Declining conventional cancer treatment and using Complementary and Alternative Medicine: A problem or a challenge?

Abstract

Background: Several studies have shown that a small, but significant percentage of cancer patients decline one or more conventional cancer treatments and use Complementary and Alternative Medicine (CAM) instead.

Objectives: To describe 1) why cancer patients decide to decline conventional cancer treatments, 2) who these patients are, and 3) physicians’ response to patients making such decisions.

Method: We draw on the literature as well as on our own ongoing research.

Results: Poor doctor-patient communication, the emotional impact of the cancer diagnosis, perceived severity of conventional treatment side effects, a high need for decision-making control and strong beliefs in holistic healing appear to impact on the decision to decline some or all conventional cancer treatments. Many patients indicated they valued ongoing follow-up care from their oncologists as long as they respect patients’ beliefs. Patients declining conventional treatments have a strong sense of internal control and prefer to make the final treatment decisions after considering their doctors’ opinion. Very few studies looked at physicians’ response to patients making such a decision. They found that doctors tendency to dichotomize patients’ decisions as rational or irrational may interfere with their ability to respond with sensitivity and understanding.

Discussion:  Declining conventional treatment is not necessarily an indicator of distrust of the medical system, but a reflection of many personal factors. Accepting and respecting such decisions may be instrumental in “keeping the door open”. 

Keywords: cancer patients’ characteristics, conventional cancer treatment, complementary and alternative medicine, physicians’ responses, control