Traditional and Complementary/ Alternative Medicine (TCAM) beliefs and use among children with cancer in Guatemala

Purpose: A high incidence of treatment abandonment has been observed among children with cancer in Guatemala. Utilization of TCAM and its consequent impact on the decision for and continuation of conventional treatment have yet to be explored. Methods: IRB approval was obtained for a survey of TCAM use among children with cancer treated at the Unidad Nacional de Oncologia Pediatrica, Guatemala. A random, cross-sectional sample of 31 parents of children with cancer, median age 8 years (1-18), was interviewed in person from May-December 2008 after obtaining consent. Demographic data, health-seeking behaviors, TCAM modalities used, and referral and communication about use were collected. Results: 81% of patients were Mestizo, 87% attended religious services regularly, and 55% lived <2 hours from the clinic. 87% reported both conventional and TCAM providers within their community; 65% generally only consulted with conventional providers when their child was ill. Presenting symptoms prior to diagnosis were believed related to conventional beliefs about disease causation (48%) or TCAM beliefs (45%); 7% reported mixed TCAM/conventional beliefs. 19% reported not understanding their child's disease and treatment plan. 87% of patients used at least one form of TCAM since becoming symptomatic. The majority of TCAM modalities used (33%) were referred by family/community members. 75% of all reported TCAM modalities were not disclosed to their pediatric oncologist. Discussion: TCAM beliefs and practices are widespread among children with cancer in Guatemala. Information gained on how TCAM impacts the delivery of conventional treatment may be instrumental in preventing treatment abandonment and improving cure rates.