Complementary medicine for breast cancer

Prof. Dr. med. Claudia M. Witt, Zurich, and Dr. med. Christian Thuile, Merano, presented a pilot project at Merano Hospital at the 29th Swiss Annual Conference on Phytotherapy. In it, patients with breast carcinoma were studied in different therapy arms. Evaluation of the data provides evidence of the efficacy of additional complementary medicine treatment compared with conventional therapy alone.

(ag) According to Prof. Dr. med. Claudia M. Witt, Zurich, it is not always easy to draw conclusions from scientific evidence for everyday clinical practice. Many randomized trials evaluate only single measures in well-defined settings. Consequently, they often overlook the complex context in routine care and often include only highly selected patient groups. In order to be able to test the benefit of different therapies also in less standardized everyday conditions, with “typical” patients and by means of patient-relevant outcome parameters, the so-called Comparative Effectiveness Research (CER) was introduced in the USA.
Most studies are on an efficacy-effectiveness continuum (Table 1) . While “efficacy” describes the extent to which a specific intervention is effective under ideal baseline conditions, “effectiveness” refers to the extent to which an intervention is effective for this population when applied in normal care.

Pilot project on complementary medicine

The study results of the pilot project initiated by the regional government of South Tyrol on the use of complementary medicine in patients with breast carcinoma were already presented in 2013 at a meeting of the International Society for Complementary Medicine Research (ISCMR) [1].
Under the direction of Dr. med. Thuile, a complex and individualized complementary medical therapy was applied. Among others, phytotherapy also played a crucial role (26% of patients received this intervention). It was offered symptom-related as an adjunctive therapy and aimed to minimize the side effects of conventional therapy as much as possible without inducing interactions. The study could not show whether any one of the procedures used was more effective than the other, but only whether complementary medicine (as applied at Merano Hospital) provided an overall additional benefit. Table 2 provides an overview of the medicinal plants frequently used at Merano Hospital and their indications.

A total of 275 patients were randomized, of whom 136 received additional complementary medicine and the others did not (n=139 in the control group). The primary endpoint (quality of life at six months) showed a statistically significantly greater improvement in the group receiving complementary medicine. Outcome was assessed using the FACT-B scale, a standard instrument used to assess quality of life in breast cancer patients. The value was 102.13 in the standard and 107.94 in the complementary group (p=0.0002) [1]. “An additional complex complementary medicine intervention was more effective in improving quality of life than routine care alone” concluded Prof. Witt in conclusion.

Source: “Complementary Medicine in Breast Cancer – Evaluation of the Pilot Project in Merano”, presentation at the 29th Swiss Annual Conference on Phytotherapy, June 18-21, 2004,
Winterthur

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