Cancer Res Treat.  2023 Apr;55(2):442-451. 10.4143/crt.2022.1483.

Status of Using Complementary and Alternative Medicine among Patients with Cancer in Korea: an Online Survey of Online Cancer Support Groups (KCSG PC21-20)

• Kim JS
• Kwon JH
• Rha SY
• Lee SC
• Chang YJ
• Kwon IS
• You KH
• Yoon HY

• KMID: 2541231
• DOI: http://doi.org/10.4143/crt.2022.1483

Abstract

Purpose
An increasing number of patients with cancers are interested in complementary and alternative medicine (CAM), which lacks scientific evidence. This study aimed to determine how CAM was used and how media affected patients in online cancer support groups (OCSG).
Materials and Methods
Between August 18 and September 12, 2021, an online survey was conducted among the members of OCSG. The survey consisted of five parts: baseline characteristics, attitudes toward and experience with CAM, source of information and reliabilities, experience with anthelmintics, and online health information literacy and usage.
Results
Among the 644 responders, a total of 221 patients with cancer completed the survey, and 78.2% (173/221) used CAM. The users’ median age was 52 years; 46.8% were males, and 43.9% had metastatic disease. Fifty-three CAM users (30.6%) discussed their physicians about CAM. In addition, 16.2% (28/173) of CAM users had the experience of anthelmintics. The use of anthelmintics in patients with cancers was associated with younger age (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.84 to 0.95), metastatic disease (OR, 10.88; 95% CI, 3.39 to 34.86), previous exposure to CAM information (OR, 5.57; 95% CI, 1.01 to 30.72), experience with more types of CAM (OR, 1.98; 95% CI, 1.29 to 3.05), and side effects (OR, 5.10; 95% CI 1.46 to 17.75).
Conclusion
Use of anthelmintics, a CAM of which information is widespread online, is affected by several factors. This study will provide essential information for developing a CAM management strategy in this digital age.

Keyword

Neoplasms; Complementary and alternative medicine; Anthelmintics; Survey

Figure

• 

  Fig. 1 Consort flow. IP, Internet Protocol address.

• 

  Fig. 2 Expectations from and experiences of complementary alternative medicine (CAM). a)For p < 0.001.

• 

  Fig. 3 Source of information and reliabilities expressed in median Likert scores. Likert score was adopted to evaluate reliabilities of each source, ranging from 0 (strongly disagree) to 4 (strongly agree).

• 

  Fig. 4 Reasons for not having discussion with physicians about complementary and alternative medicine (CAM) (n=173).

Reference

References

1. Jazieh AR, Abuelgasim KA, Ardah HI, Alkaiyat M, Da’ar OB. The trends of complementary alternative medicine use among cancer patients. BMC Complement Med Ther. 2021; 21:167.

2. Ahlgren R. Cures terminal cancer with pet medicine [Internet]. San Mateo, CA: YouTube;2019. [cited 2022 Sep 6]. Available from: https://www.youtube.com/watch?v=-WxiPf-NEDk.

3. Conrad AC, Muenstedt K, Micke O, Prott FJ, Muecke R, Huebner J. Attitudes of members of the German Society for Palliative Medicine toward complementary and alternative medicine for cancer patients. J Cancer Res Clin Oncol. 2014; 140:1229–37.

4. Buckner CA, Lafrenie RM, Denommee JA, Caswell JM, Want DA. Complementary and alternative medicine use in patients before and after a cancer diagnosis. Curr Oncol. 2018; 25:e275–81.

5. Mercadante S, Bellavia G, Cascio AL, Dabbene M, di Silvestre G, Casuccio A, et al. The use of complementary alternative medicines in advanced cancer patients followed at home. Support Care Cancer. 2022; 30:2003–8.

6. Longhi A, Setola E, Ferrari C, Carretta E. Complementary and alternative medicine in sarcoma patients treated in an Italian sarcoma center. J Cancer Res Ther. 2021; 17:516–22.

7. Sarada K, Puthiyedath R, Philip A, Ravindran GC, Pavithran K. Prevalence of the use of traditional complementary and alternative medicine amongst cancer patients in a tertiary care center in Kerala, India. J Ayurveda Integr Med. 2021; 12:359–64.

8. Kebede EB, Tan J, Iftikhar S, Abu Lebdeh HS, Duggirala MK, Ghosh AK, et al. Complementary and alternative medicine use by patients from the Gulf region seen in the International Practice of a Tertiary Care Medical Center. Glob Adv Health Med. 2021; 10:21649561211010129.

9. Kim MJ, Lee SD, Kim DR, Kong YH, Sohn WS, Ki SS, et al. Use of complementary and alternative medicine among Korean cancer patients. Korean J Intern Med. 2004; 19:250–6.

10. Kwon JH, Lee SC, Lee MA, Kim YJ, Kang JH, Kim JY, et al. Behaviors and attitudes toward the use of complementary and alternative medicine among Korean cancer patients. Cancer Res Treat. 2019; 51:851–60.

11. Kim EH, Yoon JH, Yoon SS, Lee JY, Yoon SW. Efficacy of chemotherapy integrated with traditional Korean medicine in patients with metastatic pancreatic cancer: a single-center retrospective study. Integr Cancer Ther. 2020; 19:1534735420983–457.

12. Wolf C, Rachow T, Ernst T, Hochhaus A, Zomorodbakhsch B, Foller S, et al. Complementary and alternative medicine (CAM) supplements in cancer outpatients: analyses of usage and of interaction risks with cancer treatment. J Cancer Res Clin Oncol. 2022; 148:1123–35.

13. Yang G, Zhang H, Gan Z, Fan Y, Gu W, Ling C. Discrepant views of oncologists and cancer patients on complementary and alternative medicine in a Chinese general hospital. Integr Cancer Ther. 2018; 17:451–7.

14. Huber J, Muck T, Maatz P, Keck B, Enders P, Maatouk I, et al. Face-to-face vs. online peer support groups for prostate cancer: a cross-sectional comparison study. J Cancer Surviv. 2018; 12:1–9.

15. Setoyama Y, Yamazaki Y, Nakayama K. Comparing support to breast cancer patients from online communities and face-to-face support groups. Patient Educ Couns. 2011; 85:e95–100.

16. Bender JL, Babinski S, Wong G, Tricco AC, Englesakis M, Cyr AB, et al. Establishing best practices in cancer online support groups: protocol for a realist review. BMJ Open. 2021; 11:e053916.

17. Jobst N. Percentage of population using the internet in South Korea from 2000 to 2021 [Internet]. New York: Statista;2022. [cited 2022 Aug 10]. Available from: https://www.statista.com/statistics/255859/internet-penetration-in-south-korea/.

18. Koithan M. Introducing complementary and alternative therapies. J Nurse Pract. 2009; 5:18–20.

19. Norman CD, Skinner HA. eHEALS: the eHealth Literacy Scale. J Med Internet Res. 2006; 8:e27.

20. Korean Statistical Information Service [Internet]. Daejeon: Korean Statistical Information Service;2022. [cited 2022 Aug 10]. Available from: https://kosis.kr/eng.

21. Kim D, Sung SH, Shin S, Park M. The effect of cancer on traditional, complementary and alternative medicine utilization in Korea: a fixed effect analysis using Korea Health Panel data. BMC Complement Med Ther. 2022; 22:137.

22. Bozza C, Gerratana L, Basile D, Vitale MG, Bartoletti M, Agostinetto E, et al. Use and perception of complementary and alternative medicine among cancer patients: the CAMEO-PRO study: complementary and alternative medicine in oncology. J Cancer Res Clin Oncol. 2018; 144:2029–47.

23. Bahall M. Prevalence, patterns, and perceived value of complementary and alternative medicine among cancer patients: a cross-sectional, descriptive study. BMC Complement Altern Med. 2017; 17:345.

24. Ciarlo G, Ahmadi E, Welter S, Hubner J. Factors influencing the usage of complementary and alternative medicine by patients with cancer. Complement Ther Clin Pract. 2021; 44:101389.

25. Wode K, Henriksson R, Sharp L, Stoltenberg A, Hok Nordberg J. Cancer patients’ use of complementary and alternative medicine in Sweden: a cross-sectional study. BMC Complement Altern Med. 2019; 19:62.

26. Sanford NN, Sher DJ, Ahn C, Aizer AA, Mahal BA. Prevalence and nondisclosure of complementary and alternative medicine use in patients with cancer and cancer survivors in the United States. JAMA Oncol. 2019; 5:735–7.

27. Escudero-Vilaplana V, Collado-Borrell R, Gomez Martinez-Sagrera P, Villanueva-Bueno C, Revuelta-Herrero JL, Gonzalez-Haba E, et al. Complementary and alternative medicine in cancer patients: characteristics of use and interactions with antineoplastic agents. J Cancer Res Clin Oncol. 2022. Jul. 6. [Epub]. https://doi.org/10.1007/s00432-022-04172-1.

28. Tenner L, Hlubocky FJ, Blanke CD, LeBlanc TW, Marron JM, McGinnis MM, et al. Let’s talk about those herbs you are taking: ethical considerations for communication with patients with cancer about complementary and alternative medicine. J Oncol Pract. 2019; 15:44–9.

29. Frenkel M, Ben-Arye E, Cohen L. Communication in cancer care: discussing complementary and alternative medicine. Integr Cancer Ther. 2010; 9:177–85.