Oncologists’ and specialist cancer nurses’ approaches to CAM and their impact on patient action

The inter-professional dynamics between CAM and biomedicine have been regularly examined within the sociological literature (e.g. Hirschkorn and Bourgeault, 2005; Mizrachi et al., 2005). Such analyses have focused on the management of professional boundaries and the centrality of notions of evidence, efficacy and professionalism in shaping inter-professional dynamics. However, little is known about how inter-and intra-professional dynamics manifest at a grassroots level in clinical contexts and, importantly, how patients make sense of these and how they may impact on patient action. This paucity of research is particularly evident in cancer care, where ironically CAM use is the most prolific (e.g. Ernst and Cassileth, 1998; Lewith et al., 2002; Rees et al., 2000). In this specific disease context the responses of biomedical clinicians to patients’ treatment preferences are of particular importance given the level of emotion and anxiety reported in treatment decision-making processes (see Arora, 2003; Hack et al., 2005). Moreover, effective communication about CAM has been reported by both cancer patients and clinicians to enhance the patient/practitioner relationship (Roberts et al., 2005).