title: Correlates of use of different types of complementary and alternative medicine by breast cancer survivors in the nurses' health study.
abstract: OBJECTIVE
  Among breast cancer survivors, we identified the prevalence and correlates of use of different types of complementary and alternative medicine (CAM).
  
  
  METHODS
  We included 2,022 women diagnosed with breast cancer 1998-2003 who responded to a survey about CAM use. We performed logistic regression to determine demographic and disease factors associated with use of different CAM therapies (including relaxation/imagery, spiritual healing, yoga, energy healing, acupuncture, massage, chiropractic, high-dose vitamins, herbs, and homeopathy). We also measured quality of life (QoL) using the SF36 and optimism using LOT-R and fit linear regression models to compare mean scores among CAM users and nonusers.
  
  
  RESULTS
  Sixty-two percent of respondents used CAM. Younger age was the most consistent correlate of CAM use, but factors associated with CAM use varied by type of CAM. Chemotherapy was associated with use of relaxation/imagery (OR 1.3 95%CI 1.1-1.7). Radiotherapy was associated with use of high-dose vitamins (OR 1.5 95% CI 1.2-2.0). Tamoxifen or anastrozole treatment was associated with use of homeopathy (OR 0.5 95%CI 0.3-0.9). Users of most types of CAM had worse QoL scores than nonusers, but better QoL was found among users of yoga. The lowest QoL scores were associated with the use of energy healing. Optimism was higher among users of relaxation/imagery.
  
  
  CONCLUSIONS
  Factors associated with CAM use varied according to type of CAM. Our finding of worse QoL among women using energy healing and better QoL among women using yoga suggests the need for longitudinal studies to determine the temporal relationships between these therapies and QoL.
authors.affiliation: Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, Boston, MA 02215-3325, USA. catherine_buettner@hms.harvard.edu
authors.forename: Catherine
authors.initials: C
authors.lastname: Buettner
authors.forename: Candyce H
authors.initials: CH
authors.lastname: Kroenke
authors.forename: Russell S
authors.initials: RS
authors.lastname: Phillips
authors.forename: Roger B
authors.initials: RB
authors.lastname: Davis
authors.forename: David M
authors.initials: DM
authors.lastname: Eisenberg
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Holmes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy*; D000529:Complementary Therapies; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008875:Middle Aged; D009726:Nurses; D011788:Quality of Life