Breast Cancer Survivors' Perspectives of Care Practices in Western and Alternative Medicine

Ausanee Wanchai

Jane Armer

Bob R. Stewart

survivorship, complementary and alternative therapies
ONF 2010, 37(4), 494-500. DOI: 10.1188/10.ONF.494-500

Purpose/Objectives: To explore perspectives of breast cancer survivors about their care with Western medicine and alternative medicine.

Research Approach: Qualitative, ethnonursing.

Setting: Cancer center in the midwestern region of the United States.

Participants: 9 breast cancer survivors who had experienced health care involving Western medicine and alternative medicine.

Methodologic Approach: Semistructured interviews were conducted to elicit each participant's perspective about care practices. Data were analyzed with an ethnonursing qualitative data analysis method.

Main Research Variables: Care practices in Western medicine and care practices in alternative medicine.

Findings: Western medicine was seen as traditional or mainstream treatment, whereas alternative medicine was seen as anything not involving hospitals and doctors or as complementary. Perceived outcomes from alternative therapies were coping with disease and treatment, holistic care, and emotional support, whereas perceived outcomes from Western medicine were negative things that they had to go through and as an instrument of God. Kinship, social, economical, educational, and belief factors influenced care practices.

Conclusions: Care practices from alternative medicine or Western medicine vary for breast cancer survivors. Many factors influence their selection decisions about care practices.

Interpretation: Nurses should be concerned about what care practices mean to breast cancer survivors. Further research should be considered to evaluate the potential contribution of each factor to breast cancer survivors' decision making about care practices.

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    American Cancer Society. (2009a). Breast cancer facts and figures 2009. Retrieved from
    American Cancer Society. (2009b). Complementary and alternative methods for cancer management. Retrieved from
    Boon, H., Brown, J. B., Gavin, A., Kennard, M. A., & Stewart, M. (1999). Breast cancer survivors' perceptions of complementary/alternative medicine (CAM): Making the decision to use or not to use. Qualitative Health Research, 9, 639-653.
    Buettner, C., Kroenke, C. H., Phillips, R. S., Davis, R. B., Eisenberg, D. M., & Holmes, M. D. (2006). Correlates of use of different types of complementary and alternative medicine by breast cancer survivors in the nurses' health study. Breast Cancer Research and Treatment, 100, 219-227. doi: 10.1007/s10549-006-9239-3
    Canales, M. (2004). Taking care of self: Health care decision making of American Indian women. Health Care for Women International, 25, 411-435. doi: 10.1080/07399330490438323
    DiGianni, L. M., Garber, J. E., & Winer, E. P. (2002). Complementary and alternative medicine use among women with breast cancer. Journal of Clinical Oncology, 20(18, Suppl.), 34S-38S. Retrieved from
    Er, O., Mistik, S., Ozkan, M., Ozturk, A., & Altinbas, M. (2008). Factors related to complementary/alternative medicine use among cancer patients in central Anatolia. Tumori, 94, 833-837.
    Hann, D., Baker, F., Denniston, M., & Entrekin, N. (2005). Long-term breast cancer survivors' use of complementary therapies: Perceived impact on recovery and prevention of recurrence. Integrative Cancer Therapies, 4, 14-20. doi: 10.1177/1534735404273723
    Howard, A. F., Balneaves, L. G., & Bottorff, J. L. (2007). Ethnocultural women's experiences of breast cancer: A qualitative meta-study. Cancer Nursing, 30(4), E27-E35. doi: 10.1097/01.NCC.0000281737.33232.3c
    Humpel, N., & Jones, S. C. (2005). Development of a comprehensive questionnaire of complementary and alternative medicine use among cancer patients and survivors. Complementary Health Practice Review, 10(3), 163-174. doi: 10.1177/1533210105283386
    Johnson, K. S., Elbert-Avila, K. I., & Tulsky, J. A. (2005). The influence of spiritual beliefs and practices on the treatment preferences of African Americans: A review of the literature. Journal of the American Geriatrics Society, 53, 711-719. doi: 10.1111/j.1532-5415.2005.53224.x
    Knobf, M. T. (2007). Psychosocial responses in breast cancer survivors. Seminars in Oncology Nursing, 23, 71-83. doi: 10.1016/j.soncn.2006.11.009
    Kreling, B., Figueiredo, M. I., Sheppard, V. L., & Mandelblatt, J. S. (2006). A qualitative study of factors affecting chemotherapy use in older women with breast cancer: Barriers, promoters, and implications for intervention. Psycho-Oncology, 15, 1065-1076. doi: 10.1002/pon.1042
    Leininger, M. M., & McFarland, M. R. (2006). Culture care diversity and universality: A worldwide nursing theory (2nd ed.). Sudbury, MA: Jones and Bartlett.
    Loudon, L., & Petrek, J. (2000). Lymphedema in women treated for breast cancer. Cancer Practice, 8, 65-71. doi: 10.1046/j.1523-5394.2000.82004.x
    Mansfield, C. J., Mitchell, J., & King, D. E. (2002). The doctor as God's mechanic? Beliefs in the southeastern United States. Social Science and Medicine, 54, 399-409.
    Mayer, D. K., Terrin, N. C., Menon, U., Kreps, G. L., McCance, K., Parsons, S. K., & Mooney, K. H. (2007). Health behaviors in cancer survivors. Oncology Nursing Forum, 34, 643-651. doi: 10.1188/07.ONF.643-651
    Molassiotis, A., Panteli, V., Patiraki, E., Ozden, G., Platin, N., Madsen, E., … Margulies, A. (2006). Complementary and alternative medicine use in lung cancer patients in eight European countries. Complementary Therapies in Clinical Practice, 12, 34-39. doi: 10.1016/j.ctcp.2005.09.007
    National Cancer Institute. (2009). Western medicine. Retrieved from
    National Center for Complementary and Alternative Medicine. (2009). What is complementary and alternative medicine? Retrieved from
    National Institutes of Health. (2009). What is CAM? Retrieved from
    Nishimoto, P. W., & Foley, J. (2001). Cultural beliefs of Asian Americans associated with terminal illness and death. Seminars in Oncology Nursing, 17, 179-189.
    Palinkas, L. A., & Kabongo, M. L. (2000). The use of complementary and alternative medicine by primary care patients: A SURF*NET Study. Journal of Family Practice, 49, 1121-1130. Retrieved from
    Qidwai, W., & Tayyab, A. (2004). Patients' views about physicians' spiritual role in medical practice. Journal of the College of Physicians and Surgeons—Pakistan, 14, 462-465.
    Rockson, S. G. (2002). Lymphedema after surgery for cancer: The role of patient support groups in patient therapy. Disease Management and Health Outcomes, 10, 345-347.
    Silvestri, G. A., Knittig, S., Zoller, J. S., & Nietert, P. J. (2003). Importance of faith on medical decisions regarding cancer care. Journal of Clinical Oncology, 21, 1379-1382. Retrieved from
    Yabroff, K. R., Lawrence, W. F., Clauser, S., Davis, W. W., & Brown, M. L. (2004). Burden of illness in cancer survivors: Findings from a population-based national sample. Journal of the National Cancer Institute, 96, 1322-1330. doi: 10.1093/jnci/djh255
    Yeh, C. H., Lin, C. F., Tsai, J. L., Lai, Y. M., & Ku, H. C. (1999). Determinants of parental decisions on ‘drop out’ from cancer treatment for children cancer patients. Journal of Advanced Nursing, 30, 193-199. doi: 10.1046/j.1365-2648.1999.01064.x