Critical Considerations Regarding the Article “Association Between Complementary and Alternative Medicine Use and Fear of Cancer Recurrence Among Breast Cancer Survivors” Publisher



Varnoosfaderani NJ¹ ; Amiriardekani E^{2, 3}
Source: Korean Journal of Family Medicine Published:2023

Abstract

Dear Editor We are interested in a previously published article by Kim and Kang1) in 2022 in the Korean Journal of Family Medicine. The paper highlighted the possible association between increased fear of cancer recurrence (FCR) and higher use of complementary and alternative medicine (CAM) among breast cancer survivors. Our comments on some essential pitfalls are as follows: First, based on the definition presented by the Cochrane collaboration, “complementary and alternative medicine” refers to therapeutic methods applied to a society’s formal health system outside the borders of modern medicine.2) The inclusion of vitamins, minerals, and probiotics to CAM may be misleading because physicians prescribe these agents routinely in many circumstances, such as in chemotherapy or cancer-induced complications, including anemia, diarrhea, and other conditions. If that is the case, perhaps they were not included in the CAM definition, and it was not clarified in the Methods section. For example, only high doses or special types of vitamins are categorized as CAM. Treatment of complications of chemotherapeutic agents and induced deficiencies does not fit the CAM methods. Therefore, the definition of CAM was not exactly identified by the writers. In addition, it is unclear whether the CAM definition was provided in the questionnaire or by the interviewers during the patient interview. A self-report bias was another limitation in the study design. In our opinion, failure to include the experiences of CAM professionals, such as oriental medicine experts, to improve the study design was a missed aspect that contributed to these challenges © 2023 The Korean Academy of Family Medicine