Association between Complementary and Alternative Medicine Use and Fear of Cancer Recurrence among Breast Cancer Survivors

Abstract

Background: This study aimed to evaluate the association between complementary and alternative medicine (CAM) use and fear of cancer recurrence (FCR) among breast cancer survivors, using a validated multidimensional FCR-assessing instrument. Despite the debate over its medical effects, the use of CAM in breast cancer survivors is increasing.

Methods: We recruited 326 breast cancer survivors who had completed the primary cancer treatment. Information on CAM use was obtained using a self-administered questionnaire, and FCR was assessed using the Korean version of the FCR Inventory (FCRI). Multivariate linear regression analysis was performed to evaluate the association between CAM use and FCR.

Results: CAM users had higher total FCR scores than CAM non-users after covariate adjustment (CAM users: 74.6 vs. CAM non-users: 68.7; P=0.047). Among the FCRI subscales, CAM users showed higher coping strategy scores (CAM users: 22.3 vs. CAM non-users: 20.6; P=0.034) in the multivariable adjusted analysis. The use of multiple types of CAM was associated with increased FCR in a dose-dependent manner (P=0.002).

Conclusion: Breast cancer survivors who used CAM had a higher FCR than CAM non-users. The dose-response relationship between the use of multiple types of CAM and FCR suggests that breast cancer survivors who use multiple types of CAM should be provided with appropriate psychological interventions to decrease FCR.

Keywords: Alternative Medicine; Breast Neoplasms; Cancer Survivors; Complementary Medicine; Fear of Cancer Recurrence; Fear of Cancer Recurrence Inventory.

Figure. 1.

(A–H) Association between number of complementary and alternative medicine (CAM) use and subscale components of Fear of Cancer Recurrence Inventory (FCRI). Data are presented with mean and 95% confidence interval. P trend were calculated by inserting the number of CAM use as a continues variable in the general linear model. Age and time since breast cancer diagnosis were adjusted as continuous variable, and education, history of radiotherapy, and history of hormone therapy were adjusted as categorical variable in the analysis model.