Skip to main content

Advertisement

Log in

Discrepant views of oncologists and cancer patients on complementary/alternative medicine

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Goals

Complementary/alternative medicine (CAM) is widely used by patients but rarely discussed with oncologists. To understand reasons for the communication gap, this study compares physicians and patients on perceived reasons for CAM use and nondisclosure of use, reactions of physicians to disclosure, and expectations for CAM.

Patients and methods

Cross-sectional studies assessed 82 physicians (response 68.3%) and 244 of 374 outpatients (response 65.2%) identified as CAM users at the MD Anderson Cancer Center. Data were summarized by frequency and compared using chi-square tests.

Main results

Physicians were more likely (p<0.001) than patients to attribute CAM use to hope (χ2=17.7), control (χ2=17.5), incurable disease (χ2=42.8), or a nontoxic approach (χ2=50.9). Both physicians and patients agreed CAM could relieve symptoms/side effects, but physicians were less likely (p<0.001) than patients to expect that CAM improved immunity (χ2=72.2) or quality of life (χ2=17.1), cured disease (χ2=42.5), or prolonged life (χ2=58.4). Physicians and patients responded differently (p<0.005) on reasons for nondisclosure. Physicians believed patients felt CAM discussions were unimportant (χ2=7.9) and physicians would not understand (χ2=48.1), discontinue treatment (χ2=26.4), discourage or disapprove of the use (χ2=131.7); patients attributed nondisclosure to their uncertainty of its benefit (χ2=10.4) and never being asked about CAM (χ2=9.9) by physicians. Physicians were more likely (χ2=9.5, p<0.002) to warn of risks and less likely (χ2=23.5, p<0.001) to encourage use than patients perceived.

Conclusion

Oncologists and cancer patients hold discrepant views on CAM that may contribute to a communication gap. Nevertheless, physicians should ask patients about CAM use, discuss possible benefits, and advise of potential risks.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Adler SR, Fosket JR (1999) Disclosing complementary and alternative medicine use in the medical encounter: A qualitative study in women with breast cancer. J Fam Pract 48(6):453–458

    CAS  PubMed  Google Scholar 

  2. Ashikaga T, Bosompra K, O’Brien P, Nelson L (2002) Use of complementary and alternative medicine by breast cancer patients: prevalence, patterns and communication with physicians. Support Care Cancer 10(7):542–548

    Article  PubMed  Google Scholar 

  3. Boon H, Stewart M, Kennard M, Gray R, Sawka C, Brown J, McWilliam C, Gavin A, Baron R, Aaron D, et al (2000) Use of complementary/alternative medicine by breast cancer survivors in Ontario: prevalence and perceptions . J Clin Oncol 18:2515–2521

    Google Scholar 

  4. Bruera E, Willey J, Palmer J, Rosales M (2002) Treatment decisions for breast carcinoma: patient preferences and physician perceptions. Cancer 94:2976–3080

    Article  Google Scholar 

  5. Burstein HJ, Gelber S, Guadagnoli E, Weeks JC (1999) Use of alternative medicine by women with early-stage breast cancer. JAMA 340(22):1733–1739

    Article  CAS  Google Scholar 

  6. Charles C, Whelan T, Gafni A, Willan A, Farrell S (2003) Shared treatment decision making: waht does it mean to physicians? J Clin Oncol 21(5):932–936

    Google Scholar 

  7. Conklin K (2000) Dietary antioxidants during cancer chemotherapy: impact on chemotherapeutic effectiveness and development of side effects. Nutr Cancer 37(1):1–18

    Article  CAS  PubMed  Google Scholar 

  8. Corbin Winslow L, Shapiro H (2002) Physicians want education about complementary and alternative medicine to enhance communication with their patients. Arch Intern Med 162(10):1176–1181

    Article  PubMed  Google Scholar 

  9. Eisenberg DM (1997) Advising patients who seek alternative medical therapies. Ann Inter Med 127(1):61–69

    CAS  Google Scholar 

  10. Gotay C, Hara W, Issell B, Maskarinec G (1999) Use of complemetnary and alternative medicine in Hawaii cancer patients. Hawaii Med J 58(4):94–95

    CAS  PubMed  Google Scholar 

  11. Hyodo I, Eguchi K, Nishina T, Endo H, Tanimizu M, Mikami I, Takashima S, Imanishi J (2003) Perceptions and attitudes of clinical oncologists on complementary and alternative medicine: a nationwide survey in Japan. Cancer 97(11):2861–2868

    Article  PubMed  Google Scholar 

  12. Kappauf H, Leykauf-Ammon D, Bruntsch U, Horneber M, Kaiser G, Buschel G, Gallmeir W (2000) Use of and attitudes held towards unconventional medicine by patients in a department of internal medicine/oncology and heaemetology. Support Care Cancer 8(4):314–322

    Article  CAS  PubMed  Google Scholar 

  13. Keating N, Guadagnoli E, Landrum M, Borbas C, Weeks J (2002) Treatment decision making in early-stage breast cancer: should surgeons match patients’ desired level of involvement? J Clin Oncol 20(6):1473–1479

    Google Scholar 

  14. Kelly K, Jacobson J, Kennedy D, Braudt S, Mallick M, Weiner M (2000) Use of unconventional therapies by children with cancer at an urban medical center. J Pediatr Hematol Oncol 22(5):412–426

    Article  CAS  PubMed  Google Scholar 

  15. Lamson D, Brignall M (1999) Antioxidants in cancer therapy; their actions and interactions with oncologic therapies. Altern Med Rev 4(5):304–329

    CAS  PubMed  Google Scholar 

  16. Lee MM, Lin SS, Wrensch MR, Adler SR, Eisenberg D (2000) Alternative therapies used by women with breast cancer in four ethnic populations. J Natl Cancer Inst 92(1):42–47

    Article  CAS  PubMed  Google Scholar 

  17. Lerner IJ, Kennedy BJ (1992) The prevalence of questionable methods of cancer treatment in the United States. CA Cancer J Clin 42(3):181–191

    CAS  PubMed  Google Scholar 

  18. Mathijssen R, Verweij J, de Bruijn P, Loos W, Sparreboom A (2002) Effects of St. John’s wort on irinotecan metabolism. J Natl Cancer Inst 94(16):1247–1249

    Article  CAS  PubMed  Google Scholar 

  19. McCurdy E, Spangler J, Wofford M, Chauvenet A, McLean T (2001) Complementary and alternative therapy use in pediatric oncology patients. J Ped Hem Onc A27

  20. Morris K, Johnson N, Horner L, Walts D (2000) A comparison of complementary therapy use between breast cancer patients and patients with other primary tumor sites. Am J Surg 179:407–411

    Article  CAS  PubMed  Google Scholar 

  21. Moschen R, Kemmler G, Schweigkofler H, Holzner B, Dunser M, Richter R, Fleischhacker, Sperner-Uterweger B (2001) Use of alternative/complementary therapy in breast cancer patients- a psychological perspective. Support Care Cancer 9:267–274

    Article  PubMed  Google Scholar 

  22. Moyad M (2001) The prevalence and effectiveness of complementary and alternative medicine: what has been learned and what it may be telling us about our patients, ourselves, and conventional medical treatment. Semin Urol Oncol 19(4):257–269

    CAS  PubMed  Google Scholar 

  23. National Center for Complementary and Alternative Medicine. Expanding horizons of healthcare: The five-year NCCAM strategic plan 2001–2005. http://nccam.nih.gov/about/plans/fiveyear/index.htm. Cited 20 July 2004

  24. Powell C, Dibble S, Dall’era J, Cohen I (2002) Use of herbs in women diagnosed with ovarian cancer. Int J Gynecol Cancer 12:214–217

    Article  PubMed  Google Scholar 

  25. Rees R, Feigel I, Vickers A, Zollman C, McGurk R, Smith C (2000) Prevalence of complementary therapy use by women with breast cancer: a population-based survey. Eur J Cancer 36:1359–1364

    Article  CAS  PubMed  Google Scholar 

  26. Richardson M, Straus S (2002) Complementary and alternative medicine: Opportunities and challenges for cancer management and research. Semin Oncol 29 (6):531–535

    Article  PubMed  Google Scholar 

  27. Richardson MA, Ramirez T, Palmer JL, Greisinger A, Singletary SE (2000) Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol 18:2505–2514

    Google Scholar 

  28. Sandler R, Halabi S, Kaplan E, Baron J, Paskett E, Petrelli N (2001) Use of vitamins, minerals, and nutritional supplements by participants in a chemoprevention trial. Cancer 91:1040–1045

    Article  CAS  PubMed  Google Scholar 

  29. Sollner W, Maislinger S, DeVries A, Steixner E, Rumpold G, Lukas P (2000) Use of complementary and alternative medicine by cancer patients is not associated with perceived distress or poor compliance with standard treatment but with active coping behavior. Cancer 89(4):873–880

    Article  PubMed  Google Scholar 

  30. Sparber A (2001) Clinical center sets new policy on use of herbal and other alternative supplements by CC patients. NIH Catalyst 9(6):8–9

    Google Scholar 

  31. Sparber A, Bauer L, Curt G, Eisenerg D, Levin T, Parks S, Steinberg S, Wooton J (2002) Use of complementary medicine by adult patients participating in cancer clinical trials. Oncol Nurs Forum 27(4):623–630

    Google Scholar 

  32. Tasaki K, Maskarinec G, Shumay D, Tatsumura Y, Kakai H (2002) Communication between physicians and cancer patients about complementary and alternative medicine: exploring patients’ perspectives. Psychooncol 11( ):212–220

    Article  Google Scholar 

  33. Verhoef MJ, Hagen N, Pelletier G, Forsyth P (1999) Alternative therapy use in neurologic diseases. Neurology 52:617–622

    CAS  PubMed  Google Scholar 

  34. Von Gruenigen V, White L, Kirven M, Showalter A, Hopkins M (2000) A comparison of complementary and alternative medicine use by gynecology and gynecologic oncology patients. Int J Gynecol Cancer 11:205–209

    Google Scholar 

  35. Weiger W, Smith M, Boon H, Richardson M, Kaptchuk T, Eisenberg D (2002) Adivising patients who seek complementary and alternative medical therapies for cancer. Ann Intern Med 137:889–903

    PubMed  Google Scholar 

  36. Weijl NI, Cleton FJ, Osanto S (1997) Free radicals and antioxidants in chemotherapy-induced toxicity. Cancer Treatment Reviews 23:209–240

    Article  CAS  PubMed  Google Scholar 

  37. Zeisel S, Salganik R (1999) Special commentary: antioxidants and nutrition support. Curr Opin Clin Nutr Metab Care 2(1):1–3

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors wish to thank Drs. S. Eva Singletary and Thomas D. Brown of The MD Anderson Cancer Center for serving as protocol chairs for the patient and physician surveys, biostatisticans Lynn Palmer, PhD, of MD Anderson Cancer Center and Kim McFann, PhD, of the National Center for Complementary and Alternative Medicine for their assistance with the manuscript, and the National Center for Complementary/Alternative Medicine at the National Institutes of Health (grant number 5 U24 CA66826–03) and the National Cancer Institute for support.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mary Ann Richardson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Richardson, M.A., Mâsse, L.C., Nanny, K. et al. Discrepant views of oncologists and cancer patients on complementary/alternative medicine. Support Care Cancer 12, 797–804 (2004). https://doi.org/10.1007/s00520-004-0677-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-004-0677-3

Keywords

Navigation