title: Complementary and alternative medicine use amongst Malaysian orthopaedic oncology patients.
abstract: BACKGROUND
  Although studies have shown that a large proportion of cancer patients use CAM, no study on CAM use amongst orthopaedic oncology patients has been published. Therefore, this study aims to determine the prevalence, characteristics and factors associated with CAM use amongst orthopaedic oncology patients.
  
  
  METHODS
  All consecutive consenting patients/parents who presented at the Orthopaedic Oncology Clinic, University Malaya Medical Centre (1st January to 31st December 2013) were interviewed using a structured questionnaire.
  
  
  RESULTS
  Overall, one hundred sixty-eight of the 274 patients recruited (61.3%) had used CAM at some time during their current illness. The prevalence of CAM used was 68% (123/181) for patients with malignant tumours and 48.4% (45/93) for patients with benign tumours. The most popular CAMs were biological-based therapies (90.5%), followed by mind-body techniques (40.5%). The most frequently used biological therapies were mega/multivitamins (31%), snakehead (Chana striatus) (28%) and sea cucumber (Stichopus horrens) (18%); whereas prayers (31%) and holy water (13%) dominated the mind-body category. Common reasons for CAM use were to improve physical well-being (60.1%), try out everything that would help (59.5%) and to enhance wound-healing (39.3%). Independent predictors for CAM use in multivariate analysis were paediatric patients [OR 2.46; 95% CI 0.99-6.06; p = 0.05], malignant tumours [OR 1.90; 95% CI 1.12-3.25; p = 0.018] and patients who underwent surgery [OR 2.06; 95% CI 1.15-3.69; p = 0.015]. Majority patients started taking CAMs following suggestions from family members (53%) and friends (49%). Sixty-six percent of patients felt they actually benefitted from CAM and 83.3% were satisfied/very satisfied. Only 5 patients reported side-effects. Majority of CAM users planned to continue CAM use or recommend it to others. However, only 31.5% of patients disclosed their CAM usage to their doctors.
  
  
  CONCLUSIONS
  This survey revealed a high prevalence of CAM usage amongst orthopaedic oncology patients, with majority patients expressing satisfaction towards CAM. Oncologists should proactively ask patients about CAM to prevent potential adverse effects, as most patients do not share this information with them.
authors.affiliation: Jeffrey Cheah School of Medicine and Health Sciences, Monash University, 47500 Bandar Sunway, Malaysia. amreeta.dhanoa@monash.edu.
authors.forename: Amreeta
authors.initials: A
authors.lastname: Dhanoa
authors.forename: Tze Lek
authors.initials: TL
authors.lastname: Yong
authors.forename: Stephanie Jin Leng
authors.initials: SJ
authors.lastname: Yeap
authors.forename: Isaac Shi Zhung
authors.initials: IS
authors.lastname: Lee
authors.forename: Vivek Ajit
authors.initials: VA
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000523:psychology / Q000628:therapy*; D000529:Complementary Therapies; D003430:Cross-Sectional Studies; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D015995:Prevalence; D011446:Prospective Studies; D012983:Soft Tissue Neoplasms / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D055815:Young Adult