Therapeutic pluralism? : exploring the experiences of cancer patients and professionals

The profile of complementary and alternative medicine (CAM) has risen dramatically over the last decade and cancer patients represent its most prolific users. As a result, the NHS and UK cancer services are attempting to develop a wider range of therapeutic options for patients. Despite such developments, little is known about why cancer patients use CAM, its perceived benefits and the perspectives of the doctors and nurses involved. Drawing on extensive fieldwork in the UK, Therapeutic Pluralism includes over 120 interviews with cancer patients and professionals, plus innovative ‘diary’ data which, for the first time, detail the experiences of CAM users. It gives a systematic analysis of issues such as: The development of patient preferences and influences on decision making Expectations of CAM and interpretations of ‘success’ in cancer treatment The nature and importance of ‘evidence’ and ‘effectiveness’ for patients The organisational dynamics involved in integrating CAM into the NHS Pathways to CAM and the role of the Internet The role of oncology clinicians in patients’ experiences of cancer and their use of CAMs Therapeutic Pluralism is essential reading for students and researchers of medical sociology, complementary and alternative medicine and cancer. It will also be useful to medical and health professionals, and policy-makers with an interest in complementary and alternative medicine.

The profile of complementary and alternative medicine (CAM) has risen dramatically over the last decade and cancer patients represent its most prolific users. As a result, the NHS and UK cancer services are attempting to develop a wider range of therapeutic options for patients. Despite such developments, little is known about why cancer patients use CAM, its perceived benefits and the perspectives of the doctors and nurses involved.

Drawing on extensive fieldwork in the UK, Therapeutic Pluralism includes over 120 interviews with cancer patients and professionals, plus innovative ‘diary’ data which, for the first time, detail the experiences of CAM users. It gives a systematic analysis of issues such as:

• The development of patient preferences and influences on decision making
• Expectations of CAM and interpretations of ‘success’ in cancer treatment
• The nature and importance of ‘evidence’ and ‘effectiveness’ for patients
• The organisational dynamics involved in integrating CAM into the NHS
• Pathways to CAM and the role of the Internet
• The role of oncology clinicians in patients’ experiences of cancer and their use of CAMs

Therapeutic Pluralism is essential reading for students and researchers of medical sociology, complementary and alternative medicine and cancer. It will also be useful to medical and health professionals, and policy-makers with an interest in complementary and alternative medicine.

Book Cover 1 Title 4 Copyright 5 Dedication 6 Contents 8 Acknowledgements 12 Abbreviations 14 Introduction 16 1 The dialectical tension between individuation and depersonalisation in cancer patients’ mediation of therapeutic options 43 2 The role of the Internet in cancer patients’ engagement with therapeutic options 60 3 Integrating CAM: A comparative analysis of hospice versus hospital medicine 71 4 Oncologists’ and specialist cancer nurses’ approaches to CAM and their impact on patient action 93 5 Exploring the temporal dimension in cancer patients’ experiences of non-biomedical therapeutics 111 6 The problematic nature of conflating use and advocacy in CAM integration 125 7 Conclusion 139 Notes 150 Bibliography 152 Index 168 The profile of complementary and alternative medicine (CAM) has risen dramatically over the last decade with cancer patients its most prolific users. Why do such people use CAMs, what are its benefits and what are the perspectives of those involved? Drawing on extensive fieldwork in the UK, this title includes over 120 interviews with patients and professionals, which provides access to the experiences of CAM users