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Presenting Author 1 Dr. Harsha Kumar H N Associate Professor, Department of Community Medicine,

“ A Cross-sectional study on the Use of Complementary and Alternative Medicine (CAM) by Cancer Patients in a Tertiary Care Hospital ” Harsha Kumar H N 1 , Sumedha P S, Aditi B, Megha J, Sharanya S N, Ritika S. Presenting Author 1 Dr. Harsha Kumar H N Associate Professor,

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Presenting Author 1 Dr. Harsha Kumar H N Associate Professor, Department of Community Medicine,

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  1. “A Cross-sectional study on the Use of Complementary and Alternative Medicine (CAM) by Cancer Patients in a Tertiary Care Hospital”Harsha Kumar H N 1, Sumedha P S, Aditi B, Megha J, Sharanya S N, Ritika S Presenting Author 1Dr. Harsha Kumar H N Associate Professor, Department of Community Medicine, Kasturba Medical College, ManipalUniveristy Mangalore India

  2. Background • Use of Complimentary & Alternative system of Medicine [CAM] by cancer patients has increased over last 15 years. [1,2] • Use of CAM by cancer patients in Europe is about 35.9% [Range of 14.8% - 73.1% across countries]. [1] • Increasing use of CAM for cancer from Turkey [54% - 61%], Thailand [60%] & China [93.4%]. [3-5] • Beliefs / reasons for use of CAM are: 1. Directly fights against cancer (31.1%) 2. Adjuvant to conventional treatment (25.2%), 3. Reduces suffering from allopathic treatment (33.1%). [6]

  3. Objectives • To know the proportion of cancer patients using complementary and alternative medicine [CAM] in tertiary care hospital • To know the patterns of usage of CAM among Cancer patients. • To know the reasons and perceptions for preferring CAM.

  4. Materials & Methods • Study design: This is a interview based Cross sectional study. • Study Setting: Tertiary care cancer hospital of Kasturba Medical College [Manipal University]. • Study Population: Cancer patients admitted for treatment. Those who were 1. moribund, 2. could not respond to questionnaire were excluded. • Sample Size: Using the formula for finite population [N = Z2PQ / d2], assuming that at least 40% have used CAM, for 95% Confidence Interval, a power of 80% & 10% non-response, the sample size was 144. • Sampling:Non-random sampling.

  5. Materials & Methods • Study Instrument: An interview schedule was prepared in the local language to know: 1. Socio demographic characteristics of study participants, 2. Patterns of CAM usage, 3. Reasons for preference and perception about CAM • Pre-testing: This was pretested and modified to suit our study. Interview was conducted by trained medical students well versed with local language. • The research protocol was approved by the Institutional Ethics Committee. • Data Collection: Interviews were conducted in the hospitals after obtaining informed consent.

  6. Data Analysis: Was done using SPSS Version 10. The results are presented in Tables. Chi-square test was used. ‘p’ < 0.05 was considered significant. Results • Totally 154 cancer patients participated in the study • Half [n=78; 50.6%] were between 41-60 years of age. Females were than males [n=91; 59.1%]. • Majority [n=123; 83.7%] of them were married. • Most [n=109; 70.78%] of them were educated up to secondary school. • Skilled & semiskilled occupation [n=62; 40.2%] constituted majority. About a third [n=55; 35.7%] were women who were not employed.

  7. Table 1: Type of cancer among the patients (N=154) *Bone cancer (4), Uterine cancer (4), Cervical cancer (3), Renal cell carcinoma (3), prostate cancer (2), Skin cancer (2), Liver cancer (2), Soft tissue sarcoma (2) and 18 others(all in single digits).

  8. Table 2: Details of daignosis & treatment receved by Cancer patients (N=154) Most of the patients were diagnosed & treated in last one year. *Cancer patients received a combination of treatments

  9. Figure 1: Proportion of CAM users (N=154)

  10. Table 3: Types of CAM used*(N=52) Table 4: Patterns CAM usage (N=52) *Cancer patients used / tried more than one CAM

  11. Table 5: Patterns of usage of CAM(N=52) Most (65.4%) of the patients did not spend any money on CAM. It was free.

  12. Table 6: Predominant Purpose(N=52)

  13. Table 8: Reasons and Perceptions(N=52)

  14. Table 9: Perceived Benefits (N=52)* *Cancer patients have perceived multiple benefits

  15. Table 10: Awareness & Opinion of Non-CAM users

  16. Table 11: Comparison of CAM users and Non-users [N = 154]. Comparison of socio demographic variables between users and non-users did not show any significant differences.

  17. Discussion • Proportion • Proportion of CAM users was 33.8%. This is with in the range reported from studies conducted in other countries [14.8% to 93.4%]. [1-5] • Studies conducted among patients suffering from a specific type of cancer reported a higher percentage of CAM use. 2. Types of CAM • We found that Ayurveda & herbal medicine was the most common CAM used. Other studies reported use of supplements (herbs or vitamins). [1-5] • CAM usage associated with cultural beliefs. So the preference for Ayurveda in India.

  18. Beliefs and Perceptions for CAM use • Most patients were simply trying everything that could help (84.6%). Similar findings reported from other studies. [1-5] Conclusions • About 33.8% used CAM. Majority (96.2%) of CAM users were satisfied with allopathy. Half of them used CAM as an adjuvant to Allopathy. • Limitations: 1. Repsonse bias 2. Study limited to one tertiary care center.

  19. Acknowledgement • We thank the study participants for their cooperation. We also thank Institutional Ethics Committee which approved the research

  20. References • Molassiotis A, Fernadez-Ortega P, Pud D, Ozden G, Scott JA, Panteli V et al. Use of complementary and alternative medicine in cancer patients: a European survey. Annals of oncology 2005. 16. 655-63. • Ernst E, Cassileth BR. The prevalence of complementary/alternative medicine in cancer. A systematic review. Cancer 1998 Aug 15.83(4):777-82. • Akyol AD, Oz B. The use of complementary and alternative medicine by patients with cancer in Turkey. Complementary Therapies in Clinical Practice 2011:17(4):230–4. • Shaharudin SH, Sulaiman S, Emran NA, Shahril MR, Hussain SN. The use of complementary and alternative medicine among Malay breast cancer survivors. AlternTher Health Med 2011 Jan-Feb:17(1):50-6. • Teng L, Jin K, He KHK, Bian C, Chen W, Fu K, et al. Use of complementary and alternative medicine by cancer patients at Zhejiang university teaching hospital Zhuji hospital, China. African Journal of Traditional, Complementary and Alternative Medicines 2010:7(4):322–30. • Puataweepong P, Sutheechet N, Ratanamongkol P. A survey of complementary and alternative medicine use in cancer patients treated with radiotherapy in Thailand. Evid Based Complement Alternat Med 2012; 23(6): 704-08.

  21. Thank You

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