Effect of complementary and alternative medicine on the survival and health-related quality of life among terminally ill cancer patients; a prospective cohort study

Abstract

Background: We evaluated whether complementary and alternative medicine (CAM) use influenced outcomes [survival and health-related quality of life (HRQOL)] of cancer patients whose condition had just been judged terminal. Patients and methods: From July 2005 to October 2006, we conducted a prospective cohort study of 481 terminally ill cancer patients at 11 university hospitals and the National Cancer Center in Korea. We assessed how the use of CAM affected HRQOL and survival. Results: In a follow-up of 481 patients and 163.8 person-years, we identified 466 deceased cases. On multivariate analyses, CAM users did not have better survival compared with nonusers [adjusted hazard ratio (aHR), 0.91; 95% confidence interval (CI) 0.74–1.10]. Among mind–body interventions, prayer showed significantly worse survival (aHR, 1.56; 95% CI, 1.00–2.43). Clinically, CAM users reported significantly worse cognitive functioning (−11.6 versus −1.3; P < 0.05) and fatigue (9.9 versus −1.0; P < 0.05) than nonusers. Compared with nonusers in subgroup analysis, users of alternative medical treatments, prayer, vitamin supplements, mushrooms, or rice and cereal reported clinically significant worse changes in some HRQOL subscales. Conclusion: While CAM did not provide any definite survival benefit, CAM users reported clinically significant worse HRQOLs. Key words: alternative medicine, cancer, complementary medicine, HRQOL, prospective cohort, terminal illness