{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T14:55:57Z","timestamp":1780671357339,"version":"3.54.1"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006260","name":"Technion - Israel Institute of Technology","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006260","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Integrative complementary medicine (ICM) combines complementary therapies with conventional supportive and palliative care to address quality of life (QoL). Diabetes mellitus (DM) is prevalent among patients with cancer and has been associated with worse health-related QoL. We examined the impact of an ICM program on QoL-related concerns among patients being treated for cancer, with vs. without DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective, controlled and pragmatic study examined a 6-week ICM program, comparing DM to non-DM patients using the ESAS (Edmonton Symptom Assessment Scale) and EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) tools. The threshold for statistical significance was established at a\n                      <jats:italic>P<\/jats:italic>\n                      -value of less than 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 671 patients, 135 (20%) had DM, with similar baseline QoL-related concerns (pain, fatigue, gastrointestinal and emotional concerns) in both groups. DM patients (vs. non-DM) responded significantly less on drowsiness on ESAS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.047); and emotional functioning on EORTC (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.017). Compared to baseline, the non-DM group showed significant improvement in fatigue and sleep quality (on ESAS and EORTC;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), while the DM group did not show any improvement for these concerns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with cancer and DM showed a less significant response to ICM treatments when compared to non-DM patients, emphasizing the need for identifying this sub-population of patients while creating specialized ICM programs tailored to their needs. Future research should focus on exploring the impact of ICM programs on patients with both DM and cancer.<\/jats:p>\n                    <jats:p>Trial registration<\/jats:p>\n                    <jats:p>ClinicalTrials.gov NCT01860365, 2013-05-21.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-10511-6","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T04:56:31Z","timestamp":1773723391000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of integrative medicine on quality of life in patients with diabetes mellitus and cancer"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3588-0338","authenticated-orcid":false,"given":"Sameer","family":"Kassem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orit","family":"Gressel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Samuels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nili","family":"Stein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Glaser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran","family":"Ben-Arye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"10511_CR1","doi-asserted-by":"publisher","first-page":"S137","DOI":"10.1210\/clinem\/dgae587","volume":"110","author":"JE Blanchette","year":"2025","unstructured":"Blanchette JE, Paquin F, Dobbs BN et al (2025) Incorporating complementary therapies into diabetes care. J Clin Endocrinol Metab 110:S137\u2013S146. https:\/\/doi.org\/10.1210\/clinem\/dgae587","journal-title":"J Clin Endocrinol Metab"},{"key":"10511_CR2","doi-asserted-by":"publisher","first-page":"15","DOI":"10.2337\/diacare.29.01.06.dc05-1448","volume":"29","author":"D Garrow","year":"2006","unstructured":"Garrow D, Egede LE (2006) Association between complementary and alternative medicine use, preventive care practices, and use of conventional medical services among adults with diabetes. Diabetes Care 29:15\u201319. https:\/\/doi.org\/10.2337\/diacare.29.01.06.dc05-1448","journal-title":"Diabetes Care"},{"key":"10511_CR3","doi-asserted-by":"publisher","first-page":"1986","DOI":"10.1002\/ijc.22532","volume":"120","author":"LV van de Poll-Franse","year":"2007","unstructured":"van de Poll-Franse LV, Houterman S, Janssen-Heijnen MLG et al (2007) Less aggressive treatment and worse overall survival in cancer patients with diabetes: a large population based analysis. Int J Cancer 120:1986\u20131992. https:\/\/doi.org\/10.1002\/ijc.22532","journal-title":"Int J Cancer"},{"key":"10511_CR4","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-4-17","volume":"4","author":"SL Bowker","year":"2006","unstructured":"Bowker SL, Pohar SL, Johnson JA (2006) A cross-sectional study of health-related quality of life deficits in individuals with comorbid diabetes and cancer. Health Qual Life Outcomes 4:17. https:\/\/doi.org\/10.1186\/1477-7525-4-17","journal-title":"Health Qual Life Outcomes"},{"key":"10511_CR5","doi-asserted-by":"publisher","first-page":"144","DOI":"10.3322\/caac.21706","volume":"72","author":"JJ Mao","year":"2022","unstructured":"Mao JJ, Pillai GG, Andrade CJ et al (2022) Integrative oncology: addressing the global challenges of cancer prevention and treatment. CA Cancer J Clin 72:144\u2013164. https:\/\/doi.org\/10.3322\/caac.21706","journal-title":"CA Cancer J Clin"},{"key":"10511_CR6","doi-asserted-by":"publisher","first-page":"194","DOI":"10.3322\/caac.21397","volume":"67","author":"H Greenlee","year":"2017","unstructured":"Greenlee H, DuPont-Reyes MJ, Balneaves LG et al (2017) Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin 67:194\u2013232. https:\/\/doi.org\/10.3322\/caac.21397","journal-title":"CA Cancer J Clin"},{"key":"10511_CR7","doi-asserted-by":"publisher","first-page":"2647","DOI":"10.1200\/JCO.2018.79.2721","volume":"36","author":"GH Lyman","year":"2018","unstructured":"Lyman GH, Greenlee H, Bohlke K et al (2018) Integrative therapies during and after breast cancer treatment: ASCO endorsement of the SIO clinical practice guideline. J Clin Oncol 36:2647\u20132655. https:\/\/doi.org\/10.1200\/JCO.2018.79.2721","journal-title":"J Clin Oncol"},{"key":"10511_CR8","doi-asserted-by":"publisher","first-page":"3998","DOI":"10.1200\/JCO.22.01357","volume":"40","author":"JJ Mao","year":"2022","unstructured":"Mao JJ, Ismaila N, Bao T et al (2022) Integrative medicine for pain management in oncology: society for integrative oncology-ASCO guideline. J Clin Oncol 40:3998\u20134024. https:\/\/doi.org\/10.1200\/JCO.22.01357","journal-title":"J Clin Oncol"},{"key":"10511_CR9","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1200\/JCO.24.00541","volume":"42","author":"JE Bower","year":"2024","unstructured":"Bower JE, Lacchetti C, Alici Y et al (2024) Management of fatigue in adult survivors of cancer: ASCO-society for integrative oncology guideline update. J Clin Oncol 42:2456\u20132487. https:\/\/doi.org\/10.1200\/JCO.24.00541","journal-title":"J Clin Oncol"},{"key":"10511_CR10","doi-asserted-by":"publisher","first-page":"4562","DOI":"10.1200\/JCO.23.00857","volume":"41","author":"LE Carlson","year":"2023","unstructured":"Carlson LE, Ismaila N, Addington EL et al (2023) Integrative oncology care of symptoms of anxiety and depression in adults with cancer: society for integrative oncology-ASCO guideline. J Clin Oncol 41:4562\u20134591. https:\/\/doi.org\/10.1200\/JCO.23.00857","journal-title":"J Clin Oncol"},{"key":"10511_CR11","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1007\/s00432-017-2368-8","volume":"143","author":"I Shalom-Sharabi","year":"2017","unstructured":"Shalom-Sharabi I, Samuels N, Lavie O et al (2017) Effect of a patient-tailored integrative medicine program on gastro-intestinal concerns and quality of life in patients with breast and gynecologic cancer. J Cancer Res Clin Oncol 143:1243\u20131254. https:\/\/doi.org\/10.1007\/s00432-017-2368-8","journal-title":"J Cancer Res Clin Oncol"},{"key":"10511_CR12","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2024.107857","volume":"193","author":"E Ben-Arye","year":"2024","unstructured":"Ben-Arye E, Gressel O, Lifshitz S et al (2024) Integrative oncology for patients with lung cancer: a prospective pragmatic controlled trial. Lung Cancer 193:107857. https:\/\/doi.org\/10.1016\/j.lungcan.2024.107857","journal-title":"Lung Cancer"},{"key":"10511_CR13","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1177\/082585979100700202","volume":"7","author":"E Bruera","year":"1991","unstructured":"Bruera E, Kuehn N, Miller MJ et al (1991) The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care 7:6\u20139. https:\/\/doi.org\/10.1177\/082585979100700202","journal-title":"J Palliat Care"},{"key":"10511_CR14","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1093\/jnci\/85.5.365","volume":"85","author":"NK Aaronson","year":"1993","unstructured":"Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365\u2013376. https:\/\/doi.org\/10.1093\/jnci\/85.5.365","journal-title":"J Natl Cancer Inst"},{"key":"10511_CR15","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1007\/s11764-015-0486-3","volume":"10","author":"PAJ Vissers","year":"2016","unstructured":"Vissers PAJ, Falzon L, van de Poll-Franse LV et al (2016) The impact of having both cancer and diabetes on patient-reported outcomes: a systematic review and directions for future research. J Cancer Surviv 10:406\u2013415. https:\/\/doi.org\/10.1007\/s11764-015-0486-3","journal-title":"J Cancer Surviv"},{"key":"10511_CR16","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1002\/ijc.34268","volume":"152","author":"A Mailliez","year":"2023","unstructured":"Mailliez A, Ternynck C, Duhamel A et al (2023) Diabetes is associated with high risk of severe adverse events during chemotherapy for cancer patients: a single-center study. Int J Cancer 152:408\u2013416. https:\/\/doi.org\/10.1002\/ijc.34268","journal-title":"Int J Cancer"},{"key":"10511_CR17","doi-asserted-by":"publisher","first-page":"7655","DOI":"10.1007\/s00520-022-07189-x","volume":"30","author":"AS Kleckner","year":"2022","unstructured":"Kleckner AS, Kleckner IR, Culakova E et al (2022) The association between cancer-related fatigue and diabetes from pre-chemotherapy to 6 months post-chemotherapy. Support Care Cancer 30:7655\u20137663. https:\/\/doi.org\/10.1007\/s00520-022-07189-x","journal-title":"Support Care Cancer"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-10511-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-026-10511-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-10511-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T06:40:59Z","timestamp":1776235259000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00520-026-10511-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10511"],"URL":"https:\/\/doi.org\/10.1007\/s00520-026-10511-6","relation":{},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"value":"0941-4355","type":"print"},{"value":"1433-7339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"14 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of the Carmel Medical Center in Haifa, Israel (0024-09-CMC); and registered at ClinicalTrials.gov (NCT01860365).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Participation in this study was voluntary and verified by participants\u2019 consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All authors consented to publication of the present manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"335"}}