Public Release: 

ECCO 13 offers new insights into patients' perceptions of cancer

ECCO-the European CanCer Organisation

Paris, France, Wednesday 2 November 2005 - New light has been shed on patients' perception of cancer following the results of studies, presented at the 13th European Cancer Conference (ECCO), which focused on the sufferer's own perspectives. In particular, new insights have been gained into the use of complementary and alternative medicines (CAM) following a diagnosis of cancer. Patient communication with health care professionals about sexual concerns was also highlighted as a potential issue.

In order to generate new understanding about the ways in which cancer patients use CAM as an adjuvant to conventional treatment, and to identify the perceived value of this complementary approach, a study of 304 recently diagnosed cancer patients was undertaken with funding by the Department of Health. Patients attending two cancer centres were surveyed over a 3-month period to determine CAM use before and since diagnosis. A sub-sample of 40 patients also took part in semi-structured interviews.

Before diagnosis, 33% of patients reported using CAM, with this figure dropping to 28% after cancer diagnosis. Of the recently-diagnosed patients using CAM, 57 were previous CAM users and 29 were new to CAM. Interestingly, only just over half (57 out of 100) of patients who used CAM before diagnosis had continued to take advantage of this alternative approach after their cancer was confirmed.

CAM use post-diagnosis was found to be almost universally helpful, with no patient reporting they felt it had been unhelpful. Cancer sufferers who opted to utilise alternative approaches were more likely to be younger, female and educated to a higher level. 45% of CAM users since diagnosis had breast cancer, compared with only 17% of non-CAM users. In terms of the actual pattern and type of CAM use reported by patients, this was found to vary considerably.

This study is the first to reveal how CAM use can alter following a diagnosis of cancer. In addition, the findings indicate that there may be important factors, over and above individual beliefs and motivation, that influence CAM use. Factors such as the availability of CAM within cancer treatment settings, information about CAM and overall safety considerations may also be important influencers of CAM use among patients undergoing cancer treatment.

Speaking at ECCO, Professor Alexander Molassiotis from the University of Manchester commented, "Complementary and Alternative Medicine use is about 'thinking outside the box'. It is about pushing the boundaries of medicine a bit further. It enables a more holistic approach to patient care, and different models and medical philosophies are working in an integrated manner for the patients' benefit. It can have an important role in the supportive care of patients with cancer, empowering patients and improving their emotional and physical well being."

As well as having a significant bearing on patients' perception of complementary medicine, busy clinical settings and heavy caseloads can present barriers to cancer patients receiving timely and appropriate help for unmet needs. In particular, the communication challenges felt by patients escalate when it comes to addressing sensitive psychosocial needs such as those related to sexuality. Important data showcased at ECCO 13 stemmed from a study undertaken to describe patients' perspectives about communication with cancer care professionals about their sexual concerns.

In total, 30 in-depth interviews were conducted with patients suffering from a wide range of cancers. Patients confirmed that they had experienced concerns about sexuality because of their cancer diagnosis and treatment. They also reported encountering barriers when they raised their concerns with health care providers and wanted to discuss these matters. Many felt they did not want to raise their concerns with providers who were "very busy". The findings have clear implications for education of staff members and practice concerning patient communication of sexual issues in cancer settings. These needs require addressing in a sensitive manner, with healthcare providers linking patients with the services they may need.

"The implications of these study results direct us toward education for health care professionals and toward how we can create the type of environment for communication that is comfortable for patients to discuss sensitive topics," noted Dr Margaret Fitch from Toronto Sunnybrook Regional Centre, Canada. "The findings also implicate the importance of considering the psychosocial burden patients are carrying at various times during their illness and how important their personal goals and readiness are in dealing with the issues and concerns they may have. This work is a beginning exploration of this topic area and will need to be validated in future work and other settings. The importance of cultural perspectives regarding this topic is an area for which we need much deeper understanding."

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Abstract: 1584
PP7 Patient's perspectives
Complementary and alternative therapy use among people undergoing cancer treatment

J. Harewood1, J. Corner1, J. Maher2, G. Lewith3, S. Maslin-Prothero4, T. Young2, L. Roffe1
1University of Southampton, School of Nursing and Midwifery, Southampton, United Kingdom
2Mount Vernon Hospital, Lynda Jackson Macmillan Cantre, Northwood, UK
3University of Southampton, Complementary Medicine Research Unit, Southampton, UK
4Keele University, School of Nursing and Midwifery, Stoke on Trent, UK
Aim:
This study was funded by the Department of Health to generate new understanding about the ways in which patients with cancer use Complementary and Alternative Medicines (CAM) as an adjunct to their conventional cancer treatment, and to identify the perceived value or otherwise of using CAM.
Method:
A survey of 304 recently diagnosed patients attending two cancer centres was conducted over a 3-month period to determine CAM use before and since diagnosis. Quota sampling was used to reflect national cancer incidence. A sub-sample of 40 patients participated in semi-structured interviews.
Results:
CAM use before diagnosis was reported by 33% of patients. Following diagnosis, CAM use was reported by 28% of patients. Of the 100 CAM users before cancer diagnosis, 57 had also used CAM since their diagnosis. Twenty nine CAM users since diagnosis had not used CAM before. Patients who used CAM were more likely to be younger (p<0.001 for trend) and female (p<0.001), with a higher educational level (p<0.003 for trend). Forty five percent of CAM users since diagnosis had breast cancer, compared with only 17% of non-CAM users. Almost all CAM users since diagnosis found CAM helpful and no-one reported that they were unhelpful. There were no apparent differences in CAM use according to socio-demographic characteristics, or recruitment clinic. The pattern of CAM use reported by patients varied considerably. Data indicate that there may be important factors over and above individual beliefs and motivations, influencing CAM use.
Conclusion:
This study is the first to reveal how CAM use may alter following a diagnosis of cancer. Factors such the clinical team, the availability of CAM within cancer treatment settings, information about CAM and safety considerations, may be important influences on CAM use among patients undergoing cancer treatment.

Abstract: 1581
PP7 Patient's perspectives
Patient perspectives on communicating with health care professionals about sexual concerns
G. Beaudoin, M.I. Fitch
Toronto Sunnybrook Regional Cancer Centre/Sunnybro, Psychosocial & Behavioral Research Unit, Toronto, Canada
Background:
Cancer has an impact that is felt in more than physical ways. There are often emotional, social, psychological, spiritual and practical changes as well. Patients frequently face challenges in coping with the needs which arise during the course of their treatment. In particular, patients have reported challenges in communicating with health care practitioners about their needs and in obtaining the help or assistance they would like to have. Busy clinical settings and heavy caseloads can present barriers to patients receiving timely and appropriate help for unmet needs. These challenges escalate when the needs are related to sensitive psychosocial needs such as those related to sexuality. This study was undertaken to describe patients' perspectives about communication with cancer care professionals regarding sexual concerns.
Materials and Methods:
In-depth interviews were conducted with 30 cancer patients (breast, gynecological, prostate, colorectal, and head and neck) to explore this issue. Interviews were audiotaped, transcribed verbatim, and subjected to content and thematic analysis.
Results and Conclusions:
Patients confirmed they had experienced concerns about sexuality because of their cancer diagnosis and treatment. They also experienced barriers when they raised their concerns with health care providers and wanted to discuss these matters. Many felt they did not want to raise their concerns with providers who were "very busy". The findings have clear implications for education of staff members and practice in cancer settings concerning the sexual concerns experienced by cancer patients, talking about these topics in a sensitive manner, and linking patients with the services they may required.

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