title: Cancer survivors with unmet needs were more likely to use complementary and alternative medicine.
abstract: OBJECTIVE
  Despite advancements in cancer care, cancer survivors continue to experience a substantial level of physical and emotional unmet needs (UMN). This study aims to determine the relationship between patients' perceived UMN and their use of complementary and alternative medicine (CAM) to help with cancer problems during and after treatment.
  
  
  METHODS
  A mailed, cross-sectional survey was completed by 614 cancer survivors identified through the Pennsylvania Cancer Registry 3.5 to 4 years from initial diagnosis. Relationships among UMN and CAM use along with clinical and socio-demographic factors were examined.
  
  
  RESULTS
  Respondents who identified any UMN were 63% more likely to report CAM use than those without UMN (58% vs. 36%), p < 0.001. UMN remained the only independent predictor (adjusted odds ratio = 2.30, 95% confidence interval = 1.57-3.36, p < 0.001) of CAM use in a multivariate logistic regression model that included age, sex, marital status, education, previous chemotherapy and radiotherapy. Adjusted for covariates, UMN in domains of emotional, physical, nutritional, financial, informational, treatment-related, employment-related, and daily living activities were all related to CAM use, whereas UMN in transportation, home care, medical staff, family and spirituality were not related to CAM use. Patients who experienced multiple types of unmet needs were also more likely to use multiple types of CAM (p < 0.001 for model).
  
  
  CONCLUSIONS
  Cancer survivors who experienced unmet needs within the existing cancer treatment and support system were more likely to use CAM to help with cancer problems. Research is needed to determine if appropriate CAM use decreases unmet needs among cancer survivors.
authors.affiliation: Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. maoj@uphs.upenn.edu
authors.forename: Jun J
authors.initials: JJ
authors.lastname: Mao
authors.forename: Steve C
authors.initials: SC
authors.lastname: Palmer
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Straton
authors.forename: Peter F
authors.initials: PF
authors.lastname: Cronholm
authors.forename: Shimrit
authors.initials: S
authors.lastname: Keddem
authors.forename: Kathryn
authors.initials: K
authors.lastname: Knott
authors.forename: Marjorie A
authors.initials: MA
authors.lastname: Bowman
authors.forename: Frances K
authors.initials: FK
authors.lastname: Barg
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004522:Educational Status; D004651:Employment; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income; D008297:Male; D017533:Marital Status; D008405:Massage; D019122:Meditation; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy; D016017:Odds Ratio; D012944:Social Support; D017741:Survivors