title: Use of traditional medicine and globalized complementary and alternative medicine among low-income cancer service users in Brazil.
abstract: BACKGROUND
  Complementary and alternative medicine (CAM) has become increasingly high profile in prosperous countries over the past 2 decades. Alongside this has been a renewed interest in the use of traditional medicine (TM) in poorer countries. Academic attention has tended to focus on either CAM in rich countries or indigenous TM in poorer ones. However, such a differentiation leads to a potential to gloss over global complexities, such as the study of countries where both CAM and TM are a potentially significant part of health options. Brazil is just such a country. Brazil is marked by massive socioeconomic inequalities; cancer is its second highest cause of death. To date, there has been little research on CAM/TM in cancer care in Brazil.
  
  
  OBJECTIVE
  The purpose of this study is to provide the first exploratory data on the proportion of the use of CAM and/or TM among low-income cancer service users in Brazil.
  
  
  METHODS
  A survey of cancer patients was conducted in November 2004 in a public-sector hospital in a major city in Brazil. A random sample (n = 92) was generated from a list of all appointments scheduled during that month (n = 570). Eighty-nine of the 92 patients contacted (97%) completed the questionnaire.
  
  
  RESULTS
  Of the sample, 62.9% had used at least 1 form of CAM or TM. However, this headline figure is potentially misleading. The data reveal an almost total absence of use of non-indigenous international CAM; it also shows prayer to be a major contributor to the relatively high use rate.
  
  
  CONCLUSIONS
  On the basis of this small-scale exploratory study, there is no evidence that those international CAMs ubiquitous in the West are spreading to low-income cancer service users in Brazil (despite anecdotal evidence of its increasing presence in the country generally). Moreover, when excluding prayer, use of indigenous traditional medicine was found to be relatively low. Further research is needed to examine these findings on a larger scale and to explore the relative importance of social, cultural, and economic factors behind them.
authors.affiliation: School of Healthcare, University of Leeds, United Kingdom. p.a.tovey@leeds.ac.uk
authors.forename: Philip
authors.initials: P
authors.lastname: Tovey
authors.forename: Nelson Filice
authors.initials: NF
authors.lastname: de Barros
authors.forename: Eduardo Luiz
authors.initials: EL
authors.lastname: Hoehne
authors.forename: José Barreto Campello
authors.initials: JB
authors.lastname: Carvalheira
mesh_terms: D001938:Brazil; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008519:Medicine, Traditional; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D016522:Oncology Service, Hospital; D011203:Poverty