Complementary and alternative medicine practices among Asian radiotherapy patients

Aim: To describe the prevalence, expectations and factors associated with the use of complementary and alternative medicine (CAM) in Asian radiotherapy patients. Methods: Overall 65 consecutive patients in an Asian oncology department were surveyed from December 2004 to January 2005, using a modified and translated instrument capturing information on patients' characteristics, CAM use, treatment refusal and satisfaction. Results: Some basic characteristics were: 86% Chinese; median age 56 years (range: 31-87 years); 57% women; cancer types - breast 42%, lung 20%, nasopharyngeal 11%. All had received prior radiotherapy (54%), chemotherapy (51%) or surgery (45%). The median diagnosis-to-survey time was 7.1 months (range 1-168 months). Fifty-six patients (86%) used CAM for cancer treatment. The two commonest categories were spiritual practices (48%) and traditional Chinese medicine (TCM) (37%). Significant factors in TCM use were being male (P = 0.007) and having advanced disease (P = 0.045). Overall 60% of patients using herbal treatment and 97% of patients using spiritual practices expected a cure, a longer life, symptomatic relief, improved immunity or a better quality of life. Satisfaction with western treatment correlated positively with satisfaction with CAM (Spearman's rank correlation coefficient = 0.4). Forty-six patients (71%) did not discuss their CAM use with their oncologists and 64% obtained advice from their friends or families. Fourteen patients refused previous western treatments (11 feared its side effects (79%), five preferred CAM (36%)). Conclusion: This study highlights the prevalence of CAM practices among Asian radiotherapy patients, their high expectations of the outcome and the need for better doctor-patient communication.