Who is Seeking Traditional Chinese Medicine (TCM) for Cancer? Insights from a Large Cohort in a Rehabilitation Clinic

Yong Zhang,1,* Yiding Dai,2,3,* Dan Kang,1,* Qingsong Yu,4 Xiangxi Zhou,1 Xin Tian,1 Qiulong Chen,5 Yi Chen,6 Fang Liu,2 Qiuling Shi1,3 1School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Integrated Traditional Chinese and Western Medicine, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China; 3State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China; 4Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China; 5Graduate School, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China; 6School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qiuling Shi, School of Public Health, Chongqing Medical University, No. 1, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People’s Republic of China, Tel +86-18290585397, Fax +86-28-85420116, Email [email protected]: Traditional Chinese Medicine (TCM) is widely used in cancer care, yet its utilization features are not well understood. By providing a comprehensive overview of the demographic and clinical characteristics, symptom burden, HRQoL, and TCM constitution of cancer patients seeking TCM treatment, we aim to offer insights into the integration of TCM into cancer care.Patients and Methods: The questionnaire collected data on demographic and clinical characteristics, the MD Anderson Symptom Inventory for Traditional Chinese Medicine (MDASI-TCM), the EuroQol-5Dimensions-5Levels (EQ-5D-5L), and the simplified version of the Constitution in Chinese Medicine Questionnaire (CCMQ). A descriptive analysis was conducted to profile the patients’ status and expectations of TCM. Chi-square or Fisher exact tests were employed to compare the distribution of TCM constitutional types across different cancer diagnoses.Results: Among 3047 eligible patients, 2796 (median age 55) completed the questionnaire and were subsequently included in the analysis. The cohort was predominantly female (56.5%), with lung cancer being the most common primary diagnosis (25.2%). Furthermore, 86.7% of the patients presented with a good performance status (ECOG-PS ≤ 1). The main reasons patients sought TCM treatment were to alleviate cancer-related symptoms (59.4%) and enhance immune function (55.4%). The most prevalent symptoms (scored 1– 10 on a 0– 10 scale) were fatigue (81.1%), followed by disturbed sleep (81.0%), and dry mouth (78.2%). The mean and median EQ-5D-5L utility scores were 0.81 and 0.89, respectively. About 83.4% of cancer patients exhibited a deviation in TCM constitution, with Yang-deficiency being particularly common among them.Conclusion: This study highlights the symptom burden, HRQoL, TCM constitution, and characteristics of patients who pursue TCM treatment. It advances our understanding of TCM’s role in cancer rehabilitation by shedding light on target population potential needs of care. The findings provide a foundation for developing evidence-based strategies to enhance TCM application in clinical settings, optimize resource allocation, and improve rehabilitation outcomes for cancer patients.Keywords: traditional Chinese medicine, patient-reported outcomes, symptom burden, health-related quality of life, TCM constitution, cancer rehabilitation