BMJ 1994;309:86-89 (9 July)

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Pursuit and practice of complementary therapies by cancer patients receiving conventional treatment

S M Downer, oncology research sister,a M M Cody, ICRF lecturer and clinical research fellow,a P McCluskey, oncology research sister,a P D Wilson, data manager,a S J Arnott, consultant radiotherapist,a T A Lister, consultant physician,a M L Slevin, consultant physician Department of Radiotherapy, St Bartholomew's Hospital, London EC1A 7BE a

a Department of Medical Oncology, St Bartholomew's Hospital, London EC1A 7BE

Correspondence to: Dr Slevin.

Abstract

Objectives: To determine what proportion of oncology patients receiving conventional medical treatment also use complementary treatments; to assess which complementary treatments are the most popular and to assess patients' motivation for using them; to evaluate associated advantages and risks.
Design: Postal screening questionnaire followed by semistructured interview.
Setting: Two hospitals in inner London. Subjects--600 unselected oncology patients aged 18 or over who had known their diagnosis of cancer for at least three months.
Main outcome measures: Prevalence and demography of use of complementary therapies; patients' motivation and expectations of complementary therapies; areas of satisfaction and dissatisfaction associated with conventional and complementary therapies.
Results: 415 (69%) patients returned the questionnaire. 16% had used complementary therapies. The most popular were healing, relaxation, visualisation, diets, homoeopathy, vitamins, herbalism, and the Bristol approach. Patients using complementary therapies tended to be younger, of higher social class, and female. Three quarters used two or more therapies. Therapies were mostly used for anticipated antitumour effect. Ill effects of diets and herb treatments were described. Satisfaction with both conventional and complementary therapies was high, although diets often caused difficulties. Patients using complementary therapies were less satisfied with conventional treatments, largely because of side effects and lack of hope of cure. Benefits of complementary therapies were mainly psychological.
Conclusions: A sizeable percentage of patients receiving conventional treatments for cancer also use complementary therapies. Patient satisfaction with complementary therapies, other than dietary therapies, was high even without the hoped for anticancer effect. Patients reported psychological benefits such as hope and optimism.

Clinical implications

  • Clinical implications

  • Clinicians ought to be conversant with the popular forms of complementary therapies

  • Complementary therapies can have psychological benefits for patients

  • Dietary therapies can cause significant weight loss in compromised cancer patients

  • Clinicians should not underestimate the value of a hopeful attitude in their management of cancer patients


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