Two new studies shed light on important issues in the care of advanced cancer patients—one study finds that many of these patients feel their spiritual support needs are not being met, while the other shows that many patients use biologically based complementary and alternative medicine (vitamins, minerals, and herbal preparations and other dietary supplements). Both studies are being published in the February 10 issue of the Journal of Clinical Oncology (JCO).
In the first study, researchers from the Coping with Cancer study asked 230 advanced patients from five cancer centers about the importance of religious and spiritual support in their lives, and its relationship to their quality of life and cancer treatment. They found that 68% of patients considered religion to be very important—especially African-American and Hispanic patients. Nearly three quarters (72%) of these patients reported that their spiritual needs were minimally or not at all supported by the medical system (e.g., doctors, nurses, or chaplains), and half (47%) of these patients reported that their spiritual needs were minimally or not at all supported by a religious community (e.g., clergy, members of a congregation). The study also found that patients who reported greater spiritual support were also more likely to report better quality of life. Additionally, patients who were more religious were more likely to request aggressive measures to extend their lives.
In the second study, University of Chicago researchers interviewed 212 patients with advanced cancer enrolled in phase I clinical trials. They found that 34% of patients were taking biologically based complementary and alternative medicine—which is similar to its use in the general U.S. population. Forty-one patients reported taking vitamins and minerals (such as vitamins A, C, D, E, and B12, selenium, magnesium, zinc, and copper), and 40 patients said they took herbal preparations (including cat's claw, laetrile, St. John's wort, milk thistle, ginseng, and Echinacea). Cancer patients may take these substances in an effort to relieve the side effects of anti-cancer drugs, or in the hope that they will have an anti-cancer effect. Because phase I studies are designed to evaluate the side effects of an investigational drug, and to find the highest dose that can be safely given to patients, the use of these supplements may affect the results of a clinical trial.
What Does This Mean For Patients?
The first study demonstrates that many patients with advanced cancer consider religion an important part of their lives, and reveals a significant unmet need for spiritual support. Patients and physicians should feel empowered to bring up this issue, so that patients who feel their needs are not being met can be connected to resources for religious or spiritual support.
The results of the second study underscore the importance of communication between doctors and patients about any vitamins, minerals, or herbal supplements patients may be taking. This is particularly important for patients enrolled in clinical trials—if a patient in a phase I clinical trial is taking a supplement that is affecting their treatment, researchers may not be able to accurately identify the side effects caused by the experimental drug itself.