Complementary and Alternative Medicine Use in Women With Gynecologic Malignancy

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 Complementary and Alternative Medicine Use in Women With Gynecologic Malignancy Presenting for Care at a Comprehensive Cancer Center

 Objective: We evaluated complementary and alternative medicine (CAM) practices among women presenting to a National Cancer Institute-designated Comprehensive Cancer Center with a gynecologic malignancy.
Methods: Women with a gynecologic malignancy who had consented to enrollment in our institutional prospective clinical registry between January 2003 and January 2014 and who had completed a questionnaire assessing sociodemographic characteristics, medical histories, quality of life, and CAM use were considered for analysis.
Results: Among the 2508 women identified, responses to questions on CAM use were provided by 534 (21.3%). The majority of CAM question respondents were white (93.5%) and older than 50 years (76%). Overall, 464 women (87% of CAM question respondents) used at least 1 CAM therapy during the previous 12 months. The most commonly used CAM categories were biologically based approaches (83.5%), mind and body interventions (30.6%), and manipulative and body-based therapies (18.8%). The most commonly used individual CAM therapies were vitamins and minerals (78%), herbal supplements (27.9%), spiritual healing and prayer (15.1%), and deep breathing relaxation exercises (13.1%). Complementary and alternative medicine use was greatest in age groups 20 to 30 years and older than 65 years and was more prevalent among those who were widowed (P < 0.005), retired (P = 0.02), and with a higher level of education (P < 0.01). There was no association with cancer type, race, or ethnicity.
Conclusions: Complementary and alternative medicine use is common among women being treated for gynecologic malignancy. Given the potential interactions of some CAM modalities with conventional treatment and the possible benefits in controlling symptoms and improving quality of life, providers should discuss CAM with their patients.

 Complementary and alternative medicine (CAM) use has
been increasing worldwide. In a recent survey conducted
by the Centers for Disease Control and Prevention’s National
Center for Health Statistics, almost 4 of 10 American adults
had used CAM therapy in the prior 12 months.1,2
Despite limited evidence of safety and efficacy, individuals
with cancer frequently use CAM interventions, with
more than two thirds of cancer survivors reporting use of
a CAM approach at some point during their lifetime.3,4 The
rates of CAM use in individuals with cancer have been
reported to be as high as 80% to 98%.5-7....

 TABLE 1. CAM categories
Category Intervention1. Biologically based
approaches
Vitamins, minerals, nonmineral
nonvitamin natural products,
diet-based therapies, chelation
therapy, diets, herbs, tea2. Mind-body
interventions
Yoga, spirituality, relaxation, art
and music therapy, biofeedback,
meditation, aromatherapy, deep
breathing exercises, hypnosis,
Tai chi, progressive relaxation,
guided imagery3. Energy therapies Reiki, magnets, Qigong,
healing touch4. Manipulative and
body-based therapies
Massage, chiropractic care,
osteopathy, reflexology,
acupuncture, acupressure5. Alternative medical
systems
Homeopathy, naturopathy, folk
medicine, Ayurveda

 ....The interpretation of these results may, however, be
biased because of the participation rate (21.3%). Low participation
rates have been a major concern in epidemiologic
studies as of late because they have been declining during the
past few decades,with an accelerated decline in recent years.33,34
Furthermore, a substantial number of studies, published even
in the highest-impact epidemiology journals, fail to report any
information regarding participation rates,33 among these are
some of the lead studies describing CAM use in the gynecological
cancer population.11,13....