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Lack of discussion about the decision to screen for prostate cancer and general lack of culturally appropriate communication with healthcare providers has engendered distrust, created fear, fostered disconnect, and increased the likelihood of nonparticipation in prostate cancer screening among black men.

Introduction The high prevalence of complementary and alternative medicine (CAM) use among cancer patients (40 – 83%) receiving conventional treatment and the complex relationship between the psychosocial factors that may contribute to or result from CAM use requires further understanding. We conducted a descriptive mixed-methods pilot study to understand CAM practices, attitudes and beliefs among cancer patients at the Loma Linda University Medical Center (LLUMC). Methods This was the qualitative phase of the study and no hypotheses were set. Twenty-three face-to-face interviews were conducted and thematic coding was used to analyze 22 interview transcriptions. There were fourteen CAM users (64%) and eight non-users (36%). Findings The themes present among those who used CAM were: physicians viewed as one aspect of health care options, a holistic view on wellbeing, satisfaction with CAM use, and three key coping methods (confrontive, supportive, and optimistic) to confront cancer. Themes were not independent of each other. Two themes were present among nonusers; nonusers trusted their physician and were more likely to express evasive coping methods. Discussion Perceptions and behavioral patterns are complex predictors of CAM use. A better understanding of CAM, medical pluralism, and the perceptions of patients would help health care providers deliver a better quality of care. The promotion of integrative care may help health care providers better identify medical pluralism and would shift focus to patient-centered care.

This case study reflects on the variety of approaches to health care in a pluralistic immigrant urban enclave in Southern California. In-depth interviews were conducted with a Mexican immigrant woman to explore and understand her health worldview and the strategies she uses in deciding among the diverse health care options available to protect and maintain her family's health. Kleinman's typology of health sectors (professional, folk, and popular) is applied to the popular healing practices of the key informant and her own health-seeking behaviors. These expose the conflict between a professional community that relies on categories and binary comparisons and the existence of multiple, simultaneous health care sectors. This case study highlights the paradoxical world of health and illness in a pluralistic medical setting and how those who reside in an environment where medical syncretism exists apparently see their options very differently from their professional health care providers.

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