J Cancer 2017; 8(3):395-402. doi:10.7150/jca.17506
Integrative Oncology Physician Consultations at a Comprehensive Cancer Center: Analysis of Demographic, Clinical and Patient Reported Outcomes
1. Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX;
2. Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX;
3. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX;
4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX;
5. Division of Hematology and Oncology, Case Western Reserve, Cleveland, OH.
*Contributed equally and both considered first authors.
Lopez G, McQuade J, Cohen L, Williams JT, Spelman AR, Fellman B, Li Y, Bruera E, Lee RT. Integrative Oncology Physician Consultations at a Comprehensive Cancer Center: Analysis of Demographic, Clinical and Patient Reported Outcomes. J Cancer 2017; 8(3):395-402. doi:10.7150/jca.17506. Available from http://www.jcancer.org/v08p0395.htm
Background: Integrative oncology (IO) is a relatively new field that seeks to bring evidence-based, non-conventional approaches into conventional oncology care in a coordinated and safe manner. Though complementary and alternative medicine (CAM) are highly utilized by cancer patients, little is known about the characteristics of patients seeking IO consultation.
Methods: Patients presenting for an outpatient IO consultation completed a CAM use questionnaire, Measure Yourself Concerns and Wellbeing (MYCaW), Edmonton Symptom Assessment Scale (ESAS), Quality of Life Short Form 12 (SF-12), and post-consultation satisfaction item.
Results: 2,474 new patient IO consultations were conducted from 9/2009 to 12/2013 and 2367 (96%) completed at least one measure. Most were female (69%); the most frequent cancer type was breast (29%); 38% had distant/advanced disease; 75% had used a CAM approach in prior 12 months. The most common concerns were seeking an integrative/holistic approach (34%), herbs/supplements (34%), and diet/nutrition (21%). Overall symptom burden was low, with baseline symptom scores (ESAS) highest (worst) for sleep (4.2; SD 2.8), fatigue (4.0; SD 2.8), and well-being (3.8; SD 2.6). On the SF-12, the physical health scores (35.3; SD 7.5) were significantly lower than that of a healthy population (50), but mental health scores were not (46.8; SD 10.2). Satisfaction was high (9.4; SD 1.3) with the consultation.
Conclusions: Patients presenting for IO consultation tended to have early stage disease, had previously used a CAM approach, had a relatively low symptom burden, and were most interested in developing an integrative approach to their care or discussing herbs/supplement use.
Keywords: Integrative Medicine, Integrative Oncology, Complementary Medicine, Patient Reported Outcomes, Symptom Assessment.