Real-world integrative oncology in patients with cancer and diabetes: engagement patterns, outcomes

CONTEXT AND OBJECTIVE: Integrative oncology (IO) programs address quality of life (QoL)-related concerns within palliative and supportive cancer care. This study examined adherence to and outcomes of an IO program among patients with both cancer and diabetes. METHODS: Patients with cancer and diabetes undergoing active oncology treatment were referred by their oncology care providers to an IO consultation, followed by a 6-week treatment program. Patients highly adherent to integrative care (high-AIC, attending ≥4 IO sessions during 6 weeks) and low AIC patients completed ESAS (Edmonton Symptom Assessment Scale) and EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire). RESULTS: Of 229 patients with cancer and diabetes, 135 (59%) were high-AIC, nearly half (48.6%) treated in a palliative oncology setting. Low-AIC patients reported higher levels of pain on EORTC than high-AIC (p=0.024). While high-AIC patients showed significant improvement in pain on ESAS (p=0.047) and EORTC (p=0.01), no significant changes were observed among low-AIC patients. Physical functioning significantly deteriorated in low-AIC patients (p=0.006), with no change in the high-AIC group. CONCLUSION: Significant improvement in pain management and stable physical functioning were observed in patients with high adherence to IO care. Although these findings might reflect a selection bias, where individuals with better functioning levels are more likely to adhere to IO treatments, it may also be associated with IO treatment effects.. As these findings are hypothesis-generating, and not "evidence of effect", controlled studies are needed to explore the impact of the IO program in this clinical setting.