Roxanne Nelson

October 29, 2013

VANCOUVER, British Columbia — Nearly half of all cancer patients (47%) have used complementary and alternative medicine (CAM), but the overwhelming majority did not have a healthcare professional speak to them about it, according to survey results presented here at the 10th International Conference of the Society for Integrative Oncology.

CAM is an umbrella phrase that encompasses a wide range of measures, such as acupuncture and yoga, that are not considered part of conventional medicine.

Previous surveys have shown that there is a great deal of interest in these therapies among cancer patients but that they might not be getting the information they need from practitioners.

Investigators surveyed 481 cancer patients and 100 healthcare practitioners at outpatient clinics.

Only about 1 of 5 practitioners who responded to the survey said that they were knowledgeable about CAM or prepared to address it with patients. Nonetheless, practitioners overall expressed positive attitudes toward CAM, with 90% wanting education on the measures.

Thus, the investigators conclude, there is a strong need for educational resources for patients and practitioners and support for greater integration of CAM into conventional medicine.

"There is high patient use and interest, but clearly unmet needs," said investigator Linda Carlson, PhD, CPsych, director of research and clinical psychologist at the Department of Psychosocial Resources at the Tom Baker Cancer in Calgary, Alberta, Canada. "There is also a willingness among practitioners."

Dr. Carlson's team undertook this project to replicate a survey that had been conducted a few years ago in British Columbia. "In that survey, 51% of patients reported using some type of CAM," she said.

Both Patients and Practitioners Surveyed

In the survey, patients were asked about their use of CAM, their motivations for use, barriers to use, patient–practitioner interactions, and their interest in resources.

Providers were asked about patient–practitioner interactions, their knowledge about CAM, their opinions and beliefs about CAM, and their degree of training in this area.

Dr. Carlson pointed out that this survey was different from others because both patients and their providers were included. The majority of patients participating in the surgery had gynecologic, breast, or colorectal cancer.

Half the healthcare practitioners were women, and the 2 largest groups of respondents were oncologists and nurses.

Patients using CAM were more likely to be women, to be younger, to be more educated, and to have been diagnosed with cancer for a longer time. The most commonly used CAMs were the biologically based therapies, such as herbs and supplements, and many were also using mind–body techniques. "Fewer were using specialized medical systems," she said.

The main reasons patients used CAM after their diagnosis were to improve their quality of life (65%) and because it was recommended by family and friends (44%). The biggest barriers to CAM use were financial, followed by a lack of knowledge about the therapies and the uncertainty about the evidence.

There were problems in communication between patient and provider. "That is quite shocking, in my mind," Dr. Carlson noted. "People who sought information tended to get it, but it wasn't readily available to them."

The majority (80%) of patients reported that they had not had a healthcare practitioner speak to them on this subject, and few felt they had received enough information (16%) or support (14%). In addition, 73% of patients indicated that they would use a CAM education program.

Providers Not Prepared

A minority of providers really felt prepared (18%), and about 70% said that they are not prepared to monitor use. "No one feels very knowledgeable about these things," Dr. Carlson pointed out.

But overall, this sample actually had quite positive opinions from practitioners, she noted. "Only 31% had any training, and these were mostly small conferences, seminars, and in-services, so they see the gap and want to help patients," said Dr. Carlson. "But 90% reported interest in receiving CAM education."

10th International Conference of the Society for Integrative Oncology (SIO): Abstract 93. Presented October 21, 2013.

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