Complementary and Alternative Medicine

Cancer patients are using complementary and alternative therapies now more than ever. Conservative estimates are that over 60% of cancer patients are using some form of complementary and/or alternative therapies. And yet many of these patients do not share that information with their physician out of fear of disapproval from their oncologists.  However, many oncology professionals now believe that

  • Complementary and alternative therapies are beneficial and in many cases, necessary for optimal recovery in many cancer patients.
  • There continues to be more evidence to support the use of complementary and alternative medicine.
  • The best approach is for the patient and physician to choose the right therapies at the right times.
     
What is complementary and alternative medicine?

Complementary and alternative medicine is often abbreviated as CAM.  These therapies should not be lumped together. They are two distinct approaches to care.

Complementary Therapy is something used in addition to conventional cancer treatment
 
Alternative Therapy is a treatment used instead of conventional cancer treatment. 
 

It is how you decide to use a particular therapy as to whether it is complementary or alternative.

 
What are CAM therapies?

CAM therapies are usually categorized into the following major areas:

  • Mind-body Interventions: relaxation techniques, meditation, hypnosis, dance, music
    and art therapy, support groups, prayer, mental healing.
  • Bioelectromagnetic: acupuncture, electroacupuncture, laser acupuncture, phototherapy,
    transcutaneous electrical nerve stimulation.
  • Alternative medical systems: homeopathic medicine, folk medicine, traditional oriental medicine 
  • Biologically-based treatments: herbal therapy, diet therapy, biological therapies
  • Manual Healing Treatments: acupressure, chiropractic, massage therapy, osteopathy,
    Reflexology, Reiki, Therapeutic Touch

Any of these therapies can be used as a complementary therapy or as an alternative therapy.

Most people use these therapies to lessen the side effects of cancer treatments and to improve their quality of life while others may use them as the treatment for their tumor.

 
Why doesn’t the doctor talk about CAM?

Doctor’s have been educated and trained in the western medical model. Their study is based on the scientific method. Although more medical school programs are including a more “holistic” approach, their study is based on the medical model. Therefore, there is little focus on CAM and less consideration on eastern practices.

 
Is it western versus eastern medicine?

Even though our American traditionally trained doctors have had little exposure to CAM, they are increasingly open to recommend these therapies and more and more are using an integrative approach. It is becoming second nature to European physicians when recommending a treatment plan to include the entire range of treatments and not just a drug. For example, a European oncologist would recommend surgery, chemotherapy, diet therapy, exercise therapy, herbal supplements and body work for a newly diagnosed cancer patient.

 

However, there is a groundswell of interest in these therapies and most clinicians now believe that an integration of CAM therapies with standard western medicine is the future of cancer treatment. Importantly, the Society of Integrative Oncology was formed in 2003 by a group of well-respected, traditionally trained western oncologists with the fundamental goal of improving cancer care through scientifically based integrative practice. The mission of this organization is to promote research in this area and to promote the integration of CAM therapies into the practice of traditional oncology. Therefore, many more oncologists are open to this information or may have included it within their practice already. 

 

Why is there confusion and mistrust of these therapies?

Cancer patients have long been targets of profiteering and quackery. People will sell their products or treatments to desperate patients for the chance at life-saving cures and desperate cancer patients will buy them. Doctors are reluctant to recommend any therapy that remains unproven for fear of doing more harm than good. Your oncologist will not recommend anything that hasn’t been adequately studied. 

 Thankfully, many of the CAM therapies are now being studied so that they can be considered for treatment or discounted for use. Such is the case with the recent NIH study proving that Black Cohash did not have any effectiveness in reducing hot flashes in women with breast cancer. Many women were taking this herb and now can stop taking it knowing there is no scientific basis for using it. There are certainly many other examples of therapies that have been scientifically proven to provide an advantage. For example, a recent study performed at Duke University Medical Center supported the use of acupuncture before surgery to relieve post-operative nausea.
 
As more studies are done in this area, more oncologists will integrate scientifically proven treatments in their practice.
 
How should I talk to my doctor about using CAM?
  • Be educated. You may have to be the expert on the specific treatment you wish to pursue. Review the literature yourself because your doctor may or may not be familiar with it. 
  • Be prepared. Bring a copy of the literature with you. Bring your herb or supplement bottles with you to the office. Give your doctor the opportunity to review the article or bottle ingredients. Be ready to present your case. 
  • Be proactive. Create a plan with your doctor of when you can and cannot use these therapies. You may be surprised to see how easily your doctor will accommodate your interest.   For example, your doctor may agree with acupuncture before your chemotherapy treatments to reduce nausea but ask you to withhold  herbal treatments until after the chemotherapy is completed.
  • Be open to compromise. Increasingly, doctors are allowing their patients to take part in biologically-based therapies (herbs and supplements). Your doctor will likely be more accepting when you mention using acupuncture as opposed to a using combination of herbs with your chemotherapy. Herbs and supplements need to be taken with great caution while undergoing chemotherapy. They have the potential of interacting with other drugs in your body resulting in the potential to decrease the effectiveness of the tumor treatment. Therefore, your doctor may ask you not to use the herbs or supplements during chemotherapy or he may instruct you to stop taking them a few days before and a few days after your chemotherapy. Or your doctor many ask you not to use them at all. 
  • Be honest. Let your doctors know what you are doing whether you think they will approve of it or not. Your doctor may have some insight into what may help you or what may hurt you.
  • Be reflective. Keep a record of what worked for you and what did not work for you. Report the results back to your doctor whether they were positive or negative. This will provide an opportunity for revising your care plan and possibly integrating another CAM therapy.
  • Be mindful. CAM therapy may not be an interest of your oncologist. Seek out an expert. There may be another provider in the practice who is more knowledgeable than the oncologist, such as a nurse practitioner who specializes in this area or has a true interest.
 Where can I go for up-to-date, legitimate CAM information?

There is an abundance of misinformation, profiteering and quackery on the internet. Cancer patients need to be very careful that they gather their information from reputable sources.

 Refer to the Complementary and Alternative Medicine links for excellent sources of information.
 

Bob and Jan Haase
Appendiceal Cancer Survivor, Michigan


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Breast Cancer Survivor, North Carolina



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