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Understanding the Motivation for Conventional and Complementary/Alternative Medicine Use Among Men With Prostate Cancer

Cancer Research Center of Hawaii, Honolulu

Gertraud Maskarinec, MD, PhD

Cancer Research Center of Hawaii, Honolulu, gertraud{at}crch.hawaii.edu

Dianne M. Shumay, MA

Cancer Research Center of Hawaii, Honolulu

Hypothesis: The incidence of prostate cancer and the prevalence of complementary and alternative medicine (CAM) use among prostate cancer patients have been increasing. An understanding of the underlying motivations for men to turn to CAM is essential to achieve optimal outcomes. The authors hypothesized that CAM users and nonusers differ in their assessment of conventional and CAM treatments and explored perceptions, feelings, ideas, and experiences among prostate cancer patients who made a decision to use or not to use CAM. Study Design: This qualitative study is based on in-person interviews with prostate cancer patients selected from a population-based survey. Methods: The authors conducted semistructured interviews with 27 prostate cancer patients of Asian and Caucasian ethnicity, 18 of whom used CAM and 9 of whom did not. Using qualitative research methods, they examined perceptions of conventional medicine and CAM and contrasted viewpoints of CAM users and nonusers. Based on the patients’ statements, the authors developed a model representing the viewpoints and thought patterns of CAM users as contrasted with those patients who did not use CAM. Results: The interviews revealed notable differences in viewpoints between CAM users and nonusers in 4 areas. The following themes that were important to CAM users emerged from the analysis: a view of CAM as safe and holistic coupled with a view of conventional medicine as an aggressive and isolated treatment; concern about side effects, in particular, impotence and incontinence from conventional cancer therapy; a belief in the potential efficacy of CAM despite the lack of evidence; and a need to gain a sense of control. Although nonusers expressed similar concerns about side effects of conventional treatment and considered CAM harmless, they assigned different priorities to these issues in their decision making. Conclusions: In this study, no single theme was solely responsible for CAM use among prostate cancer patients. Instead, multiple ideas woven together led patients toward CAM use. An understanding of patients’ thought processes may aid health care professionals in initiating a dialogue about decision making and potential side effects.

Key Words: complementary and alternative medicine • prostate • cancer • decision making • qualitative analysis

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