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Complementary medicine use by men with prostate cancer: a systematic review of prevalence studies

Abstract

Men with prostate cancer are reported as commonly using complementary and alternative medicine (CAM) but surveys have not recently been subjected to a rigorous systematic review incorporating quality assessment. Six electronic databases were searched using pre-defined terms. Detailed information was extracted systematically from each relevant article. Study reporting quality was assessed using a quality assessment tool, which demonstrated acceptable inter-rater reliability and produces a percentage score. In all, 42 studies are reviewed. All were published in English between 1999 and 2009; 60% were conducted in the United States. The reporting quality was mixed (median score=66%, range 23–94%). Significant heterogeneity precluded formal meta-analysis. In all, 39 studies covering 11 736 men reported overall prevalence of CAM use; this ranged from 8 to 90% (median=30%). In all, 10 studies reported prevalence of CAM use specifically for cancer care; this ranged from 8 to 50% (median=30%). Some evidence suggested CAM use is more common in men with higher education/incomes and more severe disease. The prevalence of CAM use among men with prostate cancer varies greatly across studies. Future studies should use standardised and validated data collection techniques to reduce bias and enhance comparability.

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References

  1. Penson DF, Chan JM . Prostate cancer. J Urol 2007; 177: 2020–2029.

    Article  PubMed  Google Scholar 

  2. Hsing AW, Tsao L, Devesa SS . International trends and patterns of prostate cancer incidence and mortality. Int J Cancer 2000; 85: 60–67.

    Article  CAS  PubMed  Google Scholar 

  3. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ . Cancer statistics, 2009. CA Cancer J Clin 2009; 59: 225–249.

    Article  PubMed  Google Scholar 

  4. National Institute for Health and Clinical Excellence. Prostate Cancer: Diagnosis and Treatment. Clinical Guidelines CG58. National Collaborating Centre for Cancer: Cardiff, Wales, 2008.

  5. Wilt TJ, MacDonald R, Rutks I, Shamliyan TA, Taylor BC, Kane RL . Systematic review: comparative effectiveness and harms of treatments for clinically localized prostate cancer. Ann Intern Med 2008; 148: 435–448.

    Article  PubMed  Google Scholar 

  6. Smith DP, King MT, Egger S, Berry MP, Stricker PD, Cozzi P et al. Quality of life three years after diagnosis of localised prostate cancer: population based cohort study. BMJ 2009; 339: b4817.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Eton DT, Lepore SJ . Prostate cancer and health-related quality of life: a review of the literature. Psychooncology 2002; 11: 307–326.

    Article  PubMed  PubMed Central  Google Scholar 

  8. National Center for Complementary and Alternative Medicine 2010 What is CAM?. http://nccam.nih.gov/health/whatiscam/overview.htm. 23-3-2010.

  9. Tacklind J, MacDonald R, Rutks I, Wilt TJ . Serenoa repens for benign prostatic hyperplasia. The Cochrane Library 2009; 2, Art. No.: CD001423.

  10. Avins AL, Bent S, Staccone S, Badua E, Padula A, Goldberg H et al. A detailed safety assessment of a saw palmetto extract. Complement Ther Med 2008; 16: 147–154.

    Article  PubMed  PubMed Central  Google Scholar 

  11. DiPaola RS, Zhang H, Lambert GH, Meeker R, Licitra E, Rafi MM et al. Clinical and biologic activity of an estrogenic herbal combination (PC-SPES) in prostate cancer. N Engl J Med 1998; 339: 785–791.

    Article  CAS  PubMed  Google Scholar 

  12. de la Taille A, Buttyan R, Hayek O, Bagiella E, Shabsigh A, Burchardt M et al. Herbal therapy PC-SPES: in vitro effects and evaluation of its efficacy in 69 patients with prostate cancer. J Urol 2000; 164: 1229–1234.

    Article  CAS  PubMed  Google Scholar 

  13. Meyer J-P, Gillatt DA . PC-SPES: a herbal therapy for the treatment of hormone refractory prostate cancer. Prostate Cancer and Prostatic Dis 2002; 5: 13–15.

    Article  Google Scholar 

  14. National Cancer Institute. PC-SPES and related herbals used for prostate health (PDQ(r)). Health professional version. www.cancer.gov/cancertopics/pdq/cam/pc-spes/healthprofessional; 2010; 28-5-2010. Ref Type: Electronic Citation.

  15. Lippman SM, Klein EA, Goodman PJ, Lucia MS, Thompson IM, Ford LG et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: The selenium and vitamin E cancer prevention trial (SELECT). JAMA 2009; 301: 39–51.

    Article  CAS  Google Scholar 

  16. Verhoef MJ, Balneaves LG, Boon HS, Vroegindewey A . Reasons for and characteristics associated with complementary and alternative medicine use among adult cancer patients: a systematic review. Integr Cancer Ther 2005; 4: 274–286.

    Article  PubMed  Google Scholar 

  17. Ernst E, Cassileth BR . The prevalence of complementary/alternative medicine in cancer. A systematic review. Cancer 1998; 83: 777–782.

    Article  CAS  PubMed  Google Scholar 

  18. Sparber A, Wootton JC . Surveys of complementary and alternative medicine: Part II. Use of alternative and complementary cancer therapies. J Altern Complement Med 2001; 7: 281–287.

    Article  CAS  PubMed  Google Scholar 

  19. Bishop FL, Prescott P, Chan YK, Saville J, von Elm E, Lewith GT . Prevalence of complementary medicine use in pediatric cancer: a systematic review. Pediatrics 2010; 125: 768–776.

    Article  PubMed  Google Scholar 

  20. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med 2007; 147: 573–577.

    Article  PubMed  Google Scholar 

  21. Landis JR, Koch GG . The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159–174.

    Article  CAS  PubMed  Google Scholar 

  22. Boon H, Westlake K, Stewart M, Gray R, Fleshner N, Gavin A et al. Use of complementary/alternative medicine by men diagnosed with prostate cancer: prevalence and characteristics. Urology 2003; 62: 849–853.

    Article  PubMed  Google Scholar 

  23. Bruns F, Glatzel M, Schonekaes K, Riesenbeck D, Mucke R, Buntzel J et al. Complementary and alternative medicine experience in radiation oncology patients: first results of a multi-center approach. Trace Elements and Electrolytes 2006; 23: 318–325.

    Article  Google Scholar 

  24. Chan JM, Elkin EP, Silva SJ, Broering JM, Latini DM, Carroll PR . Total and specific complementary and alternative medicine use in a large cohort of men with prostate cancer. Urology 2005; 66: 1223–1228.

    Article  CAS  PubMed  Google Scholar 

  25. Cheung GSM et al. The use of complementary medicine among the radiotherapy patients in Hong Kong. Hong Kong Radiographers Journal 2004; 8: 7–16.

    Google Scholar 

  26. Chrystal K, Allan S, Forgenson G, Isaacs R . The use of complementary/alternative medicine by cancer patients in a New Zealand regional cancer treatment centre. N Z Med J 2003; 116: U296.

    PubMed  Google Scholar 

  27. Corner J, Yardley J, Maher EJ, Roffe L, Young T, Maslin-Prothero S et al. Patterns of complementary and alternative medicine use among patients undergoing cancer treatment. Eur J Cancer Care 2009; 18: 271–279.

    Article  CAS  Google Scholar 

  28. Diefenbach MA, Hamrick N, Uzzo R, Pollack A, Horwitz E, Greenberg R et al. Clinical, demographic and psychosocial correlates of complementary and alternative medicine use by men diagnosed with localized prostate cancer. J Urol 2003; 170: 166–169.

    Article  PubMed  Google Scholar 

  29. Eng J, Ramsum D, Verhoef M, Guns E, Davison J, Gallagher R et al. A population-based survey of complementary and alternative medicine use in men recently diagnosed with prostate cancer. Integr Cancer Ther 2003; 2: 212–216.

    Article  PubMed  Google Scholar 

  30. Gansler T, Kaw C, Crammer C, Smith T . A population-based study of prevalence of complementary methods use by cancer survivors — A report from the American cancer society′s studies of cancer survivors. Cancer 2008; 113: 1048–1057.

    Article  Google Scholar 

  31. Girgis A, Adams J, Sibbritt D . The use of complementary and alternative therapies by patients with cancer. Oncol Res 2005; 15: 281–289.

    Article  PubMed  Google Scholar 

  32. Goldstein MS, Lee JH, Ballard-Barbash R, Brown ER . The use and perceived benefit of complementary and alternative medicine among Californians with cancer. Psychooncology 2008; 17: 19–25.

    Article  PubMed  Google Scholar 

  33. Gotay CC . Use of complementary and alternative medicine in Hawaii cancer patients. Hawaii Med J 1999; 58: 49–55.

    CAS  PubMed  Google Scholar 

  34. Hall JD, Bissonette EA, Boyd JC, Theodorescu D . Motivations and influences on the use of complementary medicine in patients with localized prostate cancer treated with curative intent: results of a pilot study. BJU Int 2003; 91: 603–607.

    Article  CAS  PubMed  Google Scholar 

  35. Hann DM, Baker F, Roberts CS, Witt C, McDonald J, Livingston M et al. Use of complementary therapies among breast and prostate cancer patients during treatment: a multisite study. Integr Cancer Ther 2005; 4: 294–300.

    Article  CAS  PubMed  Google Scholar 

  36. Jones HA, Metz JM, Devine P, Hahn SM, Whittington R . Rates of unconventional medical therapy use in patients with prostate cancer: standard history versus directed questions. Urology 2002; 59: 272–276.

    Article  PubMed  Google Scholar 

  37. Kao GD, Devine P . Use of complementary health practices by prostate carcinoma patients undergoing radiation therapy. Cancer 2000; 88: 615–619.

    Article  CAS  PubMed  Google Scholar 

  38. Lafferty WE, Bellas A, Corage Baden A, Tyree PT, Standish LJ, Patterson R . The use of complementary and alternative medical providers by insured cancer patients in Washington state. Cancer 2004; 100: 1522–1530.

    Article  PubMed  Google Scholar 

  39. Lee MM, Chang JS, Jacobs B, Wrensch MR . Complementary and alternative medicine use among men with prostate cancer in four ethnic groups. Am J Public Health 2002; 92: 1606–1609.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Lippert MC, McClain R, Boyd JC, Theodorescu D . Alternative medicine use in patients with localized prostate carcinoma treated with curative intent. Cancer 1999; 86: 2642–2648.

    Article  CAS  PubMed  Google Scholar 

  41. Mao JJ, Farrar JT, Xie SX, Bowman MA, Armstrong K . Use of complementary and alternative medicine and prayer among a national sample of cancer survivors compared to other populations without cancer. Complement Ther Med 2007; 15: 21–29.

    Article  PubMed  Google Scholar 

  42. Mao JJ, Palmer SC, Straton JB, Cronholm PF, Keddem S, Knott K et al. Cancer survivors with unmet needs were more likely to use complementary and alternative medicine. J Cancer Surviv 2008; 2: 116–124.

    Article  PubMed  Google Scholar 

  43. Maskarinec G, Shumay DM, Kakai H, Gotay CC . Ethnic differences in complementary and alternative medicine use among cancer patients. J Altern Complement Med 2000; 6: 531–538.

    Article  CAS  PubMed  Google Scholar 

  44. Metz JM, Jones H, Devine P, Hahn S, Glatstein E . Cancer patients use unconventional medical therapies far more frequently than standard history and physical examination suggest. Cancer J 2001; 7: 149–154.

    CAS  PubMed  Google Scholar 

  45. Miller PE, Vasey JJ, Short PF, Hartman TJ . Dietary supplement use in adult cancer survivors. Oncol Nurs Forum 2009; 36: 61–68.

    Article  PubMed  PubMed Central  Google Scholar 

  46. 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. Ann Oncol 2005; 16: 655–663.

    Article  CAS  PubMed  Google Scholar 

  47. Newsom-Davis T, Kenny L, Al-Shakarchi I, George J, Wong E, Waxman J . Voodoo dolls and the cancer patient: patients do trust their doctors. Qjm 2009; 102: 311–319.

    Article  CAS  PubMed  Google Scholar 

  48. Paltiel O, Avitzour M, Peretz T, Cherny N, Kaduri L, Pfeffer RM et al. Determinants of the use of complementary therapies by patients with cancer. J Clin Oncol 2001; 19: 2439–2448.

    Article  CAS  PubMed  Google Scholar 

  49. Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ et al. Types of alternative medicine used by patients with breast, colon, or prostate cancer: Predictors, motives, and costs. J Altern Complement Med 2002; 8: 477–485.

    Article  PubMed  Google Scholar 

  50. Ponholzer A, Struhal G, Madersbacher S . Frequent use of complementary medicine by prostate cancer patients. Eur Urol 2003; 43: 604–608.

    Article  PubMed  Google Scholar 

  51. Porter M, Kolva E, Ahl R, Diefenbach MA . Changing patterns of CAM use among prostate cancer patients two years after diagnosis: reasons for maintenance or discontinuation. Complement Ther Med 2008; 16: 318–324.

    Article  PubMed  Google Scholar 

  52. Ross LE, Hall IJ, Fairley TL, Taylor YJ, Howard DL . Prayer and self-reported health among cancer survivors in the United States, National Health Interview Survey, 2002. J Altern Complement Med 2008; 14: 931–938.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Salmenpera L . The use of complementary therapies among breast and prostate cancer patients in Finland. Eur J Cancer Care 2002; 11: 44–50.

    Google Scholar 

  54. Sheriff SK, Shohara RA, Dumican SB, Small EJ, Carroll PR, Chan JM et al. Lifestyle correlates of health perception and treatment satisfaction in a clinical cohort of men with prostate cancer. Clin Prostate Cancer 2005; 3: 239–245.

    Article  PubMed  Google Scholar 

  55. Sollner W, Maislinger S, DeVries A, Steixner E, Rumpold G, Lukas P . Use of complementary and alternative medicine by cancer patients is not associated with perceived distress or poor compliance with standard treatment but with active coping behavior. Cancer 2000; 89: 873–880.

    Article  CAS  PubMed  Google Scholar 

  56. Steginga SK, Occhipinti S, Gardiner RA, Yaxley J, Heathcote P . A prospective study of the use of alternative therapies by men with localized prostate cancer. Patient Educ Couns 2004; 55: 70–77.

    Article  PubMed  Google Scholar 

  57. Vapiwala N, Mick R, Hampshire MK, Metz JM, DeNittis AS . Patient initiation of complementary and alternative medical therapies (CAM) following cancer diagnosis. Cancer J 2006; 12: 467–474.

    Article  PubMed  Google Scholar 

  58. Wilkinson S, Gomella LG, Smith JA, Brawer MK, Dawson NA, Wajsman Z et al. Attitudes and use of complementary medicine in men with prostate cancer. J Urol 2002; 168: 2505–2509.

    Article  PubMed  Google Scholar 

  59. Wilkinson S, Farrelly S, Low J, Chakraborty A, Williams R, Wilkinson S et al. The use of complementary therapy by men with prostate cancer in the UK. Eur J Cancer Care 2008; 17: 492–499.

    Article  CAS  Google Scholar 

  60. Wiygul JB, Evans BR, Peterson BL, Polascik TJ, Walther PJ, Robertson CN et al. Supplement use among men with prostate cancer. Urology 2005; 66: 161–166.

    Article  PubMed  Google Scholar 

  61. Wyatt GK, Friedman LL, Given CW, Given BA, Beckrow KC . Complementary therapy use among older cancer patients. Cancer Pract 1999; 7: 136–144.

    Article  CAS  PubMed  Google Scholar 

  62. Yoshimura K, Ichioka K, Terada N, Terai A, Arai Y . Use of complementary and alternative medicine by patients with localized prostate carcinoma: study at a single institute in Japan. Int J Clin Oncol 2003; 8: 26–30.

    Article  PubMed  Google Scholar 

  63. Yoshimura K, Ueda N, Ichioka K, Matsui Y, Terai A, Arai Y . Use of complementary and alternative medicine by patients with urologic cancer: a prospective study at a single Japanese institution. Support Care Cancer 2005; 13: 685–690.

    Article  PubMed  Google Scholar 

  64. Tippens K, Marsman K, Zwickey H . Is prayer CAM? J Altern Complement Med 2009; 15: 435–438.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Gaziano JM, Glynn RJ, Christen WG, Kurth T, Belanger C, MacFadyen J et al. Vitamins E and C in the prevention of prostate and total cancer in men: The physicians′ health study II randomized controlled trial. JAMA 2009; 301: 52–62.

    Article  CAS  Google Scholar 

  66. Trottier G, Boström PJ, Lawrentschuk N, Fleshner NE . Nutraceuticals and prostate cancer prevention: a current review. Nat Rev Urol 2010; 7: 21–30.

    Article  CAS  PubMed  Google Scholar 

  67. Watters JL, Gail MH, Weinstein SJ, Virtamo J, Albanes D . Associations between {alpha}-Tocopherol, \{beta}-Carotene, an. Cancer Res 2009; 69: 3833–3841.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Tabassum A, Bristow RG, Venkateswaran V . Ingestion of selenium and other antioxidants during prostate cancer radiotherapy: A good thing? Cancer Treat Rev 2010; 36: 230–234.

    Article  CAS  PubMed  Google Scholar 

  69. Bishop FL, Lewith GT . Who uses CAM? A narrative review of demographic characteristics and health factors associated with CAM use. 2010; 7: 11–28.

    Article  PubMed  Google Scholar 

  70. Lachance L, Hawthorne V, Brien S, Hyland ME, Lewith G, Verhoef M et al. Delphi-derived development of a common epidemiologic core for measuring complementary and alternative medicine prevalence. J Altern Complement Med 2009; 15: 489–494.

    Article  PubMed  Google Scholar 

  71. Quandt SA, Verhoef MJ, Arcury TA, Lewith GT, Steinsbekk A, Kristoffersen AE et al. Development of an international questionnaire to measure use of complementary and alternative medicine (I-CAM-Q). J Altern Complement Med 2009; 15: 331–339.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Lee MM, Lin SS, Wrensch MR, Adler SR, Eisenberg D et al. Alternative therapies used by women with breast cancer in four ethnic populations. J Natl Cancer Inst 2000; 92: 42–47.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank the two anonymous reviewers for their helpful comments. This work was supported by the Southampton Complementary Medicine Research Trust, the Rufford Maurice Laing Foundation (to GTL), and arthritis research UK (to FLB). Forest plots were produced using a datasheet from Clark O and Djulbegovic B, 2001, Forest plots in excel software. Available at http://www.evidencias.com.

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Bishop, F., Rea, A., Lewith, H. et al. Complementary medicine use by men with prostate cancer: a systematic review of prevalence studies. Prostate Cancer Prostatic Dis 14, 1–13 (2011). https://doi.org/10.1038/pcan.2010.38

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