title: Patient-physician communication about complementary and alternative medicine in a radiation oncology setting.
abstract: OBJECTIVE
  Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings.
  
  
  METHODS
  We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was used to identify relationships between demographic/clinical variables and patients' discussion of CAM with radiation oncologists.
  
  
  RESULTS
  Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users.
  
  
  CONCLUSIONS
  Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm.
authors.affiliation: Perelman School of Medicine at the University of Pennsylvania, Department of Radiation Oncology, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104, USA.
authors.forename: Jin
authors.initials: J
authors.lastname: Ge
authors.forename: Jessica
authors.initials: J
authors.lastname: Fishman
authors.forename: Neha
authors.initials: N
authors.lastname: Vapiwala
authors.forename: Susan Q
authors.initials: SQ
authors.lastname: Li
authors.forename: Krupali
authors.initials: K
authors.lastname: Desai
authors.forename: Sharon X
authors.initials: SX
authors.lastname: Xie
authors.forename: Jun J
authors.initials: JJ
authors.lastname: Mao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D030881:Disclosure / Q000706:statistics & numerical data*; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010817:Physician-Patient Relations; D018787:Radiation Oncology / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012737:Sex Factors; D055815:Young Adult