No abstract

Background: Use of complementary and alternative medicine (CAM) by those undergoing cancer treatment is common. While some childhood cancer survivors (CCS) may use CAM to treat late effects, others may lack information about available alternative therapies. We sought to determine characteristics associated with seeking more information about CAM among an ethnically diverse sample of young adult CCS. Methods: Young adult CCS were selected from the population-based Los Angeles SEER cancer registry and surveyed at ages 18 to 39 as part of the Project Forward Cohort. Associations between demographic, clinical, and other factors with seeking information on CAM were examined with t-tests, Chi Square analyses, and logistic regression. Results: Among 1106 participants surveyed, 182 (18%) reported interest in obtaining more information on CAM. Interest in CAM was highest among males, older (vs. younger) participants, those born outside the U.S., those with a history of relapsed/recurrent or second cancers, those with greater depressive symptoms, and those with poorer self-rated health. Among Hispanic/Latino/Latinx respondents, depressive symptoms, birth outside the U.S., and higher Latino culture orientation was positively associated with CAM interest. Discussion: Depressive symptoms and unresolved health problems are associated with a need for information about alternative forms of therapy, particularly in those with born outside the U.S. Healthcare providers caring for CCS can incorporate appropriate CAM information to help address unmet physical and mental health needs.

Childhood cancer survivors are at risk for late effects related to their cancer treatment, but little is known about clinical, and demographic associated with substance use behaviors. The purpose of this study is to examine the associations between substance use behaviors (tobacco, marijuana, e-cigarette, and alcohol) and cancer-related follow-up care, treatment intensity, late effects, depressive symptoms, self-rated health, race/ethnicity, and neighborhood socioeconomic status (nSES). Participants were from the Project Forward cohort, a population-based study of young adult survivors of childhood cancer. Participants (N=1,166, Mage=25.1 years) were recruited through the Los Angeles Cancer Surveillance Program (Cancer Registry covering Los Angeles County, California). Multivariate path analyses were performed with substance use as the outcome variables and clinical and demographic factors as independent variables. Covariates included age and gender. Substance use was positively associated with depressive symptoms, and inversely associated with cancer-related follow-up care, female gender, age, Hispanic ethnicity, treatment intensity, and self-rated health. Neighborhood SES was inversely associated with tobacco use, while being positively associated with binge drinking and e-cigarette use. The results highlight the interrelationship among the clinical and demographic variables and their associations with different substance use. Findings support effective interventions targeting integrative care and health promotion efforts for polysubstance use behavior among CCS. This will help improve long-term outcomes and mitigate the risk for early morbidity.