Self-reported quality of life in users and nonusers of dietary supplements in cancer
Tóm tắt
To describe the Quality of Life (QoL) characteristics of users of dietary supplements vs nonusers. A survey of 225 cancer patients presenting for treatment at Cancer Treatment Centers of America was completed between November 2001 and October 2003. A validated instrument assessed the use of 56 dietary supplements in the past month. Two validated questionnaires assessed QoL. Mean QoL scores were compared between the users and nonusers using univariate and multivariate linear regression. Of 225 patients, 91 (40%) were males and 134 (60%) females. Sixty seven (30%) had breast cancer, 40 (18%) colorectal cancer, and 32 (14%) lung cancer. One hundred sixty four (73%) had used dietary supplements in the past month, while 61 (27%) had not. Mean European Organization for Research Treatment of Cancer QoL scores were significantly better among the users for physical and emotional function scales and fatigue, nausea, appetite loss, and constipation symptom scales adjusting for tumor site. In the stratified analysis, lung cancer patients did not show any statistically significant differences in QoL scores between the users and nonusers. Colorectal cancer patients demonstrated statistically significant differences in constipation symptom, with dietary supplement users having better QoL. Breast cancer patients demonstrated statistically significant differences in several QoL scale scores between users and nonusers. Contrary to some of the previously published research, this study, conducted at a community hospital comprehensive cancer center that combines alternative treatment approaches with conventional cancer care, found better self-reported QoL among the users of dietary supplements, as compared to nonusers. The next step in this research is to prospectively evaluate the patterns of changing QoL in relation to dietary supplement use across the entire duration of cancer diagnosis and treatment.
Tài liệu tham khảo
Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL (1993) Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 328(4):246–252
Eisenberg DM, Davis RB, Ettner SL et al (1998) Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 280(18):1569–1575
Kessler RC, Davis RB, Foster DF et al (2001) Long-term trends in the use of complementary and alternative medical therapies in the United States. Ann Intern Med 135(4):262–268
Ernst E, Cassileth BR (1998) The prevalence of complementary/alternative medicine in cancer: a systematic review. Cancer 83(4):777–782
Boon H, Stewart M, Kennard MA et al (2000) Use of complementary/alternative medicine by breast cancer survivors in Ontario: prevalence and perceptions. J Clin Oncol 18(13):2515–2521
Correa-Velez I, Clavarino A, Barnett AG, Eastwood H (2003) Use of complementary and alternative medicine and quality of life: changes at the end of life. Palliat Med 17(8):695–703
Patterson RE, Neuhouser ML, Hedderson MM et al (2002) Types of alternative medicine used by patients with breast, colon, or prostate cancer: predictors, motives, and costs. J Altern Complement Med 8(4):477–485
Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE (2000) Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol 18(13):2505–2514
Gupta D, Lis CG, Birdsall TC, Grutsch JF (2005) The use of dietary supplements in a community hospital comprehensive cancer center: implications for conventional cancer care. Support Care Cancer 2005 April 23. DOI 10.1007/s00520-005-0820-9
Henderson JW, Donatelle RJ (2004) Complementary and alternative medicine use by women after completion of allopathic treatment for breast cancer. Altern Ther Health Med 10(1):52–57
McCune JS, Hatfield AJ, Blackburn AA, Leith PO, Livingston RB, Ellis GK (2004) Potential of chemotherapy–herb interactions in adult cancer patients. Support Care Cancer 12(6):454–462
Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376
Groenvold M, Klee MC, Sprangers MA, Aaronson NK (1997) Validation of the EORTC QLQ-C30 quality of life questionnaire through combined qualitative and quantitative assessment of patient–observer agreement. J Clin Epidemiol 50(4):441–450
Hjermstad MJ, Fossa SD, Bjordal K, Kaasa S (1995) Test/retest study of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire. J Clin Oncol 13(5):1249–1254
Ferrans CE, Powers MJ (1985) Quality of life index: development and psychometric properties. J Clin Epidemiol 8(1):15–24
Ferrans CE (1990) Development of a quality of life index for patients with cancer. Oncol Nurs Forum 17(3 Suppl):15–19
Ferrans CE, Powers MJ (1992) Psychometric assessment of the Quality of Life Index. Res Nurs Health 15(1):29–38
Ferrans CE (1996) Development of a conceptual model of quality of life. Sch Inq Nurs Pract 10(3):293–304
Warnecke RB, Ferrans CE, Johnson TP et al (1996) Measuring quality of life in culturally diverse populations. J Natl Cancer Inst Monogr (20):29–38
Burstein HJ, Gelber S, Guadagnoli E, Weeks JC (1999) Use of alternative medicine by women with early-stage breast cancer. N Engl J Med 340(22):1733–1739
Cassileth BR, Lusk EJ, Guerry D et al (1991) Survival and quality of life among patients receiving unproven as compared with conventional cancer therapy. N Engl J Med 324(17):1180–1185
Paltiel O, Avitzour M, Peretz T et al (2001) Determinants of the use of complementary therapies by patients with cancer. J Clin Oncol 19(9):2439–2448
Bliley AV, Ferrans CE (1993) Quality of life after coronary angioplasty. Heart Lung 22(3):193–199
Johnson CD, Wicks MN, Milstead J, Hartwig M, Hathaway DK (1998) Racial and gender differences in quality of life following kidney transplantation. Image J Nurs Scholarsh 30(2):125–130
Panel on Definition and Description (1997) Defining and describing complementary and alternative medicine. CAM Research Methodology Conference, April 1995. Altern Ther Health Med 3(2):49–57
Chatwin J, Tovey P (2004) Complementary and alternative medicine (CAM), cancer and group-based action: a critical review of the literature. Eur J Cancer Care (Engl) 13(3):210–218
Kaptchuk TJ, Eisenberg DM (2001) Varieties of healing. 2: a taxonomy of unconventional healing practices. Ann Intern Med 135(3):196–204
Zollman C, Vickers A (1999) ABC of complementary medicine. Complementary medicine in conventional practice. BMJ 319(7214):901–904
Downer SM, Cody MM, McCluskey P et al (1994) Pursuit and practice of complementary therapies by cancer patients receiving conventional treatment. BMJ 309(6947):86–89