The Best of SIO

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The following five abstracts were chosen as the best submitted studies presented at this year’s International Conference of the Society for Integrative Oncology (SIO). They represent a diverse group of integrative therapies and interventions in the care of patients with cancer, including an oncology massage program integrated into chemotherapy infusion suites; a fatigue-reduction diet for breast cancer survivors; movement therapy to help with pain control in children with neuroblastoma; software to identify medication interactions; and clinical practice guidelines on the use of integrative therapies for breast cancer.

“The integrative oncology practices presented at our conferences are grounded in research,” said ­Lynda Balneaves, PhD, RN, President-Elect of SIO and Associate Professor in the College of Nursing at the University of Manitoba in Winnipeg, Canada. “We use the same methodological designs as those used in research studies of traditional cancer therapies. Our studies are just focused on the use of complementary therapies.”

Utilizing Massage Therapy to Help Patients Cope With Chemotherapy Infusion

Seluzicki C, Wagner K, Li S, et al: Integrating oncology massage into chemo-infusion suites: A program evaluation. 2016 SIO International Conference. Abstract 6. Presented November 7, 2016.

This study evaluates the development and implementation of an integrative clinical oncology massage program for patients with breast cancer undergoing chemotherapy in a large academic medical center. The researchers used de-identified program evaluation data to identify specific reasons individuals refuse massage and to evaluate the immediate impact of massage treatments on patient-reported outcomes. They used a modified version of the distress thermometer delivered via iPad to evaluate the immediate impact of massage treatments on patient-reported outcomes and found that the therapy reduced anxiety, nausea, pain, and fatigue from pre- to post-session. They concluded that the massage program can be safely and effectively integrated into chemotherapy infusion units to provide patients with symptom control and that the approach overcame patient barriers of cost, time, and travel.

Using Diet to Overcome Fatigue in Patients With Breast Cancer

Zick S, Djuric Z: Fatigue reduction diet in breast cancer survivors: A pilot randomized clinical trial. 2016 SIO International Conference. Abstract 30. Presented November 7, 2016.

This phase II randomized trial included 30 women with stages 0 to III breast cancer and investigated whether a diet rich in fruit, vegetables, whole grains, and omega-3 fatty acid-rich foods (fatigue-reduction diet) could improve fatigue and sleep patterns compared with a General Health Curriculum attention control group. Fifteen of the women received the fatigue-reduction diet and 15 received the General Health Curriculum.

The researchers found significant improvement in fatigue, 44% ± 39%, in the fatigue-reduction diet group compared with 8% ± 34% in the General Health Curriculum group (P < .01). Sleep quality improved by 2.5 ± 3 .3 points with the fatigue-reduction diet and diminished by 0.9 ± 2.3 with the General Health Curriculum (P = .03). They concluded that a fatigue-reduction diet intervention could provide a viable treatment strategy for persistent fatigue in patients with breast cancer.

Using Dance Therapy to Reduce Pain in Children
With Neuroblastoma

Ehrmann B, Tailor D, Tortora S, et al: Predictors of success of multisensory dance/movement therapy in improving pain control among children treated with 3F8 immunotherapy for advanced neuroblastoma. 2016 SIO International Conference. Abstract 33. Presented November 7, 2016.

This retrospective cohort study evaluated predictors of positive vs negative pain control responses to multisensory dance/movement therapy in 62 children with advanced neuroblastoma receiving the anti-GD2 antibody 3F8. There were 18 positive responders and 8 negative responders; the remainder of the children did not meet either definition. There was a trend toward male predominance, 63% vs 44%, and more 3F8 treatments, 23 vs 11, in the negative responders.

The use of multisensory dance/movement therapy appeared to be higher in the positive responders, 23% vs 17%. Positive responders were more likely to show strong engagement at treatment initiation, 73% vs 33%; communicate their needs, 45% vs 0%; and self-regulate pain/emotion, 73% vs 50%. They were also less likely to display negative emotion at treatment initiation, 9% vs 67%, and show strong parental attachment, 0% vs 67%.

“Among children receiving 3F8 for neuroblastoma, a positive pain control response to multisensory dance/movement therapy is associated with patients who are engaged, enthusiastic, have a capacity to develop coping skills, and are earlier in their treatment,” concluded the study authors.

How Software Can Help Identify Chemotherapy Interactions With Herbs
and Supplements

Lee R, Kwon N, Wu J, et al: Using software to identify potential medication interactions with herbs and supplements. 2016 SIO International Conference. Abstract 101. Presented November 7, 2016.

The researchers analyzed data collected during a phone survey of patients with breast and prostate cancers who had completed systemic anticancer therapy. Participants were asked about the medicines taken, including anticancer therapies, prescription and over-the-counter drugs, and any herbs and supplements, as well as the timing of their use. The researchers used Micromedex 2.0 and Natural Medicine Comprehensive database interaction software to identify potential medication interactions.

A total of 68 patients completed the phone survey; 85% were patients with breast cancer, and 15% had prostate cancer. The study participants took a median of nine medications, and 69% had used at least one herb or supplement. A total of 975 potential medication interactions were identified, with 70% involving herbs and supplement interactions. Overall, the researchers found that the number of prescription-related potential medication interactions nearly equaled the number of herbs and supplement-related potential medication interactions during and after chemotherapy, 368 vs 351 and 197 vs 196, respectively.

A dedicated medication interaction software program focused on herb and supplement use may help identify additional herbs and supplement-related interactions not identified by a commonly used medication software program. “Oncologists need to be aware of these interactions and discuss them with their patients,” concluded the study authors.

Determining Clinical Practice Guidelines on the Use of Integrative Therapies in Breast Cancer

Greenlee H, Dupont-Reyes MJ, Balneaves LG, et al: Integrative therapies for breast cancer patients and survivors: The latest evidence. 2016 SIO International Conference. Abstract 161. Presented November 7, 2016.

This international report updates clinical practice guidelines from the Society of Integrative Oncology on the use of integrative therapies regarding specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression, fatigue, reduced quality of life and physical functioning, and chemotherapy-induced nausea and vomiting. The report results are based on a systematic review of the literature on clinical trial findings of integrative therapy as an intervention during standard treatment or as an intervention that addressed long-term symptoms and side effects of cancer or its treatment and had a clinical indication of interest. Each therapy was graded for sample and effect size and other benefit/harm ratio indices using a modified version of the U.S. Preventive Services Task Force grading system. The researchers concluded that there is growing evidence that integrative modalities, especially mind-body therapies, such as meditation and yoga, can be used effectively to manage side effects during treatment for breast cancer. ■

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The SIO conference has become a source for high-quality research as well as a place for everyone from naturopaths, acupuncturists, and nutritionists to nurses and physicians to connect and get a broad perspective of what’s happening in this field.
— Lynda Balneaves, PhD, RN