Views and Reasons of Adult Cancer Patients on the Use of Complementary and Alternative Medicines

7/23/2019 Views and Reasons of Adult Cancer Patients on the Use of Complementary and Alternative Medicines

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DAVAO MEDICAL SCHOOL FOUNDATION, INC

Medical School Drive, Bajada, Davao City

College of Nursing

VIEWS AND REASONS OF ADULT CANCER PATIENTS

ON THE USE OF COMPLEMENTARY AND

ALTERNATIVE MEDICINES

A Research Paper Presented to the Faculty of College

of Nursing in Davao Medical School Foundation

In Partial Fulfillment of the Requirements

in Bachelor of Science in Nursing

By

Norman B. Juruena, BSN

Principal Researcher

Jean Leslie C. Bughao, BSN

Reyveen John B. Geli, BSN

Kathlyn Janine S. Mones, BSN

Mary Laureen M. Santarin, BSN

Rosthy John L. Soria, BSN

Rinnah Grace Q. Talatagod, BSN

Co-Researchers

March 2012

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APPROVAL SHEET

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ACKNOWLEDGEMENT

The researchers would like to express their deepest gratitude and indebtedness to

the following people who gave their full support and invaluable help to make this study

possible:

To Ms. Elsie S. Callueng, RN, MAN, the researchers mentor, for her support and

untiring guidance, as well as valuable suggestions and inspiring words of encouragement

to finish this study;

To Mr. Ruperto Hector A. Lindo, MAEd, the research coordinator who facilitated

this thesis, endowing the researchers with valuable suggestions and for his patience in

guiding us in completing this study;

To the members of the panel at Southern Philippines Medical Center, Ms. Vilma

Comoda, RN, MAN, Ms. Elizabeth Barriga, RN, MAN, Mr. Rueben Gaoaen, RN, MAN,

Ms. Madel Dapit and Ms. Angie Revilla for their availability and for their suggestions

and positive approaches in the improvement of this thesis;

To Ms. Elizabeth R. Soriano, RN, MAN, the Dean of College of Nursing, for

allowing the research team to conduct this study;

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To our beloved parents, for providing us the moral, financial support and

commitment to help sustain the researchers in their field of endeavour, and for the faith

and inspiration to finish this study;

And most of all, to Almighty God, who is the researchers ultimate source of

knowledge, strength, wisdom, inspiration, guiding consciousness and strength during the

difficult moments of writing this thesis.

The Researchers

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DEDICATION

The researchers dedicate this research work to God Almighty,

the source of wisdom and inner strength; and also,

to the future health care professionals.

The researchers also dedicate this research work to their loved ones,

whose assistance and understanding transcended everything

until the completion of this research work.

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ABSTRACT

Complementary and Alternative Medicines are healthcare systems, practices, and

products not considered a part of conventional medicine. The use of CAM has increased

steadily over the past 15 years or so, and undoubtedly it has gained medical, economic

and sociological importance (National Center of Complementary and Alternative

Medicine, 2009). This study used qualitative interviews specifically in-depth interview

approach as the method of data collection. This study had provided a qualitative account

of the adult cancer patients views and reasons on the use of complementary and

alternative medicines and the rationales behind their perspectives. The researchers sought

out five (5) possible respondents for this study who were currently admitted in a local

tertiary hospital. Three (3) respondents came from Internal Medicine Ward while the two

(2) remaining respondents came from Gynecology Ward. The researchers named the

following patients as Respondent A, Respondent B, Respondent C, Respondent D and

Respondent E. In conclusion, the five (5) respondents showed varied views and reasons

on the use of complementary and alternative medicines. Most of them viewed these

treatment modalities were partially effective in treating cancer due to several factors such

as age and absence of underlying illness. Furthermore, majority of the respondents had

shared common reasons on the use of complementary and alternative medicines such as

financial constraint, hope to cure cancer, reduced side-effects of chemo drugs and by the

influenced of others. With these views and reasons, it only showed that the use of

complementary and alternative medicines needs further research and progressive

investigation on its proper applications especially on its role as adjunctive therapy for

cancer.

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TABLE OF CONTENTS

Title Page .... i

Approval Sheet ... ii

Acknowledgement . iii

Dedication .. v

Abstract . vi

Table of Contents .. vii

List of Figures .. x

List of Tables x

I. CHAPTER I Introduction

Background of the Study .... 1

Conceptual Framework ... 3

Theoretical Framework ... 4

Statement of the Problem .... 8

Significance of the Study ..... 9

Scope and Delimitations ...... 9

Definition of Terms .... 10

II. CHAPTER II Review of the Related Literature

Related Readings .... 12

Demographic and Clinical Profile ..... 15

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Views and Reasons of Cancer Patients . 18

Related Studies .. 22

III. CHAPTER III Methodology

Research Design .... 25

Locale of the Study ... 25

Unit of Analysis ........ 25

Sampling Design ... 26

Data Collection Procedure .... 26

Treatment of Data ..... 27

Data Analysis .... 28

Ethical Consideration .... 28

IV. CHAPTER 1V Results and Discussions

Results ... 36

Discussions ... 36

Selected Demographic Profile . 37

Selected Clinical Profile .. 38

Respondents Views 39

Respondents Reasons . 42

V. CHAPTER V Summary, Conclusion and Recommendation

Summary .. 50

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Conclusion ... 52

Recommendation . 52

BIBLIOGRAPHY . 54

APPENDICES

Appendix 1 . 62

Appendix 2 . 64

Appendix 3 . 66

Appendix 4 . 69

Appendix 5 . 72

Appendix 6 . 74

Appendix 7 . 77

Appendix 8 . 80

Appendix 9 . 83

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LIST OF FIGURES

Figure 1. Schematic Diagram showing the Independent and Dependent Variable

of the Study .... 3

Figure 2. Revised Health Promotion Model by Nola J. Pender, 1996 ... 6

LIST OF TABLES

Table 1. Manner of Data Analysis 28

Table 2. Authorship and Contributorship . 33

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CHAPTER I

INTRODUCTION

Background of the Study

Complementary and Alternative Medicines are healthcare systems, practices, and

products not considered a part of conventional medicine. Complementary therapies are

used concurrently with conventional medicine, alternative therapies are used in place of

conventional medicine, and integrative therapies combine mainstream medical therapies

with complementary or alternative therapies for which some high-quality scientific

evidence of safety and efficacy exists (National Center for Complementary and

Alternative Medicine, 2009).

In the United States, about four (4) in ten (10) adults and one (1) in nine (9)

children are using some form complementary and alternative therapy according to the

National Health Interview Survey (Barnes, Bloom & Nahim, 2008). These therapies have

been broadly categorized as alternative medical systems, energy therapies, exercise

therapies, manipulative and body-based methods, mind-body interventions, nutritional

therapeutics, pharmacological and biologic treatments, and spiritual therapies (Office of

Cancer Complementary and Alternative Medicine, 2009). Non-vitamin, non-mineral

natural products are the most commonly used complementary, alternative, or integrative

therapies among adults. Use has increased for many therapies, including meditation;

massage therapy, deep breathing exercises, and yoga (Barnes, Bloom & Nahim, 2008).

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The list of therapies will likely to continue to evolve as novel approaches are proven to be

safe and effective, accepted as mainstream medicine, and integrated into cancer care.

Researchers report that patients with cancer and survivors are more likely to use

these therapies than those without cancer (Basch & Ulbricht, 2004; Fouladbakhsh &

Stommel, 2008). The most common reason for using them is a strong belief in their

efficacy (Verhoef, Balneaves, Boon, & Vroegindewey, 2005). Methodologically rigorous

preclinical and clinical research continues in the effort to establish safety and efficacy of

these therapies through government and nongovernment funding sources. A clinical

challenge is that 40 to 70 percent of use remains undisclosed because of patients beliefs

that these therapies are natural and safe to use, concern that providers may react

negatively, or simply, providers do not ask about their use (Robinson & McGrail, 2004).

In the Philippines, cancer ranks third in leading causes of mortality with 39,634

out of 100,000 populations in the year 2001 to 2005 according to Philippine Health

Statistics (Department of Health, 2011).

According to World Health Organization (2001), there are 250,000 practitioners

of traditional medicines in the Philippines. Approximately five (5) to eight (8)

chiropractors are practicing. There are no privately owned hospitals providing formal

traditional or complementary/alternative medical services. Natural medicines are

marketed over the counter in dozens of health food stores and in a limited number of

pharmacies (World Health Organization, 2001).

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The use of CAM has increased steadily over the past 15 years or so, and

undoubtedly it has gained medical, economic and sociological importance. However,

little is known about the use of CAM in cancer patients here in the Philippines. Thus, the

researchers become interested and choose this topic since there are an increased

percentage of those people who use CAM based on the facts we gathered. It is estimated

that 30 to 50 percent of cancer patients in all stages of the disease will experience pain

and 70 to 95 percent with advanced disease will have significant pain, but only a fraction

of these patients receive adequate treatment. Hence, the researchers will find out the

reasons and views of adult cancer patients on the use of Complementary and Alternative

Medicine.

Conceptual Framework

Figure 1. Schematic Diagram showing the Independent and Dependent Variable of the

Study

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Demographic Profile

of the Respondents:

Age

Sex

Religion

Educational

Attainment

Civil Status

Occupation

Income

Views and reasons of adult cancer

patients on the use ofComplementary and Alternative

Medicines

Independent Variable Dependent Variable

Clinical Profile of the

Respondents:

Medical Diagnosis

Treatment Options


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A variable is a characteristic that has two or more mutually exclusive values or

properties. The independent variable is the presumed cause of the dependent variable,

which is the presumed effect in a relational.

The independent variables are divided into two (2) properties: the demographic

profile of the respondents and the clinical profile of the respondents. Under the

demographic profile, the researchers would like to find out the age, sex, religion,

educational attainment, civil status, occupation and income of the respondents. On the

other hand, the researchers would also like to find out the clinical profile of the

respondents containing the medical diagnosis and treatment options. The independent

variable is made to determine the views and reasons of adult cancer patients on the use of

Complementary and Alternative Medicine which acts as a dependent variable.

Theoretical Framework

The prevalence of Complementary and Alternative Medicine (CAM) is increasing

worldwide because of the growing public interest and the predominance of cancer

worldwide. The incidence of cancer has grown dramatically around the world in recent

decades. A new American Cancer Society report estimates that there will be over 12

million new cancer cases and 7.6 million cancer deaths (about 20,000 cancer deaths a

day) worldwide in 2007 (American Cancer Society, 2007).

According to the theory of Nola Pender, Health Promotion Model (HPM), the

assumptions of the HPM reflect the behavioral science perspective and emphasize the

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active role of the patient for managing health behaviors by modifying the environmental

context. The major assumptions of the HPM: (1) Persons seek to create conditions of

living through which they can express their unique human health potential; (2) Persons

have the capacity for reflective self-awareness, including assessment of their own

competencies; (3) Persons value growths in directions viewed as positive and attempt to

achieve a personally acceptable balance change and stability; (4) Individuals seek to

actively regulate their own behavior; (5) Individuals in all their biopsychosocial

complexity interact with the environment, progressively transforming the environment

and being transformed over time; (6) Health professionals constitute a part of the

interpersonal environment, which exerts influence on persons throughout their life span;

and (7) Self-initiated reconfiguration of person-environment interactive patterns is

essential to behavior change (Tomey & Alligood, 2002).

The HPM (see Figure 2) is an attempt to depict the multifaceted nature of persons

interacting with the environment as they pursue health. It is motivated by the desire to

increase well being and actualize human potential. Nola Pender asserts that there are

complex biophysical processes that motivate individuals to engage in behaviors directed

toward the enhancement of health (Tomey & Alligood, 2002).

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Figure 2. Revised Health Promotion Model by Nola J. Pender, 1996. A.M. Tomey &

M.R. Alligood, 2002.Nursing Theorists and Their Work 5th edition, p.628.

Theoretical statements derived from the model provide a basis for investigate

work on health behaviors. The HPM is based on the following theoretical assertions: (1)

Prior behavior and inherited and acquired characteristics influence beliefs, affect, and

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enactment of health-promoting behavior; (2) Persons commit to engaging in behaviors

from which they anticipate deriving personally valued benefits; (3) Perceived barriers can

constrain commitment to action, a mediator of behavior as well as actual behavior; (4)

Perceived competence or self-efficacy to execute a given behavior increases the

likelihood of commitment to action and actual performance of the behavior; (5) Greater

perceived self-efficacy results in fewer perceived barriers to a specific health behavior;

(6) Positive affect toward a behavior results in greater perceived self-efficacy, which can

in turn, result in increased positive affect; (7) When positive emotions or affect are

associated with a behavior, the probability of commitment and action is increased; (8)

Persons are more likely to commit to and engage in health-promoting behaviors when

significant others model the behavior, expect the behavior to occur, and provide

assistance and support to enable the behavior; (9) Families, peers, and health care

providers are important sources of interpersonal influence that can increase or decrease

commitment to and engagement in health-promoting behavior; (10) Situational influences

in the external environment can increase or decrease commitment to or participation in

health-promoting behavior; (11) The greater the commitments to a specific plan of action,

the more likely health-promoting behaviors are to be maintained over time;

(12) Commitment to a plan of action is less likely to result in the desired behavior when

competing demands over which persons have little control require immediate attention;

(13) Commitment to a plan of action is less likely to result in the desired behavior when

other actions are more attractive and thus preferred over the target behavior; and

(14) Persons can modify cognitions, affect, and the interpersonal and physical

environment to create incentives for health actions (Tomey & Alligood, 2002).

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Statement of the Problem

This study aims to determine the views and reasons of adult cancer patients on the

use of Complementary and Alternative Medicine.

Specifically, this study seeks to answer the following questions:

1. What is the demographic profile of the patients in terms of:

1.1. Age

1.2. Sex

1.3. Religion

1.4. Educational attainment

1.5. Civil status

1.6. Occupation

1.7. Income

2. What is the clinical profile of the patients in terms of:

2.1. Medical Diagnosis

2.2. Treatment Options

3. What are the views of the patients on the use of Complementary and Alternative

Medicine?

4. What are the reasons why did the patients use Complementary and Alternative

Medicine?

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Significance of the Study

The result of this study will benefit the following:

The Respondents. They may benefit from the result of the study because the

information will serve as vital information to determine the views and reasons of adult

cancer patients on the use of Complementary and Alternative Medicine.

The Student Nurses. This study may serve as reference and learning materials

for classroom discussions and other school related research works on determining the

views and reasons of adult cancer patients on the use of Complementary and Alternative

Medicine.

The Health Care Providers. This study may aid health institutions and medical

practitioners to acquire current trends on CAM which may help them to render better

services and effective health teachings.

The Future Researchers. This study may enhance the knowledge and skills for

future purposes for the improvement of the nursing practice for cancer care in the hospital

and even in the community.

Scope and Delimitations

The study focuses on determining the views and reasons of adult cancer patients

on the use of Complementary and Alternative Medicines. The participants will be those

aged 18 years old onwards, who are willing to take part of the study, are awake,

conscious and coherent and as well as able to communicate effectively. Only those cancer

patients who have known their conditions and have been diagnosed for malignancy for

the past three (3) months or more will be included in the study. The data on views and

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reasons of adult cancer patients on the use of Complementary and Alternative Medicine

will be obtained through conduct of in-depth interview with at least five (5) participants.

During our data collection last September 23, 2011 at the certain local tertiary

hospital in Davao City, the total census was seven (7). Four (4) out of seven (7) came

from Internal Medicine Ward and the remaining three (3) came from Gynecology Ward.

Definition of Terms

The following terms in this study are defined operationally for clarity and

common frame of references.

Views refer to the cancer patients views on the use of Complementary and Alternative

Medicine.

Reasons refer to the capacity for rational thought of a cancer patient regarding on the

use of Complementary and Alternative Medicine.

Complementary and Alternative Medicines (CAM) refers to medical products and

practices that are not part of standard care or that which has not been shown consistently

to be effective.

Cancer refers to a class of diseases characterized by out-of-control cell growth. There

are over 100 different types of cancer, and each is classified by the type of cell that is

initially affected.

Cancer staging describes the severity of a persons cancer based on the extent of the

original (primary) tumor and whether or not cancer has spread in the body.

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In-depth interview offers the opportunity to express their self in a way ordinary life

rarely affords them.

Age refers to the length of time that one has existed; duration of life.

Sex refers to the property or quality by which organisms are classified as female or

male on the basis of their reproductive organs and functions.

Religion refers to the belief in and reverence for a supernatural power or powers

regarded as creator and governor of the universe.

Educational Attainment refers to a term commonly used by statisticians to refer to the

highest degree of education an individual has completed.

Civil Status refers to the legal standing of a person in regard to his or her marriage state.

Occupation refers to an activity that serves as ones regular source of livelihood; a

vocation.

Income refers to amount of money or its equivalent received during a period of time in

exchange for labor or services, from the sale of goods or property, or as profit from

financial investments.

Medical Diagnosis refers to the process of attempting to determine and/or identify a

possible disease or disorder and the opinion reached by this process.

Treatment options refer to the management and care of a patient or the combating of

disease or disorder.

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CHAPTER II

Review of the Related Literature

Related Readings

The use of Complementary and Alternative Medicine (CAM) by cancer patients is

reported to increase. CAM are defined as methods that are not part of standard medical

treatment (as described by evidence-based clinical practice guidelines, consensus

statements or common medical practice) and are either used instead of (alternatively) or

in addition (complementary) to a standard cancer treatment. These methods represent a

great variety ranging from chemically well-defined molecules or other substances and

mixtures from plant or animal origin to non-material methods like mind-body therapies,

spiritual healing or psychosocial procedures (National Center for Complementary and


Cancer is a word that none of us wants to hear, especially if it involves a

diagnoses of ones self or loved ones. It can be a very long battle and the treatment

options (especially chemotherapy regimens) can be brutal. During the battle with cancer,

most patients seek ways to cope with the emotional and physical hardships they must deal

with. In fact, according to a study in the Journal Oncologist, approximately 80 percent of

cancer patients use Complimentary and Alternative Medicine (CAM) (Cassileth et al,

2004).

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The goal for most patients that use CAM therapies is not to cure their cancer but

rather help to alleviate the anxiety, stress, pain and side effects of treatment. The use of

CAM therapies, including music therapy, has gained acceptance with the medical

community as an effective tool in assisting patients deal with cancer and treatments. In

fact, the American Cancer Society has a fantastic reference for CAM therapies called the

Complete Guide to Complementary and Alternative Cancer Therapies. Hundreds of

alternative therapies, to include music therapy, are listed and the evidence (or lack of it)

as well as possible side effects are discussed. Most therapies listed are safe but the

reference also lists and discusses some therapies that are used by some patients but can be

dangerous (Cassileth et al, 2004).

The National Center for Complementary and Alternative Medicine (NCCAM)

classification was found pragmatically useful. It all classifies Complementary and

Alternative Medicine (CAM) into five (5) categories of therapy which include the

Alternative Medical Systems; Mind-Body-Spirit therapies; Biologically-based therapies;

Energy and biofield therapies; Manipulative and Body-based therapies; and (National

Center for Complementary and Alternative Medicine, 2009).

Alternative medical systems are built upon complete systems of theory and

practice. Often, these systems have evolved apart from and earlier than the conventional

medical approach used in the United States. Examples of alternative medical systems that

have developed in Western cultures include homeopathic medicine and naturopathic

medicine. Examples of systems that have developed in non-Western cultures include

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traditional Chinese medicine and Ayurveda (National Center for Complementary and


Mind-body medicine uses a variety of techniques designed to enhance the mind's

capacity to affect bodily function and symptoms. Some techniques that were considered

CAM in the past have become the mainstream (for example, patient support groups and

cognitive-behavioral therapy). Other mind-body techniques are still considered CAM,

including meditation, prayer, mental healing, and therapies that use creative outlets such

as art, music, or dance (National Center for Complementary and Alternative Medicine,

2009).

Biologically-based therapies in CAM use substances found in nature, such as

herbs, foods, and vitamins. Some examples include dietary supplements, herbal products,

and the use of other so-called natural but as yet scientifically unproven therapies (for

example, using shark cartilage to treat cancer) (National Center for Complementary and


Manipulative and body-based methods in CAM are based on manipulation and/or

movement of one or more parts of the body. Some examples include chiropractic or

osteopathic manipulation, and massage (National Center for Complementary and


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Energy therapies involve the use of energy fields. They are of two types: (1)

biofield therapies are intended to affect energy fields that purportedly surround and

penetrate the human body. The existence of such fields has not yet been scientifically

proven. Some forms of energy therapy manipulate biofields by applying pressure and/or

manipulating the body by placing the hands in, or through, these fields. Examples include

qi gong, reiki, and therapeutic touch; and (2) bioelectromagnetic-based therapies involve

the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields,

or alternating current or direct current fields (National Center for Complementary and


Demographic and Clinical Profile

In particular, CAM use appears to be more common among those with higher

income, higher educational level, younger age, female gender, or history of CAM use

(Cauffield JS, 2000; Eisenberg DM, Davis RB & Ettner SL et al, 1998; Hyodo I, Amano

N & Eguchi K et al, 2005; Paltiel O, Avitzour M & Peretz T et al, 2001). Also, cancer

patients resort to CAM more frequently than patients with acute or chronic diseases,

which are not malignant (Kappauf H, Leykauf-Ammon D & Bruntsch U et al, 2000). In

addition, use of chemotherapy and advanced disease are correlated with more frequent

CAM use use (Cauffield JS, 2000; Eisenberg DM, Davis RB & Ettner SL et al, 1998;

Hyodo I, Amano N & Eguchi K et al, 2005; Paltiel O, Avitzour M & Peretz T et al,

2001). A study describing the prevalence of CAM use in patients enrolled in early-phase

chemotherapy trials at the Mayo Clinic Comprehensive Cancer Center showed a high use

of such products (Dy GK, Bekele L & Hanson LJ et al, 2004). More than 80 percent of

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patients simultaneously used pharmacologic CAM (like vitamins, herbs, and minerals) in

addition to their experimental chemotherapeutic agents (Dy GK, Bekele L & Hanson LJ

et al, 2004), which is (currently) often an exclusion criterion and/or formally not allowed

during this type of treatment. Additionally, a study in nearly 500 cancer patients revealed

that 65 percent of the 131 patients being treated with chemotherapy alone said they used

CAM in conjunction with their chemotherapy, whereas only 35 percent of the 142

patients receiving radiotherapy reported CAM use (Vapiwala N, Mick R & DeNittis A et

al, 2005).

Colorectal and breast cancer patients, in particular, seem to be likely to use

dietary supplements, compared with lung cancer patients (Gupta D, Lis CG & Birdsall

TC et al, 2005; Rakovitch E, Pignol JP & Chartier C et al, 2005). An increased perception

of the risk of cancer recurrence and cancer-related death are associated with CAM use by

breast cancer patients, as concluded in a study by Rakovitch et al. (Rakovitch E, Pignol

JP & Chartier C et al, 2005). In contrast, in another recent study, it was concluded that

CAM users are less likely to believe they will die from breast cancer (Helyer LK, Chin S

& Chui BK et al, 2006). In both studies, no relationship between CAM use and anxiety

and/or depression could be found. This is noteworthy because both anxiety and

depression are frequently mentioned as an important explanation for the more frequent

use of CAM, in particular CAM influencing mood like St. Johns wort or medicinal

cannabis (De Smet PA, 2002; Stevinson C & Ernst E, 1999; De Jong FA, Engels FK &

Mathijssen RH et al, 2005; Radbruch L & Nauck F, 2003).

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Most cancer patients combine, rather than replace, conventional therapy with

CAM (Cauffield JS, 2000; Lafferty WE, Bellas A & Corage Baden A et al, 2004;

Burstein HJ, Gelber S & Guadagnoli E et al, 1999; Cassileth BR, Lusk EJ & Strouse TB

et al, 1984; Lerner IJ & Kennedy BJ, 1992). This is clearly demonstrated in a survey by

Cassileth et al. (Cassileth BR, Lusk EJ & Strouse TB et al, 1984), in which 304 in-

patients of a cancer center and 356 patients under the care of unorthodox practitioners

were interviewed. Of all patients studied, 8 percent never received any conventional

therapy, and 54 percent of patients on conventional treatment also used unorthodox

treatments.

The use of Complementary and Alternative Medicine in cancer survivors is

underreported (Gansler, Chiewkwei, Crammer, & Smith, 2008; Saxe et al., 2008), with as

many as 81 percent of survivors having used vitamin or mineral supplements. Although

use of the more common CAMs by cancer survivors was comparable to the general

population, Gansler et al. (2008) noted an increase in other forms of CAM. Deng,

Cassileth, and Yeung (2004) suggested that CAM users are seeking a holistic approach to

their care and see CAM as a natural way to take responsibility and control of their health

and promote an increased quality of life (Frenkel, Ben-Arye, Baldwin, & Sierpina, 2005;

Saxe et al., 2008).

Increased CAM use was reported in short and long-term survivors (Gansler et al.,

2008). Use and types of therapies differ according to cancer sites (Velicer & Ulrich,

2008). Survivors of melanoma and kidney cancers were reported as least likely to use

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CAM, whereas survivors of breast, ovarian, non-Hodgkin lymphoma, and brain or central

nervous system cancers were reportedly most likely to use CAM (Gansler et al., 2008;

Richardson, Sanders, Palmer, Greisinger, & Singletary, 2000). Stage of disease also

influenced CAM use, with increases noted in advanced-stage disease (Gansler et al.,

2008). In addition, CAM use can be affected by geography, with higher use reported in

California (Goldstein et al., 2005). Goldstein et al. (2005) hypothesized that the reason

for this may be the "social milieu" that exists in California, where the population leads a

culturally creative lifestyle (Goldstein et al., 2005). Additional commonalities

identified in the survivors who use CAM included better education, a focus on health,

and a general use of more mainstream medical services (Deng et al., 2004,).

Views and Reasons of Cancer Patients

There are specific cancer-related reasons for using CAM. A Canadian survey of

more than 900 cancer patients demonstrated that 94 percent experienced disease-related

symptoms such as fatigue and anxiety that were not addressed by their conventional

treatment (Ashbury FD, Findlay H & Reynolds B et al, 1998). Most cancer patients, in

general, were satisfied with the conventional treatment they received for their cancer.

Nonetheless, they were more likely dissatisfied with the attention paid to their symptoms

and side effects. A second reason for CAM use is the presumed action as an anticancer

agent (Kosty MP, 2004; Straus SE, 2002). Several CAM products are under investigation

in clinical trials for this reason; however, they have not been under appropriate trial

development so far (Vickers AJ, Kuo J & Cassileth BR, 2006).

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CAM is used for its cancer preventive properties as well. An ideal preventive

agent has little or no toxicity, high efficacy in multiple sites, capability of oral

consumption, a known mechanism of action, low cost, and above all, general acceptance

(Siddiqui IA, Adhami VM & Saleem M et al, 2006). For example, more or less conscious

use of green tea by men has gained its place in society. Indeed, in a case-control study a

protective effect of green tea against prostate cancer was suggested (Jian L, Xie LP &

Lee AH et al, 2004), which is supported by in vitro research (Siddiqui IA, Adhami VM,

Saleem M et al, 2006; Gupta S, Ahmad N & Mohan RR et al, 1999). The risk was

thought to decline with increasing frequency, duration, and quantity of green tea

consumption. However, it should be noted that conflicting results are reported by

epidemiological studies on the use of green tea as a protective substance in relation to

prostate cancer (Jian L, Xie LP & Lee AH et al, 2004).

In addition to these reasons, cancer patients, in general, have the same reasons as

other people for using CAM (Cassileth BR, 2000; Cassileth BR, Lusk EJ & Strouse TB et

al, 1984; Kronenberg F, Mindes J & Jacobson JS, 2005). Disease-related symptoms not

easily addressed by conventional treatment and concerns about the adverse effects of

chemical/pharmaceutical medicines are some of them (Cauffield JS, 2000). Also, an

increased need for more personalized health and a greater public access to health

information (i.e., the Internet) and popular media attention to CAM fuel its increasing use

in many industrialized countries (Eisenberg DM, Davis RB & Ettner SL et al, 1998; Ernst

E & Cassileth BR, 1998; Hyodo I, Amano N & Eguchi K et al, 2005). In addition, quality

of life may also be a reason for CAM use (Lis CG, Cambron JA & Grutsch JF et al,

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2006). However, results are conflicting regarding the self-reported quality of life among

CAM users versus nonusers. In a recent report, a study performed at a community

hospital comprehensive cancer center was described, which found a better quality of life

among dietary supplement users compared with nonusers (Lis CG, Cambron JA &

Grutsch JF et al, 2006). In contrast, earlier data showed opposite results (Burstein HJ,

Gelber S & Guadagnoli E et al, 1999; Cassileth BR, Lusk EJ & Guerry D et al, 1991;

Paltiel O, Avitzour M & Peretz T et al, 2001). It should be mentioned that these findings

are not completely comparable because the latter studies used a broader definition for

CAM.

Survivors identified many reasons for using CAM, and indicated that locus of

control may be one important factor (Gansler et al., 2008). Survivors responses

positively correlated with the use of CAM as a means of stress and recurrence reduction

and enhancement of wellness and quality of life (Buettner et al., 2006; Greenlee, White,

Patterson, & Kristal, 2004; Saxe et al., 2008), with the belief that CAM therapies are

nontoxic (Richardson et al., 2000). Additionally, for those with advanced disease, CAM

use was believed to be associated with prolongation of life (Richardson et al., 2000), the

desire to remain hopeful (Richardson et al., 2000; Verhoef, Balneaves, Boon, &

Vroegindewey, 2005), or to provide cure (Richardson et al., 2000).

In cancer survivors, CAM was reportedly used primarily for treatment for

ailments such as diabetes mellitus, hypertension and other than the cancer diagnosis

(Goldstein, Lee, Ballard-Barbash, & Brown, 2008). The National Center for Health

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Statistics reported that cancer survivors were more likely to die from noncancer causes,

and that they are more likely to have at least one functional limitation. As a result, the

negative impact on quality of life or function from chronic health issues (Goldstein et al.,

2008; Saxe et al., 2008), as well as the short- and long-term cancer-related medical issues

or symptoms (Carpenter, Ganz, & Bernstein, 2008; Greenlee et al., 2004; Miller et al.,

2008; Wesa, Gubili & Cassileth, 2008), were identified as initiating factors for using

CAM by cancer survivors. The use of chemotherapy during treatment also was associated

with an increased CAM prevalence (Mao et al., 2008).

The rising costs of health care (Saxe et al., 2008), coupled with multiple unmet

needs, equates to multiple CAM uses (Mao et al., 2008). These unmet needs were

identified by Mao et al. (2008) as emotional, physical, nutritional, financial,

informational, treatment- and employment-related, and daily living activities. Other

reasons included an identified dissatisfaction with conventional care (Richardson et al.,

2000; Saxe et al., 2008), fragmentation of care into survivorship, lack of empathy and

support, or if a survivor's subsequent needs were unfulfilled (Mao et al., 2008). In

addition, Carpenter et al. (2008) identified decreased emotional function and multiple

medical issues in very long-term breast cancer survivors who used CAM. The potential

for recurrence and high levels of worry (Mao et al., 2008) and distress (Lawsin et al.,

2007) also were reported with increased use. Finally, the use of herbal supplements were

reportedly used to reduce the side effects of treatment and to boost immune function

(Buettner et al., 2006; Deng et al., 2004; Lawsin et al., 2007; Richardson et al., 2000;

Saxe et al., 2008).

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Related Studies

People who used CAM before a diagnosis are more likely to use CAM after their

diagnosis (Miller M, Boyer MJ, Butow PN, Gattelari M, Dunn SM & Childs A, 1998;

Harris P, Finlay I, Cook A, Thomas KJ & Hood K, 2003), but the biggest predictors of

use are being female, younger and tertiary educated (Harris P, Finlay I, Cook A, Thomas

KJ & Hood K, 2003; OCallaghan FV & Jordan N, 2003; Shorofi SA & Arbon P, 2010;

Girgis, A, Adams J & Sibbritt D, 2005; Hedderson M, Patterson R, Neuhouser ML,

Schwartz SM, Bowen DJ & Standish LJ, 2004).

Shorofi and Arbon (2010) claim women are more likely than men to have a

positive attitude towards CAM (Shorofi SA & Arbon P, 2010). Other studies conclude

women are 1.9 times more likely than men to use CAM (Girgis, A, Adams J & Sibbritt

D, 2005; Hedderson M, Patterson R, Neuhouser ML, Schwartz SM, Bowen D &,

Standish LJ, 2004). Hedderson et al (2004) found that about 80 percent of women and 60

percent of men used at least one CAM, and suggested it may be considered more

socially acceptable for women to seek help (Hedderson M, Patterson R, Neuhouser ML,

Schwartz SM, Bowen DJ & Standish LJ, 2004). But men were more likely to use CAM

when their symptom distress scores were higher.

In a review of public attitudes to natural medicine, Leach reported that regular

CAM users were more likely to be dissatisfied with conventional practitioners than non-

users (Leach MJ, 2004), and that over 40 percent of users turn to natural therapies

because of a perceived failure of orthodox medicine to treat their health problems.

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OCallaghan and Jordan (2003), in their survey of postmodern predictors of CAM use,

quote one study with a contrary finding: that although dissatisfaction with the doctor-

patient relationship and having postmodern values of health are significant predictors,

dissatisfaction with medical outcomes is not. OCallaghan and Jordan (2003) conclude

that holding postmodern values such as rejection of authority, and feeling responsible

for ones own health predicts a positive attitude to CAM use (OCallaghan FV &

Jordan N, 2003).

In Shorofi and Arbons (2010) comprehensive study of CAM attitudes, 46 percent

of respondents had a positive attitude towards CAM, while only 10 percent had a

negative attitude. In this study, patients rated their level of agreement to 18 statements

about attitudes towards CAM and allopathic medicine. Examples include: CAM is an

important aspect of my own familys health care (36 percent agree, 25 percent disagree,

35 percent unsure) and conventional health care services are too impersonal (27 percent

agree, 44 percent disagree, 26 percent unsure) (Shorofi SA & Arbon P, 2010).

Miller et al (1998) found that 63 percent of patients felt CAM gave them

psychological benefits and 41 percent physiological benefits. A majority would

recommend the treatment they had and use the same therapy again themselves. However,

29 percent thought CAM provided no benefit (Miller M, Boyer MJ, Butow PN, Gattelari

M, Dunn SM & Childs A, 1998).

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Salminem et al found that 25 percent of women reported no improvement from a

change in diet (Miller M, Boyer MJ, Butow PN, Gattelari M, Dunn SM & Childs A,

2004). However, 50 percent felt their condition had improved, while 25 percent were

unsure. Harris et als survey (2003) of 1034 people with cancer determined that 72

percent were satisfied with their CAM use, 25 percent were uncertain and 4 percent were

dissatisfied (Harris P, Finlay I, Cook A, Thomas KJ & Hood K, 2003). A similar result

was reported by Chrystal et al (2003), where 71 percent of patients thought CAM

beneficial and six (6) percent found CAM unhelpful (Chrystal K, Allan S, Forgeson G &

Isaacs R, 2003).

A participant in Verhoef et als study (2005) reported an improvement in physical

wellbeing, with massage or a natural health product most likely to cause these positive

outcomes. Some participants cited emotional improvements, including feelings of greater

control, more optimism, reduced anxiety and greater resilience. Others believed that

CAM helped them remain cancer free (Verhoef M, Mulkins A & Boon H, 2005).

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CHAPTER III

METHODOLOGY

Research Design

This study used qualitative research as the method of data collection. In this

context, interviews were viewed as situations where various meanings of feelings and

experiences were constructed and negotiated by the participants.

The researchers used the phenomenological type of qualitative research in which

it studies the feelings and lived experiences of a person. Moreover, the meanings of

feelings and experiences are placed in particular social and cultural contexts. In this

context, participants accounts during an interview were viewed as products of an

interrelationship between the interviewers and the interviewees. During an interview

situation, both the researchers and the participants had strived to arrive at meanings

together that both can understand.

Locale of the Study

The study was conducted in a certain local tertiary hospital in Davao City. The

involved departments were Gynecology ward, and Internal Medicine ward.

Unit of Analysis

The unit of analysis was the adult cancer patients who were awake, conscious and

coherent whose age were from 18 years old up to 65 years old and who were currently

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admitted in a certain local tertiary hospital in Davao City and who were willing to

participate in the study. This study obtained five (5) participants who were currently

using Complementary and Alternative Medicines.

Sampling Design

The non-probability purposive sampling technique was used in this study. This is

a sampling technique in which the researchers were allowed to pick respondents based on

the criteria. The criteria used for choosing the respondents were as follows: (1) must be

an adult cancer patient who is awake, conscious and coherent; (2) must be at least 18

years old; (3) must be currently admitted in a local tertiary hospital; and (4) must be a

Complementary and Alternative Medicines (CAM) user.

Data Collection Procedure

To be able to fully determine the important details and information, the

researchers devised a systematic approach to fully compensate the time involved therein.

Step 1: Preparation Phase

The researchers of this study deliberated with the necessary information. Then a

careful analysis and assessment of the data at hand and facilitated the proponents in

conceptualizing the framework for this study.

Before the researchers carry out this study, a letter of consent addressed to the

Dean of College of Nursing of Davao Medical School Foundation, Inc., the Hospital

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Administrator of the Local tertiary Hospital and as well as the consent for the respondents

were considered, seeking approval to conduct the study. Furthermore, the researchers

sought for permission to the respondents to allow us to see his/her chart regarding on

his/her clinical profile.

Step 2: Interview Phase

The researchers of this study were using the open-ended question to a patient

regarding on his/her views and reasons on the use of Complementary and Alternative

Medicine. Furthermore, the researchers were using an interview guide in gathering data

in order to have sufficient information.

Step 3: Transcription of Data

Interviews were transcribed verbatim. Transcription rules regarding on how to

handle pauses, false starts, emotional expressions and etc. were agreed upon to assure

conformity between different interview transcriptions as well as different transcribers.

Step 4: Analysis and Interpretation

The researchers of this study analyzed and interpret the patients statements.

Treatment of Data

The data were encoded into the computer using the Microsoft Word. The

qualitative data analysis approach was used to analyze the views and reasons of the adult

cancer patients on the use of Complementary and Alternative Medicines.

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Data Analysis

Objective Variable Statistical Treatment

To describe the patients

demographic profile

1. Age

2. Sex

3. Religion

4. Educational Attainment

5. Civil Status

6. Occupation

7. Income

Qualitative Data Analysis

To determine the clinical

profile of the patient

1. Medical Diagnosis

2. Treatment options


To determine the views

of using the CAM


To determine the reasons

of using the CAM


Table 1. Manner of Data Analysis

Ethical Consideration

1. Ethics Review

A. Office of the Dean, College of Nursing, DMSF

Permission was asked from the Office of the Dean to conduct study. (See

Sample Letter, Appendix 1)

B. Office of the Hospital Administrator and/or Hospital Research Committee

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A letter was sent to the Office of the Hospital Administrator and/or

Hospital Research Committee to allow us to conduct study in the area. (See

Sample Letter, Appendix 2)

2. Informed Consent (Form)

As soon as permission from the Hospital Administrator and/or Hospital Research

Committee is granted, permission from the participating individuals was been sought.

A written informed consent was been used in different languages (English and

Filipino Version Tagalog and Cebuano). (See Informed Consent, Appendix 3

English Version, Appendix 4 Tagalog Version and Appendix 5 Cebuano Version)

3. Informed Consent (Signatory)

The researchers had been giving two copies of informed consent form (one for the

researchers copy and the other one is the participants copy) and had been requiring a

signature to formalize the consent.

4. Informed Consent (Witness)

The researchers had been seeking for somebody (especially the significant others)

to witness the signing of informed consent form.

5. Informed Consent (Proxy Consent)

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The researchers allowed proxy consent if the respondent is not able to read or

write. The only person who will sign for the consent is the one who is the nearest kin

of the respondent.

6. Informed Assent

The researchers did not obtain informed assent since the unit of analysis for this

research study were adult respondents whose aged were from 18 years and onwards.

7. Informed Consent (Process)

The potential respondents were been invited to listen to a short

explanation/discussion of the study objectives. Potential respondents queries will be

entertained anytime during the explanation/discussion.

8. Informed Consent (Timing)

The researchers obtained the informed consent right after the study objectives

discussed and explained very well.

9. Informed Consent (Venue)

The researchers obtained the informed consent at the respondents bed and in

what department he/she confines.

10. Study Objectives, Risks, Benefits and Procedures

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The researchers formulated study objectives and this served as the basis for the

data collection. The researchers were asking personal question to our participants and

they were free not to answer any of those questions. There may have benefits for

taking part for this study and it may help others to understand how the

Complementary and Alternative Medicines affects their life.

11. Remuneration, reimbursement and other benefits

The participants did not spend anything during our interview. But, the researchers

were giving free snacks as sign of gratitude for their active participation in this study.

12. Confidentiality

The records from this study were kept as confidential as possible. The researchers

did not reveal information about the participants to a third party without their consent

or a clear legal reason. All transcripts and summaries were given codes and stored

separately from any names or other direct identification of participants. Research

information was kept in locked files at all times. Only research personnel had

accessed to the files and only those with an essential need to see names had accessed

to that particular file.

13. Investigators responsibility during adverse events

The researchers did not provide for any payment if the participants will be harmed

as a result of taking part in this study. If such harm occurs, treatment will be

provided. However, this treatment will not be provided free of charge.

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14. Specimen Handling

The researchers had not performed any tissue sampling in the study.

15. Voluntariness of participation

The researchers did not force anybody to participate in this study researcher. If the

participant will not decide to participate in this research, there will be no further

consequence be made. If the participant decides to participate, the participant may

stop participating at any time and the participant may decide not to answer any

specific question.

16. Alternative Options

The researchers respected the participants decision if they decided to withdraw or

refuse to participate in our study, and they will not be penalized or given charges for

that matter.

17. Privacy

The researchers did no longer contact the participants nor to have home visitations

after the scheduled interview.

18. Information of Study Results

The researchers decided not to inform the respondents involved in the study

regarding the result of the research conducted. This decision will help the researchers

maintain confidentiality and privacy of the participants.

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19. Authorship and Contributorship

Name Authorship and Contributorship

Jean Leslie Bughao Methodology (Research Design, Locale of the Study, Unit

of Analysis and Sampling Design)

Appendix 9

Reyveen John Geli Introduction (Background of the Study)

Methodology (Data Collection Procedure, Treatment of

Data and Data Analysis)

Norman Juruena Introduction (Conceptual Framework, Theoretical

Framework and Statement of the Problem)

Review of the Related Literature

Results and Discussions

Appendices 3 and 6

Kathlyn Janine Mones Introduction (Significance of the Study)

Methodology (Ethical Consideration)

Mary Laureen Santarin Introduction (Scope and Limitation)

Appendices 5 and 8

Rosthy John Soria Acknowledgement and Dedication

Bibliography and Appendices 1 and 2

Rinnah Grace Talatagod Introduction (Definition of Terms)

Appendices 4 and 7

Table 2. Authorship and Contributorship

20. Extent of use of study data

The data were encoded in the computer. There was no identifying information

encoded to the computer so that the information cannot be traced back to the person

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concerned. Only the group members had accessed to the data and the interview

schedule. The interview schedules were kept at the data storage area at the Nursing

Department of the Davao Medical School Foundation (DMSF). The interview

schedule shall be kept for a period of five (5) years. After five (5) years, the interview

schedule shall be disposed of by shredding.

21. Conflict of interest

Each of the researchers was appointed to do certain part of the research study and

was guided by the group leader and with the help of the adviser/mentor. The

researchers had shared common interest with regards in formulating the research

study.

22. Publication

The researchers will publish the research study at the end of November year 2011.

It will be placed at the Nursing Library of Davao Medical School Foundation, Inc.

This study will be use as a reference for future researchers.

23. Funding

All the expenses were coming from the researchers pocket.

24. Duplicate copy of informed consent

The researchers secured two (2) copies of an informed consent form, one for the

researchers copy and the other one is the participants copy.

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25. Questions and concerns regarding the study

The researchers allowed the participants to raise questions and voice out their

concerns about the study.

26. Contact details

The participants will contact, Mr. Norman Juruena with the contact number of

09322151358 or 302-8089, if they have any questions, concerns or complaints about

the research.

CHAPTER IV

RESULTS AND DISCUSSIONS

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Results

Five (5) adult cancer patients were interviewed for this study and who were

currently admitted in a certain local tertiary hospital. All of them were using different

complementary and alternative medicines. This study was conducted in order to find out

the selected demographic profile, selected clinical profile, and views and reasons of the

adult cancer patients on the use of complementary and alternative medicines.

Discussions

This study had provided a qualitative account of the adult cancer patients views

and reasons on the use of complementary and alternative medicines and the rationales

behind their perspectives. The findings indicated a spectrum of views and reasons on

complementary and alternative medicines. The researchers sought out five (5) possible

respondents for this study who were currently admitted in a local tertiary hospital. Three

(3) respondents came from Internal Medicine Ward while the two (2) remaining

respondents came from Gynecology Ward. The researchers obtained consent and

fortunately, the patients agreed upon on what they had read in the consent. The

researchers named the following patients as Respondent A, Respondent B, Respondent C,

Respondent D and Respondent E.

Selected Demographic Profile

This section presents the selected demographic profile of the respondents. It

includes age, sex, religion, educational attainment, civil status, occupation and income.

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Age. The age of the respondents ranged from 46 to 61 years old. First respondent

is 58 years old, second respondent is 59 years old, third respondent is 54 years old, fourth

respondent is 46 years old and the fifth respondent is 61 years old. They have a mean age

of 55.6 years old.

Sex. All of the respondents were females.

Religion. Almost all of the respondents are Roman Catholic, four (4) out of five

(5), while the remaining one (1) respondent is a Protestant (Church of Christ).

Educational Attainment. There were three (3) respondents who were college

graduates and the remaining two (2) respondents were elementary undergraduates, one of

them reached only grade one (1) and the other one (1) reached only grade two (2).

Civil Status. Almost all of the respondents were married, three (3) out of five (5),

while the remaining two (2) respondents were a single and a widower respectively.

Occupation. Only one (1) respondent is currently employed, an office clerk, to a

private company. Two (2) respondents are unemployed and the remaining two (2)

respondents are self-employed, a puto maker and a binangkal seller respectively.

Income. The monthly income of the respondents ranged from Php 1,200 to Php

4,000 with a mean average of Php 2,233.33. First respondent has an estimated monthly

income of Php 1,200 to Php 1,500. Second respondent has monthly income of Php 3,000

to Php 4,000. Third respondent has an estimated monthly income of Php 3,000. The

unemployed respondents are currently supported by their children and nearest kin.

Selected Clinical Profile

This section presents the selected clinical profile of the respondents. It includes

medical diagnosis and treatment options.

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Medical Diagnosis. There were three (3) breast cancer respondents, two (2) of

which were diagnosed with stage four (4) and the other one (1) was diagnosed with stage

three (3). The two (2) remaining respondents were diagnosed with ovarian cancer stage

one (1).

Treatment Options. All of the respondents had undergone diagnostic procedures

such as CBC, urinalysis, CT scan, chest x-ray, ultrasound and biopsy. Two (2)

respondents had undergone operations. One (1) who has breast cancer stage four (4) had

undergone Modified Radical Mastectomy (MRM) last June 2010. The other one (1) with

ovarian cancer stage one (1) had two (2) operations, Total Abdominal Hysterectomy

Bilateral Salphingo Oophorectomy (TAHBSO) and appendectomy last April 2011. Four

(4) out of five (5) respondents are currently on chemotherapy. The remaining one (1)

respondent was diagnosed to have breast cancer stage four (4) a year ago but refused to

undergo chemotherapy by that time. During the interview, she was about to start of the

said treatment. Almost all of the respondents, four (4) out of five (5), were receiving

chemotherapeutic drugs and some were given antibiotics, diuretics, pain reliever, anti-

emetic and beta adrenergic drugs.

Respondents Views

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This section presents the different views of the respondents regarding on the use

of complementary and alternative medicines. The data were collated and the respondents

views were classified as effective, partially effective and not effective.

Effective. Only one (1) respondent said that using the complementary and

alternative medicines, specifically acupuncture, is more effective than the conventional

therapy in terms of alleviating the side effects of chemotherapeutic drugs such as pain,

nausea and vomiting.

Ang gusto dyud nako kay doctors order lang gyud kung

pwede, pero kung sa acupuncture ko mag basi maayo gyud

kaayo siya, narelieved ko sa akong ginabati. Makawala og

sakit. Makaingon ko nga epektibo siya kung acupuncture

lang ang atong basehon pero sa uban dili kaayo ko kaingon

nga epektibo jud. (All I want is the Doctors Order but

when you base on the Acupuncture all I can say that it is

more effective because it relieves me from pain and can

ease my pain but for others I cannot say that it is more

effective). Respondent D, 46 years old

However, she believed that herbal medicines were not effective in treating cancer.

Furthermore, she added that the effectiveness of complementary and alternative

medicines depend on the age of a person based on her observation.

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Partially Effective. Three (3) respondents believed that complementary and

alternative medicines were partially effective. One (1) respondent believed that it will

only be more effective to those women in their pre-menopausal year (ages 12 to 45 years

old).

Pero sa akong nabantayan, mu-epekto lang man siguro

ni sa mga naga-regla pa. (As what I have observed, it is

more effective when you are still having menstruations.)

Respondent B, 59 years old.

On the other hand, the other one (1) respondent believed that these alternative

medicines alleviated her pain and other effects of the conventional therapy. Moreover,

she strongly considered that it will only help in preventing the occurrence of cancer.

Nindot siya gamiton kung wala pa kay sakit. (It is better

to use when you are not yet sick.) Respondent C, 54

years old.

While the last one (1) respondent said that the complementary and alternative

medicines had little effects in reducing the side effects of the drugs that she was taking.

She believed that only those patients diagnosed at a younger age and at the same time

using the complementary and alternative medicines will have a chance of survival.

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Makatabang pud gamay og maka-ingon ko naay epekto

gamay sa akoa. (It helps me a little and I can say that it is

somehow effective.) Respondent E, 61 years old.

The three (3) respondents all believed that the use of complementary and

alternative medicines added another year of their life.

Not Effective. The remaining one (1) respondent believed that it was not

effective. At first, she strongly believed on the effectiveness of the complementary and

alternative medicines based on the experiences of others. At the long run of using the

complementary and alternative medicines, she was really expecting that she will be cured

and the conventional therapy was no longer necessary. Unfortunately, her condition

worsens.

Pag tuo nako sa una maka ayo ni sa mga sakit-sakit, pero

mali di-ay ko, dili tanan sakit kaya niya ma tambalan og

mas maayo pa mo kunsulta sa doktor mismo aron di na mu

lala ang imong sakit (Before, I thought this will cure

any kind of illnesses, but I was wrong, not all illnessess

cured by this and it is better to consult a doctor to hinder

further worsening of the illness) Respondent A, 58

years old

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She decided to stop using the complementary and alternative medicines and

abided on the conventional therapy instead.

Wala siya makatabang sa akoa, gi-undangan na gani

nako. Mas epektibo pa ang sa hospital kaysa sa una

nakong gina pang himo (It didnt help me, so I stop

using it. It is more effective to be hospitalized than on what

I had used before) Respondent A, 58 years old

Respondents Reasons

This section presents the different reasons of the respondents on the use of

complementary and alternative medicines. The data were collated and the respondents

reasons were the following:

Financial Constraint. All of the respondents said that their income is not enough

to sustain their treatment regimen. In order to maintain their conventional therapy, they

borrowed money from their friends, neighbors and significant others for them to afford

the treatments that were being prescribed by their physicians. However, complementary

and alternative medicines were their first choice before they underwent the conventional

therapy.

Naga hiram lang ko ug kwarta sa akong mga amigo ug

amiga kay kulang akong kwarta pang palit ug tambal.

Estimate nako, mga 3,500 pesos siguro ang akong mga na

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gastos tapos Php 1,200 to Php 1,500 lang akong makuha

sa pag baligya nako ug puto taga bulan. (Im just

borrowing money from my friends so that I can afford to

buy my own medicines for my illness. My estimated

expenses was already 3,500 while I only have Php 1,200 to

Php 1,500 earnings from my puto business)

Respondent A,58 years old female.

Kulang gihapon akong gina sweldo pang palit ug tambal

para sa akong sakit Php 3,000 to Php 4,000 lang akong

sweldo taga bulan (My salary is not enough for me to

buy all my medicines monthly. My salary is only Php

3,000 to Php 4,000 ) Respondent B59 years old female.

Isa ko ka government employee sauna, nag resign na ko

karon tungod sa akong sakit. Akong duha ka anak ang

naga tabang sa ako karon. (I was a government

employee before but I resigned from my job because of my

illness. My two children were the one who are supporting

me now.) Respondent C,54 years old female

Maski naa mi negosyo kulang man gihapon among

kwarta pang maintain sa akong mga tambal kay sige lang

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ko pa lab test. (Even though we have business, our

money is not enough to buy all my maintenance medicines

because I underwent several types of diagnostic tests.)

Respondent D,46 years old female

Gamay lang kaayo ang among makuna na kwarta sa

among negosyo na binangkal, naga hiram na lng mi ug

kwarta sa akong mga igsoon pampalit ug tambal na ko.

(We only earned a little from our binangkal business,

sometimes we used to borrow money from my brother and

sister to buy my medicines.) Respondent E, 61 years old

female.

Hope to cure cancer. Four (4) out of five (5) respondents had strongly believed

that they will be cured by the complementary and alternative medicines while the

remaining one (1) respondent had partially lost her belief on the said therapy since her

condition was getting much worse. However, all of them were hoping to be cured by the

complementary and alternative medicines.

Wala siya makatabang sa akoa, gi-undangan na gani

nako. (No it doesnt help me, I stop using it)

Respondent A, 58 years old

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Nakatabang man gamay kay hangtod karon buhi gihapon

ko. (It helps me a little because until now I live).

Respondent B, 59 years old

Okey lang man. Hopeless na hopeful gihapon. Ambot

kung makaayo gani siya. Pero nindot siya gamiton kung

wala pa kay sakit. (It is okay. Hopeless but hopefull still.

I dont know if it cures me. But its nice to use when you

dont have illness yet). Respondent C, 54 years old

Maayo dyud para sa akoa ang acupuncture.

(Acupuncture is good on me). Respondent D, 49 years

old

Dili man epektibo, wala man ko maayo sa akong sakit sa

pag gamit anang mga herbal pero murag naka-ingon ko

nga murag naa siya naitabang pod gamay sa akong

kinabuhi. (Not effective, I am not being cured on my

sickness when I used herbal but I can say that it helps me a

little bit in my life). Respondent E, 61 years old

Reduce side-effects of treatment. The most devastating part of the treatment

regimen is the side effects of the conventional therapy. Almost all of the respondents,

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four (4) out of five (5), were given chemotherapeutic drugs. They were all experiencing

side effects of the said drugs such as pain, nausea, vomiting, hair fall, loss of appetite and

weight loss. Three (3) respondents were only using complementary and alternative

medicines for them to relieve from the unpleasant effects of the drugs that they were

taking.

Naka bati ko ug pag ka lipong ug suka suka pag ka

human sa akong chemotherapy (I felt so dizzy and I

vomited after my chemotherapy.) Respondent A, 58

years old female

Naka sulay ko ug walay gana sa pagkaon ug suka suka

pag kahuman sa akong chemotherapy(I experienced loss

of appetite and vomiting after my chemotherapy.)

Respondent C, 54 years old female.

Nag sige nako suka kay malasahan nako ang tambal,

tapos wala nako gana mukaon. (I always vomit because

I can already taste the medication, then I also experienced

loss appetite.) Respondent D, 46 years old female.

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Mangurog ko, magsuka tapos wala gana kaon. (I

experienced tremors, vomiting and loss of appetite.)

Respondent E, 61 years old female.

Influenced by the friends, neighbors and others. All of the respondents were

first heard about complementary and alternative medicines through their friends,

neighbors and the significant others. They were influenced to use the complementary and

alternative medicines because of their friends experiences. Moreover, complementary

and alternative medicines have become more popular because of the advertisements in

the television, radio and newsprints. The respondents had become more interested on

complementary and alternative medicines based on the experiences to those who had

used the said therapy.

Na dunggan lang nako siya sa mga silingan nako,

makatabang man siya pero dili jud kaayo. (I heard it

from my neighbors; it helps me but not that much).

Respondent A, 59 years old

Nakabalo lang man ko sa akong amiga lang pod. Ana

siya nga iyahang amiga nga naa pod kanser sa susu kay

naga-inom og mga herbal nga tambal sama na lang sa

capsicum, grapeseed, saluyot, ampalaya, termerick,

kumintang, lagundi, mangosteen, quantum, silver cure og

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bifnor liquid. Ingon siya nga naayo jud siya masking ang

iyahang doktor dili makatuo sa iyahang nakit-an nga

pagbabago. (I only knew it from my friend. She told me

that her friend, who had a cancer in her breast, used

herbal medicines such as capsicum, grapeseed, saluyot,

ampalaya, termerick, kumintang, lagundi, mangosteen,

quantum, silver cure and bifnor liquid. She told me that she

was cured by she herbal medicines and her doctor could

not even believe that there is something changed on her).

Respondent B, 59 years old

Usahay sa commercial sa T.V. na naga-ingon na maayo

gyud daw sila, ug ang uban sa ka trabaho sa akong anak

kay naka-sinati na man daw sila sa kaayo ani.

(Sometimes in the commercial on T.V. that said it can

cure, and according to my daughters coworkers said that

they have tried using it and experienced little

effectiveness.). Respondent C, 54 years old

Sa akong silingan nakadungog ani, nakagamit man pud

siya sa acupuncture og ana siya maayo daw. Mao gisulay

pud nako basi maulian ko. (I heard it from my neighbor,

and said that they were using acupuncture and said its

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good. Thats why I also tried to use it). Respondent D,

46 years old

Sa mga lain tao rapud, mga silingan namo og sa seminar

na gi-conduct sa among baranggay. (I knew it from

others especially to my neighbors and on the seminar that

was conducted in our Barangay). Respondent E, 61

years old

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CHAPTER V

SUMMARY, CONCLUSION AND RECOMMENDATION

Summary

The study was conducted in a local tertiary hospital in Davao City. The involved

departments were Gynecology ward, and Internal Medicine ward. This study aimed to

collect data regarding on the participants demographic and clinical profile, views and

reasons on the use of Complementary and Alternative Medicine. The data collection was

conducted through an in-depth interview with the use of interview guide. Five (5) adult

cancer patients who were awake, conscious and coherent were interviewed for this study.

The age of the respondents was ranging from 46 to 61 years old and all were

females. Almost of the respondents were Roman Catholic and the remaining was a

Protestant. Majority of them, three (3) out of five (5), were college graduates and some of

which were elementary undergraduates. Three (3) respondents were married, one (1) was

a single and the other one (1) was a widower. Only one (1) respondent is employed and

two (2) are unemployed. The remaining two (2) respondents are self-employed. The

monthly income of the respondents ranged from Php 1,200 to Php 4,000 with a mean

average of Php 2,233.33.

There were three (3) breast cancer respondents, two (2) of which were diagnosed

with stage four (4) and the other one (1) was diagnosed with stage three (3). The two (2)

remaining respondents were diagnosed with ovarian cancer stage one (1). All of the

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respondents had undergone diagnostic procedures such as CBC, urinalysis, CT scan,

chest x-ray, ultrasound and biopsy. Two (2) respondents had undergone operations. One

(1) who has breast cancer stage four (4) had undergone Modified Radical Mastectomy

(MRM) last June 2010. The other one (1) with ovarian cancer stage one (1) had two (2)

operations, Total Abdominal Hysterectomy Bilateral Salphingo Oophorectomy

(TAHBSO) and appendectomy last April 2011. Four (4) out of five (5) respondents are

currently on chemotherapy. The remaining one (1) respondent was diagnosed to have

breast cancer stage four (4) a year ago but refused chemotherapy by that time. Currently,

she was about to start of the said treatment. Almost all of the respondents, four (4) out of

five (5), were receiving chemotherapeutic drugs and some were given antibiotics,

diuretics, pain reliever, anti-emetic and beta adrenergic drugs.

Only one (1) respondent said that using the complementary and alternative

medicines, specifically acupuncture, is more effective than the conventional therapy in

terms of alleviating the side effects of chemotherapeutic drugs such as pain, nausea and

vomiting. However, she believed that herbal medicines were not effective in treating

cancer. Three (3) respondents believed that complementary and alternative medicines

were partially effective and also, they were all believed that their use of complementary

and alternative medicines added another year of their life. The remaining one (1)

respondent believed that it was not effective.

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Conclusion

The five (5) respondents showed varied views and reasons on the use of

complementary and alternative medicines. Most of them viewed these treatment

modalities were partially effective in treating cancer due to several factors such as age

and absence of underlying illness. Furthermore, majority of the respondents had shared

common reasons on the use of complementary and alternative medicines such as financial

constraint, hope to cure cancer, reduced side-effects of chemo drugs and by the

influenced of others. With these views and reasons, it only showed that the use of

complementary and alternative medicines needs further research and progressive

investigation on its proper applications especially on its role as adjunctive therapy for

cancer.

Recommendation

Based on the findings of this study, the researchers would like to recommend to

the following departments and institutions:

Department of Science and Technology (DOST) and other research institutes

1. To conduct concrete researches on effectivity of herbal medicines on the treatment of

cancer.

2. To disseminate research results related to complementary and alternative medicines to

avoid myths and misconceptions.

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Philippine Medical Association (PMA) and other medical societies

1. To help in educating the public on the role of complementary and alternative

medicines in treatment of the cancer.

2. To strengthen preventive campaign against cancer.

3. To give updates on the recent technologies related to the treatment of cancer.

Department of Health (DOH) and Local Government Unit (LGU)

1. To educate members of baranggay health units on proper use of the complementary

and alternative medicines.

2. To establish community support group of cancer patients.

Hospitals

1. To help document patients with cancer who use complementary and alternative

medicines to monitor disease progression related to its use.

2. To help educate patients on other well-studied treatment modalities for cancer.

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BIBLIOGRAPHY

American Cancer Society, 2007. www.cancer.org/Research/index

Ashbury FD, Findlay H, Reynolds B et al. A Canadian survey of cancer patients experi-

ences: are their needs being met? J Pain Symptom Manage 1998; 16:298306.

Barnes P.M., Bloom B., & Nahin R. (2008). National health statistics reports:

Complementary and alternative medicine use among adults and children: United

States, 2007.

Basch E., & Ulbricht C. (2004). Prevalence of CAM use among U.S. cancer patients: An

update [Editorial]. Journal of Cancer Integrative Medicine, 2(1), 1314.

Buettner C., Kroenke C.H., Phillips R.S., Davis, R.B., Eisenberg, D., & Holmes, M.

(2006). Correlates of use of different types of complementary and alternative

medicine by breast cancer survivors in

Documents

Views and Reasons of Adult Cancer Patients on the Use of Complementary and Alternative Medicines