Changing patterns of CAM use among prostate cancer patients two years after diagnosis: Reasons for maintenance or discontinuation

Objectives: To explore the extent to which men treated for early stage, localized prostate cancer maintain or discontinue CAM therapies over time and to investigate external as well as psychological factors that are related to maintenance or discontinuation of CAM therapies. Design: A survey questionnaire was mailed to a subset of participants (N=225) from an earlier study that investigated the initiation and use of CAM therapies after a prostate cancer diagnosis. Setting: Participants were recruited from a comprehensive cancer centre and affiliated network hospitals following treatment for early stage, localized prostate cancer. Main outcome measures: Usage history for the 17 CAM therapies most commonly used by prostate cancer patients. Likert-scale endorsement of reasons for discontinuing or not trying CAM therapies. A discontinuation index (i.e., the ratio of instances that the therapy was discontinued to instances that it was attempted) was computed for each therapy. Results: CAM usage decreased by approximately one quarter within two years following treatment for early stage, localized prostate cancer. Men most frequently cited beliefs that discontinued CAM therapies were ineffective, generally unsuitable, or harmful, despite a lack of objective criteria for making these judgments. Conclusions: The increase in CAM usage that tends to occur immediately after diagnosis subsides within two years after prostate cancer treatment. Although lack of confidence in CAM's effectiveness characterized all discontinuations, higher effort therapies tend to be discontinued more quickly than tower effort therapies. (C) 2008 Elsevier Ltd. All rights reserved.