Global Use of Traditional and Complementary Medicine in Childhood Cancer: A Systematic Review

Abstract

PurposeTraditional and complementary medicine (T&CM) strategies are commonly used in pediatric oncology. Patterns may vary based on country income. We systematically reviewed published studies describing T&CM use among pediatric oncology patients in low-income countries (LIC/LMIC), middle-income countries (UMIC), and high-income countries (HIC). Objectives included describing estimated prevalence of use, reasons for use, perceived effectiveness, modalities used, rates of disclosure, and reporting of delayed or abandoned treatment.MethodsMEDLINE, EMBASE, Global Health, CINAHL, PsycINFO, Allied and Complementary Medicine Database, Cochrane Database of Systematic Reviews, and ProceedingsFirst were searched. Inclusion criteria were primary studies involving children younger than the age of 18 years, undergoing active treatment of cancer, and any T&CM use. Exclusion criteria included no pediatric oncology–specific outcomes and studies involving only children off active treatment. Data were extracted by two reviewers using a systematic data extraction form determined a priori.ResultsSixty-five studies published between 1977 and 2015 were included, representing 61 unique data sets and 7,219 children from 34 countries. The prevalence of T&CM use ranged from 6% to 100%. Median rates of use were significantly different in LIC/LMIC (66.7% ± 19%), UMIC (60% ± 26%), and HIC (47.2% ± 20%; P = .02). Rates of disclosure differed significantly by country income, with higher median rates in HIC. Seven studies reported on treatment abandonment or delays.ConclusionThe use of T&CM in pediatric oncology is common worldwide, with higher median prevalence of use reported in LIC/LMIC. Further research is warranted to examine the impact on treatment abandonment and delay.

Health‐care providers’ perspectives on traditional and complementary alternative medicine of childhood cancer in Kenya

“…In a recent systematic review, the estimated median prevalence of TCAM use among children with cancer in low‐income and middle‐income countries was 67% . High prevalence rates were inversely associated with low per capita expenditure on health and number of physicians per citizen . In many African countries, TCAM is a way of life and used as the first and last resort remedy for many ailments.…”

“…2,3 Globally, interest in and use of TCAM has gained popularity, and its use among children with cancer is well documented. [4][5][6][7][8][9][10][11][12] In a recent systematic review, the estimated median prevalence of TCAM use among children with cancer in low-income and middle-income countries was 67%. 5 High prevalence rates were inversely associated with…”

“…low per capita expenditure on health and number of physicians per citizen. 5 In many African countries, TCAM is a way of life and used as the first and last resort remedy for many ailments. Cultural beliefs and practices often lead to self-care or home remedies even when modern medicine is available.…”

Complementary and integrative health methods used for the treatment of oral mucositis in children with cancer in Turkey

“…CIH is often used by parents, including curing cancer, doing everything for their child, boosting the immune system, improving general well‐being, treating adverse effects of conventional therapy (Diorio et al, ). The prevalence of CIH utilization is reported to be 10.9–87.6% around the world (Italia, Wolfenstetter, & Teuner, ; NCCIH, ), and this ratio has been reported to vary between 6% and 100% in children with cancer (Diorio et al, ).…”

“…CIH is often used by parents, including curing cancer, doing everything for their child, boosting the immune system, improving general well‐being, treating adverse effects of conventional therapy (Diorio et al, ). The prevalence of CIH utilization is reported to be 10.9–87.6% around the world (Italia, Wolfenstetter, & Teuner, ; NCCIH, ), and this ratio has been reported to vary between 6% and 100% in children with cancer (Diorio et al, ). In Turkey, the utilization rates of CIH in children has been determined to be 26–87% (Ozturk et al, ), whereas the utilization prevalence of these applications in children with cancer was determined to be 33.7–97.7% (Kurtuncu, Yildiz, & Akhan, ; Top, Sener, & Cangur, ; Turhan & Bör, ).…”