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More breast-cancer patients using complementary medicine than their oncologists realize

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American Society of Clinical Oncology (ASCO) virtual annual meeting
Reuters Health - 26/05/2021 - A large survey shows that oncologists underestimate use of complementary and lifestyle therapies among women with breast cancer.

The survey found that 73% of breast-cancer patients use at least one type of complementary medicine after their cancer diagnosis, while only 43% of oncologists think they do.

When it comes to complementary medicine, this disconnect is a "well-known and ongoing problem between practitioners and patients," Dr. Wayne Jonas, a co-author on the report and executive director for integrative health programs at the Samueli Foundation, told Reuters Health by email.

"Providers often know very little about these areas or have a negative opinion about them and so the patients don't bring them up. This results in a major communication gap that is not good for delivery of optimal healthcare," Dr. Jonas said.

The survey, conducted by IQVIA, a healthcare-data company, included responses from 115 oncologists who treat breast-cancer patients in the United States and 164 women with breast cancer who had been diagnosed within two years of the survey. It was released in conjunction with the American Society of Clinical Oncology Annual Meeting.

The survey also showed that two-thirds of oncologists (66%) and patients (65%) believe that using complementary and lifestyle therapies improve patients' quality of life. Many patients (60%) but fewer oncologists (36%) also believe these therapies lead to better health outcomes.

Patient use of tai chi/chi gong or acupuncture were most strongly correlated with a positive impact on quality of life among the 12 modalities tested.

Most oncologists surveyed were familiar with at least one therapy and these physicians cited nutrition consultation, support groups, psycho-oncology support, and exercise consultation as the most important integrative services.

However, they gave relatively low marks to spiritual services and meditation or mindfulness - two approaches that patients view as important. Patients recalled that their care teams provided fewer recommendations about these two modalities than the others.

Only about half (55%) of oncologists said they discuss complementary and lifestyle therapies with breast-cancer patients; however, less than half of patients recall their healthcare provider as a source of information.

Oncologists and patients agree that an oncologist, oncology nurse, or patient navigator is a good source of information for complementary medicine and lifestyle therapies, but patients have a slight preference to hear from the oncologists directly.

In an email to Reuters Health, Terri Crudup, senior principal of primary intelligence for IQVIA, noted that a meta-analysis from 2012 evaluated complementary and alternative medicine (CAM) use in 18 countries in a variety of cancer patients.

In this analysis, there was a "clear trend suggesting an increase in CAM use over time, from an estimated 25% in the 1970s and 1980s, to more than 32% in the 1990s and to 49% after 2000, with the U.S. having the highest usage among the countries studied. It is a trend that we believe has continued to rise since the early 2000s, in concert with the survey results," Crudup said.

Dr. Charles Shapiro, professor of medicine (hematology and medical oncology) at the Icahn School of Medicine at Mount Sinai, in New York City, said, "The prevalence of individuals with cancer seeking complementary medicines and pursuing lifestyle interventions or alternative approaches is high."

The survey's finding that about two-thirds of oncologists and women with breast cancer think that lifestyle interventions and alternative approaches improve quality of life is "good news, especially that the oncologists recognized the importance of these approaches," said Dr. Shapiro, who was not involved in the research.

The survey also shows a "disconnect between oncologists and women with breast cancer in what each group thinks are important. Spirituality, meditation, and mindfulness were rated higher by women with breast cancer than oncologists - no surprises here, never assume anything," Dr. Shapiro commented by email.

It's also not surprising, he said, that women with cancer have a "slight preference to hear from their oncologists about these complementary approaches rather than other members of the health team."

"This survey study provides useful information and serves as a model, in terms of querying both oncologists and individuals with cancer," Dr. Shapiro added.

SOURCE: https://bit.ly/3yokaZZ American Society of Clinical Oncology (ASCO) virtual annual meeting, to be held June 4-8, 2021.

By Megan Brooks



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