title: Herbal Medicine Practices of Patients With Liver Cancer in Peru: A Comprehensive Study Toward Integrative Cancer Management.
abstract: The highest burden of liver cancer occurs in developing countries, where the use of herbal medicine (HM) is still widespread. Despite this trend, few studies have been conducted to report HM practices of patients with a hepatic tumor in the developing world. Hence, this study aimed to document the use of HM among patients with liver cancer in Peru.
  
  
  
  A comparative behavioral epidemiological survey was conducted among liver cancer patients attending the National Cancer Institute of Peru. Information was obtained by direct interviews based on a semistructured questionnaire. The use of HM in Peruvian liver cancer patients was reported, first, regarding general consumption prior to the onset of disease, and second, after the appearance of symptoms that patients would relate to their tumor. In parallel, general consumption of HM in noncancerous people was assessed as a comparative figure. A correspondence analysis was performed to reveal potential associations between the symptoms of cancer and the specific use of HM.
  
  
  
  Eighty-eight patients and 117 noncancerous individuals participated in the survey. Overall, 68.3% of the people interviewed claimed to use HM on a regular basis for general health preservation. Furthermore, 56.8% of the patients turned to plants first to treat the disorders for which they later came to the cancer care center. When compared with the number of plant species used routinely (n = 78), a selection of plants was made by patients in response to the symptoms of cancer (n = 46). At least 2 plant species, Aloe vera and Morinda citrifolia, were significantly associated with the treatment of liver cancer-related symptoms in the patient group.
  
  
  
  The present study is the first survey on the HM practices of patients with liver cancer in Latin America and, more broadly, in the developing world. Our findings confirm that HM remains one of the principal primary health care resources in Peru, even for a severe disease like liver cancer. These traditional, complementary and alternative medicine practices should be taken into consideration in Peruvian health programs aiming to educate the population in cancer prevention and treatment, as well as integrative cancer management.
authors.affiliation: 1 Aix-Marseille Université, IRD, INSERM, UMR 912, Marseille, France.
authors.forename: Teresa
authors.initials: T
authors.lastname: Rojas Rojas
authors.affiliation: 2 Université de Toulouse, IRD, UPS, UMR 152, Toulouse, France.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Bourdy
authors.affiliation: 3 Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
authors.forename: Eloy
authors.initials: E
authors.lastname: Ruiz
authors.affiliation: 4 Sorbonne Universités, UPMC Univ Paris 06, Institut Pasteur, Paris, France.
authors.forename: Juan-Pablo
authors.initials: JP
authors.lastname: Cerapio
authors.affiliation: 5 Institut Pasteur, Paris, France.|6 INSERM, U 993, Paris, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Pineau
authors.affiliation: 7 Université de Montpellier, IRD, CNRS, UMR 5569, Montpellier, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Gardon
authors.affiliation: 3 Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
authors.forename: Franco
authors.initials: F
authors.lastname: Doimi
authors.affiliation: 1 Aix-Marseille Université, IRD, INSERM, UMR 912, Marseille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Deparis
authors.affiliation: 2 Université de Toulouse, IRD, UPS, UMR 152, Toulouse, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Deharo
authors.affiliation: 2 Université de Toulouse, IRD, UPS, UMR 152, Toulouse, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bertani
mesh_terms: D000328:Adult; D000529:Complementary Therapies / Q000379:methods*; D005260:Female; D019538:Health Care Surveys; D029001:Herbal Medicine / Q000379:methods; D006801:Humans; D055048:Integrative Medicine / Q000379:methods; D000073196:Integrative Oncology / Q000379:methods; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010568:Peru; D008517:Phytotherapy; D011364:Professional Practice; D055815:Young Adult
keywords: Indigenous people; Latin America; behavioral epidemiological survey; cancer; complementary and alternative medicine; developing world; ethnobotany; integrative medicine; liver disease; traditional medicine