Awareness, Use and Outlook of Complementary and Alternative Medicine (CAM) Options in an Underserved, Uninsured Minority Cancer Patient Population

Abstract

Integrative oncology aims to coordinate the delivery of conventional medicine and evidence-supported complementary and alternative medicine (CAM) to patients receiving cancer care. This field developed out of an increased interest in CAM usage among cancer patients. However, CAM use among medically underserved cancer patients remains to be well characterized. We evaluated CAM awareness as well as prevalence and characteristics of CAM use in 170 consecutive, medically underserved cancer patients presenting to a large, academic, inner-city cancer clinic, using a survey tool. Fifty-three participants declined participation and 17 survey results were incomplete. Therefore, 100 survey results were included in the final analysis. There were 65 males and 35 females in the survey with a mean age of 64.2 years. About 98% of the respondents were African American while 2% identified themselves as Hispanic. About 45% of patients had metastatic cancer, 24% had early-stage disease while 31% of patients were not aware of the stage of their cancer. About 55% patients had elementary school or lower level of education while only 16% had a college degree or higher. About 92% of respondents were unemployed. Some knowledge of CAM was reported by 22% of patients, while CAM use was reported in only 16% of patients. Female sex and college degree were significantly associated with CAM use. The most commonly used CAM modality was meditation (56%), followed by herbal remedies (31%), yoga (31%), and acupuncture (12%). Among CAM users, a majority used multiple CAM therapies. All users reported benefit from CAM use. Emotional wellbeing was the most common benefit followed by improvement in treatment related adverse effects, chemotherapy related symptoms, pain, and sleep. Even though the majority of our surveyed patients never used CAM, 90% of non-users were interested in gaining more information about the various CAM options and exploring its use and potential benefits. The majority (70%) wanted their primary oncologist to provide information about CAM options and discuss its safety and potential complementary benefit in management of their cancer and associated symptoms.

Acceptability and Use of Mind-Body Interventions Among African American Cancer Survivors: An Integrative Review

“… 26 Bari et al’s cross-sectional survey-based study included a sample of 100 survivors of any type of cancer (the majority of participants had lung cancer) who identified as coming from an uninsured, minority background; 98% of this study sample identified as African American. 11 …”

“…Four of the qualitative studies followed a focus group design, 8 , 18 , 24 , 25 one was a qualitative descriptive study, 26 and one was a cross-sectional survey-based study. 11 Yan et al’s study conducted 8 focus groups with 40 AACS (breast cancer) using a social-cognitive model to ask participants about their experiences with breast cancer survivorship and recommend culturally sensitive interventions for future survivors. 24 Smith et al’s 25 intervention focused on intervention recommendations through 4 focus groups of 60 AACS (breast cancer), and participants answered questions about barriers to socio-ecological physical activity.…”

“… 18 The descriptive study by Hamilton et al with a population (n = 31) of older (≥50 years old) AACS asked older AACS how religious songs and prayer throughout their lives affected their ability to cope with psychological stress. 26 Bari et al’s 11 cross-sectional survey-based study assessed the awareness and use of CAM among minority cancer patients (98% African American) who were uninsured.…”

“… 8 , 24 In a survey assessing AACS’ perceptions and use of CAM, Bari et al found that 16% of respondents reported using mind-body modalities, with the most commonly used being meditation (56%) and yoga (31%). 11 …”

“…Descriptive studies have demonstrated that as a group, AACS have interest in mind-body modalities, but these practices often are inaccessible to African American communities because of cost, geographical location, low socioeconomic status, and lack of knowledge or awareness. 6 - 11 …”