Received: 30 May 2002 Accepted: 17 October 2002 Published online: 24 April 2003 © Springer-Verlag 2003 Abstract Understanding the dynam- ics of oncologist-patient communica- tion regarding complementary thera- py (CT) use is essential for the devel- opment of much-needed clinical guidelines. Discussions of CT use in 314 audio-taped initial consultations between cancer patients and their on- cologists were identified and coded. Patients’ anxiety levels and coping styles were also assessed. Reference to CT use was found in 91 consulta- tions (29%). Patients and kin initiated most CT discussions, commonly dur- ing discussions of patients’ medical history, treatment options or progno- sis. In half of these discussions, pa- tients volunteered that they were cur- rently using a CT or were consider- ing its use. Discussion of CT use was more likely to occur in consultations with patients who were younger, were better educated, spoke poorer English, had metastatic disease or limited life expectancy and expressed higher levels of fighting spirit and anxious preoccupation and lower lev- els of fatalism. The most commonly discussed CTs were: changes in diet; use of multivitamins, vitamin C or antioxidants; and having a positive attitude or fighting spirit. The doc- tor’s overall response to CTs was most frequently coded as “encourag- ing”, although 35% of attempts to initiate discussion were ignored by the oncologist. Doctors were more likely to make encouraging state- ments about CTs typically perceived to be potentially helpful versus po- tentially harmful. The current find- ings point to a need for practical con- sensus on how to communicate with cancer patients on the subject of CT use so that patients can receive the support and guidance that they are seeking from their oncologists. Keywords Communication · Complementary therapy · Alternative therapy · Oncology · Unproven remedies Support Care Cancer (2003) 11:348–355 DOI 10.1007/s00520-002-0420-x ORIGINAL ARTICLE Penelope E. Schofield Ilona Juraskova Phyllis N. Butow How oncologists discuss complementary therapy use with their patients: an audio-tape audit Introduction Complementary/alternative therapies (CTs) continue to evoke strong debate and diverse views within the medi- cal community. However, the proportion of cancer pa- tients who use CTs appears to be increasing [13]. The most recent systematic review of CT prevalence in 13 countries revealed that on average 31% of cancer pa- tients (range 7–64%) use CT [14]. The wide range of es- timates is likely to be due to cultural variations, but also to the different definitions of CT used. In many countries physicians, including oncologists, may prescribe CT, such as dietary changes, herbal extracts or homeopathy [19] for their patients, but this tends not to be the case in Australia. CTs most commonly used by Australian on- cology patients include dietary changes, meditation/ relaxation, and use of multivitamins [17]. Patients rely upon their doctors for information and guidance, but oncologists typically lack knowledge about CTs [9, 20]. A recent Australian survey of oncolo- gists indicated that only a minority of oncologists report- ed knowing “a lot” about even the most commonly used P. E. Schofield ( ✉ ) Department of Haematology and Medical Oncology, Peter MacCallum Cancer Institute, A’Beckett Street, Locked bag 1, 8006 Victoria, Australia e-mail: penelope.schofield@petermac.org Tel.: +61-3-96563560 Fax: +61-3-96561337 I. Juraskova · P. N. Butow Medical Psychology Research Unit, Department of Psychological Medicine, Blackburn Building D06, University of Sydney, 2006 NSW, Australia