title: Traditional medicine use by cancer patients in Thailand.
abstract: BACKGROUND
  Cancer patients commonly use traditional medicines (TM) and in Thailand these are popular for both self-medication and as prescribed by TM practitioners, and are rarely monitored. A study was conducted at Wat Khampramong, a Thai Buddhist temple herbal medicine hospice, to document some of these practices as well as the hospice regime.
  
  
  METHODS
  Cancer patients (n = 286) were surveyed shortly after admission as to which TMs they had previously taken and perceptions of effects experienced. They were also asked to describe their current symptoms. Treatment at the hospice is built upon an 11-herb anti-cancer formula, yod-ya-mareng, prescribed for all patients, and ideally, its effects would have been evaluated. However other herbal medicines and holistic practices are integral to the regime, so instead we attempted to assess the value of the patients' stay at the hospice by measuring any change in symptom burden, as they perceived it. Surviving patients (n = 270) were therefore asked to describe their symptoms again just before leaving.
  
  
  RESULTS
  42% of patients (120/286; 95% CI 36.4%, 47.8%) had used herbal medicines before their arrival, with 31.7% (38/120; 95% CI 24%, 40.4%) using several at once. Mixed effects were reported for these products. After taking the herbal regime at Khampramong, 77% (208/270 95% CI; 71.7%, 81.7%) reported benefit, and a comparison of the incidence of the most common (pain, dyspepsia, abdominal or visceral pain, insomnia, fatigue) showed statistical significance (χ(2) 57.1, df 7, p < 0.001).
  
  
  CONCLUSIONS
  A wide range of TMs is taken by cancer patients in Thailand and considered to provide more benefit than harm, and this perception extends to the temple regime. Patients reported a significant reduction in symptoms after staying at Khampramong, indicating an improvement in quality of life, the aim of hospices everywhere. Based on this evidence, it is not possible to justify the use of TM for cancer in general, but this study suggests that further research is warranted. The uncontrolled use of TMs, many of which are uncharacterised, raises concerns, and this work also highlights the fact that validated, robust methods of assessing holistic medical regimes are urgently needed.
authors.affiliation: University of Reading School of Pharmacy, Whiteknights, Reading, Berkshire RG6 6AP, UK.
authors.forename: Benjawan
authors.initials: B
authors.lastname: Poonthananiwatkul
authors.affiliation: University of Reading School of Pharmacy, Whiteknights, Reading, Berkshire RG6 6AP, UK.
authors.forename: Rosemary H M
authors.initials: RH
authors.lastname: Lim
authors.affiliation: University of Reading School of Pharmacy, Whiteknights, Reading, Berkshire RG6 6AP, UK.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Howard
authors.affiliation: University of Reading School of Pharmacy, Whiteknights, Reading, Berkshire RG6 6AP, UK.
authors.forename: Paponpatchara
authors.initials: P
authors.lastname: Pibanpaknitee
authors.affiliation: Arokhayasala Foundation, Wat Khampramong, Sakon Nakhon, Thailand. Electronic address: e.m.williamson@reading.ac.uk.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Williamson
mesh_terms: D006801:Humans; D008519:Medicine, Traditional; D009369:Neoplasms / Q000188:drug therapy*; D008517:Phytotherapy; D028321:Plant Preparations / Q000627:therapeutic use*; D010946:Plants, Medicinal; D011795:Surveys and Questionnaires; D013785:Thailand
chemical_list: D028321:Plant Preparations
keywords: Arokhayasala; Herbal cancer hospice; Khampramong; Thai herbal medicine; Traditional medicine; Yod-ya-mareng