Complementary And Alternative Therapies Survey

Please take a moment to fill out this 15-question, anonymous survey. We are collecting information to better understand the use of therapies that are not typically prescribed by doctors or given in hospitals for cancer care.

Gender
Male
Female

Race
Caucasian
African American
Asian
Hispanic/Latino/a
Other

Highest Education Level
Grade School
High School
Some College
College Degree (BA, BS)
Graduate School (MD, PhD, JD)



  1. I have a diagnosis of following type of cancer (eg,breast, prostate, lung, throat etc.):


  2. I am currently getting or did get radiation therapy for my cancer.
    Yes
    No

  3. I am currently getting or did get chemotherapy for my cancer.
    Yes
    No

  4. I had surgery or am scheduled to have surgery for my cancer.
    Yes
    No

  5. I am currently enrolled in a clinical cancer trial or experimental study.
    Yes
    No

  6. After I was diagnosed with cancer, I started using or taking: (check all that apply)
    Vitamin supplements, including anti-oxidants (eg,vitamin C, E, etc)
    Herbal and/or botanical supplements (eg,saw palmetto, ginseng, etc)
    Soy foods, soy drinks, or other phytoestrogen-containing products
    Omega-3 Fatty Acid supplements, like fish oil or cod liver
    Medicinal skin balms/salves
    Acupuncture Therapy
    Massage Therapy
    Other
    Nothing
 

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