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IntroductionIn Japan, while public health insurance ensures evidence-based-care, high-cost private medical practices offer advanced interventions-collectively referred to as "X" in this study-which have limited scientific evidence but have raised ethical and clinical concerns, particularly in oncology. This study explores oncologists' perceptions and responses to X in practice to inform appropriate countermeasures.MethodsMembers of the Japanese Society of Medical Oncology (n = 6273) completed a questionnaire survey between April 24 and June 10, 2024. The survey explored the oncologists' evaluations of X, their responses to patient inquiries about such interventions, and their personal preferences if they were personally diagnosed with cancer.ResultsOf 828 valid responses (response rate: 13.2%), 63.4% of oncologists reported receiving patient inquiries about X in the past year. Overall, 76.4% gave a negative evaluation of X, while over 90% provided negative ratings on 7 out of the 9 specific items. Despite this, many oncologists reported a neutral stance when discussing X with the patients. Notably, even without standard of care options, most indicated that they would not choose X for themselves. The findings reveal a considerable gap between oncologists' evaluation of X and what they convey when communicating with the patients. Qualitative responses expressed concerns about insufficient follow-up care and potential exploitation of vulnerable patients.ConclusionThis study highlights the need for more transparent, evidence-based communication between oncologists and patients regarding X. Enhancing such dialogue is essential for supporting informed decision-making and maintaining the integrity of cancer care in the face of unproven private medical interventions. Furthermore, considering X's profound negative impact on patients, society, and the field of medicine, legitimate medical professionals must conduct clear and accurate evaluations of X to facilitate the understanding of the patients and general public.