S3 guideline “Complementary medicine in the treatment of oncological patients” was published for the first time

27.07.2021 11:41

The Oncology Guideline Program has developed the S3 guideline “Complementary Medicine” under the leadership of the German Cancer Society (DKG), the German Society for Hematology and Medical Oncology (DGHO), the German Society for Gynecology and Obstetrics (DGGG) and the German Society for Radiation Oncology (DEGRO). in the treatment of oncological patients”. 155 recommendations or statements were formulated that offer important recommendations and information on the available evidence not only to oncologists, but also to all general practitioners and specialists who accompany and treat people affected by cancer.

In the S3 guidelines, the most important complementary and alternative medicine methods, procedures and substances that are currently used or offered to patients in Germany are evaluated according to the criteria of evidence-based medicine. In the S3 guideline “Complementary medicine in the treatment of oncological patients” these were divided into four thematic blocks:

• Medical systems
• Mind-body procedure
• Manipulative body therapies
• Biological therapies

The aim is to create a precise reference work for everyone working in oncology (doctors, nurses, psychologists and other professional groups) that makes it possible to answer questions from those affected by cancer in an evidence-based manner and, if necessary, to actively make recommendations or advise on specific measures Procedure not recommended.

The extensive documentation in this guideline shows that there is little scientific data for most methods of complementary medicine. In addition, many studies have a small number of test subjects or lack an adequate comparison group. Such studies must be viewed methodologically critically and the interpretation of the results is therefore limited. While some studies show that the use of complementary medicine methods can have a positive effect on certain side effects of oncological therapy or on the quality of life of those affected, only a few studies have systematically recorded data on potential harm in the form of side effects and interactions of complementary or alternative methods.

However, the consideration of potential drug interactions is particularly important in oncology: Interactions can, among other things, lead to a reduction in the effectiveness of tumor therapy or supportive therapy or, conversely, can result in increased side effects, e.g. B. by increasing bioavailability. There are also side effects, e.g. B. of phytotherapeutics, which can manifest itself in organ toxicity. These may not be interpreted as a primary consequence of the complementary therapy, but rather as a consequence of the tumor therapy. All of this can lead to treatment decisions that have significant consequences for those affected by cancer, for example: B. Tumor therapies can be changed, reduced or discontinued. The frequency of interactions is difficult to determine because there are too few systematic records on this topic. There are only a few studies in which the complementary agents reported by patients were compared in databases for potential interactions with tumor therapy. However, these studies show that such interactions are likely in a third of all patients. There is also another third for whom interaction seems at least possible.

The guideline therefore recommends that all people affected by cancer should be asked as early as possible and repeatedly over the course of the process about the current and planned use of complementary measures, that if they are interested, they should be referred to reliable sources of information and that possible interactions between these applications and cancer therapy should be specifically pointed out.

A total of 72 volunteer experts from 46 specialist societies and organizations were involved in the S3 guideline “Complementary medicine in the treatment of oncological patients”. The guidelines are available on this website: www.leitlinienprogramm-onkologie.de/leitlinien/komplementaermedizin/