Complementary and alternative medicine use among general surgery, hepatobiliary surgery and surgical oncology patients.
BACKGROUND
The use of complementary and alternative medicine (CAM) is becoming more common, particularly among cancer patients. We sought to define the frequency of CAM use among general surgery, hepatobiliary and surgical oncology patients and to define some of the determinants of CAM use in patients with benign and malignant disease.


METHODS
We asked all patients attending the clinics of 3 hepatobiliary/surgical oncology surgeons from 2002 to 2005 to voluntarily respond on first and subsequent visits to a questionnaire related to the use of CAM. We randomly selected patients for review.


RESULTS
We reviewed a total of 490 surveys from 357 patients. Overall CAM use was 27%. There was significantly more CAM use among cancer (34%) versus noncancer patients (21%; p = 0.008), and the use of CAM was more common in patients with unresectable cancer (51%) than resectable cancer (22%; p < 0.001). There was no significant difference in use between men and women. There did not appear to be a change in CAM use with progression of cancer. The most common CAM was herbs or supplements (58% of all users), which were most frequently used by patients with malignant disease. Among the 27 herbs reported to be ingested, 10 are associated with bleeding and hepatotoxicity, as described in the literature.


CONCLUSIONS
Prospective studies evaluating surgical outcomes related to CAM use are needed.
Schieman
Colin
C
Department of Surgery, University of Calgary, Calgary, Alta.
Rudmik
Luke R
LR
Dixon
Elijah
E
Sutherland
Francis
F
Bathe
Oliver F
OF
D000328:Adult; D000368:Aged; D000416:Alberta; D001294:Attitude to Health; D001661:Biliary Tract Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D005260:Female; D013502:General Surgery; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016522:Oncology Service, Hospital; D010358:Patient Participation; D011379:Prognosis; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome