Does Complementary and Alternative Medicine Product Use Affect Breast Cancer Patients’ Decision to Start Treatment?

According to a noteworthy study published on 12 May in the respected medical journal JAMA Oncology, complementary and alternative medicine (CAM) product use is very common in patients with early-stage breast cancer, and CAM use affects the decision to start chemotherapy, which is crucial for patients.

In a group of patients with early-stage and locally advanced breast cancer, adjuvant treatment is known to extend survival and reduce recurrence risk. Although international treatment guidelines clearly state which patients should receive adjuvant treatment, many studies on this subject are also ongoing.

In treatment decisions, psychosocial factors, belief systems and characteristics of healthcare services offered matter alongside disease characteristics such as stage and aggressiveness.

Breast Cancer Patients Reluctant to Receive Chemotherapy Have Been Found to Have These Characteristics:

• Cancer-related anxiety,
• Optimism,
• Negative experiences with physicians,
• Belief that alternative medicine will provide benefit,
• Concerns about chemotherapy risks, and
• Insufficient knowledge about breast cancer protocols

Patients in this group also tend to use complementary and alternative medicine (CAM). CAM use among breast cancer patients has increased over the last 20 years. Some studies have evaluated how CAM use affects chemotherapy decisions.

The study discussed here included 685 women with nonmetastatic breast cancer. Indicators of initiation and adherence to breast cancer treatment were examined. In the study, 598 (87%) women reported CAM (complementary and alternative treatment) use. Chemotherapy was started in 272 (89%) women for whom it was recommended, while for 135 (36%) women chemotherapy was left as an optional choice.

Use of 5 Types of CAM Products/Practices Was Evaluated in Interviews:

1. Vitamins and/or minerals
2. Herbs and/or botanical products
3. Other natural products
4. Self-administered mind-body techniques
5. Practices with a mind-body specialist

It was suggested that CAM use may be a risk factor for not starting standard oncology treatments because the patient explores other alternative treatments or conventional oncology treatments do not align with the patient’s belief system. Among women due to receive chemotherapy, those using nutritional supplements and with high CAM use were less likely to start chemotherapy than those not using them. Also, mind-body practice use (methods such as physical therapy/exercise to preserve and improve physical and mental health) was not associated with chemotherapy initiation. In addition, among women for whom chemotherapy was optional, no relationship was found between CAM use and chemotherapy initiation.

In conclusion, the study found very high CAM use among patients with early-stage breast cancer. Nutritional supplements and numerous CAM methods were used in pursuit of benefit, reducing administration of adjuvant chemotherapy with its vital benefits. However, mind-body practices were not seen as a factor reducing chemotherapy administration. For these reasons, CAM use must be kept in mind and discussed during chemotherapy decision-making.