COMPLEMENTARY MEDICINE IN HAEMATO-ONCOLOGY:

Abstract

Up to 83% of Australians diagnosed with cancer will use complementary and alternative medicines (CAMs). CAMs include physical, psychological, herbal, nutritional and spiritual therapies, and are used for a variety of reasons, including to help relieve the effects of both cancer and its conventional therapies, to enhance the efficacy of conventional treatments, to achieve a cure, to prolong life, to improve quality of life, or to meet personal or cultural needs. While some CAMs are beneficial, some, however, carry the risk of significant harm, especially when used alongside conventional therapies. Further compounding these risks are the issues of poor physician-patient communication about CAM, inadequate education about CAM, and the lack of readily-accessible, reliable and up-to-date information about CAM. This research – comprising a narrative review of the literature about CAM and a quantitative survey of NSW cancer services – was undertaken with these concerns in mind. It provides the first empirical study of the policies and practices surrounding CAM in Australian haemato-oncology units. Forty-three of 65 eligible cancer services responded to the survey - a response rate of 66%. While the majority (77%) of cancer services asked patients about CAM use at initial assessment and just over half (56%) permitted in-patients to bring their own CAMs into hospital, only eight (19%) services provided or prescribed CAM for their patients, and just six (14%) stated that their services had formal policies about CAM. Importantly, the survey also revealed that there was little regulation or monitoring of the use of CAM by in-patients, and little, if any, counselling about the risks of “unapproved” CAM. The integration of (selected) CAMs within haemato-oncology services has been posited as a solution to many of the problems associated with CAM use by patients with cancer. Integration, however, raises difficult and complex questions, and is not, by itself, a sufficient response to the concerns raised by the use of CAM by patients with cancer. To ensure the well-being and safety of patients, irrespective of whether or not cancer services choose to provide or prescribe CAMs, steps must be taken to effectively monitor and control CAM use within cancer services, to improve education and information about CAM, and to foster open, non-judgemental, physician-patient communication about CAM.