Use of Integrative Therapies in Breast Cancer Patients. Health Service Research in a Network of Integrative Oncology

ABSTRACT Breast cancer examination delays is a condition where breast cancer patients come to know their condition exceeds the specified time (cancer stage III) when cancer can not differentiate well to get treatment. In Indonesia, almost 70% of breast cancer patients are too late to do examination. Data at Arifin Achmad Regional Public Hospital show increasing number of breast cancer cases, where in 2012 there were 145 cases, in 2013 there were 262 cases and in 2014 there were 584 cases. This research aims to know the factors that related to breast cancer examination delays such as knowledge, education, income, pain, fear, family support, BSE (breast elf examination), distance to health service, resources and family history of breast cancer. The research type is quantitative analytic observational. The research design is analytic cross sectional study. The populations are outpatients women with breast cancer who came to Arifin Achmad regional public hospital Riau Province and total sampel are 203 women. The data were analyzes by univariat, bivariat analyzes by chi square and multivariat analyzes by multiple logistic regression. The results of this research show that knowledge effect 3 times, income effect 3 times, distance to health service effect 2,5 times and pain effect 2 times to breast cancer examination delays. The conclusions of this study are there are casual link between knowledge, income, distance to health service and pain to breast cancer examination delays. Recommended to women to improve their knowledge about breast cancer examination and suggested to Health Departement of Riau Province through community health centers to give education and socialization about breast cancer to community. Keywords: Screening Delays, Breast Cancer, Knowledge, Income, Distance

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Breast Cancer Integrative Oncology Care and Its Costs

Integrative Cancer Therapies ◽

10.1177/1534735416649034 ◽

2016 ◽

Vol 16 (1) ◽

pp. 85-95 ◽

Cited By ~ 12

Author(s):

Leanna J. Standish ◽

Fred Dowd ◽

Erin Sweet ◽

Linda Dale ◽

Morgan Weaver ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Early Stage ◽

Insurance Companies ◽

Quality Data ◽

First Year ◽

Breast Cancer Patients ◽

Integrative Oncology ◽

Body Therapy ◽

Oncology Care

Background. Naturopathic oncology in conjunction with conventional treatment is commonly referred to as integrative oncology (IO). Clinics directed by oncology board certified NDs (Fellows of the American Board of Naturopathic Oncology or FABNOs) provide high-quality data for describing IO therapies, their costs and measuring clinical outcomes. Purpose. To describe the types of IO therapies prescribed to breast cancer patients by ND FABNO physicians. Study participants (n = 324). Women who sought care at 1 of 6 naturopathic oncology clinics in Washington State were asked to enroll in a prospective 5 year observational outcomes study. Methods. Medical records were abstracted to collect treatment recommendations and cost data. Results. More than 72 oral or topical, nutritional, botanical, fungal and bacterial-based medicines were prescribed to the cohort during their first year of IO care. Trametes versicolor was prescribed to 63% of the women. Mind-body therapy was recommended to 45% of patients, and 49% received acupuncture. Also, 26% were prescribed injectable therapy, including mistletoe, vitamin B complex (12%), IV ascorbate (12%), IV artesunate (7%), and IV nutrition and hydration (4%). Costs ranged from $1594/year for early-stage breast cancer to $6200/year for stage 4 breast cancer patients. Of the total amount billed for IO care for 1 year for breast cancer patients, 21% was out-of-pocket. Conclusions. IO care for women with breast cancer consists of botanical and mushroom oral therapies, parenteral botanical and nutrient therapy, mind-body medicine and acupuncture. IO clinic visits and acupuncture are partially paid for by medical insurance companies.

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Breast cancer survivorship and level of institutional involvement utilizing integrative oncology.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18588 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18588-e18588

Author(s):

Terri Crudup ◽

Linna Li ◽

Jennifer Wright Dorr ◽

Elizabeth Lawson ◽

Rachel Stout ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Metastatic Disease ◽

Multivariate Modeling ◽

Breast Cancer Patients ◽

Integrative Oncology ◽

Academic Setting ◽

Significant Difference ◽

The Relationship

e18588 Background: A growing body of evidence has shown that a Whole Person Integrative Oncology approach, adding the use of complementary and lifestyle therapies to cancer treatments, benefits patients by improving patient-reported outcomes and potentially extending overall survival. This study aims to investigate the relationship between the survival outcomes of breast cancer patients and the level of involvement in Integrative Oncology at the institutions treating those patients. Methods: Between January 2013 and December 2014, 4,815 breast cancer patients were available for survival analysis using an established claims-based method. These patients were filtered to include those with clear mapping to treating oncologists and treating institutions. To measure each institution’s level of Integrative involvement, a scoring system was developed with the Samueli Foundation and oncologists from each institution were surveyed on the education, availability, and financing of 12 complementary and lifestyle approaches during the treatment timeframe. Statistical analysis using multivariate modeling with logistic regression and a lasso approach were employed. 19 variables across region, patient demographics, and institutional profile were included. Model coefficients are exponentiated and presented as odds-ratios, with less than one having a negative impact on survival and greater than one improved survival. Results: We identified 173 patients mapping to 103 institutions and 103 oncologists who responded to our survey. Median age of breast cancer patients was 51 (range: 32-76). 14 of the patients (8%) were identified as metastatic. The 5-year overall survival among the Low scoring institutions was 89%, Low-Mid 96%, Mid-High 96%, High 95%. Chi square testing across these cohorts showed no statistically significant difference between them. On multivariate modeling, age, geography, metastatic status, academic setting, and Integrative score were predictors of 5-year survival. The most significant 9 variables are shown in Table. Having metastatic disease, treatment at a non NCCN designated facility, treatment at Midwest or Western Region predicts for lower 5-year survival. Older age, treatment at an academic setting, and having a High or Low-Mid Integrative score are predictors of improved survival. Conclusions: This study suggests that in addition to traditional predictors of survival such as metastatic disease and younger age, patients receiving treatment at an institution that supports Integrative Oncology programs may be associated with improved survival. More work is needed to evaluate the relationship between Integrative Oncology and cancer treatment outcomes.[Table: see text]

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Palliative care in patients with advanced lung cancer in a network of health service research in integrative oncology.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e20710 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e20710-e20710

Author(s):

Friedemann Schad ◽

Jan Axtner ◽

Antje Happe ◽

Matthias Kroez ◽

Burkhard Matthes ◽

...

Keyword(s):

Lung Cancer ◽

Palliative Care ◽

Health Service ◽

Health Service Research ◽

Viscum Album ◽

Advanced Lung Cancer ◽

Service Research ◽

Integrative Oncology ◽

Clinical Registry ◽

Significant Difference

e20710 Background: Early palliative care was demonstrated to result in a superior survival and improvement of health related quality of live (HRQL) in patients with advanced lung cancer. Concepts of integrative oncology (IO) offer multimodal therapy strategies aiming to enhance patients’ salutogenic resources in addition to standard care. In the present study we analyzed patients with advanced lung cancer from a clinical registry in Germany. Methods: Data were collected by the Network Oncology, a clinical registry of hospitals and outpatients care specialized in Anthroposophic Medicine and integrative oncology. We analyzed 441 C34 patients of UICC stage IV that had at least one of the following additional therapies: Viscum album, embrocation, therapeutic unction’s, rhythmical massages, lymph drainage, physiotherapy, eurythmy therapy, music or drawing therapy, modeling, speech-, breathing and hyperthermia therapy. We calculated Kaplan-Meier survival based on right censored data and using Greenwoods 95% confidence intervals. Results: 43% of the patients were female and median age was 64 yr (min 32/ max 92). 84% received chemotherapy, 55% radiation and 40% surgery. Most frequent additional therapies were Viscum album (72%), embrocation (43%), therapeutic unction (42%), eurythmy therapy and physiotherapy (both 27%). Patients used combinations up to 9 different additional therapies (median ♀=3, median ♂=2) with significant difference between genders (Fisher’s exact test, < p=0.001). Median length of VA therapy was 6.4 months. Median OS was 1.05yr (95% CI: 0.83 - 1.32), 2 and 3 year survival was 31% and 20%, respectively. Conclusions: Integrative therapy concepts are of growing interest in cancer care. In this observational study patients received conventional and complementary interventions. A relevant number of lung cancer patient use IO when offered in palliative oncology. Median OS seems to be comparable to the palliative care group of Temel et al. 2010 (median OS=0.97yr, 95% CI: 0.53 – 1.41). Health service research in multimodal IO settings needs further evaluation in terms of HRQL measurement and effectiveness.

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P-0185 Health Service Research on Patients With Colon Cancer in A Network of Integrative Oncology

Annals of Oncology ◽

10.1016/s0923-7534(20)30109-5 ◽

2012 ◽

Vol 23 ◽

pp. iv83-iv84

Author(s):

Friedemann Schad ◽

Jan Axtner ◽

Antje Happe ◽

Thomas Breitkreuz ◽

Constantin Paxino ◽

...

Keyword(s):

Colon Cancer ◽

Health Service ◽

Health Service Research ◽

Service Research ◽

Integrative Oncology

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Factors that Correlate with The Health Services Seeking on Breast Cancer Patients

Jurnal Keperawatan Padjadjaran ◽

10.24198/jkp.v7i1.841 ◽

2019 ◽

Vol 7 (1) ◽

Author(s):

Dini Fathania ◽

Laili Rahayuwati ◽

Desy Indra Yani

Keyword(s):

Breast Cancer ◽

Health Service ◽

Health Services ◽

Cancer Patients ◽

Health Belief ◽

Breast Cancer Patients ◽

Health Seeking ◽

Early Detection Of Disease ◽

Health Seeking Behavior ◽

Seeking Behavior

Most cases of breast cancer are found to be in an advanced stage. This is because of the patient delay in coming to health service after the emergence of early symptoms of breast cancer. It is necessary to identify factors that allegedly prevent patients from seeking health services as early as possible. The purpose of this study was to analyze factors related to the search for health services. This research used cross-sectional method. The population of this study was breast cancer patients where the sampling technique using consecutive sampling with the number of samples researched as many as 100 people. Data were obtained through a reliable questionnaire to use (Alpha Cronbach’s questionnaire = 0.92, Alpha Cronbach’s health questionnaire = 0.85). Analysis of this research data using univariate (frequency distribution), bivariate (Chi-Square) and multivariate (logistic regression).The result of bivariate analysis showed that the variables related to health seeking behavior are education (ρ value = 0.02; r = 0.3) and health belief (ρ value = 0.01; r = 0.24). While the variables that most related to health service seeking behavior was health belief (ρ value = 0.02) and OR value 3.46. This could be caused by patient’s health belief in which the patient assumes that the symptoms were not dangerous and the choice of alternative medicine as the first choice and the patient’s fear of treatment due to lack of information that obtained by the patient. It can be concluded that health beliefs are the most correlated factor with health-seeking behavior so it is necessary to consider the prevention efforts of breast cancer especially related to health belief. Community beliefs about routine health checks should be key interventions such as counseling and discussions with the community regarding the importance of routine health screening as part of early detection of disease.

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