Impact of risk and lifestyle factors on therapy goals in the treatment of breast cancer and gynecological cancer patients with integrative medicine

Archives of Gynecology and Obstetrics (2025) 311:1683–1695 https://doi.org/10.1007/s00404-025-08002-w RESEARCH Impact of risk and lifestyle factors on therapy goals in the treatment of breast cancer and gynecological cancer patients with integrative medicine Katharina Seitz1,3 · Anna‑Katharin Theuser2,3 · Sophia Antoniadis1,3 · Matthias W. Beckmann1,3 · Milena Beierlein1,3 · L. Brückner1,3 · Katharina Au1,3 · Carolin C. Hack1,3 Received: 2 February 2025 / Accepted: 5 March 2025 / Published online: 9 April 2025 © The Author(s) 2025 Abstract Background As a result of advancements in the diagnosis and therapy of cancer, the prognosis for cancer patients has significantly improved. The benefits of a significantly enhanced survival time lead to a more extensive concern with quality of life and managing the side effects during oncological treatment. Implementing integrative medicine strategies has been found to reduce the side effects of therapy and disease. In 2021 the S3 guideline on complementary medicine in oncology was published for the first time, which takes a stand on the most common aspects of complementary and integrative medicine in Germany. The aim was to see whether a previous healthy life style impacts the success of integrative medicine for patients. Methods Within the framework of a cross-sectional study over 15 months, 120 cancer patients were monitored at a standardized integrative medicine consultancy service at the University Integrative Medicine Center of the University Hospital Erlangen, Department of Gynecology and Obstetrics. The basic questionnaire consisted of questions on socioeconomic background information, lifestyle factors, such as dietary habits or smoking behavior, as well as information on the gynecological situation. Furthermore, an evaluation based on patient-reported therapy goals concerning the reduction of side effects of conventional cancer treatments, enhancement of disease-related quality of life and better stress and disease management, active participation in cancer treatments, mind–body stabilization, and improvements in coping strategies were assessed. In addition, the impact of patient characteristics and lifestyle on the subjective achievement of these outcomes was evaluated to set the answers in context and show its influence. Statistical analysis was performed using SPSS Statistics for Windows version 26 (IBM Corporation, Armonk in New York, USA). Mean, standard deviation, minimum, and maximum were calculated for age and BMI. The other characteristics regarding demographics, lifestyle, tumor disease, and therapy were analyzed based on their respective absolute and relative frequencies. Results A large majority of the patients' participation goal was to reduce cancer-related side effects (90.8%), second were the aspects of “Improvement of the disease-related quality of life “(72.5%). In both cases, this common goal was only fully achieved for about one quarter of the patients (25.7%/24.1%), but partially achieved in more than half of the asked patients (53.2%/52.9%). Half of the patients reported that they achieved active participation in cancer treatment with integrative medicine. Around 50% partially achieved stabilization of the body, soul, and spirit, stress, disease management, improvement in cancer-related quality of life, and reduced the side effects of conventional cancer therapies. The success of integrative therapy was independent of age, BMI, family status, children, level of education, insurance type, alcohol and tobacco consumption, sport, low-fat diet, daily fruit and vegetable servings, interest in diets, and previous use of diets. Conclusions and discussion Using a standardized procedure in integrative medicine allows patients to receive high-quality care. The previous standard of living has no effect on the benefits of integrative medicine for the patient. The goals through the use of integrative medicine could be achieved by all patient groups. It is highly encouraged to incorporate counseling and evidence-based integrative medicine into the clinical routines of cancer centers and adapt postgraduate medical education. Finally, the evidence base for the recommendations should also be strengthened by further research into the use of integrative medicine. Extended author information available on the last page of the article Vol.:(0123456789) 1684 Archives of Gynecology and Obstetrics (2025) 311:1683–1695 Keywords Cancer · Gynecological oncology · Lifestyle · Integrative medicine · Complementary and alternative medicine What does this study add to the clinical work The study clearly showed that integrative medicine can improve the quality of life of female cancer patients, regardless of their previous lifestyle or risk factors. Patients who were previously very healthy will benefit to the same extent as patients whose lifestyle was previously unhealthy, so access to integrative medicine should be open to all patient groups. Introduction Cancer therapy and side effects Over the past few years, thanks to the growing effectiveness of oncological therapies and improvements in screenings, long-term survival rates after breast cancer diagnosis have significantly improved [1]. In Europe, the 5-year survival rate for women diagnosed with breast cancer is approximately 88% [2]. New targeted therapies are being researched at a rapid pace and are finding application in an ever-changing therapeutic landscape [3, 4]. For gynecological cancer, new target treatments have been approved in the last few years and a high impact on the survival rate is expected for the years ahead [5, 6]. These good news have brought new challenges to the medical community. Moreover, with the complex, wide range of cancer treatments, including surgery, chemotherapy, endocrine therapy, and targeted therapies, the short- and long-term management of the side effects of these therapies have become an essential component of the patient treatment pathway [7–9]. Cancer survivors can experience acute and chronic side effects and are more likely to suffer from various secondary health problems, influencing health-related quality of life (HRQoL) and creating additional difficulty for the patients [10–14]. Approximately 26% of breast cancer patients report severe fatigue symptoms, which, in many instances, will be remaining for years after the completion of oncological therapy and are challenging to treat [15, 16]. On the other hand conditions like chemotherapy-induced nausea and vomiting can be well-managed in most patients with multiagent anti-emetic medications [17]. Management can also require a dose reduction, a modification in schedule, and the use of gabapentin for symptomatic treatment [18]. In addition, current research is looking at ways to prevent this condition, including tactile stimulation, cryotherapy, and acupuncture [19, 20]. It is increasingly recognized that the assessment of patient-reported outcomes in terms of toxicity and qua (...truncated)