Choi Jin Young, Chang Yoon Jung, Hong Young Seon, Heo Dae Seog, Kim Samyong, Lee Jung Lim, Choi Jong Soo, Kang Ki Mun, Kim Si-Young, Jeong Hyun Sik, Lee Chang Geol, Choi Youn Seon, Lim Ho-Yeong, Yun Young Ho
National Cancer Control Institute, National Cancer Center, Goyang, Korea.
Asian Pac J Cancer Prev. 2012;13(4):1419-24. doi: 10.7314/apjcp.2012.13.4.1419.
To investigate in depth the use of complementary and alternative medicines (CAMs) by cancer patients at the end-of-life (EOL) and how they communicate with physicians about them. DESIGN AND LOCATION: In 17 hospitals in Korea between January and December 2004 we identified 4,042 families of cancer patients.
The prevalence of CAM use among cancer patients at the EOL was 37.0%, and 93.1% had used pharmacologic types of agents. The most frequent motive for CAM use was the recommendation of friends or a close relative (53.4%) or a physician (1.6%). Only 42.5% discussed CAM use with their physicians. Satisfaction with CAMS was recalled for 37.1% . The most common reason given for that satisfaction was improvement of emotional or physical well-being, while ineffectiveness was the most common reason given for dissatisfaction. The average cost of CAM during the last month of life was $US 900. CAM use was associated with longer disease periods, primary cancers other than liver, biliary, and pancreatic, and need of support from physicians or religion.
CAM use among cancer patients at the EOL was common, not discussed with physicians, and associated with expectation of cure. Expectations were generally unmet while the treatments were a financial burden. Further studies evaluating the effects of CAM at the EOL and factors that enhance communication with the physician are needed.
深入调查癌症患者在临终时对补充和替代医学（CAMs）的使用情况，以及他们如何与医生就这些疗法进行沟通。设计与地点：2004年1月至12月期间，在韩国的17家医院中，我们识别出4042名癌症患者的家属。
临终癌症患者中使用CAMs的比例为37.0%，其中93.1%使用了药物类制剂。使用CAMs最常见的动机是朋友或近亲的推荐（53.4%）或医生的推荐（1.6%）。只有42.5%的患者与他们的医生讨论过使用CAMs的情况。37.1%的患者回忆对CAMs感到满意。产生这种满意度最常见的原因是情绪或身体状况得到改善，而不满意最常见的原因是无效。临终前最后一个月CAMs的平均费用为900美元。使用CAMs与病程较长、非肝脏、胆管和胰腺的原发性癌症以及需要医生或宗教支持有关。
临终癌症患者使用CAMs很常见，未与医生讨论，且与治愈期望有关。这些期望通常未得到满足，同时治疗构成经济负担。需要进一步研究评估临终时CAMs的效果以及加强与医生沟通的因素。
