Purpose: To conduct a prospective outcomes study describing use of Complementary and Alternative medicine (CAM), and integrated oncology (IO) and their effects on breast cancer patients in community settings. Background: Between 50% and 80% of women in the United States with breast cancer supplement their conventional medical treatment regimen with some form of CAM therapy. Most CAM use is self-prescribed and unsupervised, however, IO has matured into a set of science-based practices that warrant evaluation. IO clinics are directed by physicians, MDs, naturopathic physicians (NDs), and doctors of acupuncture and Oriental medicine (DAOM), who use best practices and evidence-based CAM to improve the health and well being of cancer patients who also receive standard conventional cancer therapy. This study will describe IO care as provided in community clinics and provide an initial evaluation of the effects of IO care and CAM use on breast cancer patients'Health Related Quality of Life (HRQOL). Hypothesis: IO services improve patients'quality of life and decrease cancer recurrence rates in breast cancer patients, as compared to women with similar disease states and prognoses who do not receive IO care, and may or may not use CAM treatment on their own. Methods: A partnership between Bastyr University and Fred Hutchinson Cancer Research Center will create a case-control matched cohort of IO using breast cancer patients and breast cancer patients with similar prognosis at time of diagnosis who did not use IO care and may or may not have used CAM on a self- prescription basis. This cohort will be followed prospectively allowing for a description of the outcomes of IO breast cancer care provided through a community IO clinic network in Seattle.
Aims : 1) To describe the treatments received by breast cancer patients receiving physician level integrative oncology (IO) care from community clinics (cohort;n = 600) and the cost of IO care for breast cancer;2) To describe the Health Related Quality of Life (HRQOL) experienced by breast cancer patients receiving physician level Integrative Oncology (IO) care (cohort;n = 300) and that of a group of comparison women with breast cancer (cohort;n = 900) receiving conventional treatment with or without self-prescribed CAM (n = 400- 450 and n = 450-500). In addition to describing changes in HRQOL associated with IO and CAM use and estimating the effects attributable to IO or CAM use, 3) To collect pilot data on survival and disease free survival in outcomes at 2 and 3 years follow-up in a cohort of 300 IO breast cancer patients, and a matched comparison group of 900 who did not choose to use IO during their initial treatment for breast cancer.

Public Health Relevance

The purpose of this five year project is to conduct a prospective matched controlled outcomes study that describes physician directed integrated oncology therapies and their effects on breast cancer patients'quality of life, cancer recurrence and survival rates for those who receive integrated oncology care in Seattle, Washington.

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Research Project (R01)
Project #
5R01AT005873-05
Application #
8651900
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Alekel, D Lee
Project Start
2010-08-01
Project End
2015-04-30
Budget Start
2014-05-01
Budget End
2015-04-30
Support Year
5
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Bastyr University
Department
Type
Organized Research Units
DUNS #
City
Kenmore
State
WA
Country
United States
Zip Code
98028
Sweet, Erin; Dowd, Fred; Zhou, May et al. (2016) The Use of Complementary and Alternative Medicine Supplements of Potential Concern during Breast Cancer Chemotherapy. Evid Based Complement Alternat Med 2016:4382687
Andersen, M Robyn; Sweet, Erin; Zhou, May et al. (2015) Complementary and alternative medicine use by breast cancer patients at time of surgery which increases the potential for excessive bleeding. Integr Cancer Ther 14:119-24
Standish, Leanna J; Sweet, Erin; Naydis, Eleonora et al. (2013) Can we demonstrate that breast cancer ""integrative oncology"" is effective? A methodology to evaluate the effectiveness of integrative oncology offered in community clinics. Integr Cancer Ther 12:126-35
Andersen, M Robyn; Sweet, Erin; Lowe, Kimberly A et al. (2012) Involvement in decision-making about treatment and ovarian cancer survivor quality of life. Gynecol Oncol 124:465-70