Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults With Cancer: Society for Integrative Oncology-ASCO Guideline

被引:62
作者
Carlson, Linda E. [1 ]
Ismaila, Nofisat [2 ]
Addington, Elizabeth L. [3 ]
Asher, Gary N. [4 ]
Atreya, Chloe [5 ]
Balneaves, Lynda G. [6 ]
Bradt, Joke [7 ]
Fuller-Shavel, Nina [8 ]
Goodman, Joseph [9 ]
Hoffman, Caroline J. [10 ]
Huston, Alissa [11 ]
Mehta, Ashwin [12 ]
Paller, Channing J. [13 ]
Richardson, Kimberly [14 ]
Seely, Dugald [15 ,16 ]
Siwik, Chelsea J. [17 ]
Temel, Jennifer S. [18 ,19 ]
Rowland, Julia H. [20 ]
机构
[1] Univ Calgary, Cumming Sch Med, Dept Oncol, Calgary, AB, Canada
[2] Amer Soc Clin Oncol, Alexandria, VA USA
[3] Northwestern Univ, Feinberg Sch Med, Chicago, IL USA
[4] Univ N Carolina, Lineberger Comprehens Canc Ctr, Chapel Hill, NC USA
[5] Univ Calif San Francisco, San Francisco, CA USA
[6] Univ Manitoba, Coll Nursing, Winnipeg, MB, Canada
[7] Drexel Univ, Dept Creat Arts Therapies, Philadelphia, PA USA
[8] Synth Clin, Winchester, England
[9] George Washington Univ, Washington, DC USA
[10] Pauls Canc Support, London, England
[11] Univ Rochester, Med Ctr, Rochester, NY USA
[12] Mem Healthcare Syst, Hollywood, FL USA
[13] Johns Hopkins Univ, Sidney Kimmel Comprehens Canc Ctr, Baltimore, MD USA
[14] Univ Illinois, Canc Ctr, Patient Representat, Chicago, IL USA
[15] Univ Ottawa, Ottawa, ON, Canada
[16] Canadian Coll Naturopath Med, Toronto, ON, Canada
[17] Univ Calif San Francisco, Osher Ctr Integrat Hlth, San Francisco, CA USA
[18] Massachusetts Gen Hosp, Boston, MA USA
[19] Harvard Med Sch, Boston, MA USA
[20] Smith Ctr Healing & Arts, Washington, DC USA
关键词
QUALITY-OF-LIFE; RANDOMIZED-CONTROLLED-TRIAL; MINDFULNESS-BASED INTERVENTIONS; PROGRESSIVE MUSCLE-RELAXATION; PATIENT-REPORTED SYMPTOMS; EXPRESSIVE GROUP-THERAPY; PLACEBO-CONTROLLED TRIAL; HEALTH-RELATED QUALITY; BREAST-CANCER; DOUBLE-BLIND;
D O I
10.1200/JCO.23.00857
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PURPOSETo provide evidence-based recommendations to health care providers on integrative approaches to managing anxiety and depression symptoms in adults living with cancer.METHODSThe Society for Integrative Oncology and ASCO convened an expert panel of integrative oncology, medical oncology, radiation oncology, surgical oncology, palliative oncology, social sciences, mind-body medicine, nursing, methodology, and patient advocacy representatives. The literature search included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2023. Outcomes of interest included anxiety or depression symptoms as measured by validated psychometric tools, and adverse events. Expert panel members used this evidence and informal consensus with the Guidelines into Decision Support methodology to develop evidence-based guideline recommendations.RESULTSThe literature search identified 110 relevant studies (30 systematic reviews and 80 randomized controlled trials) to inform the evidence base for this guideline.RECOMMENDATIONSRecommendations were made for mindfulness-based interventions (MBIs), yoga, relaxation, music therapy, reflexology, and aromatherapy (using inhalation) for treating symptoms of anxiety during active treatment; and MBIs, yoga, acupuncture, tai chi and/or qigong, and reflexology for treating anxiety symptoms after cancer treatment. For depression symptoms, MBIs, yoga, music therapy, relaxation, and reflexology were recommended during treatment, and MBIs, yoga, and tai chi and/or qigong were recommended post-treatment.DISCUSSIONIssues of patient-health care provider communication, health disparities, comorbid medical conditions, cost implications, guideline implementation, provider training and credentialing, and quality assurance of natural health products are discussed. While several approaches such as MBIs and yoga appear effective, limitations of the evidence base including assessment of risk of bias, nonstandardization of therapies, lack of diversity in study samples, and lack of active control conditions as well as future research directions are discussed.Additional information is available at www.asco.org/survivorship-guidelines.DISCUSSIONIssues of patient-health care provider communication, health disparities, comorbid medical conditions, cost implications, guideline implementation, provider training and credentialing, and quality assurance of natural health products are discussed. While several approaches such as MBIs and yoga appear effective, limitations of the evidence base including assessment of risk of bias, nonstandardization of therapies, lack of diversity in study samples, and lack of active control conditions as well as future research directions are discussed.Additional information is available at www.asco.org/survivorship-guidelines.
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页码:4562 / +
页数:37
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