scholarly journals DIPG-84. COMPLEMENTARY AND ALTERNATIVE MEDICINE IN DIFFUSE INTRINSIC PONTINE GLIOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii303-iii304
Author(s):  
Fatma El-Khouly ◽  
Syed Adil ◽  
Harry Hendrikse ◽  
Gertjan Kaspers ◽  
Christof Kramm ◽  
...  

Abstract INTRODUCTION Diffuse intrinsic pontine glioma (DIPG) is a rare and aggressive childhood brainstem malignancy with a two-year survival rate of ≤10%. In this international survey study we aim to evaluate the use of complementary and alternative medicine (CAM) in this patient population. METHODS Parents of-, and physicians treating DIPG patients were asked to participate in a retrospective online survey with questions regarding CAM use during time of illness. RESULTS 120 parents and 75 physicians contributed to the online survey between January and May 2020. Physicians estimated that <50% of their patients used CAM, whereas 69% of the parents reported to have used CAM to treat their child during time of illness. Cannabis was the most widely used form of CAM, followed by vitamins and minerals, melatonin, curcumin and boswellic acid. CAM was mainly used to actively treat the tumor. Other motivations were to treat side effects of chemotherapy, or to comfort the child. Children diagnosed ≥2016 were more likely to use CAM (χ2=6.08, p=0.014). No significant difference was found between CAM users and non-users based on ethnicity (χ2=4.18, p=0.382) and country of residence (χ2=9.37, p=0.154). Almost 50% of the physicians do not frequently ask their patients about possible CAM use. CONCLUSION This survey demonstrates that worldwide a considerable number of DIPG patients use CAM. Physicians should be more aware of potential CAM use and more actively discuss the topic. More research is needed to gain knowledge about possible anticancer effects of CAM and their interactions with conventional therapies.

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20614-e20614
Author(s):  
C. S. Tung ◽  
C. C. Sun ◽  
L. Cohen ◽  
M. Frenkel ◽  
L. M. Ramondetta ◽  
...  

e20614 Background: The use of complementary and alternative medicine (CAM) is growing as the oncology patient (pt) population increases. The purpose of this study was to assess current CAM practice patterns of oncology healthcare providers. Methods: We distributed a 20-page anonymous survey to all physicians (), mid-level practitioners, clinical pharmacists, and dietitians at a comprehensive cancer center. The survey examined factors influencing a provider's inquiry towards pt CAM use, as well as current perception and use of 15 different CAM modalities, such as meditation, acupuncture, chiropractic, and herbal therapy. Descriptive statistics, chi-square, and Student's t-test were used for analysis. Results: 671/1,601 (42%) surveys were returned with s comprising 50% of the responses. 83% of respondents believed CAM has a role in cancer care. Over 70% indicated that massage, meditation/prayer, relaxation techniques, and acupuncture have potential uses, primarily to relieve symptoms not controlled by conventional therapy (tx) (47%) and as psycho-social-spiritual support (47%). Respondents estimated 28% of pts utilize CAM; 25% of respondents and 19% of pts initiated CAM discussions during pt visits. Those in medicine-based fields were more likely to discuss pt CAM use compared to surgical specialities (30% vs. 19%, p<0.01), but there was no significant difference in comfort level to discuss CAM modalities. s were less likely to discuss CAM use compared to all other providers (21% vs. 31%, p<0.01). s were also less comfortable discussing herbs (37% vs. 51%, p<0.01), massage (73% vs. 82%, p<0.05), meditation/prayer (71% vs. 82%, p<0.05), and relaxation tx (67% vs. 77%, p<0.01) compared to all other providers but more comfortable discussing acupuncture (63% vs. 55%, p<0.05). Respondents cited lack of knowledge in CAM as the primary reason for not discussing CAM with pts. Conclusions: Past studies estimate that >50% of patients use at least one form of CAM. Our study suggests that oncology providers critically underestimate the number of patients incorporating CAM into their treatment. Improving provider education on CAM therapies is essential to improve patient-physician communication regarding potential risks and benefits of CAM with traditional cancer therapies. No significant financial relationships to disclose.


2009 ◽  
Vol 43 (5) ◽  
pp. 875-881 ◽  
Author(s):  
Vivian Wy Leung ◽  
Stephen J Shalansky ◽  
Melissa K Lo ◽  
Esther A Jadusingh

Background The use of complementary and alternative medicine (CAM), including orally administered herbals, botanicals, vitamins, and supplements, may pose a risk to patients on warfarin therapy. Objective To estimate the prevalence of CAM use among patients taking warfarin and evaluate the impact of CAM exposure on the risk of warfarin-related adverse effects. Methods A survey was administered to hospital inpatients and clinic outpatients on drug exposure (including CAM) over the previous month, self-reported bleeding events, use of alcohol and vitamin K–rich foods, and medical conditions. Prescription medication use was verified, and laboratory records were checked for out-of-range international normalized ratios (INRs) (defined as INR >4 or <2). The use of CAM, including products with reported or theoretical interactions with warfarin, was compared between patients with and without self-reported bleeding or out-of-range INR. Results Among the 314 patients who completed the survey, 44.3% reported using CAM at least weekly. Potentially interacting CAM was used by 34.1% of all patients, or 18.2% if vitamin E was excluded as an interacting CAM. Vitamin E was used by 24.2% of all patients and 71.0% of those who used potentially interacting CAM. There was no significant difference in CAM use or consumption of vitamin K–rich foods between patients with and without INRs greater than 4 or for patients with and without INRs less than 2. Conclusions The use of potentially interacting CAM in this cohort was higher than the use previously reported among patients on warfarin therapy. However, exposure to CAM was not associated with an increase in the risk of self-reported bleeding or out-of-range INR.


2020 ◽  
Vol 19 ◽  
pp. 153473542098391
Author(s):  
Chieh-Ying Chin ◽  
Yung-Hsiang Chen ◽  
Shin-Chung Wu ◽  
Chien-Ting Liu ◽  
Yun-Fang Lee ◽  
...  

Background Complementary and alternative medicine (CAM) is becoming more common in medical practice, but little is known about the concurrent use of CAM and conventional treatment. Therefore, the aim was to investigate the types of CAM used and their prevalence in a regional patient cohort with breast cancer (BC). Methods BC patients were interviewed with a structured questionnaire survey on the use of CAM in southern Taiwan at an Integrative Breast Cancer Center (IBCC). The National Centre for Complementary and Integrative Health (NCCIH) classification was used to group responses. Over a period of 8 months, all patients receiving treatment for cancer at the IBCC were approached. Results A total of 106 BC patients completed the survey (response rate: 79.7%). The prevalence of CAM use was 82.4%. Patients who were employed, were receiving radiotherapy and hormone therapy, and had cancer for a longer duration were more likely to use CAM ( P < .05). Multivariate analysis identified employment as an independent predictor of CAM use (OR = 6.92; 95% CI = 1.33-36.15). Dietary supplementation (n = 69, 82.1%) was the type of CAM most frequently used, followed by exercise (n = 48, 57.1%) and traditional Chinese medicine (n = 29, 34.5%). The main reason for using CAM was to ameliorate the side effects of conventional therapies. Almost half (46.4%) of these CAM users did not disclose that they were using it in medical consultations with their physicians. Most chose to use CAM due to recommendations from family and friends. Conclusion A large portion of BC patients at the IBCC undergoing anti-cancer treatment courses used CAM, but less than half discussed it with their physicians. Given the high prevalence of CAM, it would be justifiable to direct further resources toward this service so that cancer patients can benefit from a holistic approach to their treatment.


Cephalalgia ◽  
2005 ◽  
Vol 25 (7) ◽  
pp. 493-506 ◽  
Author(s):  
P Rossi ◽  
G Di Lorenzo ◽  
MG Malpezzi ◽  
J Faroni ◽  
F Cesarino ◽  
...  

The use of complementary and alternative medicine (CAM) in migraine is a growing phenomenon about which little is known. This study was undertaken to evaluate the rates, pattern and presence of predictors of CAM use in a clinical population of patients with different migraine subtypes. Four hundred and eighty-one migraineurs attending a headache clinic were asked to undergo a physician-administered structured interview designed to gather information on CAM use. Past use of CAM therapies was reported by 31.4% of the patients surveyed, with 17.1% having used CAM in the previous year. CAM therapies were perceived as beneficial by 39.5% of the patients who had used them. A significantly higher proportion of transformed migraine patients reported CAM treatments as ineffective compared with patients suffering from episodic migraine (73.1% vs. 50.7%, P < 0.001). The most common source of a recommendation of CAM was a friend or relative (52.7%). In most cases, migraineurs' recourse to CAM treatments was specifically for their headache (89.3%). Approximately 61% of CAM users had not informed their medical doctors of their CAM use. The most common reason for deciding to try a CAM therapy was that it offered a ‘potential improvement of headache’ (47.7%). The greatest users of CAM treatments were: patients with a diagnosis of transformed migraine; those who had consulted a high number of specialists and reported a higher lifetime number of conventional medical visits; those with a comorbid psychiatric disorder; those with a high income; and those whose headache had been either misdiagnosed or not diagnosed at all. Our findings suggest that headache clinic migraine patients, in their need of and quest for care, seek and explore both conventional and CAM approaches. Physicians should be made aware of this patient-driven change in the medical climate in order to prevent misuse of healthcare resources and to be better equipped to meet patients' needs.


2014 ◽  
Vol 23 (7) ◽  
pp. 430-434 ◽  
Author(s):  
Tenley N. Bower ◽  
Sana Muhsen ◽  
Olga Overbury ◽  
Catherine Birt ◽  
Oscar Kasner

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