Health food store recommendations: implications for breast cancer patients.
BACKGROUND
Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer.


METHODS
Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired about product safety, potential drug interactions, costs and efficacy. They also enquired about employee training related to the products.


RESULTS
Thirty-four stores were examined. A total of 33 different products were recommended, none of which are supported by sufficient evidence of efficacy. The average cost of the products they recommended was 58.09 dollars (CAD) (minimum 5.28 dollars, median 32.99 dollars, maximum 600 dollars) per month. Twenty-three employees (68%) did not ask whether the patient took prescription medications. Fifteen employees (44%) recommended visiting a healthcare professional (naturopaths (9), physicians (5), nutritionists (1). Three employees (8.8%) discussed potential adverse effects of the products. Eight employees (23.5%) discussed the potential for drug interactions. Two employees (5.9%) suggested a possible cure with the products and one employee (2.9%) suggested discontinuing Tamoxifen. Four employees (11.8%) recommended lifestyle changes and three employees (8.8%) recommended books for further reading on the products.


CONCLUSIONS
This study draws attention to the heterogeneity of advice provided by natural health food stores to individuals seeking treatments for breast cancer, and the safety and cost implications of some of the products recommended. Physicians should enquire carefully about the use of natural health food products by patients with breast cancer. Regulators need to consider regulations to protect vulnerable patients from incurring significant costs in their purchasing of natural health food products lacking evidence of benefit and of questionable safety.
Department of Research, Canadian College of Naturopathic Medicine, North York, Ontario, Canada. emills@ccnm.edu
Edward
E
Mills
Edzard
E
Ernst
Rana
R
Singh
Cory
C
Ross
Kumanan
K
Wilson
D001943:Breast Neoplasms / Q000188:drug therapy*; D000529:Complementary Therapies / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D019587:Dietary Supplements / Q000191:economics / Q000592:standards; D005260:Female; D029001:Herbal Medicine / Q000191:economics / Q000592:standards; D006801:Humans; D008517:Phytotherapy / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D016896:Treatment Outcome