Exploring the effectiveness of a patient‐tailored integrative oncology program on emotional distress during chemotherapy for localized cancer

• Published in: Psycho-oncology (Chichester, England) England), 2022-02, Vol.31 (2), p.207-218
• Main Authors: Ben‐Arye, Eran, Elly, Maya, Gressel, Orit, Reshef, Alon, Shani MD, Michal, Stein, Nili, Saliba, Walid, Samuels, Noah
• Format: Article
• Language: English
• Subjects: Acupuncture; Anxiety; Cancer; Cancer therapies; Chemotherapy; Demography; depression; Emotional distress; Emotional well being; integrative oncology; Mental depression; Oncology; palliative medicine; Patients; Psychological distress; Quality of life; Sleep; supportive care
• ISSN: 1057-9249; 1099-1611
• DOI: 10.1002/pon.5794

Study objective There is a need to explore how patient‐tailored integrative oncology (IO) programs reduce emotional distress. This study set out to bridge the IO research gap between non‐specific, quality of life‐related and specific emotional‐related concerns in chemotherapy‐treated patients. Methods This pragmatic, prospective and preference‐controlled study examined patients attending an integrative‐physician consultation and weekly IO treatments during adjuvant/neo‐adjuvant chemotherapy for localized cancer. Patients choosing to attend ≥4 IO sessions (highly adherent to integrative care, AIC) were compared to low AIC patients using the ESAS (Edmonton Symptom Assessment Scale) anxiety, depression and sleep; and the EORTC QLQ‐C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) emotional functioning scale, at baseline, 6 and 12 weeks. Emotional distress was assessed by ESAS anxiety and depression, considered as the primary study outcomes. Results Of 439 participants, 260 (59%) were high‐AIC and 179 low‐AIC, both with similar baseline demographic and cancer‐related characteristics. At 6 weeks, high‐AIC patients reported greater improvement on ESAS sleep (p = 0.044); within‐group improvement on ESAS anxiety and; and EORTC emotional functioning. Compared with low‐AIC, high‐AIC patients showed greater improvement on ESAS depression (p = 0.022) and sleep (p = 0.015) in those with high baseline ESAS anxiety scores (≥7); and ESAS anxiety (p = 0.049) for patients moderately anxious (4–6) at baseline. Conclusions High‐AIC was associated with significantly reduced anxiety, depression and sleep severity at 6 weeks, especially those with high‐to‐moderate baseline anxiety levels. These findings reduce the research gap, suggesting specific emotional‐related effects of IO.