More than a third of cancer patients in Europe use complementary and alternative medicine (CAM), most often to increase their body’s ability to fight the disease, according to the first study of alternative medicine across Europe.

Herbal medicines were by far the most commonly used CAM therapy, the first choice in nine out of 14 countries surveyed by an international research team.
Vitamins and minerals were also among the five most frequently used therapies, according to the responses from nearly 1,000 patients.
Writing in today’s issue of the Annals of Oncology (doi:10.1093/annonc/mdi110), the authors said CAM use was found to be considerably lower than surveys reporting results from US samples, where it is often well above 40 per cent.
But their results show that use is sufficient to warrant an increase in funding for research and better integration into mainstream healthcare services.
The survey was based on patient questionnaires issued by members of the European Oncology Nursing Society in clinics in 14 countries. It uses the US National Center for Complementary and Alternative Medicine definition of CAM, which includes Chinese and Ayurvedic medicine, spiritual interventions like meditation and prayer, biological therapies like supplements, body-based methods such as massage and energy therapies like Reiki.
The study’s author concluded in an interview that the EU needs to consider broader policies, common laws and rationalisation of available legislation on CAM.
A. Molassiotis, P. Fernadez-Ortega, D. Pud, G. Ozden, J. A. Scott, V. Panteli, A. Margulies, M. Browall, M. Magri, S. Selvekerova, E. Madsen, L. Milovics, I. Bruyns, G. Gudmundsdottir, S. Hummerston, A. M.-A. Ahmad, N. Platin, N. Kearney, and E. Patiraki
Use of complementary and alternative medicine in cancer patients: a European survey
Ann. Onc., Advance Access published on February 3, 2005; doi: 10.1093/annonc/mdi110.
Annals of Oncology Advance Access first published online on February 2, 2005
This version published online on February 3, 2005
Annals of Oncology, doi:10.1093/annonc/mdi110
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Articles by Molassiotis, A.
Articles by Patiraki, E.
© 2005 European Society for Medical Oncology
Received June 17, 2004
Revised November 5, 2004
Accepted November 15, 2004
Original article
Use of complementary and alternative medicine in cancer patients: a European survey
A. Molassiotis 1*, P. Fernadez-Ortega 2, D. Pud 3, G. Ozden 4, J. A. Scott 5, V. Panteli 6, A. Margulies 7, M. Browall 8, M. Magri 9, S. Selvekerova 10, E. Madsen 11, L. Milovics 12, I. Bruyns 13, G. Gudmundsdottir 14, S. Hummerston 15, A. M.-A. Ahmad 1, N. Platin 16, N. Kearney 5, and E. Patiraki 17
1 School of Nursing, University of Manchester, Manchester, UK
2 Institut Català Oncologia ICO, Barcelona, Spain
3 Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel
4 Gazi University Hospital, Ankara, Turkey
5 Department of Nursing and Midwifery, University of Stirling, Stirling, UK
6 Greek Oncology Nursing Society and Ag. Anargiri Hospital, Athens, Greece
7 Zurich University Hospital, Poliklinik Onkologie, Zurich, Switzerland
8 Sahlgrenska University Hospital, Gothenburg, Sweden
9 Università degli Studi di Milano-Istituto Nazionale Tumori, Milan, Italy
10 Masaryk Memorial Cancer Institute, Brno, Czech Republic
11 Oncology Department, Aarhus University Hospital, Aarhus, Denmark
12 Department of Education, Institute for Oncology and Radiology, Belgrade, Serbia and Montenegro
13 Belgian Society of Oncology Nursing, Brussels, Belgium
14 Department of Oncology, Lanspitali, Reykjavik, Iceland
15 Department of Oncology, City Hospital, Nottingham, UK
16 School of Health Sciences, Koc University, Istanbul, Turkey
17 Greek Oncology Nursing Society and Department of Nursing, University of Athens, Athens, Greece
* To whom correspondence should be addressed.
A. Molassiotis, E-mail:
Background: The aim of this study was to explore the use of complementary and alternative medicine (CAM) in cancer patients across a number of European countries.
Methods: A descriptive survey design was developed. Fourteen countries participated in the study and data was collected through a descriptive questionnaire from 956 patients.
Results: Data suggest that CAM is popular among cancer patients with 35.9% using some form of CAM (range among countries 14.8% to 73.1%). A heterogeneous group of 58 therapies were identified as being used. Herbal medicines and remedies were the most commonly used CAM therapies, together with homeopathy, vitamins/minerals, medicinal teas, spiritual therapies and relaxation techniques. Herbal medicine use tripled from use before diagnosis to use since diagnosis with cancer. Multivariate analysis suggested that the profile of the CAM user was that of younger people, female and with higher educational level. The source of information was mainly from friends/family and the media, while physicians and nurses played a small part in providing CAM-related information. The majority used CAM to increase the body’s ability to fight cancer or improve physical and emotional well-being, and many seemed to have benefited from using CAM (even though the benefits were not necessarily related to the initial reason for using CAM). Some 4.4% of patients, however, reported side-effects, mostly transient.
Conclusions: It is imperative that health professionals explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.
Keywords: alternative medicine; complementary medicine; Europe; herbs; homeopathy; spiritual healing; vitamins.