PHYSICIANS ATTITUDES TOWARD PATIENTS USE OF ALTERNATIVE CANCER THERAPIES

Objectives: To determine physicians' attitudes and reactions to their patients' use of alternative cancer therapies, factors that affect the se reactions and physicians' views of how the use of such therapies af fects the physician-patient relationship. Design: Qualitative study in volving in-depth semistructured interviews. Setting: Toronto. Particip ants: Nineteen oncologists and 35 general practitioners (GPs) were sel ected by means of purposive sampling; 18 oncologists and 12 GPs agreed to participate, Outcome measures: Attitudes and reactions to patients ' use of alternative cancer therapies; factors affecting physicians' r eactions to such use; and physicians' views of how the use of such the rapies affects the physician-patient relationship. Results: Many physi cians perceived themselves to be unfamiliar with available alternative cancer therapies and indicated that their main sources of information were their patients and the lay press, Although most of the physician s viewed the efficacy of such therapies as scientifically unproven, th ey would respect their patients' decision to use them and encourage th em to continue with standard treatment. Factors found to influence the physicians' reactions included the prognosis with standard treatments , the exclusivity of the use of alternative therapies and whether the alternative therapies were harmful. Although many of the participants felt that a patient's use of alternative cancer therapies did not affe ct the physician-patient relationship, a few indicated that it did cau se some tension. Conclusion: Because many physicians lack information on alternative cancer therapies and most of these therapies have not b een scientifically proven, physicians' attitudes and reactions to thei r use by patients are influenced to a greater degree by the efficacy o r inefficacy of standard treatment and the invasiveness of the alterna tive therapy than by the efficacy of the alternative therapy used.