Questions and Answers About Complementary and Alternative Medicine in Cancer Treatment

What is complementary and alternative medicine?

Are complementary and alternative cancer therapies widely used?

Can complementary and alternative medicine be evaluated using the same methods used in conventional medicine?

What should patients do when considering complementary and alternative therapies?

When considering complementary and alternative therapies, what questions should patients ask their health care provider?

How can patients and their health care providers learn more about complementary and alternative therapies?

 

1. What is complementary and alternative medicine?

   Complementary and alternative medicine (CAM)—also referred to as integrative medicine—includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments; it is often called alternative when it is used instead of conventional treatment. (Conventional treatments are those that are widely accepted and practiced by the mainstream medical community.) Depending on how they are used, some therapies can be considered either complementary or alternative.

   Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease. Some commonly used methods of complementary or alternative therapy include mind/body control interventions such as visualization or relaxation, manual healing including acupressure and massage, homeopathy, vitamins or herbal products, and acupuncture.

2. Are complementary and alternative cancer therapies widely used?

   Although there are few studies on the use of complementary and alternative therapies for cancer, one large-scale study found that the percentage of cancer patients in the United States using these therapies was nine percent overall (Lerner and Kennedy, 1992).

3. Can complementary and alternative medicine be evaluated using the same methods used in conventional medicine?

   Scientific evaluation is important in understanding if and when complementary and alternative therapies work. A number of medical centers are evaluating complementary and alternative therapies by developing scientific studies to test them.

   Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a rigorous scientific process, including clinical trials with large numbers of patients. Often, less is known about the safety and effectiveness of complementary and alternative methods. Some of these complementary and alternative therapies have not undergone rigorous evaluation. Others, once considered unorthodox, are finding a place in cancer treatment—not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. According to a panel of experts at a National Institutes of Health Consensus Conference in November 1997, acupuncture has been found to be effective in the management of chemotherapy-associated nausea and vomiting and in controlling pain associated with surgery. Some approaches, such as laetrile, have been studied and found ineffective or potentially harmful.

4. What should patients do when considering complementary and alternative therapies?

   Cancer patients considering complementary and alternative medicine should discuss this decision with their doctor or nurse, as they would any therapeutic approach, because some complementary and alternative therapies may interfere with their standard treatment or may be harmful when used with conventional treatment.

5. When considering complementary and alternative therapies, what questions should patients ask their health care provider?
   • What benefits can be expected from this therapy?
   • What are the risks associated with this therapy?
   • Do the known benefits outweigh the risks?
   • What side effects can be expected?
   • Will the therapy interfere with conventional treatment?
   • Will the therapy be covered by health insurance?
6. How can patients and their health care providers learn more about complementary and alternative therapies?

   Patients and their doctor or nurse can learn about complementary and alternative therapies from the following Government agencies:

   The NIH National Center for Complementary and Alternative Medicine (NCCAM) facilitates research and evaluation of complementary and alternative practices and has information about a variety of methods.

   NCCAM Clearinghouse
   Post Office Box 8218
   Silver Spring, MD 20907–8218
   Telephone/TTY/TDY: 1–888–644–6226 (toll free)
   

   The Food and Drug Administration (FDA) regulates drugs and medical devices to ensure that they are safe and effective.

   FDA
   5600 Fishers Lane
   Rockville, MD 20857
   Telephone: 1–888–463–6332
   Web site: http://www.fda.gov/
   

   The Federal Trade Commission (FTC) enforces consumer protection laws. Publications available from the FTC include:

   • "Who Cares: Sources of Information About Health Care Products and Services"
   • "Fraudulent Health Claims: Don't Be Fooled"

   Consumer Response Center
   Federal Trade Commission
   Room H–130
   Sixth Street & Pennsylvania Avenue, NW.
   Washington, DC 20580
   Telephone: 202–326–3128
   Web site: http://www.ftc.gov/

References:

From the National CAncer Institute & National Institues of Health

Cassileth B, Chapman C. Alternative and Complementary Cancer Therapies. Cancer 1996; 77(6):1026–1033.

Jacobs J. Unproven Alternative Methods of Cancer Treatment. In: DeVita, Hellman, Rosenberg, editors. Cancer: Principles and Practice of Oncology. 5th edition. Philadelphia: Lippincott-Raven Publishers; 1997. 2993–3001.

Lerner IJ, Kennedy BJ. The Prevalence of Questionable Methods of Cancer Treatment in the United States. CA-A Cancer Journal 1992;42:181–191.

Nelson W. Alternative Cancer Treatments. Highlights in Oncology Practice 1998; 15(4):85–93.

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