Medline ® Abstracts for References 2-10
Use of complementary/alternative therapies by women with advanced-stage breast cancer.
Shen J, Andersen R, Albert PS, Wenger N, Glaspy J, Cole M, Shekelle P
BMC Complement Altern Med. 2002;2:8. Epub 2002 Aug 13.
BACKGROUND: This study sought to describe the pattern of complementary/alternative medicine (CAM) use among a group of patients with advanced breast cancer, to examine the main reasons for their CAM use, to identify patient's information sources and their communication pattern with their physicians.
METHODS: Face-to-face structured interviews of patients with advanced-stage breast cancer at a comprehensive oncology center.
RESULTS: Seventy three percent of patients used CAM; relaxation/meditative techniques and herbal medicine were the most common. The most commonly cited primary reason for CAM use was to boost the immune system, the second, to treat cancer; however these reasons varied depending on specific CAM therapy. Friends or family members and mass media were common primary information source's about CAM.
CONCLUSIONS: A high proportion of advanced-stage breast cancer patients used CAM. Discussion withdoctors was high for ingested products. Mass media was a prominent source of patient information. Credible sources of CAM information for patients and physicians are needed.
Laboratory of Clinical Sciences, National Institute of Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD, USA. firstname.lastname@example.org
Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology.
Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE
J Clin Oncol. 2000;18(13):2505.
PURPOSE: Oncologists are aware that their patients use complementary/alternative medicine (CAM). As cancer incidence rates and survival time increase, use of CAM will likely increase. This study assessed the prevalence and predictors of CAM use in a comprehensive cancer center.
SUBJECTS AND METHODS: Subjects were English-speaking cancer patients at least 18 years of age, attending one of eight outpatient clinics at The University of Texas M.D. Anderson Cancer Center, Houston, TX, between December 1997 and June 1998. After giving written informed consent, participants completed a self-administered questionnaire. Differences between CAM users and nonusers were assessed by chi(2) and univariate logistic regression analysis. A multivariate logistic regression model identified the simultaneous impact of demographic, clinical, and treatment variables on CAM use; P values were two-sided.
RESULTS: Of the 453 participants (response rate, 51.4%), 99.3% had heard of CAM. Of those, 83.3% had used at least one CAM approach. Use was greatest for spiritual practices (80.5%), vitamins and herbs (62.6%), and movement and physical therapies (59.2%) and predicted (P<.001) by sex (female), younger age, indigent pay status, and surgery. After excluding spiritual practices and psychotherapy, 95.8% of participants were aware of CAM and 68.7% of those had used CAM. Use was predicted (P<.0001) by sex (female), education, and chemotherapy.
CONCLUSION: In most categories, CAM use was common among outpatients. Given the number of patients combining vitamins and herbs with conventional treatments, the oncology community must improve patient-provider communication, offer reliable information to patients, and initiate research to determine possible drug-herb-vitamin interactions.
Centers for Alternative Medicine Research and Health Promotion Research and Development, The University of Texas-Houston School of Public Health, Houston, TX, USA.
An assessment of the utilization of complementary and alternative medication in women with gynecologic or breast malignancies.
Navo MA, Phan J, Vaughan C, Palmer JL, Michaud L, Jones KL, Bodurka DC, Basen-Engquist K, Hortobagyi GN, Kavanagh JJ, Smith JA
J Clin Oncol. 2004;22(4):671.
PURPOSE: To describe and assess the current utilization of complementary and alternative medicines (CAMs) in women with a diagnosis of either gynecologic or breast cancer and evaluate their reasons for use.
PATIENTS AND METHODS: This study included 250 female patients from the Multidisciplinary Breast Center and 250 patients from the Gynecologic Oncology Center of The University of Texas M.D. Anderson Cancer Center (Houston, TX). Patients were selected by having an odd-numbered medical record number, and they were contacted before their clinic visit. The goals of the study were explained, and verbal consent was obtained. Patients who agreed to participate were asked to bring a written list and the medication bottles of all over-the-counter prescriptions and CAMs with them to clinic. In clinic, the investigator obtained a written informed consent and administered the survey. All patients and surveys were assessable.
RESULTS: The most frequently used herbal products and megavitamins/minerals were identified from the patient medication histories. Overall, we found the proportion of patients using CAM to be 48% (95% CI, 44% to 53%; 241 of 500 patients). CAM use was related to patients' educational status: 62% had postgraduate degrees, 50% had college degrees, 56% had some college, and 33% had a high school education or less. Also, among patients using CAMs, only 53.5% had spoken to a healthcare provider regarding CAM therapy.
CONCLUSION: The use of CAM is common among women with cancer. Studies need to be conducted to establish if there are any potential drug interactions and/or therapeutic benefit of CAM products. Moreover, there is a need to educate patients and healthcare providers on appropriate and safe use of CAM products.
College of Pharmacy, University of Houston, TX, USA.
Complementary and alternative medicine use by patients enrolled onto phase I clinical trials.
Dy GK, Bekele L, Hanson LJ, Furth A, Mandrekar S, Sloan JA, Adjei AA
J Clin Oncol. 2004;22(23):4810.
PURPOSE: To describe the prevalence, clinical characteristics, and pattern of use of complementary and alternative medicine (CAM) in patients enrolled onto phase I trials.
PATIENTS AND METHODS: Questionnaires were administered to 108 patients with advanced malignancies enrolled onto phase I chemotherapy trials at the Mayo Clinic Comprehensive Cancer Center (Rochester, MN). CAM was classified into two modalities, pharmacologic and nonpharmacologic. Clinical and demographic data, including age, sex, and prior cancer treatment, were subsequently obtained from patient charts and examined for any correlation with CAM use, using chi2 analysis.
RESULTS: One hundred two survey forms were returned. Among respondents, 88.2% (90 of 102) had used at least one CAM modality; 93.3% (84 of 90) and 53.3% (48 of 90) had used pharmacologic and nonpharmacologic CAM, respectively; and 46.7% (42 of 90) used both modalities. Vitamin and mineral preparations constituted 89.3% (75 of 84) of all pharmacologic CAM used. Intake was highest for vitamins E (48.8% [41 of 84]) and C (38.1% [32 of 84]), and 71.4%(60 of 84) of respondents took nonvitamin/mineral agents. Green tea (29.8% [25 of 84]), echinacea (13.1% [11 of 84]), and essiac (9.5% [8 of 84]) were the most popular. Prayer and spiritual practices were the most commonly used nonpharmacologic CAM, accounting for 52.1% (25 of 48). Chiropractors, the most frequently visited nontraditional medicine practitioners, were consulted by only 10% (9 of 90) of those who practiced CAM. Both CAM modalities were used more frequently by women (53.5% [23 of 43]) than men (40.4% [19 of 47]).
CONCLUSION: CAM use is common among patients in phase I trials and should be ascertained by investigators, because some of the agents used may interact with investigational agents and affect adverse effects and/or efficacy.
Division of Medical Oncology, Department of Medicine, Mayo Foundation and Mayo Clinic College of Medicine, Rochester, MN, USA.
The incidence of potential interactions between dietary supplements and prescription medications in cancer patients at a Veterans Administration Hospital.
Lee AH, Ingraham SE, Kopp M, Foraida MI, Jazieh AR
Am J Clin Oncol. 2006;29(2):178.
OBJECTIVE: The concurrent use of dietary supplements and prescription medications is common among patients with cancer. This study examines potential interactions between dietary supplements and prescription medications in a Veteran Hospital cancer population.
METHODS: Eligible patients seen at the Hematology/Oncology clinic at the Veterans Administration Medical Center in Cincinnati, OH, were administered a survey to determine their use of dietary supplements. Medication profiles were compiled from patients' medical charts and pharmacy records. It was also noted whether supplementation was previously documented. Potential interactions between dietary supplements and prescription medications were identified from a literature search of documented interactions. Several demographic factors, including age, race, marital status, education and income, were assessed for differences between patients found to be at risk for interactions and those for whom no risks were identified.
RESULTS: Dietary supplements were used by 61% of patients. Multivitamins were the most common supplement (80.3%) followed by minerals(40.6%) and herbal preparations (24.8%). Of the 121 patients taking supplements, 65 patients (54%) reported taking more than one. A potential risk for interaction between dietary supplement and prescription medication was identified in 12% of patients taking supplementations. Three patients were at risk for multiple interactions. Veterans who were not currently married were more likely to be at risk for interactions (P = 0.024). Only 28% of patients taking dietary supplements had this supplementation documented in their medical record.
CONCLUSION: Dietary supplementation by a veteran cancer population is common. Interactions between the supplement and prescription medication is a potential problem. Patient-physician discussion and documentation of these issues should be systematically addressed.
University Medical Center at Princeton, Princeton, NJ, USA.
The use of complementary and alternative medicine by cancer patients undergoing radiation therapy.
Swarup AB, Barrett W, Jazieh AR
Am J Clin Oncol. 2006;29(5):468.
OBJECTIVE: Use of complementary alternative medicine (CAM) is widespread among patients with chronic diseases including cancer. The purpose of our study was to examine the pattern of alternative medicine use in patients undergoing radiation treatment of cancer.
METHODS AND MATERIALS: A cross-sectional study was conducted among cancer patients treated with radiation therapy from July 2003 through July 2005 at the University of Cincinnati. We defined CAM as the use of dietary supplements, massage therapy, prayer, acupuncture, chiropractic, and other novel therapies undertaken after their diagnosis with cancer.
RESULTS: There were 152 patients that participated in the study. Their median age was 59 (range, 21-85), 82 (54%) were males, 108 (69%) were Caucasian. Out of 152 patients, 104 (68%) patients were users of CAM. The most common CAM modality reported was prayer 85 (82%) and use of dietary supplements 84 (80%). The majority of users were female and well-educated. Among CAM users 60 (58%) had discussed its use with their physician. Level of education, employment status and income showed a significant correlation with the use of CAM.
CONCLUSION: This study demonstrates that the use of complementary alternative medicine among cancer patients receiving radiation therapy is frequent. Given the potential risks with some CAM therapies, physicians should actively ask patients whether they use CAM and provide appropriate counseling.
Division of General Internal Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
Patient initiation of complementary and alternative medical therapies (CAM) following cancer diagnosis.
Vapiwala N, Mick R, Hampshire MK, Metz JM, DeNittis AS
Cancer J. 2006;12(6):467.
PURPOSE: Complementary and alternative medicine use is prevalent in both healthy and oncologic populations. However, few data exist to quantify complementary and alternative medicine initiation specifically after cancer diagnosis. This study evaluated patients' complementary and alternative medicine usage patterns, reasons, and general perceptions after cancer diagnosis and during or after conventional cancer therapy.
METHODS: An Internet- and clinic-based piloted questionnaire was distributed from July 2004 through September 2004. In total, 604 responses were analyzed (64% Internet, 36% oncology clinics). Patients were predominantly white females; almost half held college or graduate degrees. Respondents reported past or present history of>or=1 conventional treatment(s), primarily chemotherapy and radiotherapy.
RESULTS: Initiation of>or=1 complementary and alternative medicine after diagnosis was reported by 54% of those surveyed. Complementary and alternative medicine users were more likely than non-users to have a history of chemotherapy (P=0.003) and enrollment in clinical trials (P=0.007). Complementary and alternative medicine use was greater in females (P=0.004) and patients with higher education levels (P<0.001), but not in whites compared to non-whites (P=0.34). The most commonly cited reason for complementary and alternative medicine use after diagnosis was "general overall health." Less than one-third of patients cited their healthcare providers as primary sources of complementary and alternative medicine information. The vast majority of users (86%) expressed satisfaction with complementary and alternative medicine as a cost-effective approach.
DISCUSSION: About one-half of adult cancer patients initiate complementary and alternative medicine therapy after diagnosis and during or after conventional oncologic treatments. Healthcare providers should be aware of patients' reasons for complementary and alternative medicine use, both for symptom management and quality-of-life. Healthcare providers should also be familiar with patients' complementary and alternative medicine information sources and should supplement these sources with discussions of pertinent safety profiles and potential interactions with standard therapies.
Hospital of University of Pennsylvania, Department of Radiation Oncology, Philadelphia, Pennsylvania 19104, USA. email@example.com
A population-based study of prevalence of complementary methods use by cancer survivors: a report from the American Cancer Society's studies of cancer survivors.
Gansler T, Kaw C, Crammer C, Smith T
BACKGROUND: The use of complementary methods (CMs) is widespread and increasing in the United States. Most literature on CM use among cancer survivors focuses on the treatment period, whereas only a few studies address use further along the cancer continuum.
METHODS: This study analyzed the prevalence and the medical and demographic associations of CM use among cancer survivors surveyed 10 to 24 months after diagnosis. The study's sample-4139 survivors of 1 of 10 adult cancers-was selected from stratified random samples provided by statewide cancer registries and surveyed by mail and telephone. Three logistic regression models examined associations between medical and demographic factors and CM use among survivors of sex-specific and non-sex-specific cancers.
RESULTS: Of the 19 CMs included in the survey, the CMs most frequently reported were prayer/spiritual practice (61.4%), relaxation (44.3%), faith/spiritual healing (42.4%), nutritional supplements/vitamins (40.1%), meditation (15%), religious counseling (11.3%), massage (11.2%), and support groups (9.7%). Among these 19 CMs, the least prevalent were hypnosis (0.4%), biofeedback therapy (1.0%), and acupuncture/acupressure (1.2%). Survivors more likely to use CMs were female, younger, white, higher income, and more educated.
CONCLUSIONS: This study provides information regarding prevalence and medical-demographic determinants of CM use reported by a large, population-based sample of survivors of 10 cancers surveyed 10 to 24 months after diagnosis. These findings may be used by clinicians and researchers to inform their decisions regarding which CMs to address in practice and research.
Health Promotions, American Cancer Society, Atlanta, Georgia 30303, USA. Ted.firstname.lastname@example.org
Hunt KJ, Ernst E. Patients' use of CAM: results from the Health Survey for England 2005. Focus Alt Compl Ther 2010; 15:101.
no abstract available