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Bader Alshamsan,1 Lama Awadh Alharbi,1 Razan Ibrahim Alshudukhi,1 Fai Abdullah Alaql,1 Reema Alsweed,1 Norah Alodhaybi2 1Department of Medicine, College of Medicine, Qassim University, Buraydah, Qassim, 52571, Saudi Arabia; 2Department of Medical Oncology, Prince Faisal Cancer Center, King Fahad Specialist Hospital, Qassim Health Cluster, Buraydah, Qassim, 52366, Saudi ArabiaCorrespondence: Bader Alshamsan, Email bshmsan@qu.edu.saPurpose: Complementary and alternative medicine (CAM) is widely used by cancer patients, yet regional data from Qassim, Saudi Arabia, are lacking. This study assessed the prevalence, patterns, motivations, and predictors of CAM use among cancer patients in the region.Methods: A cross-sectional survey was conducted at Prince Faisal Cancer Center, Qassim, between February and August 2025. Eligible adults with confirmed cancer completed a culturally adapted version of the International CAM Questionnaire. CAM modalities were classified using the NCCIH/SIO framework. Descriptive statistics summarized prevalence, types, motivations, disclosure, benefits, harms, and costs. Predictors were assessed using chi-square tests and logistic regression.Results: Among 258 participants (mean age 51.6 ± 15.1 years; 57.4% female), 145 (56.2%) reported CAM use. Most described CAM as complementary (91.0%), with 6.2% as alternative, and 2.8% as integrative. Common modalities included spiritual/faith-based (91.0%; Qur’an recitation, 74.3%; Zamzam water, 72.2%), biologically based (66.7%; olive oil, 41.7%; honey, 34.7%), and traditional remedies (53.5%; camel milk, 22.2%; camel urine, 13.9%). The main motivation was belief in a cure (91.0%). Perceived benefits were reported by 58.6% (most often improved mood, 33.8%); adverse effects were rare (6.9%) and mild. Only 23.4% disclosed CAM use to physicians, and 7.6% delayed conventional therapy. Female sex (aOR 2.29, 95% CI 1.04– 5.01) and higher education (aOR 2.48, 95% CI 1.12– 5.18) independently predicted CAM use.Conclusion: CAM use was highly prevalent among cancer patients in Qassim, with faith-based and traditional practices most common. Curative expectations were widespread, but disclosure to physicians was low, creating a critical communication gap. Addressing this gap requires proactive, culturally sensitive physician–patient dialogue and integration of safe, evidence-based supportive practices into cancer care.Keywords: complementary therapies, integrative oncology, neoplasms, spiritual therapies, traditional medicine, Saudi Arabia, prevalence, patient disclosure, physician–patient communication