METHODS
161 cancer patients voluntarily participated, providing demographic information, gender, age, marital
status, and cancer type. Data on CAM use and knowledge were collected and analyzed using the Statistical
Package for the Social Sciences 22.0 program. P<0.05 was considered statistically significant, with
approval from the ethics committee.
RESULTS
53.4% were over 60 years old, and 57.8% were women. 86.3% were familiar with at least one CAM
method, and 29.2% actively used CAM. Women used CAM significantly more than men. Usage was
higher in individuals under 60 years and single patient. CAM was more popular among breast cancer
patients. Black cumin and turmeric were the most frequently used herbal methods. Patients mainly
acquired CAM knowledge from friends and online sources.
CONCLUSION
The study revealed a lower CAM usage rate compared to similar international studies in different settings,
likely due to the focus on patients seeking treatment at the radiation oncology department. As
physicians, it is crucial to expand our knowledge and educate oncology patients about CAM applications.
Bridging the information gap will cater to the growing interest in CAM among patients and ensure
informed decisions regarding treatment options.
Keywords: Breast cancer; complementary medicine; herbal; situational awareness
During cancer treatment, patients have access to
a range of CAM methods that can complement their
conventional therapies. These include herbal treatments,
acupuncture, massage, meditation, yoga, and
hypnosis. Extensive research has been conducted
to evaluate the effectiveness and safety of these approaches,
yielding diverse outcomes.[
Notably, in developing countries, there is a higher
prevalence of CAM utilization among cancer patients,
coupled with limited knowledge about these methods.
[
This study has the objective of uncovering the
level of knowledge among oncology patients in Türkiye
regarding alternative/complementary medicine,
as well as exploring their personal experiences with
these methods. By shedding light on these aspects,
the study aims to contribute to the existing body of
knowledge on CAM and its relevance in the context
of oncology care.
Participants
The study enrolled a total of 161 cancer patients who
willingly participated and provided responses to our
questionnaire. Detailed information regarding the
participants" demographic characteristics, including
gender, age, and marital status, was recorded. In addition,
the specific types of cancer from which the
participants were diagnosed were also documented
for further analysis.
Data Collecting
The study collected data on the utilization of CAM
among the participants, as well as their knowledge level
regarding CAM methods. The data collection process
involved exploring various aspects, including the rate
of CAM usage, specific CAM methods employed by
the participants, the reasons behind their decision to
utilize these methods, and the sources of information
they received from health-care professionals.
By examining these factors, the study aimed to gain insights into the patterns of CAM usage among the participants, as well as their sources of information and motivations for seeking CAM treatments. These data points provided valuable information to assess the level of knowledge and understanding among oncology patients regarding CAM methods.
Statistical Analysis
The collected data were analyzed using the Statistical
Package for the Social Sciences version 22.0 program.
Descriptive statistics such as frequency, percentage,
mean, and standard deviation were employed to summarize
and present the data. Correlation analyses were
conducted to assess relationships between variables.
To determine statistical significance, the threshold for accepting significance was set at p<0.05. This level of significance was used to evaluate the strength and significance of associations observed in the data, allowing for meaningful conclusions to be drawn from the statistical analysis.
A substantial majority of the patients, approximately 94.4%, resided in metropolitan cities, reflecting an urban-centric sample. In addition, a considerable proportion, 83.2%, were married, indicating the potential influence of marital status on their healthseeking behaviors and decision-making processes. When examining the family structure of the participants, it was found that 72% had a nuclear family arrangement, potentially impacting their support systems and dynamics within the context of their cancer journey. Moreover, a significant portion, 63.5%, had completed primary or secondary school education, representing the educational attainment level within the study population.
Among the comorbidities reported, hypertension
and diabetes were the most common, affecting 15%
of the participants. This highlights the significance of
managing and considering these concurrent health
conditions in the overall care of oncology patients.
Summarized overview of the sociodemographic information
of the patients is presented in Table
The study findings indicate that a majority of the participants, specifically 86.3% (139 patients), reported being aware of at least one CAM method. Out of these individuals, 29.2% (47 patients) confirmed using CAM methods. Regarding gender differences, the study did not observe any statistically significant variance in terms of awareness rates between men and women. However, the rate of CAM usage was found to be significantly higher among women. Among the female participants, 39.8% (37 out of 93 women) reported using CAM, whereas only 14.7% (10 out of 68 men) of male participants were utilizing these methods (p=0.001).
CAM usage was further analyzed in relation to different factors. Among the age groups, it was found that 37.3% of individuals under the age of 60 years and 22.1% of those aged 60 years and over used CAM methods, with a statistically significant difference (p=0.038). Similarly, 48.1% of single participants reported CAM usage compared to 25.4% of married participants (p=0.022). Regarding cancer types, breast cancer patients had a significantly higher CAM usage rate compared to other cancer types, with 40.8% of breast cancer patients utilizing CAM, whereas the rates for other cancer types were 24.1% and 25% (p=0.039).
Furthermore, a significant association was found
between the number of known CAM methods and
CAM usage (p=0.000024), indicating that participants
who were aware of at least three CAM methods were
more likely to use them. The most commonly used
herbal methods by the patients were black cumin (89%)
and turmeric (45%). Traditional methods such as spa,
leech therapy, and cupping were also observed to be frequently applied by the patients (Table
In addition, the frequency of CAM usage increased as the time since the cancer diagnosis progressed, indicating a potential correlation between the duration of diagnosis and the inclination to use CAM methods.
We also observed a significant difference in CAM
usage between men and women, with women using
CAM methods more frequently. This finding is consistent
with studies conducted in Türkiye and globally,[
When evaluating CAM usage by age groups, we
found that individuals under the age of 60 years were
more likely to use CAM compared to those aged 60
years and over. This finding aligns with the previous
research conducted in Türkiye and internationally,[
In terms of the specific CAM methods used, our
study identified exercise, cupping, and massage as the
most common practices among participants. These
findings are similar to other studies conducted in Türkiye,[
Furthermore, we found that hot springs/thermal
treatments, cupping, and exercise were the most frequently
applied CAM methods. These findings align
with the previous studies conducted in Türkiye and
globally,[
Regarding the influence of factors such as smoking,
alcohol use, educational status, the presence of additional
diseases, children, and family type on CAM usage
and knowledge, our study did not find statistically
significant associations between these factors. These
findings align with existing research conducted in Türkiye,
suggesting that these factors may not have a significant
impact on CAM usage or knowledge among
oncology patients.[
The findings from studies conducted worldwide align
with our study in Türkiye, demonstrating almost similar
patterns and trends. For instance, a study conducted in
the United States found no statistically significant association
between CAM usage or awareness and factors such
as smoking, alcohol use, educational status, comorbidities,
and the presence of children.[
When considering the influence of time elapsed after
cancer diagnosis on CAM usage rates, variations can
be observed depending on the geographical and cultural
factors.[
In light of these considerations, our study in Türkiye
supports the findings from global studies, revealing
both similarities and differences in the utilization and
knowledge of CAM. This underscores the complexity
of CAM usage as a multifaceted issue, where regional,
cultural, and personal factors play significant roles.
Understanding these factors is essential in comprehending
the nuances of CAM practices and tailoring
interventions and health-care approaches to meet the
diverse needs of patients worldwide.
Considering the lack of data on the efficacy and safety of CAM methods, it is important for health-care professionals to inform and guide patients on this issue. Especially in Türkiye, it is of great importance for healthcare professionals to be informed about CAM methods and to provide their patients with accurate information about the potential benefits and risks of these methods.
In addition, when the sources from which patients learned CAM methods were examined, it was determined that most of them learned these methods from their spouses and friends, the Internet, or television. This poses the risk that patients may be exposed to insecure and misleading information about CAM methods. Providing health-care professionals with accurate and reliable information about CAM methods will contribute to a better understanding of the effects of these methods on patients.
Future research may contribute to the treatment processes of oncology patients by providing more information on the use and effectiveness of CAM methods. In addition, further studies on the relationship between CAM use in Türkiye and regional and sociodemographic factors may help to better understand the effects of these methods on patients. In addition, considering that cultural and geographical differences have a significant impact on the use of CAM methods, it is important to integrate and support these methods in accordance with local and traditional practices. In line with these recommendations, it can be aimed to use CAM methods more effectively and widely to increase the quality of life of oncology patients in Türkiye.
Acknowledgements: We would like to express our deepest appreciation to the Technological Research Council of Türkiye (TÜBİTAK) for affording a sponsorship to this study.
Peer-review: Externally peer-reviewed.
Conflict of Interest: All authors declared no conflict of interest.
Ethics Committee Approval: The study was approved by the Kartal Dr. Lütfi Kirdar Training and Research Hospital Clinical Research Ethics Committee (no: 2022/514/228/28, date: 30/06/2022).
Financial Support: None declared.
Authorship contributions: Concept - Ş.K.G., M.Ç., S.T., E.Ş., Ö.Ö.; Design - Ş.K.G., İ.Y., H.T., H.L.G.; Supervision - H.L.G.; Funding - Ş.K.G., M.Ç., S.T., E.Ş., Ö.Ö., İ.Y.; Materials - Ş.K.G., İ.Y., H.T.; Data collection and/or processing - Ş.K.G., M.Ç., S.T., E.Ş., Ö.Ö., İ.Y.; Data analysis and/ or interpretation - O.A., H.T., H.L.G.; Literature search - Ş.K.G., M.Ç., S.T., E.Ş., O.A., Ö.Ö., İ.Y., H.T., H.L.G.; Writing - Ş.K.G., M.Ç., O.A.; Critical review - Ş.K.G., H.L.G.
