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Use of complementary and alternative medicine and breast cancer survival in the Health, Eating, Activity, and Lifestyle Study

  • Epidemiology
  • Published:
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Abstract

Purpose

Use of complementary and alternative medicine (CAM) is common among breast cancer patients, but less is known about whether CAM influences breast cancer survival.

Methods

Health Eating, Activity, and Lifestyle (HEAL) Study participants (n = 707) were diagnosed with stage I–IIIA breast cancer. Participants completed a 30-month post-diagnosis interview including questions on CAM use (natural products such as dietary and botanical supplements, alternative health practices, and alternative medical systems), weight, physical activity, and comorbidities. Outcomes were breast cancer-specific and total mortality, which were ascertained from the Surveillance Epidemiology and End Results registries in Western Washington, Los Angeles County, and New Mexico. Cox proportional hazards regression models were fit to data to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for mortality. Models were adjusted for potential confounding by sociodemographic, health, and cancer-related factors.

Results

Among 707 participants, 70 breast cancer-specific deaths and 149 total deaths were reported. 60.2 % of participants reported CAM use post-diagnosis. The most common CAM were natural products (51 %) including plant-based estrogenic supplements (42 %). Manipulative and body-based practices and alternative medical systems were used by 27 and 13 % of participants, respectively. No associations were observed between CAM use and breast cancer-specific (HR 1.04, 95 % CI 0.61–1.76) or total mortality (HR 0.91, 95 % CI 0.63–1.29).

Conclusion

Complementary and alternative medicine use was not associated with breast cancer-specific mortality or total mortality. Randomized controlled trials may be needed to definitively test whether there is harm or benefit from the types of CAM assessed in HEAL in relation to mortality outcomes in breast cancer survivors.

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Funding

The HEAL study was funded by National Cancer Institute (N01-CN-75036-20), N01-CN-05228, N01-PC-67010, National Institutes of Health M01-RR-00037), University of New Mexico NCRR M01-RR-0997, California Department of Health Services 050Q-8709-S1528.

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Authors and Affiliations

  1. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave North, M4B402, Seattle, WA, 98109-1024, USA

    Marian L. Neuhouser, Catherine Duggan & Anne McTiernan

  2. Outcomes Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA

    Ashley Wilder Smith

  3. Office of Disease Prevention, National Institutes of Health, Bethesda, MD, USA

    Stephanie M. George & Rachel Ballard

  4. Information Management Services, Inc., Calverton, MD, USA

    James T. Gibson

  5. Department of Epidemiology and Population Health, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA

    Kathy B. Baumgartner & Richard Baumgartner

  6. Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA

    Leslie Bernstein

Authors
  1. Marian L. Neuhouser
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  2. Ashley Wilder Smith
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  3. Stephanie M. George
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  8. Leslie Bernstein
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  10. Rachel Ballard
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Corresponding author

Correspondence to Marian L. Neuhouser.

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The authors declare that they have no conflict of interest.

Human participants

The HEAL study complied with all federal regulations for human subjects research.

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All participating institutions have approved and on-going IRB files and all participants signed written informed consent.

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Cite this article

Neuhouser, M.L., Smith, A.W., George, S.M. et al. Use of complementary and alternative medicine and breast cancer survival in the Health, Eating, Activity, and Lifestyle Study. Breast Cancer Res Treat 160, 539–546 (2016). https://doi.org/10.1007/s10549-016-4010-x

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  • DOI: https://doi.org/10.1007/s10549-016-4010-x

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