Nutritional supplements in cancer care: an international collaborative effort on evidence synthesis for patients

Article type
Authors
Boedt T1, Lemmens J2, Mullie P2, Finoulst M3, Wider B1, Vankrunkelsven P1, Lenaerts G
1Belgian Centre For Evidence-based Medicine, Leuven, Belgium
2Gezondheid en Wetenschap, Leuven, Belgium
3The Arctic University of Norway, Tromso, Norway
Abstract
"Background:
Patients with cancer commonly utilize nutritional supplements. While numerous studies exist on this topic, reliable, up-to-date, and synthesized information understandable for patients regarding the efficacy and safety of these supplements is needed.

Objectives:
We aimed to synthesize the best available evidence concerning the efficacy and safety of various nutritional supplements used in cancer care for Belgian patients.

Methods:
1. Collaborative Initiative: Three Belgian organizations collaborated in this project:
(1) “Gezondheid&Wetenschap” (Health&Science, H&S) providing reliable health information for Belgian patients and other citizens;
(2) “The Belgian Centre for Evidence-based Medicine” (Cebam) spreading and supporting evidence-based practice for healthcare professionals;
(3) “Stichting Tegen Kanker” (Foundation against Cancer, FaC), an ideal dissemination channel due to its widespread accessibility among patients with cancer.
2. Systematic search: FaC provided a list of nutritional supplements, frequently used by patients with cancer. Cebam’s methodologists followed a strict methodology to identify the best available evidence regarding supplement efficacy and safety in cancer. First, they evaluated existing international databases related to nutritional supplements in cancer. Subsequently, an additional systematic literature search was conducted in Medline and the Cochrane library to identify the recent evidence.
3. Key Questions and Layperson Understanding: Key questions relevant to knowledge transition for patients were identified in collaboration with H&S and FaC. H&S ensured that the synthesized information was comprehensible to laypersons.
4. External Review: An external expert reviewed the completeness and comprehensiveness of the synthesized content.
5. Dissemination: Finally, we disseminated the synthesized information through the website of FaC.


Results: Reliable, up-to-date, and synthesized patient information for 25 nutritional supplements in cancer care was meticulously developed. The Norway’s CAM cancer database (https://cam-cancer.org) emerged as a reliable source on nutritional supplements in cancer care, for health professionals. Through additional literature searches, we addressed the following key questions for all supplements to be comprehensible to patients:
oWhat is the supplement?
oDoes it work in preventing, treating or providing supportive care for cancer?
oIs the supplement safe?

Conclusion:
This collaborative effort bridges evidence and patient understanding and facilitates further international collaboration, to ultimately enhance informed decision-making regarding nutritional supplement use in cancer care."