Homeopathy is one of most widely used non-conventional supportive care methods used by women with breast cancer. This article aims to describe the routines and practices related to homeopathy as ...supportive care used by women with non-metastatic breast cancer in France.
This qualitative study used Grounded Theory. Participants were women with early breast cancer and healthcare professionals (General Practitioner homeopaths & oncologists). Inclusion depended on specific criteria and the aim of theoretical sampling until data saturation. Data were collected through individual semi-structured interviews and focus groups following evolving topic guides. Transcribed interviews underwent in-depth thematic analysis. Inclusion, interviewing, transcription and coding occurred iteratively. Data was reported according to COREQ guidelines.
The therapeutic agency of homeopathy was distributed to different actors and ritualized material activities highly involving the patient. The choice of remedy was mostly delegated by patients to General Practitioner homeopaths (GPH) during consultations. Individualization, that is to say adaptation to the patient, differed from other modes of access to homeopathy (self-medication and oncologists). Self-medication was mostly limited to known products in a limited time frame. However, we identified a supported self-medication using trusted homeopathic protocols. Following homeopathic prescriptions involves a high level of commitment on behalf of the patient and follows different rules for homeopathy intake. This knowledge was either acquired earlier for users or discovered along breast cancer treatment for non-users. Taking homeopathy involved small daily actions for intake of different products at different times of the day. New users used strategies to ease the integration of homeopathy into their daily life. The stance toward such rules differed among patients. Some followed rules to optimize their effects while others simplified the rules and took those rituals as part of homeopathy benefits.
Homeopathy as supportive care in breast cancer is distributed toward different actors and ritualized activities. Homeopathy is a supported practice where GPH played a role in the prescription. Health Literacy in homeopathy played a role to ease its integration into daily life and identify the potential benefits. The high involvement of patients in their homeopathic treatment is a form of treatment reappropriation and empowerment.
IntroductionBreast cancer is the leading cause of death among French women, although the survival rate is increasing thanks to therapy and supportive care. Homeopathy is one of most widely used ...non-conventional supportive approaches in this context. This article aims to describe the ways women with non-metastatic breast cancer integrate homeopathy as supportive care into their conventional therapy regimen.MethodsQualitative semi-structured interviews and focus groups were conducted using interview guides. They were audio-recorded and first, partially transcribed to elicit emerging themes to revise the interview guide, and later word-for-word for in-depth analysis using Grounded Theory. Sampling, interviewing, transcription and coding occurred iteratively. The study has been reported according to COREQ guidelines.ResultsFifty people participated: 28 patients, 13 oncologists, 6 homeopaths, 2 gynecologists and 1 nurse. Homeopathy was rarely present in the conventional patient care pathway. Turning to homeopathy was often the patient's initiative. Homeopathy was included to prevent or deal with adverse events from cancer treatments, while attempting to maximize clinical outcomes. Homeopathy was often used early in the care path if the patient had already consulted a homeopath. For others, the fear of chemotherapy triggered an active search for solutions. Homeopathic use was a form of empowerment and engagement, not only limited to patients who habitually used homeopathy. Most patients were treated by a general practitioner specialized in homeopathy, which was acknowledged by their oncologist.ConclusionHomeopathy acted as a gateway toward supportive care in tandem with conventional treatment.
To determine the possible effect of two homeopathic medicines, Ruta graveolens 5CH and Rhus toxicodendron 9CH, in the prevention of aromatase inhibitor (AI) associated joint pain and/or stiffness in ...women with early, hormone-receptor positive, breast cancer.
This prospective, unrandomized observational study was carried out between April and October 2014. Women were recruited in two groups, according to which of the two study centres they attended: one receiving homeopathy in addition to standard treatment (group H) and a control group, receiving standard treatment (group C). All women were treated with an AI. In addition, women in group H also took Ruta graveolens 5CH and Rhus toxicodendron 9CH (5 granules, twice a day) up to 7 days before starting AI treatment. The homeopathic medicines were continued for 3 months. Demographic and clinical data were recorded using a self-assessment questionnaire at inclusion (T0) and 3 months (T3). Primary evaluation criteria were the evolution of scores for joint pain and stiffness, the impact of pain on sleep and analgesic consumption in the two groups after 3 months of treatment.
Forty patients (mean age 64.9±8.1 years) were recruited, 20 in each group. Two-thirds of the patients had joint pain before starting AI treatment. There was a significant difference in the evolution of mean composite pain score between T0 and T3 in the two groups (-1.3 in group H vs. +3.4 in group C; p=0.0001). The individual components of the pain score (frequency, intensity and number of sites of pain) also decreased significantly in group H. Nine patients in group C (45%) vs. 1 (5%) in group H increased their analgesic consumption between T0 and T3 (p=0.0076). After 3 months of treatment, joint pain had a worse impact on sleep in patients in group C (35% vs. 0% of patients; p=0.0083). The differences observed in the evolution of morning and daytime stiffness between the two groups were smaller (p=0.053 and p=0.33, respectively), with the exception of time necessary for the disappearance of morning stiffness which was greater in group C (37.7±23.0 vs. 17.9±20.1 min; p=0.0173).
These preliminary results suggest that treatment with Ruta graveolens 5CH and Rhus toxicodendron 9CH may decrease joint pain/stiffness in breast cancer patients treated with AIs. A larger-scale randomized study is required to confirm these results.
Contexte : Les diarrhées se rencontrent très souvent en cas de cancer du pancréas, que ce soit de façon épisodique après certaines chimiothérapies ou de façon chronique après la chirurgie. Elles ...diminuent la qualité de vie, favorisent l’amaigrissement et perturbent le bon déroulement des chimiothérapies. Dénuée d’effets secondaires notables et d’interactions médicamenteuses, l’homéopathie est en Europe, la médecine complémentaire la plus utilisée en oncologie intégrative. Il n’existe pas « un » médicament homéopathique spécifique des diarrhées mais plusieurs médicaments candidats. Comment déterminer celui qui sera le mieux indiqué ? Méthodologie : Les auteurs ont étudié la physiopathologie des diarrhées dans les suites de pancréatectomie, recherché les symptômes présents chez tous les patients, effectué une répertorisation électronique, sélectionné les médicaments candidats, analysé leur matière médicale et construit un algorithme décisionnel. Résultats : Les symptômes retenus ont été : la sensation de selles impérieuses, les borborygmes intestinaux, la prédominance des diarrhées en journée, leur apparition après avoir mangé ou bu, la perte de poids. font partie des 6 médicaments principaux. Au total, 16 médicaments ont été analysés puis intégrés dans un algorithme d’aide à la décision. Conclusion :Il n’existe pas de traitement « type » de la diarrhée en oncologie. L’homéopathie pour être efficace doit être individualisée. Elle doit répondre aux règles habituelles de similitude, d’individualisation et d’infinitésimalité. La consultation de l’algorithme décisionnel permet d’orienter rapidement le prescripteur vers un ou plusieurs médicaments possibles. Si nécessaire, la matière médicale permettra de préciser le ou les choix thérapeutiques. Cet algorithme nécessite maintenant d’être expérimenté et validé par la pratique et les essais cliniques.
PDF
