discussioncontrasting

confidence: 41%

Cost‐Effectiveness of Real‐World Administration of Concomitant Viscum album L. Therapy for the Treatment of Stage IV Pancreatic Cancer

Thronicke

Reinhold

Trott

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Background. For patients receiving add-on Viscum album L. (VA) treatments for late-stage pancreatic cancer, an improved overall survival (OS) was observed. Only limited information regarding cost-effectiveness (CE) for comparisons between standard of care and standard of care plus add-on VA in stage IV pancreatic cancer treatment is available. The present study assessed the costs and cost-effectiveness of standard of care plus VA (V) compared to standard of care alone (C) for a hospital in Germany. Methods. An observational study was conducted using data from the Network Oncology clinical registry. Patients included had stage IV pancreatic cancer at diagnosis and received C or V treatment in a certified German Cancer Center. Cost and cost-effectiveness analyses (CEA) including the analysis of the incremental cost-effectiveness ratios (ICER) were performed from the hospital’s perspective based on routine data from the financial controlling department and observed data on OS. The primary result of the analysis was tested for robustness in a bootstrap-based sensitivity analysis. Results. 88 patients (C: n = 34; V: n = 54) were included, with a mean age 65.6 years and proportion of male patients 48.9%. Adjusted hospital’s total mean costs for patients from the C and V groups were €10068.97 (over an adjusted mean OS time of 7.1 months) and €12267.94 (over an adjusted mean OS time of 10.6 months), respectively. As to CEA analysis, a relevant total hospital’s savings of €260.81/month mean OS for V patients compared to C was calculated. The costs per additional OS month gained (ICER) with the V treatment compared to C were €628.28. Furthermore, a relevant hospital savings of €915.77 per mean hospital stay and additional costs of €75.09 per mean hospitalization day in the V group were observed compared to C. Conclusion. Based on this CEA analysis, from the hospital’s point of view, the costs per mean month of OS and per mean hospital stay were lower for patients under combinational standard of care plus VA compared to patients receiving standard of care alone for the treatment of stage IV pancreatic cancer. Further prospective cost-effectiveness studies are mandatory to reevaluate our findings.

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Section: Discussioncontrasting

confidence: 41%

Cost‐Effectiveness of Real‐World Administration of Concomitant Viscum album L. Therapy for the Treatment of Stage IV Pancreatic Cancer

Thronicke

Reinhold

Trott

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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“…As to baseline differences, the combinational group was characterized by higher proportions of patients with gastrointestinal and lung tumors as well as of patients with tumors in a metastasized stage indicating the overall application areas of add-on VA treatment. We could recently show that advanced or metastasized stage colorectal cancer (mCRC) and also lung cancer rather than early stage carcinoma patients apply Integrative Oncology (IO) therapies including add-on VA therapy [ 48 ]. This may also explain the more frequent application of bevacizumab and erlotinib in the combinational group as these are approved standard therapies in unresectable mCRC and all stage non-small cell lung cancer, respectively [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, bevacizumab compared to all other applied targeted therapies showed a reduced probability of standard oncological treatment discontinuation in the present study which complies with results from a meta-analysis evaluating add-on bevacizumab’s side effects as rather acceptable while significantly improving progression free survival and overall response rate [ 74 ]. Even though bevacizumab is mainly indicated as a targeted treatment in unresectable mCRC, the increased probability of treatment discontinuation in gastrointestinal cancer in the present cohort may rather be based on advanced cancer stages than on treatment toxicity profiles [ 48 ]. In fact, we could observe a reduced probability of treatment discontinuation in patients being diagnosed with breast cancer, which may reflect the ‘healthier’ early-stage cancer condition of this group as discussed earlier and the generally better-tolerated treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinical Safety of Combined Targeted and Viscum album L. Therapy in Oncological Patients

et al. 2018

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Background: Despite improvement of tumor response rates, targeted therapy may induce toxicities in cancer patients. Recent studies indicate amelioration of adverse events (AEs) by add-on mistletoe (Viscum album L., VA) in standard oncological treatment. The primary objective of this multicenter observational study was to determine the safety profile of targeted and add-on VA therapy compared to targeted therapy alone. Methods: Demographic and medical data were retrieved from the Network Oncology registry. Allocation to either control (targeted therapy) or combinational group (targeted/add-on VA) was performed. Safety-associated variables were evaluated by adjusted multivariable analyses. Results: The median age of the study population (n = 310) at first diagnosis was 59 years; 67.4% were female. In total, 126 patients (40.6%) were in the control and 184 patients (59.4%) in the combination group. Significant differences were observed between both groups with respect to overall AE frequency (χ2 = 4.1, p = 0.04) and to discontinuation of standard oncological treatment (χ2 = 4.8, p = 0.03) with lower rates in the combinational group (20.1%, 35% respectively) compared to control (30.2%, 60.5%, respectively). Addition of VA to targeted therapy significantly reduced the probability of oncological treatment discontinuation by 70% (Odds ratio (OR) 0.30, p = 0.02). Conclusions: Our results indicate a highly significant reduction of AE-induced treatment discontinuation in all-stage cancer patients when treated with VA in addition to targeted therapy.

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“…The aim of anthroposophical medicine is to improve quality of life and salutogenesis, with treatments like movement therapies, mind-body and art therapy and non-pharmacological interventions. [50][51][52][53][54] Through the anthroposophical orientation of the entire certified hospital the professionals of the breast cancer center have a high experience in integrative oncology confirming the specified requirements of an evidence based, certified breast cancer center.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of an Expert Guided Integrative Therapy Concept in Patients With Breast or Gynecological Cancer During Systemic Therapy

Schmidt

Mathes

Klein

et al. 2020

J Evid Based Complementary Altern Med

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Purpose. Breast and gynecological cancer patients undergoing systemic therapy frequently request integrative therapy concepts. The potential of integrative therapy (IM) lies in minimizing side effects of conventional cancer treatments and therefore decreasing treatment delays. IM can help to improve patients’ physical and emotional well-being, optimizing health and quality of life as IM involves patients in their own treatment. A counseling service for integrative medicine concepts as an outpatient program was implemented in our cancer center in 2013. Methods. In 2016 and 2017 144 breast and gynecological cancer patients were included into our specific IM program. The program comprises biological based complementary and alternative medicines (BB-CAM), a structured exercise therapy, manipulative and body-based practices, nutritional counseling, psycho-oncological and relaxing therapies. Therapists with additional specialization for IM, guide the treatment units. The program was evaluated via self-administered questionnaire. Results. 78% of the participating patients noticed an improvement by using BB-CAMs. 86% stated to feel better through participation in the structured exercise program. 74% profited from nutritional counseling and 91% from manual therapy. 93% of the patients treated with body compresses considered the application as soothing. The Bio-Frequency Sound Color Bed led to a relaxation in 96%. Psychological therapy improved coping with the disease in 70% of the patients. Conclusion. Integrative oncology combines the best practices of conventional and complementary therapy, uniting them in a holistic concept. Data show that our integrative therapy concept is well accepted by the patients and that therapy- and disease-related side effects can be reduced.

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Integrative cancer care in a certified Cancer Centre of a German Anthroposophic hospital

Cited by 18 publications

References 38 publications

Cost‐Effectiveness of Real‐World Administration of Concomitant Viscum album L. Therapy for the Treatment of Stage IV Pancreatic Cancer

Cost‐Effectiveness of Real‐World Administration of Concomitant Viscum album L. Therapy for the Treatment of Stage IV Pancreatic Cancer

Clinical Safety of Combined Targeted and Viscum album L. Therapy in Oncological Patients

Evaluation of an Expert Guided Integrative Therapy Concept in Patients With Breast or Gynecological Cancer During Systemic Therapy

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