Despite Popularity of Alternative Medicine, Most U.S. Oncologists Do Not Discuss Herb and Supplement Use With Their Patients


Key Points

  • Oncologists do not discuss herb and supplement use with most patients and most report having insufficient knowledge of the topic.
  • Oncologist factors associated with initiating discussion with patients included female sex, higher self-reported knowledge, and estimating higher prevalence of herb/supplement use among patients.

Available data indicate that a majority of cancer patients use complementary and alternative medicine. In a study reported in the Journal of Clinical Oncology, Lee et al found that oncologists responding to a survey on herb and supplement use did not discuss herb and supplement use with most of their patients. A majority of oncologists reported that they had insufficient knowledge of the topic to answer patient questions and had received no education on the topic.

In the study, a survey including questions on communication patterns, attitudes, education, and knowledge with regard to herb and supplement use was sent by mail and e-mail to a random national sample of 1,000 U.S. oncologists. Among 937 oncologists who could be contacted, 392 (42%) responded to the questionnaire. Respondents had a mean age of 48 years and most were white (75%) and male (71%); 34% reported personal use of complementary and alternative medicine.

Discussion and Knowledge

On average, oncologists discussed herb and supplement use with 41% of patients, with 26% of such discussions being initiated by the oncologist. Overall, 64% of oncologists indicated they did not have enough knowledge to answer patient questions on the topic, and 59% reported having received no education on the topic.

Factors Associated With Discussion

Factors significantly associated with initiating conversation regarding herb and supplement use were female sex (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.06–4.24), higher self-reported knowledge on the topic (OR = 2.4, 95% CI = 1.2–4.9), prior education on the topic  (OR = 2.5, 95% CI = 1.3–4.9), correctly answering ≥ 2 of 4 survey questions on what herbs/supplements to avoid with cancer treatment (OR =1.84, 95%CI = 1.01–3.36), and estimating a higher prevalence (> 40%) of herb/supplement use among patients (OR = 1.96, 95% CI = 1.04–3.7).

The investigators concluded: “Fewer than one half of oncologists are initiating discussions with patients about [herb and supplement] use, and many indicate that lack of knowledge and education is a barrier to such discussions. Improving physician education about [herbs and supplements] may facilitate more physician-patient communication about this important topic.”

Richard T. Lee, MD, of The University of Texas MD Anderson Cancer Center, is the corresponding author for the Journal of Clinical Oncology article.

The study was supported by an American Society of Clinical Oncology Cancer Foundation award and a grant from the National Cancer Institute. The study authors reported no potential conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.