title: Cancer patients' experiences of using complementary therapies: polarization and integration.
abstract: OBJECTIVE
  The use of complementary therapies by people with cancer is commonplace. In a recent synthesis of 26 qualitative studies of patients' experiences of complementary therapy use after a diagnosis of cancer, the emergent theme of 'polarization' was the most notable barrier to a positive experience of complementary therapies. In this paper, we explore the two synthesis concepts of 'polarization' and 'integration', and their relationship to health service policies and guidelines on integrated services.
  
  
  METHODS
  A systematic literature search and a meta-ethnography to synthesize key concepts.
  
  
  RESULTS
  The majority of patients who used complementary therapies after a diagnosis of cancer wanted to be certain that the therapies were not interfering with their conventional cancer treatment. They valued the therapies in wider terms including: taking 'a niche of control', relieving symptoms, improving wellbeing, and promoting reconnection and social interaction. The emergent theme of 'polarization' suggested that conventional physicians who are perceived to be poorly informed or negative about complementary approaches induce patient anxiety, safety concerns, and difficulties in access. They may compromise their therapeutic relationship and, rarely, they may trigger patients to abandon conventional medicine altogether. In contrast, integrated advice and/or services were highly valued by patients, although some patients preferred their complementary health care to be provided in a non-medicalized environment.
  
  
  CONCLUSIONS
  Our findings suggest that the current polarized situation is unhelpful to patients, detrimental to therapeutic relationships and may occasionally be dangerous. They indicate that complementary therapies, in a supportive role, should be integrated into mainstream cancer care.
authors.affiliation: Institute of Health Services Research, Peninsula College of Medicine and Dentistry, Universities of Exeter and Plymouth, Exeter, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Smithson
authors.forename: Charlotte
authors.initials: C
authors.lastname: Paterson
authors.forename: Nicky
authors.initials: N
authors.lastname: Britten
authors.forename: Maggie
authors.initials: M
authors.lastname: Evans
authors.forename: George
authors.initials: G
authors.lastname: Lewith
mesh_terms: D001294:Attitude to Health; D000529:Complementary Therapies / Q000523:psychology; D006291:Health Policy; D006801:Humans; D055048:Integrative Medicine; D009369:Neoplasms / Q000628:therapy*; D010352:Patient Dropouts; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D036301:Qualitative Research; D006113:United Kingdom