Background
Complementary and Alternative Medicines (CAM) use is increasing, particularly in patients with a cancer diagnosis. When taken alone, many CAM are safe, but when taken concurrently with chemotherapy, radiotherapy, or prior to surgery, serious side effects or interactions may occur.

Aim
To determine the incidence of CAM use among patients receiving chemotherapy at a metropolitan hospital, and to evaluate the effectiveness of pharmacist advice on the safety of CAM use during conventional anticancer treatment.

Method
Between April and June 2013 all patients commencing their first cycle of chemotherapy on the Chemotherapy Day Unit (CDU) were interviewed by the pharmacist to evaluate ingested and injected CAM use. All patients using CAM were given comprehensive, personalised verbal information on safety and potential drug interactions with their conventional treatment. Consenting patients were followed-up to evaluate adherence to pharmacist recommendations.

Results
152 patients were interviewed regarding CAM use. 39% (95%CI 32% to 47%) of patients were taking CAM; median number taken was 2 (range: 1-11) and total number of CAM was 141. 41% of CAM investigated had identified interactions with conventional anticancer treatments. 98% (95%CI 96% to 100%) of patients followed pharmacist recommendations relating to the safety of (dis)continuing CAM.

Conclusion
Nearly 40% of patients commencing chemotherapy were concurrently taking CAM. Of the investigated CAM, over 40% had identified interactions, presenting a significant risk to patients both in terms of toxicities and treatment efficacy. Provision of personalised advice from an oncology pharmacist is a highly effective intervention to improve patient safety.