Breast Cancer Research and Treatment

, Volume 100, Issue 2, pp 219–227 | Cite as

Correlates of use of different types of complementary and alternative medicine by breast cancer survivors in the nurses’ health study

  • Catherine BuettnerEmail author
  • Candyce H. Kroenke
  • Russell S. Phillips
  • Roger B. Davis
  • David M. Eisenberg
  • Michelle D. Holmes



Among breast cancer survivors, we identified the prevalence and correlates of use of different types of complementary and alternative medicine (CAM).

Patients and methods

We included 2,022 women diagnosed with breast cancer 1998–2003 who responded to a survey about CAM use. We performed logistic regression to determine demographic and disease factors associated with use of different CAM therapies (including relaxation/imagery, spiritual healing, yoga, energy healing, acupuncture, massage, chiropractic, high-dose vitamins, herbs, and homeopathy). We also measured quality of life (QoL) using the SF36 and optimism using LOT-R and fit linear regression models to compare mean scores among CAM users and nonusers.


Sixty-two percent of respondents used CAM. Younger age was the most consistent correlate of CAM use, but factors associated with CAM use varied by type of CAM. Chemotherapy was associated with use of relaxation/imagery (OR 1.3 95%CI 1.1–1.7). Radiotherapy was associated with use of high-dose vitamins (OR 1.5 95% CI 1.2–2.0). Tamoxifen or anastrozole treatment was associated with use of homeopathy (OR 0.5 95%CI 0.3–0.9). Users of most types of CAM had worse QoL scores than nonusers, but better QoL was found among users of yoga. The lowest QoL scores were associated with the use of energy healing. Optimism was higher among users of relaxation/imagery.


Factors associated with CAM use varied according to type of CAM. Our finding of worse QoL among women using energy healing and better QoL among women using yoga suggests the need for longitudinal studies to determine the temporal relationships between these therapies and QoL.


Breast neoplasms Complementary therapies 


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Dr. Buettner is supported by an NIH Institutional National Research Service Award, Grant No. T32–AT0051-03 from the National Center for Complementary and Alternative Medicine (NCCAM). Dr. Phillips is supported by a NIH NCCAM Mid-Career Investigator Award K24–AT000589. The work reported in this manuscript was supported by CA87969, the main Nurses’ Health Study grant.

Although this work was supported by the National Center for Complementary and Alternative Medicine, its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Complementary and Alternative Medicine, National Institutes of Health.


  1. 1.
    Ashikaga T, Bosompra K, O’Brien P et al (2002) Use of complimentary and alternative medicine by breast cancer patients: prevalence, patterns and communication with physicians. Support Care Cancer 10(7):542–548PubMedCrossRefGoogle Scholar
  2. 2.
    Burstein HJ, Gelber S, Guadagnoli E et al (1999) Use of alternative medicine by women with early-stage breast cancer. N Engl J Med 340(22):1733–1739PubMedCrossRefGoogle Scholar
  3. 3.
    Edgar L, Remmer J, Rosberger Z et al (2000) Resource use in women completing treatment for breast cancer. Psychooncology 9(5):428–438PubMedCrossRefGoogle Scholar
  4. 4.
    Henderson JW, Donatelle RJ (2004) Complementary and alternative medicine use by women after completion of allopathic treatment for breast cancer. Altern Ther Health Med 10(1):52–57PubMedGoogle Scholar
  5. 5.
    Lee MM, Lin SS, Wrensch MR et al (2000) Alternative therapies used by women with breast cancer in four ethnic populations. J Natl Cancer Inst 92(1):42–47PubMedCrossRefGoogle Scholar
  6. 6.
    Lengacher CA, Bennett MP, Kipp KE et al (2003) Design and testing of the use of a complementary and alternative therapies survey in women with breast cancer. Oncol Nurs Forum 30(5):811–821PubMedGoogle Scholar
  7. 7.
    Nagel G, Hoyer H, Katenkamp D (2004) Use of complementary and alternative medicine by patients with breast cancer: observations from a health-care survey. Support Care Cancer 12(11):789–796PubMedCrossRefGoogle Scholar
  8. 8.
    Navo MA, Phan J, Vaughan C et al (2004) An assessment of the utilization of complementary and alternative medication in women with gynecologic or breast malignancies. J Clin Oncol 22(4):671–677PubMedCrossRefGoogle Scholar
  9. 9.
    Richardson MA, Sanders T, Palmer JL et al (2000) Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol 18(13):2505–2514PubMedGoogle Scholar
  10. 10.
    Moschen R, Kemmler G, Schweigkofler H et al (2001) Use of alternative/complementary therapy in breast cancer patients—a psychological perspective. Support Care Cancer 9(4):267–274PubMedCrossRefGoogle Scholar
  11. 11.
    Shen J, Andersen R, Albert PS et al (2002) Use of complementary/alternative therapies by women with advanced-stage breast cancer. BMC Complement Altern Med 2:8PubMedCrossRefGoogle Scholar
  12. 12.
    Rakovitch E, Pignol JP, Chartier C et al (2005) Complementary and alternative medicine use is associated with an increased perception of breast cancer risk and death. Breast Cancer Res Treat 90(2):139–148PubMedCrossRefGoogle Scholar
  13. 13.
    Gray RE, Fitch M, Goel V et al (2003) Utilization of complementary/alternative services by women with breast cancer. J Health Soc Policy 16(4):75–84PubMedCrossRefGoogle Scholar
  14. 14.
    Boon H, Stewart M, Kennard MA et al (2000) Use of complementary/alternative medicine by breast cancer survivors in Ontario: prevalence and perceptions. J Clin Oncol 18(13):2515–2521PubMedGoogle Scholar
  15. 15.
    Casso D, Buist DS, Taplin S (2004) Quality of life of 5–10 year breast cancer survivors diagnosed between age 40 and 49. Health Qual Life Outcomes 2:25PubMedCrossRefGoogle Scholar
  16. 16.
    Paltiel O, Avitzour M, Peretz T et al (2001) Determinants of the use of complementary therapies by patients with cancer. J Clin Oncol 19(9):2439–2448PubMedGoogle Scholar
  17. 17.
    Barnes PM, Powell-Griner E, McFann K et al (2004) Complementary and alternative medicine use among adults: United States, 2002. Adv Data 2004(343):1–19Google Scholar
  18. 18.
    Alferi SM, Antoni MH, Ironson G et al (2001) Factors predicting the use of complementary therapies in a multi-ethnic sample of early-stage breast cancer patients. J Am Med Womens Assoc 56(3):120–123, 126PubMedGoogle Scholar
  19. 19.
    Swisher EM, Cohn DE, Goff BA et al (2002) Use of complementary and alternative medicine among women with gynecologic cancers. Gynecol Oncol 84(3):363–367PubMedCrossRefGoogle Scholar
  20. 20.
    Wyatt GK, Friedman LL, Given CW et al (1999) Complementary therapy use among older cancer patients. Cancer Pract 7(3):136–144PubMedCrossRefGoogle Scholar
  21. 21.
    Davidson R, Geoghegan L, McLaughlin L et al (2005) Psychological characteristics of cancer patients who use complementary therapies. Psychooncology 14(3):187–195PubMedCrossRefGoogle Scholar
  22. 22.
    Eisenberg DM, Davis RB, Ettner SL et al (1998) Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. Jama 280(18):1569–1575PubMedCrossRefGoogle Scholar
  23. 23.
    Brook RH, Ware JE Jr, Davies-Avery A et al (1979) Overview of adult health measures fielded in Rand’s health insurance study. Med Care 17(7 Suppl):iii–x, 1–131Google Scholar
  24. 24.
    Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483PubMedCrossRefGoogle Scholar
  25. 25.
    McHorney CA, Ware JE Jr, Lu JF et al (1994) The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 32(1):40–66PubMedCrossRefGoogle Scholar
  26. 26.
    McHorney CA, Ware JE Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31(3):247–263PubMedCrossRefGoogle Scholar
  27. 27.
    Scheier MF, Carver CS, Bridges MW (1994) Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test. J Pers Soc Psychol 67(6):1063–1078PubMedCrossRefGoogle Scholar
  28. 28.
    Carver CS, Pozo C, Harris SD et al (1993) How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer. J Pers Soc Psychol 65(2):375–390PubMedCrossRefGoogle Scholar
  29. 29.
    Osoba D, Bezjak A, Brundage M et al (2005) Analysis and interpretation of health-related quality-of-life data from clinical trials: basic approach of The National Cancer Institute of Canada Clinical Trials Group. Eur J Cancer 41(2):280–287PubMedCrossRefGoogle Scholar
  30. 30.
    Bairati I, Meyer F, Gelinas M et al (2005) Randomized trial of antioxidant vitamins to prevent acute adverse effects of radiation therapy in head and neck cancer patients. J Clin Oncol 23(24):5805–5813PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Catherine Buettner
    • 1
    Email author
  • Candyce H. Kroenke
    • 2
    • 3
    • 4
  • Russell S. Phillips
    • 5
    • 6
  • Roger B. Davis
    • 5
  • David M. Eisenberg
    • 1
  • Michelle D. Holmes
    • 2
  1. 1.Division for Research and Education in Complementary and Integrative Medical TherapiesHarvard Medical SchoolBostonUSA
  2. 2.Channing Laboratory, Department of MedicineBrigham and Women’s Hospital, and Harvard Medical School BostonUSA
  3. 3.Robert Wood Johnson Health and Society Scholars ProgramThe University of CaliforniaBerkeley and San FranciscoUSA
  4. 4.Robert Wood Johnson Health and Society Scholars ProgramThe University of CaliforniaSan FranciscoUSA
  5. 5.Division of General Medicine and Primary CareBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonUSA
  6. 6.Division of General Medicine and Primary CareHarvard Medical School BostonUSA

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