Complementary and alternative medicine use amongst Malaysian orthopaedic oncology patients

BMC Complementary and Alternative Medicine

Vivek Ajit Singh¹  Isaac Shi Zhung Lee²  Stephanie Jin Leng Yeap²  Tze Lek Yong²  Amreeta Dhanoa² 

[1] Department of Orthopaedic Surgery (Noceral), University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia;Jeffrey Cheah School of Medicine and Health Sciences, Monash University, 47500 Bandar Sunway, Malaysia

关键词: CAM;    Tumour;    Cancer;    Oncology;    Orthopaedic;    Alternative;    Complementary medicine;   

Others  :  1085947
DOI  :  10.1186/1472-6882-14-404

 received in 2014-07-25, accepted in 2014-09-22,  发布年份 2014

【 摘 要 】

Background

Although studies have shown that a large proportion of cancer patients use CAM, no study on CAM use amongst orthopaedic oncology patients has been published. Therefore, this study aims to determine the prevalence, characteristics and factors associated with CAM use amongst orthopaedic oncology patients.

Methods

All consecutive consenting patients/parents who presented at the Orthopaedic Oncology Clinic, University Malaya Medical Centre (1st January to 31st December 2013) were interviewed using a structured questionnaire.

Results

Overall, one hundred sixty-eight of the 274 patients recruited (61.3%) had used CAM at some time during their current illness. The prevalence of CAM used was 68% (123/181) for patients with malignant tumours and 48.4% (45/93) for patients with benign tumours. The most popular CAMs were biological-based therapies (90.5%), followed by mind-body techniques (40.5%). The most frequently used biological therapies were mega/multivitamins (31%), snakehead (Chana striatus) (28%) and sea cucumber (Stichopus horrens) (18%); whereas prayers (31%) and holy water (13%) dominated the mind-body category. Common reasons for CAM use were to improve physical well-being (60.1%), try out everything that would help (59.5%) and to enhance wound-healing (39.3%). Independent predictors for CAM use in multivariate analysis were paediatric patients [OR 2.46; 95% CI 0.99–6.06; p = 0.05], malignant tumours [OR 1.90; 95% CI 1.12–3.25; p = 0.018] and patients who underwent surgery [OR 2.06; 95% CI 1.15–3.69; p = 0.015]. Majority patients started taking CAMs following suggestions from family members (53%) and friends (49%). Sixty-six percent of patients felt they actually benefitted from CAM and 83.3% were satisfied/very satisfied. Only 5 patients reported side-effects. Majority of CAM users planned to continue CAM use or recommend it to others. However, only 31.5% of patients disclosed their CAM usage to their doctors.

Conclusions

This survey revealed a high prevalence of CAM usage amongst orthopaedic oncology patients, with majority patients expressing satisfaction towards CAM. Oncologists should proactively ask patients about CAM to prevent potential adverse effects, as most patients do not share this information with them.

【 授权许可】

   
2014 Dhanoa et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Astin JA: Why patients use alternative medicine: results of a national study. JAMA 1998, 279(19):1548-1553.
• [2]Saydah SH, Eberhardt MS: Use of complementary and alternative medicine among adults with chronic diseases: United States 2002. J Altern Complement Med 2006, 12(8):805-812.
• [3]Weaver AJ, Flannelly KJ: The role of religion and spirituality for cancer patients and their caregivers. South Med J 2004, 97(12):1210-1214.
• [4]National Center for Complementary and Alternative Medicine: What is Complementary and Alternative Medicine (CAM)? https://cim.ucdmc.ucdavis.edu/clubs/camsig/whatiscam.pdf webcite last accessed 15 September 2014
• [5]Molassiotis A, Fernadez-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, Margulies A, Browall M, Magri M, Selvekerova S, Madsen E, Milovics L, Bruyns I, Gudmundsdottir G, Hummerston S, Ahmad AM, Platin N, Kearney N, Patiraki E: Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol 2005, 16(4):655-663.
• [6]Swisher EM, Cohn DE, Goff BA, Parham J, Herzog TJ, Rader JS, Mutch DG: Use of complementary and alternative medicine among women with gynaecologic cancers. Gynecol Oncol 2002, 84(3):363-367.
• [7]Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE: Complementary and alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol 2000, 18(13):2505-2514.
• [8]Verhoef MJ, Balneaves LG, Boon HS, Vroegindewey A: Reasons for and characteristics associated with complementary and alternative medicine use among adult cancer patients: a systematic review. Integr Cancer Ther 2000, 4(4):274-286.
• [9]Ernst E, Cassileth BR: The prevalence of complementary/alternative medicine in cancer: a systematic review. Cancer 1998, 83(4):777-782.
• [10]Horneber M, Bueschel G, Dennert G, Less D, Ritter E, Zwahlen M: How many cancer patients use complementary and alternative medicine: a systemic review and metaanalysis. Integr Cancer Ther 2012, 11(3):187-203.
• [11]Molassiotis A, Potrata B, Cheng KK: A systematic review of the effectiveness of Chinese herbal medication in symptom management and improvement of quality of life in adult cancer patients. Complement Ther Med 2009, 17(2):92-120.
• [12]Liossi C, White P, Hatira P: A randomized clinical trial of a brief hypnosis intervention to control venepuncture-related pain of paediatric cancer patients. Pain 2009, 142(3):255-263.
• [13]Oh B, Butow P, Mullan B, Hale A, Lee MS, Guo X, Clarke S: A critical review of the effects of medical Qigong on quality of life, immune function, and survival in cancer patients. Integr Cancer Ther 2012, 11(2):101-110.
• [14]Markman M: Safety issues in using complementary and alternative medicine. J Clin Oncol 2002, 20(18 Suppl):39S-41S.
• [15]Markowitz JS, Donovan JL, DeVane CL, Taylor RM, Ruan Y, Wang JS, Chavin KD: Effect of St John’s wort on drug metabolism by induction of cytochrome P450 3A4 enzyme. JAMA 2003, 290(11):1500-1504.
• [16]Anon. From the Centers for Disease Control and Prevention: Hepatic toxicity possibly associated with kava-containing products—United States, Germany, and Switzerland, 1999–2002. JAMA 2003, 289(1):36-37.
• [17]Ang-Lee MK, Moss J, Yuan CS: Herbal medicines and perioperative care. JAMA 2001, 286(2):208-216.
• [18]Klafke N, Eliott JA, Wittert GA, Olver IN: Prevalence and predictors of complementary and alternative medicine (CAM) use by men in Australia cancer ouptatients services. Ann Oncol 2012, 23(6):1571-1578.
• [19]Bishop FL, Prescott P, Chan YK, Saville J, von Elm E, Lewith GT: Prevalence of complementary medicine use in paediatric cancer: a systematic review. Pediatrics 2010, 125(4):768-776.
• [20]Hamidah A, Rustam ZA, Tamil AM, Zarina LA, Zulkifli ZS, Jamal R: Prevalence and parental perceptions of complementary and alternative medicine use by children with cancer in a multi-ethnic Southeast Asian population. Pediatr Blood Cancer 2009, 52(1):70-74.
• [21]Pui CH, Gajjar AJ, Kane JR, Qaddoumi IA, Pappo AS: Challenging issues in paediatric oncology. Nat Rev Clin Oncol 2011, 8(9):540-549.
• [22]Ladas EJ, Post-White J, Hawks R, Taromina K: Evidence for symptom management in the child with cancer. J Pediatr Hematol Oncol 2006, 28(9):601-615.
• [23]Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F: World Health Organization Classification of tumours of soft tissue and bone. 4th edition. Lyon: IARC Press; 2013.
• [24]National Center for Complementary and Alternative Medicine: Expanding Horizons of Healthcare: Five-Year Strategic Plan, 2001–2005. http://nccam.nih.gov/sites/nccam.nih.gov/files/about/plans/fiveyear/fiveyear.pdf webcite (last accessed 15 September 2014)
• [25]Wieland LS, Manheimer E, Berman BM: Development and classification of an operational definition of complementary and alternative medicine for the Cochrane collaboration. Altern Ther Health Med 2011, 17(2):50-59.
• [26]Hyodo I, Amano N, Eguchi K, Narabayashi M, Imanishi J, Hirai M, Nakano T, Takashima S: Nationwide survey on complementary and alternative medicine in cancer patients in Japan. J Clin Oncol 2005, 23(12):2645-2654.
• [27]Shih V, Chiang JY, Chan A: Complementary and alternative medicine (CAM) usage in Singaporean adult cancer patients. Ann Oncol 2009, 20(4):752-757.
• [28]Yildiz I, Ozguroglu M, Toptas T, Turna H, Sen F, Yildiz M: Patterns of complementary and alternative medicine use among Turkish cancer patients. J Palliat Med 2013, 16(4):383-390.
• [29]Tomlinson D, Hesser T, Ethier MC, Sung L: Complementary and alternative medicine use in pediatric cancer reported during palliative phase of disease. Support Care Cancer 2011, 19(11):1857-1863.
• [30]Barnes PM, Bloom B, Nahin RL: Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report 2008, 12:1-23.
• [31]Lazarus RS, Folkman S: Stress, Appraisal, and Coping. New York: Springer; 1984.
• [32]Folkman S, Lazarus RS: Coping as a mediator of emotion. J Pers Soc Psychol 1988, 54(3):466-475.
• [33]LaMontagne LL, Hepworth JT, Pawlak R, Chiafery M: Parental coping and activities during pediatric critical care. Am J Crit Care 1992, 1(2):76-80.
• [34]Ezeome ER, Anarado AN: Use of complementary and alternative medicine by cancer patients at the University of Nigeria Teaching Hospital, Enugu, Nigeria. BMC Complement Altern Med 2007, 7:28. BioMed Central Full Text
• [35]Farooqui M, Hassali MA, Shatar AK, Shafie AA, Seang TB, Farooqui MA: A qualitative exploration of Malaysian cancer patients’ perspectives on cancer and its treatment. BMC Public Health 2011, 11:525. BioMed Central Full Text
• [36]Corbin L: Safety and efficacy of massage therapy for patients with cancer. Cancer Control 2005, 12(3):158-164.
• [37]Lin JG, Chen YH: The role of acupuncture in cancer supportive care. Am J Chin Med 2012, 40(2):219-229.
• [38]Gottschling S, Meyer S, Längler A, Scharifi G, Ebinger F, Gronwald B: Differences in use of complementary and alternative medicine between children and adolescents with cancer in Germany: a population based survey. Pediatr Blood Cancer 2014, 61(3):488-492.
• [39]Davis EL, Oh B, Butow PN, Mullan BA, Clarke S: Cancer patient disclosure and patient-doctor communication of complementary and alternative medicine use: a systematic review. Oncologist 2012, 17(11):1475-1481.
• [40]Öhlén J, Balneaves LG, Bottorff JL, Brazier ASA: The influence of significant others in complementary and alternative medicine decisions by cancer patients. Soc Sci Med 2006, 63(6):1625-1636.
• [41]Klafke N, Eliott JA, Olver IN, Wittert GA: The role of complementary and alternative medicine (CAM) routines and rituals in men with cancer and their significant others (SOs). A qualitative investigation. Support Care Cancer 2014, 22(5):1319-1331.
• [42]Schmidt K, Ernst E: Assessing websites on complementary and alternative medicine for cancer. Ann Oncol 2004, 15(5):733-742.
• [43]Chang KH, Brodie R, Choong MA, Sweeney KJ, Kerin MJ: Complementary and alternative medicine use in oncology: a questionnaire survey of patients and health care professionals. BMC Cancer 2011, 11:196. BioMed Central Full Text