(Using) Complementary and Alternative Medicine: The Perceptions of Palliative Patients with Cancer

Abstract

Use of complementary and alternative medicine (CAM) is increasingly common within Western societies, including Australia. This parallels calls for or claims of integration of CAM into mainstream medical practice, with oncology and palliative care specifically nominated as appropriate arenas for integration. However, there is an absence of studies examining patient perceptions of both CAM and CAM users. In this study, 28 adult patients with cancer close to death were interviewed regarding treatment decisions at the end of life, including decisions about CAM. Thematic analysis of transcribed interviews found consistent differences in talk around CAM between 12 users and 16 nonusers of CAM, primarily related to the perceived value of these treatments. Drawing upon a mind-body discourse that holds individuals responsible for their health, users valued CAM for the perceived benefit to physical or psychological well-being and compatibility with a holistic approach to health care, deemed to complement or augment conventional medicine. However, some were self-critical of their failure to continue with CAM, despite practical and financial difficulties experienced. Nonusers devalued CAM as unable to cure their disease (but did not similarly devalue conventional medicine), and negatively construed CAM users as desperate, or as challenging medical wisdom. Despite increased legitimation and medicalization of CAM, patients assess CAM differently to allopathic medicine, with different (positive and negative) assessments attributable to users. The misperception by many (nonusers) that CAM are intended to cure and available negative moral and social judgments centred around CAM use may deter patient uptake of CAM in areas where they have proven efficacy in symptom control.

Practices, Attitudes, and Beliefs Associated With Complementary and Alternative Medicine (CAM) Use Among Cancer Patients

“…As found in another study, some nonusers devalued CAM and lacked confidence in its efficacy 48 . These findings also support the literature that CAM nonusers believed the decision to use CAM was because of distrust with biomedicine 49,50 .…”

Mind–Body Therapies in Integrative Oncology

“…Mind-body interventions are defined as practices that focus on the interactions among the brain, mind, body, and behavior, with the intent to use the mind to affect physical functioning and promote overall health. The studies reviewed herein were found by means of a multipledatabase search including MEDLINE, PsycARTICLES, therapy/mind-body intervention use to their doctors for fear of offending their doctor [1]. This conclusion has some support as found in the report that some doctors do disapprove of complementary interventions [2,3].…”

Complementary and Alternative Medicine Use in Radiotherapy: What Are Patients Using?

“…24 Fear of oncologists' disapproval has been shown to be a reason for nondisclosure 5,25 of CAM use and of a reason why some patients with terminal cancer patients not taking CAMs. 26 Do doctors know what their patients are taking? Past work has shown that patient disclosure of CAM use to oncologists is in the range of 40%-60%.…”