Research article

Health food store recommendations: implications for breast cancer patients

Edward Mills^1,2 , Edzard Ernst³, Rana Singh¹, Cory Ross¹ and Kumanan Wilson⁴

¹  Department of Research, Canadian College of Naturopathic Medicine, North York, Ontario, Canada

²  University of Oxford, Oxford, UK

³  Department of Complementary Medicine, University of Exeter, Exeter, UK

⁴  Department of Medicine, University of Toronto, Toronto, Ontario, Canada

author email corresponding author email

Breast Cancer Res 2003, 5:R170-R174doi:10.1186/bcr636

Published:	6 August 2003

See related Commentary: http://breast-cancer-research.com/content/5/6/300

Abstract

Background

Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer.

Methods

Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired about product safety, potential drug interactions, costs and efficacy. They also enquired about employee training related to the products.

Results

Thirty-four stores were examined. A total of 33 different products were recommended, none of which are supported by sufficient evidence of efficacy. The average cost of the products they recommended was $58.09 (CAD) (minimum $5.28, median $32.99, maximum $600) per month. Twenty-three employees (68%) did not ask whether the patient took prescription medications. Fifteen employees (44%) recommended visiting a healthcare professional (naturopaths (9), physicians (5), nutritionists (1). Three employees (8.8%) discussed potential adverse effects of the products. Eight employees (23.5%) discussed the potential for drug interactions. Two employees (5.9%) suggested a possible cure with the products and one employee (2.9%) suggested discontinuing Tamoxifen. Four employees (11.8%) recommended lifestyle changes and three employees (8.8%) recommended books for further reading on the products.

Conclusion

This study draws attention to the heterogeneity of advice provided by natural health food stores to individuals seeking treatments for breast cancer, and the safety and cost implications of some of the products recommended. Physicians should enquire carefully about the use of natural health food products by patients with breast cancer. Regulators need to consider regulations to protect vulnerable patients from incurring significant costs in their purchasing of natural health food products lacking evidence of benefit and of questionable safety.