Supportive Care in Cancer

, Volume 22, Issue 5, pp 1303–1311

Biologically based therapies are commonly self-prescribed by Brazilian women for the treatment of advanced breast cancer or its symptoms

  • Ana Camila Callado Alfano
  • Carlos Eduardo Paiva
  • Fernanda Capella Rugno
  • Raquel Haas da Silva
  • Bianca Sakamoto Ribeiro Paiva
Original Article

Abstract

Purpose

Breast cancer (BC) might be associated with loss of function in affected patients, with a direct impact on their quality of life (QOL). Many women with metastatic BC seek relief of symptoms, including the use of complementary and alternative medicine (CAM) to cure cancer. The present study aimed to identify the pattern of CAM used by patients with metastatic BC and to assess the correlation between CAM use and scores on anxiety, depression, and QOL scales.

Methods

A total of 126 women with metastatic BC were interviewed using four instruments: (1) a questionnaire containing socioeconomic, clinical, and demographic data and CAM use; (2) European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ)-C30; (3) EORTC QLQ-BR23; and (4) the Hospital Anxiety and Depression Scale.

Results

Fifty percent of the participants reported the use of at least one CAM modality. Biologically based practices were the most frequently used to treat BC and/or its symptoms, the most commonly discussed with the oncologists, and one of the CAM categories in which more patients reported a desire to learn more about. The overall use of CAM was not correlated with the scores on the anxiety, depression, and QOL scales. However, analysis of the association of the QOL scores with specific CAM modalities revealed some potential associations (especially for food supplements, art therapy, psychotherapy, and prayer).

Conclusions

Women with metastatic BC frequently make use of CAM to treat the cancer and/or its symptoms. Biologically based practices seem to be particularly important in Brazil. An association between specific CAM modalities and some QOL domains was suggested, but it needs further confirmation.

Keywords

Alternative/complementary therapies Breast cancer Palliative chemotherapy Quality of life Anxiety Depression 

Supplementary material

520_2013_2087_MOESM1_ESM.pdf (16 kb)
Supplementary Table 1(PDF 15 kb)
520_2013_2087_MOESM2_ESM.pdf (8 kb)
Supplementary Table 2(PDF 7 kb)
520_2013_2087_MOESM3_ESM.pdf (67 kb)
Supplementary Table 3(PDF 67 kb)
520_2013_2087_MOESM4_ESM.pdf (62 kb)
Supplementary Table 4(PDF 61 kb)

References

  1. 1.
    VIRTUAL B (2008) MEDICINA COMPLEMENTAR E ALTERNATIVA http://www.bibliotecavirtual.sp.gov.br/especial/200804-medicinacomplementar.php. Accessed 08/07/2012
  2. 2.
    (NCCAM) National Center for Complementary and Alternative Medicine (2012) Complementary, alternative, or integrative health: what's in a name? National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/whatiscam.
  3. 3.
    Ernst E, Cassileth BR (1998) The prevalence of complementary/alternative medicine in cancer: a systematic review. Cancer 83(4):777–782PubMedCrossRefGoogle Scholar
  4. 4.
    Spadacio C, Barros NF (2008) Use of complementary and alternative medicine by cancer patients: systematic review. Rev Saude Publica 42(1):158–164PubMedCrossRefGoogle Scholar
  5. 5.
    DiGianni LM, Garber JE, Winer EP (2002) Complementary and alternative medicine use among women with breast cancer. J Clin Oncol 20(18 Suppl):34S–38SPubMedGoogle Scholar
  6. 6.
    Hyodo I, Amano N, Eguchi K, Narabayashi M, Imanishi J, Hirai M, Nakano T, Takashima S (2005) Nationwide survey on complementary and alternative medicine in cancer patients in Japan. J Clin Oncol 23(12):2645–2654. doi:10.1200/JCO.2005.04.126 PubMedCrossRefGoogle Scholar
  7. 7.
    Yates JS, Mustian KM, Morrow GR, Gillies LJ, Padmanaban D, Atkins JN, Issell B, Kirshner JJ, Colman LK (2005) Prevalence of complementary and alternative medicine use in cancer patients during treatment. Support Care Cancer 13(10):806–811. doi:10.1007/s00520-004-0770-7 PubMedCrossRefGoogle Scholar
  8. 8.
    Lee MM, Lin SS, Wrensch MR, Adler SR, Eisenberg D (2000) Alternative therapies used by women with breast cancer in four ethnic populations. J Natl Cancer Inst 92(1):42–47PubMedCrossRefGoogle Scholar
  9. 9.
    Feijó AM, Bueno MEN, Burille A, Silva D, Zillmer JGV, Schwartz E, Gallo CMC (2008) A utilização de terapias alternativas por clientes oncológicos em tratamento radioterápico. Paper presented at the XVII Congresso de Iniciação Científica. X Encontro de Pós Graduação, 11, 12, 13 e 14 de novembroGoogle Scholar
  10. 10.
    Boon H, Brown JB, Gavin A, Kennard MA, Stewart M (1999) Breast cancer survivors' perceptions of complementary/alternative medicine (CAM): making the decision to use or not to use. Qual Health Res 9(5):639–653PubMedCrossRefGoogle Scholar
  11. 11.
    Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A (2005) Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ 330(7493):702. doi:10.1136/bmj.38343.670868.D3 PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Brown ER, Goldstein MS (2003) Complementary and Alternative Medicine Questionnaire—A CHIS (California Health Interview Survey) 2001 Follow-back study. CHIS-CAM Questionnaire September 5Google Scholar
  13. 13.
    Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE (2000) Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol 18(13):2505–2514PubMedGoogle Scholar
  14. 14.
    Brabo EP, Paschoal ME, Biasoli I, Nogueira FE, Gomes MC, Gomes IP, Martins LC, Spector N (2006) Brazilian version of the QLQ-LC13 lung cancer module of the European Organization for Research and Treatment of Cancer: preliminary reliability and validity report. Qual Life Res 15(9):1519–1524. doi:10.1007/s11136-006-0009-9 PubMedCrossRefGoogle Scholar
  15. 15.
    Silva CB, Albuquerque V, Leite J (2010) Qualidade de Vida em Pacientes Portadoras de Neoplasia Mamária. Revista Brasileira de Cancerologia.Google Scholar
  16. 16.
    Botega NJ, Pondé MP, Medeiros P, Lima MG, Guerreiro CAM (1998) Validação da escala hospitalar de ansiedade e depressão (HAD) em pacientes epiléticos ambulatoriais. J Bras Psiquiatr 47(6):258–289Google Scholar
  17. 17.
    Kang E, Yang EJ, Kim SM, Chung IY, Han SA, Ku DH, Nam SJ, Yang JH, Kim SW (2011) Complementary and alternative medicine use and assessment of quality of life in Korean breast cancer patients: a descriptive study. Support Care Cancer 20(3):461–473. doi:10.1007/s00520-011-1094-z PubMedCrossRefGoogle Scholar
  18. 18.
    Lengacher CA, Bennett MP, Kip KE, Keller R, LaVance MS, Smith LS, Cox CE (2002) Frequency of use of complementary and alternative medicine in women with breast cancer. Oncol Nurs Forum 29(10):1445–1452. doi:10.1188/02.ONF.1445-1452 PubMedCrossRefGoogle Scholar
  19. 19.
    Ezeome ER, Anarado AN (2007) Use of complementary and alternative medicine by cancer patients at the University of Nigeria Teaching Hospital, Enugu, Nigeria. BMC Complement Altern Med 7:28. doi:10.1186/1472-6882-7-28 PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Ashikaga T, Bosompra K, O'Brien P, Nelson L (2002) Use of complementary and alternative medicine by breast cancer patients: prevalence, patterns and communication with physicians. Support Care Cancer 10(7):542–548. doi:10.1007/s00520-002-0356-1 PubMedCrossRefGoogle Scholar
  21. 21.
    El Nawawi NM, Balboni MJ, Balboni TA (2012) Palliative care and spiritual care: the crucial role of spiritual care in the care of patients with advanced illness. Curr Opin Support Palliat Care 6(2):269–274. doi:10.1097/SPC.0b013e3283530d13 PubMedCrossRefGoogle Scholar
  22. 22.
    Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS, Peteet JR, Prigerson HG (2007) Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. J Clin Oncol 25(5):555–560. doi:10.1200/JCO.2006.07.9046 PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Samano ES, Goldenstein PT, Ribeiro Lde M, Lewin F, Filho ES, Soares HP, del Giglio A (2004) Praying correlates with higher quality of life: results from a survey on complementary/alternative medicine use among a group of Brazilian cancer patients. Sao Paulo Med J 122(2):60–63PubMedCrossRefGoogle Scholar
  24. 24.
    de Melo JG, Santos AG, de Amorim EL, do Nascimento SC, de Albuquerque UP (2011) Medicinal plants used as antitumor agents in Brazil: an ethnobotanical approach. Evid Based Complement Alternat Med 2011:365359. doi:10.1155/2011/365359 PubMedCentralPubMedGoogle Scholar
  25. 25.
    Malvezzi CK, Carvalho EAG, Alves FVT (2006) Participação do enfermeiro em estudos brasileiros que envolvem a aplicação de plantas medicinais como terapia alternativa. Janus. Revista de pesquisa científica, vol 3. Faculdade de Enfermagem das Faculdades Integradas Teresa D’Ávila – FATEA,Google Scholar
  26. 26.
    Basso LA, da Silva LH, Fett-Neto AG, de Azevedo WF Jr, Moreira Ide S, Palma MS, Calixto JB, Astolfi Filho S, Santos RR, Soares MB, dos Santos DS (2005) The use of biodiversity as source of new chemical entities against defined molecular targets for treatment of malaria, tuberculosis, and T-cell mediated diseases—a review. Mem Inst Oswaldo Cruz 100(6):475–506PubMedCrossRefGoogle Scholar
  27. 27.
    Cassileth BR (1999) Evaluating complementary and alternative therapies for cancer patients. CA Cancer J Clin 49(6):362–375PubMedCrossRefGoogle Scholar
  28. 28.
    Brasil. MS/CNS Ministério da Saúde, (2006) Política Nacional de Práticas Integrativas e Complementares no SUS - PNPIC-SUS. Departamento de Atenção Básica. Ministério da Saúde, BrasíliaGoogle Scholar
  29. 29.
    Fontanella F, Speck FP, Piovezan AP, Kulkamp IC (2007) Conhecimento, acesso e aceitação das práticas integrativas e complementares em saúde por uma comunidade usuária do Sistema Único de Saúde na cidade de Tubarão/SC. Arquivos catarinenses de Medicina, vol 36. Associação Médica Brasileira,Google Scholar
  30. 30.
    Burstein HJ, Gelber S, Guadagnoli E, Weeks JC (1999) Use of alternative medicine by women with early stage breast cancer. N Engl J Med 340(22):1733–1739. doi:10.1056/NEJM199906033402206 PubMedCrossRefGoogle Scholar
  31. 31.
    Cassileth BR, Lusk EJ, Guerry D, Blake AD, Walsh WP, Kascius L, Schultz DJ (1991) Survival and quality of life among patients receiving unproven as compared with conventional cancer therapy. N Engl J Med 324(17):1180–1185. doi:10.1056/NEJM199104253241706 PubMedCrossRefGoogle Scholar
  32. 32.
    Paltiel O, Avitzour M, Peretz T, Cherny N, Kaduri L, Pfeffer RM, Wagner N, Soskolne V (2001) Determinants of the use of complementary therapies by patients with cancer. J Clin Oncol 19(9):2439–2448PubMedGoogle Scholar
  33. 33.
    Gerson-Cwilich R, Serrano-Olvera A, Villalobos-Prieto A (2006) Complementary and alternative medicine (CAM) in Mexican patients with cancer. Clin Trans Oncol Mar 8(3):200–207CrossRefGoogle Scholar
  34. 34.
    Montazeri A, Sajadian A, Ebrahimi M, Akbari ME (2005) Depression and the use of complementary medicine among breast cancer patients. Support Care Cancer May 13(5):339–342CrossRefGoogle Scholar
  35. 35.
    Rakovitch E, Pignol JP, Chartier C, Ezer M, Verma S, Dranitsaris G, Clemons M (2005) Complementary and alternative medicine use is associated with an increased perception of breast cancer risk and death. Breast Cancer Res Treat Mar 90(2):139–148CrossRefGoogle Scholar
  36. 36.
    Paiva CE, Paiva BS, de Castro RA, Souza Cde P, de Paiva Maia YC, Ayres JA, Michelin OC (2013) A pilot study addressing the impact of religious practice on quality of life of breast cancer patients during chemotherapy. J Relig Health 52(1):184–193. doi:10.1007/s10943-011-9468-6 PubMedCrossRefGoogle Scholar
  37. 37.
    Hasson-Ohayon I, Braun M, Galinsky D, Baider L (2009) Religiosity and hope: a path for women coping with a diagnosis of breast cancer. Psychosomatics 50(5):525–533. doi:10.1176/appi.psy.50.5.525 50/5/525 PubMedCrossRefGoogle Scholar
  38. 38.
    Gupta D, Lis CG, Birdsall TC, Grutsch JF (2005) The use of dietary supplements in a community hospital comprehensive cancer center: implications for conventional cancer care. Support Care Cancer 13(11):912–919. doi:10.1007/s00520-005-0820-9 PubMedCrossRefGoogle Scholar
  39. 39.
    Lis CG, Cambron JA, Grutsch JF, Granick J, Gupta D (2006) Self-reported quality of life in users and nonusers of dietary supplements in cancer. Support Care Cancer 14(2):193–199. doi:10.1007/s00520-005-0876-6 PubMedCrossRefGoogle Scholar
  40. 40.
    Henrique MC (2009) Folklore and popular medicine in the Amazon. Hist Cienc Saude Manguinhos 16(4):981–998PubMedCrossRefGoogle Scholar
  41. 41.
    Serfaty M, Wilkinson S, Freeman C, Mannix K, King M (2012) The ToT study: helping with Touch or Talk (ToT): a pilot randomised controlled trial to examine the clinical effectiveness of aromatherapy massage versus cognitive behaviour therapy for emotional distress in patients in cancer/palliative care. Psychooncology 21(5):563–569. doi:10.1002/pon.1921 PubMedCrossRefGoogle Scholar
  42. 42.
    Begbie SD, Kerestes ZL, Bell DR (1996) Patterns of alternative medicine use by cancer patients. Med J Aust 165(10):545–548PubMedGoogle Scholar
  43. 43.
    Saini A, Berruti A, Capogna S, Negro M, Sguazzotti E, Picci RL, Campagna S, Dongiovanni V, Dogliotti L, Furlan PM, Ostacoli L (2010) Prevalence of complementary/alternative medicines (CAMs) in a cancer population in northern Italy receiving antineoplastic treatments and relationship with quality of life and psychometric features. Qual Life Res 20(5):683–690. doi:10.1007/s11136-010-9795-1 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Ana Camila Callado Alfano
    • 1
    • 2
  • Carlos Eduardo Paiva
    • 2
    • 3
    • 4
    • 5
  • Fernanda Capella Rugno
    • 2
  • Raquel Haas da Silva
    • 1
  • Bianca Sakamoto Ribeiro Paiva
    • 2
    • 4
  1. 1.Clinical Research UnitBarretos Cancer HospitalBarretosBrazil
  2. 2.Research Group on Palliative Care and Quality of LifeBarretos Cancer HospitalBarretosBrazil
  3. 3.Department of Clinical OncologyBarretos Cancer HospitalBarretosBrazil
  4. 4.Teaching and Research InstituteBarretos Cancer HospitalBarretosBrazil
  5. 5.Pós-Graduação em Oncologia, Instituto de Ensino e PesquisaHospital de Câncer de BarretosBarretosBrazil

Personalised recommendations