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Chin CY, Chen YH, Wu SC, Liu CT, Lee YF, Tsai MY. Complementary and Alternative Medicine Use in Breast Cancer Patients at a Medical Center in Taiwan: A Cross-Sectional Study. Integr Cancer Ther 2021; 19:1534735420983910. [PMID: 33372560 PMCID: PMC7797811 DOI: 10.1177/1534735420983910] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Complementary and alternative medicine (CAM) is becoming more common in
medical practice, but little is known about the concurrent use of CAM and
conventional treatment. Therefore, the aim was to investigate the types of
CAM used and their prevalence in a regional patient cohort with breast
cancer (BC). Methods BC patients were interviewed with a structured questionnaire survey on the
use of CAM in southern Taiwan at an Integrative Breast Cancer Center (IBCC).
The National Centre for Complementary and Integrative Health (NCCIH)
classification was used to group responses. Over a period of 8 months, all
patients receiving treatment for cancer at the IBCC were approached. Results A total of 106 BC patients completed the survey (response rate: 79.7%). The
prevalence of CAM use was 82.4%. Patients who were employed, were receiving
radiotherapy and hormone therapy, and had cancer for a longer duration were
more likely to use CAM (P < .05). Multivariate analysis
identified employment as an independent predictor of CAM use (OR = 6.92; 95%
CI = 1.33-36.15). Dietary supplementation (n = 69, 82.1%) was the type of
CAM most frequently used, followed by exercise (n = 48, 57.1%) and
traditional Chinese medicine (n = 29, 34.5%). The main reason for using CAM
was to ameliorate the side effects of conventional therapies. Almost half
(46.4%) of these CAM users did not disclose that they were using it in
medical consultations with their physicians. Most chose to use CAM due to
recommendations from family and friends. Conclusion A large portion of BC patients at the IBCC undergoing anti-cancer treatment
courses used CAM, but less than half discussed it with their physicians.
Given the high prevalence of CAM, it would be justifiable to direct further
resources toward this service so that cancer patients can benefit from a
holistic approach to their treatment.
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Affiliation(s)
- Chieh-Ying Chin
- Department of Chinese Medicine;
Department of Surgery; Division of Oncology, Department of Internal Medicine;
Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung
University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Integrated
Medicine, College of Chinese Medicine, China Medical University, Taichung,
Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated
Medicine, College of Chinese Medicine, China Medical University, Taichung,
Taiwan
- Department of Psychology, College of
Medical and Health Science, Asia University, Taichung, Taiwan
| | - Shin-Chung Wu
- Department of Chinese Medicine;
Department of Surgery; Division of Oncology, Department of Internal Medicine;
Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung
University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Ting Liu
- Department of Chinese Medicine;
Department of Surgery; Division of Oncology, Department of Internal Medicine;
Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung
University College of Medicine, Kaohsiung, Taiwan
| | - Yun-Fang Lee
- Department of Chinese Medicine;
Department of Surgery; Division of Oncology, Department of Internal Medicine;
Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung
University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Yen Tsai
- Department of Chinese Medicine;
Department of Surgery; Division of Oncology, Department of Internal Medicine;
Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung
University College of Medicine, Kaohsiung, Taiwan
- Ming-Yen Tsai, Department of Chinese
Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College
of Medicine, No. 123, Dapi Road, Niaosong District, Kaohsiung 83301, Taiwan.
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Prevalence of the Use of Herbal Medicines among Patients with Cancer: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9963038. [PMID: 34055029 PMCID: PMC8149249 DOI: 10.1155/2021/9963038] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/01/2021] [Accepted: 05/08/2021] [Indexed: 12/24/2022]
Abstract
Background Although herbal medicines are used by patients with cancer in multiple oncology care settings, the magnitude of herbal medicine use in this context remains unclear. The purpose of this review was to establish the prevalence of herbal medicine use among patients with cancer, across various geographical settings and patient characteristics (age and gender categories). Methods Electronic databases that were searched for data published, from January 2000 to January 2020, were Medline (PubMed), Google Scholar, Embase, and African Index Medicus. Eligible studies reporting prevalence estimates of herbal medicine use amongst cancer patients were pooled using random-effects meta-analyses. Studies were grouped by World Bank region and income groups. Subgroup and meta-regression analyses were performed to explore source of heterogeneity. Results In total, 155 studies with data for 809,065 participants (53.95% female) met the inclusion criteria. Overall, the pooled prevalence of the use of herbal medicine among patients with cancer was 22% (95% confidence interval (CI): 18%–25%), with the highest prevalence estimates for Africa (40%, 95% CI: 23%–58%) and Asia (28%, 95% CI: 21%–35%). The pooled prevalence estimate was higher across low- and middle-income countries (32%, 95% CI: 23%–42%) and lower across high-income countries (17%, 95% CI: 14%–21%). Higher pooled prevalence estimates were found for adult patients with cancer (22%, 95% CI: 19%–26%) compared with children with cancer (18%, 95% CI: 11%–27%) and for female patients (27%, 95% CI: 19%–35%) compared with males (17%, 95% CI: 1%–47%). Conclusion Herbal medicine is used by a large percentage of patients with cancer use. The findings of this review highlight the need for herbal medicine to be integrated in cancer care.
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The use of complementary medicine in palliative care in France: an observational cross-sectional study. Support Care Cancer 2020; 28:4405-4412. [DOI: 10.1007/s00520-020-05296-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/03/2020] [Indexed: 10/25/2022]
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Alsharif FH, Mazanec SR. The use of complementary and alternative medicine among women with breast cancer in Saudi Arabia. Appl Nurs Res 2019; 48:75-80. [PMID: 31266612 DOI: 10.1016/j.apnr.2019.05.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 05/13/2019] [Accepted: 05/27/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE The purpose of the study was to explore the frequency of use of complementary and alternative medicine (CAM) therapies among women with breast cancer in Saudi Arabia. DESIGN A descriptive cross-sectional study design was used with face-to-face interviews using a structured questionnaire. SAMPLE A convenient sample of 85 Saudi women with breast cancer who were undergoing cancer treatment was recruited from the Oncology Department of King Faisal Hospital, Jeddah, Kingdom of Saudi Arabia. METHODS Using structured questionnaire "Use of Complementary Therapies Survey," consisted of diet and nutritional supplements, stress-reducing therapies, and other traditional treatments. RESULT Participants were predominantly married (76.5%), resided in an urban area (83.5%), unemployed (62%), and about half reported no income (49.4%). The mean age was 48 years. All participants reported using at least three or more CAM therapies (mean = 21.15, SD = 8.85) since their diagnosis. There were significant correlations between other CAM use and time since diagnosis (rs = -0.33, p < .05). The highest usage of dietary and nutritional supplements occurred with honey, olive oil, antioxidants, Fennel flower seeds, and ginger. The highest stress reducing CAM techniques included reading the Holy Qur'ãn, and praying. For other traditional CAM therapies, positive thinking and relaxation techniques were the most frequent methods reported by women. Other CAM treatments involved ZamZam water and listening to music. CONCLUSIONS The use of complementary therapies among Saudi women with breast cancer is highly prevalent, with a predominance of interventions of religious background, indicating the strong influence of religion on peoples' lives, especially when people are faced with a life-threatening illness. The results of this study will guide future studies examining the efficacy of CAM on symptom management in Saudi Arabian women with breast cancer and other types of cancer.
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Affiliation(s)
| | - Susan R Mazanec
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, United States of America
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Abu-Darwish MS, Efferth T. Medicinal Plants from Near East for Cancer Therapy. Front Pharmacol 2018; 9:56. [PMID: 29445343 PMCID: PMC5797783 DOI: 10.3389/fphar.2018.00056] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 01/16/2018] [Indexed: 01/22/2023] Open
Abstract
Background: Cancer is one of the major problems affecting public health worldwide. As other cultures, the populations of the Near East rely on medicinal herbs and their preparations to fight cancer. Methods: We compiled data derived from historical ethnopharmacological information as well as in vitro and in vivo results and clinical findings extracted from different literature databases including (PubMed, Scopus, Web of Science, and Google Scholar) during the past two decades. Results: In this survey, we analyzed the huge amount of data available on anticancer ethnopharmacological sources used in the Near East. Medicinal herbs are the most dominant ethnopharmacological formula used among cancer's patients in the Near East. The data obtained highlight for the first time the most commonly used medicinal plants in the Near East area for cancer treatment illustrating their importance as natural anticancer agents. The literature survey reveals that various Arum species, various Artemisia species, Calotropis procera, Citrullus colocynthis, Nigella sativa, Pulicaria crispa, various Urtica species, Withania somnifera, and others belong to the most frequently used plants among cancer patients in the Near East countries. Molecular modes of action that have been investigated for plant extracts and isolated compounds from Near East include cell cycle arrest and apoptosis induction with participation of major player in these processes such as p53 and p21, Bcl-2, Bax, cytochrome c release, poly (ADP-ribose) polymerase cleavage, activation of caspases, etc. Conclusion: The ethnopharmacology of the Near East was influenced by Arabic and Islamic medicine and might be promising for developing new natural and safe anticancer agents. Further research is required to elucidate their cellular and molecular mechanisms and to estimate their clinical activity.
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Affiliation(s)
- Mohammad S. Abu-Darwish
- Department of Basic and Applied Sciences, Shoubak University College, Al-Balqa’ Applied University, Al-Salt, Jordan
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz, Germany
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz, Germany
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Roumeliotis GA, Dostaler G, Boyd KU. Complementary and Alternative Medicines and Patients With Breast Cancer: A Case of Mortality and Systematic Review of Patterns of Use in Patients With Breast Cancer. Plast Surg (Oakv) 2017; 25:275-283. [PMID: 29619352 DOI: 10.1177/2292550317716126] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background The use of complementary and alternative medicines (CAMs) is common among women being treated for breast cancer. A recent mortality associated with CAM at our center precipitated a systematic review of the Cochrane, EMBASE, and PubMed databases to identify English manuscripts including "CAM" and "breast cancer." Methods Papers included for review were selected based on predefined inclusion and exclusion criteria. The primary outcome was the use of CAM by women with breast cancer. Secondary outcomes included timing of use along disease trajectory, attitudes toward CAM by allopathic practitioners, and patient disclosure of CAM use to treating allopathic physicians. Results Of 701 titles identified by the search strategy, 36 met the inclusion criteria. The weighted average proportion of women with breast cancer who use CAM was 40% (standard deviation: 18%). The diagnosis of breast cancer also prompts the initiation or increase of CAM use. However, up to 84% of patients do not disclose the use of CAM to their allopathic practitioners. Conclusions Although CAM is often dismissed as a harmless addition to allopathic therapy, significant complications and interactions can occur. Our review and the dramatic case example provided highlight the need for physicians to educate themselves regarding CAM and to engage with their patients regarding its use.
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Affiliation(s)
- Grayson A Roumeliotis
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Kirsty U Boyd
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
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Poonthananiwatkul B, Howard RL, Williamson EM, Lim RH. Why cancer patients choose in-patient complementary therapy in palliative care: A qualitative study at Arokhayasala Hospice in Thailand. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Poonthananiwatkul B, Howard RL, Williamson EM, Lim RHM. Cancer patients taking herbal medicines: A review of clinical purposes, associated factors, and perceptions of benefit or harm. JOURNAL OF ETHNOPHARMACOLOGY 2015; 175:58-66. [PMID: 26344852 DOI: 10.1016/j.jep.2015.08.052] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/18/2015] [Accepted: 08/30/2015] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cancer patients in all cultures are high consumers of herbal medicines (HMs) usually as part of a regime consisting of several complementary and alternative medicine (CAM) modalities, but the type of patient, the reasons for choosing such HM-CAM regimes, and the benefits they perceive from taking them are poorly understood. There are also concerns that local information may be ignored due to language issues. This study investigates aspects of HM-CAM use in cancer patients using two different abstracting sources: Medline, which contains only peer-reviewed studies from SCI journals, and in order to explore whether further data may be available regionally, the Thai national databases of HM and CAM were searched as an example. MATERIALS AND METHODS The international and Thai language databases were searched separately to identify relevant studies, using key words chosen to include HM use in all traditions. Analysis of these was undertaken to identify socio-demographic and clinical factors, as well as sources of information, which may inform the decision to use HMs. RESULTS Medline yielded 5638 records, with 49 papers fitting the criteria for review. The Thai databases yielded 155, with none relevant for review. Factors associated with HM-CAM usage were: a younger age, higher education or economic status, multiple chemotherapy treatment, late stage of disease. The most common purposes for using HM-CAM cited by patients were to improve physical symptoms, support emotional health, stimulate the immune system, improve quality of life, and relieve side-effects of conventional treatment. CONCLUSIONS Several indicators were identified for cancer patients who are most likely to take HM-CAM. However, interpreting the clinical reasons why patients decide to use HM-CAM is hampered by a lack of standard terminology and thematic coding, because patients' own descriptions are too variable and overlapping for meaningful comparison. Nevertheless, fears that the results of local studies published regionally are being missed, at least in the case of Thailand, appeared to be unfounded.
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Affiliation(s)
| | - Rachel L Howard
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom
| | - Elizabeth M Williamson
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom.
| | - Rosemary H M Lim
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom
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Expectations from an integrative medicine consultation in breast cancer care: a registry protocol-based study. Support Care Cancer 2014; 23:317-24. [DOI: 10.1007/s00520-014-2361-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/21/2014] [Indexed: 01/30/2023]
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Quality of Life in Women With Breast Cancer and the Use of Complementary and Alternative Medicine. Holist Nurs Pract 2014; 28:258-64. [DOI: 10.1097/hnp.0000000000000038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Can G, Demir M, Aydiner A. Complementary and alternative therapies used by Turkish breast cancer patients undergoing chemotherapy. ACTA ACUST UNITED AC 2014; 7:471-5. [PMID: 24715829 DOI: 10.1159/000345462] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Most breast cancer patients use complementary and alternative medicine (CAM), usually in parallel with their conventional treatments. This study was planned to determine the prevalence and determining factors for use of CAM by breast cancer patients undergoing chemotherapy. PATIENTS AND METHODS This descriptive study was carried out between October 2010 and May 2011, and included 96 patients at the Istanbul University Institute of Oncology. The Patient Characteristics form and Complementary and Alternative Medicine Scale were used for data collection. Descriptive and non-parametric tests were performed, and logistic regression analysis was used to predict factors affecting CAM use. RESULTS Praying was the most frequently used form of CAM, and most of the herbal supplements used by patients were harmless. Herbal use was higher among patients who had local disease (relative risk (RR) 4.48%, 95% confidence interval (CI) 1.12-17.95), and worship was more common among those who had not undergone surgery (RR 4.66%, 95% CI 1.64-13.20). CONCLUSION The CAM approaches used by patients were found to be safe. However, sage and flax seed usage for estrogen-and progesterone-positive patients and exercise for patients with spinal metastasis can be inappropriate approaches. It is important to question and inform patients about CAM use during treatment.
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Affiliation(s)
- Gulbeyaz Can
- Istanbul University, Nursing Faculty, Istanbul, Istanbul, Turkey
| | - Melike Demir
- Namik Kemal University Medical Health School, Tekirdag, Istanbul, Turkey
| | - Adnan Aydiner
- Istanbul University, Institute of Oncology, Istanbul, Turkey
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Wanchai A, Armer JM, Stewart BR. Performance care practices in complementary and alternative medicine by Thai breast cancer survivors: an ethnonursing study. Nurs Health Sci 2013; 14:339-44. [PMID: 22950615 DOI: 10.1111/j.1442-2018.2012.00730.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to explore how Thai breast cancer survivors perform care practices in complementary and alternative medicine to promote their health and well-being. Research was conducted using an ethnonursing method. Data were collected through semi-structured interviews with 17 Thai breast cancer survivors in Thailand. The transcribed interviews were analyzed using the ethnonursing analysis method. The findings showed Thai breast cancer survivors started their care practices in complementary and alternative medicine immediately following a diagnosis of breast cancer. They sought out and gathered alternative medicine information from several sources, such as the people around them, media resources, books, magazines, or newspapers. After gathering information, Thai breast cancer survivors would try out various types of complementary medicines rather than use only one type because of information from other people and their own evaluation. The findings of this study indicate the need for a conversation about complementary medicine use between healthcare providers and Thai breast cancer survivors as an on-going process throughout the cancer trajectory to ensure that safe and holistic care is provided.
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Affiliation(s)
- Ausanee Wanchai
- Boromarajonani College of Nursing, Buddhachinaraj, Thailand.
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