Percptns/Attitudes/Clin Onc CAM: Japan

Original Article

Perceptions and attitudes of clinical oncologists on complementary and alternative medicine

A nationwide survey in Japan

Ichinosuke Hyodo, M.D. 1 *, Kenji Eguchi, M.D. 2, Tomohiro Nishina, M.D. 1, Hisashi Endo, M.D. 1, Masahito Tanimizu, M.D. 1, Ichiro Mikami, M.D. 3, Shigemitsu Takashima, M.D. 4, Jiro Imanishi, M.D. 5

1Department of Medical Oncology, National Shikoku Cancer Center, Ehime, Japan 2Department of Medical Oncology, Tokai University of Medicine, Kanagawa, Japan 3Department of Psychooncology, National Shikoku Cancer Center, Ehime, Japan 4Department of Surgical Oncology, National Shikoku Cancer Center, Ehime, Japan 5Department of Microbiology, Kyoto Prefectural University of Medicine, Kyoto, Japan

email: Ichinosuke Hyodo (

*Correspondence to Ichinosuke Hyodo, Department of Medical Oncology, National Shikoku Cancer Center, Horinouchi 13, Matsuyama, 790-0007 Ehime, Japan


BACKGROUND The prevalence of complementary and alternative medicine (CAM) is increasing worldwide because of the growing public interest in natural or holistic therapies and because of the flow of information through the Internet.

However, there is a lack of communication between cancer patients and their physicians on topics relating to CAM. The authors performed a cross-sectional survey to evaluate the perceptions and attitudes of Japanese clinical oncologists toward cancer CAM.

METHODS The CAM questionnaires were sent to 2118 clinical oncologists. The questionnaires gathered data on background (age, gender, years in practice, specialty, and knowledge of cancer CAM), perception (effectiveness/ineffectiveness, scientific evidence, and drug interactions), and attitude (experience with and response to CAM users).

Questions about oncologists' perceptions and attitudes to CAM were limited to herbs and other natural products that were sold over the counter.

RESULTS One hundred sixty-six questionnaires were returned as undeliverable. Of the remaining questionnaires, 751 were returned (a response rate of 39%). Two-thirds of the responders were surgical oncologists and most of the remaining responders were medical oncologists.

The majority of oncologists (82%) believed that CAM products were ineffective against cancer. The main reason for this belief was a lack of reliable information (as cited by 85% of oncologists). Only 13% of oncologists had experienced CAM-associated disease improvement in their cancer patients.

Of all the oncologists, 84% considered the possibility of drug interactions between anticancer drugs and CAM products. The majority of oncologists (80%) replied that they could neither promote the use of CAM products nor recommend quitting the products, when they were asked about the use of CAM products by cancer patients.

CONCLUSIONS Negative perceptions of CAM products persist among clinical oncologists. A lack of proven effectiveness of CAM products and concerns about drug interactions with anticancer treatment suggest a need for both accurate information on CAM products and clinical trials.

Cancer 2003;97:2861-8.

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