Abstract
Purpose
To identify the unmonitored use of herbal medicine by female patients with breast cancer, examining the impact of an integrative physician (IP) consultation on this practice.
Methods
The files of 269 female patients with breast cancer following an IP consultation were surveyed retrospectively for use of herbal medicine for cancer-related goals. Expectations from the IP consultation and adherence to the IP-guided treatments were examined as well.
Results
Among the cohort, 111 (41.3%) reported using herbal medicine for cancer-related goals, unmonitored by their oncology healthcare professional. Factors predicting herbal medicine use were the adoption of dietary changes (odds ratio = 13.6, p < 0.001, CI 7.16–26.0) and the expectation that the IP consultation and treatments would address cancer-related goals (odds ratio = 3.29, p = 0.001, CI 1.64–6.6). Patients with metastatic disease were more likely to be using herbal medicine than non-users (34.5 vs. 22.8%; p = 0.088), as were those who had consulted with a complementary/alternative medicine practitioner (54.9 vs. 20.8%; p = 0.005). The IP advised 17 patients (15.3%) to stop taking specific herbal products due to safety-related concerns; and 10 patients to take dietary supplements for relief of specific symptoms. Herbal medicine users were less likely than non-users to adhere to the IP-recommended treatment program (34.7 vs. 48.3%; p = 0.037).
Conclusions
Unmonitored use of herbal medicine by patients with breast cancer is more frequent among those adopting dietary changes for cancer-related goals. Integrative physicians provide evidence-based guidance on the safe and effective use of herbal products, and reframe patient expectations from cancer-related goals to reducing symptoms and improving quality of life.
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References
Barbuti AM, Chen ZS (2015) Paclitaxel through the ages of anticancer therapy: exploring its role in chemoresistance and radiation therapy. Cancers Basel 7(4):2360–2371
Barton DL, Liu H, Dakhil SR, Linquist B, Sloan JA, Nichols CR, McGinn TW, Stella PJ, Seeger GR, Sood A, Loprinzi CL (2013) Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. J Natl Cancer Inst 105(16):1230–1238
Ben-Arye E, Schiff E, Zollman C, Heusser P, Mountford P, Frenkel M, Bar-Sela G, Lavie O (2013) Integrating complementary medicine in supportive cancer care models across four continents. Med Oncol 30(2):511
Ben-Arye E, Kruger D, Samuels N, Keinan-Boker L, Shalom T, Schiff E (2014) Assessing patient adherence to a complementary medicine treatment regimen in an integrative supportive care setting. Support Care Cancer 22(3):627–644
Ben-Arye E, Samuels N, Goldstein LH, Mutafoglu K, Omran S, Schiff E, Charalambous H, Dweikat T, Ghrayeb I, Bar-Sela G, Turker I, Hassan A, Hassan E, Saad B, Nimri O, Kebudi R, Silbermann M (2016) Potential risks associated with traditional herbal medicine use in cancer care: a study of Middle Eastern oncology health care professionals. Cancer 122(4):598–610
Boon HS, Olatunde F, Zick SM (2007) Trends in complementary/alternative medicine use by breast cancer survivors: comparing survey data from 1998 and 2005. BMC Womens Health 7:4
Corina G, Christine H, Klein G (2016) Oncologists’ experiences of discussing complementary and alternative treatment options with their cancer patients. A qualitative analysis. Support Care Cancer 24(9):3857–3862
Cragg GM, Newman DJ (2005) Plants as a source of anti-cancer agents. J Ethnopharmacol 100:72–79
Deng G (2008) Integrative cancer care in a US academic cancer centre: the Memorial Sloan–Kettering experience. Curr Oncol 15(Suppl 2):s108.es68–s108.es71
Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delblanco TL (1993) Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 328:246–252
Frenkel M, Cohen L, Peterson N, Palmer JL, Swint K, Bruera E (2010) Integrative medicine consultation service in a comprehensive cancer center: findings and outcomes. Integr Cancer Ther 9(3):276–283
Haefeli WE, Carls A (2014) Drug interactions with phytotherapeutics in oncology. Expert Opin Drug Metab Toxicol 10(3):359–377
Heller AR, Fischer S, Rossel T, Geiger S, Siegert G, Ragaller M, Zimmerman T, Koch T (2002) Impact of n-3 fatty acid supplemented parenteral nutrition on haemostasis patterns after major abdominal surgery. Br J Nutr 87(Suppl 1):S95–S101
Hershman DL, Unger JM, Crew KD, Minasian LM, Awad D, Moinpour CM, Hansen L, Lew DL, Greenlee H, Fehrenbacher L, Wade JL 3rd, Wong SF, Hortobagyi GN, Meyskens FL, Albain KS (2013) Randomized double-blind placebo-controlled trial of acetyl-l-carnitine for the prevention of taxane-induced neuropathy in women undergoing adjuvant breast cancer therapy. J Clin Oncol 31(20):2627–2633
Huebner J, Marienfeld S, Abbenhardt C, Ulrich C, Muenstedt K, Micke O, Muecke R, Loeser C (2014) Counseling patients on cancer diets: a review of the literature and recommendations for clinical practice. Anticancer Res 34(1):39–48
Konmun J, Danwilai K, Ngamphaiboon N, Sripanidkulchai B, Sookprasert A, Subongkot S (2017) A phase II randomized double-blind placebo-controlled study of 6-gingerol as an anti-emetic in solid tumor patients receiving moderately to highly emetogenic chemotherapy. Med Oncol 34(4):69
Kulp KS, Montgomery JL, Nelson DO, Cutter B, Latham ER, Shattuck DL, Klotz DM, Bennett LM (2006) Essiac and Flor-Essence herbal tonics stimulate the in vitro growth of human breast cancer cells. Breast Cancer Res Treat 98:249–259
Lewith G, Aldridge E (eds) (1991) Complementary medicine and the European community. C.W. Daniel, Saffron Walden
Matthews AK, Sellergren SA, Huo D, List M, Fleming G (2007) Complementary and alternative medicine use among breast cancer survivors. J Altern Complement Med 13:555–562
Prakash P, Misra A, Surin WR, Jain M, Bhatta RS, Pal R, Raj K, Barthwal MK, Dikshit M (2011) Anti-platelet effects of Curcuma oil in experimental models of myocardial ischemia-reperfusion and thrombosis. Thromb Res 127(2):111–118
Roberts CS, Baker F, Hann D, Runfola J, Witt C, McDonald J, Livingston ML, Ruiterman J, Ampela R, Kaw OC, Blanchard C (2005) Patient–physician communication regarding use of complementary therapies during cancer treatment. J Psychosoc Oncol 23:35–60
Saibul N, Shariff ZM, Rahmat A, Sulaiman S, Yaw YH (2012) Use of complementary and alternative medicine among breast cancer survivors. Asian Pac J Cancer Prev 13:4081–4086
Shalom-Sharabi I, Samuels N, Lev E, Lavie O, Keinan-Boker L, Schiff E, Ben-Arye E (2017) Impact of a complementary/integrative medicine program on the need for supportive cancer care-related medications. Support Care Cancer. doi:10.1007/s00520-017-3726-4
Shin SC, Choi JS (2009) Effects of epigallocatechin gallate on the oral bioavailability and pharmacokinetics of tamoxifen and its main metabolite, 4-hydroxytamoxifen, in rats. Anticancer Drugs 20(7):584–588
Acknowledgements
We wish to thank Ms. Ronit Leiba for her assistance with the statistical analysis.
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Samuels, N., Ben-Arye, E., Maimon, Y. et al. Unmonitored use of herbal medicine by patients with breast cancer: reframing expectations. J Cancer Res Clin Oncol 143, 2267–2273 (2017). https://doi.org/10.1007/s00432-017-2471-x
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DOI: https://doi.org/10.1007/s00432-017-2471-x