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Prevalence of traditional, complementary, and alternative medicine (TCAM) among adult cancer patients in Malawi

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Abstract

Purpose

The objective of this study is to document the prevalence of traditional, complementary, and alternative medicine (TCAM) use by adult cancer patients at a national teaching hospital in Malawi. We aim to document the products/therapies used, the reason for use, as well as patient-reported satisfaction with TCAM practitioners and modalities.

Methods

We conducted investigator-administered interviews with adult cancer patients presenting to the Kamuzu Central Hospital (KCH) Cancer Clinic in Lilongwe, Malawi between January and July 2018. The KCH is a national teaching hospital in the capital of Lilongwe, which serves patients with cancer from the northern half of Malawi. Descriptive statistics were used to describe TCAM use and logistic regression was applied to identify predictors of TCAM.

Results

A total of 263 participants completed the survey, of which 70% (n = 183) were female and average age was 45 (SD 14) years old. The prevalence of overall TCAM use was 84% (n = 222), and 60% (n = 157) of participants reported combining TCAM with conventional cancer treatment. The majority of patients used TCAM to directly treat their cancer versus for symptom management. Patients reported using faith-based healing (64%, n = 168), herbal medicine (56%, n = 148), diet change (46%, n = 120), and vitamins/minerals (23%, n = 61). Participants reported the highest satisfaction for physicians among practitioners and diet change for modalities. Female gender was found to be a predictor of TCAM with conventional treatment use, no other significant predictors were observed.

Conclusion

There is a high prevalence of TCAM use among an adult population with cancer in Malawi, and a wide variety in the TCAM modalities used among patients. Additional studies are needed to identify risks and benefits of TCAM use to assist with policy and public health, patient safety, and holistically address the global burden of cancer.

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Data availability

See supplemental data files for survey materials used for this study.

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Funding

University of North Carolina, Chapel Hill, Lineberger Comprehensive Cancer Center Tier 1 Pilot Development Award. The Research Fellowship in Complementary and Integrative Health (5T32AT003378-12) from the National Center for Complementary and Integrative Health provided salary support for Dr. Hill.

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Authors and Affiliations

  1. University of North Carolina, Chapel Hill, 101 Manning Dr., Chapel Hill, NC, 27599, USA

    Jacob Hill, Olivia Vaz, Quefeng Li, Hannan Yang & Jennifer S. Smith

  2. Malawi Cancer Consortium and Regional Center of Research Excellence for Non-Communicable Diseases, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi

    Ryan Seguin, Agness Manda & Maria Chikasema

  3. Center for Global Health, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD, 20850, USA

    Satish Gopal

  4. Program on Integrative Medicine, University of North Carolina, 101 Manning Dr., Chapel Hill, NC, 27599, USA

    Jacob Hill

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Correspondence to Jacob Hill.

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The authors have no conflict of interest to disclose.

Disclaimer

This work was completed while Dr. Satish Gopal was employed at the University of North Carolina at Chapel Hill. The opinions expressed in this article are the authors own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States Government.

Ethical approval

This study has been approved by the University of North Carolina Institutional Review Board (Protocol #17-0933) as well as the National Health Science Research Committee of Malawi (Protocol #21711).

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All study participants provided written informed consent for participation.

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Consent for publication was included in the written informed consent signed by each participation.

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Hill, J., Seguin, R., Manda, A. et al. Prevalence of traditional, complementary, and alternative medicine (TCAM) among adult cancer patients in Malawi. Cancer Causes Control 33, 1047–1057 (2022). https://doi.org/10.1007/s10552-022-01563-0

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