Traditional and Complementary Medicine in Pediatric Oncology and Low-Middle Income Countries: Recommendations from the International Society of Pediatric Oncology (SIOP), T&amp;CM Collaborative

Ladas, Elena J.; Marjerrison, Stacey; Arora, Brijesh; Hesseling, Peter; Ortiz, Roberta; Antillón, Federico; Jatia, Shalini; Afungchwi, Glenn Mbah

doi:10.1093/jncimonographs/lgx014

Cited by 17 publications

(22 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other factors affecting survival rates included late diagnosis, 38 and common use of unsafe traditional and complementary treatment. 34,39 The predominance of late stage III (81%) and IV (9%) disease in this cohort was similar to that in earlier reports in this region. 11 It was apparent that patients were more likely to survive when the principal guardian was the father and other members of the family than when it was the mother alone.…”

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

Destitution, treatment adherence and survival of children with Burkitt lymphoma in a twinning programme in Northwest Cameroon

Afungchwi

Hesseling

Elsland

et al. 2019

Pediatric Blood & Cancer

Self Cite

View full text Add to dashboard Cite

Background Burkitt lymphoma (BL) is a curable childhood cancer. Treatment adherence is crucial for a good outcome, but is potentially problematic in low‐ and middle‐income countries owing to parental financial constraints. Aims To investigate the association of destitution with treatment adherence and its effect on the survival of patients with BL. Methods Patients received free medical treatment from a twinning programme at two Cameroon Baptist hospitals. A destitution assessment questionnaire, based on socioeconomic status, was completed at diagnosis. Medical records were reviewed for treatment adherence and survival. Chi‐squared and Fisher's exact tests were used to compare groups. Kaplan‐Meier plots were used to calculate overall survival, and log‐rank chi‐squared tests when comparing survival rates between patient subgroups. Significance was measured at P < .05. Results The 225 children with BL had a mean age of 8.2 years (median 8.0) and the overall survival was 52%. The mean family destitution score was 56% on a linear scale. Few (8%) patients delayed treatment appointments. A quarter (25%) experienced more than a 1‐week follow‐up delay and 9.8% absconded within 1 year. The destitution score was not significantly associated with delay of treatment, but with delay in follow‐up (P < .001). Guardian relationship (single mother) and patient's age were significantly associated with overall survival (P = .025). Conclusions Though linked to poor follow‐up, destitution was not significantly associated with absconding patients, poor outcome or poor adherence to treatment, probably due to comprehensive financial support from the international twinning programme. However, additional support for single mothers should be considered.

show abstract

Section: Discussionsupporting

confidence: 89%

“…Other factors affecting survival rates included late diagnosis, and common use of unsafe traditional and complementary treatment . The predominance of late stage III (81%) and IV (9%) disease in this cohort was similar to that in earlier reports in this region .…”

Section: Discussionmentioning

confidence: 99%

Destitution, treatment adherence and survival of children with Burkitt lymphoma in a twinning programme in Northwest Cameroon

Afungchwi

Hesseling

Elsland

et al. 2019

Pediatric Blood & Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

“…It is estimated that LMICs account for 99% of TxA worldwide, which in turn might account for at least a third of the survival gap between HICs and LMICs . Determinants of TxA in our study (socioeconomic factors, perceived prognosis of disease, concerns about toxicity, and preference for TCAM) are very similar to those worldwide, as established in a global online survey, a systematic review, and other reports . Strategies to reduce abandonment are being studied and increasingly reported .…”

Section: Discussionsupporting

confidence: 65%

“…19 Determinants of TxA in our study (socioeconomic factors, perceived prognosis of disease, concerns about toxicity, and preference for TCAM) are very similar to those worldwide, as established in a global online survey, a systematic review, and other reports. [18][19][20][21][22][23] Strategies to reduce abandonment are being studied and increasingly reported. 9,10,[24][25][26][27][28] Most centers have adopted overlapping strategies that stem from an increased understanding of the deficiencies common to most LMIC settings.…”

Section: Discussionmentioning

confidence: 99%

Holistic support coupled with prospective tracking reduces abandonment in childhood cancers: A report from India

Jatia

Prasad

Paradkar

et al. 2019

Pediatric Blood & Cancer

Self Cite

View full text Add to dashboard Cite

Background High cure rates of over 80% in childhood cancers reported from high‐income countries (HICs) are not replicated in low‐ and middle‐income countries (LMICs). Treatment abandonment (TxA) is an important reason for this poorer outcome. We assessed the effect of a holistic support group approach coupled with prospective tracking on TxA in children with cancer in a limited‐resources environment. Methods In 2010, all existing nongovernmental organizations (NGOs) working with childhood cancer at our hospital were brought together to form a pediatric cancer foundation with the aim of providing holistic support to the patient and family, including financial, psychosocial, lodging, educational, and bereavement support. Simultaneously, prospective tracking of all children with a Time‐Responsive Electronic Abandonment Tracking (TREAT) system was also established. The impact of these measures on TxA over the 2009–2016 period was compared using the log‐rank test. Results The annual rate of abandonment reduced from 20% in 2009 to 10.4% in 2010 and 5.2% in 2011. It has been consistently between 3% and 6% from 2012 to 2016 (P −0.04). TxA after the initiation of treatment dropped from 9% in 2009 to 1% in 2016 (P −0.02), while refusal to initiate treatment dropped from 11% to 2.7% (P −0.23) over the same period. Conclusions A holistic support group consisting of the hospital team, as well as existing NGOs and governmental organizations, along with a systematic and prospective tracking system significantly reduced abandonment in a resource‐constrained setting. This cost‐effective holistic support group may be applicable in other LMICs with similar healthcare systems.

show abstract

“…Complementary and alternative medicine (CAM) can be defined as healthcare approaches that are not typically part of conventional medical care or that may have origins outside of usual Western practice [1]. Although not part of mainstream medicine, an increasing number of children with cancer use CAM along with conventional therapies [2]. Parents choose CAM for treatment and cure of cancer in their children [3], and also as supportive care agent to help minimize side effects of cancer treatment and to improve the general quality of life and well-being [4,5].…”

Section: Introductionmentioning

confidence: 99%

Development of an evidence-based decision aid on complementary and alternative medicine (CAM) and pain for parents of children with cancer

Jong

Boers

Wietmarschen

et al. 2019

Support Care Cancer

View full text Add to dashboard Cite

Purpose To develop an evidence-based decision aid for parents of children with cancer and to help guide them in the use of complementary and alternative medicine (CAM) for cancer care. Methods This study had a mixed research design. The needs of parents were investigated by survey and focus group. A systematic review and meta-analysis were performed on the effectiveness of CAM using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Clinical experts were interviewed and a decision aid on CAM treatment for pain was developed. Results Parents emphasized the importance of reliable information on CAM, focusing primarily on communication and a broad spectrum of complaints related to cancer treatment. The decision aid on CAM for pain included five modalities based on 11 randomized control trials (RCTs): hypnotherapy, mind-body techniques, massage, healing touch, and music therapy. Metaanalysis could be performed on hypnotherapy, which significantly reduced cancer-related procedural pain compared with standard care (MD, − 1.37; 95% CI, − 1.60, − 1.15; P < 0.00001) and attention control (MD, − 1.13; 95% CI, − 1.34, − 0.94; P < 0.00001), and massage, demonstrating no effect on pain compared with standard care (MD, − 0.77; 95% CI, − 1.82, 0.28; P = 0.15). Research evidence and supplementary information from clinical practice and patient were incorporated in a websitebased decision aid. Conclusions An evidence-based decision aid was developed to support parents of children with cancer in making decisions about CAM for pain management. Next steps will be to expand the website to include additional childhood cancer-related complaints and to evaluate its use in practice.

show abstract

Traditional and Complementary Medicine in Pediatric Oncology and Low-Middle Income Countries: Recommendations from the International Society of Pediatric Oncology (SIOP), T&CM Collaborative

Cited by 17 publications

References 12 publications

Destitution, treatment adherence and survival of children with Burkitt lymphoma in a twinning programme in Northwest Cameroon

Destitution, treatment adherence and survival of children with Burkitt lymphoma in a twinning programme in Northwest Cameroon

Holistic support coupled with prospective tracking reduces abandonment in childhood cancers: A report from India

Development of an evidence-based decision aid on complementary and alternative medicine (CAM) and pain for parents of children with cancer

Contact Info

Product

Resources

About