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Cancer Care

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

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(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) 2013, 20(5):353-360.

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(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):152-157.

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(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):837-842.

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

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(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. Pediatr Blood Cancer 2010, 55(6):1111-1117 LID - 1110.1002/pbc.22523 [doi].

(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, 2:364.

(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):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, 21 Suppl 1:S3-9 LID - 10.1016/j.ctim.2012.1002.1007 [doi] LID - S0965-2299(1012)00037-00034 [pii].

(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):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):166.