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Research Article

Natural remedy use in a prospective cohort of breast cancer patients in southern Sweden

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Pages 134-143 | Received 03 Feb 2010, Accepted 07 Apr 2010, Published online: 25 May 2010
 

Abstract

Background. Complementary and alternative medicine (CAM) use is common among breast cancer patients. Several CAM therapies may have negative side effects or interact with conventional therapies. We studied biologically based CAM use with and without vitamins/minerals in relation to patient and tumor characteristics as well as treatment in an ongoing prospective cohort of 855 primary breast cancer patients. Methods. Patients from two hospitals in southern Sweden were included. Pre-operative and follow-up questionnaires containing questions on food intake, lifestyle, and concomitant medications, including natural remedies, were completed up to five years postoperatively. Clinical information was obtained from clinical records and tumor characteristics from pathology reports. Results. CAM and/or vitamins/minerals were used by 34.2% pre-operatively and by 57.9% during at least one visit. Over 100 different preparations were reported. At least eight of the commonly used preparations may interact with conventional breast cancer therapies. CAM users more often had a BMI <25 kg/m2 (OR 1.76; 95%CI 1.33–2.33), were more often nulliparous (OR 1.59; 1.08–2.34), alcohol (OR 2.13; 1.44–3.14), antidepressants (OR 1.48; 1.02–2.15), and hormone therapy users (OR 1.57; 1.18–2.07), less often smokers (OR 0.71; 0.50–0.99), and consumed less coffee (OR 0.88; 0.82–0.95) than non CAM users. Tumor characteristics were not associated with CAM use. CAM use was more common among tamoxifen (OR 1.32; 1.00–1.75) and less common among chemotherapy (OR 0.63; 0.42–0.92) treated patients. Vitamins/minerals use was more common in aromatase inhibitor treated patients (OR 1.84; 1.33–2.53). There was no significant association between short-term disease-free survival and CAM use. Conclusion. CAM use was common and associated with certain patient characteristics. CAM use may cause clinically significant drug interactions and it is therefore of clinical interest to identify potential CAM users.

Acknowledgements

This study was supported by grants from The Swedish Cancer Society, The Swedish Research Council, The Medical Faculty at Lund University, The Mrs. Berta Kamprad's Foundation, The Gunnar Nilsson Foundation, The Crafoord Foundation, The South Swedish Health Care Region (Region Skåne ALF), BRO, and Lund Hospital Fund. We thank our research nurses Maj-Britt Hedenblad, Karin Henriksson, Anette Möller, Linda Ågren, Anna Weddig, Ulrika Midelund, Arnhild Nilsson, and Karina Sandström. We thank Dr. Eric T. Dryver for proofreading the manuscript. No conflicts of interest are to be declared.

Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.

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