Prevalence of Complementary and Alternative Medicine Use in Brain Tumor Patients at King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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Original Article Prevalence of complementary and alternative medicine use in brain tumor patients at King Abdulaziz University Hospital, Jeddah, Saudi Arabia Abdulgadir Atteiah, MBBS, Azmi Marouf, MBBS, Rayan Alhazmi, MBBS, Albaraa Alghamdi, MBBS, Khalid Almalki, MBBS, Faisal Albugamy, MBBS, Soha A. Alomar, MD, MPH. ABSTRACT was conducted via phone interviews after obtaining patient consent. Ÿ«u½√Ë —UA²½« ÈbÄ sŽ nAJë vÃ≈ WÝ«—bë Ác¼ ‰öš sÄ ·bN½ ·«b¼_« «b+²Ý« vÃ≈ XF,œ w²Ã« WKL²;« qÄ«uFÃ«Ë Âb+²-*« q¹b³Ã«Ë wKOLJ²Ã« VDë Results: A total of 72 patients were included. Te Æ⁄UÄbë «—ËQÐ 5ÐUB*« v{d*« Èbà q¹b³Ã«Ë wKOLJ²Ã« VDë WI¹dDë mean age of the participants was 45.89 (±16.52) ÊUO³²Ý« vKŽ WLzUÁ WOFDIÄ WÝ«—œ sŽ …—U³Ž U¼UM¹dł√ w²Ã« WÝ«—bë X½U years. We found that education level signifcantly pK*« WFÄUł vHA²-Ä w, ⁄UÄbë «—ËQÐ rNBO+Að - s¹cë v{dLKà afected the use of CAM. Fewer users of CAM held WÝ«—bë Ác¼ XKLý Æ2018 u¹UÄ vÃ≈ 2011 d¹UM¹ sÄ …d²Hë ‰öš e¹eFëb³Ž bachelor’s degree and patients with lower degrees used d³Ž ÊUO³²Ýô« Ídł√Ô ÆW¹u½U¦Ã«Ë WOÃË_« ⁄UÄbë «—Ë√ sÄ Êu½UF¹ s¹cë v{d*« CAM more frequently (p=0.027). Te most frequent Æi¹d*« WI,«uÄ vKŽ ‰uB(« bFÐ WOHðUNë öÐUI*« types of CAM were Zamzam (holy water) and Ruqya ZzU²Më (Quran reading). Family members were the most ±16.52 45 89 © ® ¨ 5—UA*« dLŽ jÝu²Ä ÊU Æi¹dÄ ∑≤ WÝ«—bë XKLý frequent source of information about the use of CAM VDë «b+²Ý« vKŽ dO³Â qJAÐ dŁ√ bÁ rOKF²Ã« Èu²-Ä Ê√ U½błË ÆWMÝ (81.6%). wKOLJ²Ã« VDë wÄb+²-Ä sÄ qÁ_« œbFë ÊU Æq¹b³Ã«Ë wKOLJ²Ã« v{d*« Âb+²Ý« ULMOÐ ¨‚u, UL, ”u¹—uÃUJ³Ã« Wł—œ vKŽ 5K;UŠ q¹b³Ã«Ë —dJ²Ä qJAÐ q¹b³Ã«Ë wKOLJ²Ã« VDë qÁ√ WOLKŽ Uł—œ vKŽ 5K;U(« Conclusion: Education level has a signifcant efect ÂeÄ“ ¡UÄ w¼ UŽÎ uOý q¹b³Ã«Ë wKOLJ²Ã« VDë Ÿ«u½√ d¦Â√ ÊU ƩpΩ0.027® on CAM use. Gender plays a role in the type of ‰uŠ UÄuKFLKà UŽuOý d¦Â_« —bB*« …dÝ_« œ«d,√ ÊU ÆWOŽdAë WOÁdÃ«Ë CAM used. Future research should focus on the Æ©% 81¨6® W³-MÐ q¹b³Ã«Ë wKOLJ²Ã« VDë «b+²Ý« adverse efects of some CAM therapies, how efective CAM therapies are, and the efect CAM may play in wKOLJ²Ã« VDë «b+²Ý« vKŽ dO³Â dOŁQð rOKF²Ã« Èu²-LKà ʫ ∫W;ö)« delaying patients from seeking medical advice. ÆÂb+²-*« q¹b³Ã«Ë wKOLJ²Ã« VDë Ÿu½ w, «—˜ΠfM'« VFK¹ UL Æq¹b³Ã«Ë VDë UłöŽ iF³Ã …—UCë —UŁü« vKŽ WOK³I²-*« ÀU×Ð_« eÂdð Ê√ V−¹ dOŁQ²Ã«Ë ¨q¹b³Ã«Ë wKOLJ²Ã« VDë UłöŽ WOÃUF, ÈbÄË ¨q¹b³Ã«Ë wKOLJ²Ã« Keywords: tumor, alternative medicine, malignancy, …—uA*« VKÞ sŽ v{d*« dOšQð w, q¹b³Ã«Ë wKOLJ²Ã« VDë t³FK¹ bÁ Ícë brain, treatment, complementary medicine ÆWO³Dë ÆwKOLJ²Ã« VDë ¨ÃöŽ ¨aÄ ¨ÊUÞdÝ ¨q¹b³Ã« VDë ¨Â—Ë ∫Wëbë ULKJë Saudi Med J 2020; Vol. 41 (6): 614-621 doi: 10.15537/smj.2020.625102 Objectives: To determine the prevalence and types of complementary and alternative medicine (CAM) From the Faculty of Medicine (Atteiah, Marouf, Alhazmi, Alghamdi, being utilized and the possible factors that prompted Almalki, Albugamy) and from the Department of Surgery Division of the use of CAM in patients with brain tumors. Neurosurgery (Alomar), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. Methods: Te study conducted was a questionnaire- Received 28th February 2020. Accepted 5th May 2020. based, cross-sectional study of patients diagnosed with brain tumors at King Abdulaziz University Hospital Address correspondence and reprint request to: Dr. Abdulgadir Atteiah. (KAUH), Jeddah, Saudi Arabia from January 2011 Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of to May 2018. Patients with primary and secondary Saudi Arabia. E-mail: [email protected] brain tumors, were included. Our questionnaire ORCID ID: https://orcid.org/.0000-0001-6759-0779 OPEN ACCESS www.smj.org.sa Saudi Med J 2020; Vol. 41 (6) 614 CAM use in brain tumor patients ... Atteiah et al rain tumors have a signifcant efect on patients was carried out in Qassim, Saudi Arabia revealed that Band their caregivers as well as on the health CAM users for various illnesses paid an out-of-pocket system.1-3 Primary brain tumors arise in the brain while US$650000 on CAM visits and products.16 secondary tumors originate in distal tissue and spread Multiple studies have focused on CAM use in patients to the brain.4 Although malignant tumors have worse diagnosed with breast and prostate cancer but few outcomes, benign tumors may produce neurological or studies have addressed CAM use in patients with brain systemic symptoms. According to the Cancer Incidence tumors.17,18 In a recent retrospective review on over 19 Report issued by the Saudi Cancer Registry, 329 new million cancer patients, the use of CAM independently brain and central nervous system tumor cases occurred lowered the 5-year survival.19-21 Complementary and in 2014 among Saudis.5 Patients tend to explore alternative medicine use can alter the management plan complementary and alternative medicine (CAM) designed by the medical team, delay treatment or, in as a treatment for their tumors or symptoms due some cases, make the patients believe that there is no to the distressing efects of brain tumor diagnoses or need for any medical care.22 Currently, there are limited symptoms and treatment side efect.1 Complementary available data on CAM use among brain tumor patients and alternative medicine is defned as any intervention in Saudi Arabia. for treatment other than conventional medicine sought We aim to assess the prevalence of CAM use, the by patients in an attempt to improve their disease types of CAM that are being utilized and the possible progression and prognosis.6 Tere are many types of factors and reasons that promoted the use of CAM in CAM. Te National Center for Complementary and patients with brain tumors at King Abdulaziz University Alternative Medicine, United States of America (USA) Hospital (KAUH), Jeddah, Saudi Arabia. listed 5 classes of CAM therapies: alternative medical categories, mind-body interventions, biologically based Methods. Ethical approval was obtained from the therapies, manipulation and body-based methods, and Research Ethics Committee at KAUH. We conducted energy therapies.7 Te most common types of CAM a questionnaire-based, cross-sectional study of living used in Saudi Arabia are related to religious beliefs such patients, age 18 or older, with the principle histologic as Holy Quran, honey, black seed, Myrrh, and cupping or radiologic diagnosis of benign or malignant therapy.8-10 It is in contrast to what is commonly used (primary or secondary) brain tumor. Patients of the in western countries such as acupuncture, massage neurosurgery division at KAUH, Jeddah, Saudi Arabia, therapy, and yoga. between January 2011 and May 2018, who matched Existing data showed that 50% of all patients with the mentioned criteria, were invited to participate in cancer use CAM, and CAM use has grown in recent this study. King Abdulaziz University Hospital is an years.11 Complementary and alternative medicine use 845 bed, university hospital that is a tertiary center, is not limited to adult patients. Sudairy et al12 studied which treats complicated oncology cases with either 41 pediatric oncology patients. All patients used surgical or medical care. Of the 204 patients identifed non-dietary CAM such as Quran and more than 80% from the Neurosurgery Department at the time of used supplication. Supplements like honey and black the study, 89 were deceased, leaving 115 prospective seed used by 95% of the sample. Olive oil in two-thirds patients. We contacted these prospective patients by and Zamzam water in more than three-quarter. Herbs phone. Forty-three could not be reached, leaving 72 were used by 29%.13 to compose our convenience sample (62.6% response A study in the USA showed that adults spent US rate). All participants had been diagnosed with a brain $59 billion on CAM. Another survey in the United tumor at least one year prior. Kingdom (UK) revealed that the annual expenditures Inclusion criteria: age 18 or older, with histologic for CAM were approximately £1.6 billion.14 In 2013, or radiologic diagnosis of benign or malignant (primary it was found that the median cost of CAM in patients or secondary) brain tumor. Exclusion criteria: age less with diabetes and cardiovascular disease in Australia than 18, deceased patient, or not confrmed diagnosis was approximately AU$600 yearly.15 In 2011 a study of brain tumor. Our questionnaire was conducted via phone interview after obtaining the patients’ consents and confrming that enough time was available to fnish the Disclosure. Tis study was supported by the Deanship of Scientifc Research, King Abdulaziz University, Jeddah, questionnaire. Both the nature of the survey and the Saudi Arabia (Grant No. DF-184-248-1441). number of questions were explained. For the purposes of the questionnaire, CAM was defned as: “any treatment 615 Saudi Med J 2020; Vol. 41 (6) www.smj.org.sa CAM use in brain tumor patients ... Atteiah et al other than surgery, radiation, or chemotherapy for your by the internet.