Complementary and alternative medicines use prevalent among prostate cancer patients
Use of complementary and alternative medicine (CAM) is common among patients with prostate cancer and has seen an increase among those who are newly diagnosed with the disease, a study has shown. Multivitamins and omega-3 fatty acids are the most commonly used CAMs from 1996 to 2016, while vitamin D use has increased dramatically from 2006 to 2010.
“This information reinforces the importance of discussing CAM use with patients, including referral to specialists when indicated, and may help prioritize future research,” the researchers said.
Questionnaires on the use of nearly 70 CAM types were completed by a total of 7,989 participants between 1996 and 2016. Users were defined as those who indicated that they had ever used CAMs. CAM use within 24 months of diagnosis was considered to analyse trends among 7,696 patients with newly diagnosed prostate cancer. The researchers then calculated the percent change in CAM use between groups defined by the year of diagnosis.
Fifty-six percent of patients with prostate cancer reported using CAM on at least one questionnaire. Of these, 40 percent used multivitamins and 24 percent omega-3 fatty acid. Majority of CAM users, compared with nonusers, were college educated, had a higher household income, and lived in the West and Midwest. [J Urol 2019;202:689-695]
CAM users and nonusers had a median prostate-specific antigen of 5.8 (interquartile range [IQR], 4.4–8.4) and 6.2 ng/ml (IQR, 4.7–10.1), respectively (p<0.01).
CAM use increased by 128 percent, from 24 percent to 54 percent, between those diagnosed in 1996 to 2000 and 2011 to 2016. Comparisons of patients diagnosed in 2006 to 2010 with those diagnosed in 2011 to 2016 demonstrated a 108-percent increase in supplemental vitamin D use and a 48-percent decrease in supplemental vitamin E use.
“These data demonstrate that overall CAM use is common and increasing,” the researchers said. “Many professional organizations recognize the usefulness of CAM for cancer survivorship.”
The American Cancer Society, for instance, recommends a plant-based diet low in saturated fat as part of its survivorship guidelines for prostate cancer, while the American Society of Clinical Oncology has recently endorsed the clinical practice guidelines of the Society for Integrative Oncology on CAM use in patients with breast cancer. [J Clin Oncol 2018;36:2647-2655; CA Cancer J Clin 2014;64:225-249]
“Clinicians should have an open conversation with their patients about commonly used CAMs,” the researchers said. “For example, given the common use of ingested CAMs, it is important that patients understand the lack of regulation of nutritional supplements by the U.S. Food and Drug Administration, which raises concerns about quality and accuracy of labeling.” [Drug Test Anal 2016;8:410-412]
Moreover, these data indicate the prevalence of multivitamin use, making it necessary to emphasize that while daily use may lower the overall risk of cancer, it appears to have no effect of the risk of prostate cancer, according to the researchers. On the other hand, excessive intake of multivitamins, alone or in combination with other single supplements, is associated with an increased risk of advanced and lethal prostate cancer. [JNCI 2007;99:754-764; JAMA 2012;308:1871-1880]