ISSN: 2226-3624
Open access
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.
Choi, S., Karki Kunwor, S., Im, H., Choi, D., Hwang, J., Ahmed, M., & Han, D. (2024). Traditional and complementary medicine use among cancer patients in Asian countries: A systematic review and meta-analysis. Cancers, 16(18), Article 3130.
Chui, P. L., Abdullah, K. L., Wong, L. P., & Taib, N. A. (2014). Prayer-for-health and complementary alternative medicine use among Malaysian breast cancer patients during chemotherapy. BMC Complementary and Alternative Medicine, 14, Article 425.
Cohen, J. (2013). Statistical power analysis for the behavioral sciences (2nd ed.). Routledge.
Department of Statistics Malaysia. (2023). Household income survey report 2022 (Malaysia & states).
Farooqui, M., Hassali, M. A., Shatar, A. K. A., Shafie, A. A., Tan, B. S., & Farooqui, M. A. (2012). Complementary and alternative medicine (CAM) use by Malaysian oncology patients. Complementary Therapies in Clinical Practice, 18(2), 114–120.
Greenland, S., Senn, S. J., Rothman, K. J., Carlin, J. B., Poole, C., Goodman, S. N., & Altman, D. G. (2016). Statistical tests, P values, confidence intervals, and power: A guide to misinterpretations. European Journal of Epidemiology, 31, 337–350.
Institute for Public Health. (2015). National Health and Morbidity Survey 2015 (NHMS 2015): Volume IV, traditional and complementary medicine (T&CM). Ministry of Health Malaysia. https://iku.gov.my/images/IKU/Document/REPORT/NHMS2015-VolumeIV.pdf
Johny, A. K., Cheah, W. L., & Razitasham, S. (2017). Disclosure of traditional and complementary medicine use and its associated factors to medical doctor in primary care clinics in Kuching Division, Sarawak, Malaysia. Evidence-Based Complementary and Alternative Medicine, 2017, Article 5146478.
Kong, Y.-C., Kimman, M., Subramaniam, S., Yip, C.-H., Jan, S., Aung, S., Khoa, M. T., Ngelangel, C. A., Nyein, H. L., Sangrajrang, S., Tanabodee, J., Bhoo-Pathy, N., & ACTION Study Group. (2022). Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in Southeast Asia: A prospective cohort study. The Lancet Global Health, 10(3), e416–e428.
Lim, M. S. H., Voon, P. J., Ali, A., Mohamad, F. S., Jong, L. L., Chew, L. P., Bujang, M. A., Augustin, Y., & Cheng, Y. K. (2024). Gaps in cancer care in a multi-ethnic population in Sarawak, Borneo: A central referral centre study. PLOS ONE, 19(7), Article e0296954.
McHugh, M. L. (2013). The chi-square test of independence. Biochemia Medica, 23(2), 143–149.
Mohd Mujar, N. M., Dahlui, M., Emran, N. A., Abdul Hadi, I., Wai, Y. Y., Arulanantham, S., Hooi, C. C., & Mohd Taib, N. A. (2017). Complementary and alternative medicine (CAM) use and delays in presentation and diagnosis of breast cancer patients in public hospitals in Malaysia. PLOS ONE, 12(4), Article e0176394.
National Cancer Institute. (2024, April 25). Cancer therapy interactions with foods and dietary supplements (PDQ®)—patient version. https://www.cancer.gov/about-cancer/treatment/cam/patient/dietary-interactions-pdq
National Cancer Registry Department. (2024). Summary of Malaysia National Cancer Registry Report 2017–2021. Institut Kanser Negara, Ministry of Health Malaysia. https://nci.moh.gov.my/images/pdf_folder/SUMMARY-OF-MALAYSIA-NATIONAL-CANCER-REGISTRY-REPORT-2017-2021.pdf
Saibul, N., Mohd Shariff, Z., Rahmat, A., Sulaiman, S., & Yaw, Y. H. (2012). Use of complementary and alternative medicine among breast cancer survivors. Asian Pacific Journal of Cancer Prevention, 13(8), 4081–4086.
Sekaran, U., & Bougie, R. (2010). Research methods for business: A skill-building approach (5th ed.). John Wiley & Sons.
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. PLOS Medicine, 4(10), e296.
World Health Organization. (2026, July 3). Breast cancer. https://www.who.int/news-room/fact-sheets/detail/breast-cancer
Zulkipli, A. F., Islam, T., Mohd Taib, N. A., Dahlui, M., Bhoo-Pathy, N., Al-Sadat, N., Abdul Majid, H., & Hussain, S. (2018). Use of complementary and alternative medicine among newly diagnosed breast cancer patients in Malaysia: An early report from the MyBCC study. Integrative Cancer Therapies, 17(2), 312–321.
Yap, S.-L., Wong, S. S.-L., Chew, K.-S., & Kueh, J. S.-H. (2026). Traditional and Complementary Medicine Practices and Supplementary Products among Breast Cancer Patients in Sarawak: Use and Reasons for Nonuse. International Journal of Academic Research in Economics and Management Sciences, 15(4), 86–105.
Copyright: © 2026 The Author(s)
Published by HRMARS (www.hrmars.com)
This article is published under the Creative Commons Attribution (CC BY 4.0) license. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this license may be seen at: http://creativecommons.org/licences/by/4.0/legalcode