Effect of a patient-tailored integrative medicine program on gastro-intestinal concerns and quality of life in patients with breast and gynecologic cancer

Context and objectives: This study was conducted to assess the impact of a patient-tailored complementary/integrative medicine (CIM) program on gastro-intestinal (GI) symptoms and other concerns in female patients with breast/gynecological cancer undergoing chemotherapy. Methods: Patients with breast/gynecological cancer reporting GI-related concerns were referred to an integrative physician (IP) consultation. The treatment group included patients agreeing to attend the consultation; controls those who did not. The Edmonton Symptom Assessment Scale (ESAS) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were administered at baseline and at 6 weeks. Adherence to integrative care (AIC) was defined as attending ≥4 CIM treatments, with ≤30 days between each session. Results: Of 496 patients approached, 289 reported GI-related concerns. Optimal assessment at baseline and 6 weeks was achieved in 117 patients in the treatment arm, with 86 adhering to the CIM program (AIC subgroup); and in 89 of controls. EORTC scores improved more significantly in the treatment arm for appetite (P = 0.018), fatigue (P = 0.026), cognitive functioning (P < 0.001) and emotional functioning (P = 0.002); and ESAS scores for pain (P = 0.038), anxiety (P = 0.016), and sleep (P = 0.001). EORTC scores improved more significantly in the AIC group for global health status/QOL (P = 0.041), physical functioning (P = 0.004), role functioning (P = 0.011), appetite (P = 0.019), and fatigue (P = 0.001); and ESAS scores for pain (P = 0.048), fatigue (P = 0.011), drowsiness (P = 0.035), and appetite (P = 0.002). Conclusion: The integration of CIM may improve chemotherapy-related GI and other QOL-related concerns in patients with breast and gynecological cancer, with greater benefit observed in adherent patients.