Acquiescence to adjunctive experimental therapies may relate to psychological distress: pilot data from a bone marrow transplant center

Complementary and alternative medicine use is associated with an increased perception of breast cancer risk and death

PURPOSE

Complementary and alternative medicines (CAMS) are frequently used by patients with breast cancer and their use may be related to the presence of psychosocial distress. The objective of this study is to assess the presence of anxiety and depression in breast cancer patients who use CAM and assess how they perceive their risks of recurrence and dying from breast cancer compared to non-users.

METHODS

Breast cancer patients attending ambulatory clinics at a single cancer center were approached by their oncologist. Participants completed a self-administered survey regarding CAM usage, beliefs associated with CAM, views of their risks of developing recurrent cancer, and of dying of breast cancer. The presence of anxiety and depression was scored using the Hospital Anxiety and Depression Scale (HADS). Responses were scored and compared between CAM users and non-users.

RESULTS

A total of 251 patients completed the survey. CAM usage was reported by 43% of patients. Individuals who used CAM were younger [53.1 versus 63.0 year (p < 0.001)], had higher education (p < 0.001), were more likely to have full time employment [25.7 versus 16.3% (p < 0.001)] and have private insurance for medications (76 versus 60%, p = 0.007) compared to non-users. CAM users perceived their risk of recurrence (p = 0.011) and death from breast cancer (p = 0.0001) as being significantly greater than non-users. There were no significant differences in anxiety or depression scores between CAM and non-users.

CONCLUSION

CAM use is associated with an increased perception of breast cancer recurrence and of breast cancer-related death. There was no association between the presence of anxiety or depression and CAM use. Improved patient understanding of actual risks of recurrence and death are required such that women will be able to make more informed decisions about using CAMs.

Psychological distress in cancer patients: hypothesis of a distress model

A substantial body of research suggests links between stress, coping and cancer. Research also implicates the immune system as a link between stressful events and cancer. The current trend in research in the area of psycho-oncology attempts to define the types of stress and coping mechanisms being used in order to identify predictors of psychological distress. Based on the available review of literature, the impact of distress does seem to play a prominent role in the transition from a state of health to that of ill-health or even a terminal event. In the light of these studies, a distress model for the cancer patient has been hypothesized here.