Breast Cancer and CAM
5/16/2007


WomanWhat a difference seven years can make. Just-published data confirm what many have suspected for years: the number of breast cancer patients pursuing complementary and alternative medicine (CAM) therapies has risen dramatically.

The numbers, then and now

A University of Toronto team examined trends in CAM use in 1998 and 2005 among women diagnosed with breast cancer.

Selected from the Ontario Cancer Registry, participants (425 women in 1998, and 553 women in 2005) completed questionnaires asking them to identify the types of CAM practitioners they had ever visited, as well as the CAM therapies and/or products they had ever used.

CAM was defined as “medical interventions that are not taught widely in medical schools or generally available in hospitals.”

In addition to sharing demographic information, participants also provided information about their cancer stages and the conventional treatments they had tried. (Most had surgery, and many were on medication, says primary investigator Heather Boon, PhD.)

In 2005, the questionnaire asked participants if they visited CAM practitioners or used CAM therapies specifically to manage their breast cancer or for some other reason.

The resulting data do support the hearsay. The team’s findings include the following:

1998

(425 breast cancer patients)

2005

(553 breast cancer patients)

Reported ever using a CAM product or therapy or seen a CAM Practitioner66.7%81.9%
Reported ever using CAM products or therapies62.0%70.6%
Reported ever seeing a CAM practitioner39.4%

57.4%

(massage therapists, dietitians most frequently reported)

Reported ever using CAM specifically to manage breast cancerNot asked

41.0% (220 women)

(Green tea, vitamin E, flaxseed, and vitamin C most frequently reported)

The data also indicated:

• A significant increase in visits to body work practitioners (such as massage and therapeutic touch therapists, and Reiki and shiatsu practitioners), acupuncturists, and homeopathic and traditional Chinese medicine practitioners;

• A significant increase in the overall use of herbal remedies, particularly green tea and special foods;

• A significant decrease in the use of Essiac, an herbal mixture formerly very popular in Canada. Use dropped to about half of what it had been, with no solid evidence to indicate why, Boon says.

“We’ve suspected for a long time that CAM use has been increasing among breast cancer patients, but it’s been difficult to back that up with numbers,” says Boon. “People who pursue CAM therapies aren’t in the minority anymore, and because CAM use is increasingly becoming the norm, we need to make sure that it is recognized by those working in the health care system.”

Caution urged, dialogue encouraged

Whether they’re dabblers or devotees, the growing number of CAM users underscores the great need for research into the safety and efficacy of many complementary and alternative medicine therapies. It also highlights the need for physicians to stay informed about which CAM treatments are out there – and which ones their patients are using.

Research suggests that only about 50 percent of patients tell their doctors about their use of CAM therapies, Boon says – and many doctors simply don’t think to ask.

“It just doesn’t occur to many patients that their doctors and pharmacists need to know about everything they’re doing, including their use of CAM therapies,” she says. “Drug interactions and unexplained changes in a patient’s condition – for better or worse – can take a lot longer to figure out when providers don’t know everything patients are doing.”

Cancer patients undergoing treatment must be especially cautious, Boon warns.

“There are a lot of unknowns about ingesting natural products during active cancer treatment, and there are always concerns about potentially harmful interactions,” she says. “Patients in active treatment should definitely speak with their physicians before pursuing any CAM therapies or practitioners.”

Boon’s advice is simple. “Practitioners, ask your patients about their use of complementary therapies – and patients, be open with your healthcare providers about what you’re doing,” she says. “We really need to open this dialogue.”


Boon et al., Trends in Complementary/Alternative Medicine Use by Breast Cancer Survivors: Comparing Survey Data from 1998 and 2005. BMC Women’s Health, 2007 Mar 30;7:4.



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