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Category: Pubblicazioni scientifiche

Title of the practice: Multidisciplinary and integrative approach to cancer patients and disease

Organisation name: Institute for the Study, the Prevention and the Oncological Network (ISPRO) and Regional Center for Integrative Medicine (RCIM)

Region: Tuscany
Country: Italy
Total Region Population: 3,729,641 (2018)
Cooperation partners: Local Health Unit Tuscany Center; Local Health Unit Tuscany North West; Local Health Unit Tuscany South East – Healthcare Service, Region of Tuscany

Summary:
Over the last 25 years, the Region of Tuscany has started a process of integration of complementary medicine (CM) in the Regional Health Service, defining oncology as a priority area of intervention. Based on the scientific evidence, some integrative therapies have been included in the oncological network, aimed to reduce the side effects of conventional anticancer therapies and improve the quality of life of patients. In 2019, the Regional Guidelines (Diagnostic and Therapeutic Care Pathway, DTCP) on breast cancer included a section on complementary and integrative medicine as supportive cancer care. In November 2021, the document ‘DTCP - Integrative Medicine for Cancer Patients’ designed the principles and actions of the application of complementary integrative medicine in oncology. The aim is to ensure patients effective, safe, high quality and uniform treatments and improve their quality of life, reducing the side effects of anticancer therapy in a multidisciplinary and sustainable approach.

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Background

Recent research in the field of oncology has yielded important contributions concerning all the cancer disease phases. A growing amount of data is available regarding patient needs related to the physical and psychosocial sequelae of cancer and their association with overall quality of life (QoL) [1]. Such needs may be related to specific therapeutic steps and services provided (e.g., patients\' need for more information on their health status), as well as specific symptom management (e.g.,..

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Category: Pubblicazioni scientifiche

Elio Rossi, MD,1 Cristina Noberasco, MD,1 Marco Picchi, PsyD,1 Mariella Di Stefano, MA,1 Antonella Rossi, BS,1 Linda Nurra, PhD,1 and Leonardo Ventura, MS2

Abstract

Background: To address the side effects of anticancer treatments, the Clinic for Complementary Medicine and Diet in Oncology was opened, in collaboration with the oncology department, at the Hospital of Lucca (Italy) in 2013.

Aim: To present the results of complementary medicine treatment targeted toward reducing the adverse effects of anticancer therapy and cancer symptoms, and improving patient quality of life. Dietary advice was aimed at the reduction of foods that promote inflammation in favor of those with antioxidant and anti-inflammatory properties.

Methods: This is a retrospective observational study on 357 patients consecutively visited from September 2013 to December 2017. The intensity of symptoms was evaluated according to a grading system from G0 (absent) to G1 (slight), G2 (moderate), and G3 (strong). The severity of radiodermatitis was evaluated with the Radiation Therapy Oncology Group (RTOG) scale. Almost all the patients (91.6%) were receiving or had just finished some form of conventional anticancer therapy.

Results: The main types of cancer were breast (57.1%), colon (7.3%), lung (5.0%), ovary (3.9%), stomach (2.5%), prostate (2.2%), and uterus (2.5%). Comparison of clinical conditions before and after treatment showed a significant amelioration of nausea, insomnia, depression, anxiety, fatigue, mucositis, hot flashes, joint pain, dysgeusia, neuropathy, and all symptoms. Moreover, in a subgroup of 17 patients in radiotherapy undergoing integrative treatment, the level of toxicities and the severity of radiodermatitis were much lower than in the 13 patients without integrative treatment. Twenty-one cancer patients (6.2%) either refused (18) or discontinued (3) conventional anticancer treatment against the recommendation of their oncologist; after the integrative oncology (IO) visit, 7 (41.2%) out of 17 patients with follow-up decided to accept standard oncologic treatments.

Conclusions: An IO clinic may contribute to reducing the adverse effects of anticancer therapy and improving the quality of life of cancer patients.

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Category: Pubblicazioni scientifiche

Abstract

Since 2011, the Tuscany Regional Authority has been funding the use of Integrated Medicine (IM) in a clinical setting in Pitigliano Hospital, with the aim of testing the true efficacy of complementary and alternative medicine (CAM) in a hospital setting. The clinical setting also comprises the Manciano rehabilitation facility whose services include post-stroke rehabilitation.

This study aims to establish if IM helps to improve the rehabilitation performance of stroke patients. The study compared 212 patients divided into two groups: 94 treated with IM (conventional therapy plus homeopathy and acupuncture) and 118 treated with conventional therapy alone. All patients were evaluated with the rehabilitation scores in use at the center (Trunk Control Test and Barthel Index) before and after completing the rehabilitation course. The results demonstrate a considerable benefit for the use of IM with a significance of p = 0.001 for the Trunk Control Test difference and p < 0.001 for the Barthel Index difference.

No side effects were documented in any patient treated with IM. The level acceptance of the integrated therapies was high (accepted by 95.94% of patients: 94 out of 98 inpatients).

Keywords

Orthodox medicine; integrated medicine; acupuncture; homeopathy; post-stroke rehabilitation performance

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