Integrative Oncology in Young Women With Breast Cancer.

Small studies have demonstrated the benefit of integrative oncology (IO) therapies in patients with breast cancer; however, referral patterns and timing of therapies are unknown. This study describes the referral pattern and utilization of IO services by young women with breast cancer. A retrospective review identified female patients, 40 years or younger, with a breast cancer diagnosis between 2014 and 2019, and a documented IO consultation. Patient demographics, cancer characteristics, treatments, reasons for seeking and timing of IO consultation, and IO treatment modalities were analyzed. The IO program treated 64 young women with a median age of 38.6 years. Clinical staging was primarily IA (27%), IIA (34%), or IIB (27%), and 64% of patients were clinically node negative with no evidence of metastasis. Women utilized the IO program for recurrence risk reduction and for treatment-related adverse effects (TRAEs), most commonly vasomotor complaints (44%). Therapies utilized were acupuncture (36%), healing touch (28%), oncology massage (30%), and other (75%; music therapy, therapeutic art, spiritual care, meditation, t'ai chi, yoga, and nutrition), which were commonly initiated during treatment (69%). Our data suggest that young women utilize IO services to reduce their future cancer risk and TRAEs, but they are often referred after standard cancer care treatments have begun. Future studies could examine the optimal timing for IO intervention.

Cancer Pain Relief After Healing Touch and Massage.

OBJECTIVES: To establish and compare the effectiveness of Healing Touch (HT) and Oncology Massage (OM) therapies on cancer patients' pain. DESIGN: pretest/post-test, observational, retrospective study. SETTINGS/LOCATION: Outpatient oncology setting at an academic hybrid, multisite, community-based cancer institute. SUBJECTS: n = 572 cancer outpatients. INTERVENTIONS: Patients reported pain before and after receiving a single session of either HT or OM from a certified practitioner. OUTCOME MEASURES: Pain scores from 0 = no pain to 10 = worst possible pain. RESULTS: Two hundred ninety-one patients (50.9%) receiving HT and 281 (49.1%) receiving OM reported pretherapy and post-therapy pain. Pretherapy mean pain was higher in HT patients (M = 5.1, ±2.2) than OM (M = 4.4, ±2.2), p < 0.001; post-therapy mean pain remained higher in HT patients (M = 2.6, ±2.1) than OM (M = 2.0, ±1.8), p < 0.001. Both HT (p < 0.01) and OM (p < 0.01) significantly reduced pain. Unadjusted rates of clinically significant pain improvement (defined as ≥2-point reduction in pain score) were 0.68 HT and 0.71 OM. Adjusted for pretherapy pain, OM was associated with increased odds of pain improvement (odds ratio [OR] 1.49 95% confidence interval (1.02-2.19); p = 0.041). For patients with severe pretherapy pain, OM was not more effective in yielding clinically significant pain reduction (p = 0.236) when adjusting for pretherapy pain score. CONCLUSIONS: Both HT and OM provided immediate pain relief. Future research should explore the duration of pain relief, patient attitudes about HT compared with OM, and how this may differ among patients with varied pretherapy pain levels.

Implementing and measuring the impact of patient navigation at a comprehensive community cancer center.

PURPOSE/OBJECTIVES: To determine whether patient navigation in a comprehensive community cancer center affects patient and staff perceptions of patient preparation for treatment, access to care, and overall satisfaction. DESIGN: Program evaluation with patient and staff surveys. SETTING: Comprehensive community cancer center accredited by the American College of Surgeons in the southeastern United States with 1,037 analytic cases of cancer in 2007; population of the main county served is about 177,963. SAMPLE: 48 patients (28 navigator and 20 non-navigator) and 26 employees, including physicians, nurses, and other support staff. METHODS: A 10-item survey with Likert scale format was sent to a stratified sample of 100 newly diagnosed patients with cancer. A five-item survey with the same format was sent to 40 staff working with the patients. MAIN RESEARCH VARIABLE: Patient navigation. FINDINGS: Patients who received navigation services responded more positively to survey statements. Statistical significance (p > 0.05) was identified in 7 of 10 statements when patient groups were compared. Provider responses indicated agreement with all five statements included in the survey. CONCLUSIONS: Patients with cancer and oncology staff reported that patient navigation is effective in increasing patient satisfaction and decreasing barriers to care. IMPLICATIONS FOR NURSING: Patient navigation is an emerging trend in cancer care. Patient navigators can play a significant role in assisting patients with coordinating services across the continuum of care. Continued research is essential in refining the role and eminence of patient navigators.