Complementary and Alternative Medicine Use and Latina Breast Cancer Survivors' Symptoms and Functioning.

Christina Rush,Kristi Graves,Maxie Blasini,Claudia Campos,Adriana Serrano,Tania Lobo

doi:10.3390/healthcare4040080

Abstract

Complementary and alternative medicine (CAM) is used widely in cancer populations, particularly among women, and has shown promise for addressing symptom and functioning outcomes. Few studies to date have evaluated CAM use and associations over time with symptoms and function among Latina breast cancer survivors. We administered a baseline (N = 136) and follow-up (n = 58) telephone survey in Spanish or English assessing Latina breast cancer survivor demographics, physical function, anxiety, depression, fatigue, satisfaction with social roles, and both CAM activities and devotional and spiritual practices. About one-third of our sample (35% baseline; 36% follow-up) reported using CAM (yoga, meditation, massage, or herbal/dietary supplements). We assessed devotional and spiritual practices separately from CAM (church attendance, prayer, religious groups, and reading devotional and religious texts); the majority of Latina survivors reported devotional and spiritual practices (80% baseline; 81% follow-up). At baseline, CAM demonstrated a positive association with better physical functioning and lower depression. In contrast, CAM use at the time of follow-up appeared to be related to lower levels of satisfaction with social roles and physical function. In longitudinal analyses, devotional and spiritual practices at baseline significantly predicted lower anxiety, depression, and fatigue at follow-up. Findings suggest CAM plays a complex and not always linear role in symptoms and function outcomes for Latina breast cancer survivors. These findings contribute to the literature on longitudinal CAM use and associations with symptom and functioning outcomes among Latina breast cancer survivors.

Highlights

Complementary and alternative medicine (CAM) is defined in terms of its relationship to conventional medicine
We developed an Activities Questionnaire to assess other activities participants may engage in that could impact patient-reported symptom and functioning quality of life (QOL) outcomes, including, among others, support groups and workshops related to cancer, physical therapy, counseling, and complementary and alternative medicine (CAM) practices
Survivors represented over 12 different countries and regions of origin, with 25% from Mexico, 23% from Central America, 26% from South America, 19% from the Caribbean, and 7% from the U.S The vast majority of survivor baseline surveys were conducted in Spanish (93%) and many survivors self-identified as more than one race (43%)

Summary

Introduction

Complementary and alternative medicine (CAM) is defined in terms of its relationship to conventional medicine. If used alongside conventional medicine, a CAM practice is considered “complementary”; if used to replace conventional medicine, a CAM practice is considered “alternative” [1]. For the purposes of this study, CAM includes iterations of mind-body medicine (yoga, meditation), massage, and naturopathic medicine (herbal supplements and dietary regimens). Aspects of religious and spirituality practices (church attendance, prayer, religious groups, and devotional and religious texts) have been considered part of CAM in some prior studies [2,3]; other work calls for a distinction between CAM and spirituality and devotional practices [4].

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