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Studies show that, in many parts of Asia, traditional herbal medicine is used by a large majority of breast cancer patients[1]. A study from Shanghai found that 86.7% of breast cancer patients used Chinese herbal medicine after their breast cancer diagnosis[2], while a Taiwan study found that 81.5% of female breast cancer patients used TCM services[3]. Most patients in these studies used herbal medicine to complement conventional cancer therapies, not replace them, and herbs are often completely integrated into the conventional treatment. In China, it is estimated that about 80% of all cancer patients have used traditional Chinese medicine and 90% of oncologists have prescribed herbs; for simultaneous use with conventional cancer therapies, an estimated 37.9%, 42.2%, and 39.5% of Stage 0–II, Stage III, and Stage IV breast cancer patients respectively were found to use TCM[5]. According to data from the Shanghai Breast Cancer Survival Study, herbal use among breast cancer patients was more common among patients with the following characteristics: higher income, completion of chemotherapy, younger age, symptoms of menopause, and past use of tamoxifen, and less common among those with earlier clinical stages and past use of radiotherapy[4]. A systematic review from Thailand found some similar trends, with higher herbal medicine use among cancer patients of younger age, higher education or economic status, and being in a later stage of disease or phase of chemotherapy treatment [5].

Outside of Asia, Traditional Chinese Medicine (TCM) is increasingly accepted and recognized, with the prevalence of Complementary and Alternative Medicine (CAM, which includes TCM and other non-biomedical modalities such as yoga, homeopathy, Ayurveda, meditation, bodywork, etc.) almost doubling from the 1970s until the 2000s[6]. According to data from a 2012 World Health Organization (WHO) survey, 80% of the 129 member states now accept the use of acupuncture as a treatment modality[7],[8]. In terms of botanical medicine, increasing research interest in discovering cancer-fighting compounds, meeting the challenges of multi-drug resistance, and developing immunomodulatory, metabolic, and personalized medicine approaches to cancer treatment have all fueled interest in investigating medicinal herbs. Indeed, most cancer drugs used today are derived from natural botanical medicines[9]. One survey reports that 46% of breast cancer patients use CAM, including 19% using herbal medicine (of any kind, not necessarily Chinese herbs)[10]. In oncology, a survey found that 29% of oncological and comprehensive cancer centers in Germany offered TCM[11].

Breast cancer patients report various reasons for using TCM herbal medicine. The majority of them did not typically choose to use herbs for direct anti-cancer activity, but to enhance general health, boost energy levels, manage symptoms and/or side-effects of conventional treatments, obtain more personalized care and psychosocial or spiritual support, and regain a feeling of control over some aspects of their health[2]. The Shanghai Breast Cancer Survival Study found that three out of four breast cancer patients said they used TCM herbs for immune-strengthening, and two thirds believed TCM herbs were effective.[10]

[1] CARMADY B, SMITH C. Use of Chinese medicine by cancer patients: a review of surveys [J]. Chinese Medicine, 2011, 6: 22.

[2] CUI Y, SHU XO, GAO Y et al. Use of Complementary and Alternative Medicine by Chinese women with breast cancer [J]. Breast Cancer Research and Treatment, 2004, 85(3): 263-70.

[3] WANG B-R, CHANG Y-L, CHEN T-J et al. Coprescription of Chinese herbal medicine and Western medication among female patients with breast cancer in Taiwan: analysis of national insurance claims[J]. Patient preference and adherence, 2014, 8: 671–682.

[4] CHEN Z, GU K, ZHENG Y et al. The use of complementary and alternative medicine among Chinese women with breast cancer[J]. Journal of Alternative and Complementary Medicine, 2008, 14(8): 1049–1055.

[5] POONTHANANIWATKUL B, LIM R H M, HOWARD R L et al. Traditional medicine use by cancer patients in Thailand[J]. Journal of Ethnopharmacology, 2015, 168: 100–107.

[6] CRAMER H, COHEN L, DOBOS G et al. Integrative Oncology: Best of Both Worlds—Theoretical, Practical, and Research Issues [J]. Evidence-Based Complementary and Alternative Medicine, 2013, 383142.

[7] FUNG F Y, LINN Y C. Developing Traditional Chinese Medicine in the Era of Evidence-Based Medicine: Current Evidences and Challenges[J]. Evidence-based Complementary and Alternative Medicine : eCAM, 2015, 2015 : 425037.

[8] SHEA J. Applying Evidence-Based Medicine to Traditional Chinese Medicine: Debate and Strategy [J]. Journal of Alternative and Complementary Medicine, 2006, 12(3): 255–263.

[9] SAFARZADEH E, SANDOGHCHIAN SHOTORBANI S, BARADARAN B. Herbal Medicine as Inducers of Apoptosis in Cancer Treatment[J]. Advanced Pharmaceutical Bulletin, 2014, 4(Suppl 1): 421–427.

[10] TEMPLETON A et al. Cross-sectional study of self-reported physical activity, eating habits and use of complementary medicine in breast cancer survivors [J]. BMC Cancer, 2013, 13: 153.

[11] HENF A, WESSELMANN S, HUTHMANN D et al. Complementary and Alternative Medicine in German Cancer Centers[J]. Oncology Research and Treatment, 2014, 37(7–8): 390–394.

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