Real-World Integrative Oncology in Patients With Cancer and Diabetes: Engagement Patterns, Outcomes.

Abstract

Integrative oncology (IO) programs address quality of life (QoL)-related concerns within palliative and supportive cancer care. This study examined adherence to and outcomes of an IO program among patients with both cancer and diabetes. Patients with cancer and diabetes undergoing active oncology treatment were referred by their oncology care providers to an IO consultation, followed by a six week treatment program. Patients highly adherent to integrative care (high-AIC, attending ≥4 IO sessions during six weeks) and low-AIC patients completed the Edmonton Symptom Assessment Scale (ESAS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Of 229 patients with cancer and diabetes, 135 (59%) were high-AIC, nearly half (48.6%) treated in a palliative oncology setting. Low-AIC patients reported higher levels of pain on EORTC than high-AIC (P = 0.024). While high-AIC patients showed significant improvement in pain on ESAS (P = 0.047) and EORTC (P = 0.01), no significant changes were observed among low-AIC patients. Physical functioning significantly deteriorated in low-AIC patients (P = 0.006), with no change in the high-AIC group. Significant improvement in pain management and stable physical functioning were observed in patients with high adherence to IO care. Although these findings might reflect a selection bias, where individuals with better functioning levels are more likely to adhere to IO treatments, it may also be associated with IO treatment effects. As these findings are hypothesis-generating, and not "evidence of effect", controlled studies are needed to explore the impact of the IO program in this clinical setting.