Analysis of Oncological Second Opinions in a Certified University Breast and Gynecological Cancer Center in Relation to Complementary and Alternative Medicine

Introduction: Oncological second opinions are becoming increasingly important given more complex treatment strategies, simultaneously more patients use complementary and alternative medicine (CAM), and many comprehensive cancer centers initiate integrative medicine programs. The present study focuses on analyzing the effects of a second opinion in relation to attitudes toward CAM. Methods: In this prospective study patients (n = 97) with a diagnosis of breast cancer or gynecological malignancies who had requested a second opinion received a questionnaire before and after the second opinion concerning their attitudes toward CAM. Results: The majority of patients had breast cancer (72.2%, n = 70). Only 6.2% (n = 6) stated that they had been informed about CAM by the doctors who treated them first, 21.6% (n = 21) had received information about it when seeking the second opinion. After the first opinion, 42.3% (n = 41) wanted to try CAM, the same proportion trusted orthodox medicine alone. After the second opinion, 24 patients (24.7%) wanted to try CAM, while 38.1% (n = 37) relied exclusively on orthodox medicine. There was a significant correlation between an increased patients’ need for information and interest in CAM (p = 0.02). Conclusions: Today, aspects of CAM still are very often no part of oncological first and second opinions. This might hence lead to discouraging patients to try out CAM and therefore integrative medicine programs in comprehensive cancer centers might be problem-solving.

[1]  M. Lux,et al.  Analysis of motives and patient satisfaction in oncological second opinions provided by a certified university breast and gynecological cancer center , 2020, Archives of Gynecology and Obstetrics.

[2]  M. Lux,et al.  Update Breast Cancer 2019 Part 4 – Diagnostic and Therapeutic Challenges of New, Personalised Therapies for Patients with Early Breast Cancer , 2019, Geburtshilfe und Frauenheilkunde.

[3]  M. Lux,et al.  Update Breast Cancer 2019 Part 5 – Diagnostic and Therapeutic Challenges of New, Personalised Therapies in Patients with Advanced Breast Cancer , 2019, Geburtshilfe und Frauenheilkunde.

[4]  M. Lux,et al.  Update Breast Cancer 2019 Part 3 – Current Developments in Early Breast Cancer: Review and Critical Assessment by an International Expert Panel , 2019, Geburtshilfe und Frauenheilkunde.

[5]  M. Lux,et al.  Update Breast Cancer 2019 Part 1 – Implementation of Study Results of Novel Study Designs in Clinical Practice in Patients with Early Breast Cancer , 2019, Geburtshilfe und Frauenheilkunde.

[6]  M. Lux,et al.  Update Breast Cancer 2019 Part 2 – Implementation of Novel Diagnostics and Therapeutics in Advanced Breast Cancer Patients in Clinical Practice , 2019, Geburtshilfe und Frauenheilkunde.

[7]  C. Witt,et al.  A Comprehensive Definition for Integrative Oncology. , 2017, Journal of the National Cancer Institute. Monographs.

[8]  D. Pieper,et al.  [Limited Data for Second Opinion Programs: a Systematic Review]. , 2017, Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)).

[9]  U. Tirelli,et al.  Use of Complementary and Alternative Medicine (CAM) in cancer patients: An Italian multicenter survey , 2016, Oncotarget.

[10]  D. Ruetters,et al.  Is there evidence for a better health care for cancer patients after a second opinion? A systematic review , 2016, Journal of Cancer Research and Clinical Oncology.

[11]  M. Beckmann,et al.  A Review of Integrative Medicine in Gynaecological Oncology , 2016, Geburtshilfe und Frauenheilkunde.

[12]  R. Kreienberg,et al.  Quality of care in breast cancer centers: results of benchmarking by the German Cancer Society and German Society for Breast Diseases. , 2015, Breast.

[13]  C. Pforr,et al.  The legacy of Sebastian Kneipp: linking wellness, naturopathic, and allopathic medicine. , 2014, Journal of alternative and complementary medicine.

[14]  A. Hein,et al.  Klassische Naturheilverfahren nach Kneipp in der Gynäkologie und Geburtshilfe , 2014, Frauenheilkunde up2date.

[15]  L. Weeks,et al.  A systematic review of integrative oncology programs. , 2012, Current oncology.

[16]  M. Zwahlen,et al.  How Many Cancer Patients Use Complementary and Alternative Medicine , 2012, Integrative cancer therapies.

[17]  J. Harrigan Patient disclosure of the use of complementary and alternative medicine to their obstetrician/gynaecologist , 2011, Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.

[18]  C. Wittekind [2010 TNM system: on the 7th edition of TNM classification of malignant tumors]. , 2010, Der Pathologe.

[19]  M. Jefford,et al.  Effectively discussing complementary and alternative medicine in a conventional oncology setting: communication recommendations for clinicians. , 2010, Patient education and counseling.

[20]  Jason Goh Quality of care. , 2010, Clinical medicine.

[21]  P. Cleary,et al.  Perceptions of cancer‐related information among cancer survivors: A report from the American Cancer Society's Studies of Cancer Survivors , 2008, Cancer.

[22]  J. Pierce,et al.  Disclosure to Physicians of CAM Use by Breast Cancer Patients: Findings From the Women's Healthy Eating and Living Study , 2008, Integrative cancer therapies.

[23]  W. Schmiegel,et al.  Onkologie. 3-Stufen-Modell optimiert Behandlung unter Kostendeckung. Wie die künftigen Strukturen der onkologischen Versorgung in Deutschland aussehen sollten , 2008 .

[24]  S. Bauer-Wu,et al.  Prevalence and predictors of complementary therapy use in advanced-stage breast cancer patients. , 2007, Journal of oncology practice.

[25]  Julia A Scott,et al.  Complementary and alternative medicine use in breast cancer patients in Europe , 2006, Supportive Care in Cancer.

[26]  Julia A Scott,et al.  Use of complementary and alternative medicine in cancer patients: a European survey. , 2005, Annals of oncology : official journal of the European Society for Medical Oncology.

[27]  E. Swisher,et al.  Use of complementary and alternative medicine among women with gynecologic cancers. , 2002, Gynecologic oncology.

[28]  E. Jenison,et al.  A comparison of complementary and alternative medicine use by gynecology and gynecologic oncology patients , 2001, International Journal of Gynecologic Cancer.

[29]  J. Siewert,et al.  ["Second opinion"--attempt at establishing a definition]. , 1996, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[30]  W. Jungi,et al.  [Why do cancer patients use alternative medicine?]. , 1991, Schweizerische medizinische Wochenschrift.

[31]  M. Lux,et al.  [Resilience, Fear of Progression and Psychosocial Distress in Patients with Breast Cancer and Gynecological Tumors Seeking a Second Opinion]. , 2018, Psychotherapie, Psychosomatik, medizinische Psychologie.

[32]  M. Beckmann,et al.  The concept of the certification system of the German Cancer Society and its impact on gynecological cancer care , 2013, Archives of Gynecology and Obstetrics.

[33]  K. Münstedt,et al.  Unconventional cancer therapy —survey of patients with gynaecological malignancy , 2004, Archives of Gynecology and Obstetrics.