Background: Concepts of integrative oncology (IO), as have been offered by anthroposophic medicine (AM) for decades, are gaining increasing interest and acceptance. Central aspects are multimodal therapeutic interventions, health-related quality of live, and patients' preference as well as therapeutic relationship and clinical outcome. Despite its broad application, IO lacks evaluation in clinical practice and complementary therapies are not monitored by any cancer registries. Methods: To close this gap we established ‘Network Oncology' (NO), a conjoint registry of German outpatient AM practitioners and AM hospitals. In this paper we present the project and a first data overview and compare it to epidemiological registers and current literature. Results: NO has collected 10,405 cancer patients' records in 6 years. Compared to epidemiological registers our data show minor differences in disease entity distribution, age, and gender. There is an overproportional amount of young breast cancer patients in NO institutions indicating a demand for integrative therapies in this group. There is no difference between the UICC (Union for International Cancer Control) stages at first diagnosis and at admission to a NO facility. According to our data conventional therapies were less frequently administered after admission to a NO facility. Nevertheless, one third of the patients received their first conventional therapy in a NO facility. 80% of the patients received mistletoe preparations and 63% had nonpharmacotherapeutic, complementary interventions. Conclusion: Integrative oncological approaches attract a great number of patients visiting AM institutions. The NO provides an infrastructure to evaluate integrative interventions in AM, allows comparison to other clinical registers, and thus can contribute to health service research in this field.

Gaber E, Wildner M: Sterblichkeit, Todesursachen und regionale Unterschiede, ed, revised. Berlin, Robert Koch Institute, 2011.
Husmann G, Kaatsch P, Katalinic A, et al.: Cancer in Germany 2005/2006. Incidence and trends, ed, revised. Berlin, Robert Koch Institute and Association of Population-Based Cancer Registries in Germany, 2010.
Parkin DM: The role of cancer registries in cancer control. Internat J Clin Oncol 2008;13:102-111.
Ploeckinger U, Kloeppel G, Wiedenmann B, Lohmann R: The German NET-registry: an audit on the diagnosis and therapy of neuroendocrine tumours. Neuroendocrinology 2009;90:349-363.
Erlic Z, Ploeckinger U, Cascon A, et al.: Systematic comparison of sporadic and syndromic pancreatic islet cell tumours. Endocr Relat Cancer 2010;17:875-883.
Wardelmann E, Merkelbach-Bruse S, Schildhaus HU, Büttner R: Are sarcoma centers needed in Germany? Experience gained with the Bonner GIST register. Der Pathologe 2011;32:72-75.
Sinn H, Hermanek P, Wagner G, Wittekind C: Organ-spezifische Tumordokumentation. Internetfassung (‘OTD-3-Internet'), 2009. (accessed 09.10.2013).
Cassileth BR, Deng G: Complementary and alternative therapies for cancer. Oncologist 2004;9:80-89.
Tascilar M, de Jong FA, Verweij J, Mathijssen RHJ: Complementary and alternative medicine during cancer treatment: beyond innocence. Oncologist 2006;11:732-741.
Sagar SM: Integrative Oncology in North America. Journal of the Society of Integrative Oncology 2006;4:27-39.
Molassiotis A, Fernadez-Ortega P, Pud D, et al.: Use of complementary and alternative medicine in cancer patients: a European survey. Annal Oncol 2005; 16:655-663.
Hyodo I, Amano N, Eguchi K, et al.: Nationwide survey on complementary and alternative medicin in cancer patients in Japan. J Clin Oncol 2005;23:2645-2654.
Ernst E: The prevalence of complementary/alternative medicine in cancer. Cancer 1998;83:777-782.
Klafke N, Eliott JA, Wittert GA, Olver IN: Prevalence and predictors of complementary and alternative medicine (CAM) use by men in Australian cancer outpatient services. Ann Oncol 2012;23:1571-1578.
Horneber M, Bueschel G, Dennert G, et al.: How many cancer patients use complementary and alternative medicine - a systematic review and metaanalysis. Integr Cancer Ther 2012;11:187-203.
Härtel U, Volger E: Inanspruchnahme und Akzeptanz klassischer Naturheilverfahren und alternativer Heilmethoden in Deutschland - Ergebnisse einer repräsentativen Bevölkerungsstudie. Forsch Komplementärmed Klass Naturheilkd 2004;11:327-334.
Kienle GS, Kiene H: Complementary cancer therapy: a systematic review of prospective clinical trials on anthroposophic mistletoe extracts. Eur J Med Res 2007;12:103-119.
Corner J, Yardley J, Maher EJ, et al.: Patterns of complementary and alternative medicine use among patients undergoing cancer treatment. Eur J Cancer Care 2009;18:271-279.
Schönekaes K, Micke O, Mücke R, et al.: Anwendung komplementärer/alternativer Therapiemassnahmen bei Patientinnen mit Brustkrebs. Forsch Komplementärmed Klass Naturheilkd 2003;10:304-308.
Fasching PA, Thiel F, Nicolaisen-Murmann K, et al.: Association of complementary methods with quality of life and life satisfaction in patients with gynaecologic and breast malignancies. Support Care Cancer 2007;15:1277-1284.
Engdal S, Steinsbekk A, Klepp O, Nilsen OG: Herbal use among cancer patients during palliative or curative chemotherapy treatment in Norway. Support Care Cancer 2008;16:763-769.
Deng G, Cassileth BR: Integrative oncology: complementary therapies for pain, anxiety, and mood disturbance. CA Cancer J Clin 2005;55:109-116.
Cassileth BR, Deng GE, Gomez JE, et al.: Complementary therapies and integrative oncology in lung cancer. Chest 2007;132:340-354.
Gerhard I, Abel U, Loewe-Mesch A, et al.: Problems of randomized studies in complementary medicine demonstrated in a study on mistletoe treatment of patients with breast cancer. Forsch Komplementärmed Klass Naturheilkd 2004;11:150-157.
Schad F, Matthes B, Pissarek J, Matthes H: Neue, flexible und offene Tumorbasisdokumentation: QuaDoSta: Qualitätssicherung, Dokumentation und Statistik, eine ‘open source' Lösung am Beispiel onkologischer Dokumentation. Tagungsband der 7. Fachtagung Medizinische Dokumentation des DVMD e.V. in Berlin, 21.-23.3.2002. Deutscher Verband Medizinischer Dokumentare e.V., pp 169-173.
Schad F, Pissarek J, Albrecht U, Matthes H: QuaDoSta (Quality Assurance, Documentation and Statistics) - a flexible, platform-independent, open source database for oncological documentation. J Cancer Res Clin Oncol 2004;130:785.
Jeschke E, Schad F, Pissarek J, et al.: QuaDoSta - ein frei konfgurierbares System zur Unterstützung multizentrischer Datenerhebungen in medizinischer Versorgung und Forschung. GMS Med Inform Biom Epidemiol 2007;3:10.
Stabenow R, Streller B, Wilsdorf-Köhler H, Eisinger B: Krebsinzidenz und Krebsmortalität 2005-2006. Berlin, Gemeinsames Krebsregister der Länder Berlin, Brandenburg, Mecklenburg-Vorpommern, Sachsen-Anhalt und der Freistaaten Sachsen und Thüringen, 2009.
Dudeck J, Wagner G, Grundmann E, Hermanek P: Basisdokumentation für Tumorkranke. Berlin, Springer, 1994.
Dudeck J, Wagner G, Grundmann E, Hermanek P: Basisdokumentation für Tumorkranke - Prinzipien und Verschlüsselungsanweisungen für Klinik und Praxis Deutsche Krebsgesellschaft. München, Zuckschwerdt, 1999.
Altmann U, Katz FR, Dudeck J: A reference model for clinical tumour documentation. Stud Health Technol Inform 2006;124:139-144.
Müller R-P, Seegenschmiedt MH, Höffken K, et al.: Common toxicity criteria (CTC): Dokumentation von Nebenwirkungen in der Onkologie. Dtsch Arztebl 1999;96:489-495.
Medical Dictionary for Regulatory Activities (MedDRA®). (accessed 09.10.2013).
Evans JM, McNaughton D, Donnan PT, MacDonald TM: Pharmacoepidemiological research at the medicines monitoring unit, Scotland: data protection and confidentiality. Pharmacoepidemiol Drug Saf 2001;10:669-673.
Deng GE, Frenkel M, Cohen L, et al.: Evidence-based clinical practice guidelines for integrative oncology: complementary therapies and botanicals. J Soc Integr Oncol 2009;7:85-120.
Hanaway P: Systems approaches: a global and historical perspective on integrative medicine. Global Advances in Health and Medicine 2012;1:10-11.
Stange R, Amhof R, Moebus S: Complementary and alternative medicine: attitudes and patterns of use by German physicians in a national survey. J Altern Complement Med 2008;14:1255-1261.
Münstedt K, Harren H, von Georgi R, Hackethal A: Complementary and alternative medicine: comparison of current knowledge, attitudes and interest among German medical students and doctors. Evid Based Complement Alternat Med 2011;2011:790951.
Burstein HJ, Gelber S, Guadagnoli E, Weeks JC: Use of alternative medicine by women with early-stage breast cancer. N Engl J Med 2011;340:1733-1739.
Boon HS, Olatunde F, Zick SM: Trends in complementary/alternative medicine use by breast cancer survivors: comparing survey data from 1998 and 2005. BMC Women's Health 2007;7:4.
Astin JA, Reilly C, Perkins C, Child WL: Breast cancer patients' perspectives on and use of complementary and alternative medicine: a study by the Susan G. Komen breast cancer foundation. J Soc Integr Oncol 2006;4:157-169.
Jeschke E, Ostermann T, Tabali M, et al.: Pharmacotherapy of elderly patients in everyday anthroposophic medical practice: a prospective, multicenter observational study. BMC Geriatr 2010;10:48.
Bosetti C, Bertuccio P, Levi F, et al.: The decline in breast cancer mortality in Europe: an update (to 2009). Breast 2012;21:77-82.
Malvezzi M, Bertuccio P, Levi F, et al.: European cancer mortality predictions for the year 2012. Ann Oncol 2012;23:1044-1052.
Birgisson H, Pahlman L, Gunnarsson U, Glimelius B: Occurrence of second cancers in patients treated with radiotherapy for rectal cancer. J Clin Oncol 2005;23:6126-6131.
Andersson M, Jensen MB, Engholm G, et al.: Risk of second primary cancer among patients with early operable breast cancer registered or randomised in Danish breast cancer cooperative group (DBCG) protocols of the 77, 82 and 89 programmes during 1977-2001. Acta Oncol 2008;47:755-764.
Härtel U, Volger E: Inanspruchnahme und Akzeptanz klassischer Naturheilverfahren und alternativer Heilmethoden in Deutschland - Ergebnisse einer repräsentativen Bevölkerungsstudie. Forsch Komplementärmed Klass Naturheilkd 2004;11:327-334.
Schad F, Axtner J, Happe A, et al.: Use of integrative therapies in breast cancer patients. Health service research in a network of integrative oncology. Annals of Oncology 2012;23(suppl 9):ix447-ix461.
Schad F, Axtner J, Happe A, et al.: Health service research on patients with colon cancer in a network of integrative oncology. Ann Oncol 2012;23(suppl 4):iv31-iv118.
Schad F, Axtner J, Happe A, et al.: Health service research in integrative oncology: viscum album use and non-pharmacotherapeutic interventions in lung cancer patients. Ann Oncol 2012;23(suppl 9): ix462-ix468.
Wanchai A, Armer J, Stewart B: Complementary and alternative medicine use among women with breast cancer: a systematic review. Clin J Oncol Nurs 2010;14:E45-E55.
Astin JA: Why patients use alternative medicine. JAMA 1998;279:1548-1553.
Wilkinson JM, Jelinek H: Complementary medicine use among attendees at a rural health screening clinic. Complement Ther Clin Pract 2009;15:80-84.
Newsom-Davis T, Kenny L, Al-Shakarchi I, et al.: Voodoo dolls and the cancer patient: patients do trust their doctors. QJM 2009;102:311-319.
Adler SR, Wrubel J, Hughes E, Beinfeld H: Patients' interactions with physicians and complementary and alternative medicine practitioners: Older women with breast cancer and self-managed health care. Integr Cancer Ther 2009;8:63-70.
Hlubocky FJ, Ratain MJ, Wen M, Daugherty CK: Complementary and aternative medicine among advanced cancer patients enrolled on phase I trials: a study of prognosis, quality of life, and preferences for decision making. J Clin Oncol 2007;25:548-554.
Vickers KA, Jolly KB, Greenfield SM: Herbal medicine: women's views, knowledge and interaction with doctors: a qualitative study. BMC Complement Altern Med 2006;6:40.
Brunnhuber S, Michalsen A: Psychosomatik und Mind-Body-Medizin: Integrative, komplementäre oder alternative Disziplinen? Ein entwicklungslogisches Argument. Forsch Komplementmed 2012;19:86-92.
Temel JS, Greer JA, Muzikansky A, et al.: Early palliative care for patients with metastatic non-small-cell lung cancer. N Eng J Med 2010;363:733-742.
Kienle GS, Berrino F, Büssing A, et al.: Mistletoe in cancer, a systematic review on controlled clinical trials. Eur J Med Res 2003;8:109-119.
Kienle GS, Kiene H: Influence of Viscum album L (European mistletoe) extracts on quality of life in cancer patients: a systematic review of controlled clinical studies. Integr Cancer Ther 2010;9:142-157.
Ostermann T, Raak C, Büssing A: Survival of cancer patients treated with mistletoe extract (Iscador): a systematic review. BMC Cancer 2009;9:451.
Büssing A, Raak C, Ostermann T: Quality of life and related dimensions in cancer patients treated with mistletoe extract (Iscador): a meta-analysis. Evid Based Complement Alternat Med 2012;2012:219402.
Ernst E, Schmidt K, Steuer-Vogt MK: Mistletoe for cancer? A systematic review of randomised clinical trials. Int J Cancer 2003;107:262-267.
Fønnebø V, Grimsgaard S, Walach H, et al.: Researching complementary and alternative treatments - the gatekeepers are not at home. BMC Med Res Methodol 2007;7:7.
Gurley BJ, Gardner SF, Hubbard MA, et al.: In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-426.
Gurley BJ, Gardner SF, Hubbard MA, et al.: Clinical assessment of botanical supplementation on cytochrome P450 phenotypes in the elderly: St. John's wort, garlic oil, Panax ginseng, and Ginkgo biloba. Drugs Aging 2005;22:525-539.
Mathijssen RHJ, Verweij J, de Bruijn P, et al.: Effects of St. John's wort on irinotecan metabolism. J Natl Cancer Inst 2002;94:1247-1249.
Hölzel D: Versorgungsforschung mit Krebsregistern. Der Onkologe 2011;17:143-152.
Witt C, Treszl A, Wegschneider K: Externer Validität auf der Spur. Dtsch Arztebl 2011;108:2468-2474.
Greenstein AJ, Wolfe BM: Clinical research improves patient care; in Tichansky DS, Morton J, Jones DB (eds): The SAGES Manual of Quality, Outcomes and Patient Safety. Boston, Springer, 2012, pp 119-126.
Welte T: Versorgungsforschung - Implikationen für den klinischen Alltag. Dtsch Arztebl 2012;109:759-776.
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