Hi, I'm Terri Harrel. I'm here at M. D. Anderson Cancer Center in Houston. It seems that not a week goes by without stories in the news and popular press about herbal remedies... natural cures... dietary supplements... and mind-body and spiritual approaches to healing. We know there is widespread interest in these topics, and it's also been documented that many cancer patients use complementary therapies alongside their prescribed treatment. But are they talking with their physicians about it?
Voices over images:
It's just tea - I didn't think to mention it...
I only use "natural" stuff... I figure it couldn't hurt... not like taking other medicines or something...
No, I haven't told my doctor about the herbs ... I don't think he'd approve...
She didn't ask...
I always thought the herbs and minerals I'm taking are natural...like food. I wouldn't think to tell my doctor about them.
Communication between patients and their health care providers is one of the biggest issues in Complementary Medicine today. We know that many cancer patients use remedies other than the ones prescribed by their health care team. Some may be truly complementary to their treatment. Some are thought to be beneficial — perhaps not in terms of curing disease, but in terms of helping support patients through their illness and treatment.
Of perhaps greater concern are things that are potentially harmful, or that might interfere with prescribed treatment or diminish its efficacy.
We know that many people who use complementary or alternative therapies DON'T talk with their physicians about it, for various reasons.
Judith Smith, Pharm D:
I don't think they're trying to hide information from us. I think it's more so, they just don't consider it medication. They consider it it's an herb; it's a plant; it's a supplement; it's like my vegetables that I take. I'm just getting extra in a pill form.
Joan Engebretson, DrPH:
People are getting information from magazines, television, radio and the internet I think the internet has just opened up a whole new venue of information, good and bad, and so I think it's very challenging for health care providers to be not only up to date on all the latest medical news, because patients can go on there and get that, and they're very... a patient who has a particular disease or a particular problem has got a lot more time to invest in that very specific information to search out all the information on the Internet whereas a physician has to knowledgeable about a number of things.
Walter Baile, MD:
I think there are important philosophical issues here also, and as we move toward a society in which more and more medication is available for self consumption, I think individuals feel more empowered to more or less take things into their own hands.
Nicki Lowenstein, MS, RD, LD, CNSD:
Part of our general assessment of patients when we see patients is to ask them what types of supplements they're on, and I don't know whether dieticians just aren't particularly intimidating or they think we're going to be more giving on those types of things, but almost every patient will tell us what they're taking.
But then, along those same lines, we will almost always ask the patient now have you told your doctor you're taking these supplements? And many times I would say probably half the time we'll find that patients have not communicated this with their physician.
Eva Singletary MD:
I think in the past, most physicians did not consider complementary medicine to be an issue, whereas patients did. They thought well if my doctors are not interested in it, there's no need for me to tell the doctor about what we're doing. And I think there's been a bigger awareness that patients are using alternative medicine and why it's important to know what they're doing.
In this program, we'll explore some of those issues in more depth. We'll look at who's using complementary therapies and why... some of the possible barriers to establishing communication... and then we'll talk with experts about how to use known clinical communications protocols and techniques in this setting.
The experts you'll see in this program include physicians and scientists... and specialists in pharmacology, nutrition and nursing... all of whom have clinical interests in Complementary Medicine or clinical communications.
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