Samano E S T, Ribeiro L M, Campos A S, Lewin F, Filho E S V, Goldenstein P T, Costa L J M, del Giglio A
ABC Foundation School of Medicine, Sao Paulo, Brazil.
Eur J Cancer Care (Engl). 2005 May;14(2):143-8. doi: 10.1111/j.1365-2354.2005.00524.x.
Complementary and alternative medicine (CAM) is frequently employed by patients with cancer. An extensive survey was conducted among Brazilian cancer physicians to understand their attitude towards CAM. A questionnaire was sent to all 655 members of the Brazilian Cancer Society asking what is their opinion regarding CAM and if they would prescribe any CAM modality for their patients. They were also questioned regarding their degree of awareness of CAM self-administration by their patients. Overall, 119 questionnaires were returned to us (18%). Most oncologists knew at least one type of CAM (96.6%) and 76.7% had previously made use of at least one type of CAM for themselves. We observed that 76 (63.8%) of the oncologists used to ask their patients about CAM utilization and 37.8% described at least one reason to stimulate its use (68.8% as complementary treatment). Only 10% of the oncologists would prescribe at least one type of CAM and this attitude correlated significantly with previous physicians' use of CAM and with being a clinical oncologist as well as with having questioned patients about CAM use. Most oncologists (80.7%) would not indicate the use of CAM, mainly for lack of scientific proof of its efficacy (56.2%). Physicians knew many kinds of CAM and had frequently used some of them themselves, but only a minority of Brazilian oncologists would indicate them. As CAM use is very prevalent in our population, we believe that most of its utilization depends, probably, on patient's own and independent initiatives. However, these results should be viewed with caution because of the low response rate we observed in this study.
癌症患者经常使用补充和替代医学(CAM)。我们对巴西的癌症医生进行了一项广泛的调查,以了解他们对CAM的态度。我们向巴西癌症协会的所有655名成员发送了一份问卷,询问他们对CAM的看法,以及他们是否会为患者开任何CAM疗法。我们还询问了他们对患者自行使用CAM的了解程度。总体而言,我们共收到119份问卷回复(回复率为18%)。大多数肿瘤学家至少了解一种CAM(96.6%),76.7%的人自己曾至少使用过一种CAM。我们发现,76名(63.8%)肿瘤学家过去常常询问患者是否使用CAM,37.8%的人描述了至少一个鼓励使用CAM的理由(68.8%是作为辅助治疗)。只有10%的肿瘤学家会为患者开至少一种CAM疗法,这种态度与医生之前使用CAM、作为临床肿瘤学家以及询问过患者是否使用CAM显著相关。大多数肿瘤学家(80.7%)不会推荐使用CAM,主要原因是缺乏其疗效的科学证据(56.2%)。医生们了解多种CAM,自己也经常使用其中一些,但只有少数巴西肿瘤学家会推荐它们。由于CAM在我们的人群中使用非常普遍,我们认为其大部分使用可能依赖于患者自身的主动行为。然而,由于本研究中观察到的低回复率,这些结果应谨慎看待。