The Unsuspecting CAM User: Cancer patients and the changing nature of holistic health

A M. Kabel, L. P. Johnson


The number of cancer patients using complementary and alternative medicine (CAM) in the United States is growing, yet little is known about the meaning these activities have for users. Current literature supports the assumption that stigma surrounding CAM and holistic health practices are responsible for the reluctance of many cancer patients to self-identify as CAM users. This study explored the frequency of use, and familiarity with CAM among 25 female patients at a Midwestern oncology clinic. Findings suggest that patients need to be asked about CAM use multiple times and in multiple formats to gain an accurate assessment. Also, the assumptions about stigma may no longer be the reason patients are less than forthcoming about CAM use. The rise of integrative medicine and shifting boundaries of the holistic health movement may be equally, or in some cases, more responsible for the reluctance for CAM users to self-identify.

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Abrahamson, J. A., Fisher, K. E., Turner, A. G., Durrance, J. C., and T. C. Turner

Lay Information Mediary Behavior Uncovered: Exploring How Nonprofessionals Seek Health Information for Themselves and Others Online. Journal of Medical Library Association 96 (4): 310-323.

Alfano, Catherine M., Ganz, Patricia A., Rowland, Julia H., and Erin E. Hahn

Cancer Survivorship and Cancer Rehabilitation: Revitalizing the Link. Journal of Clinical Oncology 30 (9): 904-906.

Altekruse SF, Kosary CL, Krapcho M, et al., eds. 2010 SEER cancer statistics review, 1975--2007. Bethesda, MD: National Cancer Institute; .

American Cancer Society

Cancer Treatment and Survivorship Facts & Figures 2003. Atlanta: American Cancer Society.

American Cancer Society: Cancer Facts and Figures 2012-2013. Atlanta: American Cancer Society.

Aziz, N. and Rowland, J.

Trends and Advances in Cancer Survivorship Research: Challenge and Opportunity. Seminars in Radiation Oncology, 13(3): 248-266.

Baer,Hans. 2004 Toward an Integrative Medicine: Merging Alternative Therapies with Biomedicine. New York: Altamira Press. ISBN-10: 0759103011

Blank , Thomas O.

Cancer from Both Sides Now: Combining Personal and Research Perspectives on Survivorship. Journal of General Internal Medicine 24 (2):425-428. Doi: 10.1007/s11606-009-1018-5

Boon H, Stewart M, Kennard MA, Gray R, Sawka C, Brown JB, McWilliam C, Garvin A, Baron RA, Aaron D, Haines-Kamka T. 2000 Use of complementary/alternative medicine by breast cancer survivors in Ontario: prevalence and perceptions. Journal of Clinical Oncology; 189130: 2515-2521.

Cassileth B. and Deng G.

Complementary and Alternative Therapies for Cancer. The Oncologist (9): 80-89.

Edgington, Amy and Mary Ann Morgan

Looking Beyond Recurrence: Comorbidities in Cancer Survivors. Clinical Journal of Oncology Nursing 15 (1): E3-E12. DOI: 10.1188/11.CJON.E3-E12

Eisenberg DM, Davis R, Ettner S, Appl S, Wilkey S, Van Rompay M, Kessler RC.

Trends in alternative medicine use in the United States, 1990-1997. JAMA (280): 1569-1575. DOI: 10.1001/jama.280.18.1569

Eisenberg DM, Kessler R., Foster C., Norlock F., Calkins D., Delbance T.,

Unconventional Medicine in the United States: Prevalence, Costs and Patterns of Use. NEJM. 28 (328): 246-252.

Eheman C, Henley SJ, Ballard-Barbash R, Jacobs EJ, Schymura MJ, Noone AM, Pan L, Anderson, RN, Fulton JE, Kohler BA, Jemal A, Ward E, Plescia M, Ries LAG, Edwards BK.

Annual Report to the Nation on the Status of Cancer, 1975–2008, Featuring Cancers Associated with Excess Weight and Lack of Sufficient Physical Activity. CANCER; Published Early Online: March 28, 2012. DOI: 10.1002/cncr.27514

Ehrenreich, Barbara

Welcome to Cancer Land. Harper’s Magazine Harper's Magazine November 2001, 43-53.

Ernest E., Cassileth B. R. 1998 The Prevalence of Complementary/alternative Medicine in Cancer: A Systematic Review. Cancer 83:777-782. DOI: 10.1200/JCO.2005.11.922

Fennell, Dana, Liberato, Ana S. Q., and Barbara Zsembik 2009 Definitions and patterns of CAM use by the Lay Public. Complementary Therapies in Medicine (17): 71-77.

Gansler, Ted, Chiewkwei, Kaw Crammer, Corinne and Tenbroeck Amith.

A Population-Based Study of Prevalence of Complementary Methods Used by Cancer Survivors: A Report from the American Cancer Society’s Studies of Cancer Survivors. Cancer 113 (5):1048-1057. DOI: 10.1002/cncr.23659

Giordano, James, Boatwright, Douglas, Stapleton, Sarai, and Lew Huff

Blending the Boundaries: Steps toward an Integration of Complementary and Alternative Medicine into Mainstream Practice. The Journal of Alternative and Complementary Medicine Volume 8 (6): 897–906. DOI: 10.1089/10755530260511892

Hill, Terry E. 2010 How Clinicians Make (or Avoid) Moral Judgments of Patients: Implications of the Evidence for Relationships and Research. Philosophy, Ethics and Humanities in Medicine 5: 11. DOI: 10.1186/1747-5341-5-11

King, Samantha 2008 Pink Ribbons, Inc.: Breast Cancer and the Politics of Philanthropy. University of Minnesota Press. ISBN 10: 0816648999 / 0-8166-4899-9

Lewith, George T. 2008 The Cultural Context of CAM. The Journal of Alternative and Complementary Medicine 14 (10): 1179-1180. DOI: 10.1089/acm.2008.0348

Mao JJ, Palmer CS, Healy KE, Desai K, Amsterdam J. 2011Complementary and alternative medicine use among cancer survivors: a population-based study. Journal of Cancer Survivorship: Research and Practice 5(1):8-17. DOI: 10.1007/s11764-010-0153-7

Maizes, Victoria, Rakel, David and Catherine Niemiec. 2009 Integrative Medicine and Patient-Centered Care. Explore 5 (5):277-289. DOI: 10.1016/j.explore.2009.06.008

Monti D. M. and Stoner M. 2002 Complementary and Alternative Medicine, in Kornstein SG, Clyaton AH (eds): Women’s Mental Health. New York, NY, Guilford: 344-356.

Monti, D and Yang J. 2005 Complementary Medicine in Chronic Cancer Care. Seminars in Oncology 32:225-231.

Nagler, R. H., Gray, S. W., Romantan, A., Kelly, B. J., DeMichel, A., Armstrong, K., Schwartz, J. S., and R.C. Hornik 2010 Differences in Information Seeking among Breast, Prostate, and Colorectal Cancer Patients: Results from a Population-Based Survey. Patient Education and Counseling 81 (Supplement): S54-S62.

Navo, Marisa A, Phan Julie, Vaughn, Christy,Palmer, J. Lynn, Michaud, Laura, Jones, Kellie L., Bodurka, Diane C., Basen-Engquist, Karen, Hortobgyi, Gabriel N, Kavanagh, John J., and Judith A. Smith.

An Assessment of the Utilization of Complementary and Alternative Medication in Women with Gynecologic or Breast Malignancies. Journal of Clinical Oncology 22:671-677. DOI: 10.1200/JCO.2004.04.162

National Cancer Institute. 2011. A Snapshot of Ovarian Cancer. US Department of Health and Human Services. National Institutes of Health. Pages 1-2.

National Research Council.

Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. Washington, DC: The National Academies Press.


Park, Crystal L, Zlateva, Ianita, and Blank, Thomas O. 2009. Self-identity After Cancer: “Survivor”, “Victim”, “Patient”, and “Person with Cancer.” Journal of General Internal Medicine, 24 (Supplement 2): 430-435.DOI: 10.1007/s11606-009-0993-x

Parry, Carla, Kent, Erin E., Mariotto, Angela B., Alfano1, Catherine M., and Julia H. Rowland

Cancer Survivors: A Booming Population. Cancer Epidemiology Biomarkers and Prevention 20(10) 1996-2005. DOI: 10.1158/1055-9965.EPI-11-0729

Rhode JM., Patel, Divya A., Sen, Ananda, Schimp, Veronica L.,Johnston, Carolyn M., and Rebecca Liu.

Perception and use of complementary and alternative medicine among gynecologic oncology care providers. International Journal of Gynecology and Obstetrics 103:111-115.

Richardson MA, Sanders T Palmer JL, Greisinger A, Singletary SE.

Complementary/Alternative Medicine use in a comprehensive cancer center and the implications for oncology. Journal of Clinical Oncology 18(13): 2505-2514.

Rojas-Cooley, M. Teresa and Marcia Grant 2009 Complementary and Alternative Medicine: Oncology Nurses’ Knowledge and Attitudes. Oncology Nursing Forum 36 (2): 217-224. DOI:10.1188/09.ONF.217-224

Rose, Leslie B.

CAM at the Crossroads. Evaluation and the Health Professions 32 (4): 331-334. DOI:10.1177/0163278709346820

Sewitch, Maida J., Cepoui, Monica, Rigillo, Nicole and Donald Sproule. 2008 A Literature Review of Health Care Professional Attitudes toward Complementary and Alternative Medicine. Complementary Health Practice Review 13:139. DOI: 10.1177/1533210108325549

Sulik Gayle A. 2010. Pink Ribbon Blues How Breast Cancer Culture Undermines Women's Health. Oxford University Press. ISBN10: 0199740453

Weaver, Kathryn E., Rowland, Julia H; Bellizzi, Keith M.; and Aziz, Noreen M.

Forgoing Medical Care Because of Cost: Assessing Disparities in Healthcare Access Among Cancer Survivors Living in the United States. Cancer 116:3493–3504. DOI: 10.1002/cncr.25209

Yates JS, Mustian KM, Morrow GR, Gillies LJ, Padmanaban D, Atkins JN, Issell B, Kirshner JJ, Colman LK. 2005 Prevalence of complementary and alternative medicine use in cancer patients during treatment. Support Care Cancer. 13(10): 806-11. DOI: 10.1007/s00520-004-0770-7

Welch, Cline R. J., Penner, L. A., Harper, F. W., Foster, T. S., Ruckdeschel, J. C., and T. L. Albrecht

The Roles of Patients' Internet Use for Cancer Information and sScioeconomic Status in Oncologist-Patient Communication. Journal of Oncology Practice. May 3(3):167-71. DOI: 10.1200/JOP.0737001

Zhang, Yan, Peck, Kim, Spalding, Mary, Jones, Betsy G., and Ronald L. Cook

Discrepancy between patients’ use of and health providers’ familiarity with CAM. Patient Education and Counseling [in press].



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