Use of supportive anthroposophic medicine in a German integrative paediatric oncology centre

Tycho Jan Zuzak, Rico Seiler, Thomas Ostermann, Peter Heusser, Melanie Schwermer, Alfred Längler
Article-ID: DMS-21425-EN
DOI: https://doi.org/10.14271/DMS-21425-EN

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Introduction: The only German centre for integrative paediatric oncology (PO) at the Gemeinschaftskrankenhaus Herdecke offers integrative-anthroposophic supportive treatment in addition to conventional therapy.

Methods: All paediatric oncological inpatients between 1999 and 2008 were retrospectively documented. Patient and parent experiences were analysed by a modified ZUF-8 questionnaire.

Results: Among the 116 patients, 97.0% received some form of supportive integrative-anthroposophic therapies. Non-drug treatments are applied in 79.3% of patients and 94.0% of patients received anthroposophic drug treatment, whereby mistletoe therapy (75.0%) was most frequently used. Our survey revealed that parents were highly satisfied with the integrative PO treatment.

Conclusion: Integrative therapies are well integrated in the clinical routine of the integrative PO centre. Presented data make anthroposophic medicine more transparent and comprehensible to physicians, patients and parents, as well as to health professionals and service providers. Further prospective controlled trials are necessary to estimate effectiveness of such integrative approaches.

1 Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 1998;280(18):1569–1575. DOI: https://doi.org/10.1001/jama.280.18.1569. [Crossref]

2 Bishop FL, Prescott P, Chan YK, et al. Prevalence of complementary medicine use in pediatric cancer: a systematic review. Pediatrics 2010;125(4):768–776. DOI: https://doi.org/10.1542/peds.2009-1775. [Crossref]

3 Längler A, Spix C, Seifert G, et al. Complementary and alternative treatment methods in children with cancer: A populationbased retrospective survey on the prevalence of use in Germany. Eur J Cancer 2008;44(15):2233–2240. DOI: https://doi.org/10.1016/j.ejca.2008.07.020. [Crossref]

4 Laengler A, Spix C, Edelhauser F, et al. Anthroposophic medicine in paediatric oncology in Germany: results of a populationbased retrospective parental survey. Pediatr Blood Cancer 2010;55(6):1111–1117. DOI: https://doi.org/10.1002/pbc.22523. [Crossref]

5 Steiner R, Wegman I. Grundlegendes für eine Erweiterung der Heilkunst nach geisteswissenschaftlichen Erkenntnissen. 8. Aufl. Dornach: Rudolf Steiner Verlag; 2014.

6 Kienle GS, Albonico HU, Baars E, et al. Anthroposophic medicine: an integrative medical system originating in europe. Glob Adv Health Med 2013;2:20–31. DOI: https://doi.org/10.7453/gahmj.2012.087. [Crossref]

7 Längler A, Zuzak TJ. Complementary and alternative medicine in paediatrics in daily practice – A European perspective. Complement Ther Med 2013;21 Suppl1:S26–33. DOI: https://doi.org/10.1016/j.ctim.2012.01.005. [Crossref]

8 Merzweiler A, Ehlerding H, Creutzig U, et al. Terminologiestandardisierung in der Pädiatrischen Onkologie – der Basisdatensatz. Klin Padiatr 2002;214(4):212–217. DOI: https://doi.org/10.1055/s-2002-33191. [Crossref]

9 Rossig C, Juergens H, Schrappe M, et al. Effective childhood cancer treatment: The impact of large scale clinical trials in Germany and Austria. Pediatr Blood Cancer 2013;60(10):1574–1581. DOI: https://doi.org/10.1002/pbc.24598. [Crossref]

10 Schmidt J, Lamprecht F, Wittmann WW. Zufriedenheit mit der stationären Versorgung. Entwicklung eines Fragebogens und erste Validitätsuntersuchungen. Psychother Psychosom Med Psychol 1989;39(7):248–255.

11 Kinderkrebsregister. Jahresbericht 2010. Verfügbar unter https://www.kinderkrebsregister.de/typo3temp/secure_downloads/22651/0/ebc3988cc429f1f3e9d341ece76b74d489470cc8/jb2010_3_Routine.pdf (31.03.2021).

12 Kienle GS, Glockmann A, Schink M, et al. Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. J Exp Clin Cancer Res 2009;28:79. DOI: https://doi.org/10.1186/1756-9966-28-79. [Crossref]

13 Kelly KM, Jacobson JS, Kennedy DD, et al. Use of unconventional therapies by children with cancer at an urban medical center. J Pediatr Hematol Oncol 2000;22(5):412–416. DOI: https://doi.org/10.1097/00043426-200009000-00005. [Crossref]

14 Magi T, Kuehni CE, Torchetti L, et al. Use of complementary and alternative medicine in children with cancer: A study at a Swiss university hospital. PLoS One 2015;10:e0145787. DOI: https://doi.org/10.1371/journal.pone.0145787. [Crossref]

15 Längler A, Spix C, Gottschling S, et al. Elternbefragung zur Anwendung alternativer und komplementärer Behandlungsmethoden in der Kinderonkologie in Deutschland. Klin Padiatr 2005;217(6):357–364. DOI: https://doi.org/10.1055/s-2005-872522. [Crossref]

16 Diorio C, Lam CG, Ladas EJ, et al. Global use of traditional and complementary medicine in childhood cancer: A systematic review. J Glob Oncol 2017;3(6):791–800. DOI: https://doi.org/10.1200/JGO.2016.005587. [Crossref]

17 Längler A, Boeker R, Kameda G, et al. Attitudes and beliefs of paediatric oncologists regarding complementary and alternative therapies. Complement Ther Med 2013;21 Suppl 1:S10–19. DOI: https://doi.org/10.1016/j.ctim.2012.02.006. [Crossref]

18 Roth M, Lin J, Kim M, et al. Pediatric oncologists’ views toward the use of complementary and alternative medicine in children with cancer. J Pediatr Hematol Oncol 2009;31(3):177–182. DOI: https://doi.org/10.1097/MPH.0b013e3181984f5a. [Crossref]

19 Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) at the University Medical Center of the Johannes Gutenberg University Mainz. German Childhood Cancer Registry – Annual Report 2009. 2009.

20 Schütze T, Längler A, Zuzak TJ, et al. Use of complementary and alternative medicine by pediatric oncology patients during palliative care. Support Care Cancer 2016;24:2869–2875. DOI: https://doi.org/10.1007/s00520-016-3097-2. [Crossref]

21 Seifert G, Rutkowski S, Jesse P, et al. Anthroposophic supportive treatment in children with medulloblastoma receiving firstline therapy. J Pediatr Hematol Oncol 2011;33(3):e105–108. DOI: https://doi.org/10.1097/MPH.0b013e31820946d3. [Crossref]

22 Büssing A, Vervecken W, Wagner M, et al. Expression of mitochondrial Apo2.7 molecules and caspase-3 activation in human lymphocytes treated with the ribosome-inhibiting mistletoe lectins and the cell membrane permeabilizing viscotoxins. Cytometry 1999;37(2):133–139.

23 Stein G, Henn W, von Laue H, et al. Modulation of the cellular and humoral immune responses of tumor patients by mistletoe therapy. Eur J Med Res 1998;3(4):194–202.

24 Steinborn C, Klemd AM, Sanchez-Campillo AS, et al. Viscum album neutralizes tumor-induced immunosuppression in a human in vitro cell model. PLoS One 2017;12(11):e0181553. DOI: https://doi.org/10.1371/journal.pone.0181553. [Crossref]

25 Hostanska K, Vuong V, Rocha S, et al. Recombinant mistletoe lectin induces p53-independent apoptosis in tumour cells and cooperates with ionising radiation. Br J Cancer 2003;88:1785–1792. DOI: https://doi.org/10.1038/sj.bjc.6600982. [Crossref]

26 Janssen O, Scheffler A, Kabelitz D. In vitro effects of mistletoe extracts and mistletoe lectins. Cytotoxicity towards tumor cells due to the induction of programmed cell death (apoptosis). Arzneimittelforschung 1993;43(11):1221–1227.

27 Tröger W, Galun D, Reif M, et al. Viscum album L. extract therapy in patients with locally advanced or metastatic pancreatic cancer: A randomised clinical trial on overall survival. Eur J Cancer 2013;49(18):3788–3797. DOI: https://doi.org/10.1016/j.ejca.2013.06.043. [Crossref]

28 Kienle GS, Kiene H. Complementary cancer therapy: a systematic review of prospective clinical trials on anthroposophic mistletoe extracts. Eur J Med Res 2007;12(3):103–119.

29 Kienle GS, Kiene H. Review article: Influence of Viscum album L (European mistletoe) extracts on quality of life in cancer patients: a systematic review of controlled clinical studies. Integr Cancer Ther 2010;9:142–157. DOI: https://doi.org/10.1177/1534735410369673. [Crossref]

30 Mansky PJ, Wallerstedt DB, Sannes TS, et al. NCCAM/NCI Phase 1 study of mistletoe extract and gemcitabine in patients with advanced solid tumors. Evid Based Complement Alternat Med 2013;2013:964592. DOI: https://doi.org/10.1155/2013/964592. [Crossref]

31 Siegle I, Fritz P, McClellan M, et al. Combined cytotoxic action of Viscum album agglutinin-1 and anticancer agents against human A549 lung cancer cells. Anticancer Res 2001;21(4A):2687–2691.

32 Weissenstein U, Kunz M, Urech K, et al. Interaction of standardized mistletoe (Viscum album) extracts with chemotherapeutic drugs regarding cytostatic and cytotoxic effects in vitro. BMC Complement Altern Med 2014;14:6. DOI: https://doi.org/10.1186/1472-6882-14-6. [Crossref]

33 Engdal S, Nilsen OG. In vitro inhibition of CYP3A4 by herbal remedies frequently used by cancer patients. Phytother Res 2009;23(7):906–912. DOI: https://doi.org/10.1002/ptr.2750. [Crossref]

34 Doehmer J, Eisenbraun J. Assessment of extracts from mistletoe (Viscum album) for herb-drug interaction by inhibition and induction of cytochrome P450 activities. Phytother Res 2012;26(1):11–17. DOI: https://doi.org/10.1002/ptr.3473. [Crossref]

35 Zuzak TJ, Wasmuth A, Bernitzki S, et al. Safety of high-dose intravenous mistletoe therapy in pediatric cancer patients: A case series. Complement Ther Med 2018;40:198–202. DOI: https://doi.org/10.1016/j.ctim.2018.01.002. [Crossref]

36 Steele ML, Axtner J, Happe A, et al. Adverse drug reactions and expected effects to therapy with subcutaneous mistletoe extracts (Viscum album L.) in cancer patients. Evid Based Complement Alternat Med 2014;2014:724258. DOI: https://doi.org/10.1155/2014/724258. [Crossref]

37 Steele ML, Axtner J, Happe A, et al. Safety of intravenous application of mistletoe (Viscum album L.) preparations in oncology: An observational study. Evid Based Complement Alternat Med 2014;2014:236310. DOI: https://doi.org/10.1155/2014/236310. [Crossref]

38 Steele ML, Axtner J, Happe A, et al. Use and safety of intratumoral application of European mistletoe (Viscum album L) preparations in oncology. Integr Cancer Ther 2015;14(2):140–148. DOI: https://doi.org/10.1177/1534735414563977. [Crossref]

39 Vademecum Anthroposophische Arzneimittel. Band 1. Edition B. 4. Aufl. München: Verlag der Gesellschaft Anthroposophischer Ärzte in Deutschland; 2017.

40 Hamre HJ, Becker-Witt C, Glockmann A, et al. Anthroposophic therapies in chronic disease: the Anthroposophic Medicine Outcomes Study (AMOS). Eur J Med Res 2004;9(7):351–360.

41 Hamre HJ, Kiene H, Ziegler R, et al. Overview of the publications from the Anthroposophic Medicine Outcomes Study (AMOS): A whole system evaluation study. Glob Adv Health Med 2014;3(1):54–70. DOI: https://doi.org/10.7453/gahmj.2013.010. [Crossref]

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