Abstract
Objective Integrative oncology is widely used by patients with breast cancer. This study aims to investigate the relationship between the survival outcomes of breast cancer patients and the level of involvement in integrative oncology at the institutions treating them. Methods Claims-based data were used to find 4,815 newly diagnosed breast cancer patients treated between January 2013 and December 2014 for survival analysis. A scoring system was developed by asking oncologists about their institutions' efforts to educate, support, and provide funding for 12 complementary and lifestyle approaches. Cohort analysis using two-tailed chi-square and a separate multivariate model using SMOTE and lasso regression were used. Nine variables across patient and institutional profiles were included. The model coefficients were exponentiated and presented as odds ratios. Results 173 patients mapped to 103 institutions and 103 oncologists. The median patient age was 51, and 8% were metastatic. Institutions were scored for integrative oncology involvement and placed into four cohorts. Low-scoring institutions showed less effort to educate, support, and provide integrative therapies compared to others. The 5-year survival of patients in the low cohort was directionally but not significantly lower than others. In the multivariate model, a composite integrative oncology score was shown to increase 5-year survival odds three times for institutions in the low-mid cohort and 48% in the mid-high, compared to the low. Conclusion Crossing the threshold beyond ‘low' involvement in integrative oncology represents a new path to incremental survival benefit for many cancer patients. Entities invested in the survival of breast cancer patients should increase education, access, and funding for a core set of six therapies: nutrition counselling, exercise counselling, patient support groups, spiritual services, meditation, and psycho-oncology support.
Highlights
Cancer impacts the whole person affecting all dimensions of the individual—mind, body, and spirit
While the oncology community relies on conventional medicine as the backbone of therapy, many patients combine complementary and lifestyle therapies in an approach known as integrative oncology
While wellknown and often recommended, they have variable availability in cancer treatment. ere is a growing body of evidence that adding complementary and lifestyle approaches to conventional oncology treatment benefits patients by helping them manage the side effects of treatment [2], improving patient-reported outcomes [3], and contributing to improved overall survival [4, 5]. is study aimed to investigate the relationship between institutional involvement in integrative oncology and survival in breast cancer patients
Summary
Cancer impacts the whole person affecting all dimensions of the individual—mind, body, and spirit. While the oncology community relies on conventional medicine as the backbone of therapy, many patients combine complementary and lifestyle therapies in an approach known as integrative oncology. Integrative oncology is defined as “a patient-centered, evidence-. Journal of Oncology informed field of cancer care that utilizes mind-body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments” [1]. Ere is a growing body of evidence that adding complementary and lifestyle approaches to conventional oncology treatment benefits patients by helping them manage the side effects of treatment [2], improving patient-reported outcomes [3], and contributing to improved overall survival [4, 5]. Is study aimed to investigate the relationship between institutional involvement in integrative oncology and survival in breast cancer patients While wellknown and often recommended, they have variable availability in cancer treatment. ere is a growing body of evidence that adding complementary and lifestyle approaches to conventional oncology treatment benefits patients by helping them manage the side effects of treatment [2], improving patient-reported outcomes [3], and contributing to improved overall survival [4, 5]. is study aimed to investigate the relationship between institutional involvement in integrative oncology and survival in breast cancer patients
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