Abstract
Complementary medicine (CM) is used by one third to one half of cancer patients throughout the world. The objective of this study was to describe the prevalence of CM use and the potential for interactions with cancer treatments in an academic oncology centre. A cross-sectional study was conducted among patients undergoing current cancer treatment. Among 132 included patients, 56% had used CM since their cancer diagnosis and 45% were using CM during cancer treatment at the time of the survey. The main CM used were green tea (35%), herbal tea (35%), homeopathy (27%), dietary supplements (27%), and herbal medicines (27%). A small majority of patients (58%) spontaneously mentioned the use of CM to their oncologist. Of 42 identified combinations of concomitant use of biologically based CM and anticancer agents among the study patients, the potential for pharmacokinetic interactions of clinical relevance was not expected in 17 combinations (40%), hypothetical and deemed unlikely in 23 (55%), and of probable low clinical relevance in 2 (5%). Considering the high prevalence of CM use, active enquiries should be made by healthcare professionals to detect symptoms that may relate to CM tolerance and effects or that suggest interactions between CM and cancer treatments.
Highlights
The World Health Organization (WHO) defines complementary medicine (CM) as “a broad set of healthcare practices that are not part of a country’s own tradition or conventional medicine and are not fully integrated into the dominant healthcare system.” In the USA, the 1-year prevalence of Complementary medicine (CM) use was 33.8–42.1% in the nineties[1]
Two interactions of probable low clinical relevance between biologically based CM and anticancer agents were found among all study patients
The prevalence of CM use among oncology patients during this study was higher than in studies conducted in a neighbouring academic hospital (26.5%)[8] and in a region of the German-speaking part of Switzerland (39%)[7]
Summary
The World Health Organization (WHO) defines complementary medicine (CM) as “a broad set of healthcare practices that are not part of a country’s own tradition or conventional medicine and are not fully integrated into the dominant healthcare system.” In the USA, the 1-year prevalence of CM use was 33.8–42.1% in the nineties[1]. Given that up to 70% of patients tend to not spontaneously disclose their CM use to their oncologist[14], there is a risk that CM-related adverse events will not be detected or will be confounded with side effects related to cancer treatments. The objectives of this study were twofold: first, to describe the prevalence and characteristics of CM use in patients currently undergoing cancer therapy in the outpatient setting of a Swiss academic hospital oncology centre, as well as to explore communication about CM use between patients and physicians or nurses; and second, to evaluate the risk of interactions between cancer treatments and the CM used by these patients from a thorough search of the available literature
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