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BackgroundThere is widespread use of Complementary and Alternative Medicine (CAM) in Ghana, driven by cultural consideration and paradigm to disease causation. Whether there is concurrent use of conventional medicine and CAM in cancer patients is unknown. This study investigates the prevalence, pattern and predictors of CAM use in cancer patients. Overlapping toxicity, sources of information, and whether users inform their doctor about CAM use is examined.MethodCross-sectional study using a questionnaire administered to cancer patients, who were receiving radiotherapy and or chemotherapy or had recently completed treatment at a single institution was used.ResultsNinety eight patients participated in the study with a mean age of 55.5 (18–89), made up of 51% females. Married individuals formed 56% of the respondents, whilst 49% had either secondary or tertiary education. Head and neck cancer patients were 15.3%, breast (21.4%), abdomen/pelvic cancers constituted (52%).Seventy seven (78.6%) patients received radiotherapy only, 16.3% received radiation and chemotherapy and 5.3% had chemotherapy only.Ninety five patients were diagnosed of cancer within the past 24 months,73.5% were CAM users as follows; massage(66.3%), herbal(59.2%), mega vitamins(55.1%), Chinese medicine(53.1%),and prayer(42.9%). Sixty eight percent were treated with curative intent. Overlapping toxicity was reported. Majority (83.3%) of users had not informed their doctor about CAM use.On univariate analysis, female (p=0.004) and palliative patients, p=0.032 were more likely to be CAM users. Multivariate analysis identified female (p<0.01), as significant for use, whilst head and neck site was significant for non use (p<0.028). Young, married and highly educated individuals are more likely to use CAM.Friends and Media are the main sources of information on CAM. There was increase in CAM use after the diagnosis of cancer mainly for Chinese Medicine and vitamins.ConclusionThere is high CAM usage among Cancer patients, comparable to use in the general population, there is concurrent use of CAM and conventional medicine with reported overlapping toxicity but without informing Oncologist about use. Women and palliative patients are more likely to use CAM. Doctor patient communication on herbal-radiotherapy and drug treatment interaction needs to be strengthened. Standardization and regulation of CAM use is paramount.

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in female's worldwide. Its incidence is on the ascendancy in Africa including Ghana. In addition, Ghanaian women are more likely to be diagnosed with high-grade tumours that are triple negative breast tumours. The objectives of the study were to investigate the clinicopathologic features of breast cancer in Ghanaian women; identify and describe breast cancer survival pattern in Ghana and factors that explain the disparity in survival rates for breast cancer by the use of Cox proportional hazard. Two thousand three hundred and ninety seven (2397) women were sampled for the study from the Korle-Bu Teaching Hospital (KBTH), of which 1022 (42.64%) were diagnosed with breast cancer between the periods 1 st January 2002 to 31 st December 2008. The cases were followed up to January 2011. It was found that Mean age for the cases was 47.97 years. The largest number of cases being 59.69% was aged 40 -49 years. Invasive Ductal Carcinoma (IDC) was 72.90%, 71.28% had lump size of 2-5 cm. Axillary lymph node involvement was found in 90% of the women diagnosed with breast cancer. 5-year cumulative survival was 91.94% for stage 0&I and 15.09% for stage IV. Data relating to tumour grading were 92.07% for high grade 2 and 3. Triple negative breast cancer was identified in 66.38% (77 out of 116) of the cases with complete information on Estrogen Receptor, Progesterone Receptor and HER2 status. Cumulative 5-year survival was 47.91. Survival rate was better for early staged presentation; lymph node involvement of less than 25% and tumour size of less than 5 cm. The study reinforces the urgent need for improved screening techniques for early detection, and for an aggressive health education campaign to increase the awareness of women in Ghana about the potential risk of breast cancer and early detection by regular testing.

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