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Determinants of use of oral complementary-alternative medicine among women with early breast cancer: a focus on cancer-related fatigue

  • Epidemiology
  • Published:
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Abstract

Background

Despite the questionable effectiveness of oral complementary and alternative medicine (OCAM) in relieving cancer-related symptoms, including fatigue (CRF), many patients use it aiming to improve their quality of life. We assessed factors associated with OCAM use, focusing on CRF.

Methods

Women with stage I–III breast cancer (BC) were included from CANTO (NCT01993498). OCAM use was defined as taking homeopathy, vitamins/minerals, or herbal/dietary supplements. Multivariable multinomial logistic regressions evaluated associations of CRF (EORTC QLQ-C30), patient, and treatment characteristics with OCAM use.

Results

Among 5237 women, 23.0% reported OCAM use overall (49.3% at diagnosis, 50.7% starting post-diagnosis), mostly homeopathy (65.4%). Mean (SD) CRF score was 27.6 (24.0) at diagnosis and 35.1 (25.3) at post-diagnosis. More intense CRF was consistently associated with OCAM use at diagnosis and post-diagnosis [adjusted odds ratio (aOR) for 10-point increase 1.05 (95% Confidence interval 1.01–1.09) and 1.04 (1.01–1.09) vs. never use, respectively]. Odds of using OCAM at diagnosis were higher among older [for 5-year increase, 1.09 (1.04–1.14)] and more educated patients [college vs. primary 1.80 (1.27–2.55)]. Women with income > 3000 [vs. < 1500 euros/month, 1.44 (1.02–2.03)], anxiety [vs. not, 1.25 (1.01–1.54)], and those receiving chemotherapy [vs. not, 1.32 (1.04–1.68)] had higher odds of using OCAM post-diagnosis.

Conclusion

One-in-four patients reported use of OCAM. More severe CRF was consistently associated with its use. Moreover, older, better educated, wealthier, more anxious women, and those receiving chemotherapy seemed more prone to use OCAM. Characterizing profiles of BC patients more frequently resorting to OCAM may help deliver targeted information about its benefits and potential risks.

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Data availability

CANTO data are available upon request to a dedicated study Executive Committee (http://www.unicancer.fr/rd-unicancer/letude-canto).

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Acknowledgements

This research was supported by: a Career Catalyst Research grant from Susan G. Komen (Grant No. CCR17483507), funding from Odyssea, and from Foundation Gustave Roussy to Ines Vaz-Luis; and by a Career Pathway Grant in symptom management from Conquer Cancer, the ASCO Foundation and Rising Tide Foundation for Clinical Cancer Research to Antonio Di Meglio. The CANTO study is supported by the French Government under the “Investment for the Future” program managed by the National Research Agency (ANR), Grant No. ANR-10-COHO-0004.

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Authors and Affiliations

  1. Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France

    Pietro Lapidari, Julie Havas, Arnauld Gbenou, Elise Martin, Fabrice Andre, Ines Vaz-Luis & Antonio Di Meglio

  2. Univesità Degli Studi di Pavia, Pavia, Italy

    Pietro Lapidari

  3. Medical Oncology, Gustave Roussy, Villejuif, France

    Nardjes Djehal & Barbara Pistilli

  4. Bordeaux Public Health, Université de Bordeaux, U1219, Bordeaux, France

    Cecile Charles

  5. Département Interdisciplinaire de Soins de Support aux Patients en Onco-hématologie, Gustave Roussy, Villejuif, France

    Sarah Dauchy

  6. Harvard Medical School, Boston, MA, USA

    Claire Cadeau

  7. Centre Georges-François Leclerc, Methodology and Biostatistic Unit, Dijon, France

    Aurélie Bertaut

  8. Unicancer, Paris, France

    Sibille Everhard & Anne-Laure Martin

  9. Medical Oncology, Centre Georges-François Leclerc, Dijon, France

    Charles Coutant

  10. Medical Oncology, Institut Curie, Paris, France

    Paul Cottu

  11. Institut Pierre Louis dʹEpidémiologie et de Santé Publique, Paris, France

    Gwenn Menvielle

  12. ECEVE UMR 1123, Université de Paris, Paris, France

    Agnes Dumas

  13. Service de Biostatistique et d’Epidémiologie, Gustave Roussy, Villejuif, France

    Stefan Michiels

  14. Inserm, University Paris-Saclay, Labeled «Ligue Contre le Cancer», Oncostat U1018, Villejuif, France

    Stefan Michiels

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  1. Pietro Lapidari
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Contributions

PL, IVL, and ADM: Conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, resources, software, supervision, validation, visualization, original draft writing, and review and editing. JH and AG: Data curation, formal analysis, and methodology. ND, EM, CC, SD, BP, CC, AB, SE, ALM, CC, PC, GM, AD, FA, and SM: Conceptualization, investigation, methodology, and validation. ALM and SE: Project administration and resources. All authors gave substantial contribution to collection and interpretation of data, revised this manuscript for important intellectual content, reviewed, and approved its final version.

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Correspondence to Antonio Di Meglio.

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The authors declare no conflict of interest.

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The CANTO study was approved by the national regulatory authorities of France (ID-RCB: 2011-A01095-36) and by the ethics committee CPP IDF VII (11-039).

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Informed consent for study participation was obtained at patient enrollment.

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Lapidari, P., Djehal, N., Havas, J. et al. Determinants of use of oral complementary-alternative medicine among women with early breast cancer: a focus on cancer-related fatigue. Breast Cancer Res Treat 190, 517–529 (2021). https://doi.org/10.1007/s10549-021-06394-2

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