title: Complementary and alternative therapy use before and after breast cancer diagnosis: the Pathways Study.
abstract: Many women use complementary and alternative medicine (CAM) to maintain or improve their health. We describe CAM use among the first 1,000 participants enrolled in the Pathways Study, an ongoing prospective cohort study of women diagnosed with breast cancer (BC). Participants, identified by rapid case ascertainment in Kaiser Permanente Northern California, are women > or = 21 years diagnosed with first invasive BC. Comprehensive baseline data are collected on CAM use through in-person interviews. Study participants include 70.9% non-Hispanic whites, 10.2% Hispanics, 9.0% Asians, 6.5% African-Americans, and 3.4% others. Most women (82.2%) were diagnosed with AJCC stage I/II BC at average (+/-SD) age 59.5 (+/-12.0) years and reported prior use of at least one form of CAM (96.5% of participants). In the 5 years before diagnosis, CAM therapies used at least weekly by >20% of women included green tea, glucosamine, omega-3 fatty acids, prayer and religion. CAM use was high (86.1% of participants) in the period immediately following diagnosis; 47.5% used botanical supplements, 47.2% used other natural products, 28.8% used special diets, 64.2% used mind-body healing, and 26.5% used body/energy/other treatments. In multivariable analyses, frequent use of each CAM modality before and after diagnosis was associated with use of other CAM modalities and other health behaviors (i.e., high fruit/vegetable intake, lower BMI). CAM use before and after BC diagnosis is common in this diverse group of women. Our results emphasize the need for clinicians to discuss CAM use with all BC patients.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St., 7th Floor, New York, NY 10032, USA. hg2120@columbia.edu
authors.forename: Heather
authors.initials: H
authors.lastname: Greenlee
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Kwan
authors.forename: Isaac Joshua
authors.initials: IJ
authors.lastname: Ergas
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Sherman
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Krathwohl
authors.forename: Christine
authors.initials: C
authors.lastname: Bonnell
authors.forename: Marion M
authors.initials: MM
authors.lastname: Lee
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Kushi
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D000529:Complementary Therapies / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging