Women’s experiences in the use of complementary and alternative medicine for breast cancer management in Indonesia

Background: Complementary and Alternative Medicine (CAM) describes a group of natural products and mind and body practice-based treatments used to support healing, promote health and prevent disease. The use of CAM might be integrated with or in place of mainstream healthcare and usage is very common among women with breast cancer in Indonesia. Misuse of CAM may, however, cause adverse effects, health deterioration, delayed healing, and high financial cost. Thus, the aim of this study was to understand women’s lived experiences in the use of CAM for breast cancer management in Indonesia.
Methods: A qualitative approach and phenomenology design were used to understand women’s lived experiences of their use of CAM for breast cancer management. Using purposive and snowball sampling techniques, women diagnosed with breast cancer were recruited from two cancer support groups located in two regions of Indonesia. A total of 21 women voluntarily participated in the study undertaking a semi-structured interview method that was audiotaped. The interviews were conducted in Bahasa (Indonesian language), transcribed verbatim, and then translated into English language for data analysis. Data was analysed using a thematic analysis framework.

Results: The data analysis generated four preliminary main themes namely: ‘Awareness, access and affordability of medical treatment’, ‘Having beliefs about CAM’, ‘Feeling the potential benefits of CAM’ and ‘Acknowledging the negative aspects of CAM’. The results of this study indicated these women had a lack of knowledge and awareness about breast cancer, treatment and CAM, as well having limited access and affordability to medical treatment. These aspects caused the participants to utilise CAM as their first breast cancer management option. Family members were very influential for the women when making their decision to use CAM. Additionally, most of the CAM used was obtained from uncertified and non-professional CAM therapists. The woman also hid the use of CAM from health professionals including oncologists and nurses. The women stated they had experienced some benefits using CAM, but then began to mistrust CAM and sought medical treatment, after realising the negative aspects of CAM.

Conclusion: Based on these women’s lived experiences, it is recommended that medical treatment should be the primary breast cancer treatment option, and CAM is best to be used as an adjunct therapy. There is a need for health literacy related to breast cancer and its treatment including specific education programs to enhance women’s awareness. Healthcare professionals including nurses, are expected to communicate CAM to women, as a part of breast cancer management. Nurses’ who support the use of evidence-based CAM can contribute to the maintenance of quality of cancer care and optimise positive outcomes. Health assessment related the use of CAM could be conducted to ensure the efficacy and safety of CAM considered for use. Ultimately, further research investigating the effectiveness and safety of various CAM therapies in Indonesia is needed.