Complementary and alternative medicine and other health behaviors.

Abstract

23 Background: Complementary and alternative medicine (CAM) use in patients with cancer has increased. A patient’s decision to seek CAM alongside conventional cancer treatment is complex. We evaluated whether patients who sought CAM were also more likely to engage in other healthy behaviours such as exercise, smoking cessation, alcohol reduction, and maintaining a healthy weight. Methods: As part of a larger survey of cancer survivors, 551 cancer patients across Princess Margaret Cancer Centre (Canada) were queried on clinico-demographic information, their use of CAM and other health-related behaviors (smoking, alcohol use, healthy weight, etc.). Multivariable logistic regression assessed each health behavior, adjusting for clinical factors associated with CAM use. Results: Females: 53%; median age: 54 years; Caucasian: 83%. Primary tumor sites: breast/gynecologic 22%; gastrointestinal/genitourinary 28%; hematologic 23%; lung/head and neck 12%. Following their cancer diagnosis, 43% used CAM. Being female (odds ratio=2.55, 95% CI [1.8-3.7], having higher education (2.08 [1.4-3.1]) or higher income (1.80 [1.2-2.7]), and having breast/gynaecological cancers (vs. all others; 2.82 [1.8-4.3]) were associated with greater CAM use. These factors served as adjustment variables for the analysis of behaviors. Behaviors associated with increased use of CAM included: use of CAM prior to diagnosis (10.6 [6.5-17.2]), participation in support groups (3.39 [2.1-5.6]), not being overweight or obese one year prior to diagnosis (1.82 [1.2-2.7]), and meeting Canadian physical activity guidelines either before diagnosis (1.80 [1.2-2.8]) or currently (1.70 [1.0-2.8]). No association was observed between CAM use and smoking status or cessation, alcohol intake or reduction, self-described diet habits prior to cancer diagnosis or dietary changes after diagnosis. Conclusions: Some behaviors such as baseline and current physical activity, participation in support groups, not being overweight, and prior use of CAM were each associated with greater CAM use. Smoking, alcohol and diet were not associated with CAM use. Improved understanding of the reasons for CAM use can an improve patient-physician communication, decision-making, and treatment planning.