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Complementary and alternative medicine in breast cancer patients

Published online by Cambridge University Press:  29 January 2005

ZEINA NAHLEH  and
IMAD A. TABBARA
ZEINA NAHLEH
Affiliation:
George Washington University Medical Center, Washington, DC Present address: University of Cincinnati Medical Center, Division of Hematology and Oncology, The Barrett Cancer Center, 234 Goodman Avenue, ML 0501, Cincinnati, OH 45267-0501
IMAD A. TABBARA
Affiliation:
The University of Virginia Health System, Division of Hematology/Oncology, Charlottesville, Virginia
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Abstract

Objective: Complementary and Alternative Medicine (CAM) is becoming increasingly popular among cancer patients, in particular those with breast cancer. It represents one of the fastest growing treatment modalities in the United States. Therefore, knowledge of CAM therapies is becoming necessary for physicians and other health care providers. CAM encompasses a wide range of modalities including special diet and nutrition, mind–body approaches, and traditional Chinese medicine.

Methods: We reviewed the biomedical literature on CAM use in breast cancer patients, using Medline search from 1975 until 2002. In addition, consensus reports and books on CAM and breast cancer were included in the review. We evaluated the prevalence of CAM use in breast cancer patients, the reasons cited for its use, the different available modalities, and the reported outcomes.

Results: Use of CAM in breast cancer patients ranges between 48% and 70% in the United States. The most commonly used CAM modalities include dietary supplements, mind–body approaches, and acupuncture. The reasons cited for using CAM were to boost the immune system, improve the quality of life, prevent recurrence of cancer, provide control over life, and treat breast cancer and the side effects of treatment. Several studies reported favorable results including improved survival, better pain control, reduced anxiety, improvement in coping strategies and significant efficacy in treating nausea and vomiting. Other less well-organized trials have reported either no benefit or negative effect of CAM and potential toxicity of some commercial products.

Significance of results: CAM is a growing field in health care and particularly among breast cancer patients. Knowledge of CAM by physicians, especially oncologists, is necessary. Oncologists should be willing to discuss the role of CAM with their patients and encourage patients to participate in well-organized research about CAM.

Keywords

Breast cancerAlternative therapyComplementary treatment
Type
REVIEW ARTICLE
Information
Palliative & Supportive Care , Volume 1 , Issue 3 , September 2003 , pp. 267 - 273
Copyright
© 2003 Cambridge University Press

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References

REFERENCES

Adler, S.R. (1999). Complementary and alternative medicine use among women with breast cancer. Medical Anthropology Q, 13, 214–222.CrossRefGoogle Scholar
Arathuzik, D. (1994). Effects of cognitive behavioral strategies on pain in cancer patients. Cancer Nursing, 17, 207–214.Google Scholar
Ashar, B. & Vargo, E. (1996). Shark cartilage induced hepatitis. Annals of Internal Medicine, 125, 780–781.Google Scholar
Astin, J.A. (1998). Why patients use alternative medicine: Results of a national study. Journal of the American Medical Association, 279, 1548–1553.CrossRefGoogle Scholar
Bagenal, F.S., Easton, D.F., Harris, & E., et al. (1990). Survival of patients with breast cancer attending Bristol Cancer Help Center. Lancet, 336, 606–610.Google Scholar
Bahnson, C.B. (1980). Stress and cancer: The state of the art. Psychosomatics, 21(12), 975–981.Google Scholar
Boon, H., Stewart, M., Kennard, & M.A., et al. (2000). Use of complementary/alternative medicine by breast cancer survivors in Ontario: Prevalence and perceptions. Journal of Clinical Oncology, 18(13), 2515–2521.Google Scholar
Brinker, F. (1998). Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Medical Publishers.
Bu-Abbas, A., Clifford, M.N., Walker, & R., et al. (1994). Marked antimutagenic potential of aqueous green tea extracts: Mechanism of action. Mutagenesis, 9, 325–331.Google Scholar
Burnstein, H.J., Gelber, S., Guadagnoli, & E., et al. (1999). Use of alternative medicine by women with early stage breast cancer. New England Journal of Medicine, 340, 1733–1739.Google Scholar
Burton Goldberg Group (ed.) (1997). Alternative medicine: The definitive guide. Fife, WA: Future Medicine Publishing Inc.
Cassileth, B.R. (ed.) (1998). The Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies. New York, NY: Norton.
Cassileth, B.R. (1999). Evaluating complementary and alternative therapies for cancer patients. CA Cancer Journal for Clinicians, 49, 362–375.CrossRefGoogle Scholar
Clarke, R., Hilakivi-Clarke, L., & Trock, B. (2001). Breast cancer: Dietary and environmental Oestrogens. Biologist, 48, 21–26.Google Scholar
Coates, A., Gebski, V., Signorini, & D., et al. (1992). Prognostic value of quality of life scores during chemotherapy for advanced breast cancer. Journal of Clinical Oncology, 10, 1833–1838.Google Scholar
Coss, R.A., McGrath, P., & Caggiano, V. (1998). Alternative care: Patient choices for adjunct therapies within a cancer center. Cancer Practices, 6, 176–181.CrossRefGoogle Scholar
Crocetti, E., Crotti, N., Feltrin, & A., et al. (1998). The use of complementary therapies by breast cancer patients attending conventional treatment. European Journal of Cancer, 34, 324–328.CrossRefGoogle Scholar
Davis, H. (1986). Effects of biofeedback and cognitive therapy on stress in patients with breast cancer. Psychological Reports, 59, 967–974.CrossRefGoogle Scholar
Downer, S.M., Cody, M.M., McCluskey, & P., et al. (1994). Pursuit and practice of complementary therapies by cancer patients receiving conventional treatment. British Medical Journal, 309, 86–89.CrossRefGoogle Scholar
Drew, A.K. & Myers, S.P. (1997). Safety issues in herbal medicine: Implications for the health professions. Medical Journal of Australia, 166, 538–541.Google Scholar
Dundee, J.W., Chestnut, W.N., Ghaly, & R.G., et al. (1986). Traditional Chinese acupuncture: A potentially useful antiemetic? British Medical Journal, 293, 583–584.Google Scholar
Eisenberg, D.M., Kessler, R.C., Foster, & C., et al. (1993). Unconventional medicine in the United States: Prevalence, costs, and patterns of use. New England Journal of Medicine, 328, 246–252.Google Scholar
Ernst, E. (1999). Use of alternative medicine by women with breast cancer. New England Journal of Medicine, 341(15), 1155–1157.Google Scholar
Ernst, E. & Cassileth, B.R. (1998). The prevalence of complementary/alternative medicine in cancer: A systematic review. Cancer, 83, 777–782.3.0.CO;2-O>CrossRefGoogle Scholar
Fraser, S.C., Ramirez, A.J., Ebbs, & S.R., et al. (1993). A daily diary for quality of life measurement in advanced breast cancer trials. British Journal of Cancer, 67, 341–346.CrossRefGoogle Scholar
Gao, Y.T., McLaughlin, J.K., Blot, & W.J., et al. (1994). Reduced risk of esophageal cancer associated with green tea consumption. Journal of the National Cancer Institute, 86, 855–858.CrossRefGoogle Scholar
Gogos, C.A., Giropoulous, P., Salsa, & B., et al. (1998). Dietary omega 3 polyunsaturated fatty acids plus vitamin E restore immunodeficiency and prolong survival for severely ill patients with generalized malignancy: A randomized control trial. Cancer, 82, 395–402.3.0.CO;2-1>CrossRefGoogle Scholar
Goodwin, P.J., Leszcz, M., Ennis, & M., et al. (2001). The effect of group psychosocial support on survival in metastatic breast cancer. New England Journal of Medicine, 345, 1719–1726.CrossRefGoogle Scholar
Gotay, C.C. & Dumitriu, D. (2000). Health food recommendations for breast cancer patients. Archives in Family Medicine, 9, 692–698.Google Scholar
Government data proves it: Alternative medicine is growing? (1995). Alternative Medicine Digest, 9, 42.
Greer, S. & Silberfarb, P.M. (1982). Psychological concomitants of cancer: Current state of research. Psychologic Medicine, 12, 563–573.CrossRefGoogle Scholar
Guo, R., Zhang, L., Gong, & Y., et al. (1995). The treatment of pain in bone metastasis of cancer with the analgesic decoction of cancer and the acupoint therapeutic apparatus. Journal of Traditional Chinese Medicine, 15, 262–264.Google Scholar
Hankey, B.F., Miller, B., Curtis, R., et al. (1994). Trends in breast cancer in younger women in contrast to older women. Journal of the National Cancer Institute, 16, 7–14.Google Scholar
He, J.P., Friederich, M., Ertan, & A.K., et al. (1999). Pain relief and movement improvement by acupuncture after ablation and axillary lymphadenectomy in patients with mammary cancer. Clinical Experts in Obstetrics and Gynecology, 26, 81–84.Google Scholar
Hornsby, R. (1995). The use of compression to treat lymphedema. Professional Nursing, 11, 127–128.Google Scholar
Irvine, D., Brown, B., Crooks, & D., et al. (1991). Psychosocial adjustment in women with breast cancer. Cancer, 67, 1097–1117.3.0.CO;2-Z>CrossRefGoogle Scholar
Jacobson, J.S., Workman, S.B., & Kronenberg, F. (2000). Research on complementary/alternative medicine for patients with breast cancer: A review of the biomedical literature. Journal of Clinical Oncology, 18(13), 668–683.CrossRefGoogle Scholar
Klaunig, J.E. (1992). Chemopreventive effects of green tea components on hepatic carcinogenesis. Preventive Medicine, 21, 510–519.CrossRefGoogle Scholar
Koch, C.J. & Bigalow, J.E. (1978). Toxicity, radiation sensitivity modification, and metabolic effects of Dehydroascobate and Ascorbate in mammalian cells. Journal of Cell Physiology, 94, 299–306.CrossRefGoogle Scholar
Kurbacher, C.M., Wagner, U., Kolster, & B., et al. (1996). Ascorbic acid (vitamin C) improves the antineoplastic activity of doxorubicin, cisplatin, and paclitaxel in human breast cancer cell lines in vitro. Cancer Letters, 103, 183–189.CrossRefGoogle Scholar
Labriola, D. (2000). Complementary Cancer Therapies. Roseville, CA: Prima Publishing.
Lee, H.P., Gourley, L., Duffee, & S.W., et al. (1991). Dietary effects on breast cancer risk in Singapore. Lancet, 337, 1197–1200.CrossRefGoogle Scholar
Lee, M.M., Lin, S.S., Wrensch, & M.R., et al. (2000). Alternative therapies used by women with breast cancer in four ethnic populations. Journal of the National Cancer Institute, 92(1), 42–47.CrossRefGoogle Scholar
Lerner, I.J. & Kennedy, B.J. (1992). The prevalence of questionable methods of cancer treatment in the United States. CA Cancer Journal for Clinicians, 42, 181–191.CrossRefGoogle Scholar
Lockwood, K., Moesgaard, S., Hanioka, & T., et al. (1994). Apparent partial remission of breast cancer in “high risk” patients supplemented with nutritional oxidants, essential fatty acids and coenzyme Q10. Molecular Aspects of Medicine, 15, S231–S240.CrossRefGoogle Scholar
Markman, M. (2002). Safety issues in using Complementary and Alternative Medicine. Journal of Clinical Oncology, 20(18), 39s–41s.Google Scholar
Marti, J. (ed.) (1995). The Alternative Health and Medicine Encyclopedia. Detroit, MI: Invisible Ink Press.
Miller, D.R., Anderson, G.T., Stark, & J.J., et al. (1998). Phase I/II trial of the safety and efficacy of shark cartilage in the treatment of advanced cancer. Journal of Clinical Oncology, 16, 3649–3655.CrossRefGoogle Scholar
Mukhtar, H., Katiyar, S.K., & Agarwal, R. (1994). Green tea and skin-anticarcinogenic effects. Journal of Investigational Dermatology, 102, 3–7.CrossRefGoogle Scholar
Munstedt, K., Kirsh, K., Milch, & W., et al. (1996). Unconventional cancer therapy: Survey of patients with gynecological malignancy. Archives in Gynecology and Obstetrics, 258, 81–88.Google Scholar
National Institutes of Health. (1997). Acupuncture. NIH consensus statement. 15, 1–34.Google Scholar
Newman, V., Rock, C.L., Faerber, & S., et al. (1998). Dietary supplements used by women at risk of breast cancer recurrence. The women's healthy eating and living study group. Journal of the American Diet Association, 98, 285–292.Google Scholar
Nortier, J.L., Martinez, M.C., Schmeiser, & H.H., et al. (2000). Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). New England Journal of Medicine, 342, 1686–1692.CrossRefGoogle Scholar
Parker, S.L., Tong, T., Bolden, & S., et al. (1997). Cancer statistics. CA Cancer Journal for Clinicians, 47, 5–27.CrossRefGoogle Scholar
Pelton, R. (1995). Dietary Fat—The 20 Percent Solution, How to Prevent Breast Cancer, pp. 145–158. New York: Simon & Schuster.
Pomeran, Z.B. (ed.) (1998). The Scientific Basis of Acupuncture: Basis of Acupuncture, pp. 6–17. New York, NY: Springer-Verlag.
Richardson, M.A., Post-White, J., Grimm, & E.A., et al. (1997). Coping, life attitudes, and immune responses to imagery and group support after breast cancer treatment. Alternative Therapies in Health Medicine, 3, 62–70.Google Scholar
Richardson, M.A., Sanders, T., Palmer, & J.L., et al. (2000). Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. Journal of Clinical Oncology, 18(13), 2505–2514.CrossRefGoogle Scholar
Risberg, T., Lund, E., Wist, & E., et al. (1998). Cancer patients use of unproven therapy: A 5-year follow up study. Journal of Clinical Oncology, 16, 6–12.Google Scholar
Ruschitzka, F., Meier, P.J., Turina, & M., et al. (2000). Acute heart transplant rejection due to Saint John's wort. Lancet, 355, 548–549.CrossRefGoogle Scholar
Schimpff, S.C. (1997). Complementary medicine. Current Opinions in Oncology, 9, 327–331.CrossRefGoogle Scholar
Sellick, S.M. & Zaza, C. (1998). Critical review of 5 nonpharmacologic strategies for managing cancer pain. Cancer Prevention and Control, 2, 7–14.Google Scholar
Sierpina, V. (ed.) (2001). Integrative Health Care, pp. 256–269. Philadelphia, PA: F.A. Davis Company.
Spaulding-Albright, N. (1997). A review of some herbal and related products commonly used in cancer patients. Journal of the American Diet Association, 97, S208–S215.CrossRefGoogle Scholar
Spiegel, D. & Bloom, J.R. (1983). Group therapy and hypnosis reduce metastatic breast carcinoma pain. Psychosomatic Medicine, 45, 333–339.CrossRefGoogle Scholar
Spiegel, D., Bloom, J.R., Kraemer, & H.C., et al. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 2, 888–891.CrossRefGoogle Scholar
Stammler, G. & Volm, M. (1997). Green tea catechins have modulating effects on the activity of doxorubicin in drug resistant cell lines. Anticancer Drugs, 8, 265–268.CrossRefGoogle Scholar
Tagliafferi, M., Cohen, I., & Tripathy, D. (2001). Complementary and alternative medicine in early stage breast cancer. Seminars in Oncology, 28(1), 121–134.CrossRefGoogle Scholar
Walker, L.G., Heys, S.D., Walker, & M.B., et al. (1999). Psychological factors can predict the response to primary chemotherapy in patients with locally advanced breast cancer. European Journal of Cancer, 35(13), 1783–1788.CrossRefGoogle Scholar
Weeks, J. (1992). Quality of life assessment: Performance status upstaged? Journal of Clinical Oncology, 10, 1827–1829.Google Scholar
Weis, J. (2001). Psycho-oncology and its importance in oncology: Actual trends and future tasks of research. Onkologie, 24, 74–79.CrossRefGoogle Scholar
Wu, B., Zhou, R., & He, J. (1999). Current situation and prospect of researches on acupuncture mediating immunoresponses. Shanghai Journal of Acupuncture Moxibustion, 1, 73–76.Google Scholar
Wu, L. & Zhou, X. (1998). 300 cases of menopausal syndrome treated by acupuncture. Journal of Traditional Chinese Medicine, 18, 259–262.Google Scholar
Wyatt, G.K., Friedman, L.L., Given, & C.W., et al. (1999). Complementary therapy use among older cancer patients. Cancer Practices, 7(3), 136–144.CrossRefGoogle Scholar
Zanolla, R., Monzeglio, C., Balzarini, & A., et al. (1984). Evaluation of the results of 3 different methods of postmastectomy lymphedema. Journal of Surgical Oncology, 26, 210–213.CrossRefGoogle Scholar
Zhang, S., Hunter, D.J., Forman, & M.R., et al. (1999). Dietary carotenoids and vitamins A, C, and E and risk of breast cancer. Journal of the National Cancer Institute, 91, 547–556.CrossRefGoogle Scholar
Zhou, J., Li, Z., & Jin, P. (1999). A clinical study on acupuncture for prevention and treatment of toxic side effects during radiotherapy and chemotherapy. Journal of Traditional Chinese Medicine, 19, 16–21.Google Scholar
Ziegler, R.G., Hoover, R.N., Pike, & M.C., et al. (1993). Migration patterns and breast cancer risk in Asia-American women. Journal of the National Cancer Institute, 85, 1819–1827.CrossRefGoogle Scholar