Interest in Integrative Medicine Among Postmenopausal Hormone Receptor–Positive Breast Cancer Patients in the EvAluate-TM Study

Abstract

Background. Breast cancer patients often use complementary and alternative medicine, but few prospectively collected data on the topic are available specifically for postmenopausal breast cancer patients. A large prospective study was therefore conducted within a noninterventional study in order to identify the characteristics of patients interested in integrative medicine. Methods. The EvAluate-TM study is a prospective, multicenter noninterventional study in which treatment with the aromatase inhibitor letrozole was evaluated in postmenopausal women with hormone receptor–positive primary breast cancer. Between 2008 and 2009, 5045 postmenopausal patients were enrolled at 339 certified breast centers in Germany. As part of the data collection process, patients were asked at the baseline about their interest in and information needs relating to integrative medicine. Results. Of the 5045 patients recruited, 3411 responded to the questionnaire on integrative medicine and took part in the analysis, 1583 patients expressed an interest in integrative medicine, and 1828 patients declared no interest. Relevant predictors of interest in integrative medicine were age, body mass index, tumor size, previous chemotherapy, and use of concomitant medications for other medical conditions. Interest in integrative medicine declined highly significantly (P < .001) with age (<50 years, 74.1%; 50-60 years, 54.1%; >65 years, 38.0%). Patients in favor of integrative medicine were significantly less satisfied with the information received about individual treatments and antihormonal therapy. Patients with interest in integrative medicine were more often interested in rehabilitation and fitness, nutritional counseling, and additional support from self-help organizations. These women were mostly interested in receiving information about their disease and integrative medicine from a physician, rather than from other sources. Conclusions. This study shows that a considerable proportion of postmenopausal breast cancer patients are interested in integrative medicine. Information about integrative medicine should therefore be provided as part of patient care for this group. It was found that receiving concomitant medication for other medical conditions is one of the main predictors for women not being interested in integrative medicine. This group of patients may need special attention and individualized information about integrative medicine. Additionally, most patients were interested in obtaining the relevant information from their doctor.

Evaluating the Demand for Integrative Medicine Practices in Breast and Gynecological Cancer Patients

“…Patients' characteristics significantly associated with the wish for integration of complementary healing approaches are mainly the same, namely age, education, employment, and usage of CAM. This is concordant with the literature [5,6,8,39] and suggests that patients inclined towards one of the supportive services are very likely to be interested in integrative medicine in general.…”

“…The scarce coverage of the demand for supportive care services is a phenomenon not seldom observed in the literature [5,6,35,36]. Despite conspicuous interest among patients as well as growing acceptance among physicians, a persistent lack of implementation of integrative medicine into standard cancer care in Germany has been reported [37].…”

“…As conventional medical care does not always satisfactorily relieve these symptoms, patients frequently turn to complementary alternative medicine (CAM) concepts in their search for alleviation [5,6,7]. Research highlights various other reasons why cancer patients opt for health approaches which fall outside the sphere of conventional medical care: the wish to enhance the body's ability to fight the cancer, the desire to promote healing processes and to improve physical and emotional well-being, and the hope to augment the effectiveness of regular cancer therapy [5,6,7,8]. In response to that, the field of integrative oncology (IO) has emerged, a discipline that embraces conventional and evidence-based complementary therapies.…”

Complementary and alternative medicine and musculoskeletal pain in the first year of adjuvant aromatase inhibitor treatment in early breast cancer patients

“…A cross-sectional study mainly including postmenopausal patients with early breast cancer found that 69% of the patients were physically active, 87% paid attention to nutrition, and 46% used CAM [34]. Almost 50% of postmenopausal BC patients treated with an AI are interested in CAM [33]. An Australian study investigating strategies for managing aromatase inhibitor musculoskeletal syndrome (AIMSS), including CAM, noted only limited effectiveness of CAM in patients who had AIMSS [13].…”

Gynecologic oncologists’ attitudes and practices relating to integrative medicine: results of a nationwide AGO survey

“…Most of the breast cancer patients show high interest in CAM [13, 14]. However, little is known about the acceptance and use of integrative medicine by gynecological oncologists in Germany.…”