Oncologists, Breast Cancer Patients Differ on Alternative Therapies

June 14, 2021 — Oncologists may be underestimating how many breast cancer patients are using some type of complementary medicine or alternative treatments, according to a new survey released along with the American Society of Clinical Oncology’s annual meeting.

Complementary or alternative treatments typically 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 to be complementary medicine, according to the CDC.

The survey’s results showed that oncologists were discussing complementary medicine with only about half of patients, and that oncologists and patients differed in their opinions as to which type of treatments offered the most benefit and improvement to 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.”

Even though the use of complementary medicine in cancer care has been increasing among cancer patients, gaps remain in doctor-patient communication and education. The survey was done to measure awareness, usage, and attitudes toward complementary and lifestyle therapies among oncologists and patients when included as part of cancer treatment.

Done in late 2020, the survey included 115 oncologists who treat patients with breast cancer as well as 164 breast cancer patients who had been 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 they were diagnosed with cancer, oncologists believed that percentage was much lower (43%), the researchers found

About two-thirds of both oncologists and patients agreed that complementary and lifestyle approaches contributed to improved quality of life and well-being for patients. But these viewpoints were very different when it came to whether they helped. While 60% of patients believed they did, only 36% of oncologists said the same.

What’s more, oncologists in the survey reported that they discussed complementary and lifestyle therapies with 55% of patients, but only 28% of patients said their doctor had been the source of information.

The survey also gauged awareness of complementary and lifestyle therapies among patients and oncologists. Most oncologists (92%) reported that they were familiar with at least one therapy, and viewed nutrition consultation, support groups, mental health support, and exercise consultation as the most important forms of complementary medicine. Spiritual services and meditation or mindfulness were considered less important, though these were two approaches patients gave high marks to.

“There is disconnect between oncologists and women with breast cancer in what each group thinks are important,” said 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.”

The Samueli Foundation is providing funding for the Society for Integrative Oncology and the American Society of Clinical Oncology to develop clinical practice guidelines that will cover the use of complementary approaches in cancer treatment. The first set of guidelines is on schedule to be released this 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,” said Jonas.