Reasons for and Characteristics Associated With Complementary and Alternative Medicine Use Among Adult Cancer Patients: A Systematic Review

Abstract

Purpose: To conduct a systematic review of reasons for and sociodemographic and disease characteristics associated with complementary and alternative medicine (CAM) use in cancer patients. Methods: Eligible studies were identified by searching the following databases: Alt Health Watch, AMED, CINAHL, CancerLit, PremMEDLINE, MEDLINE, Pub-Med, Ingenta, EMBASE, and Health Star, as well as reference lists in review articles. Only English-language articles published between 1994 and 2004 were included. Search terms included CAM and oncology/cancer , decision making and CAM and oncology/cancer , treatment decision making and CAM and oncology/cancer , and health care choices and CAM and oncology/cancer . Results: Fifty-two eligible studies were identified and summarized. These studies were conducted in 14 different countries, with the largest number of studies being completed in the United States (34.6%). A therapeutic response, wanting control, a strong belief in CAM, CAM as a last resort, and finding hope were the most commonly cited reasons for using CAM. Age, socioeconomic status, and gender were the dominant characteristics associated with CAM use. Conclusion: Reasons for and characteristics associated with CAM use among cancer patients have been studied extensively. Future CAM research among cancer patients should focus on identifying decision-making processes and building theoretical decision-making models. These can be used in the development of decisional aids for patients when confronted with the choice to use CAM as part of their cancer treatment.

Keywords

complementary and alternative medicine decision making cancer systematic review

References

What is complementary and alternative medicine (CAM)? [National Center for Complementary and Alternative Medicine Web site.] Available at: http://nccam.nih.gov/health/whatiscam/%236-. Accessed August 23, 2004.

Risberg T , Lund E , Kaasa S , Wilsgaard T. Cancer patients’ use of non-proven therapy: a 5-year follow-up study. J Clin Oncol. 1995; 16:6-12.

Ernst E , Cassileth BR . The prevalence of complementary/alternative medicine in cancer. Cancer. 1998;83:777-782.

Boon H , Brown JB , Gavin A , Kennard A , Stewart M. Breast cancer survivors’ perceptions of complementary/alternative medicine (CAM): making the decision to use or not to use. Qual Health Res. 1999;9:639-653.

Boon H , Stewart M , Kennard MA , et al. Use of complementary/alternative medicine by breast cancer survivors in Ontario: prevalence and perceptions. J Clin Oncol. 2000;18:2515-2521.

Balneaves LG , Kristjanson LJ , Tataryn D. Beyond convention: describing complementary therapy use by women living with breast cancer. Patient Educ Couns. 1999;38:143-153.

Montbriand MJ . Decision tree model describing alternate health care choices made by oncology patients. Cancer Nurs. 1995;18:104-117.

Truant T , Bottorff JL . Decision making related to complementary therapies: a process of regaining control. Patient Educ Couns. 1999;38:131-142.

Sparber A , Wooton J. Surveys of complementary and alternative medicine: part II. Use of alternative and complementary cancer therapies. J Altern Complement Med. 2001;7:281-287.

10.

DiGianni L , Garber JE , Winer EP . Complementary and alternative medicine use among women with breast cancer. J Clin Oncol. 2002;20:34-38.

11.

Giordano J , Boatwright D , Stapleton S , Huff L. Blending the boundaries: steps toward an integration of complementary and alternative medicine into mainstream practice. J Altern Complement Med. 2002;8:897-906.

12.

Gozum S , Tezel A , Koc M. Complementary alternative treatments used by patients with cancer in Eastern Turkey. Cancer Nurs. 2003;26:230-236.

13.

Moschen R , Kemmler G , Schweigkofler H , et al. Use of alternative/complementary therapy in breast cancer patients—a psychological perspective. Support Care Cancer. 2001;9:267-274.

14.

Lengacher CA , Bennet MP , Kip KE , et al. Frequency of use of complementary and alternative medicine in women with breast cancer. Oncol Nurs Forum. 2002;29:1445-1452.

15.

Mackenzie E , Taylor L , Bloom BS , Hufford DJ , Johnson JC . Ethnic minority use of complementary and alternative medicine (CAM): a national survey of CAM utilizers. Altern Ther Health Med. 2003;9:50-56.

16.

Maskarinec G , Shumay DM , Kakai H , Gotay CG . Ethnic differences in complementary and alternative medicine use among cancer patients. J Altern Complement Med. 2000;6:531-538.

17.

Ceylan S , Hamzaoglu O , Komurcu S , Beyan C , Yalcin A. Survey of the use of complementary and alternative medicine among Turkish cancer patients. Complement Ther Med. 2002;10:94-99.

18.

Gotay CC , Hara W , Issell BF , Maskarinec G. Use of complementary and alternative medicine in Hawaii cancer patients. Hawaii Med J. 1999;58:94-98.

19.

Nam RK , Fleshner N , Rakovitch E , et al. Prevalence and patterns of the use of complementary therapies among prostate cancer patients: an epidemiological analysis. J Urol. 1999;161: 1521-1524.

20.

Boon H , Westlake K , Stewart M , et al. Use of complementary/alternative medicine by men diagnosed with prostate cancer: prevalence and characteristics. Urology. 2003;62:849-853.

21.

Lee MM , Lin SS , Wrensch RM , Adler SR , Eisenberg D. Alternative therapies used by women with breast cancer in four ethnic populations. J Natl Cancer Inst. 2000;92:42-47.

22.

Jordan ML , Delunas LR . Quality of life and patterns of non-traditional therapy use by patients with cancer. Oncol Nurs Forum. 2001;28:1107-1113.

23.

Adler SR . Complementary and alternative medicine use among women with breast cancer. Med Anthropol Q. 1999;13:214-222.

24.

Maxwell JA . Qualitative Research Design: An Interactive Approach. Thousand Oaks, CA: SAGE Publications; 1996:14-24

25.

Adler SR . Relationships among older patients, CAM practitioners and physicians: the advantages of qualitative inquiry. Altern Ther Health Med. 2003;9:104-110.

26.

O’Connor AM , Legare F , Stacey D. Risk communication in practice: the contribution of decision aids. BMJ. 2003;327:736-740.

27.

O’Connor AM , Stacey D , Entwistle V , et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2005:1.

28.

Whelan T , Sawka C , Levine M , et al. Helping patients make informed choices: a randomized trial of a decision aid for adjuvant chemotherapy in lymph node-negative breast cancer. J Natl Cancer Inst. 2003;98:581-587.

29.

Beyerstein BL . Alternative medicine and common errors of reasoning. Acad Med. 2001;76:230-237.

30.

Downer SM , Cody MM , McCluskey , et al. Pursuit and practice of complementary therapies by cancer patients receiving conventional treatment. BMJ. 1994;309:86-89.

31.

Risberg T , Lund E , Wist E , et al. The use of non-proven therapy among patients treated in Norwegian oncological departments: a cross-sectional national multi-centre study. Eur J Cancer. 1995; 31A:1785-1789.

32.

Risberg T , Lund E , Wist E. Use of non-proven therapies: differences in attitudes between Norwegian patients with non-malignant disease and patients suffering from cancer. Acta Oncol. 1995;34:893-898.

33.

Munstedt K , Kirsch W , Milch W , Sachsse S , Vahrson H. Unconventional cancer therapy-survey of patients with gynaecological malignancy. Arch Gynaecol Obstet. 1996;258:81-88.

34.

Begbie SD , Kerestes ZL , Bell DR . Patterns of alternative medicine use by cancer patients. Med J Aust. 1996;165:545-548.

35.

Liu JM , Chu HC , Chin YH , et al. Cross sectional study of use of alternative medicines in Chinese cancer patients. Jpn J Clin Oncol. 1997;27:37-41.

36.

Risberg T , Kaasa S , Wist E , Melsom H. Why are cancer patients using non-proven complementary therapies? A cross-sectional multi-centre study in Norway. Eur J Cancer. 1997;33:575-580.

37.

Crocetti E , Crotti E , Feltrin A , Ponton P , Geddes M , Buiatti E. The use of complementary therapies by breast cancer patients attending conventional treatment. Eur J Cancer. 1998;34:324-328.

38.

Oneschuk D , Fennell L , Hanson J , Bruera E. The use of complementary medications by cancer patients attending an outpatient pain and symptom clinic. J Palliat Care. 1998;14:21-26.

39.

Burstein HJ , Gelber S , Guaddagnoli E , Weeks JC . Use of alternative medicine by women with early-stage breast cancer. N Engl J Med. 1999;340:1733-1739.

40.

Lippert MC , McClain R , Boyd JC , Theodorescu D. Alternative medicine use in patients with localized prostate carcinoma treated with curative intent. Cancer. 1999;86:2642-2648.

41.

Verhoef MJ , Hagen N , Pelletier G , Forsyth P. Alternative therapy use in neurologic disease: use in brain tumor patients. Neurology. 1999;52:617-622.

42.

Warrick PD , Irish JC , Morningstar M , Gilbert R , Brown D , Gullane P. Use of alternative medicine among patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 1999; 125:573-579.

43.

Wyatt GK , Friedman LL , Given CW , Given BA , Beckrow KC . Complementary therapy use among older cancer patients. Cancer Pract. 1999;7:136-144.

44.

Kao GD , Devine P. Use of complementary health practices by prostate carcinoma patients undergoing radiation therapy. Cancer. 2000;88:615-619.

45.

Malik IA , Nasseeruddin A , Khan A , Khan W. Use of unconventional methods of therapy by cancer patients in Pakistan. Eur J Epidemiol. 2000;16:155-160.

46.

Morris KT , Johnson N , Homer L , Walts D. A comparison of complementary therapy use between breast cancer patients and patients with other primary tumor sites. Am J Surg. 2000;179: 407-411.

47.

Rees RW , Feigel I , Vickers A , Zollmann C , McGurk R , Smith C. Prevalence of complementary therapy use by women with breast cancer: a population based survey. Eur J Cancer. 2000;36:1359-1364.

48.

Richardson MA , Sanders T , Palmer JL , Greisinger A , Singletary SE . Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol. 2000;18:2505-2514.

49.

Sparber A , Bauer L , Curt G , et al. Use of complementary medicine by adults participating in cancer clinical trials. Oncol Nurs Forum. 2000;27:623-630.

50.

Alferi SM , Antoni MH , Ironson G , Kilbourn KM , Carver CS . Factors predicting the use of complementary therapies in a multi-ethnic sample of early stage breast cancer patients. J Am Med Womens Assoc. 2001;56:120-126.

51.

Paltiel O , Avitzour M , Peretz T , et al. Determinants of the use of complementary therapies by patients with cancer. J Clin Oncol. 2001;19:2439-2448.

52.

Samur M , Bozcuk HS , Kara A , Savas B. Factors associated with utilization of non proven cancer therapies in Turkey. Support Care Cancer. 2001;9:452-458.

53.

Jones HA , Metz JM , Devine P , Hahn SM , Whittington R. Rates of unconventional medical therapy use in patients with prostate cancer: standard history versus directed questions. Urology. 2002;59:272-276.

54.

Patterson RE , Neuhouser ML , Hedderson MM , et al. Types of alternative medicine used by patients with breast, colon or prostate cancer: predictors, motives and costs. J Altern Complement Med. 2002;8:477-485.

55.

Salmenpera L. The use of complementary therapies among breast and prostate cancer patients in Finland. Eur J Cancer Care (Engl). 2002;11:44-50.

56.

Shen J , Andersen R , Albert PS , et al. Use of complementary/alternative therapies by women with advanced breast cancer. BMC Complement Altern Med. 2002;2:8.

57.

Shumay DM , Maskarinec CG , Gotay C , Heiby EM , Kakai H. Determinants of the degree of complementary and alternative medicine use among patients with cancer. J Altern Complement Med. 2002;8:661-671.

58.

Tough SC , Johnston DW , Verhoef MJ , Arthur K , Bryant H. Complementary and alternative medicine use among colorectal cancer patients in Alberta, Canada. Altern Ther Health Med. 2002; 8:54-64.

59.

Wilkinson S , Gomella LG , Smith JA , et al. Attitudes and use of complementary medicine in men with prostate cancer. J Urol. 2002;68:2505-2509.

60.

Chrystal K , Simon A , Forgeson G , Isaacs R. The use of complementary/alternative medicine by cancer patients in a New Zealand regional cancer treatment centre. N Z Med J. 2003; 116:1168. Available at: http://www.nzma.org.nz/journal/116-1168/296/.

61.

Eng J , Ramsum D , Verhoef M , Guns E , Davison J , Gallagher R. A population based survey of complementary and alternative medicine use in men recently diagnosed with prostate cancer. Integr Cancer Ther. 2003;2:221-216.

62.

Hall JD , Bissonette EA , Boyd JC , Theodorescu D. Motivations and influences on the use of complementary medicine in patients with localized prostate cancer treated with curative intent: results of a pilot study. Br J Urol. 2003;91:603-607.

63.

Harris P , Finlay IG , Cook A , Thomas KH , Hood K. Complementary and alternative medicine use by patients with cancer in Wales: a cross sectional survey. Complement Ther Med. 2003;11: 249-253.

64.

Ponholzer A , Struhal G , Madersbacher S. Frequent use of complementary medicine by prostate cancer patients. Eur Urol. 2003;43:604-608.

65.

Yoshimura K , Ichioka K , Terada N , Terai A , Arai Y. Use of complementary and alternative medicine by patients with localized prostate carcinoma: a study at a single institute in Japan. Int J Clin Oncol. 2003;8:26-30.

66.

Henderson JW , Donatelle R. Complementary and alternative medicine use by women after completion of allopathic treatment for breast cancer. Altern Ther Health Med. 2004;10:52-57.

67.

Navo MA , Phan J , Vaughan C , et al. An assessment of the utilization of complementary and alternative medication in women with gynaecologic or breast malignancies. J Clin Oncol. 2004;22: 671-677.

68.

Cui Y , Shu X , Gao Y , et al. Use of complementary and alternative medicine by Chinese women with breast cancer. Breast Cancer Res Treat. 2004;85:263-270.