Use of Mind–Body Complementary Therapies (MBCTs) in Patients with Cancer

Dear Editor:

Mind–body complementary therapies (MBCTs) are a wide range of practices that provide an interactions among brain, body, and behavior with an intention to promote physical and functional well-being. ¹ Prayers, faith-healing spiritual practices, meditation, yoga, t'ai chi, qigong, support group, and distant healing are among commonly practiced MBCTs to relieve stress and to improve quality of life (QoL). ^1,2 The emotional impact of cancer diagnosis causes a great deal of distress for which patients seek numerous alternative ways to cope with cancer. In recent years, considerable attention has been given to recognizing the role of MBCTs in the Malaysian health care system. MBCTs such as hypnotherapy and psychotherapy are referred as mind–body–soul therapies and are offered by the Traditional and Complementary Medicine (T&CM) division under the Ministry of Health, Malaysia. ³ To investigate the prevalence of MBCTs use and to compare the Health-Related Quality of Life (HRQoL) of MBCTs users and nonusers, we undertook a survey among 393 patients with cancer between August and November 2011. MBCTs use was extracted after the analysis from a more comprehensive study on complementary and alternative medicines (CAM) use among patients with cancer. Those reported to use CAM other than MBCTs were labeled as MBCTs nonusers and vice versa. Less than half of participants (184; 46.8%) reported the use of different types of CAM. Among the CAM users, 75 (40.8%) of the participants self-reported using MBCTs. The majority of the MBCTs users were female (60/75, p=0.01), and were Muslims of Malay ethnicity (46/75). Sociodemographic factors including age (r_s=0.15, p=0.03) and monthly household income (r_s=−0.25, p<0.001) were significantly correlated with MBCTs use. Prayers for health reasons were the most frequent (51, 27.7%) MBCT, followed by spiritual practices (20, 10.8%), meditation (11, 5.9%), t'ai chi (7, 3.8%), music therapy (4, 2.1%), yoga (3, 1.6%), qigong (1, 0.5%), hypnotherapy (1, 0.5%), and Reiki (1, 0.5%). Approximately 21.3% (16/75) reported spending an average of 50–100 MYR (Malaysian Ringgit) per month on MBCTs (Table 1). The HRQoL was assessed using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). ⁴ On the functional scale, we found significant differences in physical (p=0.035), role (p=0.021), emotional (p=0.011), cognitive (p=0.001), and social (p=0.024) domains between MBCTs users and nonusers. For the symptoms scale, only fatigue (p=0.01), nausea and vomiting (p=0.04), pain (p=0.031) and insomnia (p=0.01) were significantly different among MBCTs users and nonusers. No significant difference was found in global health status scores between MBCTs users and nonusers (p=0.83). MBCTs users show significant poor scores on functional and symptoms scales as compare to MBCTs nonusers. The result supports the assumption that patients with cancer suffer a great deal of functional and psychologic stress. Based on this study, recommendations can be made to evaluate the potential role of MBCTs in cancer care. Incorporating MBCTs to complement conventional cancer therapies may help to address the emotional and psychologic needs of patients with cancer. As different types of MBCTs have been listed in the national T&CM policy, it is important that controlled clinical trials be carried out to evaluate their beneficial effects in cancer care.