Abstract
PURPOSE: Integrative complementary medicine (ICM) combines complementary therapies with conventional supportive and palliative care to address quality of life (QoL). Diabetes mellitus (DM) is prevalent among patients with cancer and has been associated with worse health-related QoL. We examined the impact of an ICM program on QoL-related concerns among patients being treated for cancer, with vs. without DM. METHODS: This prospective, controlled and pragmatic study examined a 6-week ICM program, comparing DM to non-DM patients using the ESAS (Edmonton Symptom Assessment Scale) and EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) tools. The threshold for statistical significance was established at a P-value of less than 0.05. RESULTS: Of 671 patients, 135 (20%) had DM, with similar baseline QoL-related concerns (pain, fatigue, gastrointestinal and emotional concerns) in both groups. DM patients (vs. non-DM) responded significantly less on drowsiness on ESAS (P = 0.047); and emotional functioning on EORTC (P = 0.017). Compared to baseline, the non-DM group showed significant improvement in fatigue and sleep quality (on ESAS and EORTC; P < 0.001), while the DM group did not show any improvement for these concerns. CONCLUSION: Patients with cancer and DM showed a less significant response to ICM treatments when compared to non-DM patients, emphasizing the need for identifying this sub-population of patients while creating specialized ICM programs tailored to their needs. Future research should focus on exploring the impact of ICM programs on patients with both DM and cancer. Trial registration ClinicalTrials.gov NCT01860365, 2013-05-21.