Use of dietary and herbal supplements (DHS) is common among patients with chronic lymphocytic leukemia (CLL), but data in the era of targeted therapies are limited. We conducted a national prospective survey of Hebrew-speaking adults with CLL in Israel (2025), assessing DHS prevalence, patterns of use, sources of recommendation, reporting to hematologists, and patient expectations. Multivariate logistic regression identified factors associated with DHS use. Among 267 respondents, 49% reported current or past DHS use. Use was independently associated with female gender and residence in Central Israel. Most DHS were used for general or 'immune' strengthening, with high perceived effectiveness. Hematologists were the main advisors for 42% of DHS use, and 65% of patients disclosed DHS use to their physician. DHS use is common among patients with CLL and involves relatively high patient-hematologist communication, underscoring the need for evidence-based integrative counseling.

CONTEXT:Implementing clinical integrative oncology (IO) guidelines requires training healthcare providers (HCPs). OBJECTIVES:We developed and preliminarily validated a questionnaire assessing baseline core clinical IO competencies (CCC-IO) among HCP trainees. METHODS:The CCC-IO questionnaire was developed by an international multidisciplinary team and examined for reliability and validity in a cross-sectional study, nested within a randomized controlled trial of a national competency-based medical education (CBME) IO training program. Pretraining questionnaires, administered at baseline following randomization, examined 20 IO-related trainee-perceived competencies from five domains: Risks/Contraindications, Intercultural Challenges, Data Mining for herbal medicine, Anxiety Relief using Mind-Body Practices, and Acupressure for Pain Relief. Trainees were randomized to a CBME-focused training group, a Clerkship group, observing clinical IO practices, and candidates for future training (controls). Reliability was tested by Cronbach's alpha, validity using preliminary exploratory factor analysis (EFA). RESULTS:A total of 109 pretraining questionnaires were completed (CBME group, 33; Clerkship, 30; controls, 46), with no between-group differences for sociodemographic characteristics, total domain scores, and overall scores for all 20 IO competencies. EFA identified five domains, with Anxiety Relief providing the highest explanatory rate (52.39%). Cronbach's alpha for each domain in all groups ranged from 0.78 to 0.97, with a value of 0.95 for the entire cohort (CBME group, 0.94; Clerkship group, 0.92; controls, 0.97). CONCLUSION:The CCC-IO tool showed construct validity and high reliability, supporting its use for baseline assessment of HCP trainees' clinical competencies in an intensive national IO training program. Future research needs to examine the tool's use in other palliative care settings, cultures, and languages.

Introduction: Lymphoma has recovery rates above 60%, but many survivors experience impaired quality-of-life (QoL) requiring survivorship care. This study evaluated the role of an integrative oncology (IO) clinic in managing lymphoma survivors. Methods: In this exploratory preference-based controlled trial, adults in remission after lymphoma treatment were allocated to two groups: those attending the IO survivorship clinic (intervention) and those declining (control). The intervention included complementary medicine, spiritual, and social support, delivered weekly for up to 6 months in addition to standard follow-up. The primary outcome was QoL improvement (EQ-5D-5L index). Secondary outcomes included symptom relief (MYCAW), cognitive function, and perceived control. Results: Twenty-nine patients were enrolled: 15 in the intervention and 14 in the control group. Over the first 3 months, a significant time × group interaction in EQ-5D-5L scores favored the intervention (p = 0.005), reflecting superior QoL trajectory. MYCAW concerns also improved significantly in the intervention group across 6 months (p = 0.005 and p = 0.03). At 3 months, FACT Cog-Oth scores were significantly higher in the intervention arm (p = 0.01), indicating better “other” cognitive functions (e.g., memory, clarity, confusion). To note, adherence to IO mainly decreased after 3 months. Conclusion: In this exploratory preference-based study, an IO survivorship clinic for lymphoma survivors was associated with improvements in QoL, especially for adherent patients. Given the preference-based design, these findings should be interpreted cautiously and viewed as hypothesis-generating rather than confirmatory. Further studies are warranted to evaluate long-term benefits and sustainability of this approach.

Background: In-hospital palliative end-of-life care (EOLC) is highly challenging. Trust and confidence between caregivers and the medical staff are crucial for reducing stress and enabling relatives to better accept this difficult situation. Therefore, assessing caregiver satisfaction of EOLC is highly important. Currently, the validated FAMCARE-2 questionnaire serves this purpose. In this study, we performed validation of FAMCARE-2 into Hebrew in order to facilitate EOLC assessment among Hebrew-speaking caregivers. Methods: Following translation and backward translation by certified translators, the questionnaire was distributed to a multidisciplinary team comprising 10 experts who specialize in EOLC. They ranked the questionnaire on a Likert scale of 1 (very insufficient) to 7 (excellent) for clarity, internal validity, and structural validity. The questionnaire was then distributed twice in a 24-48-hour interval to 124 primary caregivers of dying patients hospitalized in a single internal medicine ward, for test-retest analysis. Finally, factor analysis was performed to allow for continued validation. Results: Backward English translation resulted in a version similar to the original English version. Expert opinion on clarity, internal and structural validity varied, with means ranging from 5.7 to 6.95. Cronbach's alpha was 0.968, indicating a high degree of internal consistency, and Spearman's rho coefficients for test-retest analyses of the different questions varied from 0.727-0.845 (strong correlation). Factor analysis revealed 2 categories of questions, with a Kaiser-Meyer-Olkin adequacy of 0.932 and significant Bartlett's test of sphericity (p < 0.001), indicating appropriate factor analysis. Conclusions: The Hebrew version of FAMCARE-2 seems to be a valid and culturally adapted tool for examining satisfaction with EOLC.

Complementary and integrative medicine (CIM) use is increasing among patients with hematologic diseases, yet determinants of CIM receipt in hematology settings are poorly characterized. We aimed to characterize hematologic patients receiving CIM. Adults with ≥5 annual visits in a tertiary hematology division were included in a retrospective study (2021-2024). Electronic medical record data were analyzed. Staff completed a questionnaire assessing referral practices. The primary outcome was receipt of CIM. Predictors of CIM use and adherence were analyzed with multivariable logistic and Poisson regression analyses. Of 391 patients, 138 (35%) received CIM, mainly younger, female, and hemato-oncologic patients. Among 23 staff respondents, 56% referred 1-5 patients monthly. Pain, anxiety/depression, and neuropathy were main referral indications, with high perceived effectiveness and no reported contraindications. CIM receipt is common in hematologic malignancies and associated with demographic and disease-related factors. Structured referral pathways and culturally adapted communication may enhance integrative hematology care.

OBJECTIVES:Supportive and palliative care include non-oncology settings where patients suffer from pain and quality of life-related concerns. Integrative medicine plays important roles in supportive care and symptom management, including Integrative Obstetric (IOb) programmes within peri-partum settings. Multidisciplinary approaches may help nurse-midwives and obstetricians improve patient care and associated outcomes. This study presents a national perspective on IOb programmes in Israel. METHODS:A qualitative research methodology was codesigned by the Society for Complementary Medicine and Society of Maternal-Fetal Medicine, Israel Medical Association. A questionnaire with 17 open-ended questions was distributed throughout obstetrics and gynaecology departments across Israel. Respondent narratives were qualitatively analysed using ATLAS.Ti software for systematic coding. RESULTS:22 senior obstetricians and IOb directors across 11 centres with IOb programmes completed the questionnaire. Core themes considered essential for the design and operation of IOb programmes included (1) determining major goals and indications for referral, primarily pain and anxiety; (2) targeting patients most likely to benefit; (3) identifying barriers and enablers to implementation and communication with the obstetric team; (4) designing the referral process and (5) documenting outcomes and safety of the IOb intervention in electronic medical files. CONCLUSIONS:Designing and implementing IOb models of care that effectively support holistic symptom management within obstetric settings requires identifying barriers and enablers and establishing effective communication between obstetric and integrative medical teams. Further research should explore other multidisciplinary models of IOb care and structured referral development and testing while assessing risks and effectiveness.

Background:Preoperative anxiety is common. To date, no randomized controlled trial has examined the effectiveness of reflexology in reducing preoperative anxiety in patients undergoing elective laparoscopic cholecystectomy. Methods:A randomized, single blinded, interventional trial was conducted with 300 patients undergoing elective laparoscopic cholecystectomy, comparing the following three groups: controls receiving standard-of-care (SoC) only (group 1); intervention group receiving reflexology and SoC (group 2); and a group receiving sham reflexology and SoC (group 3). The primary outcome was the mean difference between the three groups in visual analog scale for anxiety (VAS-A). The secondary outcome was a similar analysis confined to patients experiencing baseline moderate-to-high anxiety. In all groups, level of preoperative anxiety was evaluated at entry and exit from the holding room area (HRA). The evaluation was carried out using the VAS-A questionnaire. The study was registered at clinicaltrials.gov (NCT01733771). Results:101 patients were randomly assigned to the reflexology group, 99 to the sham reflexology arm, and 100 received SoC alone. In all groups, SoC included anxiolytics in 25% of patients received about 2 h before the operation. Baseline anxiety (at entry to HRA) was similar in all groups, averaging 5.3. Between-group analysis comparing the reflexology and sham groups detected 0.8 point difference on 0-10 VAS scale in favor of the reflexology group (p = 0.022). Subgroup analysis of patients with moderate to high level of anxiety (VAS-A>4) at baseline (consisting of 75% of study participants), indicated 1.3 points difference (p = 0.023). Conclusions:The study findings suggest that reflexology treatments have a small, yet significant advantage over sham reflexology and over standard-of-care in reducing preoperative anxiety, in patients with moderate-to-high levels of anxiety. Clinical trial registration:https://clinicaltrials.gov/study/NCT01733771?tab=results, Identifier: NCT01733771.

Context and objectives Integrative oncology (IO) programs are being implemented in supportive and palliative cancer care services worldwide, though research on the design of IO training programs is limited. This paper explores perspectives of trainees undergoing a national, multi-disciplinary IO training program in Israel, through their pre- and post-training narratives. Methods Trainees underwent a 110-hour IO training program focused on symptom management, through online and in-person instruction. Qualitative analysis was performed on the written narratives of program trainees, addressing pre-training expectations and post-training outcomes. A digital questionnaire with open-ended questions was used, with free-text reflective narratives analyzed using ATLAS.Ti software for systematic coding. Results Of the 68 trainees participating in the program, 62 provided pre-course assessment; and 44 completed training, of which 33 provided post-training narratives. Pre-training themes included an expectation for enhancing communication-related competencies, primarily with patients but also with other healthcare professionals. Post-training narratives highlighted themes which included forming a professional identity as IO providers; enhanced collaboration within multidisciplinary teams; acquisition of practical competencies across diverse IO modalities; sharing clinical strategies and knowledge; and experiences of both personal and professional growth. Conclusions Trainees in this national multidisciplinary IO training program expressed pre-training expectations focused primarily on communication skills; and post-training reflections emphasizing professional development, team-based practice, and integration of IO into palliative care. These findings suggest that IO training supports the transition from theoretical learning to practical clinical competencies. Further research is warranted to evaluate long-term symptom management and communication-related outcomes of combined IO and palliative care programs.

IntroductionDietary and herbal supplements (DHS) are used by 30% of hematological patients despite safety concerns. A service of integrative safety consultations was implemented in the Hematological Institute of Bnai Zion Medical Center. This study examines the effect of such consultation on DHS safety in hematologic patients.MethodsPatients from the Hematological Institute were referred to the "integrative safety consultation team." The naturopath recommended DHS according to symptoms disclosed, and safety analysis was performed by the clinical pharmacist. Symptom and side effect assessment was repeated in each follow-up visit to evaluate DHS safety.ResultsBetween 2021 and 2024, 42 patients were included. Twenty-eight (67%) used DHS before the consultation. Employed patients were more likely to use DHS (p = 0.02). A total of 176 potential interactions were described in 30 patients. Most interactions were theoretical (45%), with a pharmacodynamic additive mechanism (59%), involving herbs (82%) and antihypertensives (26%) or anticoagulants (23%). One side effect was disclosed following Hericium prescription to a patient that developed leg edema and neuropathic pain exacerbation (probable causality according to the Naranjo scale and FDA algorithm). Patients' concerns improved from the first to the second visit. In 21% of the patients who used DHS before the consultation, DHS was documented in the medical chart by the time of first consultation, all of them pertaining to vitamins or minerals.ConclusionConsideration of DHS in the management of patients with hematological conditions requires a systematic and comprehensive process to ensure patient safety and wellbeing. An integrative safety naturopathic-pharmacologic consultation can address such needs.

Background: Acute skin infections, like cellulitis or erysipelas, are common and respond well to antibiotic treatment. However, complete resolution of the inflammatory process is often slow and associated with prolonged pain and reduced mobility. Several studies have indicated that acupuncture may effectively treat inflammatory skin diseases. Objectives: To evaluate the efficacy of acupuncture for treating cellulitis in patients hospitalized in internal medicine departments. Methods: In this pilot randomized sham-controlled trial, patients hospitalized with cellulitis in internal medicine departments were randomized to acupuncture or sham acupuncture, in addition to standard care. The primary outcome was the degree of improvement in the cellulitis score at day 4 of hospitalization. Secondary endpoints included patient pain self-assessment and local and systemic inflammatory signs. Results: The study comprised 29 patients; 15 treated with acupuncture, 14 by a sham procedure. At day 4, patients in the acupuncture arm had an improved cellulitis score (4.1 +/- 2.8) compared with the sham-control group (7.9 +/- 3.3, P = 0.003). Pain intensity based on the Visual Assessment Scale was lower in the acupuncture group 3.8 +/- 2.7 vs. 6.3 +/- 2.8; P= 0.023. There was no difference in the rate of leukocyte change. However, C-reactive protein significantly decreased to 27.0 +/- 22.1 mg/L at day 4 following acupuncture compared to 63.9 +/- 51.9 mg/L (P = 0.025). Conclusions: In our pilot study, we found acupuncture to be efficacious as an adjunctive therapy in the treatment of leg cellulitis. A large-scale trial on the effectiveness of acupuncture for skin infections is needed.

BackgroundPromoting the resilience of healthcare providers (HCP) is crucial during peaceful times and even more during national crisis. The outbreak of the war in Israel, Gaza strip, and Lebanon in October 2023 prompted the establishment of integrative medicine resilience clinics (IMRC) in three hospitals; incorporating evidence based integrative medicine (IM) modalities, for reducing emotional and physical concerns among HCP. Our objective was to explore the impact of the IMRC through narratives of IM practitioners who provided the treatments. To explore the impact of the IMRC through narratives of IM practitioners who provided the treatments.MethodsQualitative narrative research was based on in-depth interviews with 16 IM practitioners from IMRC’s in three hospitals.ResultsThe interviewees’ narratives revealed four spheres where the IMRC’s contribution is suggested: 1- IM practitioners conceived their work to be effective in improving HCP wellbeing; 2- they felt that HCP functioned more effectively and provided better patient care; 3- practitioners described feeling meaningful, and acknowledged in the healthcare organization; 4- the positive impact of IM on HCP and administrators, positions them as potential advocates for IM in public health.ConclusionIMRC for hospital HCP may have an important role in maintaining HCP resilience during wartime. These effects may also have ramifications on the recognition of the role of IM in public health during crisis and everyday times.

Context and objectives. To explore the feasibility of implementing the joint guideline on integrative medicine for pain management in oncology, published by the Society for Integrative Oncology (SIO) and the American Society of Clinical Oncology (ASCO), for integrative oncology (IO) services in supportive and palliative care. Methods. A qualitative research methodology was co -designed by the SIO-ASCO guideline committee, with the Society for Complementary Medicine, Israel Medical Association (IMA). A questionnaire with five open-ended questions exploring barriers and enablers to implementing the guideline was distributed to chairs and board members of nine IMA-affiliated medical societies; four deans of Israeli medical schools; and nurses from the Israeli Society for Oncology Nursing. Respondent narratives were qualitatively analyzed using ATLAS.Ti software for systematic coding. Results. Questionnaires were completed by 52 physicians and nurses from medical oncology, hematology, gynecological oncology, pediatric oncology, palliative medicine, pain, family medicine, internal medicine, and integrative medicine. The SIOASCO guidelines were endorsed by nine IMA-affiliated societies. The domains identified included the importance of guideline implementation in clinical practice; barriers and facilitators to implementation; practical aspects required for this implementation (e.g., IO training); clinical indications for referral; budget -related issues; and clinical and administrative models enabling practical implementation of the guideline. Conclusion. We found across-the-board consensus among the nine IMA-affiliated societies supporting the current guideline. This, while identifying potential facilitators and barriers in order to address the implementation of the SIO-ASCO guideline recommendations. Published by Elsevier Inc. All rights reserved.

OBJECTIVE:The present conflict in Israel has led to a surge in cases of acute stress disorder (ASD). The study examined a training program for integrative medicine (IM) providers working in supportive and palliative care settings, teaching clinical skills for treating ASD. METHODS:A 10-h online training program, designed by supportive care trained IM and mental health professionals was attended by a group of 32 IM providers. The impact of the course was assessed using pre- and post-training questionnaires, which underwent qualitative evaluation. Three open-ended questions addressed expectations from the program, anticipated barriers to combining IM with mental health interventions, and explored willingness for multi-disciplinary collaboration. A conventional content analysis was used, where coding categories are derived directly from the text data. Narratives were analyzed using ATLAS.ti software for systematic coding. RESULTS:Narrative themes identified within the group of 32 trainees included expectations regarding facilitating a multi-disciplinary integrative model of care, enriching the ASD-related clinical "toolbox," increasing the effectiveness of IM treatments, and reducing IM treatment-associated risks. Insights were provided for bridging communication gaps between IM practitioners and mental health providers, supporting the multi-disciplinary collaboration. CONCLUSIONS:ASD-focused training for IM practitioners may increase their level of clinical skills and advance collaboration with mental health providers. Future research examining the feasibility of the integrative model and its implementation in supportive care setting is warranted.

STUDY OBJECTIVE:The study examined a training program for integrative medicine (IM) providers, teaching clinical skills for treating acute stress disorder (ASD). METHODS:A 10-h online training program, designed by IM and mental health professionals, was attended by a group of 32 IM providers working in supportive and palliative oncology care. Pre- and post-course questionnaires assessed self-perceived levels of IM and mental health ASD-related skills (from 1, very low; to 7, very high). RESULTS:Most participants (25; 78%) completed pre- and post-study questionnaires, which showed an increase in post-course scores for the expectation that IM could reduce ASD-related pain (p = 0.004). Scores for self-assessed skill levels increased for treating gastro-intestinal symptoms and appetite (p = 0.039) and for dyspnea (p = 0.048). A borderline increase for arousal was observed (p = 0.063), with no increase with other arousal symptom cluster symptoms. CONCLUSIONS:The ASD-focused training program for IM practitioners was associated with an increase in self-perceived levels for related clinical skills quality of life-related concerns, primarily pain, appetite and dyspnea. Further research is needed to better understand the implications of the findings, and to explore the implementation of the learned skills in clinical practice.

CONTEXT AND OBJECTIVES:Cancer centers are increasingly providing complementary medicine as part of an emerging discipline termed 'integrative oncology' (IO). The present study explored factors associated with disparities in referral and adherence to a freely-provided IO program. METHODS:The databases of three oncology centers in northern Israel were searched retrospectively for chemotherapy-treated oncology patients eligible for referral by their oncology healthcare professionals to an integrative physician (IP) consultation. Demographic and cancer-related variables associated with the referral, and attendance by patients at the consultation were identified, as was adherence to the 6-week IO treatment program (high adherence, attending ≥4 IO treatment sessions; low adherence, 0-3 sessions). RESULTS:Of 4988 eligible patients, 1694 (34%) were referred to the IP consultation, with 1331 (78.6%) attending the consultation of which 766 (57.6%) were adherent to IO treatments. Multivariate analysis revealed lower referral rates among patients speaking primarily Arabic and Russian vs. Hebrew (OR = 3.0, 95% CI = 2.0-4.6, P < 0.0001); males vs. females (OR = 1.94, CI = 1.3-2.9, P = 0.001); those not reporting emotional distress (OR = 1.5, CI = 1.02-2.16, P = 0.037); and older age (OR = 1.04, CI = 1.03-1.06, P < 0.0001). Arabic and Russian-speaking patients were less likely to adhere to IO treatments (OR = 0.52, 95% CI = 0.32-0.83, P = 0.006). CONCLUSION:Patients' ethno-national origin and immigration status (primary language, Arabic and Russian), male gender and older age were associated with lower rates of referral to and attendance of the IP consultation, with reduced adherence to weekly IO treatments. These findings require further study to identify barriers toward diversity, equity and inclusion in IO care, increasing awareness among healthcare professionals regarding the benefits of these services for improving patient wellbeing.

Background: Inflammatory skin rash resulting from treatment with epidermal growth factor receptor inhibitors may cause physical and mental disabling to patients treated for their oncologic condition and may, in some cases, lead to the cessation of biological treatment. Case Report: In this case report, acupuncture treatment was provided to a patient with metastatic colorectal carcinoma who developed skin toxicity from panitumumab including rash, itching, and skin inflammation. Itching, infection, and inflammation symptoms improved significantly following acupuncture, subsequently relapsed following treatment cessation, and improved once again following reintroduction of acupuncture. Conclusion: Acupuncture may be effective in alleviating panitumumab-related skin inflammatory symptoms.

Objective To compare the effectiveness of acupuncture alone or with additional integrative oncology modalities for taxane-induced peripheral neuropathy-related symptoms in patients with gynecological and breast cancer. Methods The study was a prospective evaluation of patients undergoing twice-weekly treatments with either acupuncture alone (single-modality, group A) or with additional manual-movement and mind-body therapies (multimodality, group B), for 6 weeks. Symptom severity was assessed at baseline, 6 weeks, and 9 weeks using the Functional Assessment of Cancer Therapy-Taxane (FACT-Tax) tool; and von Frey perception thresholds. Additional symptoms were also assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Measure Yourself Concerns and Wellbeing (MYCaW) study tool. Results For the 120 participants (60 in each study arm), baseline to 6-week scores were similar in both groups for improved FACT-Tax physical wellbeing and scores for hand numbness/tingling; EORTC physical functioning and global health status; and MYCaW scores. FACT-Tax taxane subscales and scores for foot numbness/tingling improved only in group A (p=0.038), while emotional wellbeing FACT-Tax (p=0.02) and EORTC pain (p=0.005) improved only in group B. Group B showed greater improvement for FACT-Tax neuropathy-related concerns than group A at 24 hours (p=0.043) and 7 days (p=0.009) after the first treatment. Conclusion Acupuncture alone or with additional integrative oncology modalities may help reduce neuropathy-related symptoms. The single-modality group demonstrated greater improvement for foot numbness/tingling, and the multimodality group demonstrated improvement for pain and improved emotional wellbeing and neuropathy-related concerns in the first week of treatment. Trial registration number NCT03290976 .

The present study examined the impact of intraoperative acupuncture on anesthesia-related parameters in patients undergoing gynecological oncology surgery. Participants underwent preoperative integrative oncology (IO) touch/relaxation treatments, followed by intraoperative acupuncture (Group A); preoperative IO treatments without acupuncture (Group B); or standard care only (Group C). Mean arterial pressure (MAP), heart rate (HR), MAP variability (mean of MAP standard deviation), bispectral index (BIS), and calculated blood pressure Average Real Variability (ARV) were measured intraoperatively. A total of 91 patients participated: Group A, 41; Group B, 24; Group C, 26. Among patients undergoing open laparotomy, Group A showed lower and more stable MAP and HR compared to Group B, (MAP, p = 0.026; HR, p = 0.029) and Group C (MAP, p = 0.025). Mean BIS, from incision to suture closing, was lower in Group A (vs. controls, p = 0.024). In patients undergoing laparoscopic surgery, MAP was elevated within Group A (p = 0.026) throughout surgery, with MAP variability significantly higher in Group A (P = 0.023) and Group B (P = 0.013) 10 min post-incision (vs. pre-incision). All groups showed similar intraoperative and post-anesthesia use of analgesic medication. Intraoperative acupuncture was shown to reduce and stabilize MAP and HR, and reduce BIS in gynecology oncology patients undergoing laparotomy, with no impact on perioperative analgesic medication use. In the laparoscopic setting, intraoperative acupuncture was associated with elevated MAP. Further research is needed to explore the hemodynamic and BIS-associated benefits and risks of intraoperative acupuncture, and the impact on the use of analgesic drugs in response to these changes.

BackgroundTo explore the impact of acupuncture with other complementary and integrative medicine (CIM) modalities on chemotherapy‐induced peripheral neuropathy (CIPN) and quality of life (QoL) in oncology patients.MethodsIn this prospective, pragmatic, and patient‐preference study, patients with CIPN were treated with acupuncture and CIM therapies (intervention group) or standard care alone (controls) for 6 weeks. Patients in the intervention arm were randomized to twice‐weekly acupuncture‐only (group A) or acupuncture with additional manual‐movement or mind–body CIM therapies (group B). Severity of CIPN was assessed at baseline and at 6 weeks using the Functional Assessment of Cancer Therapy‐Taxane (FACT‐Tax) tool. Other QoL‐related outcomes were assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC); and the Measure Yourself Concerns and Well‐being questionnaire. Von Frey measurements examined perception thresholds.ResultsOf 168 participants, 136 underwent the study intervention (group A, 69; group B, 67), with 32 controls. Baseline‐to‐6‐week assessment scores improved significantly in the intervention arm (vs controls) on FACT‐Tax (p = .038) and emotional well‐being (p = .04) scores; FACT‐TAX scores for hand numbness/tingling (p = .007) and discomfort (p < .0001); and EORTC physical functioning (p = .045). Intervention groups A and B showed improved FACT‐Tax physical well‐being (p < .001), FACT‐TAX total score (p < .001), FACT‐TAX feet discomfort (p = .003), and EORTC pain (p = .017) scores.ConclusionsAcupuncture, with or without CIM modalities, can relieve CIPN‐related symptoms during oncology treatment. This is most pronounced for hand numbness, tingling, pain, discomfort, and for physical functioning.

OBJECTIVE:The present study aimed to explore attitudes of medical students following a course in integrative medicine (IM) focused on palliative and supportive cancer.METHOD:Attitudes to IM among pre-clerkship medical students were assessed following a 3-day required course, which included interviews with international experts in IM and "hands-on" workshops mentored by IM and non-IM healthcare professionals. Student reflections were analyzed qualitatively, and written narratives were examined thematically.RESULTS:Of 161 students, 102 (63.4%) provided post-course reflections. The main narrative themes included pre-course attitudes, attitude changes and influencing factors, and insights on implementing IM in clinical practice. Pre-course attitudes were predominantly skeptical, with post-course attitudes more open and non-judgmental, addressing research on IM effectiveness and safety. Students looked favorably on the implementation of IM in clinical practice and felt the course enhanced communication with patients.CONCLUSIONS:Student attitudes to IM shifted following the course, from a skeptical to a more non-judgmental and accepting approach. IM course may facilitate a better understanding of the limitations and risks of IM practices, particularly in the supportive cancer care setting, as well as implications regarding students' own resilience and professional growth.