1388P - Complementary and Alternative Medicines (Cam) – A Curse to Breast Cancers of the Indian Subcontinent

Abstract

ABSTRACT Purpose In India, CAM practitioners get a major share of the first visits by patients with breast lumps, leading to inadvertent delays in their management. This multi-institutional prospective study conducted in IPGMER, M.C.H & R.G Kar, Kolkata, aims to quantify the exact percentage prevalence of CAM usage, demographic factors, magnitude of delay & subsequent prognostic losses incurred by this population. Methodology The study included all breast cancer cases reporting for treatment & permitting to be interviewed, in three medical colleges of Kolkata, India, between 1st Jan'2011 and 31st Dec'2011. Patients initially treated by CAM were subjected to detailed Questionnaires, focused on CAM professionals involved in the first medical attention; Initial size of the tumor (Based on Lumpometer designed by TMH, Mumbai); initial presence of nodal disease; history of Biopsy; demographic charters; the perceived benefits of CAM; & the time & costs involved. They were then staged and treated according to their present status. Results Analysis included 736 patients. Prior to reporting at the study centers 35.37% (260) patients opted for CAM. Analysis of this group revealed, 73.07 % came from Rural areas; 67.3% had poor socio-economic status; 46.16% were uneducated; none were screened or Biopsied. Homeopathy is the commonest form of CAM resorted to 70.76 %; Ayurveda 9.6%; Quack Allopathy 16.15%; Unani 1.92% & Spiritual Healing 1.53%.The median duration of symptoms at the first visit to the CAM professional was10 weeks [2-18]. 65.38% had non-tender breast lumps. The median initial T- Size was 2.5 cm [1-6.5]; median time lost 9.3 months [1.5 -28] & median expenditures 980 Rs [150-3500]. The median T-size at presentation to the study centers was 4.2 cm [2.8-12.5]. New onset nodal disease was seen in 38.0 %; Changes in disease staging seen in 56.15 %. The reasons were overlapping, unaffordability 51.92 %; inaccessibility 34.61%; 38.46% feared disfigurement; homeopathy can liquefy tumors was reasoned by 30.76%. Conclusion With more than 1/3 of breast cancer patients still opting for CAM for obvious reasons, none biopsied, valuable 9.3 months lost & 56% presenting upstaged, the anticipated prognostic losses are unacceptably large. Disclosure All authors have declared no conflicts of interest.