City of Hope surgical oncologist Lily Lai, M.D., knows that patients often use therapies beyond the medications she recommends on her prescription pad.
Medicinal herbs. Yoga. Acupuncture. Steaming infusions and botanical elixirs. Elements of complementary and alternative medicine continue to abound in society as people seek whole-body healing and wellbeing. But what do physicians, physical therapists, nurses and other health-care professionals think about these options — and what do they need to learn to help their patients use them more healthfully?
That’s what Lai and her colleagues want to find out.
As part of the Sheri & Les Biller Patient and Family Resource Center at City of Hope, Lai leads an effort to survey City of Hope health-care professionals and researchers about their attitudes, knowledge and practice within the realm of complementary and alternative medicine. Biller Resource Center researchers hope to use their findings to integrate and improve care among their own patients — and increase awareness about the topic outside their walls through published research, as well.
“As it turns out, somewhere around 70 or even 80 percent of all patients are already using complementary treatments,” said Lai, assistant professor of surgery and specialist in colorectal cancers. “In a cancer center, particularly, where many patients are using them, we really need to identify and understand them.”
According to the National Institutes of Health (NIH), complementary and alternative medicine includes a variety of health-related systems, practices and products considered outside of today’s conventional medicine. Examples might include traditional Chinese medicine, music therapy, exercise, homeopathy and Ayurveda, as well as supplements, certain foods and mind-body therapies such as meditation.
The area has grown so rapidly that the NIH created its own entity to study it — the National Center for Complementary and Alternative Medicine.
Lai and her colleagues designed their survey to gauge knowledge and interest among health-care professionals and researchers across City of Hope within specific areas of complementary and alternative medicine, including herbs, massage, acupuncture and more. They also will touch on cultural issues, and will ask whether respondents are interested in learning more about specific areas.
It’s not just about increasing general knowledge, though. Some of the therapies can influence the effectiveness or side effects of patients’ cancer treatments. “Sometimes herbal supplements may be contraindicated with chemotherapy,” Lai said. In one example, the popular herb St. John’s Wort was found to interfere with how the liver breaks down several conventional drugs — lowering the drugs’ effectiveness.
But gathering key information from patients about their use of these therapies means that health-care professionals must be comfortable enough to inquire about them.
“Patients won’t really tell you everything they’re doing unless you ask,” Lai said.
Once the Biller Resource Center researchers gather and process data from the surveys, they will analyze it to determine participants’ attitudes and plan education topics to address areas of interest and deficiency. In addition, the survey will help direct research into the integration of complementary treatments with conventional medicine.
“This will drive our educational and research agenda,” Lai said. “Research topics could be as simple as looking at the value of exercise after colon cancer diagnosis, or perhaps the usefulness of hypnosis during invasive procedures, for example.”
Researchers also plan to survey patients and families to understand their use of complementary and alternative therapies.
“Ensuring patient safety is our first order of business,” Lai said. “With the documented high usage of complementary treatments in patients with cancer, we’d be better off integrating it rather than ignoring it.”
It’s not just alternative anymore
The National Center for Complementary and Alternative Medicine has found that many Americans rely on alternative therapies in their daily lives:
In the United States, 36 percent of adults use some type of complementary and alternative medicine.
If multivitamin use and prayer for health reasons also are included, that number rises to 62 percent.
Complementary medicine is used more by women than men. It’s also used more by people with higher educational levels, people who have been hospitalized in the past year, and former smokers (compared with current smokers or those who have never smoked).
Prayer for health reasons is the most common form of complementary and alternative therapy. The next most-common forms include natural products and deep breathing. Interestingly, an informal poll in City of Hope’s eHope indicated that more than 60 percent of eHope respondents used prayer or spiritual healing — far outpacing the 17 percent of respondents who practiced yoga.
Sources: National Health Interview Survey (2002) and July 2007 eHope.