The Harm in Kratom

Objective. To explore the nondisclosure of complementary and alternative medicine (CAM) use among cancer patients, includ-ing reasons for and outcomes from nondisclosure of CAM use, within the context of patient-doctor communication. Method. A systematic review was conducted exploring investigations surrounding the communication of CAM use for patientswith cancer published until August 2011. Results. A total of 21 studies were located, which reported a prevalence of CAM use among patients with cancer ranging between11% and 95%; of these patients, 20% to 77% did not disclose their CAM use. The main reasons for nondisclosure were the doctor’slack of inquiry; patient’s anticipation of the doctor’s disapproval, disinterest, or inability to help; and patient’s perception that dis-closure of CAM use is irrelevant to their conventional care. There is some evidence to suggest that patient-doctor communicationabout the use of CAM was associated with an enhanced patient-doctor relationship and higher patient satisfaction. Conclusion. Although the use of CAM by patients with cancer is high, patients frequently fail to disclose its use to their health pro-fessionals for reasons emanating from both sides of the dyadic patient-doctor relationship. Because a substantial proportion ofpatients with cancer may use CAM and there is potential for herbor vitamin-drug interactions, further research in patient-doctorcommunication about CAM is necessary to maintain patient safety and wellbeing. The development of effective interventions toimprove the disclosure of CAM use should be an integral part of this future research.Drago, Lane, Kochav et al.1011 www.TheOncologist.comOc AlphaMed Press