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Federico Antill ón, MD, PhD, MMM fantillo@ufm ayuvi.gt

The use of Traditional Complementary/Alternative Modalities (TCAM) among children with cancer residing in Guatemala. Federico Antill ón, MD, PhD, MMM fantillo@ufm.edu www.ayuvi.org.gt. Area 130,890 km 2 Po pulation 13,276,517 0-14 years 40% Median age 19.4 years

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Federico Antill ón, MD, PhD, MMM fantillo@ufm ayuvi.gt

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  1. The use of Traditional Complementary/Alternative Modalities (TCAM) among children with cancer residing in Guatemala Federico Antillón, MD, PhD, MMM fantillo@ufm.edu www.ayuvi.org.gt

  2. Area 130,890 km2 Population 13,276,517 0-14 years 40% Median age 19.4 years Birth Rate 28/1000 persons Infant mortality 27.8/1000 live born Life expectancy 70.3 years Fertility 3.47 born/women Literacy 70% GDP per capita $ 5,300 Mobile phones 10.3 million Internet users 1.32 million HIV prevalence 0.8% *CIA World Fact Book September 2009

  3. Background • ~300+ children newly diagnosed with cancer are treated each year at the Unidad Nacional de Oncologia Pediatrica • TCAM use is prevalent among children with cancer in other countries • Disparity in cure rates between low and high-income countries is primarily attributed to poverty delays in seeking medical help, and abandonment of conventional treatment • Identifying preventable causes of barriers is important in reducing the mortality of childhood cancer in low-income countries • A greater understanding of TCAM use may shed light on these issues

  4. Objectives • Investigate the prevalence of TCAM use in children diagnosed with cancer in Guatemala • Collect descriptive data on the reasons for TCAM use • Collect information on types of TCAM

  5. Patients and Methods • Institutional review board approval was obtained for a survey of TCAM • Upon consent, the survey was administered in a face-to-face interview • The survey gathered demographic information as well as attempted to determine the frequency and type of TCAM utilized including: • (1) diet, nutrition, and lifestyle changes, • (2) psychological and behavioral mind/body therapies, including spiritualism and prayer, • (3) traditional and ethnomedical systems of medical practice, • (4) manual healing and touch therapy, • (5) pharmacologic and biologic treatment, • (6) biomagnetic applications • (7) herbal medicine

  6. Patients and Methods • A survey forms the basis of this observational study • Columbia University Health Questionnaire for Children and Parents • The survey is modeled upon two surveys on CAM use in children with cancer conducted by the Division of Pediatric Oncology, Columbia University.

  7. Results: TCAM • 40 parents were interviewed from May 2008-March 2009 • Median age: 9.5 years (1-18) • Ethnicity: 82.5% Mestizo, 17.5% Mayan • Diagnosis • Acute leukemias (65%), • Lymphomas (15%), • Solid tumors (10%) • Other (10%).

  8. Results: TCAM • 90% of patients reported TCAM use • 47.5% used dietary modifications • 50% herbal supplements • 22.5% juicing • 12.5% bioenergetics • 7.5% topical therapies • 17.5% manual healing • 12.5% nutritional supplements • 2.5% detoxification • 5% mind/body program

  9. Results: TCAM • Reasons for using TCAM were • immune support (40%) • improve nutrition (35%) • improve hemoglobin (17.5%) • cure (15%) • overall strengthening (15%) • gastrointestinal relief (10%) • relaxation (7.5%) • blocking negative energies (2.5%).

  10. Results: TCAM • 74% of TCAM therapies were described very effective • 11% somewhat effective • 8% not effective • Sixteen (40%) patients informed their physician of TCAM use • Only 25% of all reported TCAM modalities were disclosed. • Nutrition/juicing and dietary modifications accounted for 67% of disclosures, while only 24% of herbal supplements were disclosed.

  11. Conclusions • TCAM is widespread among pediatric oncology patients in Guatemala. • While patients readily disclosed nutrition interventions, they were less likely to disclose the use of herbal therapies. • Focusing on the integration of TCAM in this patient population may open the lines of communication and understanding. • The use of TCAM in conjunction with trust in conventional treatments may offer this group of patients improved outcomes

  12. Federico Antillon1 Nader El-Mallawany5 Silvia Rivas3 Elena Ladas5 Sue Kaste4 Deborah Hughes5 Kara Kelly2 (1) Unidad Nacional de Oncolgia Pediatrica, Guatemala (2) Columbia University, Pediatrics, New Yor, United states (3) Unidad Nacional de Oncologia Pediatrica, Palliative, Guatemala, Guatemala (4) St. Jude Childrens Research Hospital, Division of Diagnostic Imaging, Memphis, United states (5) Columbia University, Integrative Therapies Program for Children with Cancer, New York, United states Collaborating persons

  13. ¡Thanks! por estos 10 años de amor y solidaridad

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