Psycho-Oncology Psycho-Oncology 20: 746–754 (2011) Published online 19 May 2010 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.1773 Spirituality and use of complementary therapies for cure in advanced cancer Mateya Trinkaus 1,2 , Debika Burman 3,4 , Niusha Barmala 3 , Gary Rodin 3,4,5 , Jennifer Jones 3,5 , Christopher Lo 3,4 and Camilla Zimmermann 1,3,4,Ã 1 Division of Medical Oncology and Haematology, Department of Medicine, University of Toronto, Toronto, Ont., Canada 2 Department of Medical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Ont., Canada 3 Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, University Health Network, Toronto, Ont., Canada 4 Campbell Family Cancer Research Institute, Ontario Cancer Institute, Princess Margaret Hospital, University Health Network, Toronto, Ont., Canada 5 Department of Psychiatry, University of Toronto, Toronto, Ont., Canada Abstract Objective: Complementary and alternative medicine (CAM) is frequently used by patients with advanced cancer, for a variety of reasons. We examined the use of CAM in this population, and associations of use for potential cure with spiritual faith and existential well-being. Methods: Patients with advanced cancer on a palliative care unit completed a measure of spiritual well-being (existential well-being and faith), and a survey assessing complementary therapy use and reasons for such use. Information was also gathered on demographic data, previous cancer treatment, performance status, and symptom distress. Regression analyses assessed the association between the spirituality domains of existential well-being and faith, and the use of CAM for cure. Results: Of 123 participants, 85% had used CAM, 42% with curative intent. More than 95% would consider future use of CAM, 48% for potential cure. Previous use for cure predicted current interest in using CAM for cure (po0.0001). Spiritual faith was associated with previous (po0.02) and interest in future use for cure (po0.0001). Poor existential well- being was associated with interest in future use of CAM for cure (p 5 0.04). Conclusions: Interest in considering CAM for cure was relatively high in this group of inpatients on a palliative care unit, and was associated with increased spiritual faith and decreased existential well-being. Understanding factors associated with seeking CAM for cure may help health-care professionals to support and educate patients with advanced cancer. Copyright r 2010 John Wiley & Sons, Ltd. Keywords: advanced cancer; complementary and alternative medicine; faith; palliative care; spirituality; oncology Introduction Complementary and alternative medicine (CAM) is defined as medical and health-care treatments, practices, and products that are not presently considered to be part of conventional medicine, and are used together with or instead of standard treatments [1]. Examples include acupuncture, aromatherapy, homeopathy, massage therapy, herbal or vitamin supplements, therapeutic touch, meditation, music therapy, and spiritual healing [2–4]. CAM use among patients with cancer is highly prevalent and often not disclosed to health-care practitioners [5,6]. The average rate of CAM use in the general US population is approximately 38% [7], which is similar to the rate that has been reported in patients with cancer [8]. In the setting of advanced cancer, reported rates of CAM use are greater than 50% [9,10] and as high as 91% among those receiving cancer treatment [6]. Characteristics associated with CAM use in pa- tients with cancer include female gender, younger age, high income, higher education, and advanced disease [2,9]. Patients who use CAM cite multiple reasons for doing so including boosting their immune system [11,12], to increase a sense of control over the disease [13–15], and to improve symptoms or quality of life [13,16]. Patients with cancer may also turn to CAM either to improve survival [5,12,17,18] or to seek a cure [5,19]. A study investigating the portrayal of CAM in the Canadian press found that the potential to cure cancer was the most frequently described benefit [20]. Among a group of patients with cancer who were near death, the perception that CAM could * Correspondence to: Department of Psychosocial Oncology and Palliative Care, Palliative Care Services, Princess Margaret Hospital, 610 University Avenue, 16- 712, Toronto, Ont., Canada M5G 2M9. E-mail: camilla.zimmermann@ uhn.on.ca Received: 6 January 2010 Revised: 3 April 2010 Accepted: 7 April 2010 Copyright r 2010 John Wiley & Sons, Ltd.