Klinik Für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
Strahlentherapie RheinMain, Rüsselsheim, Germany.
J Cancer Res Clin Oncol. 2023 Aug;149(9):6067-6074. doi: 10.1007/s00432-022-04528-7. Epub 2023 Jan 18.
The usage of complementary and alternative medicine (CAM) is widespread among cancer patients. While reasons for and aims of using CAM have been evaluated in many studies, less is known about whether patients' concepts of how and why cancer develops has an influence on the choice of the CAM method.
We pooled the data from all studies of our working group containing questions on lay etiological concepts and CAM usage and reanalyzed them with respect to the associations between these parameters.
The pooled dataset from 12 studies included 4792 patients. A third (1645 patients) reported using CAM. Most often used were supplements (55.9%), relaxation techniques (43.6%), and homeopathy (37.9%). Regarding perceived causes, patients most often marked stress (35.4%) followed by genes (31.9%). While all lay etiological beliefs were highly significantly associated with usage of CAM in general, there was no association between single lay etiological concepts and types of CAM used. Yet, in a network analysis, we found two associations: one comprising trauma, mistletoe, genes, and nutritional supplements, the other yoga, vitamin C, nutritional supplements, and TCM herbs. In the correlation heatmap, one cluster comprises etiological concepts of personality, immune system and trauma, and two clusters of CAM methods emerged: one comprising praying, yoga, meditation, and relaxation procedures, the other nutritional supplements, selenium, vitamins A and C.
While physicians are trained to derive treatment strategies from etiological concepts, lay people choosing CAM do not follow these rules, which may point to other needs of patients addressed by CAM.
补充和替代医学(CAM)在癌症患者中广泛使用。虽然已经有许多研究评估了使用 CAM 的原因和目的,但对于患者对癌症发生的方式和原因的概念是否会影响 CAM 方法的选择知之甚少。
我们汇总了我们工作组中所有包含关于外行病因概念和 CAM 使用问题的研究的数据,并重新分析了这些参数之间的关联。
来自 12 项研究的汇总数据集包括 4792 名患者。三分之一(1645 名)患者报告使用了 CAM。最常使用的是补充剂(55.9%)、放松技术(43.6%)和顺势疗法(37.9%)。关于感知原因,患者最常标记压力(35.4%),其次是基因(31.9%)。虽然所有外行病因观念都与 CAM 的普遍使用高度相关,但单个外行病因概念与使用的 CAM 类型之间没有关联。然而,在网络分析中,我们发现了两个关联:一个包括创伤、槲寄生、基因和营养补充剂,另一个包括瑜伽、维生素 C、营养补充剂和中药。在相关热图中,一个聚类包含人格、免疫系统和创伤的病因概念,两个 CAM 方法聚类出现:一个包括祈祷、瑜伽、冥想和放松程序,另一个包括营养补充剂、硒、维生素 A 和 C。
虽然医生接受的培训是根据病因概念制定治疗策略,但选择 CAM 的外行人士并不遵循这些规则,这可能表明 CAM 满足了患者的其他需求。