title: Use of Complementary and Alternative Medicine (CAM) in cancer patients: An Italian multicenter survey.
abstract: BACKGROUND
  Complementary and Alternative Medicine (CAM) include a wide range of products (herbs, vitamins, minerals, and probiotics) and medical practices, developed outside of the mainstream Western medicine. Patients with cancer are more likely to resort to CAM first or then in their disease history; the potential side effects as well as the costs of such practices are largely underestimated.
  
  
  METHODS
  We conducted a descriptive survey in five Italian hospitals involving 468 patients with different malignancies. The survey consisted of a forty-two question questionnaire, patients were eligible if they were Italian-speaking and receiving an anticancer treatment at the time of the survey or had received an anticancer treatment no more than three years before participating in the survey.
  
  
  RESULTS
  Of our patients, 48.9% said they use or have recently used CAM. The univariate analysis showed that female gender, high education, receiving treatment in a highly specialized institute and receiving chemotherapy are associated with CAM use; at the multivariate analysis high education (Odds Ratio, (OR): 1.96 95% Confidence Interval, CI, 1.27-3.05) and receiving treatment in a specialized cancer center (OR: 2.75 95% CI, 1.53-4.94) were confirmed as risk factors for CAM use.
  
  
  CONCLUSIONS
  Roughly half of our patients receiving treatment for cancer use CAM. It is necessary that health professional explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.
authors.affiliation: Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Berretta
authors.affiliation: Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Della Pepa
authors.affiliation: Division of Medical Oncology, "Umberto I" Hospital, Syracuse, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tralongo
authors.affiliation: Department of Medicine and Surgery of Integrated Treatment, Division of Thoracic Oncology, "San Camillo Forlanini" Hospital, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fulvi
authors.affiliation: Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Martellotta
authors.affiliation: Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Arben
authors.initials: A
authors.lastname: Lleshi
authors.affiliation: Department of Abdominal Oncology, Division of Medical Oncology B, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Nasti
authors.affiliation: Department of Surgery, University of Catania, Catania, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Fisichella
authors.affiliation: Department of Abdominal Oncology, Division of Medical Oncology B, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Romano
authors.affiliation: Department of Abdominal Oncology, Division of Medical Oncology B, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: De Divitiis
authors.affiliation: Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Taibi
authors.affiliation: Department of Radiation Oncology University Hospital Ferrara, Division of Radiotherapy, "Arcispedale Sant'Anna" Hospital, Ferrara, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fiorica
authors.affiliation: Department of Hematology, Istituto Nazionale Tumori 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy.|Gruppo Oncologico Ricercatori Italiani, GORI, Pordenone, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Di Francia
authors.affiliation: Division of Medical Oncology, "Umberto I" Hospital, Syracuse, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Di Mari
authors.affiliation: Division of Gynaecological Oncology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Lino
authors.initials: L
authors.lastname: Del Pup
authors.affiliation: Unit of Epidemiology, Struttura Complessa di Statistica Medica, Biometria e Bioinformatica, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Crispo
authors.affiliation: Scientific Directorate, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: De Paoli
authors.affiliation: Department of Plastic Surgery, Regenerative Medicine, Health Park Hospital, Naples, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Santorelli
authors.affiliation: Department of Abdominal Oncology, Division of Medical Oncology B, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Quagliariello
authors.affiliation: Department of Abdominal Oncology, Division of Medical Oncology B, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy.
authors.forename: Rosario Vincenzo
authors.initials: RV
authors.lastname: Iaffaioli
authors.affiliation: Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Tirelli
authors.affiliation: Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Facchini
mesh_terms: D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*
keywords: alternative medicine; cancer; complementary medicine; survey; treatment