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The 5 Domains of Complementary and Alternative Medicine. Put together from NCCIH. 

The 5 Domains of Complementary and Alternative Medicine. Put together from NCCIH. 

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Purpose of review: Due to medical advances and an aging population, the number of cancer survivors continues to rise. Survivors often experience late and long-term sequelae of cancer and its treatment (e.g., fatigue, pain, fear of recurrence, and stress). As a result, some patients have utilized or expressed interest in integrative medicine (IM) m...

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... medicine promotes the physical, emotional, and spiritual health of a person by incorporating multiple evidence informed modalities alongside conventional therapy. The National Center for Complementary and Integrative Health (NCCIH) developed a five domain concept: 1) manipulative & body-based methods, 2) mind-body medicine, 3) alternative medical systems, 4) energy therapies, 5) biologically based therapies (Figure 1). According to the Society for Integrative Oncology, specific modalities include physical activity, diet, dietary supplements, mind-body modalities, acupuncture, and massage therapy [3]. ...
Context 2
... medicine promotes the physical, emotional, and spiritual health of a person by incorporating multiple evidence informed modalities alongside conventional therapy. The National Center for Complementary and Integrative Health (NCCIH) developed a five domain concept: 1) manipulative & body-based methods, 2) mind-body medicine, 3) alternative medical systems, 4) energy therapies, 5) biologically based therapies (Figure 1). According to the Society for Integrative Oncology, specific modalities include physical activity, diet, dietary supplements, mind-body modalities, acupuncture, and massage therapy [3]. Cancer survivors often use integrative medicine to address long-term adverse effects and symptoms [2]. In fact, many times oncology patients utilize integrative modalities without the knowledge of their providers [4]. This manuscript aims to highlight studies published during 2016 that either offer novel ideas for integrative medicine or include findings that may substantially change or reinforce current ...

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There is a significant increase in the number of people surviving cancer as a result of improved detection and better treatments. In the United States (US) alone, these numbers are estimated to reach 20 million by 2026 [Miller et al (2016) CA Cancer J Clin 66(4) 271-289)]; [Bluethmann et al (2016) Cancer Epidemiol Biomarkers Prev 25(7) 1029-1036]....

Citations

... The main findings of the present systematic review underline the high heterogeneity of rehabilitation interventions that might positively influence AWS symptoms, improving the cord characteristics and the functional limitations affecting the quality of life of BC female patients [13,[31][32][33][34][35][36][37][38][39][40]. These data are in accordance with the current trend in rehabilitation management of other BC sequelae, highlighting the need for integrated therapeutic strategies improving functional outcomes and HR-QoL with a multitarget intervention [43,44]. ...
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Background: Axillary web syndrome (AWS) is one of the most prevalent and underrecognized disorders affecting breast cancer (BC) women. However, the optimal therapeutic strategy to manage AWS is far from being fully characterized. Therefore, this systematic review aims to provide a broad overview of the available rehabilitation treatments in this burdensome condition. Methods: On 13 January 2022, PubMed, Scopus, Web of Science, Cochrane, and PEDro were systematically searched for clinical studies assessing rehabilitation interventions in post-surgical BC women with AWS. The outcomes analyzed were pain, AWS clinical resolution, upper limb function, and health-related quality of life (HR-QoL). Results: The search identified 1115 records, of which 11 studies were included. A total of 174 patients were assessed (ages ranging from 37 and 66 years old). The interventions included manual lymphatic drainage, manual therapy, stretching, resistance training, mobilization techniques, and Kinesio tape. Positive improvements were reported in terms of pain relief (in 7 studies), AWS clinical resolution (in 9 studies), upper limb function (in 10 studies), and HR-QoL (in 2 studies). Conclusions: Our findings suggest that rehabilitation might be considered an effective therapeutic strategy in AWS patients. Further RCTs are needed to characterize the optimal rehabilitative interventions.
... 2,3 Mind-body exercise and complementary and alternative medicine (CAM) interventions such as mediation, yoga, mindfulness, massage therapy, acupuncture, Tai Chi, and Qigong can improve cancer patients' mental health, sleep quality, physical fitness, pain management, and lifespan. 4,5 Despite documented positive effects, AACS remain an underserved population in mind-body research, and these interventions are rarely offered to AACS. Descriptive studies have demonstrated that as a group, AACS have interest in mind-body modalities, but these practices often are inaccessible to African American communities because of cost, geographical location, low socioeconomic status, and lack of knowledge or awareness. ...
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Mind-body interventions have been shown to improve physical and mental health outcomes among cancer survivors, and African Americans have one of the highest cancer mortality rates of all racial/ethnic groups, while often facing considerable barriers to quality healthcare. African American cancer survivors report difficulty accessing mind-body practices, and few studies have focused exclusively on African American populations. This integrative review aims to explore the acceptability and use of mind-body interventions among African American cancer survivors. This review seeks to determine if current research indicates that mind-body interventions may be helpful in improving outcomes for African American cancer survivors. The literature search resulted in 284 studies, of which 14 met the inclusion criteria. Inclusion criteria were articles published in or after 2016, written in the English language, addressing mind-body modalities, and including a study population of ≥50% African American cancer survivors. Other reviews, meta-analyses, or studies without results were excluded. Results indicate that African American cancer survivors have expressed receptiveness to interventions incorporating mindfulness, meditation, yoga, Tai Chi, and other mind-body or complimentary/alternative medicine interventions. Still, few studies have offered such interventions exclusively to African American cancer survivors. This review indicated that African American cancer survivors across demographic backgrounds are interested in and view mind-body practices as an acceptable way to improve quality of life, pain interference, fatigue, anxiety, depression, and physical health; however, the interventions should be culturally appropriate and accessible. In conclusion, despite a growing interest in mind-body interventions, African American communities are often unaware of opportunities to engage in these practices in their communities, and mind-body practices are inaccessible due to cost or geographical location. Additional research that offers such interventions specific to African American cancer survivors is warranted.
... Our study found that survivors of childhood CNS tumors were two times more likely to utilize non-oral therapies than survivors of non-CNS cancers, probably because survivors of CNS tumors may be more susceptible to muscle weakness and diminished mobility and fitness [33]. Studies have demonstrated some effectiveness of non-oral therapies for managing cancer-related pain and fatigue, though its use in pediatric cancer survivors still warrants further investigation in future studies [34]. We found that certain groups of childhood cancer survivors may use chronic medications and CAM to manage late effects and/or improve their general health. ...
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Purpose This study explored the pattern of complementary or alternative medicine (CAM) use among Chinese survivors of childhood cancer and identified potential drug-CAM interactions and factors predicting CAM use. Methods This cross-sectional study recruited 393 survivors of childhood cancer (male, 57.8%; mean age, 17.7 [SD = 7.3] years; mean years post-treatment, 8.8 [SD = 5.0]) from a public hospital in Hong Kong. Participants reported CAM and over-the-counter medications that they used in the past year. Prescription drug data were extracted from pharmacy dispensing records. Potential interactions between concurrent CAM and chronic medications were identified from well-established CAM-drug/herb-drug interaction databases. A multivariate logistic regression was performed to analyze associations of socio-demographic and clinical factors with CAM use. Results Half (n = 205/393, 52.2%) of the participants reported the use of CAM. The most popular CAMs were traditional Chinese medicine (n = 127/205, 62.0%) and natural products (n = 114/205, 55.3%). Among the 69 survivors (33.7%) concurrently using CAM and chronic medications, one-third (n = 21/69, 30.4%) were at risk of drug-CAM interactions that are of moderate significance. Adult survivors were more likely to use CAM than pediatric survivors (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.31–4.41). Brain tumor survivors were more likely than other solid tumor survivors to use non-oral therapies (OR, 2.70; 95% CI, 1.01–7.72). Conclusions The prevalence of CAM use among Chinese survivors of childhood cancer was high. A minority of survivors had a risk of clinically significant CAM-drug interactions. Future studies should focus on survivors’ behavior and motivations for CAM use. Implications for Cancer Survivors As the concurrent use of CAM and chronic medications might result in interactions, healthcare providers should proactively identify such interactions and develop referral pathways to promote evidence-based integrative therapies for survivors.
... A meta-analysis of studies using the Fear of Cancer Recurrence Inventory (FCRI) found slightly higher rates of clinical FCR (30-53%) [9], depending on the cutoff used to define clinical FCR [12]. While targeted psychosocial interventions and integrative medicine modalities may be helpful to reduce FCR [13][14][15], effective FCR interventions have not been implemented until now in French routine care. ...
Article
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Purpose Fear of cancer recurrence (FCR) is frequent in survivors, but less is known about FCR in long-term survivors with very low risk of relapse. Our aim was to estimate the prevalence and clinical and socio-behavioural factors associated with FCR in young women 5 years after diagnosis of a good-prognosis cancer. Methods Using data from the VICAN-5 survey, conducted in 2015–2016 amongst a national representative French sample of cancer survivors, we included women with non-metastatic melanoma, breast, or thyroid cancer, aged 55 years or under at diagnosis, who experienced no disease progression in the 5 years post-diagnosis. Multinomial logistic regression was used to identify factors associated with FCR, characterised using a three-level indicator: no, mild, and moderate/severe FCR. Results Amongst the 1153 women included, mean age was 44 years at diagnosis, and 81.8% had breast cancer, 12.5% thyroid cancer, and 5.8% melanoma. Five years after diagnosis, 35.4% reported no FCR, 46.0% mild FCR, and 18.6% moderate/severe FCR. Women with thyroid cancer were less likely to suffer from mild or moderate/severe FCR, while cancer-related treatment sequelae, fatigue, and anxiety were more likely. Limited health literacy was associated with mild FCR. Women who reported only occasionally consulting a general practitioner (GP) for the management of their cancer had a higher probability of FCR. Conclusion Moderate/severe FCR affected nearly 20% of young female long-term survivors diagnosed with a good-prognosis cancer, particularly those reporting cancer-related sequelae, suffering from fatigue or anxiety, with breast cancer or melanoma (versus thyroid cancer), and consulting a GP only occasionally for cancer management. Implications for Cancer Survivors Given the recognised impact of FCR on quality of life, it is essential to detect it as early as possible, and to implement targeted interventions in routine care.
... Despite progress in supportive care for survivors, gaps still exist in addressing complex symptoms such as anxiety, pain, fatigue, insomnia, neuropathy, and cognitive dysfunction. 40,41 Moreover, the physical, emotional, and social ramifications of cancer may linger years after treatment, 42 further challenging the infrastructure and resources of health care systems. 43 Early integration of palliative care, which is considered an essential component of universal health care by the WHO to improve quality of life, 44 is also not easily accessible worldwide. ...
Article
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The increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low‐ and middle‐income countries (LMICs) when it comes to receiving evidence‐based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence‐based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence‐informed, patient‐centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment‐related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence‐based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence‐informed, and culturally sensitive cancer care.
... Integrative medicine is becoming an important aspect of SC [9]. We asked a series of questions in our survey regarding the nature and use of these techniques. ...
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IntroductionThe increasing number of cancer diagnoses and deaths underlines the importance of supportive and palliative care. It is defined as “all the care and the support necessary for patients throughout their illness.”AimTo evaluate the current status of the supportive and palliative care organization in Belgium.Methods The Belgian Society of Medical Oncology (BSMO) supportive care task force conducted an observational study by sending a 31-point questionnaire to medical doctors responsible for the supportive care units of university, public, or private hospitals in Belgium.ResultsThirty centers completed the questionnaire, of which 12 were university hospitals. Inpatient supportive care units are available in more than 50% of the centers, whereas outpatient supportive care is less available in Brussels than in Flanders and Wallonia. Multidisciplinary teams or specific units dedicated exclusively to supportive care are represented less frequently in all 3 areas of Belgium. Intensive care units for cancer patients are even scarcer. In terms of research and teaching, active research is present in 10 (33%) centers. Of complementary and alternative medicine modalities available to cancer patients, mindfulness and massage are offered most frequently. Reference guidelines for various symptoms are widely used in Flanders and Brussels but less so in Wallonia.Conclusion This is the first in-depth survey in Belgium that shows the limited availability of dedicated supportive care services throughout the country. This represents an unmet need for Belgian cancer patients. Within the BSMO supportive care task force, there is a great opportunity to expand services and develop active research in the area of supportive and palliative care.
... As terapias integrativas que facilitam as conexões mentecorpo, como a hipnose e o relaxamento muscular, podem ajudar a melhorar a imagem corporal, aliviar o stresse e contribuem para proporcionar uma reconexão da mente com o corpo, com um efeito positivo na saúde sexual e mais satisfação a sua sexualidade. (Viscuse et al., 2017;Faria, 2014;Kremser et al., 2008). ...
Article
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Enquadramento: o tratamento do cancro da mama traz consigo terapêuticas agressivas e invasivas, trazendo alterações a nível físico e psicológico que afetam a vida da mulher e a vivência da sua sexualidade. Objetivo: mapear o contributo das terapias integrativas na sexualidade da mulher com cancro da mama. Metodologia: a Scoping Review foi construída seguindo as recomendações da extensão PRISMA. A estratégia de pesquisa incluiu as bases de dados: CINAHL Complete; MEDLINE Complete; Nursing & Allied Health Collection: Comprehensive; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Cochrane Methodology Register; Library, Information Science & Technology Abstracts; MedicLatina, via EBSCOhost - Research Databases, Google Académico, PubMed, B-On, LILACS, MEDLINE e SCIELO. Foi definido como limite cronológico janeiro de 1999 a março de 2020. O corpus da revisão ficou constituído por cinco artigos científicos. Resultados: os estudos analisados são unânimes: demostrando que o recurso às terapias integrativas por parte das mulheres com cancro de mama, mastectomizadas, refletem em efeitos positivos na saúde das mesmas. Conclusão: as terapias integrativas promovem nas mulheres, através da harmonia dos seus próprios recursos, trazendo efeitos positivos na vivência da sua sexualidade.
... 5 A review, published in 2018, summarized research studies focusing on integrative medicine modalities in cancer survivors. 6 In the category of mind-body modalities, a majority of the reviewed studies focused on Mind Body Stress Reduction (MBSR), a mind-body therapy utilizing group yoga, meditation exercises, and discussions about stress and coping, provided by trained instructors. Clinical trials and small randomized trials support that MBSR improves anxiety, fear of recurrence, and fatigue; however, quality of life, pain, and depression measures were not clearly impacted. ...
... Clinical trials and small randomized trials support that MBSR improves anxiety, fear of recurrence, and fatigue; however, quality of life, pain, and depression measures were not clearly impacted. 6 An additional review of Phase I and II clinical trials evaluating the use of low-intensity forms of yoga has demonstrated that this type of intervention is safe and effective for treating cancer-related symptoms such as fatigue, psychosocial distress, and musculoskeletal symptoms. 7 The current project aimed to add to the literature on yoga in survivors by studying the patient perspective regarding how specific symptoms responded to yoga after breast cancer treatment, and the magnitude of benefit yoga may provide. ...
Article
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Purpose Integrative therapies such as yoga are potential treatments for many psychological and physical symptoms that occur during and/or after treatment for cancer. The purpose of the current study was to evaluate the patient-perceived benefit of yoga for symptoms commonly experienced by breast cancer survivors. Methods 1,049 breast cancer survivors who had self-reported use of yoga on a follow up survey, in an ongoing prospective Mayo Clinic Breast Disease Registry (MCBDR), received an additional mailed yoga-focused survey asking about the impact of yoga on a variety of symptoms. Differences between pre- and post- scores were assessed using Wilcoxon Signed Rank Test. Results 802/1,049 (76%) of women who were approached to participate, consented and returned the survey. 507/802 (63%) reported use of yoga during and/or after their cancer diagnosis. The vast majority of respondents (89.4%) reported some symptomatic benefit from yoga. The most common symptoms that prompted the use of yoga were breast/chest wall pain, lymphedema, and anxiety. Only 9% of patients reported that they had been referred to yoga by a medical professional. While the greatest symptom improvement was reported with breast/chest wall pain and anxiety, significant improvement was also perceived in joint pain, muscle pain, fatigue, headache, quality of life, hot flashes, nausea/vomiting, depression, insomnia, lymphedema, and peripheral neuropathy, (all p-values <0.004). Conclusion Data supporting the use of yoga for symptom management after cancer are limited and typically focus on mental health. In this study, users of yoga often reported physical benefits as well as mental health benefits. Further prospective studies investigating the efficacy of yoga in survivorship are warranted.
... However, some studies do not find a significant difference in anxiety after massage [25], and many OM studies suffer from methodological, longitudinal, and population data flaws [26]. There is a lack of standardization in the anxiety evaluation tools and control/comparator groups. ...
Article
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Literature suggests Oncology Massage (OM) reduces anxiety. However, research is limited in large, diverse, nonexperimentally manipulated outpatient samples of cancer patients. The purpose of this study was to 1) describe OM visit patterns, 2) describe anxiety response to OM, and 3) determine if OM resulted in significantly reduced anxiety at first visit, across all visits, and longitudinally over time controlling for demographic factors. From January 2015-June 2019, a cohesive, consecutive, retrospective sample evaluated their anxiety before and immediately after OM from 0=no anxiety to 10=worst possible anxiety during routine clinical therapy within an Integrative Oncology program at an academic hybrid, multi-site, community-based cancer institute. Descriptive statistics summarized patient characteristics, visit patterns, and anxiety outcomes. A paired t-test compared pre-to post-anxiety before and after the first OM visit and a variance component model evaluated anxiety scores across all visits. Pre-therapy anxiety was modelled longitudinally. A mixed model and a weighted least squares linear model estimated anxiety over time. 749 patients attended 2,666 total visits. 428 of the 749 (57.1%) recorded at least two visits. OM therapy usage patterns were diverse for all characteristics measured (i.e., days between first and second visits, days between adjacent visits, duration of OM therapy). OM was associated with significantly decreased anxiety after the first visit (p<0.01) and across all visits (p<0.01), although not associated with decreased anxiety longitudinally (p=0.516). Diverse OM therapy usage patterns suggest wide variations in utilization of routine clinical services. Evidence suggests OM provides short-term anxiety reduction, yet may not have a cumulative effect across multiple visits. Future research should examine characteristics of OM therapy (e.g., frequency, duration) most effective for anxiety and the impact of OM on anxiety among diverse demographic groups (e.g. cancer stage at diagnosis).
... For example, nutritional habits and their changes (for example, due to the introduction of integrative or alternative medicine approaches) are thought to influence pharmacokinetics via microbiome alteration [93]. Given that nutritional habits are known to be different between genders and since microbiome has been reported to be sex-specific [94] and able to influence a series of metabolic functions as well as immune system efficiency, the possibility that gender-related determinants (also including psychological and cultural habits and others) can influence therapeutic predictivity cannot be ruled out [95,96]. ...
Article
Gliomas are tumors that originate from the glial tissue, thus involving the central nervous system with varying degrees of malignancy. The most aggressive and frequent form is glioblastoma multiforme, a disease characterized by resistance to therapies, frequent recurrences, and extremely poor median survival time. Data on overall glioma case studies demonstrate clear sex disparities regarding incidence, prognosis, drug toxicity, clinical outcome, and, recently, prediction of therapeutic response. In this study, we analyze data in the literature regarding malignant glioma, mainly glioblastoma multiforme, focusing on epidemiological and clinical evaluations. Less discussed issues, such as the role of viral infections, energy metabolism, and predictive aspects concerning the possible use of dedicated therapeutic approaches for male or female patients, will be reported together with different estimated pathogenetic mechanisms underlying astrocyte transformation and glioma chemosensitivity. In this era, where personalized/precision medicine is the most important driver for targeted cancer therapies, the lines of evidence discussed herein strongly suggest that clinical approaches to malignant glioma should consider the patient’s sex. Furthermore, retrospectively revising previous clinical studies considering patient sex as a crucial variable is recommended.