• Irene Teo, Michelle Chow, Isha Chaudhry, Chetna Malhotra, Semra Ozdemir, and Eric A Finkelstein.
• Department of Psychosocial Oncology (I.T.), National Cancer Centre Singapore, Singapore; Lien Centre for Palliative Care (I.T., M.C., I.C., C.M., S.O., E.A.F.), Duke-NUS Medical School, Singapore; Programme in Health Services and Systems Research (I.T., C.M., E.A.F.), Duke-NUS Medical School, Singapore. Electronic address: irene.teo@duke-nus.edu.sg.
• J Pain Symptom Manage. 2025 Jan 2.

ContextThere has been growing interest in the role of complementary and alternative medicine (CAM) as part of end-of-life care.ObjectivesThis study prospectively examined the prevalence, predictors and outcomes of ingestible CAM use among cancer patients in their last year of life in Singapore.MethodsThis study (N = 427) utilized data across 12 months (four time points) prior to patient death. Utilizing mixed effects logistic regressions, we examined sociodemographic, clinical (symptom burden) and treatment-related factors associated with CAM use. Subsequently, the association between patient quality of life (i.e., physical, social, emotional, functional well-being) and CAM use were examined.ResultsHalf of the patients (50%) reported using CAM at least once in the last year of life while 36% of patients reported using CAM in the last 3 months of life. Among CAM users, 67% reported using western herbal supplements while 56% reported using traditional Chinese medicine. Further, 27-28% of patients used CAM consistently (i.e., for six months or more). Most patients (73%) reported using CAM as a complementary treatment. Patients who were ethnically Chinese (OR: 5.59, 95% CI: 2.29-13.69), reported less financial difficulties (OR: 0.82, 95% CI: 0.69-0.98), and believed in other curative treatments for cancer (OR: 2.39, 95% CI: 1.00-5.70) were more likely to use CAM. Controlling for time, CAM use (β: 0.60, CI: 0.01-1.19) was associated with higher social well-being.ConclusionsA significant proportion of terminal cancer patients reported using CAM as a complementary treatment in the last year of life.Copyright © 2025 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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