Exploring the potential of the traditional Indian system of medicine, Ayurveda, for developing an evidence-based integrative model of cancer care in elderly patients with cancer.
Authors: Yogesh Narayan Bendale, Avinash Kadam, Poonam Birari-Gawande, Anandrao Patil, Dhanashri Ingale
Journal: Journal of Clinical Oncology (2024)

e13527 Background: Available evidence suggests that age is a deterrent to accepting cancer-directed treatment, with up to 38% of advanced-stage elderly cancer patients declining conventional anticancer therapy. Such patients opt for various complementary and alternative medicine (CAM). Considering the paucity of available evidence about CAM, it is necessary that the outcomes of CAM in elderly cancer patients should be studied and an evidence-based integrated model for cancer care should be developed. In the present study, we evaluated various characteristics and outcomes of elderly cancer patients from India who voluntarily opt for Ayurveda cancer therapy, either after having a persistent disease after completing conventional therapies or declining conventional therapy. Methods: This observational study was conducted on the elderly population (age&gt; 65 years) approaching treatment at our specialty Ayurveda cancer clinic in India. Data about demography, comorbidity, and efficacy outcome variables like QoL (FACT-G), Performance status (ECOG), anxiety and depression (HADS) was obtained through chart review based on the computerized database of patients who approached treatment between years 2020 to 2023. This being a preliminary proof of concept study the obtained data was subjected to per protocol analysis for avoiding the effect of various confounding variables which can lead to dropouts and poor compliance. As such, study analysis includes only those patients who completed at least 180 days of treatment with more than 80% compliance to the therapy for at least 6 months. Results: From database of 1010 elderly cancer patients, data from 172 patients (92 males and 80 females) who fulfilled the eligibility criteria was selected. Amongst the total sample size, 131 patients were of stage III and IV. The number of patients with uncontrolled hypertension, uncontrolled diabetes, and a history of cardiovascular accidents was 45 (26.1%), 83 (48.2%) and 8 (4.6%) respectively. More than one comorbidity was present in 70 patients (40.6%), whereas 64 patients (37%) patients voluntarily refused anticancer therapies. The duration of treatment was 459.58 (±246.89) days. At the end of 90 and 180 days, a significant improvement was observed in Qol, Performance status, depression, and anxiety (all P&gt;0.01). Conclusions: This study suggests that amongst the elderly Indian cancer patients who opt for Ayurveda therapy, around 38% of them decline conventional therapy whereas others opt for Ayurveda therapy after completing conventional anti-cancer therapies. Ayurveda therapy has been shown to improve health-related Quality of life, performance status, anxiety, and depression. This finding warrants further prospective pragmatic studies which can act as a basis to develop an evidence-based integrative model for cancer care in the elderly population.