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