Table 5.
Comparison of Surveys on the Use of Complementary and Alternative Medicine (CAM) in Brain Tumor Patients
| Verhoef et al 11 | Fox et al 8 | Armstrong et al 7 | Heese et al 9 | Mulpur et al 10 | Present Survey | |
|---|---|---|---|---|---|---|
| Year of Publication | 1999 | 2006 | 2006 | 2010 | 2015 | 2018 |
| Participants | 167 | 186 | 101 | 622 | 470 | 209 |
| Region | Alberta, Canada | USA (29 states) and Canada | Houston, TX, USA | Germany | USA | Switzerland |
| Tumor Types | LGG (28%), MG (26%), meningioma (16%), glioblastoma (14%), MB (3%), other (12%) | Gliomas of WHO grade III and IV | Glioblastoma (39), AG (31), LGG (19), PCNSL (3), MB (2), other (7) | Gliomas of WHO grades I to IV | Glioblastoma | Gliomas of WHO grades II to IV |
| Assessment | Prospective, questionnaire- based | Secondary analysis of Glioma Outcomes Project | Prospective, questionnaire- based | Questionnaire mailed to patients from German Glioma Network | Structured interview on nutritional or herbal supplements | Prospective, questionnaire- based |
| CAM Use | 24% | 32% | 54% | 40% | 77% | 49% |
| CAM Use Associated With | Younger age, higher income, no association with QoL, KPS or type of tumor | Younger age, female, college education | Higher KPS, no association with QoL or WHO grade | Younger age, female, university degree, no association with WHO grade | Younger age, female, lower KPS less likely, no association with education | Younger age, less likely glioma of WHO grade II, no association with gender or education |
| Top 3 CAM Used | Herbs, mind-body therapies, animal-/ vegetable-derived products | Meditation, vitamins, herbs | Prayer, vitamins, herbs | Homeopathy, vitamins, psychological methods | Vitamin C, vitamin E, zinc | Psychological methods, homeopathy, vitamins |
| Main Sources of Inspiration for CAM Use | Family and friends | NR | NR | Friends, physicians, family | NR | Friends, family, physicians |
| Main Motivations to Use CAM | Wish for patient- focused treatment, take charge of their care | NR | Being proactive in fighting the disease, improving QoL, minimizing side effects | To do something for the treatment by myself, to build up body resistance, to support conventional therapy, to have tried everything possible | NR | To support conventional therapy, to do something for the treatment by myself, to build up body resistance, to have tried everything possible |
| Perceived Effects of CAM | 73% positive effects | NR | 88% expressed satisfaction | 60% attributed improvment of general condition to CAM | NR | 69% attributed improvment of emotional, 70% of physical condition to CAM |
| Side Effects of CAM | 10%, most commonly bad breath | NR | 4.9% minor side effects | NR | 9% mild to moderate side effects | |
| Doctor’s Awareness of CAM Use | 23% not aware, 33% not sure | NR | 74% not aware | NR | NR | NR |
| CAM Use and Survival | NR | NR | NR | NR | Vitamin D, herbal supplementsa | NR |
Abbreviations: AG, anaplastic glioma; LGG, low-grade glioma; MB, medulloblastoma; MG, malignant glioma; NR, not reported; PCNSL, primary central nervous sytem lymphoma; QoL, quality of life: USA, United States of America; WHO, World Health Organization.
aIn this study, a possible association of intake of vitamin D or herbal supplements with increased survival is described, a finding that needs to be confirmed in further studies.