Rates of unconventional medical therapy use in patients with prostate cancer: Standard history versus directed questions

Objectives. The use of unconventional medical therapies (UMTs) in the general population has increased dramatically in the past decade. Studies have estimated that 9% to 64% of patients with cancer use UMTs, and many do not disclose this information to their physicians. This study was designed to evaluate the rates of UMT use by patients with prostate cancer revealed by standard versus directed questioning and to identify demographic markers that may predict use. Methods. A prospective study of 287 consecutive patients with cancer presenting to the Department of Radiation Oncology was performed. The prostate cancer population was 29% (84 of 287) of the total cancer patient population. Each patient underwent the standard history interview, including questions regarding prescription and over-the-counter medication. At the completion of the standard history interview, patients were then asked a set of directed questions regarding the use of UMTs. Results. Of the 84 patients with prostate cancer, 31 (37%) used unconventional therapies. The standard history revealed that 6 (19%) of 31 used UMTs, and directed questioning revealed an additional 25 patients (81%) used UMTs in the study population (P < 0.001). Of those using UMTs, 65% used megavitamins, 49% used herbal remedies, 13% used meditation or guided imagery, and 20% used nonherbal natural supplements. Conclusions. UMT use is prevalent among patients with prostate cancer. Some of these treatments may have a potential biologic impact on tumor behavior, therapeutic endpoints, and measured prostate-specific antigen values. The use of directed questioning during the patient evaluation significantly increases the physician's ability to identify patients with prostate cancer using UMTs. UROLOGY 59: 272-276, 2002. (C) 2002, Elsevier Science Inc.