Complementary and alternative approaches in palliative care: why are advanced cancer patients using them?

摘要

Introduction nnThis paper discusses why advanced cancer patients use Complementary and Alternative Medicine (CAM) and how they communicate about this with their physicians. While several studies have examined the extent of CAM use by advanced cancer patients, the reasons for CAM use have been addressed much less. nnApproach nnUsing peer-reviewed online journal databases, we conducted a search for current literature dating back to 2000 related to the use of CAM in palliative cancer care. These databases included: Pubmed, Academic Search Complete, SocIndex, Healthsource, CINAHL, Alt Healthwatch, and Academic Search Elite. Keyword combinations that were used are: Complementary medicine OR alternative medicine OR holistic medicine OR unorthodox medicine OR unproven medicine (AND) cancer OR oncology OR advanced cancer OR tumor OR malignant (AND) palliative care OR palliative OR hospice (AND) decision making. nnResults nnSeven studies were found addressing the use of CAM by advanced cancer patients.nnThe most common reasons for CAM use in advanced cancer patients are symptom relief, looking for a cure and survival/lengthening life. The studies varied widely in terms of how CAM was operationalized, as well as in terms of type of cancer diagnosis, socio-demographic characteristics, sampling strategy, and study design (mostly surveys). Generally patients would like their health care providers to initiate the discussion about CAM use and ask them about CAM use in a non-judgemental manner, listening carefully to their experiences and needs. nnDiscussion nnIt is important for physicians to be prepared to discuss CAM use with their patients and to have a basic understanding of the most common types of CAM. Patients often do not seem as concerned about evidence as health care providers. It would be to the patients’ benefit if integration of CAM modalities in palliative care becomes more readily available.