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E. Harmrin
Linkoping University, Department of Medicine and Care, Clinical Pharmacology, Linkoping, Sweden
In Sweden, with a population of about 8.8 million people and an incidence of about 5,700 women with breast cancer a year, complementary medicine is often desired by the patients but also rejected by traditional medicine because of lack of evidence.
The first major study in Scandinavia on evaluating anthroposophic care in breast cancer has been going on in the County of Stockholm since 1995. The project group has been multidisciplinary with expertise from oncology, anthroposophic medicine, psychology and nursing. A matching procedure has been developed, where each breast cancer patient who has been admitted to the anthroposophic clinic has been matched with a "twin" with the same disease.
The matching criteria have been based on stage of the disease, age, pre-admittance treatment and prognosis. 60&60 patients with a mean age of 49 years have been included in the study and followed for one year with a test-battery, where quality of life measurements have been central. Five year follow-ups are ongoing.
The results show that the survivors among the anthroposophic group, scoring lower quality of life from the beginning, are steadily improving their quality of life up to one year after admission to the study.
This patter is not being found in the matching group, where QOL is unchanged or deteriorating. Data are also available based on qualitative interviews.
The challenge of the study has been the matching part and the development and use of the different assessment instruments. Randomisation has not been possible because of the present health care system and that the fundings from the Swedish Cancer Society and other sources did not cover the stay of the patients in the anthroposophic clinic.
In spite of our careful matching procedures, the women who had chosen complementary care, had a different professional profiled where about 23% were in cultural professions.
Also we cannot exclude their own motivation and expectations for this type of care as an important factor. In the future it would be of importance to find fundings which make it possible to use randomisation for a more strict comparison between different care procedures.
European J of Cancer, Vol 37, Suppl. 6, October 2001, p 406
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