Experiences of healthcare encounters among patients using complementary and alternative medicine alongside oncology or palliative care: a qualitative interview study in Sweden.

Abstract

A substantial proportion of patients with cancer use complementary and alternative medicine (CAM), yet the topic is rarely addressed in clinical encounters. This communication gap may affect patient safety, trust and participation in care. This study aimed to explore how patients experience encounters with healthcare professionals when using CAM alongside oncological or palliative care. An exploratory qualitative study using semi-structured interviews and qualitative content analysis. Oncology and palliative care services in a Swedish healthcare region. 19 adult patients with cancer who used CAM alongside conventional cancer care and were purposively recruited from a larger regional survey. Patients described continuously assessing whether it was appropriate to mention CAM. Subtle verbal and non-verbal cues from healthcare professionals shaped perceptions of what was considered legitimate within clinical encounters, often leading to silence or withdrawal. In contrast, neutral or respectful responses facilitated trust and dialogue. Openness regarding CAM was not fixed but adjusted from one encounter to another, influenced by interpersonal interactions, organisational conditions and prevailing evidence norms. Participants expressed a need for respectful dialogue, basic competence among healthcare staff and practical support for safe CAM use, without implying endorsement. Patients who use CAM navigate a healthcare context characterised by shifting relational cues and structural constraints that influence communication. Safe, person-centred care may be supported by normalising discussions about CAM, improving basic staff knowledge and facilitating open dialogue. Such measures may promote trust, improve communication and reduce risks associated with undisclosed CAM use.