The purpose of this study is to conduct a randomized controlled trial or RCT of the following 2 supportive care interventions in recent breast cancer survivors: an Integrative Medicine intervention based on Ayurvedic medicine and a Health Education intervention.
Post-treatment cancer survivorship is often associated with a void in care given the drop-off in support provided to survivors from the medical team as well as family and friends. In addition, cancer associated symptoms and impaired quality of life remain significant problems for patients despite advances in cancer treatment. Few effective treatment options exist for these symptoms. Integrative medicine is rising in popularity in the United States; however, few integrative medicine modalities have been rigorously studied. Ayurveda, a whole system of medicine that originated in the Indian subcontinent, has its own system of diagnostics and therapeutics, and among its strengths are wellness and prevention. In the Integrative Medicine intervention, Ayurvedic nutrition and lifestyle guidance will be presented, along with instruction in Yoga. In the Health Education intervention, informative content on issues relevant to breast cancer survivors will be presented including the physical, social and emotional impacts of survivorship. The investigators aim to perform a pilot RCT in breast cancer survivors with impaired quality of life. Specifically, the investigators aim to assess feasibility of randomization, adherence and retention to the Integrative Medicine and Health Education interventions.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
30
Study participants will attend 14 sessions with an Integrative Medicine clinician over the course of 6 months, potentially followed by a 6 month maintenance phase.
Study participants will attend 14 sessions with a Health Educator over the course of 6 months.
University of California, San Francisco, Osher Center for Integrative Medicine
San Francisco, California, United States
Change in quality of life over 6 months
The investigators will use the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30) in conjunction with a breast cancer-specific subscale, BR23, to collect data on qualify of life and cancer-related symptoms. The scales range in score from 0 to 100. A high scale score represents a higher response level. Thus a high score for a functional scale represents a high / healthy level of functioning, a high score for the global health status / QoL represents a high QoL, but a high score for a symptom scale / item represents a high level of symptomatology / problems. The principle for scoring these scales is the same in all cases: 1. Estimate the average of the items that contribute to the scale; this is the raw score. 2. Use a linear transformation to standardise the raw score, so that scores range from 0 to 100; a higher score represents a higher ("better") level of functioning, or a higher ("worse") level of symptoms.
Time frame: Baseline, 3 months, 6 months
Change in fatigue over 6 months
The investigators will use the Lee Fatigue Scale (LFS) to collect data on fatigue. The scale ranges from 0 - 10. Scoring Instructions: To interpret it clinically, it is good to think about the lower 1/3 scores (0-3.2) being none or minimal fatigue, the middle 1/3 (3.3 to 6.6) being moderate fatigue, and the top 1/3 (6.7 to 10) being high fatigue. * Energy Item Score: Mean of items 6-10 * Fatigue Item Score: Mean of 1-5 and 11-18
Time frame: Baseline, 3 months, 6 months
Change in sleep quality over 6 months
The investigators will use the General Sleep Disturbance Scale (GSDS) to collect data on sleep disturbance. The scale ranges from 0 (never) - 7 (Every Day) Reverse score items: 4, 10, 11, 12 (e.g., 0=7, 1=6, 2=5, 3=4, 4=3, 5=2, 6=1, 7=0). Scoring Instructions: * Total Sum Score (gstot): Mean of all items \* 21 (must have at least 16 items scored) * Medications for Sleep Sum Score (gsmed): Mean of items 16-21 \* 16 (must have at least 4) * Quality of Sleep Sum Score (gsqal): Mean of items 4, 5, 10 \* 3 (must have at least 2) * Quantity of Sleep Sum Score (gsqnt): Mean of items 12, 13 \* 2 (must have at least 2) * Sleep Onset Latency (gsol): Item 1 * Mid Sleep Wakes (gsmid): Item 2 * Early Awakenings (gsend): Item 3 * Excessive Daytime Sleepiness Sum Score (gseds): Mean of 6, 7, 8, 9, 11, 14, 15 \* 7 (must have at least 5)
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Time frame: Baseline, 3 months, 6 months
Change in anxiety over 6 months
The investigators will use the Spielberger State Anxiety Inventory (STAI-S) to collect data on anxiety. The scale ranges from 1 (Not at all) - 4 (Very much so) Reverse Scoring Items: 1, 2, 5, 8, 10, 11, 15, 16, 19, 20 Outcome Variables: Scores range between 20-80 * Total Sum Score (no missing values): Sum all questions * Total Sum Score (few items missing): Average of the non-missing items and multiply by 20.
Time frame: Baseline, 3 months, 6 months
Change in depressive symptoms over 6 months
The investigators will use the Center for Epidemiological Studies - Depression Scale (CES-D) to collect data on depressive symptoms. The scale ranges from 0 (Rarely) - 3 (Most Days) Reverse Scoring Items: 4, 8, 12, 16 Outcome Variables: Scores range between 0-60. If participant scores higher than 16, refer to guidelines for CES-D • Total Sum Score: Sum of 20 questions. Do not score if more than 4 missing answers.
Time frame: Baseline, 3 months, 6 months
Change in pain over 6 months
The investigators will use the Brief Pain Inventory (BPI) to collect data on pain intensity and interference with function.
Time frame: Baseline, 3 months, 6 months
Change in diet over 6 months
The investigators will use the Automated Self-Administered 24-hour Recall (ASA24) to assess dietary recall over a 24 hour period.
Time frame: Baseline, 3 months, 6 months