9066 Background: Few have examined the effect of complementary and alternative medicine (CAM) use on survival and health-related quality of life (HRQOL) in cancer patients. Methods: From July 2005 to October 2006, we conducted a prospective cohort study of 481 terminally ill cancer patients at 11 university hospitals and the National Cancer Center in Korea. We assessed how the use of CAM affected HRQOL and survival. Results: In a follow-up of 481 patients and 163.8 person-years, we identified 466 deceased cases. On multivariate analyses, CAM users did not have better survival than nonusers (adjusted hazard ratio (aHR), 0.91; 95% confidence interval (CI), 0.74-1.10). Among biologically based therapies, dietary supplements (aHR, 0.70; 95% CI, 0.48–1.01) and ginseng (aHR, 0.73; 95% CI, 0.52–1.04) did not show significantly better survival. Among mind-body interventions, prayer showed significantly worse survival (aHR,1.56; 95% CI, 1.00–2.43). Clinically, CAM users reported significantly worse cognitive functioning (-11.6 v -1.3; p < 0.05) and fatigue (9.9 v -1.0; p < 0.05) than non-users. Compared with non-users in subgroup analysis, users of alternative medical treatments, prayer, vitamin supplements, mushrooms, or rice and cereal reported clinically significant worse changes in some HRQOL subscales. Conclusions: While CAM did not provide any definite survival benefit, CAM users reported clinically significant worse HRQOLs.
Effect of Prognosis Awareness on the Survival and Quality of Life of Terminally Ill Cancer Patients: A Prospective Cohort Study