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Published on: August 1, 2019
Integrative gynaecological oncology in prehabilitation: scoping review of patient-centred care models
Eran Ben-Arye1, Jalid Sehouli2, Georg Seifert3
1Integrative Oncology Program, Oncology Service, Lin, Carmel & Zebulun Medical Centers; and Technion Israel Institute of Technology, Haifa, Israel eranben@netvision.net.il.
Objectives:
Enhanced recovery after surgery is a concept increasingly addressed in prehabilitation research, addressing patients' unmet needs and quality of life (QOL)-related concerns, while overcoming barriers to implementing effective models of care. The present narrative overview examined the gynaecological oncology prehabilitation literature, within the context of integrative oncology (IO) whose goals include enriching prehabilitation care.
Methods:
A multidisciplinary and multinational team of 9 coauthors from Israel and Germany conducted a narrative review, searching PubMed/Medline databases for complementary medicine and IO-related keywords relevant to the gynaecological oncology-related prehabilitation setting.
Results:
A total of 55 papers addressing IO-related prehabilitation models in gynaecological oncology were identified. The research addressed issues related to QoL-related concerns, including anxiety and uncertainty among patients during prehabilitation. IO modalities addressing these symptoms included mind-body medicine; manual-movement therapies; acupuncture and guidance on the use of herbal medicine. Five stages along the prehabilitation timeline for implementing IO therapies were identified, beginning at the initial diagnosis of cancer, until surgery or the initiation of chemotherapy and other oncological drug treatments.
Conclusions:
The inclusion of IO programmes during prehabilitation for gynaecological cancer should be a routine part of patient care, from the initial diagnosis of cancer through surgery and anti-cancer drug treatments. The IO model of care can significantly enhance the patient-centred prehabilitation setting for those with gynaecological cancer, while exploring the patient's health belief model, expectations and unmet needs, especially for QoL-related concerns for which currently available supportive care has limited effectiveness.
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