title: Indian Cancer Patients' use of Traditional, Complementary and Alternative Medicine (TCAM) and delays in presentation to Hospital.
abstract: OBJECTIVE
  A majority of Indian cancer patients are often presented with incurable diseases at the latest phase of disease progression. The use of traditional, complementary and alternative medicine (TCAM) has been identified by Indian oncologists as a potential factor for the delay in seeking health from medical practitioners but no research has been conducted to verify such claims. The aim of this study is to identify socio-demographic and disease status differences between TCAM and non-TCAM users among cancer patients in India and associated patterns of seeking professional medical help.
  
  
  METHODS
  A random survey of 825 cancer patients in one public and one private hospital was conducted in Delhi, India. Using four interviewers, a list sampling technique was used to interview every patient over a four month period, with a response rate of 80%.
  
  
  RESULTS
  The results showed that 34.3% of cancer patients had used TCAM. The results also demonstrated a statistically significant relationship between the use of TCAM and reported delay in seeking help from clinical medicine (p<0.001). On the other hand, 35.2% of TCAM users reported seeking help immediately after onset of symptoms, whereas 50% of non-users immediately sought help from conventional medicine. Furthermore, 11.5% of TCAM users reported waiting for six months or more after noticing cancer-related symptoms, while only 2.1% of non-users waited this long.
  
  
  CONCLUSIONS
  Overall, early diagnosis and intervention is critical for effective treatment of many malignancies. Delays in presentation related to the use of TCAM may be an important factor relating to the high rates of advanced disease on presentation and low survival rates in the care of Indian cancer patients. Further research is needed to explore the reasons for using TCAM and to ensure existing issues of delays in help seeking are addressed.
authors.forename: Alex
authors.initials: A
authors.lastname: Broom
authors.forename: Kr
authors.initials: K
authors.lastname: Nayar
authors.forename: Philip
authors.initials: P
authors.lastname: Tovey
authors.forename: Rashmi
authors.initials: R
authors.lastname: Shirali
authors.forename: Rakesh
authors.initials: R
authors.lastname: Thakur
authors.forename: Tulika
authors.initials: T
authors.lastname: Seth
authors.forename: Prem
authors.initials: P
authors.lastname: Chhetri