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Supplement use and its impact on daily life of cancer patients: a cross-sectional study

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Abstract

Purpose

This cross-sectional study aimed to investigate the prevalence and characteristics of supplement usage among cancer patients and explore its potential associations with anxiety, excessive daytime sleepiness, and overall quality of life.

Methods

Cancer patients receiving specific care at Hôtel Dieu de France University Hospital, Beirut, were enrolled between April and June 2023. In face-to-face interviews, participants were asked to complete a questionnaire consisting of sociodemographic information, supplement usage details, and cancer-related variables. Three validated surveys (Epworth Sleepiness Scale, GAD-7, and EORTC-QLQ-C15-PAL) were employed to assess excessive daytime sleepiness, anxiety, and overall quality of life. Statistical analyses, including chi-square tests, t-tests, and multiple regression models, were conducted to examine associations between supplement use and other variables.

Results

A total of 202 participants were interviewed. Fifty-two percent reported regular use of supplements following their cancer diagnosis, with vitamin D being the most commonly used supplement. Using multivariate logistic regression, supplement use was associated with being female, having lower educational levels, having a longer duration since cancer diagnosis, and having a poor overall quality of life. The multivariate logistic regression showed no significant correlation between supplement use and excessive daytime sleepiness and anxiety.

Conclusion

This study highlights a high prevalence of supplement usage among cancer patients in Lebanon, indicating a rising interest in alternative therapies aimed at enhancing quality of life. Larger prospective studies are needed to assess the relation between supplement intake and excessive daytime sleepiness and anxiety and establish clear guidelines pertaining to supplement use in cancer patients.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon request.

References

  1. Dietary supplements. American Cancer Society (n.d.) https://www.cancer.org/cancer/managing-cancer/treatment-types/complementary-and-integrative-medicine/dietary-supplements.html

  2. Horneber M, Bueschel G, Dennert G, Less D, Ritter E, Zwahlen M (2012) How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis. Integr Cancer Ther 11(3):187–203. https://doi.org/10.1177/1534735411423920

    Article  PubMed  Google Scholar 

  3. Du M, Luo H, Blumberg JB, Rogers G, Chen F, Ruan M, Shan Z, Biever E, Zhang FF (2020) Dietary supplement use among adult cancer survivors in the United States. J Nutr 150(6):1499–1508. https://doi.org/10.1093/jn/nxaa040

    Article  PubMed  PubMed Central  Google Scholar 

  4. Naja F, Anouti B, Shatila H, Akel R, Haibe Y, Tfayli A (2017) Prevalence and correlates of complementary and alternative medicine use among patients with lung cancer: a cross-sectional study in Beirut, Lebanon. Evid-Based Complement Altern Med: eCAM 2017:8434697. https://doi.org/10.1155/2017/8434697

    Article  Google Scholar 

  5. Naja F, Fadel RA, Alameddine M, Aridi Y, Zarif A, Hariri D, Mugharbel A, Khalil M, Nahleh Z, Tfayli A (2015) Complementary and alternative medicine use and its association with quality of life among Lebanese breast cancer patients: a cross-sectional study. BMC Complement Altern Med 15:444. https://doi.org/10.1186/s12906-015-0969-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Bailey RL et al (2011) Dietary supplement use in the United States, 2003–2006. J Nutr 141:261–266. https://doi.org/10.3945/jn.110.133025

    Article  CAS  PubMed  Google Scholar 

  7. Li K, Kaaks R, Linseisen J, Rohrmann S (2010) Consistency of vitamin and/or mineral supplement use and demographic, lifestyle and health-status predictors: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heidelberg cohort. Br J Nutr 104:1058–1064. https://doi.org/10.1017/S0007114510001728

    Article  CAS  PubMed  Google Scholar 

  8. Clinton SK, Giovannucci EL, Hursting SD (2020) The World Cancer Research Fund/American Institute for Cancer Research third expert report on diet, nutrition, physical activity, and cancer: impact and future directions. J Nutr 150(4):663–671. https://doi.org/10.1093/jn/nxz268

    Article  PubMed  Google Scholar 

  9. U.S. Department of Health and Human Services (2021) Cancer and complementary health approaches: what you need to know. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/cancer-and-complementary-health-approaches-what-you-need-to-know. Accessed 2021

  10. Sohl SJ, Weaver KE, Birdee G, Kent EE, Danhauer SC, Hamilton AS (2014) Characteristics associated with the use of complementary health approaches among long-term cancer survivors. Support Care Cancer 22(4):927–936. https://doi.org/10.1007/s00520-013-2040-z

    Article  PubMed  Google Scholar 

  11. Tank M, Franz K, Cereda E, Norman K (2021) Dietary supplement use in ambulatory cancer patients: a survey on prevalence, motivation, and attitudes. J Cancer Res Clin Oncol 147(7):1917–1925. https://doi.org/10.1007/s00432-021-03594-7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, Meader N (2011) Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol 12(2):160–174. https://doi.org/10.1016/S1470-2045(11)70002-X

    Article  PubMed  Google Scholar 

  13. Lee HR, Song YM, Jeon KH, Cho IY (2021) The association between the use of dietary supplement and psychological status of cancer survivors in Korea: a cross-sectional study. Korean J Fam Med 42(4):317–326. https://doi.org/10.4082/kjfm.20.0184

    Article  PubMed  PubMed Central  Google Scholar 

  14. Saini A, Berruti A, Capogna S, Negro M, Sguazzotti E, Picci RL, Campagna S, Dongiovanni V, Dogliotti L, Furlan PM, Ostacoli L (2011) 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. https://doi.org/10.1007/s11136-010-9795-1

    Article  PubMed  Google Scholar 

  15. 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. https://doi.org/10.1007/s00520-005-0876-6

    Article  PubMed  Google Scholar 

  16. Büttner-Teleagă A, Kim YT, Osel T, Richter K (2021) Sleep disorders in cancer-a systematic review. Int J Environ Res Public Health 18(21):11696. https://doi.org/10.3390/ijerph182111696

    Article  PubMed  PubMed Central  Google Scholar 

  17. Spitzer RL, Kroenke K, Williams JB, Löwe B (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166(10):1092–1097. https://doi.org/10.1001/archinte.166.10.1092

    Article  PubMed  Google Scholar 

  18. Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14(6):540–545. https://doi.org/10.1093/sleep/14.6.540

    Article  CAS  PubMed  Google Scholar 

  19. Groenvold M, Petersen MA, Aaronson NK, Arraras JI, Blazeby JM, Bottomley A, Fayers PM, de Graeff A, Hammerlid E, Kaasa S, Sprangers MA, Bjorner JB, EORTC Quality of Life Group (2006) The development of the EORTC QLQ-C15-PAL: a shortened questionnaire for cancer patients in palliative care. Eur J Cancer 42(1):55–64. https://doi.org/10.1016/j.ejca.2005.06.022

  20. Bauml J, Langer CJ, Evans T, Garland SN, Desai K, Mao JJ (2014) Does perceived control predict complementary and alternative medicine (CAM) use among patients with lung cancer? A cross-sectional survey. Support Care Cancer 22(9):2465–2472. https://doi.org/10.1007/s00520-014-2220-5

    Article  PubMed  PubMed Central  Google Scholar 

  21. Akpınar Ş, Karadağ MG (2022) Is vitamin D important in anxiety or depression? What is the truth? Curr Nutr Rep 11(4):675–681. https://doi.org/10.1007/s13668-022-00441-0

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ferrucci LM, McCorkle R, Smith T, Stein KD, Cartmel B (2009) Factors related to the use of dietary supplements by cancer survivors. J Altern Complement Med 15(6):673–680. https://doi.org/10.1089/acm.2008.0387

    Article  PubMed  PubMed Central  Google Scholar 

  23. Verhoef MJ, Rose MS, White M, Balneaves LG (2008) Declining conventional cancer treatment and using complementary and alternative medicine: a problem or a challenge? Curr Oncol 15 Suppl 2(Suppl 2):s101–s106. https://doi.org/10.3747/co.v15i0.281

  24. Asif A, Farooq N (2023) Vitamin D toxicity. StatPearls Publishing, In StatPearls

    Google Scholar 

  25. Ambrosone CB, Zirpoli GR, Hutson AD, McCann WE, McCann SE, Barlow WE, Kelly KM, Cannioto R, Sucheston-Campbell LE, Hershman DL, Unger JM, Moore HCF, Stewart JA, Isaacs C, Hobday TJ, Salim M, Hortobagyi GN, Gralow JR, Budd GT, Albain KS (2020) Dietary supplement use during chemotherapy and survival outcomes of patients with breast cancer enrolled in a cooperative group clinical trial (SWOG S0221). J Clin Oncol 38(8):804–814. https://doi.org/10.1200/JCO.19.01203

    Article  CAS  PubMed  Google Scholar 

  26. Vollbracht C, Schneider B, Leendert V, Weiss G, Auerbach L, Beuth J (2011) Intravenous vitamin C administration improves quality of life in breast cancer patients during chemo-/radiotherapy and aftercare: results of a retrospective, multicentre, epidemiological cohort study in Germany. In vivo (Athens, Greece) 25(6):983–990

    CAS  PubMed  Google Scholar 

  27. Magrì A, Germano G, Lorenzato A, Lamba S, Chilà R, Montone M, Amodio V, Ceruti T, Sassi F, Arena S, Abrignani S, D’Incalci M, Zucchetti M, Di Nicolantonio F, Bardelli A (2020) High-dose vitamin C enhances cancer immunotherapy. Sci Transl Med 12(532):eaay8707. https://doi.org/10.1126/scitranslmed.aay8707

    Article  CAS  PubMed  Google Scholar 

  28. Andersen MR, Sweet E, Hager S, Gaul M, Dowd F, Standish LJ (2019) Effects of vitamin D use on health-related quality of life of breast cancer patients in early survivorship. Integr Cancer Ther 18:1534735418822056. https://doi.org/10.1177/1534735418822056

    Article  PubMed  PubMed Central  Google Scholar 

  29. Liu J, Dong Y, Lu C, Wang Y, Peng L, Jiang M, Tang Y, Zhao Q (2017) Meta-analysis of the correlation between vitamin D and lung cancer risk and outcomes. Oncotarget 8(46):81040–81051. https://doi.org/10.18632/oncotarget.18766

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon

    Youssef El Toum, Tarek Costa & Tina Haddad

  2. Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon

    Elissa El Toum & Pascale Salameh

  3. Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon

    Fady El karak, Marwan Ghosn, Fady Nasr, Georges Chahine, Joseph Kattan & Hampig Raphael Kourie

Authors
  1. Youssef El Toum
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  2. Tarek Costa
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Y.E., T. C., E.E and T. H.. Analysis was performed by Y. E., T. C., E.E and P. S.. The first draft of the manuscript was written by Y.E., T. C., E.E and T. H.. and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Youssef El Toum.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Hôtel Dieu de France, Beirut, Lebanon (March 28th, 2023/CEHDF 2139).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare no competing interests.

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El Toum, Y., Costa, T., El Toum, E. et al. Supplement use and its impact on daily life of cancer patients: a cross-sectional study. Support Care Cancer 32, 172 (2024). https://doi.org/10.1007/s00520-024-08380-y

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