title: Why some cancer patients choose complementary and alternative medicine instead of conventional treatment.
abstract: OBJECTIVE
  We examined cancer patients' reasons for declining all or part of recommended cancer treatment and choosing complementary and alternative medicine (CAM).
  
  
  METHODS
  This was a qualitative interview study.
  
  
  METHODS
  Fourteen cancer survivors who reported having declined all or part of the recommended conventional treatment (surgery, chemotherapy, or radiation) were included. The participants were a subset from a multi-ethnic (Asian, Native Hawaiian, and white) group of 143 adults diagnosed with cancer in 1995 or 1996 who were recruited through a population-based tumor registry and interviewed about CAM.
  
  
  METHODS
  We performed semistructured interviews regarding experience with conventional cancer treatment and providers, use of CAM, and beliefs about disease.
  
  
  RESULTS
  All participants used 3 or more types of CAM, most commonly herbal or nutritional supplements. Across the board, participants stated that their reason for declining conventional treatment was to avoid damage or harm to the body. The majority of participants also felt that conventional treatment would not make a difference in disease outcome, and some but not all participants perceived an unsatisfactory or alienating relationship with health care providers. Some participants reported that their discovery of CAM contributed to their decision to decline conventional treatment, and participants generally perceived CAM as an effective and less harmful alternative to conventional treatment.
  
  
  CONCLUSIONS
  Cancer patients may benefit from interventions (eg, patient education, improvements in physician-patient communication, and psychologic therapy) to facilitate treatment decision making through increased understanding of conventional and CAM treatments and to identify barriers to treatment for individual patients.
authors.affiliation: Cancer Research Center of Hawaii, University of Hawaii at M~noa, 1236 Lauhala St, Honolulu, HI 96813, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Shumay
authors.forename: G
authors.initials: G
authors.lastname: Maskarinec
authors.forename: H
authors.initials: H
authors.lastname: Kakai
authors.forename: C C
authors.initials: CC
authors.lastname: Gotay
mesh_terms: D000529:Complementary Therapies / Q000379:methods / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003625:Data Collection; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006254:Hawaii; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011159:Population Surveillance; D012016:Reference Values; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology