P-5 The use of complementary and alternative medicine among colorectal cancer patients in Tunisia

The rate of complementary and alternative medicine (CAM) use among cancer patients is increasing worldwide. The aim of our study was to explore the prevalence, patterns, sociological and economic effects, harms, and benefits of this type of therapy in colorectal cancer (CRC) patients. We conducted a prospective study including patients with CRC treated in the oncology department of the military hospital of Tunis between January 2020 and August 2020. We interviewed patients after obtaining their consent. 250 patients were included. Median age was 53 years (23-76 years). 61% of them were males. The prevalence of CAM use was 68%. All patients used CAM in association with FOLFOX chemotherapy (CT). Most common methods were natural products such as Ephedra (38%), nuts (26%), honey (23%), beets (22%), and olive oil (23%). Patients reported that they used CAM to treat cancer in 62%, to enhance the immune system in 47%, and to improve appetite in 11% of cases. Adverse events were reported in 4% of patients and were mild in most cases. 54% of users spent over 50 dollars a month on CAM. The majority of CAM users (88%) have reached advanced levels of education. 85% of the patients didn’t inform their doctor of their CAM use mainly because of their fear that he would refuse these practices (35%). The prevalence of CAM use is relatively high in our population despite its expensive costs, side effects, and potential interactions with conventional treatments. Communication between doctors and patients regarding CAM use is mandatory.