PURPOSE: Oncologists are aware that their patients use complementary/alternative medicine (CAM). As cancer incidence rates and survival time increase, use of CAM will likely increase. This study assessed the prevalence and predictors of CAM use in a comprehensive cancer center. SUBJECTS AND METHODS: Subjects were English-speaking cancer patients at least 18 years of age, attending one of eight outpatient clinics at The University of Texas M.D. Anderson Cancer Center, Houston, TX, between December 1997 and June 1998. After giving written informed consent, participants completed a self-administered questionnaire. Differences between CAM users and nonusers were assessed by χ2 and univariate logistic regression analysis. A multivariate logistic regression model identified the simultaneous impact of demographic, clinical, and treatment variables on CAM use; P values were two-sided. RESULTS: Of the 453 participants (response rate, 51.4%), 99.3% had heard of CAM. Of those, 83.3% had used at least one CAM approac...

Complementary/Alternative Medicine Use in a Comprehensive Cancer Center and the Implications for Oncology

BACKGROUND

Complementary/alternative cancer treatments are believed to be prevalent. However, reliable prevalence rates do not exist. The aim of this review was to summarize the existing data on this topic.



METHODS

A series of computerized literature searches was performed to locate all published studies documenting the prevalence of complementary and/or alternative therapy (CAM) use among patients with cancer.



RESULTS

A total of 26 surveys from 13 countries, including 4 studies of pediatric patients, was retrieved. The use of CAM therapies in adult populations ranged from 7-64%. The average prevalence across all adult studies was 31.4%.



CONCLUSIONS

This large degree of variability most likely is due to different understandings of "complementary/alternative medicine" on the part of both investigators and patients. It is likely that the results of the current study reflect the primarily adjunctive use of CAM treatments. Future studies should use a standardized protocol to determine the true prevalence of these therapies more closely. Cancer 1998;83:777-782. © 1998 American Cancer Society.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/%28SICI%291097-0142%2819980815%2983%3A4%3C777%3A%3AAID-CNCR22%3E3.0.CO%3B2-O

The prevalence of complementary/alternative medicine in cancer: a systematic review.

These guidelines update previous guidance published in 2005. They have been revised by a group who are members of the UK and Ireland Neuroendocrine Tumour Society with endorsement from the clinical committees of the British Society of Gastroenterology, the Society for Endocrinology, the Association of Surgeons of Great Britain and Ireland (and its Surgical Specialty Associations), the British Society of Gastrointestinal and Abdominal Radiology and others. The authorship represents leaders of the various groups in the UK and Ireland Neuroendocrine Tumour Society, but a large amount of work has been carried out by other specialists, many of whom attended a guidelines conference in May 2009. We have attempted to represent this work in the acknowledgements section. Over the past few years, there have been advances in the management of neuroendocrine tumours, which have included clearer characterisation, more specific and therapeutically relevant diagnosis, and improved treatments. However, there remain few randomised trials in the field and the disease is uncommon, hence all evidence must be considered weak in comparison with other more common cancers.

https://gut.bmj.com/content/gutjnl/61/1/6.full.pdf

Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs)

Information needs and sources of information among cancer patients: a systematic review of research (1980–2003)

Objectives: To explore why cancer patients do not want or seek information about their condition beyond that volunteered by their physicians at times during their illness. Design: Qualitative study based on in-depth interviews. Setting: Outpatient oncology clinics at a London cancer centre. Participants: 17 patients with cancer diagnosed in previous 6 months. Main outcome measures: Analysis of patients9 narratives to identify key themes and categories. Results: While all patients wanted basic information on diagnosis and treatment, not all wanted further information at all stages of their illness. Three overarching attitudes to their management of cancer limited patients9 deon with life as normal and could be maintained through silence and avoiding information, especially too detailed or “unsafe” information. Charity to fellow patients, especially those seen as more needy than themselves, was expressed in the recognition that scarce resources—including information and explanations—had to be shared and meant that limited information was accepted as inevitable. Conclusions: Cancer patients9 attitudes to cancer and their strategies for coping with their illness can constrain their wish for information and their efforts to obtain it. In developing recommendations, the government9s cancer information strategy should attend to variations in patients9 desires for information and the reasons for them.

https://www.bmj.com/content/bmj/320/7239/909.full.pdf

Cancer patients' information needs and information seeking behaviour: in depth interview study

Objectives: To determine what proportion of oncology patients receiving conventional medical treatment also use complementary treatments; to assess which complementary treatments are the most popular and to assess patients9 motivation for using them; to evaluate associated advantages and risks. Design: Postal screening questionnaire followed by semistructured interview. Setting: Two hospitals in inner London. Subjects—600 unselected oncology patients aged 18 or over who had known their diagnosis of cancer for at least three months. Main outcome measures: Prevalence and demography of use of complementary therapies; patients9 motivation and expectations of complementary therapies; areas of satisfaction and dissatisfaction associated with conventional and complementary therapies. Results: 415 (69%) patients returned the questionnaire. 16% had used complementary therapies. The most popular were healing, relaxation, visualisation, diets, homoeopathy, vitamins, herbalism, and the Bristol approach. Patients using complementary therapies tended to be younger, of higher social class, and female. Three quarters used two or more therapies. Therapies were mostly used for anticipated antitumour effect. Ill effects of diets and herb treatments were described. Satisfaction with both conventional and complementary therapies was high, although diets often caused difficulties. Patients using complementary therapies were less satisfied with conventional treatments, largely because of side effects and lack of hope of cure. Benefits of complementary therapies were mainly psychological. Conclusions: A sizeable percentage of patients receiving conventional treatments for cancer also use complementary therapies. Patient satisfaction with complementary therapies, other than dietary therapies, was high even without the hoped for anticancer effect. Patients reported psychological benefits such as hope and optimism.

/pdf/pursuit-and-practice-of-complementary-therapies-by-cancer-ajn2978n37.pdf

Pursuit and practice of complementary therapies by cancer patients receiving conventional treatment

For many cancer patients and their families the experience of cancer is an intensely stressful one. Emotional support is important for most cancer patients during their illness and can be gained from different people and services. This study evaluates patients' attitudes to different sources of support and rates their satisfaction with sources already used. A total of 431 patients completed a questionnaire covering the use of different sources, including individuals, support groups and information sources. The questionnaire also incorporated validated measurements of anxiety, depression and locus of control. The results revealed that the three most important sources of emotional support were senior registrars (73%) and family (73%), followed by consultants (63%). Patients would prefer doctor- and nurse-led support groups to patient only-led groups (26% vs 12%). Pamphlets, such as the BACUP booklets, proved the most important of the informational sources sought (50%). A total of 86% of patients were satisfied or very satisfied with the emotional support received. Patients who expressed dissatisfaction with their emotional support were significantly more likely to be anxious and depressed (P < 0.001). Patients who used information sources were more likely to have a higher locus of control over the course of their disease. These results show how important the doctor's role is in the provision of emotional support.

M Cody

Papers

Pursuit and practice of complementary therapies by cancer patients receiving conventional treatment

Emotional support for cancer patients : what do patients really want ?

Evaluation of emotional support for cancer patients