Dietary supplements, crystals, and spiritual advisors may sound outside the mainstream for the masses, but more than 70% of adult cancer patients in a recent study reported using alternative and complementary treatments such as these. Almost all of them said it improved their sense of well-being.

The study, in The Journal of Alternative and Complementary Medicine (Vol. 8, No. 4: 477-485), is the first to look at what might predict whether cancer patients will use complementary and alternative treatments, why, and how much they spend.

It is also the first study to look at cancer patients' thoughts on how well the treatments worked, wrote Ruth E. Patterson, PhD, RD, of the Fred Hutchinson Cancer Research Center's public health sciences division.

It is important to note the difference between complementary and alternative medicine, said Terri Ades, RN, MS, AOCN, director of quality of life and Health Promotion Strategy for the American Cancer Society (ACS).

"The [ACS] defines alternative therapies as those that have not been proven to be safe and effective yet are used to treat an illness instead of using, or as an alternative to, conventional or standard medical practice," she said.

"Complementary is very different. These are therapies used along with standard medical treatment," Ades said. "Massage therapy is not used to treat breast, prostate, or colon cancer, but rather it is used to improve the person’s quality of life by relaxing muscles to reduce stress."

In the report, Patterson said that there is a sense among people working in cancer research that there's high use of complementary and alternative treatments among cancer patients. But, she noted, there wasn't much information on why people used them and how they felt about them.

"It's clear that a lot of these [complementary and alternative treatments] are being used for general well-being," she said. But, "around 50% to 60% said they were using [them] for treatment of cancer or cancer-related symptoms."

Patterson and her colleagues interviewed by telephone 356 female breast, prostate, and colon cancer patients age 20 to 79. These people came from 13 counties in western Washington State.

All of the participants were part of the Cancer Surveillance System. This system is part of the National Cancer Institute's SEER (Surveillance, Epidemiologyand End Results) program. Age, gender, race, education, and income for the patients was noted.

The patients were divided into three groups by type of medical treatment:

• Surgery only.
• One treatment such as chemotherapy or radiation (more than three quarters of these patients also had surgery).
• More than one treatment, such as hormone therapy and chemotherapy.

The authors defined use of complementary and alternative medicine as use of at least one of three therapies:

• Alternative providers (such as an acupuncturist or massage therapist).
• Mental or other therapies (such as meditation, prayer, group support, hypnotism, guided imagery, or use of magnets).
• Dietary supplements (single supplements of vitamins, minerals or herbals, but not daily-use multivitamins. The authors said this was because their use was widely accepted by doctors).

Compared to those with a high-school education or less, college-educated patients were five times likelier to seek an alternative provider, three times likelier to seek mental therapies, and twice as likely to take dietary supplements, the authors found.

Females were five times more likely than males to use an alternative provider and about twice as likely to use supplements or mental therapies. And women with breast cancer were much more likely to see alternative providers or take dietary supplements than colorectal cancer patients.

But patients older than 70 were the least likely to use mental or other therapies.

While the patients' stage at diagnosis wasn't linked with use of complementary and alternative medicine, the authors said, patients in the multiple therapies group were twice as likely to use those therapies compared to patients who only had surgery.

The most common reason for using alternative providers given by all patients was for "general health and well-being" and "improved well-being," wrote Patterson.

"Since most therapies were used to enhance overall health and well-being, it seems unlikely that patients would substitute these therapies for conventional medicine," wrote Patterson.

While the patients spent an average of $68 each per year on various treatments, the costs ranged from $4 to $14,659, wrote the authors.

"I can't help but think there's a lot of value in just taking some personal control," said Patterson. She acknowledged how patients might feel helpless at times. "Here's an opportunity to do some things for yourself."

However, there is a possibility of drug and herb interactions, according to the study. And use of supplements, especially antioxidants, could interfere with chemotherapy. Because of these dangers, patients should let their doctors know what they're doing, she said.

"Patients should be helped to feel that they can talk to their doctor or nurse about the use of practices and methods that may not be what their doctor has prescribed," said the ACS' Ades.

Patterson also said doctors should show respect for their patients' beliefs. "It's highly prevalent, its use is common, and people feel good about it," she said.