Use of dietary supplements by breast cancer patients undergoing conventional cancer treatment
Identifieur interne : 004054 ( Ncbi/Merge ); précédent : 004053; suivant : 004055Use of dietary supplements by breast cancer patients undergoing conventional cancer treatment
Auteurs : Lai Yi Eliza Wong ; Ping Chung Leung ; Jin-Ling Tang [Hong Kong] ; Stewart W. Mercer [Royaume-Uni]Source :
- Patient preference and adherence [ 1177-889X ] ; 2010.
Abstract
Many breast cancer patients use some form of dietary supplement (DS) to complement their conventional cancer treatment, in the hope that they might lessen the side effects of treatment, improve quality of life, give a greater sense of control, and reduce stress. This pilot study assessed the level of DS usage by breast cancer patients undergoing conventional cancer treatment, and their concerns about the use of DS.
A cross-sectional descriptive survey in three breast cancer centers in Hong Kong using face-to-face interviewing was performed.
Of 82 female Chinese breast cancer patients who completed the survey, 99% reported that they had been using DS since their cancer was diagnosed. The most frequently used DS were Chinese herbal medicines, and patients spent about US$258 on DS every month. The reason given for using DS was to enhance their recovery from cancer, but at the same time the patients had safety concerns. However, most patients did not feel able to discuss these concerns with health professionals.
The majority of the patients had some safety concerns, and said that they would welcome detailed and reliable information on DS. The lack of reliable information on the potential risks and benefits of using such supplements as an adjuvant to conventional treatment and the reluctance of patients to discuss their use of DS with health professionals is a major area of concern that warrants further attention.
Url:
DOI: 10.2147/PPA.S13639
PubMed: 21206516
PubMed Central: 3003607
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Use of dietary supplements by breast cancer patients undergoing conventional cancer treatment</title><author><name sortKey="Wong, Lai Yi Eliza" sort="Wong, Lai Yi Eliza" uniqKey="Wong L" first="Lai Yi Eliza" last="Wong">Lai Yi Eliza Wong</name><affiliation><nlm:aff id="af1-ppa-4-407">Department of Community and Family Medicine</nlm:aff></affiliation></author><author><name sortKey="Leung, Ping Chung" sort="Leung, Ping Chung" uniqKey="Leung P" first="Ping Chung" last="Leung">Ping Chung Leung</name><affiliation><nlm:aff id="af2-ppa-4-407">Institute of Chinese Medicine</nlm:aff></affiliation></author><author><name sortKey="Tang, Jin Ling" sort="Tang, Jin Ling" uniqKey="Tang J" first="Jin-Ling" last="Tang">Jin-Ling Tang</name><affiliation wicri:level="4"><nlm:aff id="af3-ppa-4-407">Hong Kong Branch of The Chinese Cochrane Centre, School of Public Health, The Chinese University of Hong Kong, New Territories, Hong Kong;</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Hong Kong Branch of The Chinese Cochrane Centre, School of Public Health, The Chinese University of Hong Kong, New Territories</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Mercer, Stewart W" sort="Mercer, Stewart W" uniqKey="Mercer S" first="Stewart W" last="Mercer">Stewart W. Mercer</name><affiliation wicri:level="4"><nlm:aff id="af4-ppa-4-407">Centre of Population Health Services, College of Medical, Veterinary & Life Sciences, General Practice and Primary Care, University of Glasgow, Glasgow, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre of Population Health Services, College of Medical, Veterinary & Life Sciences, General Practice and Primary Care, University of Glasgow, Glasgow</wicri:regionArea><orgName type="university">Université de Glasgow</orgName><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21206516</idno><idno type="pmc">3003607</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003607</idno><idno type="RBID">PMC:3003607</idno><idno type="doi">10.2147/PPA.S13639</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">004557</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004557</idno><idno type="wicri:Area/Pmc/Curation">004556</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004556</idno><idno type="wicri:Area/Pmc/Checkpoint">003159</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">003159</idno><idno type="wicri:Area/Ncbi/Merge">004054</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Use of dietary supplements by breast cancer patients undergoing conventional cancer treatment</title><author><name sortKey="Wong, Lai Yi Eliza" sort="Wong, Lai Yi Eliza" uniqKey="Wong L" first="Lai Yi Eliza" last="Wong">Lai Yi Eliza Wong</name><affiliation><nlm:aff id="af1-ppa-4-407">Department of Community and Family Medicine</nlm:aff></affiliation></author><author><name sortKey="Leung, Ping Chung" sort="Leung, Ping Chung" uniqKey="Leung P" first="Ping Chung" last="Leung">Ping Chung Leung</name><affiliation><nlm:aff id="af2-ppa-4-407">Institute of Chinese Medicine</nlm:aff></affiliation></author><author><name sortKey="Tang, Jin Ling" sort="Tang, Jin Ling" uniqKey="Tang J" first="Jin-Ling" last="Tang">Jin-Ling Tang</name><affiliation wicri:level="4"><nlm:aff id="af3-ppa-4-407">Hong Kong Branch of The Chinese Cochrane Centre, School of Public Health, The Chinese University of Hong Kong, New Territories, Hong Kong;</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Hong Kong Branch of The Chinese Cochrane Centre, School of Public Health, The Chinese University of Hong Kong, New Territories</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Mercer, Stewart W" sort="Mercer, Stewart W" uniqKey="Mercer S" first="Stewart W" last="Mercer">Stewart W. Mercer</name><affiliation wicri:level="4"><nlm:aff id="af4-ppa-4-407">Centre of Population Health Services, College of Medical, Veterinary & Life Sciences, General Practice and Primary Care, University of Glasgow, Glasgow, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre of Population Health Services, College of Medical, Veterinary & Life Sciences, General Practice and Primary Care, University of Glasgow, Glasgow</wicri:regionArea><orgName type="university">Université de Glasgow</orgName><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName></affiliation></author></analytic><series><title level="j">Patient preference and adherence</title><idno type="eISSN">1177-889X</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background:</title><p>Many breast cancer patients use some form of dietary supplement (DS) to complement their conventional cancer treatment, in the hope that they might lessen the side effects of treatment, improve quality of life, give a greater sense of control, and reduce stress. This pilot study assessed the level of DS usage by breast cancer patients undergoing conventional cancer treatment, and their concerns about the use of DS.</p></sec><sec><title>Method:</title><p>A cross-sectional descriptive survey in three breast cancer centers in Hong Kong using face-to-face interviewing was performed.</p></sec><sec><title>Results:</title><p>Of 82 female Chinese breast cancer patients who completed the survey, 99% reported that they had been using DS since their cancer was diagnosed. The most frequently used DS were Chinese herbal medicines, and patients spent about US$258 on DS every month. The reason given for using DS was to enhance their recovery from cancer, but at the same time the patients had safety concerns. However, most patients did not feel able to discuss these concerns with health professionals.</p></sec><sec><title>Conclusion:</title><p>The majority of the patients had some safety concerns, and said that they would welcome detailed and reliable information on DS. The lack of reliable information on the potential risks and benefits of using such supplements as an adjuvant to conventional treatment and the reluctance of patients to discuss their use of DS with health professionals is a major area of concern that warrants further attention.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Parkin, Dm" uniqKey="Parkin D">DM Parkin</name></author><author><name sortKey="Bray, F" uniqKey="Bray F">F Bray</name></author><author><name sortKey="Ferlay, J" uniqKey="Ferlay J">J Ferlay</name></author><author><name sortKey="Pisani, P" uniqKey="Pisani P">P Pisani</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Patrick, Dl" uniqKey="Patrick D">DL Patrick</name></author><author><name sortKey="Ferketich, Sl" uniqKey="Ferketich S">SL Ferketich</name></author><author><name sortKey="Frame, Ps" uniqKey="Frame P">PS 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Patient Prefer Adherence</journal-id><journal-title-group><journal-title>Patient preference and adherence</journal-title></journal-title-group><issn pub-type="epub">1177-889X</issn><publisher><publisher-name>Dove Medical Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21206516</article-id><article-id pub-id-type="pmc">3003607</article-id><article-id pub-id-type="doi">10.2147/PPA.S13639</article-id><article-id pub-id-type="publisher-id">ppa-4-407</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Research</subject></subj-group></article-categories><title-group><article-title>Use of dietary supplements by breast cancer patients undergoing conventional cancer treatment</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Wong</surname><given-names>Lai Yi Eliza</given-names></name><xref ref-type="aff" rid="af1-ppa-4-407">1</xref><xref ref-type="corresp" rid="c1-ppa-4-407"></xref></contrib><contrib contrib-type="author"><name><surname>Leung</surname><given-names>Ping Chung</given-names></name><xref ref-type="aff" rid="af2-ppa-4-407">2</xref></contrib><contrib contrib-type="author"><name><surname>Tang</surname><given-names>Jin-Ling</given-names></name><xref ref-type="aff" rid="af3-ppa-4-407">3</xref></contrib><contrib contrib-type="author"><name><surname>Mercer</surname><given-names>Stewart W</given-names></name><xref ref-type="aff" rid="af4-ppa-4-407">4</xref></contrib></contrib-group><aff id="af1-ppa-4-407"><label>1</label>Department of Community and Family Medicine</aff><aff id="af2-ppa-4-407"><label>2</label>Institute of Chinese Medicine</aff><aff id="af3-ppa-4-407"><label>3</label>Hong Kong Branch of The Chinese Cochrane Centre, School of Public Health, The Chinese University of Hong Kong, New Territories, Hong Kong;</aff><aff id="af4-ppa-4-407"><label>4</label>Centre of Population Health Services, College of Medical, Veterinary & Life Sciences, General Practice and Primary Care, University of Glasgow, Glasgow, UK</aff><author-notes><corresp id="c1-ppa-4-407">Correspondence: Lai Yi Eliza Wong, Department of Community and Family Medicine, The Chinese University of Hong Kong, 4/F, School of Public Health Building, Prince of Wales Hospital, New Territories, Hong Kong, Tel +852 2252 8772, Fax +852 2606 3500, Email <email>lywong@cuhk.edu.hk</email></corresp></author-notes><pub-date pub-type="collection"><year>2010</year></pub-date><pub-date pub-type="epub"><day>18</day><month>11</month><year>2010</year></pub-date><volume>4</volume><fpage>407</fpage><lpage>414</lpage><history><date date-type="received"><day>17</day><month>11</month><year>2010</year></date></history><permissions><copyright-statement>© 2010 Wong et al, publisher and licensee Dove Medical Press Ltd.</copyright-statement><license><license-p>This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Background:</title><p>Many breast cancer patients use some form of dietary supplement (DS) to complement their conventional cancer treatment, in the hope that they might lessen the side effects of treatment, improve quality of life, give a greater sense of control, and reduce stress. This pilot study assessed the level of DS usage by breast cancer patients undergoing conventional cancer treatment, and their concerns about the use of DS.</p></sec><sec><title>Method:</title><p>A cross-sectional descriptive survey in three breast cancer centers in Hong Kong using face-to-face interviewing was performed.</p></sec><sec><title>Results:</title><p>Of 82 female Chinese breast cancer patients who completed the survey, 99% reported that they had been using DS since their cancer was diagnosed. The most frequently used DS were Chinese herbal medicines, and patients spent about US$258 on DS every month. The reason given for using DS was to enhance their recovery from cancer, but at the same time the patients had safety concerns. However, most patients did not feel able to discuss these concerns with health professionals.</p></sec><sec><title>Conclusion:</title><p>The majority of the patients had some safety concerns, and said that they would welcome detailed and reliable information on DS. The lack of reliable information on the potential risks and benefits of using such supplements as an adjuvant to conventional treatment and the reluctance of patients to discuss their use of DS with health professionals is a major area of concern that warrants further attention.</p></sec></abstract><kwd-group><kwd>breast cancer</kwd><kwd>dietary supplement</kwd><kwd>prevalence</kwd><kwd>concern</kwd><kwd>expense</kwd></kwd-group></article-meta></front><floats-group><table-wrap id="t1-ppa-4-407" position="float"><label>Table 1</label><caption><p>Demographic and clinical characteristics of 82 breast cancer patients between June and October 2002 in Hong Kong</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th align="left" valign="top" rowspan="1" colspan="1"><bold>Mean (SD)</bold></th><th align="left" valign="top" rowspan="1" colspan="1"><bold>Median (range)</bold></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Age (years)</td><td align="left" valign="top" rowspan="1" colspan="1">45.8 (6.9)</td><td align="left" valign="top" rowspan="1" colspan="1">45.0 (30–63)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Duration in Hong Kong (years)</td><td align="left" valign="top" rowspan="1" colspan="1">35.5 (15.2)</td><td align="left" valign="top" rowspan="1" colspan="1">40.0 (1–59)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Interval between cancer diagnosis and survey (weeks)</td><td align="left" valign="top" rowspan="1" colspan="1">56.1 (28.3)</td><td align="left" valign="top" rowspan="1" colspan="1">52.0 (8–140)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1"><bold>Category</bold></td><td align="left" valign="top" rowspan="1" colspan="1"><bold>Frequency (%)</bold></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Sex</td><td align="left" valign="top" rowspan="1" colspan="1">Female</td><td align="left" valign="top" rowspan="1" colspan="1">82 (100%)</td></tr><tr><td align="left" valign="top" rowspan="5" colspan="1">Education</td><td align="left" valign="top" rowspan="1" colspan="1">≤Primary</td><td align="left" valign="top" rowspan="1" colspan="1">17 (20.7%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Form 3</td><td align="left" valign="top" rowspan="1" colspan="1">19 (23.2%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Form 5/vocational/technical/</td><td align="left" valign="top" rowspan="1" colspan="1">28 (34.1%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">matriculation level</td><td align="left" valign="top" rowspan="1" colspan="1">3 (3.7%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">university/diploma/postgraduate</td><td align="left" valign="top" rowspan="1" colspan="1">15 (18.3%)</td></tr><tr><td align="left" valign="top" rowspan="5" colspan="1">Occupation</td><td align="left" valign="top" rowspan="1" colspan="1">Health professional</td><td align="left" valign="top" rowspan="1" colspan="1">3 (3.7%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Executive/nonhealth professional</td><td align="left" valign="top" rowspan="1" colspan="1">5 (6.1%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">White collar</td><td align="left" valign="top" rowspan="1" colspan="1">13 (15.9%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Blue collar</td><td align="left" valign="top" rowspan="1" colspan="1">7 (8.5%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Housewife/unemployed</td><td align="left" valign="top" rowspan="1" colspan="1">54 (65.8%)</td></tr><tr><td align="left" valign="top" rowspan="5" colspan="1">Religion</td><td align="left" valign="top" rowspan="1" colspan="1">No religious belief</td><td align="left" valign="top" rowspan="1" colspan="1">33 (40.2%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Christianity</td><td align="left" valign="top" rowspan="1" colspan="1">17 (20.7%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Buddhism</td><td align="left" valign="top" rowspan="1" colspan="1">13 (15.9%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Ancestor</td><td align="left" valign="top" rowspan="1" colspan="1">2 (2.4%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Multireligion</td><td align="left" valign="top" rowspan="1" colspan="1">17 (20.7%)</td></tr><tr><td align="left" valign="top" rowspan="4" colspan="1">Marital status</td><td align="left" valign="top" rowspan="1" colspan="1">Single</td><td align="left" valign="top" rowspan="1" colspan="1">8 (9.8%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Married</td><td align="left" valign="top" rowspan="1" colspan="1">69 (84.1%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Divorced</td><td align="left" valign="top" rowspan="1" colspan="1">4 (4.9%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Widowed</td><td align="left" valign="top" rowspan="1" colspan="1">1 (1.2%)</td></tr><tr><td align="left" valign="top" rowspan="3" colspan="1">Location of birth</td><td align="left" valign="top" rowspan="1" colspan="1">Hong Kong</td><td align="left" valign="top" rowspan="1" colspan="1">48 (58.5%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Mainland China</td><td align="left" valign="top" rowspan="1" colspan="1">31 (37.8%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Other Asian countries</td><td align="left" valign="top" rowspan="1" colspan="1">3 (3.7%)</td></tr><tr><td align="left" valign="top" rowspan="3" colspan="1">Location of residence</td><td align="left" valign="top" rowspan="1" colspan="1">Hong Kong Island</td><td align="left" valign="top" rowspan="1" colspan="1">8 (9.8%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Kowloon</td><td align="left" valign="top" rowspan="1" colspan="1">24 (29.3%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">New Territories</td><td align="left" valign="top" rowspan="1" colspan="1">50 (61%)</td></tr><tr><td align="left" valign="top" rowspan="3" colspan="1">Cancer status</td><td align="left" valign="top" rowspan="1" colspan="1">Stage I</td><td align="left" valign="top" rowspan="1" colspan="1">24 (29.3%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Stage II</td><td align="left" valign="top" rowspan="1" colspan="1">51 (62.2%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Stage III</td><td align="left" valign="top" rowspan="1" colspan="1">7(8.5%)</td></tr><tr><td align="left" valign="top" rowspan="4" colspan="1">Cancer treatment</td><td align="left" valign="top" rowspan="1" colspan="1">Surgery</td><td align="left" valign="top" rowspan="1" colspan="1">82 (100%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Chemotherapy</td><td align="left" valign="top" rowspan="1" colspan="1">64 (78%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Radiotherapy</td><td align="left" valign="top" rowspan="1" colspan="1">61 (74.4%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Hormone replacement therapy</td><td align="left" valign="top" rowspan="1" colspan="1">58 (70.7%)</td></tr></tbody></table></table-wrap><table-wrap id="t2-ppa-4-407" position="float"><label>Table 2</label><caption><p>Demographic characteristics of dietary supplement used by breast cancer patients</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="2" colspan="1"></th><th align="left" valign="top" rowspan="2" colspan="1"><bold>Category</bold></th><th align="left" valign="top" rowspan="2" colspan="1"></th><th colspan="2" align="left" valign="top" rowspan="1"><bold>Use of supplement</bold><hr></hr></th></tr><tr><th align="left" valign="top" rowspan="1" colspan="1"><bold>Yes (n = 81)</bold></th><th align="left" valign="top" rowspan="1" colspan="1"><bold>No (n = 1)</bold></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Age (years)</td><td align="left" valign="top" rowspan="1" colspan="1">Mean (SD)</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">45.9 (6.9)</td><td align="left" valign="top" rowspan="1" colspan="1">39 (n.a.)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Duration in Hong Kong (years)</td><td align="left" valign="top" rowspan="1" colspan="1">Mean (SD)</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">35.7 (15.3)</td><td align="left" valign="top" rowspan="1" colspan="1">21 (n.a.)</td></tr><tr><td colspan="5" align="left" valign="top" rowspan="1"><bold>Interval from cancer diagnosis to survey (weeks)</bold></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">Mean (SD)</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">56.6 (28.2)</td><td align="left" valign="top" rowspan="1" colspan="1">20 (n.a.)</td></tr><tr><td align="left" valign="top" rowspan="2" colspan="1">Education</td><td align="left" valign="top" rowspan="1" colspan="1">≤Primary level</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">36 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">≥Secondary level</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">45 (97.8)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (2.2%)</td></tr><tr><td align="left" valign="top" rowspan="2" colspan="1">Occupation</td><td align="left" valign="top" rowspan="1" colspan="1">Working class</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">27 (96.4%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (3.6%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Housewife/retired/unemployed</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">54 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="2" colspan="1">Religion</td><td align="left" valign="top" rowspan="1" colspan="1">No religious belief</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">33 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Have religious belief</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">48 (98%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (2%)</td></tr><tr><td align="left" valign="top" rowspan="2" colspan="1">Marital status</td><td align="left" valign="top" rowspan="1" colspan="1">Single</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">8 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Married</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">73 (98.6%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (1.4%)</td></tr><tr><td align="left" valign="top" rowspan="2" colspan="1">Location of birth</td><td align="left" valign="top" rowspan="1" colspan="1">Hong Kong</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">48 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Other countries</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">33 (97.1%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (2.9%)</td></tr><tr><td align="left" valign="top" rowspan="2" colspan="1">Location of residence</td><td align="left" valign="top" rowspan="1" colspan="1">Not New Territories</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">31 (96.9%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (3.1%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">New Territories</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">50 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="3" colspan="1">Cancer status</td><td align="left" valign="top" rowspan="1" colspan="1">Stage I</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">23 (95.8%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (4.2%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Stage II</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">51 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Stage III</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1">7 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="8" colspan="1">Cancer treatment</td><td align="left" valign="top" rowspan="2" colspan="1">Surgery</td><td align="left" valign="top" rowspan="1" colspan="1">Yes</td><td align="left" valign="top" rowspan="1" colspan="1">81 (98.8%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (1.2%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">No</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="2" colspan="1">Chemotherapy</td><td align="left" valign="top" rowspan="1" colspan="1">Yes</td><td align="left" valign="top" rowspan="1" colspan="1">63 (98.4%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (1.6%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">No</td><td align="left" valign="top" rowspan="1" colspan="1">18 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="2" colspan="1">Radiotherapy</td><td align="left" valign="top" rowspan="1" colspan="1">Yes</td><td align="left" valign="top" rowspan="1" colspan="1">61 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">No</td><td align="left" valign="top" rowspan="1" colspan="1">20 (95.2%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (4.8%)</td></tr><tr><td align="left" valign="top" rowspan="2" colspan="1">Hormone replacement therapy</td><td align="left" valign="top" rowspan="1" colspan="1">Yes</td><td align="left" valign="top" rowspan="1" colspan="1">58 (100%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">No</td><td align="left" valign="top" rowspan="1" colspan="1">23 (95.8%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (4.2%)</td></tr></tbody></table><table-wrap-foot><fn id="tfn1-ppa-4-407"><p><bold>Abbreviations:</bold> SD, standard deviation; n.a, not available.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t3-ppa-4-407" position="float"><label>Table 3</label><caption><p>Classification and frequency of dietary supplement used in 82 breast cancer patients</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th align="left" valign="top" rowspan="1" colspan="1"><bold>Frequency (%)</bold></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Dietary supplement</td><td align="left" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> No</td><td align="left" valign="top" rowspan="1" colspan="1">1 (1.2%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Yes</td><td align="left" valign="top" rowspan="1" colspan="1">81 (98.8)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Western supplement</td><td align="left" valign="top" rowspan="1" colspan="1">14 (17.3%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Chinese supplement</td><td align="left" valign="top" rowspan="1" colspan="1">81 (100%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Herbal tea</td><td align="left" valign="top" rowspan="1" colspan="1">53 (65.4%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Herbal soup</td><td align="left" valign="top" rowspan="1" colspan="1">48 (59.3%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Proprietary medicine</td><td align="left" valign="top" rowspan="1" colspan="1">42 (51.9%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Other plant/animal supplements</td><td align="left" valign="top" rowspan="1" colspan="1">12 (14.8%)</td></tr></tbody></table></table-wrap><table-wrap id="t4-ppa-4-407" position="float"><label>Table 4</label><caption><p>Top five dietary supplement ingredients used in 81 breast cancer patients</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"><bold>Type of dietary supplement and ingredients</bold></th><th align="left" valign="top" rowspan="1" colspan="1"><bold>Frequency</bold></th><th align="left" valign="top" rowspan="1" colspan="1"><bold>Percent</bold></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Western supplement ingredients (14 users)<xref ref-type="table-fn" rid="tfn3-ppa-4-407">*</xref></td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Any vitamins</td><td align="left" valign="top" rowspan="1" colspan="1">12</td><td align="left" valign="top" rowspan="1" colspan="1">86</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Calcium supplement</td><td align="left" valign="top" rowspan="1" colspan="1">6</td><td align="left" valign="top" rowspan="1" colspan="1">43</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Glucosine sulphate</td><td align="left" valign="top" rowspan="1" colspan="1">1</td><td align="left" valign="top" rowspan="1" colspan="1">7</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Omega3</td><td align="left" valign="top" rowspan="1" colspan="1">1</td><td align="left" valign="top" rowspan="1" colspan="1">7</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Herbal tea ingredients (53 users)</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Hedyotis diffusa</italic></td><td align="left" valign="top" rowspan="1" colspan="1">29</td><td align="left" valign="top" rowspan="1" colspan="1">55</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Herba scutellariae barbatae</italic></td><td align="left" valign="top" rowspan="1" colspan="1">24</td><td align="left" valign="top" rowspan="1" colspan="1">45</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Ganoderma lucidum</italic></td><td align="left" valign="top" rowspan="1" colspan="1">14</td><td align="left" valign="top" rowspan="1" colspan="1">26</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Spica prunellae</italic></td><td align="left" valign="top" rowspan="1" colspan="1">8</td><td align="left" valign="top" rowspan="1" colspan="1">15</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Flos lonicerae japonicae and Flos chrysanthemi</italic></td><td align="left" valign="top" rowspan="1" colspan="1">7</td><td align="left" valign="top" rowspan="1" colspan="1">13</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Herbal soup ingredients (48 users)</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Rhizoma dioscoreae</italic></td><td align="left" valign="top" rowspan="1" colspan="1">29</td><td align="left" valign="top" rowspan="1" colspan="1">60</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Semen euryales</italic></td><td align="left" valign="top" rowspan="1" colspan="1">20</td><td align="left" valign="top" rowspan="1" colspan="1">42</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Fructus lycii</italic></td><td align="left" valign="top" rowspan="1" colspan="1">16</td><td align="left" valign="top" rowspan="1" colspan="1">33</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Arillus longan</italic></td><td align="left" valign="top" rowspan="1" colspan="1">12</td><td align="left" valign="top" rowspan="1" colspan="1">25</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Semen nelumbinis</italic></td><td align="left" valign="top" rowspan="1" colspan="1">11</td><td align="left" valign="top" rowspan="1" colspan="1">23</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Chinese proprietary medicine (42 users)</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Coriolus vesicolor</italic></td><td align="left" valign="top" rowspan="1" colspan="1">25</td><td align="left" valign="top" rowspan="1" colspan="1">60</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Ganoderma lucidum</italic></td><td align="left" valign="top" rowspan="1" colspan="1">16</td><td align="left" valign="top" rowspan="1" colspan="1">38</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Radix isatidis</italic></td><td align="left" valign="top" rowspan="1" colspan="1">1</td><td align="left" valign="top" rowspan="1" colspan="1">2</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Radix et Rhizoma ginseng</italic></td><td align="left" valign="top" rowspan="1" colspan="1">1</td><td align="left" valign="top" rowspan="1" colspan="1">2</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> <italic>Pteria margaritifera</italic></td><td align="left" valign="top" rowspan="1" colspan="1">1</td><td align="left" valign="top" rowspan="1" colspan="1">2</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Other plants/animals extraction supplements (12 users)</td><td align="left" valign="top" rowspan="1" colspan="1"></td><td align="left" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Shark extraction</td><td align="left" valign="top" rowspan="1" colspan="1">4</td><td align="left" valign="top" rowspan="1" colspan="1">33</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Fish oil extraction</td><td align="left" valign="top" rowspan="1" colspan="1">3</td><td align="left" valign="top" rowspan="1" colspan="1">25</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Bird nest extraction</td><td align="left" valign="top" rowspan="1" colspan="1">1</td><td align="left" valign="top" rowspan="1" colspan="1">8</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Green tea extraction</td><td align="left" valign="top" rowspan="1" colspan="1">1</td><td align="left" valign="top" rowspan="1" colspan="1">8</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Grape seed extraction</td><td align="left" valign="top" rowspan="1" colspan="1">1</td><td align="left" valign="top" rowspan="1" colspan="1">8</td></tr></tbody></table><table-wrap-foot><fn id="tfn2-ppa-4-407"><p><bold>Note:</bold></p></fn><fn id="tfn3-ppa-4-407"><label>*</label><p>Only 4 types of western supplements reported in 81 breast cancer patients.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t5-ppa-4-407" position="float"><label>Table 5</label><caption><p>Expenditure on dietary supplement per month (US$) in 82 breast cancer patients</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th align="left" valign="top" rowspan="1" colspan="1"><bold>Mean (SD)</bold></th><th align="left" valign="top" rowspan="1" colspan="1"><bold>Median (range)</bold></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Dietary supplement</td><td align="left" valign="top" rowspan="1" colspan="1">257.8 (2.6)</td><td align="left" valign="top" rowspan="1" colspan="1">178.8 (0–1679.9)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Western supplement</td><td align="left" valign="top" rowspan="1" colspan="1">2.6 (9.5)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0–59.8)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Chinese supplement</td><td align="left" valign="top" rowspan="1" colspan="1">250 (257.8)</td><td align="left" valign="top" rowspan="1" colspan="1">178.8 (0–1679.9)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Herbal tea</td><td align="left" valign="top" rowspan="1" colspan="1">14.7 (48.7)</td><td align="left" valign="top" rowspan="1" colspan="1">0.8 (0–412.8)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Herbal soup</td><td align="left" valign="top" rowspan="1" colspan="1">29.7 (100.4)</td><td align="left" valign="top" rowspan="1" colspan="1">1.3 (0–717.9)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Proprietary medicine</td><td align="left" valign="top" rowspan="1" colspan="1">67.5 (140.4)</td><td align="left" valign="top" rowspan="1" colspan="1">3.2 (0–112.5)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Traditional Chinese medicine practitioner consultation</td><td align="left" valign="top" rowspan="1" colspan="1">138.1 (166.8)</td><td align="left" valign="top" rowspan="1" colspan="1">76.9 (0–717.9)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Other plants/animals supplements</td><td align="left" valign="top" rowspan="1" colspan="1">5.2 (17.7)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0–92.3)</td></tr></tbody></table></table-wrap><table-wrap id="t6-ppa-4-407" position="float"><label>Table 6</label><caption><p>Reason for taking dietary supplements in 81 breast cancer patients</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"><bold>Reasons</bold></th><th align="left" valign="top" rowspan="1" colspan="1"><bold>Frequency (%)</bold></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Enhance recovery</td><td align="left" valign="top" rowspan="1" colspan="1">38 (47%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Cancer prevention</td><td align="left" valign="top" rowspan="1" colspan="1">25 (31%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Enhance immune</td><td align="left" valign="top" rowspan="1" colspan="1">21 (26%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Lessen side effects of chemotherapy</td><td align="left" valign="top" rowspan="1" colspan="1">11 (14%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Lessen side effects of hormone replacement therapy</td><td align="left" valign="top" rowspan="1" colspan="1">4 (5%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Clear disease root</td><td align="left" valign="top" rowspan="1" colspan="1">3 (4%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Remove internal heat and toxin</td><td align="left" valign="top" rowspan="1" colspan="1">3 (4%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">General health promotion</td><td align="left" valign="top" rowspan="1" colspan="1">3 (4%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Increase survival rate</td><td align="left" valign="top" rowspan="1" colspan="1">1 (1%)</td></tr></tbody></table></table-wrap></floats-group></pmc><affiliations><list><country><li>Hong Kong</li><li>Royaume-Uni</li></country><region><li>Écosse</li></region><settlement><li>Glasgow</li><li>Sha Tin</li></settlement><orgName><li>Université chinoise de Hong Kong</li><li>Université de Glasgow</li></orgName></list><tree><noCountry><name sortKey="Leung, Ping Chung" sort="Leung, Ping Chung" uniqKey="Leung P" first="Ping Chung" last="Leung">Ping Chung Leung</name><name sortKey="Wong, Lai Yi Eliza" sort="Wong, Lai Yi Eliza" uniqKey="Wong L" first="Lai Yi Eliza" last="Wong">Lai Yi Eliza Wong</name></noCountry><country name="Hong Kong"><noRegion><name sortKey="Tang, Jin Ling" sort="Tang, Jin Ling" uniqKey="Tang J" first="Jin-Ling" last="Tang">Jin-Ling Tang</name></noRegion></country><country name="Royaume-Uni"><region name="Écosse"><name sortKey="Mercer, Stewart W" sort="Mercer, Stewart W" uniqKey="Mercer S" first="Stewart W" last="Mercer">Stewart W. 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