INTRODUCTION
Skin cancer is one of the most common malignancies in humans.1 There are 3 main categories of skin cancer, derived from the cell from which these cancers arise: basal cell carcinoma, squamous cell carcinoma, and cutaneous melanoma.2 The pathogenesis of skin cancer is multifactorial and involves UV exposure, environmental factors, and genetic risk factors.2 The mainstay treatment for skin cancer is surgical excision; ablative techniques, adjuvant chemotherapy, or immunotherapy may additionally play a role.2 Given the increasing prevalence of skin cancer, there are emerging novel therapies and off-label therapeutics that may be employed.2
The prevalence of CAM usage in patients with skin cancer varies widely between and within countries, though it has been estimated that about 20% of non-melanoma skin cancer patients6 and 40% to 50% of melanoma patients4 have used a form of CAM at some point. Understanding the frequency and patterns of CAM use in cancer patients is essential to assess its implications in oncological care given the potential for CAM to interact with cancer treatments, either through reduction of efficacy or enhancement of adverse effects.7 Given the investigative nature of complementary and alternative medicine, and the paucity of randomized controlled trials evaluating its effects on cancer treatment in humans, a scoping review style was pursued. The purpose of this paper is to provide a review of studies that evaluated the prevalence of, and characteristics associated with biologically based CAM use in patients with skin cancer, and to offer insight into the importance of recognizing and acknowledging patient use.
Dermatology patients have been shown to have a growing interest in complementary and alternative medicine (CAM) therapies.1,3 Reasons for CAM use are vast, including but not limited to restoring physical strength, enhancing the immune system, minimizing side effects of anticancer therapies, and treating cancer.4 Complementary medicine is described by The National Center for Complementary and Integrative Health as a non-mainstream therapy that is used in conjunction with conventional therapy; alternative medicine is considered a non-mainstream therapy that is utilized instead of conventional medicine.5 For this review, complementary and alternative medicine will be used in conjunction or interchangeably unless otherwise specified. There are approximately 4 categories of CAM: nutritional (eg, dietary supplements, herbs, and probiotics), psychological (eg, meditation), physical (eg, massage), and other (eg, Chinese medicine, homeopathy, ayurvedic medicine, and naturopathy). Nutritional therapies were previously categorized as natural products, as these are the types of agents commonly employed in this approach.5 However, definitions of CAM vary widely across the literature. For this review, the term "biologically based CAM" encompasses products such as nutritional CAM, natural products, homeopathy, Ayurvedic medicine, and Chinese herbs.
The prevalence of CAM usage in patients with skin cancer varies widely between and within countries, though it has been estimated that about 20% of non-melanoma skin cancer patients6 and 40% to 50% of melanoma patients4 have used a form of CAM at some point. Understanding the frequency and patterns of CAM use in cancer patients is essential to assess its implications in oncological care given the potential for CAM to interact with cancer treatments, either through reduction of efficacy or enhancement of adverse effects.7 Given the investigative nature of complementary and alternative medicine, and the paucity of randomized controlled trials evaluating its effects on cancer treatment in humans, a scoping review style was pursued. The purpose of this paper is to provide a review of studies that evaluated the prevalence of, and characteristics associated with biologically based CAM use in patients with skin cancer, and to offer insight into the importance of recognizing and acknowledging patient use.
