Complementary and Alternative Medicine Use in Women With Gynecologic Malignancy

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 Complementary and Alternative Medicine Use in Women With Gynecologic Malignancy Presenting for Care at a Comprehensive Cancer Center

 Objective: We evaluated complementary and alternative medicine (CAM) practices among women presenting to a National Cancer Institute-designated Comprehensive Cancer Center with a gynecologic malignancy.
Methods: Women with a gynecologic malignancy who had consented to enrollment in our institutional prospective clinical registry between January 2003 and January 2014 and who had completed a questionnaire assessing sociodemographic characteristics, medical histories, quality of life, and CAM use were considered for analysis.
Results: Among the 2508 women identified, responses to questions on CAM use were provided by 534 (21.3%). The majority of CAM question respondents were white (93.5%) and older than 50 years (76%). Overall, 464 women (87% of CAM question respondents) used at least 1 CAM therapy during the previous 12 months. The most commonly used CAM categories were biologically based approaches (83.5%), mind and body interventions (30.6%), and manipulative and body-based therapies (18.8%). The most commonly used individual CAM therapies were vitamins and minerals (78%), herbal supplements (27.9%), spiritual healing and prayer (15.1%), and deep breathing relaxation exercises (13.1%). Complementary and alternative medicine use was greatest in age groups 20 to 30 years and older than 65 years and was more prevalent among those who were widowed (P < 0.005), retired (P = 0.02), and with a higher level of education (P < 0.01). There was no association with cancer type, race, or ethnicity.
Conclusions: Complementary and alternative medicine use is common among women being treated for gynecologic malignancy. Given the potential interactions of some CAM modalities with conventional treatment and the possible benefits in controlling symptoms and improving quality of life, providers should discuss CAM with their patients.

 Complementary and alternative medicine (CAM) use has
been increasing worldwide. In a recent survey conducted
by the Centers for Disease Control and Prevention’s National
Center for Health Statistics, almost 4 of 10 American adults
had used CAM therapy in the prior 12 months.1,2
Despite limited evidence of safety and efficacy, individuals
with cancer frequently use CAM interventions, with
more than two thirds of cancer survivors reporting use of
a CAM approach at some point during their lifetime.3,4 The
rates of CAM use in individuals with cancer have been
reported to be as high as 80% to 98%.5-7....

 TABLE 1. CAM categories
Category Intervention1. Biologically based
approaches
Vitamins, minerals, nonmineral
nonvitamin natural products,
diet-based therapies, chelation
therapy, diets, herbs, tea2. Mind-body
interventions
Yoga, spirituality, relaxation, art
and music therapy, biofeedback,
meditation, aromatherapy, deep
breathing exercises, hypnosis,
Tai chi, progressive relaxation,
guided imagery3. Energy therapies Reiki, magnets, Qigong,
healing touch4. Manipulative and
body-based therapies
Massage, chiropractic care,
osteopathy, reflexology,
acupuncture, acupressure5. Alternative medical
systems
Homeopathy, naturopathy, folk
medicine, Ayurveda

 ....The interpretation of these results may, however, be
biased because of the participation rate (21.3%). Low participation
rates have been a major concern in epidemiologic
studies as of late because they have been declining during the
past few decades,with an accelerated decline in recent years.33,34
Furthermore, a substantial number of studies, published even
in the highest-impact epidemiology journals, fail to report any
information regarding participation rates,33 among these are
some of the lead studies describing CAM use in the gynecological
cancer population.11,13....

Occult tubal carcinoma found at risk reducing salpingectomy in a BRCA1 carrier

Open access
 

Highlights

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This is the first report of occult cancer diagnosed at risk-reducing salpingectomy.

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We propose a two-step risk-reducing strategy for premenopausal high-risk women, to begin and expedite surgical prevention.

Article outline

• Highlights
• Keyword
• Introduction
• Case
• Discussion
• Conflict of interest statement
• References

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Introduction

Recent studies highlight the importance of the fallopian tube as a putative site of origin for serous ovarian carcinomas, previously felt to arise exclusively from ovarian tissue. The initial association emerged from the pathologic analysis of BRCA mutation carriers undergoing risk-reducing bilateral salpingo-oophorectomy (RRBSO), where a high percentage of incidentally diagnosed cancers and cancer precursor lesions were discovered in the distal fallopian tube ( Herzog and Dinkelspiel, 2013, Crum et al., 2012 and Kwon et al., 2013). These findings have enlivened the discussion on the appropriate management of women at high risk for ovarian cancer, proposing risk-reducing bilateral salpingectomy with delayed bilateral oophorectomy as a reasonable alternative to RRBSO and a means to diminish postoperative sequelae related to estrogen-deficiency.....

Review Metformin: risk-benefit profile with a focus on cancer

abstract

Areas covered: The present review focuses on epidemiological data and clinical trials testing the efficacy of metformin on cancer, the safety in nondiabetic patients and the future development of this promising drug.

Expert opinion: Meta-analyses of epidemiological in which metformin treatment has been used for diabetic patients show a positive trend for benefit; nevertheless, clinical data outcomes are preliminary and the results of ongoing trials are awaited. The different types of cancer, heterogeneity of populations and presence of comorbidity make it difficult to determine the benefits of metformin in cancer prevention and treatment.

50 States of Teal (OCNA)

50 States of Teal
 

INTRODUCTION
The past few years have seen dramatic changes in health care delivery across the United States with the implementation of the Affordable Care Act and the rise of personalized treatment for cancer. We felt it was an opportune time to examine how these recent changes have affected care for women with ovarian cancer. Policy decisions at the state level, including the implementation of many provisions of the ACA, play a vital role in ensuring access to quality care for women with ovarian cancer.