Talking to cancer patients about complementary therapies: is it the physician’s responsibility?

BACKGROUND: To ensure the safety and effectiveness of cancer management, it is important for physicians treating cancer patients to know whether their patients are using complementary and alternative medicine (cam) and if so, why. OBJECTIVE: Here, we discuss the ethical and legal obligations of physicians to discuss cam use in an oncology setting, and we provide practical advice on how patient–provider communication about cam can be improved. RESULTS: Physicians have both ethical and legal obligations to their patients, including the obligation to respect patient autonomy. This latter obligation extends to use of cam by patients and needs to be addressed beginning early in the patient–provider relationship. Because lack of education in this field and lack of time during patient consultations are barriers to talking with patients about cam, we provide resources to facilitate such discussions. These resources include suggestions on how to discuss the topic of cam and a wide range of information sources. CONCLUSIONS: Discussing cam with patients is the physician’s responsibility, and such discussion will facilitate evidence-based, patient-centred cancer care.