Views on Alternative Medicines Predict Use in Cancer Patients

A survey of cancer patients showed that patients’ beliefs and attitudes about complementary and alternative medicines explained the use of these medicines more so than demographics and patients’ clinical characteristics. The study, published in Cancer, suggests that shaping complementary and alternative medicine programs via patients’ beliefs about these approaches may be more effective and result in better patient-centered care.

Of the patients surveyed, 58.5% had used some form of alternative medicine since their cancer diagnosis.

According to Jun Mao, MD, Joshua Bauml, MD, both of the Abramson Cancer Center at the University of Pennsylvania’s Perelman School of Medicine, and colleagues, the results could help cancer centers and hospitals develop more accessible and effective integrative oncology care for patients.

An age of ≤ 65 years, female sex, and college education were all associated with a significantly greater expected benefit from complementary approaches (P < .0001 for all factors). Active employment also had a greater expected benefit (P < .001). Patients with these characteristics also showed fewer perceived barriers to accessing these types of medicines.

According to the study authors, this was the first study to report clinical and demographic patient factors associated with patients’ beliefs on complementary and alternative medicines.

“We found that specific attitudes and beliefs-such as expectation of therapeutic benefits, patient-perceived barriers regarding cost and access, and opinions of patients’ physicians and family members-may predict patients’ use of complementary and alternative medicine following cancer diagnoses,” said Mao in a statement.

The fact that the attitudes on alternative medicines varied by factors such as patient race, sex, and education level underscores the need for individualized approaches to integrating these types of medicines into oncology care, according to Mao.

As many as 67% of cancer survivors use some form of alternative medicine, according to some measures. Recent studies have supported the utility of several forms of complementary and alternative medicine approaches-such as yoga and acupuncture-for the mitigation of several cancer-related toxicities. These studies have facilitated the integration of these approaches into the hospital setting-known as integrative oncology-and cancer centers are beginning to conduct more research on these typically non-traditional approaches to rigorously test their utility for cancer patients.

Mao, Bauml, and colleagues surveyed 969 patients between June 2010 and September 2011. Patients completed a 20-minute survey using the Attitudes and Beliefs about Complementary and Alternative Medicine (ABCAM) instrument.

Patients were all ≥ 18 years old and had a primary diagnosis of cancer. Of the patients, 63.4% were female and 78.6% were white.

Patients had breast, gastrointestinal, and lung cancers at about equal proportions. Of the patients, 45.2% had metastatic disease.

Non-white patients reported more perceived barriers to the use of these alternative medicines compared with their white counterparts. Reasons for barriers included transport to alternative medicine appointments and concerns about side effects.

Patients who were treated with chemotherapy were more likely to have perceived barriers to alternative medicine use (P = .024).

“By aligning with patients’ expectations, removing unnecessary structural barriers, and engaging patients’ social and support networks, we can develop patient-centered clinical programs that better serve diverse groups of cancer patients regardless of sex, race, and education levels,” said Bauml in a statement.