Complementary and alternative medicine among advanced cancer patients enrolled on phase I trials: a study of prognosis, quality of life, and preferences for decision making.
OBJECTIVE
We sought to describe complementary and alternative medicine (CAM) usage among phase I trial participants and to describe these patients' treatment decision-making preferences, awareness of prognosis, survival, and quality of life.


METHODS
Advanced cancer patients enrolling onto phase I trials were surveyed regarding biologically based CAM use. Decision-making preferences and awareness of prognosis were assessed using validated and/or standardized instruments. The Functional Assessment of Cancer Therapy-General instrument was used to assess quality of life. Univariate and multivariate analyses were performed to detect differences between CAM users and nonusers.


RESULTS
Of 212 interviewed patients, 34% (n = 72) described taking biologically based CAM. Median age of those taking biologically based CAM was 55 years, compared with 62 years for nonusers (P < .005). There were no statistically significant differences found between CAM usage and preferences for degree of patient involvement in medical decision making. Those patients who acknowledged that their deaths were likely to occur within 1 year were more likely to admit to prior CAM use (70% v 34%; P = .02). CAM users had poorer overall quality of life compared with nonusers (87.0 +/- 12.4 v 91.2 +/- 14.7; P = .007). No differences in survival were identified.


CONCLUSIONS
Prior CAM use among phase I cancer trial patients studied was common and associated with age, stated acknowledgment of prognosis, and quality of life. Patients enrolling onto early-phase trials should be questioned about CAM use. Additional study is needed to determine the frequency of use of those biologically based CAM agents that threaten the accuracy of early-phase cancer trial data.
Hlubocky
Fay J
FJ
Department of Medicine, Section of Hematology/Oncology, MacLean Center for Clinical Medical Ethics, the Cancer Research Center, The University of Chicago, Chicago, IL 60637, USA.
Ratain
Mark J
MJ
Wen
Ming
M
Daugherty
Christopher K
CK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D002641:Chicago; D017321:Clinical Trials, Phase I as Topic / Q000379:methods*; D000529:Complementary Therapies; D003657:Decision Making; D019587:Dietary Supplements; D005260:Female; D041743:Herb-Drug Interactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000523:psychology / Q000628:therapy; D010358:Patient Participation; D010361:Patients / Q000523:psychology*; D028321:Plant Preparations / Q000627:therapeutic use; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014815:Vitamins / Q000627:therapeutic use
D000970:Antineoplastic Agents; D028321:Plant Preparations; D014815:Vitamins