Lee Richard T, Hlubocky Fay J, Hu Je-Jen, Stafford Randall S, Daugherty Christopher K
Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL 60637, USA.
Integr Cancer Ther. 2008 Jun;7(2):70-5. doi: 10.1177/1534735408319059. Epub 2008 May 27.
In China and Taiwan, Complementary and Alternative Medicine (CAM) therapies such as traditional Chinese medicine have been an option to cancer patients for centuries, whereas in the United States, CAM has been growing in popularity only in the past few decades. Prior research has indicated that the prevalence of CAM use among cancer patients may exceed 80%. Because of a long cultural history of CAM, we hypothesized that oncologists in China and Taiwan (C/T) would communicate and combine CAM with conventional treatments more often than US oncologists.
In 2004-2005, a convenience sample of oncologists from the United States, mainland China, and Taiwan were surveyed regarding their opinions and self-reported practice patterns regarding CAM.
A total 95 oncologists returned surveys, providing a 38% response rate. Four out of 5 respondents (78%) felt their medical training was inadequate to use CAM. However, 70% reported they would allow CAM use during active cancer treatment, even in the setting of curable disease. Responding C/T oncologists tended to ask patients more frequently (they ask > 25% of patients) about CAM use and recommended CAM more commonly (recommend to > 10%) to patients than surveyed US oncologists, 55% versus 37% (P = .09) and 81% versus 53% (P < .05). Respondents from the United States felt no more prepared for CAM use than C/T respondents, but 70% reported willingness to combine CAM with conventional treatments for curable disease as compared with only 48% (P < .05) of C/T oncologists.
As expected, responding C/T oncologists communicate more often about CAM with patients by asking and recommending CAM. However, contrary to our original hypothesis, C/T oncologists reported a much lower rate of combining CAM with conventional treatment among curable patients than responding US oncologists. Further research is needed to explore, in depth, the reasons for differences in CAM practice patterns among oncologists.
在中国和台湾，几个世纪以来，诸如传统中医等补充替代医学（CAM）疗法一直是癌症患者的一种选择，而在美国，CAM只是在过去几十年才日益普及。先前的研究表明，癌症患者中使用CAM的比例可能超过80%。由于CAM有着悠久的文化历史，我们推测中国大陆和台湾（C/T）的肿瘤学家比美国肿瘤学家更常与患者交流并将CAM与传统治疗相结合。
在2004 - 2005年，对来自美国、中国大陆和台湾的肿瘤学家进行了一项便利抽样调查，询问他们对CAM的看法以及自我报告的CAM使用模式。
共有95位肿瘤学家回复了调查问卷，回复率为38%。五分之四的受访者（78%）觉得他们的医学培训不足以使用CAM。然而，70%的受访者表示他们会允许在积极的癌症治疗期间使用CAM，即使是在可治愈疾病的情况下。与接受调查的美国肿瘤学家相比，回复问卷的C/T肿瘤学家倾向于更频繁地询问患者（询问超过25%的患者）关于CAM的使用情况，并且更普遍地（向超过10%的患者）向患者推荐CAM，比例分别为55%对37%（P = 0.09）和81%对53%（P < 0.05）。美国的受访者觉得他们在使用CAM方面并不比C/T受访者准备更充分，但70%的受访者表示愿意将CAM与可治愈疾病的传统治疗相结合，相比之下，C/T肿瘤学家中只有48%（P < 0.05）愿意这样做。
正如预期的那样，回复问卷的C/T肿瘤学家通过询问和推荐CAM与患者就CAM进行更频繁的交流。然而，与我们最初的假设相反，C/T肿瘤学家报告称，在可治愈患者中，将CAM与传统治疗相结合的比例比回复问卷的美国肿瘤学家低得多。需要进一步研究来深入探讨肿瘤学家在CAM使用模式上存在差异的原因。
