Prevalence and Predictors of Complementary Therapy Use in Advanced-Stage Breast Cancer Patients

Purpose Information on the use of complementary therapies in patients with advanced-stage cancer is limited. Given the disease and treatment complexities associated with the care of patients with metastatic cancer, oncology clinicians would benefit from having an appreciation of the extent of usage of unconventional, adjunctive therapies among these patients. This study evaluated the prevalence and demographic predictors of complementary therapy use in a sample of women with metastatic breast cancer. Methods Subjects with stage IV breast cancer were recruited from six treatment facilities in New England. A written, mailed survey assessing complementary therapy use and sociodemographic information was completed by each subject, while disease and treatment information was obtained from medical records. Descriptive statistics and multivariate logistic regression analyses were conducted. Results Of the 173 participants, 78% used at least one type of complementary therapy, 43% used two or more types, and 23% used three or more types, excluding spiritual practices and physical exercise. When including spiritual practices and physical exercise, 90% used at least one complementary therapy, 70% used two or more types, and 45% used three or more types. Visits to alternative health practitioners were predicted by younger age (P = .009) and higher education level (P = .002). Younger participants (P = .045) were more likely to use and spend more money on vitamins and herbal products (P = .02). Conclusions Use of unconventional therapies is pervasive among metastatic breast cancer patients, particularly among those who are younger and highly educated. Oncology providers need to assess patients' complementary therapy use and consider potential interactions with prescribed treatment protocols.

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Accelerated-Intensified Cyclophosphamide, Epirubicin, and Fluorouracil (CEF) Compared With Standard CEF in Metastatic Breast Cancer Patients: Results of a Multicenter, Randomized Phase III Study of the Italian Gruppo Oncologico Nord-Ouest–Mammella Inter Gruppo Group

Journal of Clinical Oncology ◽

10.1200/jco.2001.19.8.2213 ◽

2001 ◽

Vol 19 (8) ◽

pp. 2213-2221 ◽

Cited By ~ 29

Author(s):

Lucia Del Mastro ◽

Marco Venturini ◽

Rita Lionetto ◽

Flavio Carnino ◽

Domenico Guarneri ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Cancer Patients ◽

Standard Dose ◽

Metastatic Breast ◽

Dose Intensity ◽

Phase Iii ◽

Intensity Increase ◽

Breast Cancer Patients ◽

Stage Iv Breast Cancer

PURPOSE: To evaluate whether an accelerated-intensified cyclophosphamide, epirubicin, and fluorouracil (CEF) chemotherapy regimen with the support of granulocyte colony-stimulating factor (G-CSF) induces a higher activity and efficacy compared with standard CEF in metastatic breast cancer patients. PATIENTS AND METHODS: Stage IV breast cancer patients were randomized to receive as first-line chemotherapy either standard CEF (cyclophosphamide 600 mg/m2, epirubicin 60 mg/m2, and fluorouracil 600 mg/m2) administered every 21 days (CEF21) or accelerated-intensified CEF (cyclophosphamide 1,000 mg/m2, epirubicin 80 mg/m2, and fluorouracil 600 mg/m2) administered every 14 days (HD-CEF14) with the support of G-CSF. Treatment was administered for eight cycles. RESULTS: A total of 151 patients were randomized (74 patients on the CEF21 arm and 77 on the HD-CEF14 arm). In both arms, the median number of administered cycles was eight. The dose-intensity actually administered was 93% and 86% of that planned, in CEF21- and HD-CEF14–treated patients, respectively. Compared with the CEF21 arm, the dose-intensity increase in the HD-CEF14 arm was 80%. Both nonhematologic and hematologic toxicities were higher in the HD-CEF14 arm than in the CEF21 arm. During chemotherapy, four deaths occurred in the HD-CEF14 arm. No difference in overall response rate (complete plus partial responses) was observed: 49% and 51% in the CEF21 and HD-CEF14 arms, respectively (P = .94). A slightly non–statistically significant higher percentage of complete response was observed in the HD-CEF14 arm (20% v 15%). No difference in efficacy was observed. The median time to progression was 14.3 and 12.8 months in the CEF21 and HD-CEF14 arms, respectively (P = .69). Median overall survival was 32.7 and 27.2 months in the CEF21 and HD-CEF14 arms, respectively (P = .16). CONCLUSION: In metastatic breast cancer patients, an 80% increase in dose-intensity of the CEF regimen, obtained by both acceleration and dose intensification, does not improve the activity and the efficacy compared with a standard dose-intensity CEF regimen.

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MetaPink Program: Simplifying the Breast Cancer Journey for Patients With Advanced Stage Breast Cancer in Nigeria

Journal of Global Oncology ◽

10.1200/jgo.18.38600 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 170s-170s

Author(s):

E. Nwankwo

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Metastatic Breast Cancer ◽

Cancer Patients ◽

Support Group ◽

Metastatic Breast ◽

Advanced Stage ◽

Breast Cancer Patients ◽

Cancer Management

Background and context: Breast cancer is the number one diagnosed cancer in Nigeria. 75% of these breast cancer diagnosis are at stage 3 and 4. This is due in part to lack of awareness of the signs and symptoms, inadequate screening and diagnostic facilities, insufficient policies and guidelines, and fear. Metastatic breast cancer patients do not have the time nor the strength to deal with the stress, delay, and confusion of trying to find adequate care. Run For a Cure Africa (RFCA) wishes to establish a program that helps navigate metastatic breast cancer patients in Lagos state, and surrounding states in Nigeria toward breast cancer care and resources. Aim: The MetaPink program empowers and educates patients with advanced stage breast cancer by providing them with timely and relevant information and resources on their disease and how they, the patient, can improve their quality of life and overall prognosis. Additionally, RFCA creates greater awareness of metastatic breast cancer in the community and the necessity for regular screenings. Strategy/Tactics: This project is being implemented by RFCA. RFCA is working work with the health care professionals (HCP) in the oncology and community health department at the Lagos University Teaching Hospital (LUTH) in addition to their organization mentors, The Rose Foundation in Houston, Texas. RFCA is also working with community associations, drama troupes, and groups to create sensitization in hard to access areas. Patients and participants of the MetaPink program have a support team, through the monthly support group, with whom they fellowship, ask advice, gain insight, and just off load any looming concerns. Program/Policy process: RFCA enrolls metastatic patients through our supported clinics, call ins, and our screening outreaches. Each patient enrolled in the program gets a starter pack. RFCA hosts monthly support groups and Q&A sessions anchored by medical professionals, RFCA also hosts community outreach events via the radio, market drama skits, and musical awareness presentations. Periodically we follow-up and communicate with MetaPink program participants via MetaPink WhatsApp, telephone, in-person meetings/visits, and support group meetings. Outcomes: The objective of the MetaPink program is to simplify the breast cancer journey for metastatic breast cancer patients in Nigeria and give them the emotional support and confidence to understand and navigate through their personal breast cancer journey. RFCA also creates larger community awareness of advanced stage breast cancer in a method that is culturally appealing and resonates with the environment. What was learned: As the program progresses, RFCA will learn how to effectively navigate patients in this resource-poor environment. This will contribute to their quality of life and improved breast cancer management in Nigeria. [Figure: see text]

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