May 19, 2007

Breast Cancer: Has complementary/alternative medicine (CAM) become the "norm"?

by Kevin Flatt

Canadian and American researchers examining trends in complementary/alternative medicine (CAM) use by breast cancer survivors compared survey data from 1998 and 2005 to evaluate overall patterns of CAM use. The study was published in BMC Women's Health, 2007.

The researchers noted that the use of complementary and alternative medicine (CAM) by women with breast cancer is often said to be increasing, yet few data exist to confirm this commonly held belief.

The purpose of their paper was to compare overall patterns of CAM use, as well as use of specific products and therapies at two different points in time (1998 vs 2005) by women diagnosed with breast cancer.

Ontario has the highest incidence of breast cancer cases in Canada, with 8,200 of the 21,600 new cases in 2005, therefore this study was focused on complementary and alternative medicine use in Ontario. Surveys were mailed to women 18 years and older and diagnosed with breast cancer, randomly selected from the Ontario Cancer Registry (Canada) in the spring of 1998 and again in the spring of 2005.

In 2005, 81.9 percent of women reported using either a CAM product/practice or seeing a CAM therapist at some time in their lives as compared with 66.7 percent in 1998. Increases were seen in both use of at least one complementary and alternative medicine (CAM) product or therapy (70.6 percent in 2005 vs. 62 percent in 1998) and visits to CAM practitioners (57.4 percent of respondents in 2005 versus 39.4 percent of respondents in 1998).

Women in 2005 reported that 41 percent used complementary and alternative medicine (CAM) as part of the management of their breast cancer. The most commonly used products and practitioners for managing breast cancer included green tea, vitamin E, flaxseed and vitamin C, massage therapists and dieticians/nutritionists.

Significant increases were seen in use of body work practitioners (including Reiki practitioners, massage therapists, therapeutic touch practitioners and shiatsu practitioners), acupuncturists/traditional Chinese medicine (TCM) practitioners, homeopathic practitioners and a general "other" category in 2005 compared to 1998.

Significant increases were also seen in use of herbal remedies overall and specifically in the use of green tea and special foods/diets.

Overall, the researchers found that both the use of CAM products and visits to CAM practitioners by women diagnosed with breast cancer significantly increased from 1998 to 2005. In 2005, 81.9 percent of respondents reported using CAM (41 percent to help manage their breast cancer) compared to 66.7 percent in 1998, suggesting that in 2005 CAM use has become the "norm" in this patient population.

The biggest increases were seen in the percentage of women seeing bodywork practitioners (including massage therapists, but not chiropractors), traditional Chinese medicine practitioners/acupuncturists, homeopaths and "others". This may be related to the fact that massage therapy and acupuncture are two of the complementary and alternative medicine (CAM) practices which are generally the most accepted by the medical profession.

In addition, given that neither acupuncture nor massage involves taking anything orally, it is likely they are perceived to have fewer potential adverse effects or interactions with conventional cancer treatments than some other CAM therapies. So it is possible that conventional MDs are either recommending these options more often to patients or at least not discouraging patients from using them.

Perception of safety and perceived lack of drug interactions may also explain the increased use of homeopathy. In addition, the homeopathic community was under review by the Health Professions Regulation Advisory Council for consideration as a future regulated health profession in Ontario during 2005 when this survey was conducted. Although the council hearing did not receive much media attention at the time, it may partially explain the increased use of homeopathy reported here.

Overall, there was a significant increase in the use of herbal products such as garlic, ginger, ginseng and green tea and special foods/diets. Both green tea and special diets/foods are used by more than 10 percent of all women diagnosed with breast cancer specifically to help manage their breast cancer.

The researchers concluded that as more than 80 percent of all women with breast cancer report using CAM (41 percent in a specific attempt to management their breast cancer), CAM use can no longer be regarded as an "alternative" or unusual approach to managing breast cancer and that the increasing popularity of complementary and alternative medicine increases the urgency for research into the safety and efficacy of these products and therapies.


CAM – complementary and alternative medicine

TCM – traditional Chinese medicine


Heather S Boon, Folashade Olatunde and Suzanna M Zick. Trends in complementary/alternative medicine use by breast cancer survivors: Comparing survey data from 1998 and 2005. BMC Women's Health 2007, 7:4 doi:10.1186/1472-6874-7-4. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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