Exploring the Landscape of Integrative Medicine in Pediatric Oncology: Characterization of an Outpatient Consultative Service
Abstract
:1. Introduction
2. Methods
2.1. Clinical Population
2.2. Data Abstraction and Analysis
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Linder, L.A.; Hooke, M.C. Symptoms in Children Receiving Treatment for Cancer-Part II: Pain, Sadness, and Symptom Clusters. J. Pediatr. Oncol. Nurs. 2019, 36, 262–279. [Google Scholar] [CrossRef] [PubMed]
- Walter, L.M.; Nixon, G.M.; Davey, M.J.; Downie, P.A.; Horne, R.S. Sleep and fatigue in pediatric oncology: A review of the literature. Sleep Med. Rev. 2015, 24, 71–82. [Google Scholar] [CrossRef]
- Schulte, F.S.M.; Patton, M.; Alberts, N.M.; Kunin-Batson, A.; Olson-Bullis, B.A.; Forbes, C.; Russell, K.B.; Neville, A.; Heathcote, L.C.; Karlson, C.W.; et al. Pain in long-term survivors of childhood cancer: A systematic review of the current state of knowledge and a call to action from the Children’s Oncology Group. Cancer 2020, 127, 35–44. [Google Scholar] [CrossRef] [PubMed]
- Bishop, F.L.; Prescott, P.; Chan, Y.K.; Saville, J.; von Elm, E.; Lewith, G.T. Prevalence of complementary medicine use in pediatric cancer: A systematic review. Pediatrics 2010, 125, 768–776. [Google Scholar] [CrossRef]
- Diorio, C.; Lam, C.G.; Ladas, E.J.; Njuguna, F.; Afungchwi, G.M.; Taromina, K.; Marjerrison, S. Global Use of Traditional and Complementary Medicine in Childhood Cancer: A Systematic Review. J. Glob. Oncol. 2017, 3, 791–800. [Google Scholar] [CrossRef] [PubMed]
- Zhou, E.S.; Gardiner, P.; Bertisch, S.M. Integrative Medicine for Insomnia. Med. Clin. N. Am. 2017, 101, 865–879. [Google Scholar] [CrossRef] [PubMed]
- Sencer, S.F.; Kelly, K.M. Complementary and alternative therapies in pediatric oncology. Pediatr. Clin. N. Am. 2007, 54, 1043–1060. [Google Scholar] [CrossRef] [PubMed]
- Black, L.I.; Clarke, T.C.; Barnes, P.M.; Stussman, B.J.; Nahin, R.L. Use of complementary health approaches among children aged 4–17 years in the United States: National Health Interview Survey, 2007–2012. Natl. Health Stat. Rep. 2015, 78, 1–19. [Google Scholar]
- Lee, S.M.; Choi, H.C.; Hyun, M.K. An Overview of Systematic Reviews: Complementary Therapies for Cancer Patients. Integr. Cancer Ther. 2019, 18, 1534735419890029. [Google Scholar] [CrossRef]
- Deng, G. Integrative Medicine Therapies for Pain Management in Cancer Patients. Cancer J. 2019, 25, 343–348. [Google Scholar] [CrossRef]
- Thrane, S. Effectiveness of integrative modalities for pain and anxiety in children and adolescents with cancer: A systematic review. J. Pediatr. Oncol. Nurs. 2013, 30, 320–332. [Google Scholar] [CrossRef]
- Duong, N.; Davis, H.; Robinson, P.D.; Oberoi, S.; Cataudella, D.; Culos-Reed, S.N.; Gibson, F.; Götte, M.; Hinds, P.; Nijhof, S.L.; et al. Mind and body practices for fatigue reduction in patients with cancer and hematopoietic stem cell transplant recipients: A systematic review and meta-analysis. Crit. Rev. Oncol./Hematol. 2017, 120, 210–216. [Google Scholar] [CrossRef]
- Madden, J.R.; Mowry, P.; Gao, D.; Cullen, P.M.; Foreman, N.K. Creative arts therapy improves quality of life for pediatric brain tumor patients receiving outpatient chemotherapy. J. Pediatr. Oncol. Nurs. 2010, 27, 133–145. [Google Scholar] [CrossRef] [PubMed]
- Epstein, A.S.; Liou, K.T.; Romero, S.A.D.; Baser, R.E.; Wong, G.; Xiao, H.; Mo, Z.; Walker, D.; MacLeod, J.; Li, Q.; et al. Acupuncture vs Massage for Pain in Patients Living With Advanced Cancer: The IMPACT Randomized Clinical Trial. JAMA Netw. Open 2023, 6, e2342482. [Google Scholar] [CrossRef] [PubMed]
- Wilkinson, S.; Barnes, K.; Storey, L. Massage for symptom relief in patients with cancer: Systematic review. J. Adv. Nurs. 2008, 63, 430–439. [Google Scholar] [CrossRef] [PubMed]
- Wong, J.; Ghiasuddin, A.; Kimata, C.; Patelesio, B.; Siu, A. The Impact of Healing Touch on Pediatric Oncology Patients. Integr. Cancer Ther. 2012, 12, 25–30. [Google Scholar] [CrossRef] [PubMed]
- Yun, H.; Romero, S.A.D.; Record, B.; Kearney, J.; Raghunathan, N.J.; Sands, S.; Mao, J.J. Utilization of integrative medicine differs by age among pediatric oncology patients. Pediatr. Blood Cancer 2019, 66, e27639. [Google Scholar] [CrossRef]
- Kemper, K.J.; Wornham, W.L. Consultations for Holistic Pediatric Services for Inpatients and Outpatient Oncology Patients at a Children’s Hospital. Arch. Pediatr. Adolesc. Med. 2001, 155, 449–454. [Google Scholar] [CrossRef] [PubMed]
- Cotton, S.; Luberto, C.M.; Bogenschutz, L.H.; Pelley, T.J.; Dusek, J. Integrative care therapies and pain in hospitalized children and adolescents: A retrospective database review. J. Altern. Complement. Med. 2014, 20, 98–102. [Google Scholar] [CrossRef]
- Tortora, S.; Raghunathan, N.J.; Seifert, G.; Sibinga, E.M.S.; Ghelman, R. A comprehensive definition for pediatric integrative oncology through an international consensus. Complement. Ther. Med. 2021, 57, 102678. [Google Scholar] [CrossRef]
- Yun, H.; Sun, L.; Mao, J.J. Growth of Integrative Medicine at Leading Cancer Centers Between 2009 and 2016: A Systematic Analysis of NCI-Designated Comprehensive Cancer Center Websites. J. Natl. Cancer Inst. Monogr. 2017, 2017, lgx004. [Google Scholar] [CrossRef]
- Brauer, J.A.; El Sehamy, A.; Metz, J.M.; Mao, J.J. Complementary and alternative medicine and supportive care at leading cancer centers: A systematic analysis of websites. J. Altern. Complement. Med. 2010, 16, 183–186. [Google Scholar] [CrossRef]
- Horrigan, B.; Lewis, S.; Abrams, D.I.; Pechura, C. Integrative Medicine in America—How Integrative Medicine is Being Practiced in Clinical Centers across the United States. Glob. Adv. Health Med. 2012, 1, 18–52. [Google Scholar] [CrossRef]
- Myklebust, M.; Pradhan, E.K.; Gorenflo, D. An integrative medicine patient care model and evaluation of its outcomes: The University of Michigan experience. J. Altern. Complement. Med. 2008, 14, 821–826. [Google Scholar] [CrossRef]
- Cassileth, B.R. The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center. Semin. Oncol. 2002, 29, 585–588. [Google Scholar] [CrossRef] [PubMed]
- Momani, T.G.; Berry, D.L. Integrative Therapeutic Approaches for the Management and Control of Nausea in Children Undergoing Cancer Treatment: A Systematic Review of Literature. J. Pediatr. Oncol. Nurs. 2017, 34, 173–184. [Google Scholar] [CrossRef] [PubMed]
- Jong, M.C.; Boers, I.; van Wietmarschen, H.; Busch, M.; Naafs, M.C.; Kaspers, G.J.L.; Tissing, W.J.E. Development of an evidence-based decision aid on complementary and alternative medicine (CAM) and pain for parents of children with cancer. Support. Care Cancer 2020, 28, 2415–2429. [Google Scholar] [CrossRef]
- Ladas, E.J. Integrative Medicine in Childhood Cancer. J. Altern. Complement. Med. 2018, 24, 910–915. [Google Scholar] [CrossRef] [PubMed]
- Luthi, E.; Diezi, M.; Danon, N.; Dubois, J.; Pasquier, J.; Burnand, B.; Rodondi, P.Y. Complementary and alternative medicine use by pediatric oncology patients before, during, and after treatment. BMC Complement. Med. Ther. 2021, 21, 96. [Google Scholar] [CrossRef]
- Mao, J.J.; Ismaila, N.; Bao, T.; Barton, D.; Ben-Arye, E.; Garland, E.L.; Greenlee, H.; Leblanc, T.; Lee, R.T.; Lopez, A.M.; et al. Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline. J. Clin. Oncol. 2022, 40, 3998–4024. [Google Scholar] [CrossRef]
- Gowin, K.; Muminovic, M.; Zick, S.M.; Lee, R.T.; Lacchetti, C.; Mehta, A. Integrative Therapies in Cancer Care: An Update on the Guidelines. Am. Soc. Clin. Oncol. Educ. Book 2024, 44, e431554. [Google Scholar] [CrossRef] [PubMed]
- Pirson, L.; Luer, S.C.; Diezi, M.; Kroiss, S.; Brazzola, P.; Schilling, F.H.; von der Weid, N.; Scheinemann, K.; Greiner, J.; Zuzak, T.J.; et al. Pediatric oncologists’ perspectives on the use of complementary medicine in pediatric cancer patients in Switzerland: A national survey-based cross-sectional study. Cancer Rep. 2023, 6, e1649. [Google Scholar] [CrossRef] [PubMed]
- Stub, T.; Kristoffersen, A.E.; Overvag, G.; Jong, M.C. An integrative review on the information and communication needs of parents of children with cancer regarding the use of complementary and alternative medicine. BMC Complement. Med. Ther. 2020, 20, 90. [Google Scholar] [CrossRef]
- Stub, T.; Quandt, S.A.; Kristoffersen, A.E.; Jong, M.C.; Arcury, T.A. Communication and information needs about complementary and alternative medicine: A qualitative study of parents of children with cancer. BMC Complement. Med. Ther. 2021, 21, 85. [Google Scholar] [CrossRef]
- Lazard, A.J.; Nicolla, S.; Vereen, R.N.; Pendleton, S.; Charlot, M.; Tan, H.J.; DiFranzo, D.; Pulido, M.; Dasgupta, N. Exposure and Reactions to Cancer Treatment Misinformation and Advice: Survey Study. JMIR Cancer 2023, 9, e43749. [Google Scholar] [CrossRef] [PubMed]
- Wahner-Roedler, D.L.; Vincent, A.; Elkin, P.L.; Loehrer, L.L.; Cha, S.S.; Bauer, B.A. Physicians’ attitudes toward complementary and alternative medicine and their knowledge of specific therapies: A survey at an academic medical center. Evid. Based Complement. Altern. Med. 2006, 3, 495–501. [Google Scholar] [CrossRef] [PubMed]
Characteristic | Total, n (%) | Age 0–4 Years, n (%) | Age 5–12 Years, n (%) | Age 13–18 Years, n (%) | |
---|---|---|---|---|---|
Total | 207 | 35 (16.9%) | 82 (39.6) | 90 (43.5) | |
Sex | |||||
Male | 110 (53.1%) | 19 (54.3%) | 44 (53.7%) | 47 (52.2%) | |
Female | 97 (46.9%) | 16 (45.7%) | 38 (46.3%) | 43 (47.8%) | |
Race | |||||
White | 141 (68.1%) | 21 (60.0%) | 54 (65.9%) | 66 (73.3%) | |
Black | 14 (6.80%) | 4 (11.4%) | 4 (4.9%) | 6 (6.7%) | |
Asian | 19 (9.20%) | 2 (5.7%) | 11 (13.4%) | 6 (6.7%) | |
Other | 19 (9.20%) | 4 (11.4%) | 9 (11.0%) | 6 (6.7%) | |
Unknown | 14 (6.80%) | 4 (11.4%) | 4 (4.9%) | 6 (6.7%) | |
Ethnicity | |||||
Non-Hispanic | 168 (81.2%) | 30 (85.7%) | 63 (76.8%) | 75 (83.3%) | |
Hispanic | 28 (13.5%) | 3 (8.6%) | 15 (18.3%) | 10 (11.1%) | |
Unknown | 11 (5.3%) | 2 (5.7%) | 4 (4.9%) | 5 (5.6%) | |
Cancer Type | |||||
Solid | 157 (75.8%) | 29 (82.9%) | 64 (78.0%) | 64 (71.1%) | |
Liquid | 34 (16.4%) | 1 (2.9%) | 10 (12.2%) | 23 (25.6%) | |
Other * | 16 (7.7%) | 5 (14.3%) | 8 (9.8%) | 3 (3.3%) | |
Undergoing Active Treatment | |||||
Yes | 180 (87%) | 31 (88.6%) | 72 (87.8%) | 77 (85.6%) | |
No | 27 (13%) | 4 (11.4%) | 10 (12.2%) | 13 (14.4%) |
Presenting Symptoms | Total, n(%) | Age 0–4 Years, n (%) | Age 5–12 Years, n (%) | Age 13–18 Years, n (%) |
---|---|---|---|---|
Total | 207 | 35 | 82 | 90 |
Nausea | 72 (34.8) | 7 (20.0) | 22 (26.8) | 43 (47.8) |
Pain | 62 (30) | 11 (31.4) | 23 (28.0) | 28 (31.1) |
Poor Appetite | 53 (25.6) | 11 (31.4) | 23 (28.0) | 19 (21.1) |
Anxiety | 48 (23.2) | 4 (11.4) | 20 (24.4) | 24 (26.7) |
Irritability | 41 (19.8) | 14 (40.0) | 16 (19.5) | 11 (12.2) |
Fatigue | 39 (18.8) | 4 (11.4) | 10 (12.2) | 25 (27.8) |
Poor Sleep | 25 (12.1) | 4 (11.4) | 12 (14.6) | 9 (10.0) |
Constipation | 21 (10.1) | 6 (17.1) | 9 (11.0) | 6 (6.7) |
Plan | Total, n (%) | Age 0–4 Years, n (%) | Age 5–12 Years, n (%) | Age 13–18 Years, n (%) |
---|---|---|---|---|
Total | 207 | 35 | 82 | 90 |
Supplements | 195 (95.2) | 33 (94.3) | 77 (93.9) | 85 (94.4) |
Diet | 188 (90.8) | 29 (82.9) | 73 (89.0) | 86 (95.6) |
Stress | 170 (82.1) | 25 (71.4) | 67 (81.7) | 78 (86.7) |
IM Therapy Referrals | 125 (60.4) | 24 (68.6) | 47 (57.3) | 54 (60.0) |
Cannabis | 112 (54.1) | 21 (60) | 43 (52.4) | 48 (53.3) |
Exercise | 60 (29.0) | 3 (8.6) | 15 (18.3) | 42 (46.7) |
Acupuncture | 20 (9.7) | 0 (0.0) | 5 (6.1) | 15 (16.7) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Wu, H.-W.V.; Dominguez Garcia, D.; Glade Bender, J.L.; Mao, J.J.; Raghunathan, N.J. Exploring the Landscape of Integrative Medicine in Pediatric Oncology: Characterization of an Outpatient Consultative Service. Children 2025, 12, 198. https://doi.org/10.3390/children12020198
Wu H-WV, Dominguez Garcia D, Glade Bender JL, Mao JJ, Raghunathan NJ. Exploring the Landscape of Integrative Medicine in Pediatric Oncology: Characterization of an Outpatient Consultative Service. Children. 2025; 12(2):198. https://doi.org/10.3390/children12020198
Chicago/Turabian StyleWu, Han-Wei V., Diana Dominguez Garcia, Julia L. Glade Bender, Jun J. Mao, and Nirupa J. Raghunathan. 2025. "Exploring the Landscape of Integrative Medicine in Pediatric Oncology: Characterization of an Outpatient Consultative Service" Children 12, no. 2: 198. https://doi.org/10.3390/children12020198
APA StyleWu, H.-W. V., Dominguez Garcia, D., Glade Bender, J. L., Mao, J. J., & Raghunathan, N. J. (2025). Exploring the Landscape of Integrative Medicine in Pediatric Oncology: Characterization of an Outpatient Consultative Service. Children, 12(2), 198. https://doi.org/10.3390/children12020198