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Complementary medicine in radiation oncology

German health care professionals’ current qualifications and therapeutic methods

Komplementärmedizin in der Radioonkologie

Aktuelle Qualifikationen und Therapiemethoden deutscher medizinischer Fachkräfte

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Abstract

Introduction

Recently, complementary and alternative medicine (CAM) has moved more into the focus, and cancer societies such as the German Cancer Society (Deutsche Krebsgesellschaft, DKG) have established working groups to develop a guideline for CAM. The present work aims to evaluate the acceptance of CAM in the whole radiation oncology community.

Methods

We conducted an online survey on CAM and sent the modified questionnaire that was successfully distributed to all members of the Research Group on Gynecological Oncology (Arbeitsgemeinschaft Gynakologische Onkologie, AGO) of the DKG in 2014 to the members of the German Society of Radiation Oncology (Deutsche Gesellschaft für Radioonkologie und Strahlentherapie, DEGRO). The survey consisted of 17 questions regarding personal information and current CAM guidelines within the workplace/clinic.

Results

A total of 143 members participated. Of these, 12% had some CAM qualification. For hematological cancer in 35% and in up to 76% for breast cancer, CAM treatment is offered in German radiation oncology facilities, mainly due to fatigue symptoms. CAM is part of routine treatment in 32.2%, 22.0% are planning to incorporate it. Most physicians advise patients to partake in sports activities and recommend dietary supplements and nutritional counseling. The cost of CAM treatment is fully covered in 9.8% of all participating facilities.

Conclusion

Today, CAM is integrated into cancer care; however, skepticism regarding its effect still exists. Evidence-based results must be generated to convince physicians of the effectiveness of CAM methods. CAM qualifications must be included in physicians’ training to improve their understanding and counseling regarding CAM options in cancer care.

Zusammenfassung

Hintergrund

Die Komplementär- und Alternativmedizin (CAM) rückt als begleitende Krebstherapie immer stärker in den Fokus und Gesellschaften wie die Deutsche Krebsgesellschaft (DKG) gründeten Arbeitsgruppen, um eine Leitlinie zu CAM zu entwickeln. Die vorliegende Arbeit zielt darauf ab, die Akzeptanz von CAM im gesamten Bereich der Radioonkologie zu bewerten.

Methoden

Wir führten eine Online-Befragung zum Thema CAM durch und schickten den im Jahr 2014 erfolgreich verteilten Fragebogen der Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) an die Mitglieder der Gesellschaft für Radioonkologie und Strahlentherapie (DEGRO). Die Umfrage umfasste 17 Fragen zu persönlichen Informationen und aktuellen Richtlinien in der Klinik und Praxis bezüglich CAM.

Ergebnisse

Insgesamt nahmen 143 Mitglieder teil. Von allen hatten 12 % eine CAM-Zusatzqualifikation. In deutschen onkologischen Strahlenkliniken wird eine CAM-Behandlung in 35% bei hämatologischen Krebserkrankungen und in bis zu 76 % bei Mammakarzinomen – hauptsächlich aufgrund einer Fatigue-Symptomatik – angeboten. In 32,2 % ist CAM Teil der Routinebehandlung; 22,0 % planen CAM zu integrieren. Die meisten Ärzte raten den Patienten selbst zu Sport, Nahrungsergänzungsmitteln und Ernährungsberatung. Die CAM-Behandlung ist in 9,8 % aller teilnehmenden Einrichtungen kostendeckend.

Schlussfolgerung

CAM ist bereits in die Krebsbehandlung integriert; dennoch gibt es Skeptiker bezüglich ihrer Wirkung. Evidenzbasierte Ergebnisse müssen generiert werden, um Onkologen von CAM-Methoden zu überzeugen. CAM-Zusatzqualifikation müssen bereits in der Ausbildung der Ärzte gefördert werden, um ihr Verständnis und ihre Beratung bezüglich CAM-Optionen in der Krebsbehandlung zu verbessern.

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Acknowledgements

We thank all DEGRO members who participated in this survey.

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Authors and Affiliations

  1. Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Straße 22, 81675, Munich, Germany

    Kerstin A. Kessel & Stephanie E. Combs

  2. Institute for Innovative Radiotherapy(iRT), Helmholtz Zentrum München, Ingolstädter Landstraße 1, Neuherberg, Germany

    Kerstin A. Kessel & Stephanie E. Combs

  3. Department of Gynecology and Obstetrics, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany

    Evelyn Klein

  4. Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstraße 21–23, Erlangen, Germany

    Carolin C. Hack

Authors
  1. Kerstin A. Kessel
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  2. Evelyn Klein
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  3. Carolin C. Hack
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  4. Stephanie E. Combs
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Corresponding author

Correspondence to Kerstin A. Kessel.

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Conflict of interest

K.A. Kessel, E. Klein, C.C. Hack, and S.E. Combs declare that they have no competing interests.

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Kessel, K.A., Klein, E., Hack, C.C. et al. Complementary medicine in radiation oncology. Strahlenther Onkol 194, 904–910 (2018). https://doi.org/10.1007/s00066-018-1345-8

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