The interviewees expressed a series of opinions on TCM and allowed a thorough examination of their perceptions on communication practices during their treatments and TCM care. Four common themes were identified among the interviewed cancer patients: 1) Confidence in TCM care in cancer treatment; 2) The communication mode of TCM; 3) Advantages of TCM over conventional medicine, and 4) Integration of TCM and conventional medicine in cancer care.
1) Confidence in TCM in cancer treatment
TCM in Hong Kong is attracting more and more patients with references to the interviewees. When talking about the trends of using TCM in curing intestine cancer, one patient (Lei) explained the assurance factor is what made him stick with TCM for a long time. In fact, to a large extent, people turn to TCM for mental assurance and confirmation due to their preferences of the TCM consultation style that involves the overall lifestyle and health condition of a patient before making a diagnosis. Patients would often be in favour of such detailed and tailored treatment, resulting in greater confidence in involving TCM in their cancer treatment ,.
‘If the practitioner could make you confident about what he’s doing and lend you plenty of information about your health condition, it will make your heart sort of settled… In my case, since I have only visited TCM doctors twice, in overall speaking the experience has been quite positive, as I would get clear answers to whatever I asked. So far speaking I am quite satisfied with it.’
(Lei, interview 39)
Besides, TCM doesn’t exclude other treatments at the same time or even encourage its patients to ask for other help if necessary. This is crucially important in clarifying the doubts that patients may have during a hard time, according to a cancer patient (Zung)’s interview. As TCM also recommends other treatment when needed, it gives patients a feeling that their health is of the utmost priority in TCM practitioners’ eyes, thus making them willing to receive the information and suggestions provided by a TCM practitioner in the belief that it’s right.
‘I have been consulting TCM for a long time since 2013, with conventional medicine simultaneously. I began to consult TCM even before I receive chemo. It was my sister who recommended Dr CHAN to me whom I kept visiting until he retired… The consultation between me and a TCM practitioner is not as frequent as that with a conventional medicine doctor, however, after listening to the explanations of a TCM practitioner, I got more confident even sometimes conventional medicine tells me the contrary. That’s also the reason why I haven’t stopped visiting TCM till now.’
(Zung, interview 37)
2) The communication mode of TCM
During a treatment process, it is inevitable for a patient to be scared and full of doubts about what’s to come. In such conditions, the communication mode adopted by TCM, which focuses on learning about the general health conditions of a patient, would naturally build a connection between the practitioner and the patient.5 With the foundation laid in the first place, their consultations could go much deeper than that in a conventional medicine context and make the patients calm as in the case of Mr MAN.
‘I have visited TCM even before I visited a conventional medicine doctor… When the hospital informed me that I needed to receive chemo, I turned to my TCM practitioner for advice. He told me that I must go through the chemo process and I listened. He said that he understood it is hard to go through chemo and explained to me that it doesn’t have any side effect… When I am visiting a TCM doctor, the whole consultation process is much more detailed, I would be asked for a report and he kept things down carefully to give me suggestions as well as the whole situation, which makes me feel so assured.’
(Man, interview 34)
On the other hand, because of the lack of general understanding among patients about the practice of TCM, this communication mode also faces its drawbacks. As Mr NG mentioned in his speech, it would be really hard to understand what’s fundamentally going on if one hasn’t learned the basics of a TCM treatment, unlike in the conventional medicine context where people tend to know about the basics more or less. This, however, doesn’t seem to affect the understandings of the patient during a consultation. Like Ms GAM explained, the elaborations given by the TCM practitioner are clear and straightforward and such a communication mode adopted by TCM still works for them to make them assured.
‘During the whole treatment process, the explanations of the practitioner were quite clear. Even though we didn’t get to be told what functions the medicines hold, we didn’t need to know that. All we think is that it helped us after operations.’ (Gam, interview 35)
‘Whenever I visit a TCM practitioner, I always feel the consultation is much more personal and well connected since it is always the same doctor I see when I am in a TCM consultation, unlike in conventional medicine ones, where I am appointed to different doctors who tend to finish the conversation within several minutes. It is assuring to know that someone keeps tracking your profile and help to control your illness. However, if you didn’t know anything about TCM previously, what a TCM practitioner says to you may not make much sense. In that case, it would be conventional medicine that could offer clearer explanations.’
(Ng, interview 33)
3) Advantages of TCM over conventional medicine
To start with, Leung brought up TCM’s suitability to patients, which is lacked in conventional medicine. By suitability he explained that no matter it’s a cold or emotion fluctuation, TCM always finds a way to combine the overall discomforts, while conventional medicine turns to separate those in several different branches and treat various illnesses individually. Moreover, Leung mentioned that TCM turns to be combined with the weather and environmental conditions while healing, putting more attention to the patients themselves. While on the contrary, conventional medicine treats their patients more like a task, by which he also hopes for an improvement in this situation.
“The change of seasons leads to different causes to the cold, such as wind, cold, heat, wetness, dryness, and fire. There are different methods to treat cold with different causes. We also have to take the seven emotions caused by the cold into account before prescribing TCM to patients. These emotions are happiness, anger, worry, thoughtful, scare, horror, and sadness.”
(Leung, interview 5)
The result of conventional treatments, he claimed, could be ineffective to patients sometimes. He met a patient who fainted after eating the prescribed convention medicine.
“Sometimes conventional medicine doctors randomly give patients medicine without considering their bodies thoroughly. One of my patients fainted after eating conventional medicine and came to find me immediately.”
(Leung, interview 5)
However, He said he could not blame conventional medicine doctors as they have their way of treating patients, just like TCM doctors. Both TCM and conventional medicine doctors are healthcare practitioners who put their patients' health to the highest level of their concern. The same suggestion is then verified by a patient diagnosed with intestine cancer with such statements below:
‘It can’t promise to cure you, but you could visit TCM doctors. And you should visit a TCM doctor after visiting a conventional medicine doctor because it will help you gain a stronger body system, as the TCM treatments tend to penetrate your body and bring some fundamental changes. conventional medicine, on the other hand, doesn’t provide this function.’
(Lai, interview 36)
4) Integration of TCM and conventional medicine in cancer care
TCM could not be used in isolation when dealing with cancer, especially when it comes to the first stage of diagnosing. Furthermore, with different focuses during the treatment process, TCM and conventional medicine could provide the patient with various benefits that could not be compensated by using another .
‘In my perception, when talking about TCM in cancer treatment, it has to be diagnosed using conventional medicine, and analysed further by TCM, with these two combined. The reason is that you can only rely on conventional medicine to make sure it is cancer, the same as you can only use the differentiation theory in TCM to take the medicines properly.’
(Chen, interview 1)
When talking about the attitudes that are held by many doctors and the general public, Dr MA mentioned that he has noticed a constant rivalry and quarrel between TCM and conventional medicine, arguing which should dominate the treatment. However, he also thinks that both sides should treat each other with respect and more understanding, based on more in-depth communications in between.
‘And I hope you could take this as a remark, that is I think TCM could have a much deeper dialogue with conventional medicine, with everybody prejudicing less against one another. I think I am pretty neutral when talking about the relationship between TCM and conventional medicine, as my family are traditional doctors in TCM and I am a conventional medicine doctor. Whenever I see conflicts existing between the two sides, I always think they could coexist in harmony.’
(Ma, interview 12)