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DOI: 10.1055/a-0754-2923
Supportive Infusions in Integrative Breast and Gynecological Oncology – Report on Patientsʼ Satisfaction and Self-reported Effects and Side Effects
Article in several languages: English | deutschPublication History
received 30 July 2018
revised 14 September 2018
accepted 05 October 2018
Publication Date:
26 November 2018 (online)
![](https://www.thieme-connect.de/media/gebfra/201811/lookinside/thumbnails/10-1055-a-0754-2923_gf7542923_en-1.jpg)
Abstract
Background During cancer therapy, many patients suffer from malnutrition or vitamin deficiency. Treatment for nutrition-related deficiencies should therefore include nutritional therapy and possibly oral or intravenous substitution of micronutrients. Little information exists on multinutrient infusion therapies. The aim of this study was to develop standardized infusion protocols for integrative medicine infusions with micronutrients (IMed infusions) and to report on side effects of the treatment and patientsʼ satisfaction with it.
Methods For the IMed consultancy service, four special formulas for intravenous use were developed in cooperation with the pharmacy at Erlangen University Hospital. A retrospective cross-sectional study was conducted between October 2015 and January 2018 in which 45 patients with gynecological or breast cancer (BC) and IMed infusion therapy were included. Follow-up data were obtained from 20 patients using a standardized questionnaire on IMed infusions.
Results A total of 280 IMed infusions were administered in the study period. The majority of the patients received an IMed regeneration infusion (78%). The majority of the patients had BC and were receiving chemotherapy. Most patients reported a high or very high level of satisfaction with the organization (60%), general treatment (65%) and counseling (85%). Subjective improvement in their disease-related and therapy-induced symptoms, such as fatigue, polyneuropathy and physical efficiency, was reported by 70% of the patients, while 75% reported a subjective increase in quality of life. Side effects were rare and minor.
Conclusions Therapy with IMed infusions in women with BC or gynecological cancer requires the same standards set for drug therapy. Although vitamins represent dietary supplements, appropriate assessment of the patientʼs medical history is needed and patients must receive appropriate information. For this purpose, standardized processes, as in the context of an IMed consultancy service, are helpful.
Key words
cancer - gynecological oncology - breast cancer - vitamins - infusion - dietary supplements - micronutrients - integrative medicine - complementary and alternative medicineSupporting Information
- Supporting Information
Appendix 1. Patient Questionnaire: Evaluation of Patients’ Satisfaction with IMed Infusions
Ergänzendes Material
- Supporting Information
Appendix 2. Patientinnenumfrage: Anschlussbefragung zum Besuch in der IMed-Sprechstunde
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References/Literatur
- 1 Consortium of Academic Health Centers for Integrative Medicine (CAHCIM). Academic Consortium for Integrative Medicine & Health, ed.. 2017 Online: https://www.imconsortium.org/about/about-us.cfm last access: 16.08.2017
- 2 Hack CC, Hüttner NBM, Paepke D. et al. Integrative Medizin in der Gynäkologischen Onkologie – Möglichkeiten und Grenzen Teil 1. Senologie – Zeitschrift für Mammadiagnostik und -therapie 2014; 11: 217-226
- 3 Kalder M, Müller T, Fischer D. et al. Arbeitsgruppe Integrative Medizin (AG IMed) der AGO e.V.. Begriffsdefinition, Gründung, Ziele und Perspektiven der AG Integrative Medizin. Geburtsh Frauenheilk 2015; 75: 532-536 doi:10.1055/s-0035-1546226
- 4 Horneber M, Bueschel G, Dennert G. et al. How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis. Integr Cancer Ther 2012; 11: 187-203
- 5 Molassiotis A, Fernadez-Ortega P, Pud D. et al. Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol 2005; 16: 655-663
- 6 Molassiotis A, Scott JA, Kearney N. et al. Complementary and alternative medicine use in breast cancer patients in Europe. Support Care Cancer 2006; 14: 260-267
- 7 Molassiotis A, Browall M, Milovics L. et al. Complementary and alternative medicine use in patients with gynecological cancers in Europe. Int J Gynecol Cancer 2006; 16 (Suppl. 01) 219-224
- 8 Fremd C, Hack CC, Schneeweiss A. et al. Use of complementary and integrative medicine among German breast cancer patients: predictors and implications for patient care within the PRAEGNANT study network. Arch Gynecol Obstet 2017; 295: 1239-1245
- 9 Hack CC, Fasching PA, Fehm T. et al. Interest in Integrative Medicine Among Postmenopausal Hormone Receptor-Positive Breast Cancer Patients in the EvAluate-TM Study. Integr Cancer Ther 2017; 16: 165-175 doi:10.1177/1534735416668575
- 10 Hack CC, Hüttner NB, Fasching PA. et al. Development and Validation of a Standardized Questionnaire and Standardized Diary for Use in Integrative Medicine Consultations in Gynecologic Oncology. Geburtsh Frauenheilk 2015; 75: 377-383
- 11 Klein E, Beckmann MW, Bader W. et al. Gynecologic oncologistsʼ attitudes and practices relating to integrative medicine: results of a nationwide AGO survey. Arch Gynecol Obstet 2017; 296: 295-301
- 12 Weijl NI, Hopman GD, Wipkink-Bakker A. et al. Cisplatin combination chemotherapy induces a fall in plasma antioxidants of cancer patients. Ann Oncol 1998; 9: 1331-1337
- 13 Hack CC, Voiss P, Lange S. et al. Local and Systemic Therapies for Breast Cancer Patients: Reducing Short-term Symptoms with the Methods of Integrative Medicine. Geburtsh Frauenheilk 2015; 75: 675-682
- 14 Hoffer LJ, Levine M, Assouline S. et al. Phase I clinical trial of i.v. ascorbic acid in advanced malignancy. Ann Oncol 2008; 19: 1969-1974
- 15 Fritz H, Flower G, Weeks L. et al. Intravenous Vitamin C and Cancer: A Systematic Review. Integr Cancer Ther 2014; 13: 280-300
- 16 Hoffer LJ, Robitaille L, Zakarian R. et al. High-dose intravenous vitamin C combined with cytotoxic chemotherapy in patients with advanced cancer: a phase I–II clinical trial. PLoS One 2015; 10: e0120228
- 17 Gaby AR. Intravenous nutrient therapy: the “Myersʼ cocktail”. Altern Med Rev 2002; 7: 389-403
- 18 Lonsdale D, Shamberger RJ, Stahl JP. et al. Evaluation of the biochemical effects of administration of intravenous nutrients using erythrocyte ATP/ADP ratios. Altern Med Rev 1999; 4: 37-44
- 19 DiGianni LM, Garber JE, Winer EP. Complementary and alternative medicine use among women with breast cancer. J Clin Oncol 2002; 20: 34S-38S
- 20 Jacobson JS, Chetty AP. Complementary and alternative medicine in prostate cancer. Curr Oncol Rep 2001; 3: 448-452
- 21 Greenlee H, Neugut AI, Falci L. et al. Association Between Complementary and Alternative Medicine Use and Breast Cancer Chemotherapy Initiation: The Breast Cancer Quality of Care (BQUAL) Study. JAMA Oncol 2016; 2: 1170-1176
- 22 Sweet E, Dowd F, Zhou M. et al. The Use of Complementary and Alternative Medicine Supplements of Potential Concern during Breast Cancer Chemotherapy. Evid Based Complement Alternat Med 2016; 2016: 4382687
- 23 Lux MP, Janni W, Hartkopf AD. et al. Update Breast Cancer 2017 – Implementation of Novel Therapies. Geburtsh Frauenheilk 2017; 77: 1281-1290
- 24 Du J, Cullen JJ, Buettner GR. Ascorbic acid: chemistry, biology and the treatment of cancer. Biochim Biophys Acta 2012; 1826: 443-457
- 25 Monti DA, Mitchell E, Bazzan AJ. et al. Phase I evaluation of intravenous ascorbic acid in combination with gemcitabine and erlotinib in patients with metastatic pancreatic cancer. PLoS One 2012; 7: e29794
- 26 Wallwiener M, Simoes E, Sokolov AN. et al. Health-related Quality of Life in Metastatic and Adjuvant Breast Cancer Patients. Geburtsh Frauenheilk 2016; 76: 1065-1073
- 27 Gonzalez MJ, Miranda-Massari JR, Mora EM. et al. Orthomolecular oncology review: ascorbic acid and cancer 25 years later. Integr Cancer Ther 2005; 4: 32-44
- 28 Cabanillas F. Vitamin C and cancer: what can we conclude–1,609 patients and 33 years later?. P R Health Sci J 2010; 29: 215-217
- 29 Riordan HD, Casciari JJ, Gonzalez MJ. et al. A pilot clinical study of continuous intravenous ascorbate in terminal cancer patients. P R Health Sci J 2005; 24: 269-276
- 30 Stephenson CM, Levin RD, Spector T. et al. Phase I clinical trial to evaluate the safety, tolerability, and pharmacokinetics of high-dose intravenous ascorbic acid in patients with advanced cancer. Cancer Chemother Pharmacol 2013; 72: 139-146
- 31 Ma Y, Chapman J, Levine M. et al. High-dose parenteral ascorbate enhanced chemosensitivity of ovarian cancer and reduced toxicity of chemotherapy. Sci Transl Med 2014; 6: 222ra218
- 32 Jacobs C, Hutton B, Ng T. et al. Is there a role for oral or intravenous ascorbate (vitamin C) in treating patients with cancer? A systematic review. Oncologist 2015; 20: 210-223
- 33 Leitlinienprogramm Onkologie der AWMF. Deutschen Krebsgesellschaft e. V. und Deutschen Krebshilfe e. V., Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) e.V.. Interdisziplinäre S3-Leitlinie für die Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms. AWMF Registernummer: 032–045OL. 4.0. 2017 Online: http://www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/LL_Mammakarzinom_Langversion_4.0.pdf last access: 01.02.2018
- 34 Ali A, Njike VY, Northrup V. et al. Intravenous micronutrient therapy (Myersʼ Cocktail) for fibromyalgia: a placebo-controlled pilot study. J Altern Complement Med 2009; 15: 247-257
- 35 Hack CC, Hackl J, Huttner NBM. et al. Self-reported Improvement in Side Effects and Quality of Life With Integrative Medicine in Breast Cancer Patients. Integr Cancer Ther 2018; 17: 941-951