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


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.


RESULTS
Physicians were more likely (p<0.001) than patients to attribute CAM use to hope (chi2=17.7), control (chi2=17.5), incurable disease (chi2=42.8), or a nontoxic approach (chi2=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 (chi2=72.2) or quality of life (chi2=17.1), cured disease (chi2=42.5), or prolonged life (chi2=58.4). Physicians and patients responded differently (p<0.005) on reasons for nondisclosure. Physicians believed patients felt CAM discussions were unimportant (chi2=7.9) and physicians would not understand (chi2 =48.1), discontinue treatment (chi2=26.4), discourage or disapprove of the use (chi2=131.7); patients attributed nondisclosure to their uncertainty of its benefit (chi2=10.4) and never being asked about CAM (chi2=9.9) by physicians. Physicians were more likely (chi2=9.5, p<0.002) to warn of risks and less likely (chi2=23.5, p<0.001) to encourage use than patients perceived.


CONCLUSIONS
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.
Richardson
Mary Ann
MA
National Foundation for Alternative Medicine, Washington, DC 20006, USA. marich@nfam.org
Mâsse
Louise C
LC
Nanny
Kelly
K
Sanders
Christina
C
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D016009:Chi-Square Distribution; D000529:Complementary Therapies / Q000379:methods* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D011336:Probability; D011379:Prognosis; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014481:United States