Originally published as JCO Early Release 10.1200/JCO.2005.04.126 on February 22 2005

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Nationwide Survey on Complementary and Alternative Medicine in Cancer Patients in Japan

From the Medical Oncology Division and Surgical Oncology Division, National Shikoku Cancer Center, Matsuyama; Tokai University of Medicine, Isehara; Saitama Medical College, Saitama; Kyoto Prefectural University of Medicine, Kyoto; Kobe Pharmaceutical University, Kobe; and National Cancer Center, Tokyo, Japan

Address reprint requests to Ichinosuke Hyodo, MD, Medical Oncology Division, National Shikoku Cancer Center, Horinouchi 13, Matsuyama, 790-0007 Ehime, Japan; e-mail: ihyodo{at}shikoku-cc.go.jp

PURPOSE: To determine the prevalence of use of complementary and alternative medicine (CAM) by patients with cancer in Japan, and to compare the characteristics of CAM users and CAM nonusers.

PATIENTS AND METHODS: A questionnaire on cancer CAM and the Hospital Anxiety and Depression Scale were delivered to 6,607 patients who were treated in 16 cancer centers and 40 palliative care units.

RESULTS: There were 3,461 available replies for a response rate of 52.4%. The prevalence of CAM use was 44.6% (1,382 of 3,100) in cancer patients and 25.5% (92 of 361) in noncancer patients with benign tumors. Multiple logistic regression analysis determined that history of chemotherapy, institute (palliative care units), higher education, an altered outlook on life after cancer diagnosis, primary cancer site, and younger age were strongly associated with CAM use in cancer patients. Most of the CAM users with cancer (96.2%) used products such as mushrooms, herbs, and shark cartilage. The motivation for most CAM use was recommendation from family members or friends (77.7%) rather than personal choice (23.3%). Positive effects were experienced by 24.3% of CAM users with cancer, although all of them received conventional cancer therapy concurrently. Adverse reactions were reported by 5.3% of cancer patients. CAM products were used without sufficient information by 57.3% of users with cancer and without a consultation with a doctor by 60.7% of users.

CONCLUSION: This survey revealed a high prevalence of CAM use among cancer patients, without sufficient information or consultation with their physicians. Oncologists should not ignore the CAM products used by their patients because of a lack of proven efficacy and safety.

Supported by a Grant-in-Aid (13-20) for Cancer Research from the Ministry of Health, Labor and Welfare, Japan.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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