Traditional and Complementary Medicine Practices and Supplementary Products among Breast Cancer Patients in Sarawak: Use and Reasons for Nonuse

Abstract

Backgroud: Traditional and complementary medicine (T&CM) studies in breast cancer often combine heterogeneous practices and supplementary products, complicating interpretation of prevalence estimates. This study examined recent use of questionnaire-listed T&CM practices and supplementary products among breast cancer patients attending follow-up care in Sarawak, Malaysia, and explored variation in combined use across participant characteristics and reasons for no listed use. Methods: A cross-sectional questionnaire study was conducted among 431 adults attending breast cancer follow-up at Sarawak General Hospital from June 2023 to August 2024. Combined use was defined as reporting at least one listed T&CM practice or supplementary product during the preceding six months. Frequencies and percentages summarised reported practices, products, and reasons for no listed use. Pearson chi-square tests examined differences in combined-use status across participant characteristics. Results: Overall, 298 participants (69.1%) met the combined-use definition. However, only 51 participants (17.1% of combined users; 11.8% of the total sample) reported at least one listed traditional practice. Supplementary products predominated, especially fortified milk or colostrum (182/298, 61.1%) and vitamins or minerals (158/298, 53.0%). Combined-use status differed significantly by age group (p = .033), ethnicity (p = .018), residence (p = .018), and educational attainment (p = .048), but not household income, employment status, or cancer stage. Among 133 participants reporting no listed use, 99 (74.4%) had not considered T&CM. Conclusion: The high combined-use estimate was driven mainly by supplementary products rather than traditional therapeutic practices. Distinguishing practices from products provides a more meaningful account of patient behaviour and supports more precise, nonjudgmental oncology follow-up discussions. Future research should examine product formulation, dose, purpose, disclosure, expenditure, and timing in relation to cancer treatment within culturally diverse cancer care settings such as Sarawak.