Three-Fourths of Breast Cancer Survivors Report CAM Use

BOSTON—Use of complementary and alternative medicine (CAM) is typically higher among cancer patients than the general population. Researchers from the Dana-Farber Cancer Institute further refined this observation by studying the use of CAM among women with varying degrees of breast cancer risk. Reporting at the Third International Conference of the Society for Integrative Oncology (abstract F075), they found that breast cancer survivors with a family history of cancer used significantly more CAM than the other groups.

The 417 women in the study completed a self-administered questionnaire that included questions about CAM use for cancer prevention from four categories: Mind/body, biological, manipulative/body based, and energy medicine (see Table). The four risk groups were:

• 100 women who were breast cancer survivors with a family history of breast cancer (FH)

• 102 high-risk women without cancer (HR)

• 91 breast cancer survivors with no family history (BCS)

• 124 women from the general population undergoing routine mammography screening (PR or population risk)

"We found that 67% of the overall cohort used some form of CAM for cancer prevention," said Lisa DiGianni, PhD, a senior research scientist at Dana-Farber. The most commonly used individual CAMs were exercise (53%), vitamins (43%), spirituality (22%), yoga (14%), and imagery (14%). Cancer patients with a family history used significantly more CAM in all categories, compared with other risk groups (FH 80%, BCS 74%, HR 59%, PR 59%).

More significant differences emerged when the women were analyzing by cancer status—cancer patients vs healthy women—instead of the original four risk groups: 77% of the cancer patients had used any form of CAM, compared with 59% of the healthy women.

Exercise and vitamins were the most common CAMs the women discussed with their providers, with about half of the sample reporting they had talked with their providers about CAMs. No difference was seen between the cancer patients and the healthy women.

The women were also asked when they began CAM use. "We wanted to see if CAM use began as a result of their diagnosis," she said. "Surprisingly, we found that 60% of patients reported they first used CAM before their diagnosis." There was no difference between those with a family history vs those without one.

The most common expectations of the cancer patients were improving immunity and quality of life, prolonging lifespan, and preventing cancer. "Those with a family history reported a significantly higher level of expectation in all areas, compared to those without a family history," Dr. DiGianni said.

She concluded that patients are clearly very interested in CAM and are using CAM. "They are also telling us they are interested in clinical trials that contain exercise," she said. "We felt that this is particularly important in view of recent reports in the literature showing that exercise may be an important factor in breast cancer prevention." She and her colleagues have obtained pilot funding to go forward next year with an exercise intervention trial for high-risk patients that will utilize a web-based motivational intervention.