OBJECTIVES: The use of alternative medicine is increasing worldwide with total annual expenditures on herbal medicine and/or supplements approaching 10 billion dollars in the US alone. Cancer patients often feel uncomfortable discussing the use of herbals. This survey study was designed to identify the types of herbals used, evaluate the patients' expectation of results of use, communication with the physician regarding use, out-of pocket expenditure and possible correlations between these and other demographic factors. METHODS: A survey consisting of 17 questions was developed with a list of herbal medications purchased by the patient. The instrument was administered with the assistance of a nurse or pharmacist to 450 patients in the Pre-op and Symptom and Palliative Care Clinic (SCPC), 300 and 150 respectively. The type and stage of cancer were retrieved from the chart. RESULTS: An equal number of male and female were enrolled. For those patient using herbals the mean age for the Pre-op clinic and SCPC was 60 and 55 years, respectively. Of those taking herbal medication, 41% indicated they started after their cancer diagnosis. Overall, 64-74% of patients spent $25 or less per month with an additional 23-28% spending up to $100 and 3-8% spending over $100. Patients reported taking herbal medications to cure their disease, feel more in control, help with conventional therapy, and help control symptoms. Sixty-six percent of the SCPC group and 70% of the Pre-op group had informed one of their physicians of herbal use. There were no statistical correlations between any of the demographic or other parameters report in the survey. CONCLUSION: As the use of herbal medications and other alternative treatments increase for the cancer population it is important for health care professionals to understand their use by the patient and incorporate these treatments into the patient care plan.