Shaking the Stigma

IF YOU TAKE VITAMINS, use herbal supplements or seek treatments such as acupuncture or reflexology, you’re not alone.

According to the Public Health Agency of Canada, more than 70 per cent of Canadians regularly use therapies that are considered “complementary and alternative” by the mainstream health-care system. Despite the popularity of such treatments, Dr. Lynda Balneaves [B.Sc./90, BN/94, MN/96] says that when it comes to talking with their doctors, many patients keep this crucial information to themselves.

“People may be spending hundreds, or even thousands of dollars using these therapies,” says Balneaves, associate professor in the College of Nursing. “But when they want to talk to their physician about it, a lot of the time they’re told, ‘That’s silly. You’re throwing away your money. It’s going to hurt you.’”

Balneaves, who prefers the term “complementary and integrative,” is a leading expert on the use of such therapies. If patients fly under the radar instead of disclosing them, there can be drug interactions and serious health risks, she says. But it doesn’t help when health-care practitioners stigmatize complementary therapies and shame patients about them.

“What we want is for patients to be able to make balanced, evidence-informed decisions,” she says. “That can’t happen if they’re not comfortable talking about it.”

The Winnipeg-bred Balneaves received bachelor’s and master’s degrees at the U of M before earning her PhD in nursing at the University of British Columbia, where she was on the nursing faculty from 2002 to 2014.

She joined the U of M faculty in 2016 after serving as director of the Centre for Integrative Medicine at the University of Toronto.

Balneaves has conducted many studies over the past 22 years on the use of complementary therapies by cancer patients. She has examined decision-making and beliefs about therapies such as black cohosh, omega-3 fish oil and meditation.

She has also studied patients who decline conventional cancer treatment entirely, in favour of alternative approaches. She has just published a study of Chinese-speaking cancer patients in British Columbia. “More than 65 per cent reported using complementary medicines, particularly traditional Chinese medicinal herbs,” she says. “But very few (18.5 per cent) spoke with their cancer specialist about it.

“The key finding was that patients need culturally appropriate information and support in deciding whether to use treatments that may be very popular in their ethnocultural group.”

Integrative oncology is an evidence-based approach to cancer care that uses proven complementary therapies in concert with standard biomedical treatments. “It combines the best of both in a way that is holistic and patientcentred,” the professor says.

Balneaves is president of the worldwide Society for Integrative Oncology. “The society promotes research, so we can keep amassing scientific evidence of the benefit – or lack of benefit – of so-called alternative therapies, and see evidence-based therapies move into clinical practice,” she says.

“One of our key goals is to develop more communication materials that can be used by health-care practitioners, patients and family members. There’s a huge need for balanced, nonjudgmental, evidence-based information about complementary therapies and how to make decisions about them.”

Balneaves leads a current study at CancerCare Manitoba called the Complementary and Integrative Medicine Best Practice Guideline Project. It’s focused on standardized assessment and documentation of cancer patients’ use of natural products and complementary therapies.

“Patients are having their use recorded in their electronic medical record, so all the health-care professionals providing care to that individual are on the same page,” Balneaves says.

“What we mean by ‘integrative’ is that, ideally, both the patient and the practitioner are fully informed and agree on how the two approaches – conventional and complementary – can work in harmony. My work is all about leaving ‘either/or’ thinking behind and finding ways to maximize the well-being and dignity of the patient.”