Preferences for Non-Pharmacological Traditional Chinese Medicine in Cancer Care: A Mixed-Methods Systematic Review

Abstract

Background: Non-pharmacological therapies in traditional Chinese medicine (TCM) are gradually gaining popularity. However, there has been no systematic understanding about cancer patients’ preferences regarding these treatments. Objective: This review aims to clarify cancer patients’ preferences for these therapies and the factors influencing them through systematic integration of evidence. Methods: A systematic search was conducted among eight databases. The time period spanned from the inception of each database to April 7, 2025. The Mixed Methods Assessment Tool was employed to assess the quality of the studies that met inclusion criteria. The JBI Convergent Synthesis Method was used to transform the extracted quantitative data into qualitative data that was then synthesized with qualitative data. A socio-ecological model was applied to group factors that influence TCM choices. Results: A total of 27 studies were included in this review, consisting of 13 quantitative and 14 qualitative studies. The factors that might affect cancer patients’ preferences in favor of TCM non-pharmacological therapies are multifaceted, covering every level that exists within the socio-ecological model, including the individual (belief and past experiences), interpersonal (professional recommendations and family), healthcare system (service accessibility and cost), society (cultural origins and resources), and governmental (insurance and standards). The PROSPERO registration was dated April 6, 2025 (Registration Number: CRD420251026914). Conclusion: Patients’ preference for TCM non-pharmacological therapies is driven by cultural affinity and interpersonal care needs rather than objective clinical evidence. This reminds us that while respecting patient preferences is essential for achieving patient-centered care, we must also adhere to evidence-based science to ensure safety and effectiveness. Future research should prioritize non-pharmacological therapies other than acupuncture (eg, massage, qigong) to bridge the evidence gap regarding their safety and efficacy. One limitation of this review lies in the overemphasis on acupuncture among cited studies and the cultural homogeneity.