Can We Demonstrate That Breast Cancer “Integrative Oncology” Is Effective? A Methodology to Evaluate the Effectiveness of Integrative Oncology Offered in Community Clinics

Abstract

Background. Many women diagnosed with breast cancer receive both standard cancer treatment and care from providers trained in the emerging field of medicine called integrative oncology (IO) in which science-based complementary and alternative medical therapies are prescribed by physicians. The effectiveness of IO services has not been fully studied, so is yet unknown. Purpose. Determine if a matched, case-controlled prospective outcomes study evaluating the efficacy and safety of breast cancer IO care is feasible. Methods. Methodological proof of principle requires demonstration that (1) it is possible to find matched control breast cancer patients using the Surveillance, Epidemiology and End Results (SEER) Program’s western Washington Cancer Surveillance System (CSS) and (2) an IO clinic can recruit breast cancer patients into a matched controlled study. Results. A pilot study was conducted in 2008 (n = 14) to determine if matched controlled women could be identified in the western Washington SEER database. All 14 women who were approached agreed to participate. The cases were matched to the CSS along 5 variables: age and stage at diagnosis, race, and marital and Estrogen Receptors/Progesterone Receptors (ER/PR) status. Multiple matches were found for 12 of the 14 participants. Conclusion: A prospective cohort study with a matched comparison group is a feasible and potentially rigorous study design with high patient acceptability. It may provide valuable data for the evaluation of the effectiveness of IO care on patient health, relapse rate, and health-related quality of life (HRQOL). A federally funded matched case controlled outcomes study is currently under way at Bastyr University and the Fred Hutchinson Cancer Research Center.