title: Patient initiation of complementary and alternative medical therapies (CAM) following cancer diagnosis.
abstract: OBJECTIVE
  Complementary and alternative medicine use is prevalent in both healthy and oncologic populations. However, few data exist to quantify complementary and alternative medicine initiation specifically after cancer diagnosis. This study evaluated patients' complementary and alternative medicine usage patterns, reasons, and general perceptions after cancer diagnosis and during or after conventional cancer therapy.
  
  
  METHODS
  An Internet- and clinic-based piloted questionnaire was distributed from July 2004 through September 2004. In total, 604 responses were analyzed (64% Internet, 36% oncology clinics). Patients were predominantly white females; almost half held college or graduate degrees. Respondents reported past or present history of >or=1 conventional treatment(s), primarily chemotherapy and radiotherapy.
  
  
  RESULTS
  Initiation of >or=1 complementary and alternative medicine after diagnosis was reported by 54% of those surveyed. Complementary and alternative medicine users were more likely than non-users to have a history of chemotherapy (P=0.003) and enrollment in clinical trials (P=0.007). Complementary and alternative medicine use was greater in females (P=0.004) and patients with higher education levels (P<0.001), but not in whites compared to non-whites (P=0.34). The most commonly cited reason for complementary and alternative medicine use after diagnosis was "general overall health." Less than one-third of patients cited their healthcare providers as primary sources of complementary and alternative medicine information. The vast majority of users (86%) expressed satisfaction with complementary and alternative medicine as a cost-effective approach.
  
  
  CONCLUSIONS
  About one-half of adult cancer patients initiate complementary and alternative medicine therapy after diagnosis and during or after conventional oncologic treatments. Healthcare providers should be aware of patients' reasons for complementary and alternative medicine use, both for symptom management and quality-of-life. Healthcare providers should also be familiar with patients' complementary and alternative medicine information sources and should supplement these sources with discussions of pertinent safety profiles and potential interactions with standard therapies.
authors.affiliation: Hospital of University of Pennsylvania, Department of Radiation Oncology, Philadelphia, Pennsylvania 19104, USA. vapiwala@xrt.upenn.edu
authors.forename: Neha
authors.initials: N
authors.lastname: Vapiwala
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Mick
authors.forename: Margaret K
authors.initials: MK
authors.lastname: Hampshire
authors.forename: James M
authors.initials: JM
authors.lastname: Metz
authors.forename: Albert S
authors.initials: AS
authors.lastname: DeNittis
mesh_terms: D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D015995:Prevalence; D011795:Surveys and Questionnaires