Internationale Koordination
Anthroposophische Medizin
Freie Hochschule für Geisteswissenschaft
Medizinische Sektion am Goetheanum

Cancer Care

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The approach of Anthroposophic Medicine (AM) for cancer care is integrative (integration of standard oncological treatment and AM) as well as multimodal (1) (2). Along with metastases and common side-effects associated with chemo- and radiotherapy , cancer-related fatigue (CRF), insomnia, cognitive dysfunction, distress and pain are major burdensome symptoms accompanied by rhythm alterations (3, 4, 5, 6, 7). First studies support the prognostic impact of sleep quality and rest/activity regulation on survival in patients with metastatic cancer (7, 8).

As a therapeutic answer to the complex symptom burden, the multimodal approach of AM integrates standard, conventional treatments with mistletoe therapy, pharmacological AM therapies, nursing interventions such as embrocation and compresses, rhythmical massage, psycho-oncology, eurythmy therapy, music and art therapy (9, 10, 11, 12). A pilot study in cancer patients undergoing chemotherapy and being treated concomitantly with painting therapy showed a significant reduction of depressive symptoms (13). In another pilot study, pediatric posterior fossa tumour survivors were treated with eurythmy therapy (14).

In consecutive studies investigating the impact of a ten-week multimodal intervention (psycho-education, sleep-education and –restriction, eurythmy and painting therapy) in breast cancer patients with CRF, a pilot study showed an improvement of fatigue, sleep quality and autonomic regulation (15). In a comprehensive cohort design study, a combined multimodal treatment group (CT) whose treatment included aerobic training was confirmatively not superior to the standard aerobic treatment after ten weeks of intervention, but was exploratively superior six months later. A multimodal treatment (MT) group was exploratively superior to the standard treatment after ten weeks of intervention and six months later; both CT and MT had strong effect sizes (16).   

July 2017

Priv. Doz. Dr. med Matthias Kröz
Forschungsinstitut Havelhöhe gGmbH,
Gemeinschaftskrankenhaus Havelhöhe gGmbH, Berlin

References

  1. Hamre HJ, Kiene H, Glockmann A, Ziegler R, Kienle GS: Long-term outcomes of anthroposophic treatment for chronic disease : a four-year follow-up analysis of 1510 patients from a prospective observational study in routine outpatient settings. BMC ResNotes 2013; 6(1), pp. 269

  2. Schad F, Axtner J, Happe A, Breitkreuz T, Paxino C, Gutsch J, Matthes B, Debus M, Kröz M, Spahn G et al: Network Oncology (NO) : a Clinical Cancer Register for Health Services Research and the Evaluation of Integrative Therapeutic Interventions in Anthroposophic Medicine. Forschende Komplementarmedizin 2006; 20(5), pp. 353-360.

  3. Stone P, Richardson A, Ream E, Smith AG, Kerr DJ, Kearney N: Cancer-related fatigue : inevitable, unimportant and untreatable? Results of a multi-centre patient survey. Cancer Fatigue Forum. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO 2000 2000; 11(8), pp. 971-975

  4. Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H: Persistence of restrictions in quality of life from the first to the third year after diagnosis in women with breast cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2005; 23(22), pp. 4945-4953.

  5. Innominato PF, Focan C, Gorlia T, Moreau T, Garufi C, Waterhouse J, Giacchetti S, Coudert B, Iacobelli S, Genet D et al: Circadian rhythm in rest and activity : a biological correlate of quality of life and a predictor of survival in patients with metastatic colorectal cancer. Cancer research 2009; 69(11), pp. 4700-4707.

  6. Kröz M, Linke J, Gutenbrunner C, Girke M, Hecht K, Bockelbrink A, Dimeo F, Matthes H: Cancer Fatigue, disturbed rest/activity regulation and sleep disturbances with female patients with non metastatic breast cancer : a pilotstudy. Phys Med Rehab Kuror 2010; 20(3), pp. 152-157.

  7. Innominato PF, Spiegel D, Ulusakarya A, Giacchetti S, Bjarnason GA, Levi F, Palesh O: Subjective sleep and overall survival in chemotherapy : naive patients with metastatic colorectal cancer. Sleep medicine 2015; 16(3), pp. 391-398.

  8. Palesh O, Aldridge-Gerry A, Zeitzer JM, Koopman C, Neri E, Giese-Davis J, Jo B, Kraemer H, Nouriani B, Spiegel D: Actigraphy-measured sleep disruption as a predictor of survival among women with advanced breast cancer. Sleep 2014; 37(5), pp. 837-842.

  9. Girke M: Kapitel XIII - Onkologie. In: Innere Medizin Krankheitsverständnis und Therapiekonzepte der Anthroposophischen Medizin. Berlin: Salumed Verlag; 2010; pp. 413-546.

  10. Heusser P, Braun SB, Ziegler R, Bertschy M, Helwig S, van Wegberg B, Cerny T: Palliative in-patient cancer treatment in an anthroposophic hospital : I. Treatment patterns and compliance with anthroposophic medicine. Forsch Komplementarmed 2006; 13(2), pp. 94-100.

  11. Laengler A, Spix C Fau - Edelhauser F, Edelhauser F Fau - Martin DD, Martin Dd Fau - Kameda G, Kameda G Fau - Kaatsch P, Kaatsch P Fau - Seifert G, Seifert G: Anthroposophic medicine in paediatric oncology in Germany : results of a population-based retrospective parental survey. Pediatr Blood Cancer 2010; 55(6), pp. 1111-1117
    https://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002/pbc.22523

  12. Ben-Arye E, Schiff E, Levy M, Raz OG, Barak Y, Bar-Sela G: Barriers and challenges in integration of anthroposophic medicine in supportive breast cancer care. Springerplus; 2013; 2, pp. 364.

  13. Bar-Sela G, Atid L, Danos S, Gabay N, Epelbaum R: Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy. Psycho-oncology 2007; 16(11), pp. 980-984.

  14. Kanitz JL, Pretzer K Fau - Calaminus G, Calaminus G Fau - Wiener A, Wiener A Fau - Langler A, Langler A Fau - Henze G, Henze G Fau - Driever PH, Driever Ph Fau - Seifert G, Seifert G: Eurythmy therapy in the aftercare of pediatric posterior fossa tumour. Complementary therapies in medicine 2013; pp. 3-9 LID

  15. Kröz M, Fink M, Reif M, Grobbecker S, Zerm R, Quetz M, Frühwirth M, Brinkhaus B, Bartsch C, Girke M et al: Multimodal therapy concept and aerobic training in breast cancer patients with chronic cancer-related fatigue. Integrative cancer therapies 2013; 12(4), pp. 301-311.

  16. Kröz M, Reif M, Glinz A, Berger B, Nikolaou A, Zerm R, Brinkhaus B, Girke M, Büssing A, Gutenbrunner C: Impact of a combined multimodal-aerobic and multimodal intervention compared to standard aerobic treatment in breast cancer survivors with chronic cancer-related fatigue : results of a three-armed pragmatic trial in a comprehensive cohort design. BMC cancer 2017; 17(1), pp. 166.