Access to basic integrative healthcare services increases breast cancer patient's chance of survival

Breast cancer patients treated at hospitals and health systems that educate patients and provide integrative health services have a better chance of survival compared to those treated at institutions with few of these resources, according to a new study published in the Journal of Oncology. Integrative health services include complementary and lifestyle therapies, such as nutrition and exercise counseling, in addition to medical cancer treatments, such as chemotherapy and surgery.

Access to basic integrative healthcare services in cancer care not only supports a higher quality of life, but this study also shows that these services increase a patient's chance of survival. These findings serve as a call to action for hospitals and oncologists to support a whole-person approach to cancer care."

Wayne Jonas, MD, Study Co-Author and Executive Director for Integrative Health Programs, Samueli Foundation

For the study, researchers analyzed claims data for 4,815 newly diagnosed breast cancer patients who were treated in 2013 and 2014. Treating oncologists were surveyed about their institutions' efforts to educate patients and to support 12 complementary and lifestyle approaches to treatment. Responses were received from 103 oncologists at 103 institutions involved in the treatment of 173 patients.

Scoring physician responses, the study identified institutions with low, low-mid, mid-high, or high levels of education and support for complementary and lifestyle therapies. Researchers found that patients treated at institutions that had crossed the threshold above the low integrative score into a low-mid score or higher were up to three times more likely to survive over the five-year period, compared to patients treated at institutions with a low score.

Institutional ratings were based on support for 12 types of complementary and lifestyle therapy consultations, programs, or services, including nutrition, exercise, patient support groups, spiritual services, psycho-oncology support, massage therapy, meditation or mindfulness, yoga, acupuncture or acupressure, music and art therapy, Reiki or healing touch, and tai chi or qi gong. All patients in the study also received conventional medical treatments such as surgery, chemotherapy, and radiation.

Institutions with higher levels of investment commonly offered a core set of six therapies: nutrition consultation, exercise consultation, patient support groups, spiritual services, meditation/ mindfulness, and psycho-oncology support.

"Patients can play an active role in their cancer treatment and outcomes – but they are much more likely to do it with approval and help from their health system," said Terri Crudup, lead author of the study and senior principal of Primary Intelligence at the global research and technology firm IQVIA. "Oncologists and institutions that treat these patients need to consider providing education, support, and funding for these complementary and lifestyle therapies."

The study authors enumerated ways that health care institutions can cross the threshold from low into higher integrative health involvement:

• Using print materials, websites, and direct discussions to educate patients about six core complementary and lifestyle modalities.
• Offering a path to access these types of therapies onsite, such as nutrition and exercise counselling and psycho-oncology support, and other therapies at a referred location, such as patient support groups, chaplain services and meditation.
• Covering the costs of the therapies offered onsite.
• Including on-site staffing of a nutritionist, exercise consultant/physical therapist, social worker, and psychologist.

The authors noted that their study is limited due to patient variables that can affect treatment outcomes that were not included in this study. Researchers also suggest the study should be replicated with a larger sample size, and additional research should validate the scoring system for integrative health care that was used.