Cancer is a disease that does not have just a single cause; it includes a group of diseases which have different causes, symptoms, treatments and prognoses. Despite significant improvements in diagnosis and understanding cancer including causes, prevention, early diagnosis, diagnostic tools, determinants of prognosis, treatment and management of symptoms; most people still believe that cancer is associated with pain and death (1). According to the latest statistics published by the World Health Organization (WHO), cancer as a non-communicable disease (NCD) with approximately 18 million 78 thousand new cases, and 9 million deaths in 2018, after cardiovascular diseases, is the second cause of death by non-communicable diseases in the world (2–3).
Cancer occurs in all ages and in both genders; buy it is more prevalent in men, in people over 65 years old, and in industrial societies. It is considered to be the third cause of death in Iran; and the three most common cancers in Iran are breast cancer, colorectal cancer and gastric cancer in both genders. Because of considerable prevalence, numerous complications, and high mortality at all ages, cancer is the focus of most health planning’s and policies. In three recent decades, the overall incidence and mortality related to common cancers (lung, breast, colon and prostate cancers) have not changed; and in lots of cases, traditional medical treatments were not enough to meet the medical needs of patients (4). The treatments suggested to cancer patient are varied based on therapeutic goals of each particular cancer, the cancer’s grade and its stage. Therapeutic goals include complete elimination of malignant disease (treatment), increasing survival, limiting growth of cancer cells (control), or reduction of related symptoms and promoting life’s quality. The treatment will not begin until the cancer is definitely diagnosed, and the grade and stage of tumor is determined. Generally, there are numerous treatments for cancer including surgery, radiation therapy, chemotherapy, targeted treatment and heat therapy; which they may be used simultaneously or in separate times (1). Depending on the cancer stage and medical history of the patient, surgery, radiation therapy, chemotherapy or hormone therapy may be necessary for its treatment (5).
According to some studies, cancer survivors try to use different methods of complementary and alternative medicine (CAM). New studies indicate daily increase in the number of patients, particularly cancer patients to refer to different branches of CAM (6). Based on available estimations, until 2016 in European countries, these referrals have reported to be 44.3% of total patients (7). Patients with cancer who undergo traditional medical treatments, usually refer to CAM therapists to decrease the side effects of the disease and its treatments, or to interrupt the spread of cancer, or prevent metastasis. Sometimes they do that in a hope to be completely healed (8–10).
Complementary and alternative medicine (CAM) include treatment methods such as homeopathy, acupuncture, chiropractic, aromatherapy, exercise therapy, kinesiotherapy, massage therapy, music therapy, image therapy, herbal therapy, nutritional therapy, pressure therapy, energy therapy or meditation, nutritional supplements or other methods. These therapeutic methods which are not common treatments and used regionally or generally are so diverse (10–11). Application of CAM is also expanding in Australia, Europe and North America. Some reports indicate that more than half of Europe's population are interested to use some CAM methods in order to improve their health. In Iran, using these methods is rooted in the Iranian people's attachments to their beliefs and old traditions. It can also be due to later achievements (11). Prevalence of using CAM treatments is reported 33% in the UK, 46% in Australia, 34% in the USA, 66–75% in Belgium, 49% in France, 18% in Netherlands, and 20–30% in Germany (6).
According to conducted surveys, understanding the concept of CAM and its application is on the rise in cancer patients. Similarly, in Iran different methods of CAM are used by incurable patients and patients with cancer, which using these methods is rooted in the culture and traditional Iranian treatment methods. It should be noted that using these methods without supervision and approval by the healthcare teams, can cause interference with conventional medical treatments. It can also result in complications such as skin and gastrointestinal complications, delay in wound healing, delay in diagnosis and treatment of the disease, and many other problems. Also, there is no official statistics about amount and used methods of CAM. Obviously by investigating the status of using various CAM methods in different regions of Iran, patients’ attitude toward CAM, and application of CAM’s different sub-branches by cancer patients; health policies and public and regional approaches, can be planed for proper and optimal use. Moreover, occurrence of CAM complications can be minimized and also its beneficial effects can be used at the same time. Besides, employees of health care systems by recognizing different methods of CAM used by patients, and providing necessary educations, can play an important role to gain therapeutic goals; and they can move toward improving cancer treatment outcomes. The aim of this study was to investigate the use of complementary and alternative medicine in cancer patients in Iran.