Uso de medicina alternativa en pacientes oncológicos en la ciudad de Neiva (Colombia)
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feb 16, 2024
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Nicolás Martínez-Ramos
https://orcid.org/0000-0002-4461-9660
Carolina Mariño
https://orcid.org/0000-0002-5704-8465
Laura Camila Olaya-SanMiguel
https://orcid.org/0000-0001-8052-6122
Raúl Murillo
https://orcid.org/0000-0001-7187-9946
https://orcid.org/0000-0002-4461-9660
Carolina Mariño
https://orcid.org/0000-0002-5704-8465
Laura Camila Olaya-SanMiguel
https://orcid.org/0000-0001-8052-6122
Raúl Murillo
https://orcid.org/0000-0001-7187-9946
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Resumen
Objetivo: Determinar la frecuencia de uso de medicina alternativa y complementaria (MAC) en pacientes oncológicos en la ciudad de Neiva (Colombia) así como caracterizar las prácticas de MAC empleadas por los pacientes. Materiales y métodos: Estudio descriptivo en el que se encuestaron a pacientes en un centro de salud de Neiva. Se incluyeron pacientes adultos con cualquier tipo de cáncer, en todos los estadios clínicos y que se encontraran en tratamiento activo. Mediante un análisis multivariado se buscó identificar asociaciones entre el empleo de MAC y variables sociodemográficas-clínicas. Resultados: Se incluyeron 526 pacientes, de los cuales el 57,2% (301) reportaron ser usuarios de MAC. La principal razón fue la intención paliativa; pero un número significativo las utiliza con fin curativo. Las MAC más frecuentes fueron las de tipo de herbal, de las cuales el anamú fue el producto al cual más recurrieron los pacientes. Se encontraron asociaciones significativas entre MAC sexo, edad y ocupación. Conclusiones: Una elevada proporción de pacientes oncológicos en tratamiento activo emplea MAC. Es necesario incorporar esta información en el cuidado del paciente y desarrollar servicios que orienten este tipo de prácticas.
Keywords
cancer, Colombia, complementary therapies, integrative oncology, surveys and questionnairescáncer, Colombia, terapias complementarias, oncología integrativa, encuestas y cuestionarios
References
References
1. NCCIH: Centro Nacional de Salud Complementaria e Integrativa. Salud complementaria, alternativa o integral: ¿qué hay detrás de estos nombres? [Internet]. 2023. Available from: https://www.nccih.nih.gov/health/espanol/salud-complementaria-alternativa-o-integral-que-significan-estos-terminos
2. Kristoffersen AE, Nilsen JV, Stub T, Nordberg JH, Wider B, Mora DC, et al. Use of complementary and alternative medicine in the context of cancer; prevalence, reasons for use, disclosure, information received, risks and benefits reported by people with cancer in Norway. BMC Complement Med Ther. 2022;22(1). https://doi.org/10.1186/s12906-022-03606-0
3. Harris PE, Cooper K, Relton C, Thomas KJ. Prevalence of complementary and alternative medicine (CAM) use by the general population: a systematic review and update. Int J Clin Pract. 2012;66. https://doi.org/10.1111/j.1742-1241.2012.02945.x
4. Sánchez R, Venegas M. Aproximaciones complementarias y alternativas al cuidado de la salud en el Instituto Nacional de Cancerología: estudio de prevalencia. Rev Colomb Cancerol. 2010;14(3):135-43. https://doi.org/10.35509/issn.0123-9015
5. Murillo R, Pinto-Martínez N, Serrano N, Uribe C, Navarro E, Duque J, et al. Use of complementary and alternative medicine by cancer patients in Colombia. BMC Complement Med Ther. 2023;23:321. https://doi.org/10.1186/s12906-023-04144-z
6. García-Padilla P, Reyes CO, Medina P, Deaza GF, Morales OL, Murillo R. Perspectivas de pacientes y profesionales en torno al uso de medicinas alternativas y complementarias para el cuidado del cáncer: un estudio exploratorio. Univ Med. 2021;62(1). https://doi.org/10.11144/Javeriana.umed62-1.pppu
7. Sparreboom A, Cox MC, Acharya MR, Figg WD. Herbal remedies in the United States: potential adverse interactions with anticancer agents. J Clin Oncol. 2004;22(12):2489-503. https://doi.org/10.1200/JCO.2004.08.182
8. Mathijssen R, Verweij J, de Brujin P, Loos W, Sparreboom A. Effects of St. John’s wort on irinotecan metabolism. J Natl Cancer Inst. 2002;94(16):1247-9. https://doi.org/10.1093/jnci/94.16.1247
9. Li M, Zhang Z, Hill DL, Wang H, Zhang R. Curcumin, a dietary component, has anticancer, chemosensitization, and radiosensitization effects by down-regulating the MDM2 oncogene through the PI3K/mTOR/ETS2 pathway. Cancer Res. 2007;67(5):1988-96. https://doi.org/10.1158/0008-5472.CAN-06-3066
10. Hoshyar R, Mahboob Z, Zarban A. The antioxidant and chemical properties of Berberis vulgaris and its cytotoxic effect on human breast carcinoma cells. Cytotechnology. 2016;68(4):1207-13. https://doi.org/10.1007/s10616-015-9880-y
11. Adams M, Jewell A. The use of complementary and alternative medicine by cancer patients. Int Sem Surg Oncol. 2007;4:10. https://doi.org/10.1186/1477-7800-4-10
12. García-Padilla P, García-Padilla D, Ramírez-Castro MF, Pulido-Rincón P, Murillo R. Patient-doctor interactions around alternative and complementary medicine in the context of oncology care in a Latin American country. Complement Ther Med. 2023;78:1-8. https://doi.org/10.1016/j.ctim.2023.102986
13. Spadacio C, de Barros NF. Use of complementary and alternative medicine by cancer patients: systematic review. Rev Saúde Pública. 2008;42(1):1-7. https://doi.org/10.1590/s0034-89102008000100023
14. Pardo C, Cendales R. Incidencia, mortalidad y prevalencia de cáncer en Colombia, 2012-2016 [Internet]. Vol. 1. Bogotá: Instituto Nacional de Cancerología; 2022. Available from: https://www.cancer.gov.co/recursos_user/files/libros/archivos/LIBRO_DIGITAL_1_INCIDENCIA,_MORTALIDAD_Y_PREVALENCIA_INC.pdf.pdf
15. Pardo C, Guzmán J, Rodríguez O. Cáncer en la Unidad de Cancerología de Huila, 2006-2008. Rev Colomb Cancerol. 2013;17(2):62-8. https://doi.org/10.35509/issn.0123-9015
16. Fondo Colombiano de Enfermedades de Alto Costo Cuenta de Alto Costo (CAC). Situación del cáncer en la población adulta atendida en el SGSSS de Colombia 2022 [Internet]. Bogotá; 2023. Available from: https://cuentadealtocosto.org/publicaciones/situacion-del-cancer-en-la-poblacion-adulta-atendida-en-el-sgsss-de-colombia-2022/
17. Zapata-Ossa H de J, Cubides-Munévar AM, López MC, Pinzón-Gómez EM, Filigrana-Villegas PA, Cassiani-Miranda CA. Muestreo por conglomerados en encuestas poblacionales. Rev Salúd Pública [Internet]. 2011;13(1):141-51. Available from: http://www.redalyc.org/articulo.oa?id=42219906012
18. Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103-208. https://doi.org/10.1016/j.jbi.2019.103208
19. Van Rossum G, Drake Jr FL. Python reference manual. Amsterdam: Centrum voor Wiskunde en Informatica Amsterdam; 1995.
20. R Core Team. R: a language and environment for statistical computing [Internet]. Vienna, Austria: R Foundation for Statistical Computing; 2023. Available from: https://www.R-project.org
21. López G, Salas CA, Cádiz F, Barriga C, González P, Acevedo S, et al. Complementary and integrative medicine use in individuals seeking conventional medical oncology care in Chile: prevalence and patient characteristics. J Glob Oncol. 2019;5. https://doi.org/10.1200/JGO.18.00190.
22. Santiváñez-Acosta R, Valenzuela-Oré F, Angulo-Bazán Y. Uso de terapias de medicina alternativa y complementaria en la provincia de Coronel Portillo, Ucayali, Perú. Rev Peru Med Exp Salud Publica. 2020;37(3):510-15. https://doi.org/10.17843/rpmesp.2020.373.4939.
23. Idoyaga A, Luxardo N. Medicinas no convencionales en cáncer. Medicina (B Aires) [Internet]. 2005;65(5):390-4. Available from: http://www.scielo.org.ar/pdf/medba/v65n5/v65n5a02.pdf
24. Källman M, Bergström S, Carlsson T, Järås J, Holgersson G, Nordberg JH, et al. Use of CAM among cancer patients. BMC Complement Med Ther. 2023;23:51. https://doi.org/10.1186/s12906-023-03876-2
25. Molassiotis A, Fernadez-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, et al. Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol. 2005;16(4):655-63. https://doi.org/10.1093/annonc/mdi110
26. Juanbeltz R, Pérez-Fernández MD, Bianka T, Cruz S, Sarobe MT. Complementary medicine use in cancer patients receiving intravenous antineoplastic treatment. Farm Hospit. 2017;41(5):589-600. https://doi.org/10.7399/fh.10805
27. Helyer L, Chin S, Chui B, Fitzgerald B, Verma S, Rakovitch E, et al. The use of complementary and alternative medicines among patients with locally advanced breast cancer: a descriptive study. BMC Cancer. 2006;6(39):1-8. https://doi.org/10.1186/1471-2407-6-39
28. Marshik PL, Kharat AA, Jakeman B, Borrego ME, Dodd MA, Bachyrycz AM, et al. Complementary and alternative medicine and therapy use in a diverse New Mexican population. J Altern Complement Med. 2016;22(1):45-51. https://doi.org/10.1089/acm.2014.0378
29. Wode K, Henriksson R, Sharp L, Stoltenberg A, Nordberg JH. Cancer patients’ use of complementary and alternative medicine in Sweden: a cross-sectional study. BMC Complement Med Ther. 2019;19. https://doi.org/10.1186/s12906-019-2452-5
30. Kim JS, Kwon JH, Rha SY, Lee SC, Chang YJ, Kwon IS, et al. Status of using complementary and alternative medicine among patients with cancer in Korea: an online survey of online cancer support groups (KCSG PC21-20). Cancer Res Treat. 2023;55(2):442-51. https://doi.org/10.4143/crt.2022.1483
31. Hvidberg L, Nielsen C, Fischer A, Vedsted P. Barriers to healthcare seeking, beliefs about cancer and the role of socio-economic position: a Danish population-based study. Prev Med. 2015;71:107-13. http://dx.doi.org/10.1016/j.ypmed.2014.12.0070
32. Dufter SA, Hübner J, Ahmadi E, Zomorodbakhsch B. Traits of cancer patients and CAM usage. J Cancer Res Clin Oncol. 2021;147:3685-92. https://doi.org/10.1007/s00432-021-03605-7
33. Li L, Jianzhong H, Yao L. Snake venoms in cancer therapy: past, present and future. Toxins. 2018;10(9):1-8. https://doi.org/10.3390/toxins10090346
34. Pérez-Peinado C, Defaus S, Andreu D. Hitchhiking with nature: snake venom peptides to fight cancer and superbugs. Toxins. 2020;12(4):1-23. https://doi.org/10.3390/toxins12040255
35. Asiimwe JB, Nagendrappa PB, Atukunda EC, Kamatenesi MM, Nambozi G, Tolo CU, et al. Prevalence of the use of herbal medicines among patients with cancer: a systematic review and meta-analysis. J Evid Based Complement Altern Med: eCAM. 2021;2021:1-19. https://doi.org/10.1155/2021/9963038
1. NCCIH: Centro Nacional de Salud Complementaria e Integrativa. Salud complementaria, alternativa o integral: ¿qué hay detrás de estos nombres? [Internet]. 2023. Available from: https://www.nccih.nih.gov/health/espanol/salud-complementaria-alternativa-o-integral-que-significan-estos-terminos
2. Kristoffersen AE, Nilsen JV, Stub T, Nordberg JH, Wider B, Mora DC, et al. Use of complementary and alternative medicine in the context of cancer; prevalence, reasons for use, disclosure, information received, risks and benefits reported by people with cancer in Norway. BMC Complement Med Ther. 2022;22(1). https://doi.org/10.1186/s12906-022-03606-0
3. Harris PE, Cooper K, Relton C, Thomas KJ. Prevalence of complementary and alternative medicine (CAM) use by the general population: a systematic review and update. Int J Clin Pract. 2012;66. https://doi.org/10.1111/j.1742-1241.2012.02945.x
4. Sánchez R, Venegas M. Aproximaciones complementarias y alternativas al cuidado de la salud en el Instituto Nacional de Cancerología: estudio de prevalencia. Rev Colomb Cancerol. 2010;14(3):135-43. https://doi.org/10.35509/issn.0123-9015
5. Murillo R, Pinto-Martínez N, Serrano N, Uribe C, Navarro E, Duque J, et al. Use of complementary and alternative medicine by cancer patients in Colombia. BMC Complement Med Ther. 2023;23:321. https://doi.org/10.1186/s12906-023-04144-z
6. García-Padilla P, Reyes CO, Medina P, Deaza GF, Morales OL, Murillo R. Perspectivas de pacientes y profesionales en torno al uso de medicinas alternativas y complementarias para el cuidado del cáncer: un estudio exploratorio. Univ Med. 2021;62(1). https://doi.org/10.11144/Javeriana.umed62-1.pppu
7. Sparreboom A, Cox MC, Acharya MR, Figg WD. Herbal remedies in the United States: potential adverse interactions with anticancer agents. J Clin Oncol. 2004;22(12):2489-503. https://doi.org/10.1200/JCO.2004.08.182
8. Mathijssen R, Verweij J, de Brujin P, Loos W, Sparreboom A. Effects of St. John’s wort on irinotecan metabolism. J Natl Cancer Inst. 2002;94(16):1247-9. https://doi.org/10.1093/jnci/94.16.1247
9. Li M, Zhang Z, Hill DL, Wang H, Zhang R. Curcumin, a dietary component, has anticancer, chemosensitization, and radiosensitization effects by down-regulating the MDM2 oncogene through the PI3K/mTOR/ETS2 pathway. Cancer Res. 2007;67(5):1988-96. https://doi.org/10.1158/0008-5472.CAN-06-3066
10. Hoshyar R, Mahboob Z, Zarban A. The antioxidant and chemical properties of Berberis vulgaris and its cytotoxic effect on human breast carcinoma cells. Cytotechnology. 2016;68(4):1207-13. https://doi.org/10.1007/s10616-015-9880-y
11. Adams M, Jewell A. The use of complementary and alternative medicine by cancer patients. Int Sem Surg Oncol. 2007;4:10. https://doi.org/10.1186/1477-7800-4-10
12. García-Padilla P, García-Padilla D, Ramírez-Castro MF, Pulido-Rincón P, Murillo R. Patient-doctor interactions around alternative and complementary medicine in the context of oncology care in a Latin American country. Complement Ther Med. 2023;78:1-8. https://doi.org/10.1016/j.ctim.2023.102986
13. Spadacio C, de Barros NF. Use of complementary and alternative medicine by cancer patients: systematic review. Rev Saúde Pública. 2008;42(1):1-7. https://doi.org/10.1590/s0034-89102008000100023
14. Pardo C, Cendales R. Incidencia, mortalidad y prevalencia de cáncer en Colombia, 2012-2016 [Internet]. Vol. 1. Bogotá: Instituto Nacional de Cancerología; 2022. Available from: https://www.cancer.gov.co/recursos_user/files/libros/archivos/LIBRO_DIGITAL_1_INCIDENCIA,_MORTALIDAD_Y_PREVALENCIA_INC.pdf.pdf
15. Pardo C, Guzmán J, Rodríguez O. Cáncer en la Unidad de Cancerología de Huila, 2006-2008. Rev Colomb Cancerol. 2013;17(2):62-8. https://doi.org/10.35509/issn.0123-9015
16. Fondo Colombiano de Enfermedades de Alto Costo Cuenta de Alto Costo (CAC). Situación del cáncer en la población adulta atendida en el SGSSS de Colombia 2022 [Internet]. Bogotá; 2023. Available from: https://cuentadealtocosto.org/publicaciones/situacion-del-cancer-en-la-poblacion-adulta-atendida-en-el-sgsss-de-colombia-2022/
17. Zapata-Ossa H de J, Cubides-Munévar AM, López MC, Pinzón-Gómez EM, Filigrana-Villegas PA, Cassiani-Miranda CA. Muestreo por conglomerados en encuestas poblacionales. Rev Salúd Pública [Internet]. 2011;13(1):141-51. Available from: http://www.redalyc.org/articulo.oa?id=42219906012
18. Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103-208. https://doi.org/10.1016/j.jbi.2019.103208
19. Van Rossum G, Drake Jr FL. Python reference manual. Amsterdam: Centrum voor Wiskunde en Informatica Amsterdam; 1995.
20. R Core Team. R: a language and environment for statistical computing [Internet]. Vienna, Austria: R Foundation for Statistical Computing; 2023. Available from: https://www.R-project.org
21. López G, Salas CA, Cádiz F, Barriga C, González P, Acevedo S, et al. Complementary and integrative medicine use in individuals seeking conventional medical oncology care in Chile: prevalence and patient characteristics. J Glob Oncol. 2019;5. https://doi.org/10.1200/JGO.18.00190.
22. Santiváñez-Acosta R, Valenzuela-Oré F, Angulo-Bazán Y. Uso de terapias de medicina alternativa y complementaria en la provincia de Coronel Portillo, Ucayali, Perú. Rev Peru Med Exp Salud Publica. 2020;37(3):510-15. https://doi.org/10.17843/rpmesp.2020.373.4939.
23. Idoyaga A, Luxardo N. Medicinas no convencionales en cáncer. Medicina (B Aires) [Internet]. 2005;65(5):390-4. Available from: http://www.scielo.org.ar/pdf/medba/v65n5/v65n5a02.pdf
24. Källman M, Bergström S, Carlsson T, Järås J, Holgersson G, Nordberg JH, et al. Use of CAM among cancer patients. BMC Complement Med Ther. 2023;23:51. https://doi.org/10.1186/s12906-023-03876-2
25. Molassiotis A, Fernadez-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, et al. Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol. 2005;16(4):655-63. https://doi.org/10.1093/annonc/mdi110
26. Juanbeltz R, Pérez-Fernández MD, Bianka T, Cruz S, Sarobe MT. Complementary medicine use in cancer patients receiving intravenous antineoplastic treatment. Farm Hospit. 2017;41(5):589-600. https://doi.org/10.7399/fh.10805
27. Helyer L, Chin S, Chui B, Fitzgerald B, Verma S, Rakovitch E, et al. The use of complementary and alternative medicines among patients with locally advanced breast cancer: a descriptive study. BMC Cancer. 2006;6(39):1-8. https://doi.org/10.1186/1471-2407-6-39
28. Marshik PL, Kharat AA, Jakeman B, Borrego ME, Dodd MA, Bachyrycz AM, et al. Complementary and alternative medicine and therapy use in a diverse New Mexican population. J Altern Complement Med. 2016;22(1):45-51. https://doi.org/10.1089/acm.2014.0378
29. Wode K, Henriksson R, Sharp L, Stoltenberg A, Nordberg JH. Cancer patients’ use of complementary and alternative medicine in Sweden: a cross-sectional study. BMC Complement Med Ther. 2019;19. https://doi.org/10.1186/s12906-019-2452-5
30. Kim JS, Kwon JH, Rha SY, Lee SC, Chang YJ, Kwon IS, et al. Status of using complementary and alternative medicine among patients with cancer in Korea: an online survey of online cancer support groups (KCSG PC21-20). Cancer Res Treat. 2023;55(2):442-51. https://doi.org/10.4143/crt.2022.1483
31. Hvidberg L, Nielsen C, Fischer A, Vedsted P. Barriers to healthcare seeking, beliefs about cancer and the role of socio-economic position: a Danish population-based study. Prev Med. 2015;71:107-13. http://dx.doi.org/10.1016/j.ypmed.2014.12.0070
32. Dufter SA, Hübner J, Ahmadi E, Zomorodbakhsch B. Traits of cancer patients and CAM usage. J Cancer Res Clin Oncol. 2021;147:3685-92. https://doi.org/10.1007/s00432-021-03605-7
33. Li L, Jianzhong H, Yao L. Snake venoms in cancer therapy: past, present and future. Toxins. 2018;10(9):1-8. https://doi.org/10.3390/toxins10090346
34. Pérez-Peinado C, Defaus S, Andreu D. Hitchhiking with nature: snake venom peptides to fight cancer and superbugs. Toxins. 2020;12(4):1-23. https://doi.org/10.3390/toxins12040255
35. Asiimwe JB, Nagendrappa PB, Atukunda EC, Kamatenesi MM, Nambozi G, Tolo CU, et al. Prevalence of the use of herbal medicines among patients with cancer: a systematic review and meta-analysis. J Evid Based Complement Altern Med: eCAM. 2021;2021:1-19. https://doi.org/10.1155/2021/9963038
Cómo citar
Martínez-Ramos, N., Mariño, C., Olaya-SanMiguel, L. C., & Murillo, R. (2024). Uso de medicina alternativa en pacientes oncológicos en la ciudad de Neiva (Colombia). Universitas Medica, 65, 1–9. https://doi.org/10.11144/Javeriana.umed65.umap
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