title: Interactions from complementary and alternative medicine in patients with melanoma.
abstract: Biological-based (BbCAM) methods from complementary and alternative medicine (CAM) may interact with cancer treatments, reduce efficacy, or enhance adverse effects. Although CAM usage has been evaluated well in other cancer entities, data on melanoma patients are still missing. The aim of this study was to determine CAM usage of melanoma patients using a standardized questionnaire to identify potential interactions with established and new systemic melanoma therapies. This multicenter study was carried out in seven German skin cancer centers. During routine care contact, CAM usage of former and current melanoma treatment was assessed in melanoma patients. The probability of interaction was classified into four categories ranging from 'interaction unlikely' (I), 'possible' (II), 'likely' (III), or 'no data' (IV). The questionnaire was filled out by 1157 patients, of whom 1089 were eligible for evaluation. CAM usage was reported by 41% of melanoma patients, of whom 63.1% took BbCAM such as vitamins, trace elements, supplements, or phytotherapeuticals. Of 335 patients with former or current therapy, 28.1% used BbCAM. The melanoma treatment included interferon, radiotherapy, chemotherapy, BRAF-inhibitor, or other tyrosine kinase inhibitors and ipilimumab. On the basis of our model of likelihood of interaction, we found that 23.9% of those on cancer therapy and 85.1% of those also using BbCAM were at some risk of interactions. The main limitation of our study is that no reliable and comprehensive database on clinical relevant interactions with CAM in oncology exists. Most patients receiving a melanoma-specific treatment and using BbCAM methods are at risk for interactions, which raises concerns on the safety and treatment efficacy of these patients. To protect melanoma patients from potential harm by the combination of their cancer treatment and CAM usage, patients should systematically be encouraged to report their CAM use, while oncologists should be trained on evidence of CAM, and patient guidance for saver CAM use.
authors.affiliation: aDepartment of Dermatology bDepartment of Medical Biometrie, Epidemiology and Informatics, University Medical Center Mainz, Mainz cDepartment of Dermatology, University Medical Center Dresden, Dresden dDepartment of Dermatology, Wald Klinikum Gera, Gera eDepartment of Dermatology, University Medical Center Kiel, Kiel fDepartment of Dermatology, University Hospital Cologne, Cologne gDepartment of Dermatology, University Medical Center Freiburg, Freiburg hDepartment of Radio-Oncology, Franziskus Hospital Bielefeld, Bielefeld iDepartment of Radio-Oncology, Ruhr University Bochum, Bochum jDepartment of Gynecology and Obstetrics, Clinic Offenburg, Offenburg kDepartment of Dermatology, Klinikum Dortmund gGmbH, Dortmund lPractice of Dermatology, Dresden mClinic Herzoghoehe Bayreuth, Bayreuth nInstitute of Occupational Medicine, University Hospital, RWTH Aachen University, Aachen oDr. Senckenberg Chronomedical Insitute, J.W. Goethe University Frankfurt, Frankfurt, Germany.
authors.forename: Carmen
authors.initials: C
authors.lastname: Loquai
authors.forename: Irene
authors.initials: I
authors.lastname: Schmidtmann
authors.forename: Marlene
authors.initials: M
authors.lastname: Garzarolli
authors.forename: Martin
authors.initials: M
authors.lastname: Kaatz
authors.forename: Katharina C
authors.initials: KC
authors.lastname: Kähler
authors.forename: Peter
authors.initials: P
authors.lastname: Kurschat
authors.forename: Frank
authors.initials: F
authors.lastname: Meiss
authors.forename: Oliver
authors.initials: O
authors.lastname: Micke
authors.forename: Ralph
authors.initials: R
authors.lastname: Muecke
authors.forename: Karsten
authors.initials: K
authors.lastname: Muenstedt
authors.forename: Dorothee
authors.initials: D
authors.lastname: Nashan
authors.forename: Annette
authors.initials: A
authors.lastname: Stein
authors.forename: Christoph
authors.initials: C
authors.lastname: Stoll
authors.forename: Dagmar
authors.initials: D
authors.lastname: Dechent
authors.forename: Jutta
authors.initials: J
authors.lastname: Huebner
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000529:Complementary Therapies; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D041743:Herb-Drug Interactions; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents; D004365:Drugs, Chinese Herbal