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Integrative Medicine Approaches in Children and Adolescents with Cancer
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Integrative Medicine Approaches in Children and Adolescents with Cancer

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Hematology & Oncology".

Deadline for manuscript submissions: closed (5 June 2025) | Viewed by 3903

Special Issue Editors

Dr. Jennifer A. Hoag

E-Mail Website
Guest Editor
Pediatric Psychology and Developmental Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
Interests: pediatric psycho-oncology; physical activity during pediatric cancer treatment; hematopoietic stem cell donor experience and psychosocial outcomes
Special Issues, Collections and Topics in MDPI journals
Dr. Sherilynn Chan

E-Mail Website
Guest Editor
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
Interests: pediatric psycho-oncology; cancer survivorship; adolescents and young adults with cancer; peer relationships among adolescents with cancer

Special Issue Information

Dear Colleagues,

The treatment of pediatric cancer can have significant emotional and physical impacts on children and can contribute to feelings of stress, fear, anxiety, and depression, as well as symptoms of pain, nausea, vomiting, and fatigue. In order to ease suffering, caregivers and pediatric cancer centers are increasingly turning to integrative medicine for supportive care. Treatments such as biofeedback, acupuncture, massage, and creative arts are used to reduce side effects and improve the quality of life for children with cancer. This Special Issue of Children will focus on “Integrative Medicine Approaches in Children and Adolescents with Cancer”. Topics may include, but are not limited to, the following: therapeutic gaming, creative arts therapies (e.g., art, music, dance, writing), animal-assisted therapy, recreational therapy, massage therapy, yoga, prayer and spiritual care, meditation and mindfulness, acupuncture, biofeedback, hypnosis, nutrition, and physical activity. We welcome original research, systematic and scoping reviews, clinical case reports, and commentaries. Manuscripts that highlight interdisciplinary research are especially encouraged.

Dr. Jennifer A. Hoag
Dr. Sherilynn Chan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • children
  • adolescents
  • cancer
  • integrative medicine
  • complementary therapies

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Published Papers (5 papers)

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11 pages, 810 KiB  
Article
Pediatric Hematology–Oncology Provider Attitudes and Beliefs About the Use of Acupuncture for Their Patients
by Holly L. Spraker-Perlman, Kenneth M. Busby, Amy Ly, Maggi Meyer, Justin N. Baker and Deena R. Levine
Children 2025, 12(8), 961; https://doi.org/10.3390/children12080961 - 22 Jul 2025
Viewed by 447
Abstract
Background/Objectives: Children with cancer suffer due to the underlying disease and prescribed cancer-directed therapies, and non-pharmacologic modalities may offer improved symptom control without additional medications. We sought to elicit knowledge, attitudes, and beliefs of Pediatric Hematology Oncology (PHO) providers surrounding the incorporation [...] Read more.
Background/Objectives: Children with cancer suffer due to the underlying disease and prescribed cancer-directed therapies, and non-pharmacologic modalities may offer improved symptom control without additional medications. We sought to elicit knowledge, attitudes, and beliefs of Pediatric Hematology Oncology (PHO) providers surrounding the incorporation of acupuncture for symptom management for their patients. Methods: A cross-sectional survey instrument was created, formatted, and delivered to physicians and advanced practice providers (APPs) at a single US pediatric cancer center. Survey responses were summarized by descriptive statistics. Results: A total of 78 PHO clinicians participated (response rate 29%). Most participants were interested in learning more about acupuncture (n = 42, 56.0%), yet rarely (n = 17, 22.7%) or never (n = 46, 61.3%) recommend acupuncture to patients. Most (n = 51, 73.9%) noted that they would support institutional development of an acupuncture program. Over half (n = 37, 52.2%) indicated their threshold for minimum hematologic indices for acupuncture includes a platelet count greater than 20,000 and absolute neutrophil count (ANC) greater than 500 (n = 37, 54.4%). Approximately two-thirds (n = 52, 66.7%) of participants noted that acupuncture could improve their patient’s quality of life, and most (n = 46, 67.6%) were not worried about harm. Conclusions: Acupuncture for symptom management is an evidenced-based, guideline-concordant recommendation for adults with cancer, but robust data in the pediatric oncology population are lacking. PHO providers do not routinely recommend acupuncture for patients but note that it may improve quality of life. Given their high symptom burden, rigorous studies of non-pharmacologic strategies for pediatric symptom management are vital. Acupuncture should be examined as a potential beneficial adjunct. Full article
(This article belongs to the Special Issue Integrative Medicine Approaches in Children and Adolescents with Cancer)
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14 pages, 241 KiB  
Article
Team Survivors: Preliminary Analysis of an Innovative Intervention to Promote Physical Activity in Survivors of Childhood Cancer and Hematopoietic Stem Cell Transplant
by Meghan K. Flannery, Jocelyn Morin, Katrina O’Malley, Debra Schmidt and Jennifer A. Hoag
Children 2025, 12(4), 399; https://doi.org/10.3390/children12040399 - 21 Mar 2025
Viewed by 638
Abstract
(1) Background: Inadequate physical activity is an ongoing issue for pediatric survivors of childhood cancer and hematopoietic stem cell transplant (HSCT), increasing their risk for chronic health conditions and decreasing quality of life. Team Survivors is a 12-week program in which survivors train [...] Read more.
(1) Background: Inadequate physical activity is an ongoing issue for pediatric survivors of childhood cancer and hematopoietic stem cell transplant (HSCT), increasing their risk for chronic health conditions and decreasing quality of life. Team Survivors is a 12-week program in which survivors train as a group to participate in a community triathlon. Preliminary findings from a quality improvement project of Team Survivors were used to assess its feasibility in influencing survivors’ physical activity and quality of life and their family’s perception of the program. (2) Methods: Repeated measures t-tests evaluated changes in caregiver-reported exercise self-efficacy and health-related quality of life (HRQoL). These findings were supplemented by a narrative review of qualitative data from caregivers and survivors on their overall experience and satisfaction with the program. (3) Results: All participants successfully completed the triathlon, and families reported satisfaction with the program’s logistics (i.e., coordination, coaching, and practice). Neither caregiver-reported exercise self-efficacy nor HRQoL significantly differed between pre- and post-intervention, but notable improvements were reported in all domains of HRQoL. Qualitatively, the perceived benefits reported by caregivers and survivors were multifaceted. Physical benefits included improvements in survivors’ physical activity level and endurance. Psychosocially, caregivers and survivors reported greater confidence and motivation for physical activity, improved coping, and increased social engagement and feelings of normalcy. (4) Conclusions: Mixed method results support the feasibility of Team Survivors in positively impacting survivors’ ability to engage in physical activity. The multifaceted structure of the program may more broadly impact psychosocial functioning in addition to physical activity. Future studies require a larger sample size to adequately power the analyses. Full article
(This article belongs to the Special Issue Integrative Medicine Approaches in Children and Adolescents with Cancer)
9 pages, 380 KiB  
Article
Exploring the Landscape of Integrative Medicine in Pediatric Oncology: Characterization of an Outpatient Consultative Service
by Han-Wei V. Wu, Diana Dominguez Garcia, Julia L. Glade Bender, Jun J. Mao and Nirupa J. Raghunathan
Children 2025, 12(2), 198; https://doi.org/10.3390/children12020198 - 7 Feb 2025
Viewed by 1046
Abstract
Background/Objectives: Symptoms from cancer and treatments often cause pediatric patients and their families to seek complementary and integrative medicine (IM) for relief. The aim of this study was to better describe the characteristics of pediatric patients at a tertiary cancer center who [...] Read more.
Background/Objectives: Symptoms from cancer and treatments often cause pediatric patients and their families to seek complementary and integrative medicine (IM) for relief. The aim of this study was to better describe the characteristics of pediatric patients at a tertiary cancer center who utilize an IM consultative service in the outpatient setting and the associated discussions with a pediatric-focused IM physician. Methods: A retrospective study was conducted on initial IM visits for patients aged less than 19 years old at the time of the visit from January 2019 through April 2022 at a tertiary cancer center. Patient demographics, clinical characteristics, and visit information were abstracted from electronic medical records, and discussions with the provider (presenting symptoms and recommendations) were described. Results: In total, 207 patients and their associated visit discussions met the criteria. About half (47%, n = 97) of the patients were female with a mean patient age of 10 years old (median age 11 years, range 0 to 18 years). The overall most common presenting symptoms were nausea (35%, n = 72), pain (30%, n = 62), and poor appetite (26%, n = 53) with variations between age groups. The most discussed topics were supplements (94%), diet (91%), stress management (82%), IM therapies (60%), and medical cannabis (54%). Conclusions: Priority symptoms reported by patients and referred to the IM outpatient consultative service included nausea, pain, and poor appetite. Concerns were addressed during tailored discussions with patients and their families. Having an outpatient consultative IM service may benefit providers, patients, and families to facilitate receiving evidence-informed recommendations in a dedicated, consolidated setting. Full article
(This article belongs to the Special Issue Integrative Medicine Approaches in Children and Adolescents with Cancer)
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23 pages, 974 KiB  
Systematic Review
Biofeedback in Pediatric, Adolescent, and Young Adult Cancer Care: A Systematic Review
by Marie Barnett, Shari A. Langer, Konstantina Matsoukas, Sanjana Dugad, Anelisa Mdleleni and Inna Khazan
Children 2025, 12(8), 998; https://doi.org/10.3390/children12080998 - 29 Jul 2025
Viewed by 491
Abstract
Background/Objectives: Biofeedback interventions are increasingly utilized in pediatric and adult care, with evidence in treating specific medical conditions and specific symptoms. However, evidence supporting their efficacy among children and adolescents and young adults (AYAs, aged 15–39) with cancer is limited. The aims [...] Read more.
Background/Objectives: Biofeedback interventions are increasingly utilized in pediatric and adult care, with evidence in treating specific medical conditions and specific symptoms. However, evidence supporting their efficacy among children and adolescents and young adults (AYAs, aged 15–39) with cancer is limited. The aims of this systematic review are to present, assess, and synthesize the existing research on biofeedback in pediatric and AYA oncology, identify gaps in biofeedback research within this population, and provide recommendations for future research and clinical implications. Methods: A systematic search for articles was conducted using six bibliographic databases—PubMed/MEDLINE (NLM), EMBASE (Elsevier), CINAHL (EBSCO), SPORTDiscus (EBSCO), PsycINFO (OVID), and PEDro (NeuRA)—with an update on 5/7/2025. Included were studies involving pediatric/AYA oncology participants (0–39 years old) and those receiving at least one biofeedback modality. The methodological quality and risk of bias among included articles were assessed using the Cochrane Risk of Bias (ROB) Tool (modified version for non-randomized studies). A narrative synthesis of included studies examined the type of cancer studied, type of biofeedback used, study designs and methodological quality, and key outcomes evaluated. Results: While the literature suggests that biofeedback may offer beneficial outcomes for managing various pediatric/AYA oncology-related symptoms, such as pain, anxiety, and fatigue, only 8 studies out of 1013 screened (<1%) met inclusion criteria. Limitations included low study quality (small sample sizes, lack of control groups, and methodological inconsistencies). Conclusions: While biofeedback shows promise as a feasible and effective intervention, there is a call to action for well-designed, methodologically rigorous studies to substantiate its effectiveness and inform evidence-based practice specifically for pediatric/AYA oncology patients and clinicians. Full article
(This article belongs to the Special Issue Integrative Medicine Approaches in Children and Adolescents with Cancer)
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9 pages, 264 KiB  
Perspective
The Rhythm of Connection: Describing the Heartbeats Intervention for Patients and Families Receiving Paediatric Palliative Care
by Holly E. Evans, Matthew Ralph, Tiina Jaaniste, Claire E. Wakefield and Ursula M. Sansom-Daly
Children 2025, 12(7), 884; https://doi.org/10.3390/children12070884 - 3 Jul 2025
Viewed by 406
Abstract
Music therapy in paediatric palliative care offers a unique opportunity for emotional support, legacy creation, and therapeutic connection for children and their families. This paper describes the Heartbeats Intervention, as delivered by a paediatric palliative care music therapist at Sydney Children’s Hospital Australia. [...] Read more.
Music therapy in paediatric palliative care offers a unique opportunity for emotional support, legacy creation, and therapeutic connection for children and their families. This paper describes the Heartbeats Intervention, as delivered by a paediatric palliative care music therapist at Sydney Children’s Hospital Australia. This intervention involves recording and creatively integrating the heartbeats of children and family members into personalised musical compositions. Originally inspired by music therapist Brian Schreck’s work, the intervention has evolved to meet diverse therapeutic goals, from soothing children with serious illnesses (including cancer) with recordings of their families’ heartbeats to creating legacy song tracks that support families through bereavement. Despite some logistical and resource challenges, the intervention has been well-received and continues to expand, including the integration of environmental soundscapes and broader community involvement, which allows the intervention to be experienced by a greater number of families. This paper contributes to the limited but growing literature on music therapy in paediatric palliative care, highlighting the Heartbeats Intervention as a flexible and meaningful way to enhance psychosocial support and connection for children and their families. Further research to evaluate its long-term impact and to explore children’s direct experiences of the intervention is needed. Full article
(This article belongs to the Special Issue Integrative Medicine Approaches in Children and Adolescents with Cancer)
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