Arndt, Jamie/ Cook, Alison/ Goldenberg, Jamie L./ Cox, Cathy R.
Cancer and the Threat of Death: The Cognitive Dynamics of Death-Thought Suppression and Its Impact on Behavioral Health Intentions. Journal of Personality and Social Psychology 2007, 92(1), 12-29.
Five studies examined the cognitive association between thoughts of cancer and thoughts of death and their implication for screening intentions. Study 1 found that explicit contemplation of cancer did not increase death-thought accessibility. In support of the hypothesis that this reflects suppression of death-related thoughts, Study 2 found that individuals who thought about cancer exhibited elevated death-thought accessibility under high cognitive load, and Study 3 demonstrated that subliminal primes of the word cancer led to increased death-thought accessibility. Study 4 revealed lower levels of death-thought accessibility when perceived vulnerability to cancer was high, once again suggesting suppression of death-related thoughts in response to conscious threats associated with cancer. Study 5 extended the analysis by finding that after cancer salience, high cognitive load, which presumably disrupts suppression of the association between cancer and death, decreased cancer-related self-exam
intentions. Theoretical and practical implications for understanding terror management, priming and suppression, and responses to cancer are discussed.

Auerbach, Leo. Complementary and Alternative Medicine in the Treatment of Prostate Cancer. Elsevier Ireland Ltd. December 2006, 3(4), 397–403.
Abstract
Treatments based on complementary medicine have gained significant ground in oncology. Patients are mainly interested in adequate support, reduction of the side effects of clinical medicine, strengthening their immune system and enhancing quality of life both during and after chemotherapy and irradiation
treatments. In the last few years, a number of complementary strategies for the treatment of prostate cancer have been evaluated and published in international journals. These studies allow us to present today, with scientific accuracy, the initial results of complementary treatment methods, describe their contraindications and interactions, and discuss a safe individualized therapy with the patient. In Western Europe and the USA, immunomodulatory, anti-oxidative and herbal therapies, in particular, have been investigated and published. Of these, we discuss mistletoe therapy, enzyme therapy, carotinoids, lycopene, vitamin A, C, E, selenium, phytoestrogens, PC-SPES, physical therapy and relaxation techniques and psychological therapy. Several studies have demonstrated the improvement in quality of life and the value of complementary medicine as an adjunct to chemotherapy or radiotherapy. Based on fruitful communication and cooperation with the treating oncological urologist, internist/oncologist or radiotherapist, complementary therapy might serve as a valuable and useful supportive measure for prostate cancer patients.

Bowman, Karen F./ Rose, Julia H./ Deimling, Gary T. Appraisal of the Cancer Experience by Family Members and Survivors in Long-Term Survivorship. Psycho-Oncology 2006, 15, 834–845.
Summary
This study assessed the appraisal of the stressfulness of the cancer experience and its correlates for family members and older survivors living in the long-term survivorship phase of the disease. On average, family members appraised the cancer experience as more stressful than their surviving relatives. Beliefs about the effect of the diagnosis and treatment on family members were important correlates for both family members and survivors in the appraisal process. Cancer characteristics were not related to appraisal for survivors, but stage at diagnosis was associated with a more stressful appraisal for family members. Demographic characteristics were unrelated to appraisal for family members, but being African-American was linked to a less stressful appraisal for survivors. These findings highlight the stressful impact of the cancer experience on family members and can help guide health care interventions which include family members from African-American and White ethnicities.

Bellizzi, Keith M./ Blank, Thomas O./ Oakes, Claudia E. Social Comparison Processes in Autobiographies of Adult Cancer Survivors. Journal of Health Psychology 2006, 11(5), 777–786.
Abstract
Cancer survivors often compare their situations to other survivors’ situations. However, types of social comparison processes used and resulting outcomes are not clearly delineated. This study explores usage and consequences of three social comparison styles (downward, upward and parallel) of adult cancer survivors in free narratives, using content analysis of 30 autobiographical books by survivors ranging in age from 30–70 (M = 54, SD = 10.04); 43 percent prostate cancer, 17 percent breast cancer and 40 percent other cancers. Overall, cancer survivors used more parallel comparisons than directional comparisons, followed by upward comparisons. Each type of comparison was associated with different kinds of positive and negative consequences.

Boon, Heather S./ Olatunde, Folashade/ Zick, Suzanna M. Trends in Complementary/Alternative Medicine Use by Breast Cancer Survivors: Comparing Survey Data from 1998 and 2005. BMC Women's Health 2007, 7, 4.
Abstract
Background: Use of complementary and alternative medicine (CAM) by women with breast cancer is often said to be increasing, yet few data exist to confirm this commonly held belief. The purpose of this paper is to compare overall patterns of CAM use, as well as use of specific products and therapies at two different points in time (1998 vs 2005) by women diagnosed with breast cancer.
Methods: Surveys were mailed to women randomly selected from the Ontario Cancer Registry (Canada) in the spring of 1998 (n=557) and again in the spring of 2005(n=877).
Results: The response rates were 76.3% in 1998 and 63% in 2005. In 1998, 66.7% of women reported using either a CAM product/therapy or seeing a CAM therapist at some time in their lives as compared with 81.9% in 2005 (p=0.0002). Increases were seen in both use of CAM products/therapies (62% in 1998 vs. 70.6% in 2005) and visits to CAM practitioners (39.4% of respondents in 1998 vs 57.4% of respondents in 2005). Women in 2005 reported that 41% used CAM for treating their breast cancer. The most commonly used products and practitioners for treating breast cancer as reported in 2005 were green tea, vitamin E, flaxseed, vitamin C, massage therapists and dietitians/nutritionists.
Conclusion: CAM use (both self-medication with products and visits to CAM practitioners) increased significantly from 1998 to 2005. Now that more than 80% of all women with breast cancer report using CAM (41% in a specific attempt to management their breast cancer), CAM use can no longer be regarded as an “alternative” or unusual approach to managing breast cancer.

Buettner, Catherine/ Kroenke, Candyce H./ Phillips, Russell S./ Davis, Roger B./ Eisenberg , David M./ Holmes, Michelle D. Correlates of Use of Different Types of Complementary and Alternative Medicine by Breast Cancer Survivors in the Nurses’ Health Study. Breast Cancer Res Treat, March 2006.
Abstract
Purpose Among breast cancer survivors, we identified the prevalence and correlates of use of different types of complementary and alternative medicine(CAM).
Patients and methods We included 2,022 women diagnosed with breast cancer 1998–2003 who responded to a survey about CAM use. We performed logistic regression to determine demographic and disease factors associated with use of different CAM therapies (including relaxation/imagery, spiritual healing, yoga, energy healing, acupuncture, massage, chiropractic, high-dose vitamins, herbs, and homeopathy). We also measured quality of life (QoL) using the SF36 and optimism using LOT-R and fit linear regression models to compare mean scores among CAM users and nonusers.
Results Sixty-two percent of respondents used CAM. Younger age was the most consistent correlate of CAM use, but factors associated with CAM use varied by type of CAM. Chemotherapy was associated with use of relaxation/imagery (OR 1.3 95%CI 1.1–1.7). Radiotherapy was associated with use of high-dose vitamins (OR 1.5 95% CI 1.2–2.0). Tamoxifen or anastrozole treatment was associated with use of homeopathy (OR 0.5 95%CI 0.3–0.9). Users of most types of CAM had worse QoL scores than nonusers, but better QoL was found among users of yoga. The lowest QoL scores were associated with the use of energy healing. Optimism was higher among users of relaxation/imagery.
Conclusions Factors associated with CAM use varied according to type of CAM. Our finding of worse QoL among women using energy healing and better QoL among women using yoga suggests the need for longitudinal studies to determine the temporal relationships between these therapies and QoL.

Collie, Kate/ Bottorff, Joan L. / Long, Bonita C. A Narrative View of Art Therapy and Art Making by Women with Breast Cancer. Journal of Health Psychology, 2006, 11(5), 761–775.
Abstract
Art therapy (with an art therapist) and art making (without an art therapist) show promise as avenues for psychosocial support for women with breast cancer. The purpose of this study was to gain an in-depth understanding of how 17 women with breast cancer in Canada and the USA used art therapy and their own art making to address their psychosocial needs, focusing particularly on meaning making. Narrative analysis of interviews yielded four storylines: Art and Art Therapy as a Haven; Getting a Clearer View; Clearing the Way Emotionally; and Enhancing and Enlivening the Self. The storylines show existence being affirmed, confirmed and proclaimed through visual artistic expression and meaning making being achieved through physical acts of making.

Culos-Reed, S. Nicole/ Carlson, Linda E./ Daroux, Lisa M./ Hately-Aldous, Susi.  A Pilot Study of Yoga for Breast Cancer Survivors: Physical and Psychological Benefits.  Psycho-Oncology, 2006, 15, 891–897.
Summary
Background: Physical activity provides a number of physical and psychological benefits to cancer survivors, including lessening the impact of detrimental cancer-related symptoms and treatment side-effects (e.g. fatigue, nausea), and improving overall well-being and quality of life. The purpose of the present pilot study was to examine the physical and psychological benefits afforded by a 7-week yoga program for cancer survivors.
Method: Eligible participants (per-screened with PAR-Q/PAR-MED-X) were randomly assigned to either the intervention (n = 20) or control group (n = 18). All participants completed pre- and post-testing assessments immediately before and after the yoga program, respectively.
Results: The yoga program participants (M age = 51.18 (10.33); 92% female) included primarily breast cancer survivors, on average 55.95 (54.39) months post-diagnosis. Significant differences between the intervention and the control group at post-intervention were seen only in psychosocial (i.e. global quality of life, emotional function, and diarrhea) variables (all p’s <0.05). There were also trends for group differences, in the hypothesized directions, for the psychosocial variables of emotional irritability, gastrointestinal symptoms, cognitive disorganization, mood disturbance, tension, depression, and confusion (all p’s <0.10). Finally, there were also significant improvements in both the program participants and the controls from pre- to post-intervention on a number of physical fitness variables.
Conclusions: These initial findings suggest that yoga has significant potential and should be further explored as a beneficial physical activity option for cancer survivors. Future research might attempt to include a broader range of participants (e.g. other types of cancer diagnoses, male subjects), a larger sample size, and a longer program duration in an RCT.

Daykin, Norma/ PGDipMus/ Bunt, Leslie/ McClean, Stuart. Music and Healing in Cancer Care: A Survey of Supportive Care Providers. The Arts in Psychotherapy 2006, 33, 402–413.
Abstract
This paper explores the role of music activity and music therapy in health care drawing on a survey of UK cancer care providers offering music interventions and music therapy. The survey examined the extent and type of music provision and explored providers’ views about the role and contribution of music and music therapy in healing. As well as music, the survey organisations offered a range of supportive therapies including complementary and alternative therapies (CAM) and creative therapies such as art therapy. The results provide insight into the way in which music and creative therapies are viewed by those responsible for care provision in this sector. The data point towards some of the challenges acing music therapists in the changing world of cancer care. These include responding to changes arising from developments in treatment and the organisation of care as well as increased collaboration with a diverse range of supportive care practitioners. These include providers of music and arts for health activity as well as complementary and alternative therapy practitioners who are increasingly involved in cancer care provision. We discuss the implications of these changes for the development of music therapy in cancer care.

Doorenbos, Ardith Z./ Given, Charles W./ Given, Barbara/ Verbitsky, Natalya. Symptom Experience in the Last Year of Life Among Individuals with Cancer. Journal of Pain and Symptom Management November 2006, 32, 403-412.
Abstract
Individuals with cancer often experience many symptoms that impair their quality of life at the end of life. This study examines symptom experience at end of life among individuals with cancer, and determines if symptom experience changes with proximity to death, or differs by depressive symptomatology, sex, site of cancer, or age. A secondary analysis of data from three prospective, descriptive, longitudinal studies (n = 174) was performed, using a three level hierarchical linear model. Fatigue, weakness, pain, shortness of breath, and cough were the five most prevalent symptoms in the last year of life. The symptom experience in the last year of life was significantly associated with site of cancer, depressive symptomatology, dependencies in activities of daily living, and independent activities of daily living at the start of the study. These findings shed light on the symptom experience in the last year of life for individuals with cancer. With greater understanding of the symptom experience, intervention strategies can be targeted to achieve the desired outcome of increased quality of life at the end of life.

Hann, Danette/ Allen, Susan/ Ciambrone, Desirée/ Shah, Ann. Use of Complementary Therapies During Chemotherapy: Influence of Patients’ Satisfaction With Treatment Decision Making and the Treating Oncologist. Integrative Cancer Therapies 2006, 5(3), 224-231.
The relationship between the use of complementary therapy (CT) and satisfaction with medical treatment decision making and with the treating oncologist was evaluated in a sample of 166 women who were undergoing an initial course of chemotherapy for early-stage breast cancer. At the beginning of chemotherapy, 39% indicated already trying CT and an additional 13% reported planning to try CT. These women mentioned a variety of vitamin, nutritional, herbal, physical, mental, and spiritual approaches. Four months later, when most patients had completed chemotherapy, more than half (53%) reported using CT, with another 8% planning to try it. Regression analysis controlling for psychosocial and medical variables revealed that women who were younger and less satisfied with their treatment decision making experience were significantly more likely to use CT. When predicting use of CT at the conclusion of treatment, baseline utilization was the greatest predictor, but dissatisfaction with the oncologist was also a significant predictor. These findings suggest that patients who are dissatisfied with their medical care may be more likely to use CT during treatment. Further research is needed to elucidate the relationship between satisfaction with medical decision making and the patient-physician relationship to CT use among cancer patients. The findings also highlight the importance of good patient-physician communication about CT use throughout the cancer treatment experience.

Kornblith, Alice B./ Regan, Meredith M./ Kim, Youngmee/ Greer, Greta/ Parker, Beverly/ Bennett, Samantha/ Winer, Eric. Cancer-Related Communication Between Female Patients and Male Partners Scale: A Pilot Study. Psycho-Oncology 2006, 15, 780–794. 
Summary
Background: The study’s objective was to evaluate the reliability and validity of the Cancer-Related Communication Problems within Couples Scale (CRCP), a measure to assess whether patients and their partners have difficulty talking about cancer with each other.
Methods: The CRCP Scale included 18 items concerning open communication/emotional support, treatment specific issues, self-protection, and protective buffering. Patients and partners responded through the American Cancer Society’s website and mailed questionnaires through Y-ME. The CRCP’s validity was tested using the Hospital Anxiety and Depression Scale (HADS) and the Dyadic Adjustment Scale (DAS, marital relationship).
Results: 189 female patients and 135 male partners participated in the survey. Three items were deleted based on lack of clarity or an item not being applicable to many respondents, resulting in a 15 item scale. The number of CRCP problems’ internal consistency in the 15 item scale was good for both patients and partners (alpha coefficient = 0:87, 0.81, respectively). The number of patients’ CRCP problems correlated with the DAS (p<0.0001), and the number of partners’ CRCP problems correlated with the HADS (p<0.0001) and the DAS (p<0.0001).
Conclusion: Analyses supported the CRCP Scale’s reliability and validity for female cancer patients and male partners.

Mackenzie, Michael J./ Carlson, Linda E./ Munoz, Marleny/ Speca, Michael. A Qualitative Study of Self - Perceived Effects of Mindfulness-Based Stress Reduction (MBSR) in a Psychosocial Oncology Setting. Stress and Health, 2006, Received 1 December 2005; Accepted 17 June 2006.
Summary
Quantitative research has shown Mindfulness-based Stress Reduction (MBSR) programmes can reduce mood disturbance, improve quality of life, and decrease stress symptoms of cancer patients. However, the range of subjective effects experienced by programme participants has not been clearly described. Nine cancer patients who had participated in an 8-week MBSR programme through the Tom Baker Cancer Centre’s Department of Psychosocial Resources, and who continued to attend weekly drop-in MBSR sessions were interviewed for this study. Qualitative research was conducted using grounded theory analysis. Data from semi-structured interviews and a focus group were analysed using QSR N6 software to identify themes concerning the effects patients experienced by adding meditation to their lives. Five major themes emerged from the data: (1) opening to change; (2) self-control; (3) shared experience; (4) personal growth; (5) spirituality. This information was used to develop specific theory concerning mechanisms whereby MBSR effects change for cancer patients. These understandings may be used to refine and further develop MBSR programmes to better assist patients during cancer diagnosis, treatment and recovery.

Mansky, Patrick J./ Wallerstedt, Dawn B. Complementary Medicine in Palliative Care and Cancer Symptom Management. Cancer J 2006, 12, 425-431.
Abstract
Complementary and alternative medicine (CAM) use among cancer patients varies according to geographical area, gender, and disease diagnosis. The prevalence of CAM use among cancer patients in the United States has been estimated to be between 7% and 54%. Most cancer patients use CAM with the hope of boosting the immune system, relieving pain, and controlling side effects related to disease or treatment. Only a minority of patients include CAM in the treatment plan with curative intent. This review article focuses on practices beionging to the CAM domains of mindbody medicine, CAM botanicals, manipulative practices, and energy medicine, because they are widely used as complementary approaches to palliative cancer care and cancer symptom management. In the area of cancer symptom management, auricular acupuncture, therapeutic touch, and hypnosis may help to manage cancer pain. Music therapy, massage, and hypnosis may have an effect on anxiety, and both acupuncture and massage may have a therapeutic role in cancer fatigue. Acupuncture and selected botanicals may reduce chemotherapy-induced nausea and emesis,and hypnosis and guided imagery may be beneficial in anticipatory nausea and vomiting. Transcendental meditation and the mindfulness-based stress reduction can play a role in the management of depressed mood and anxiety. Black cohosh and phytoestrogen-rich foods may reduce vasomotor symptoms in postmenopausal women. Most CAM approaches to the treatment of cancer are safe when used by a CAM practitioner experienced in the treatment of cancer patients.

Mercadante, Sebastiano/ Ferrera, Patrizia/ Villari, Patrizia/ Casuccio, Alessandra. Opioid Escalation in Patients with Cancer Pain: The Effect of Age. Journal of Pain and Symptom Management 2006, 32, 413-419.
Abstract
Elderly people are commonly considered more susceptible to opioid effects. However, no data regarding the need for opioid escalation in patients already receiving opioids for the management of chronic pain are available. The purpose of this study was to evaluate the differences between younger and older patients during the crucial phase of opioid titration. One hundred consecutive patients with cancer pain requiring further opioid dose refinement were recruited for this cohort study. Pain intensity, dose of opioids, number of opioids used
(need to switch), routes of administration used, and opioid-related symptoms were measured from admission until dose stabilization. Opioid escalation indexes (OEIs) were calculated. For the purpose of analysis, patients were divided into three age groups (<65, 65-74, 75 or over). Despite differences in opioid doses at admission (lower in older patients), no differences were found in routes, need to switch, OEI, or other parameters between younger and older patients. Similarly, adverse effects did not significantly differ between the three groups, although an overall distress score worsened in older patients during acute titration and then improved at stabilization time. These data contradict the assumption that older patients who already receive opioids are more susceptible than younger adults to opioid effects during opioid titration. Although the elderly require lower doses, opioid effects do not appear to vary with age in this population. However, the group of patients over 75 was relatively small and data should be interpreted with caution. Careful titration based on the individual response seems appropriate irrespective of age.

Myers, Cynthia/ Stuber, Margaret L./ Bonamer-Rheingans, Jennifer I./ Zeltzer, Lonnie K. Complementary Therapies and Childhood Cancer. Cancer Control: Journal of the Moffitt Cancer Center 2005,12(3), 172-180.  http://www.medscape.com/viewarticle/510218
A growing number of pediatric cancer patients use complementary therapies as part of their treatment regimen to attempt to improve outcomes or enhance quality of life.
Abstract
Background: The use of complementary and alternative therapies by children with cancer is common. Up to 84% of children have used complementary therapies along with conventional medical treatment for cancer.
Methods: We reviewed the PubMed and CINAHL databases for studies published between 1994 and 2004 on the use of complementary and alternative therapies by children with cancer and reports from any publication year through 2004 of clinical trials involving complementary and alternative therapies for children with cancer.
Results: Fourteen studies were retrieved reporting the results of survey or interview data collected from parents on children's use of complementary and alternative therapies during or after childhood cancer. Across studies, the use of such therapies ranged from 31% to 84%. Common reasons for using complementary and alternative therapies were to do everything possible for their child, to help with symptom management, and to boost the immune system. Many parents indicated they also hoped to treat or cure the cancer. In most cases, the child's treating physician had not been informed of the child's use of complementary and alternative therapies.
Conclusions: Use of complementary therapies by children with cancer is common, although methodological variations limit the ability to compare results across studies. Treating physicians often do not know the child is using complementary therapies in addition to medical treatments. The scientific evidence is limited regarding the effects and mechanisms of action of complementary or alternative therapies, but research is being conducted on these topics.

Nedstrand, Elizabeth/ Wyon, Yvonne/ Hammar, Mats/ Wijma, Klaas.
Psychological Well-Being Improves in Women with Breast Cancer After Treatment with Applied Relaxation or Electro-Acupuncture for Vasomotor Symptom. Journal of Psychosomatic Obstetrics & Gynecology, December 2006, 27(4), 193–199.
Abstract
The aim of this study was to evaluate the effect of applied relaxation and electro-acupuncture (EA) on psychological well-being in breast cancer-treated women with vasomotor symptoms. Thirty-eight breast cancer-treated postmenopausal women with vasomotor symptoms were included in the study. They were randomized to either treatment with electro-acupuncture (EA) (n=19, three of them with tamoxifen) or applied relaxation (AR) (n=19, five of them with tamoxifen) over a 12-week study period with six months follow-up. Vasomotor symptoms were registered daily. A visual analog scale was used to assess
climacteric symptom, estimation of general well-being was made using the Symptom Checklist, and mood using the Mood Scale. These were applied during treatment and at follow-up. In total 31 women completed 12 weeks of treatment and six months of follow-up. Hot flushes were reduced by more than 50%. Climacteric symptoms significantly decreased during treatment and remained so six months after treatment in both groups. Psychological well-being significantly improved during therapy and at follow-up visits in both groups. Mood improved significantly in the electro-acupuncture treated group. In conclusion psychological well-being improved in women with breast cancer randomized to treatment with either AR or EA for vasomotor symptoms and we therefore suggest that further studies should be performed in order to evaluate and develop these alternative therapies.

Ott, Mary Jane/ Norris, Rebecca L./ Bauer-Wu, Susan M. Mindfulness Meditation for Oncology Patients: A Discussion and Critical Review. Integrative Cancer Therapies 2006, 5(2), 98-108.
The purpose of this article is to (1) provide a comprehensive overview and discussion of mindfulness meditation and its clinical applicability in oncology and (2) report and critically evaluate the existing and emerging research on mindfulness meditation as an intervention for cancer patients. Using relevant
keywords, a comprehensive search of MEDLINE, PsycInfo, and Ovid was completed along with a review of published abstracts from the annual conferences sponsored by the Center for Mindfulness in Medicine, Health Care, and Society and the American Psychosocial Oncology Society. Each article and abstract was critiqued and systematically assessed for purpose statement or research questions, study design, sample size, characteristics of subjects, characteristics of mindfulness intervention, outcomes, and results. The search produced 9 research articles published in the past 5 years and 5 conference abstracts published in 2004. Most studies were conducted with breast and prostate cancer patients, and the mindfulness intervention was done in a clinic-based group setting. Consistent benefits—improved psychological functioning, reduction of stress symptoms, enhanced coping and well-being in cancer outpatients —were found. More research in this area is warranted: using randomized, controlled designs, rigorous methods, and different cancer diagnoses and treatment settings; expanding outcomes to include quality of life, physiological, health care use, and health-related outcomes; exploring mediating factors; and discerning dose effects and optimal frequency and length of home practice. Mindfulness meditation has clinically relevant implications to alleviate psychological and physical suffering of persons living with cancer. Use of this behavioral intervention for oncology patients is an area of burgeoning interest to clinicians and researchers.

Pearce, Michelle J./ Singer, Jerome L. Religious Coping among Caregivers of Terminally Ill Cancer Patients Main Effects and Psychosocial Mediators. Journal of Health Psychology 2006, 11(5), 743–759.
Abstract
This study investigated the association between religious coping, mental health and the caring experience, as well as potential explanatory mechanisms, among 162 informal caregivers of terminally ill cancer patients. Regression analyses indicated that, controlling for socio-demographic variables, more use of positive religious coping strategies was associated with more burden, yet, also more satisfaction. In contrast, more use of negative religious coping strategies was related to more burden, poorer quality of life and less satisfaction, and correlated with an increased likelihood of Major Depressive Disorder and anxiety disorders. In a number of models, negative religious coping was related to outcomes through its relationship with social support, optimism and self-efficacy. Implications for research and healthcare are discussed.

Post-White, Janice. Complementary and Alternative Medicine in Pediatric Oncology. Journal of Pediatric Oncology Nursing (September-October) 2006, 23(5), 244-253.
Children with cancer and their families use complementary and alternative medicine (CAM) to reduce symptoms, cope with life-threatening illness, and improve overall well-being. Despite numerous published surveys on the use of CAM in pediatric oncology, few studies have tested CAM therapies for safety and
efficacy. A growing body of literature in adult oncology provides evidence for the role of CAM to help manage symptoms and reduce distress. Translating this research to children requires studies with new models that address family roles and include measurement of outcomes relevant to children’s developmental stages and unique responses. One of the limitations in pediatrics is the small samples available to single institutions. Conducting clinical trials through the cooperative group mechanism is one way of obtaining sufficient sample sizes to determine effectiveness and safety of CAM therapies. This article summarizes research to date and describes a beginning approach to measuring outcomes of supportive CAM therapies in children with cancer.

Pothoulaki, Maria/ MacDonald, Raymond/ Flowers, Paul. Methodological Issues in Music Interventions in Oncology Settings: A Systematic Literature Review. The Arts in Psychotherapy 2006, 33, 446–455.
Abstract
This paper is part of a systematic literature review and presents methodological issues within studies, investigating therapeutic applications of music in cancer patients. This review focuses on published international research from the USA, Canada, Australia and European countries using four electronic databases: PSYCHINFO, WEB OF SCIENCE, MEDLINE and SCIENCEDIRECT.
Thirty-two papers were identified and each paper was coded in terms of sample type, basic research question, research design and methodological details, results and implications for future research. This paper addresses questions related to study design and methodology. It explores and discusses the relative advantages and disadvantages of various approaches.

Rosenbaum, Elana . Here for Now: Living Well With Cancer Through Mindfulness. Hardwick, MA: Satya House Publications, 2005.
Here for Now: Living Well With Cancer Through Mindfulness is a personal account and a self-help book that is filled with touching stories, practical and effective exercises, colorful images, and inspiring poems and affirmations—all which enthuse and instruct patients with cancer to live fully amidst the challenges and uncertainties of their disease. With authenticity, the author shares her journey with lymphoma and a stem cell transplant. Her experience is complemented by her insight as a talented psychotherapist and skill as a mindfulness meditation instructor who taught for 20 years in the renowned University of Massachusetts.

Sood, Amit/ Barton, Debra L./ Bauer Brent A./ Loprinzi, Charles L.
A Critical Review of Complementary Therapies for Cancer-Related Fatigue. Integr Cancer Ther 2007, 6(1), 8-13.
http://ict.sagepub.com/cgi/content/abstract/6/1/8
Purpose: To review the available literature on the use of complementary and alternative medicine (CAM) treatments for cancer-related fatigue with an aim to develop directions for future research.
Methods: PubMed, EMBASE, CINAHL, PsycINFO, and SPORTDiscus were searched for relevant studies. Original clinical trials reporting on the use of CAM
treatments for cancer-related fatigue were abstracted and critically reviewed.
Results: CAM interventions tested for cancer-related fatigue include acupuncture, aromatherapy, adenosine triphosphate infusions, energy conservation and activity management, healing touch, hypnosis, lectinstandardized mistletoe extract, levocarnitine, massage, mindfulness-based stress reduction, polarity therapy, relaxation, sleep promotion, support group, and Tibetan yoga. Several of these interventions seem promising in initial studies.
Conclusion: Currently, insufficient data exist to recommend any specific CAM modality for cancer-related fatigue. Therefore, potentially effective CAM interventions ready for further study in large, randomized clinical trials (eg, acupuncture, massage, levocarnitine, and the use of mistletoe) should be pursued. Other interventions should be tested in well-designed feasibility and phase II trials.

Staples, Julie K./ Wilson, Amy T./ Pierce, Beverly/ Gordon, James S. Effectiveness of CancerGuides®: A Study of an Integrative Cancer Care Training Program for Health. Integrative Cancer Therapies 2007, 6(1), 14-24.
http://ict.sagepub.com/cgi/content/abstract/6/1/14
Purpose: To determine how CancerGuidesâ®, an integrative cancer care training program, would affect participants’ perception of their professional skills, their mood, use of selfcare and mind-body modalities, and the acceptance of integrative cancer care at their institutions. Study Design: Qualitative and quantitative measures were used during the training program and at 6-month follow-up. A focus group met before and after the training, and individual interviews of focus group participants were done at follow-up.
Methods: The week-long program consisted of lectures that provided information on integrating conventional and complementary therapies into individualized programs of cancer care. Small group sessions used mind-body techniques to allow participants to understand the dilemmas faced by cancer patients. A self-report survey was administered at the training program and at 6-month follow-up. The survey included questions on the personal and professional use of modalities and on participants’ sense of how well they met the course objectives. Qualitative questions addressed self-care, changes in clinical practice, and the acceptance of integrative therapies by their institutions. The Profile of Mood States was administered before and after the training.
Results: Six months after the training, there was a significant increase in the use and/or recommendation of complementary and alternative medicine modalities in clinical practice and a significant increase in the personal practice of these modalities. Participants’ perceived level of skill for all of the course objectives was significantly increased following the training and was maintained at 6-month follow-up. There were significant reductions in the Anger-Hostility and Tension-Anxiety subscale scores of the Profile of Mood States questionnaire. In response to qualitative questions, participants reported positive changes in patient care and in their clinical practices at 6-month follow-up. The subset of participants in the focus group interviews reported similar improvements. Thirty-five percent of those responding at follow-up reported an increase in acceptance of integrative cancer therapies at their institutions, and 77% reported making positive changes in self-care.
Conclusions: Cancer-Guides provided training that allowed participants to enhance personal self-care, to interact more effectively with their patients, and to develop programs of integrative cancer care.

Swarup, Anu B./ Barrett, William/ Jazieh, Abdul Rahman. The Use of Complementary and Alternative Medicine By Cancer Patients Undergoing Radiation Therapy. Am J Clin Oncol 2006, 29, 468–473.
Objective: Use of complementary alternative medicine (CAM) is widespread among patients with chronic diseases including cancer.
The purpose of our study was to examine the pattern of alternative medicine use in patients undergoing radiation treatment of cancer.
Methods and Materials: A cross-sectional study was conducted among cancer patients treated with radiation therapy from July 2003 through July 2005 at the University of Cincinnati. We defined CAM as the use of dietary supplements, massage therapy, prayer, acupuncture, chiropractic, and other novel therapies undertaken after their diagnosis with cancer.
Results: There were 152 patients that participated in the study. Their median age was 59 (range, 21–85), 82 (54%) were males, 108 (69%) were Caucasian. Out of 152 patients, 104 (68%) patients were users of CAM. The most common CAM modality reported was prayer 85 (82%) and use of dietary supplements 84 (80%). The majority of users were female and well-educated. Among CAM users 60 (58%) had discussed its use with their physician. Level of education, employment status and income showed a significant correlation with
the use of CAM.
Conclusion: This study demonstrates that the use of complementary alternative medicine among cancer patients receiving radiation therapy is frequent. Given the potential risks with some CAM therapies, physicians should actively ask patients whether they use CAM and provide appropriate counseling.

Tomich, Patricia L./ Helgeson, Vicki S. Cognitive Adaptation Theory and Breast Cancer Recurrence: Are There Limits? Journal of Consulting and Clinical Psychology 2006, 74(5), 980-987.
Relations of the components of cognitive adaptation theory (self-esteem, optimism, control) to quality of life and benefit finding were examined for 70 women (91% Caucasian) diagnosed with Stage I, II, or III breast cancer over 5 years ago. Half of these women experienced a recurrence within the 5 years; the
other half remained disease free. Women were matched on age, race, stage of disease, and intervention condition. Baseline perceptions of personal control over illness, but not general self-esteem or optimism, were associated with women’s reports of worse physical functioning, worse mental functioning, and less
benefit finding 5 years later for recurrent women but not disease-free women. These findings highlight the notion that there may be boundary conditions on the adaptiveness of perceived control.

Vapiwala, Neha/ Mick, Rosemarie/ Hampshire, Margaret K./ Metz, James M.
Patient Initiation of Complementary and Alternative Medical Therapies (CAM) Following Cancer Diagnosis. Cancer J 2006, 12, 467-474.
Purpose  Complementary and alternative medicine use is prevalent in both healthy and oncologic populations. However, few data exist to quantify complementary and alternative medicine Initiation specifically after cancer diagnosis. This study evaluated patients' complementary and alternative medicine usage patterns, reasons, and general perceptions after cancer diagnosis and during or after conventional cancer therapy.
Methods  An Internet- and clinic-based piloted questionnaire was distributed from July 2004 through September 2004. In total, 604 responses were analyzed (64% Internet, 36% oncology clinics). Patients were predominantly white females; almost half held college or graduate degrees. Respondents reported past or present history of > 1 conventional treatment(s), primarily chemotherapy and radiotherapy.
Results  Initiation of > 1 complementary and alternative medicine after diagnosis was reported by 54% of those surveyed. Complementary and alternative medicine users were more likely than non-users to have a history of chemotherapy (P =0.003) and enrollment in clinical trials (P = 0.007). Complementary and alternative medicine use was greater in females {P= 0.004) and patients with higher education levels (P < 0.001), but not in whites compared to non-whites (P =0.34). The most commonly cited reason for complementary and alternative medicine use after diagnosis was "general overall health." Less than one-third of patients cited their healthcare providers as primary sources of complementary and alternative medicine information. The vast majority of users (86%) expressed satisfaction with complementary and alternative medicine as a cost-effective approach.
Discussion  About one-half of adult cancer patients initiate complementary and alternative medicine therapy after diagnosis and during or after conventional oncologic treatments. Healthcare providers should be aware of patients' reasons for complementary and alternative medicine use, both for symptom management and quality-of-life. Healthcare providers should also be familiar with patients' complementary and alternative medicine information sources and should supplement these sources with discussions of pertinent safety profiles and potential interactions with standard therapies.

Wells, Marjorie/ Sarna, Linda/ Cooley, Mary E./ Brown, Jean K./ Williams Chernecky, Cynthia/ Roma D./ Padilla, Geraldine/ Danao, Leda Layo.
Use of Complementary and Alternative Medicine Therapies to Control Symptoms in Women Living With Lung Cancer. Cancer Nursing™ 2007, 30(1).
Complementary and alternative medicine (CAM) use by cancer patients, especially women, is increasing. However, CAM use among patients with lung cancer, who have been reported to have the highest symptom burden, is poorly documented. This study describes types and frequencies of specific CAM therapies used by women with lung cancer to manage symptoms, and examines differences in demographic and clinical characteristics between CAM users and non-CAM users. Participants included 189 women with non-small cell lung cancer and >1 of 8 symptoms. Six CAM therapies, used to control symptoms, were assessed, including herbs, tea, acupuncture, massage, meditation, and prayer. Forty-four percent (84 women) used CAM therapies, including prayer (34.9%), meditation (11.6%), tea (11.6%), herbs (9.0%), massage (6.9%), and acupuncture (2.6%). Complementary and alternative medicine use was greatest for difficulty breathing and pain (54.8% each), with prayer the most commonly used CAM for all symptoms. Significant differences (P < .05) were found for age (t = 2.24), symptom frequency (t = -3.02), and geographic location (x² = 7.51). Women who were younger, experienced more symptoms, and lived on the West Coast or South (vs Northeast) were more likely to use CAM. We found that CAM use is variable by symptom and may be an indicator of symptom burden. Our results provide important initial data regarding CAM use for managing symptoms by women with lung cancer.

Wilde, Daxton (and his mother, Sherry Wilde). I’m a Superhero. Illustrated by Daxton Wilde. Layton, UT: Gibbs Smith, 2005.
I’m a Superhero is a children’s book that was written and illustrated by a four-year old boy with a brain tumor (with the assistance of his mother). The book is intended to help other children battling cancer know what to expect and conveys the importance of a positive attitude.

Zapka, Jane/ Fisher, Gene/ Lemon, Stephanie/ Clemow, Lynn/ Fletcher, Kenneth. Relationship and Distress in Relatives of Breast Cancer Patients. Families. Systems, & Health 2006, 24(2), 198–212.
This study examines the association of relationship factors with distress among first-degree female relatives (FDFRs; n = 540) of newly diagnosed breast cancer patients (n = 306). Cancer factors (receiving chemotherapy, positive nodes) and relationship factors (more contact, greater emotional closeness, and being told the diagnosis by the patient) were related to greater perceived impact of the cancer on the patient. Several of these factors, as well as FDFR factors (younger age, minority status, higher risk perception) and relationship factors (being the mother or daughter of the patient), were significantly related to the FDFR’s cancer-specific distress, general distress, or both. Notably, the FDFR’s own social support was associated with both cancerspecific and general distress. Appreciating the impact of a relative’s cancer on FDFRs and offering guidance and support via patient-centered counseling can enhance quality of care.