TREATMENT PATHWAYS AND DELAYS IN TREATMENT AMONG CANCER PATIENTS ATTENDING A TERTIARY CARE HEALTH FACILITY IN CHANDIGARH, NORTH INDIA

*Dr. Dinesh Kumar, Dr. Naveen Krishan Goel, Dr. Awadhesh K Pandey and Dr. Meenu Kalia

ABSTRACT

Background: Approaching to various alternative therapies by cancer patients before adopting standard therapies may delay in diagnosis and treatment initiation resulting in poor clinical outcomes for cancer patients. Present study attempts to investigate treatment pathways adopted by cancer patients and resulting delays in seeking treatment by them and other delays in a tertiary allopathic health care facility. Methods: Hospital based cross sectional study conducted 1117 among cancer patients attending a tertiary health facility. A systematic sampling design was adopted to select patients of different types of cancer at different stages approaching for allopathic treatment at the health facility. Data variables included personal and family characteristics, beliefs and practices related with CAM, reasons of adopting CAM therapies, delay in seeking treatment, prior treatment availed, perceived reasons of delays in approaching for current treatment along with related information. Elementary statistical methods were applied for data analysis. Results: Among 1117 cancer patients surveyed including 44.9% males and 55.1% females, Study reported only 10% patients delaying in diagnosis and start of the treatment. Main reasons of treatment delay were reported to be financial problems (40.7%), family problems (22.1%) and use of CAM/ herbal treatment (13.3%). Females were more likely to delay the treatment as compared to males. More than 90% patients approached for allopathic treatment as a first pathway to treatment showing reliance in the allopathic treatment. Average duration of CAM use was found to be about four months only and average amount spent was about Rs. 1564/- per month. Conclusions: Findings of the present study demonstrates a very low prevalence treatment delays among cancer patients approaching for allopathic treatment. High satisfaction rate is also reported with conventional therapies. There is an urgent need of conducting further in-depth epidemiological studies to evaluate different type of delays and its association with CAM therapies in use for cancer. Future research should also be focused towards investigating consequences of treatment delays.

Keywords: Complementary and alternative (CAM); Diagnostic delay; Holistic approach; Referral delay; Treatment delay.