Can We Demonstrate That Breast Cancer “Integrative Oncology” Is Effective? A Methodology to Evaluate the Effectiveness of Integrative Oncology Offered in Community Clinics

Abstract

Background Many women diagnosed with breast cancer receive both standard cancer treatment and care from providers trained in the emerging field of medicine called ‘integrative oncology’ (IO) in which science-based complementary and alternative medical1 therapies are prescribed by physicians. The effectiveness of IO services has not been fully studied, so is yet unknown. Purpose Determine if a matched case-controlled prospective outcomes study evaluating the efficacy and safety of breast cancer IO care is feasible. Methods Methodological proof of principle requires demonstration that 1) it is possible to find matched control breast cancer patients using the Surveillance, Epidemiology and End Results (SEER) Program’s western Washington Cancer Surveillance System (CSS), and 2) an IO clinic can recruit breast cancer patients into a matched controlled study. Results A pilot study was conducted in 2008 (N=14) to determine if matched controlled women could be identified in the western Washington SEER database. All 14 women who were approached agreed to participate. The cases were matched to the CSS along five variables - age and stage at diagnosis, race, marital and ER/PR status. Multiple matches were found for 12 of the 14 participants. Conclusion A prospective cohort study with a matched comparison group is a feasible and potentially rigorous study design with high patient acceptability. It may provide valuable data for the evaluation of the effectiveness of IO care on patient health, relapse rate, and health-related quality of life (HRQOL). A federally funded matched-case controlled outcomes study is currently underway at Bastyr University and the Fred Hutchinson Cancer Research Center.

“I Made All Decisions Myself”: Breast Cancer Treatment Decision-Making by Receivers and Decliners

“…The other four women who were interviewed came from the usual cohort of the study group who were recruited from the CSS registry. Standish et al [15] discuss the recruitment procedures in detail.…”

Recurrence of Breast Cancer After Primary Treatment: A Matched Comparison Study of Disease-Free Survival in Women Who Do and Do Not Receive Adjunctive Naturopathic Oncology Care

“…Women participated for up to 5 years. See Standish et al 36,37 for detailed description of study methods and the cohorts.…”

“…Comparison patients were selected and recruited based on similarity to a NO case in age, stage at diagnosis, marital status, race, and ethnicity, with the goal of identifying 2 matches for each NO case. 36 Women were considered ineligible for the comparison cohort if they reported any use of NO; self-prescribed CAM use was not an exclusion criterion for either cohort.…”

Breast Cancer Integrative Oncology Care and Its Costs

“…The methods used to conduct a matched comparison prospective observational study in CAM community clinics have previously been described. 8 The current article provides a description of breast cancer IO treatments recommended and their costs per year.…”