June 14, 2021 – Oncologists may underestimate how many breast cancer patients are using some type of complementary medicine or alternative treatments, according to a new survey published in conjunction with the American Society of Clinical Oncology annual meeting.
Complementary or alternative treatments usually refer to treatments that are used alongside standard or conventional treatments; Acupuncture, massage therapy, homeopathy, and reflexology are some examples. Mind-body therapies such as yoga as well as herbs and vitamins are also considered complementary medicine according to the CDC.
The results of the survey showed that oncologists only discussed complementary medicine with about half of the patients, and that oncologists and patients disagreed on which type of treatment offered the greatest benefit and quality of life.
“This is a known and ongoing problem between clinicians and patients,” said Wayne Jonas, MD, co-author of the report and executive director of inclusive health programs for the Samueli Foundation. “Patients use complementary and integrative medicine much more often than providers realize, and providers often know very little about these areas or have a negative opinion about them that patients do not bring them up.”
Even if the use of complementary medicine in cancer treatment has increased in cancer patients, there are still gaps in doctor-patient communication and education. The survey was conducted to measure awareness, use, and attitudes towards complementary and lifestyle therapies among oncologists and patients when they are part of cancer treatment.
The survey conducted at the end of 2020 included 115 oncologists treating patients with breast cancer and 164 breast cancer patients diagnosed within 2 years of the survey.
While nearly three-quarters of breast cancer patients (73%) reported using at least one type of complementary medicine after diagnosing cancer, oncologists believed that percentage was much lower (43%).
About two-thirds of oncologists and patients agreed that complementary and lifestyle approaches contribute to improved quality of life and patient wellbeing. But these points of view were very different when it came to whether or not they helped. While 60% of patients believed they were doing this, only 36% of oncologists said the same thing.
Additionally, oncologists in the survey reported that they discussed complementary and lifestyle therapies with 55% of patients, but only 28% of patients said their doctor was the source of information.
The survey also captured patient and oncologists’ awareness of complementary and lifestyle therapies. Most oncologists (92%) stated that they were familiar with at least one therapy and viewed nutritional advice, self-help groups, psychological support and exercise advice as the most important forms of complementary medicine. Spiritual ministry and meditation or mindfulness were considered less important, although these were two approaches that patients gave high marks.
“There is a discrepancy between oncologists and women with breast cancer in what each group considers important,” said Charles Shapiro, MD, professor of medicine, hematology, and medical oncology at the Icahn School of Medicine on Mount Sinai, New York City. who was not involved in the study. “Spirituality, meditation and mindfulness were rated higher by women with breast cancer than by oncologists – no surprises, no assumptions.”
The Samueli Foundation provides funding to the Society for Integrative Oncology and the American Society of Clinical Oncology to develop clinical practice guidelines that cover the use of complementary approaches in cancer treatment. The first guide is due to be published this autumn.
“Evidence-based instruments like these guidelines can help doctors speak more proactively with their patients about the use of complementary or integrative medicine and close this communication gap,” said Jonas.
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CDC: “Complementary and Alternative Medicine”.
Wayne Jonas, MD, Executive Director, Inclusive Health Programs, Samueli Foundation.
Samueli Foundation.
Charles Shapiro, MD, professor of medicine, hematology, and medical oncology at the Icahn School of Medicine on Mount Sinai, New York City.
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