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Comparative Study
. 2009 Oct;52(5):422-6.

Complementary and alternative medicine use among general surgery, hepatobiliary surgery and surgical oncology patients

Colin Schieman  1 , Luke R Rudmik, Elijah Dixon, Francis Sutherland, Oliver F Bathe
Affiliations
Comparative Study

Complementary and alternative medicine use among general surgery, hepatobiliary surgery and surgical oncology patients

Colin Schieman et al. Can J Surg. 2009 Oct.

Abstract
in English, French

Background: The use of complementary and alternative medicine (CAM) is becoming more common, particularly among cancer patients. We sought to define the frequency of CAM use among general surgery, hepatobiliary and surgical oncology patients and to define some of the determinants of CAM use in patients with benign and malignant disease.

Methods: We asked all patients attending the clinics of 3 hepatobiliary/surgical oncology surgeons from 2002 to 2005 to voluntarily respond on first and subsequent visits to a questionnaire related to the use of CAM. We randomly selected patients for review.

Results: We reviewed a total of 490 surveys from 357 patients. Overall CAM use was 27%. There was significantly more CAM use among cancer (34%) versus noncancer patients (21%; p = 0.008), and the use of CAM was more common in patients with unresectable cancer (51%) than resectable cancer (22%; p < 0.001). There was no significant difference in use between men and women. There did not appear to be a change in CAM use with progression of cancer. The most common CAM was herbs or supplements (58% of all users), which were most frequently used by patients with malignant disease. Among the 27 herbs reported to be ingested, 10 are associated with bleeding and hepatotoxicity, as described in the literature.

Conclusion: Prospective studies evaluating surgical outcomes related to CAM use are needed.

Contexte: Le recours aux médecines complémentaires et parallèles (MCP) devient plus courant, particulièrement chez les patients atteints de cancer. Nous avons cherché à cerner la fréquence du recours aux MCP chez les patients en chirurgie générale, chirurgie hépatobiliaire et oncologie chirurgicale, et à définir certains des déterminants du recours aux MCP chez les patients atteints de maladie bénigne et maligne.

Méthodes: Nous avons demandé à tous les patients qui se sont présentés aux cliniques de 3 chirurgiens en oncologie chirurgicale et chirurgie hépatobiliaire de 2002 à 2005 de répondre volontairement, au cours de leur première consultation et des visites subséquentes, à un questionnaire portant sur le recours aux MCP. Nous avons choisi les patients au hasard pour l’étude.

Résultats: Nous avons étudié au total 490 questionnaires remplis par 357 patients. Dans l’ensemble, le recours aux MCP s’établissait à 27 %. Il était beaucoup plus important chez les patients atteints de cancer (34 %) que chez les autres (21 %; p = 0,008) et le recours aux MCP était plus courant chez les patients atteints d’un cancer irrésécable (51 %) que chez ceux qui étaient atteints d’un cancer résécable (22 %; p < 0,001). Il n’y avait pas de différence importante de recours aux MCP entre les hommes et les femmes. Le recours aux MCP ne semblait pas changer avec l’évolution du cancer. Les MCP les plus courantes étaient les plantes médicinales ou les suppléments (58 % de tous les utilisateurs), que les patients atteints d’une maladie maligne utilisaient le plus souvent. Parmi les 27 plantes médicinales que l’on a déclaré prendre, 10 sont associées à des saignements et à une hépatotoxicité décrites dans les publications.

Conclusion: Des études prospectives évaluant les résultats chirurgicaux reliés au recours aux MCP s’imposent.

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Figures

Fig. 1
Fig. 1
Types of complementary and alternative medicines (CAMs) used by surveyed patients of a hepatobiliary/surgical oncology practice. Individuals may have reported using more than 1 type of CAM.
See this image and copyright information in PMC

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