A prospective, multicenter study of complementary/alternative medicine (CAM) utilization during definitive radiation for breast cancer.
OBJECTIVE
Although complementary and alternative medicine (CAM) utilization in breast cancer patients is reported to be high, there are few data on CAM practices in breast patients specifically during radiation. This prospective, multi-institutional study was conducted to define CAM utilization in breast cancer during definitive radiation.


METHODS
A validated CAM instrument with a self-skin assessment was administered to 360 Stage 0-III breast cancer patients from 5 centers during the last week of radiation. All data were analyzed to detect significant differences between users/nonusers.


RESULTS
CAM usage was reported in 54% of the study cohort (n=194/360). Of CAM users, 71% reported activity-based CAM (eg, Reiki, meditation), 26% topical CAM, and 45% oral CAM. Only 16% received advice/counseling from naturopathic/homeopathic/medical professionals before initiating CAM. CAM use significantly correlated with higher education level (P<.001), inversely correlated with concomitant hormone/radiation therapy use (P=.010), with a trend toward greater use in younger patients (P=.066). On multivariate analysis, level of education (OR: 6.821, 95% CI: 2.307-20.168, P<.001) and hormones/radiation therapy (OR: 0.573, 95% CI: 0.347-0.949, P=.031) independently predicted for CAM use. Significantly lower skin toxicity scores were reported in CAM users vs nonusers, respectively (mild: 34% vs 25%, severe: 17% vs 29%, P=.017).


CONCLUSIONS
This is the first prospective study to assess CAM practices in breast patients during radiation, with definition of these practices as the first step for future investigation of CAM/radiation interactions. These results should alert radiation oncologists that a large percentage of breast cancer patients use CAM during radiation without disclosure or consideration for potential interactions, and should encourage increased awareness, communication, and documentation of CAM practices in patients undergoing radiation treatment for breast cancer.
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06520-8040, USA. meena.moran@yale.edu
Meena S
MS
Moran
Shuangge
S
Ma
Reshma
R
Jagsi
Tzu-I Jonathan
TJ
Yang
Susan A
SA
Higgins
Joanne B
JB
Weidhaas
Lynn D
LD
Wilson
Shane
S
Lloyd
Richard
R
Peschel
Bryant
B
Gaudreau
Sara
S
Rockwell
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000208:ethnology / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D000529:Complementary Therapies / Q000379:methods / Q000706:statistics & numerical data*; D003376:Counseling / Q000706:statistics & numerical data; D030881:Disclosure; D004522:Educational Status; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011855:Radiodermatitis / Q000473:pathology; D011879:Radiotherapy Dosage; D011795:Surveys and Questionnaires
D018931:Antineoplastic Agents, Hormonal