title: Effect of complementary and alternative medicine on the survival and health-related quality of life among terminally ill cancer patients: a prospective cohort study.
abstract: BACKGROUND
  We evaluated whether complementary and alternative medicine (CAM) use influenced outcomes [survival and health-related quality of life (HRQOL)] of cancer patients whose condition had just been judged terminal.
  
  
  METHODS
  From July 2005 to October 2006, we conducted a prospective cohort study of 481 terminally ill cancer patients at 11 university hospitals and the National Cancer Center in Korea. We assessed how the use of CAM affected HRQOL and survival.
  
  
  RESULTS
  In a follow-up of 481 patients and 163.8 person-years, we identified 466 deceased cases. On multivariate analyses, CAM users did not have better survival compared with nonusers [adjusted hazard ratio (aHR), 0.91; 95% confidence interval (CI) 0.74-1.10]. Among mind-body interventions, prayer showed significantly worse survival (aHR, 1.56; 95% CI, 1.00-2.43). Clinically, CAM users reported significantly worse cognitive functioning (-11.6 versus -1.3; P < 0.05) and fatigue (9.9 versus -1.0; P < 0.05) than nonusers. Compared with nonusers in subgroup analysis, users of alternative medical treatments, prayer, vitamin supplements, mushrooms, or rice and cereal reported clinically significant worse changes in some HRQOL subscales.
  
  
  CONCLUSIONS
  While CAM did not provide any definite survival benefit, CAM users reported clinically significant worse HRQOLs.
authors.affiliation: Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul. Electronic address: lawyun@snu.ac.kr.
authors.forename: Y H
authors.initials: YH
authors.lastname: Yun
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang.
authors.forename: M K
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Seoul National University Hospital and College of Medicine, Seoul.
authors.forename: S M
authors.initials: SM
authors.lastname: Park
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang.
authors.forename: Y A
authors.initials: YA
authors.lastname: Kim
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang.
authors.forename: W J
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang.
authors.forename: K S
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Oncology, Gangneung Asan Hospital, Gangneung.
authors.forename: J S
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul.
authors.forename: K H
authors.initials: KH
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu.
authors.forename: Y R
authors.initials: YR
authors.lastname: Do
authors.affiliation: Department of Internal Medicine, Chungnam University School of Medicine, Daejeon.
authors.forename: S Y
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: D S
authors.initials: DS
authors.lastname: Heo
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang.
authors.forename: H T
authors.initials: HT
authors.lastname: Kim
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang.
authors.forename: S R
authors.initials: SR
authors.lastname: Park
mesh_terms: D000368:Aged; D015331:Cohort Studies; D000529:Complementary Therapies / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate; D019452:Terminally Ill; D016896:Treatment Outcome