• V M Raszeja, C F C Jordens, and I H Kerridge.
• Centre for Values, Ethics and the Law in Medicine, School of Public Health, University of Sydney, Sydney, New South Wales, Australia. veronica.raszeja@sydney.edu.au
• Intern Med J. 2013 Jan 1; 43 (1): 84-8.

AimsTo examine policies and practices relating to the provision, prescription and monitoring of complementary and alternative medicine and therapies (CAM) in conventional cancer services in NSW.MethodsSelf-administered questionnaire sent to directors of all 65 eligible cancer services in NSW in 2009.ResultsForty-three services responded to the survey (response rate 66%). Only six (14%) services reported having formal policies about CAM. Most (n = 33, 77%) expected that patients would be asked about CAM use during their initial assessment. Eight services (19%) provided and/or prescribed CAM for patients, and most of these (n = 7) recorded details of CAM use in patients' records. Only four (9%) services permitted CAM practitioners from the community to attend inpatients, whereas 24 (56%) permitted inpatients to bring in their own CAM. Most of these services (n = 17) required medical approval for the use of CAM. Of the latter, most (n = 13) recorded the use of approved CAM, but only seven recorded use of unapproved CAM and only three refused permission to continue use of unapproved CAM.ConclusionMost cancer services in NSW recognise potential CAM use by patients and expect medical staff to ask patients about their use of CAM. While few cancer services provided or prescribed CAM, over half permitted inpatients to bring their own CAM into hospital. There was little control over the use of CAM, however, and monitoring was lax. Given the wide usage of CAM by patients with cancer, this lack of control may compromise clinical outcomes, with potentially dangerous consequences.© 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

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