Prevalence of late and long-term effects of cancer (treatment) and use of complementary and alternative medicine in Norway

Abstract

Background The increasing number of patients surviving cancer leads to more people experiencing late and long term-effects from the disease and its treatment. Fatigue, sleep disorders, early menopause, pain, and nerve damage are commonly reported. Methods helping people to recover after cancer treatment are therefore essential. The aims of this study were threefold; (1) to determine the level of cancer patients suffering from late and long-term effects of cancer diagnosis and treatment in Norway, (2) explore complementary and alternative medicine (CAM) modalities used for managing these adversities, and (3) describe self-perceived benefits and harms of the CAM interventions. Methods The study was conducted in cooperation with the Norwegian Cancer Society (NCS) and consisted of an online cross-sectional study among members of the NCS user panel with present or previous cancer (n = 706). The study was carried out in September/October 2021 using a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). A total of 315 women and 153 men agreed to participate, resulting in a response rate of 67%. Results Most of the participants (83%) suffered from late and long-term effects of cancer treatment; mostly fatigue (59.2%), sleep disorder (41.5%), hot flashes (39.2%), nerve damage (polyneuropathy, 38.0%), and pain (36.6%) with a mean number of 5.1 different late and long-term effects. Late and long-term effects were positively associated with younger age and college/university education. Nearly half of the participants experiencing late and long-term effects (43%) reported having used CAM to treat these complaints. Most frequently used were self-help practices (26%) such as relaxation therapy (19%), yoga (14%) and meditation (13%), but also visits to CAM providers were reported by 22%. Herbal- and other natural remedies to treat late and long-term effects were used by 13%. A high percentage of CAM users reported self-perceived improvements of their symptoms (86% for self-help practices, 90% for visits to CAM providers). Few experienced adverse effects of the CAM treatment. Conclusion A large proportion of cancer patients suffered from a wide range of late and long-term effects of cancer diagnosis and treatment, and they use CAM to treat these complaints to a rather high degree. Relaxation therapy, yoga, meditation, massage, and acupuncture were the most frequently used therapies regardless of complaint. The therapies used are generally considered to be both safe and beneficial for the respective complaint, indicating that the participants seem to be well informed about the choices they make.

Empowerment-Led Guided Self-Help Intervention for Symptom Burden in Breast Cancer Women Treated With Ovarian Function Suppression: A Randomized Trial Protocol

“…GSH has the advantages of not being limited by time and space, being flexible, being less costly, and reducing patient confinement in face-to-face interventions. As a result, GSH has higher adherence and lower dropout rates and facilitates an excellent therapeutic relationship [ 24 , 25 ]. The National Institute for Health and Care Excellence guideline recommends GSH as a measure for managing depression and anxiety [ 26 ].…”

Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults With Cancer: Society for Integrative Oncology–ASCO Guideline

“…Integrative therapies such as those mentioned in the definition are commonly used by people with cancer, with worldwide usage in approximately half of all people with cancer in both developed 19,20 and low- and middle-income regions. 21 A review of studies from 18 countries with over 65,000 people with cancer found the highest usage rates in the United States and the lowest in Italy and the Netherlands.…”

Adherence to lifestyle recommendations among Norwegian cancer survivors and the impact of traditional and complementary medicine use: the Tromsø Study 2015–2016

“…Life expectancy after a cancer diagnosis continues to increase in many parts of the world [ 1 ] due to improved screening and treatment, and improved general health [ 2 ]. However, cancer survivors remain at risk for recurrence, second primary cancer [ 2 ], and long-term or late effects of cancer [ 3 , 4 ]. A cancer survivor is generally defined as someone diagnosed with cancer, regardless of phase or prognosis of the disease, starting from the time of diagnosis until death from or with cancer [ 5 ].…”

“…The most common provider-based T&CM among cancer survivors in Norway are massage/aromatherapy (19%) and acupuncture (11%) [ 28 ]. The use of T&CM among cancer survivors varies from 33 to 90%, with some of the use beginning upon cancer diagnosis [ 4 , 29 – 31 ]. T&CM centers around health preservation and maintenance [ 32 ] and thus, may motivate healthy lifestyle changes [ 33 ].…”

“…For example, T&CM was shown to be associated with physical activity and improved diet [ 36 ]. Norway had approximately 320 000 cancer survivors at the end of 2021 [ 2 ] and up to 79% of the Norwegian cancer survivors report using T&CM [ 4 , 30 ].…”