Complementary and Alternative Medicine Use among Cancer Patients at the End of Life: Korean National Study

Abstract

Objectives: To investigate in depth the use of complementary and alternative medicines (CAMs) by cancer patients at the end-of-life (EOL) and how they communicate with physicians about them. Design and location: In 17 hospitals in Korea between January and December 2004 we identified 4,042 families of cancer patients. Results: The prevalence of CAM use among cancer patients at the EOL was 37.0%, and 93.1% had used pharmacologic types of agents. The most frequent motive for CAM use was the recommendation of friends or a close relative (53.4%) or a physician (1.6%). Only 42.5% discussed CAM use with their physicians. Satisfaction with CAMS was recalled for 37.1% . The most common reason given for that satisfaction was improvement of emotional or physical well-being, while ineffectiveness was the most common reason given for dissatisfaction. The average cost of CAM during the last month of life was $US 900. CAM use was associated with longer disease periods, primary cancers other than liver, biliary, and pancreatic, and need of support from physicians or religion. Conclusions: CAM use among cancer patients at the EOL was common, not discussed with physicians, and associated with expectation of cure. Expectations were generally unmet while the treatments were a financial burden. Further studies evaluating the effects of CAM at the EOL and factors that enhance communication with the physician are needed.

Factors Associated with Discontinuation of Complementary and Alternative Medicine among Korean Cancer Patients

“…Nonetheless, CAM is attracting a significant level of interest from cancer patients due to the psychological support it provides. According to previous studies, the most frequently used form of CAM is herbs (Samur et al, 2001; Molassiotis et al, 2005;Er et al, 2008;Choi et al, 2012;Saibul et al, 2012;Nazik et al, 2012). Cancer patients are thought to employ CAM to increase physical strength, restrain cancer growth, enhance the immune system, and alleviate symptoms (Hyodo et al, 2005;Molassiotis et al, 2005;Molassiotis et al, 2006;Er et al, 2008;Shin et al, 2009;Saibul et al, 2012).…”

Dietary Supplement Use Among Patients With Hepatocellular Carcinoma

“…9 International studies confirm the increased use of alternative medicine among cancer patients worldwide. 8,29,31,33 This use is also often not disclosed to treating oncologists, in part due to discordant beliefs of patients and healthcare providers regarding the benefits of supplements. 34 Gender differences may be partially responsible for the differences between prostate and breast cancer patients in reported use of supplements.…”

“…[28][29][30] Despite the unclear benefits of supplements, use tends to increase after a cancer diagnosis. 8,9,31 In 1998, Ernst and Cassileth reported a systematic review of 26 studies evaluating complementary alternative medicine (CAM) use in cancer patients, and they found that 40% of patients reported alternative medicine use. This review was limited as each individual study defined CAM differently, including both nonpharmacologic treatments and dietary supplements.…”

Changes in Complementary and Alternative Medicine Use Across Cancer Treatment and Relationship to Stress, Mood, and Quality of Life

“…In previous studies, overall reasons for taking CAMs have included strengthening the immune system, improving emotional or physical well-being, improving the body's capacity to perform daily activities, 11,29,31 reducing psychological stress and physical symptoms, and gaining a feeling of control over treatment, but a distinctive pattern for specific CAM types and specific reasons was not clearly apparent. 32,33 In terms of satisfaction, most users were satisfied with perceived benefits of CAM, 29,32 but lack of improvement in expected goal was the most common reason for dissatisfaction.…”

“…32,33 In terms of satisfaction, most users were satisfied with perceived benefits of CAM, 29,32 but lack of improvement in expected goal was the most common reason for dissatisfaction. 31 …”