Many cancer patients use alternative or complementary therapies in conjunction with their main course of treatment, but a new survey shows that many oncologists underestimate how many of their patients are using these types of therapies. It also appears that oncologists and patients disagree about how effective each type of alternative therapy may be.

Complementary and alternative therapies are treatments that can be used alongside conventional therapies to treat certain ailments, in this case, cancer. They may include things like acupuncture, massage therapy, homeopathy, and reflexology. The CDC also recognizes mind-body therapies like yoga and meditation, as well as herbs and vitamins, as complementary medicines.

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The 2020 survey, released at the American Society of Clinical Oncology‘s annual meeting, included 115 oncologists and 164 breast cancer patients, all of whom had been diagnosed with breast cancer within two years of the survey. The survey’s purpose was to measure the awareness, usage, and attitudes toward complementary and lifestyle therapies among oncologists and cancer patients.

The results showed that oncologists only spoke with about half of their patients regarding the use of complementary medicines or therapies. Patients and oncologists also disagreed about which types of treatments offered the most benefits and improved quality of life.

“This is a well-known and ongoing problem between practitioners and patients,” says Wayne Jonas, MD, a co-author of the report and executive director of integrative health programs at the Samueli Foundation. “Patients are much more likely to use complementary and integrative medicine than providers realize, and providers often know very little about these areas or have a negative opinion about them, and so the patients don’t bring them up.”

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The use of complementary medicine among cancer patients has been increasing, but there are still gaps in doctor-patient communication and education regarding these therapies.

According to the survey, 73 percent of breast cancer patients used at least one type of complementary medicine after they were diagnosed with breast cancer. Oncologists, however, said believed only about 43 percent of patients used these therapies.

On the whole, oncologists and patients both agreed that complementary and lifestyle approaches contributed to an improved quality of life and well-being for patients, with two-thirds of each group agreeing with the statement. However, when the question of whether the therapies helped treat the disease came up, oncologists and patients differed in their answers. 60 percent of patients believed their alternative therapies were treating their cancer, while only 36 percent of oncologists agreed.

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Patients were also highly unlikely to have gotten their information regarding alternative therapies from their doctors. While doctors said they talked about complementary therapies with 55 percent of their patients, only 28 percent of patients said their doctor had been the source of their information about complementary therapies.

Another purpose of the survey was to understand more about how familiar oncologists are with different types of alternative therapies and which ones they considered important. 92 percent of them reported having familiarity with at least one alternative therapy, and they were most likely to place an emphasis on nutrition consultation, support groups, mental health support, or exercise consultation. Less emphasis was placed on meditation, mindfulness, or other spiritual services, although patients seemed to think these were important treatment tools.

“There is a disconnect between oncologists and women with breast cancer in what each group thinks are important,” says Charles Shapiro, MD, a professor of medicine, hematology, and medical oncology at the Icahn School of Medicine at Mount Sinai in New York City, who was not involved in the study. “Spirituality, meditation, and mindfulness were rated higher by women with breast cancer than oncologists—no surprises here, never assume anything.”

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The Society for Integrative Oncology and the American Society of Clinical Oncology plan to develop a new set of guidelines on the use of complementary approaches in cancer treatment, to be released in the fall.

“Evidence-based tools, such as these guidelines, can help clinicians more proactively engage with their patients about the use of complementary or integrative medicine and close that communications gap,” says Jonas.

We hope this research can be a learning tool for many doctors out there. However, there will always be some doctors who want to do things the way they’ve always been done and aren’t terribly interested in trying new therapies, even those backed by data. Cancer patients should always have options and feel empowered in their treatment, and they should never be afraid to do their own research, ask their doctors about alternative therapies, and, when necessary, seek a second opinion.

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