Use of biologically based complementary medicines in patients with neuroendocrine tumors

Scand J Gastroenterol. 2019 Aug;54(8):998-1002. doi: 10.1080/00365521.2019.1646799. Epub 2019 Aug 1.


Background: Biologically based complementary medicines (BB-CMs) are popular in patients with cancer. However, there are only limited data for BB-CMs in patients with neuroendocrine tumors (NET). We aimed to identify the prevalence and type of BB-CM use and the association to the nutritional risk score (NRS-2002) in NET patients. Methods: We performed a cross-sectional questionnaire study in NET outpatients at the Department of Hepatology and Gastroenterology at Aarhus University Hospital. The nutritional risk was determined by the NRS-2002. Results: We included 186 patients (51% women, median age 66 years). Sixty-six percent were regular BB-CM users. Forty-two percent used at least two supplements. The most popular BB-CMs were vitamin and mineral supplements (47%), calcium and vitamin D (34%). One-third used non-vitamin non-mineral supplements such as fish oil, herbs, Ginger, Q-10, garlic and probiotics. The use of BB-CMs was associated with female gender (48% vs. 37%, p < .05). Intake was significantly more frequent among patients with an NRS score ≥ 3, (60% vs. 76%) and in patients with change in performance status (58% vs. 76%), (p < .05, all). Patients reporting dietary changes used BB-CMs more frequently than patients without dietary changes (61% vs. 77%) (p < .05). Conclusions: In our study, 66% percent of NET patients use BB-CM and 42% used two or more supplements. Vitamins with and without herbal ingredients, minerals, calcium, vitamin D, and fish oil were the most popular supplements. The use of BB-CMs was associated with an NRS score ≥ 3, change in dietary intake, female gender, and change in ECOG performance status.

Keywords: Neuroendocrine tumor; biologically based complementary medicines (BB-CMs); cancer; herbal; herbal medicine; supplements and NETs; supplements use in neuroendocrine tumors; vitamins and minerals.

MeSH terms

  • Aged
  • Complementary Therapies*
  • Cross-Sectional Studies
  • Denmark
  • Dietary Supplements*
  • Female
  • Fish Oils / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Minerals / therapeutic use
  • Neuroendocrine Tumors / drug therapy*
  • Nutrition Assessment*
  • Nutritional Status
  • Phytotherapy
  • Surveys and Questionnaires
  • Vitamin D / therapeutic use


  • Fish Oils
  • Minerals
  • Vitamin D