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Can Complementary and Alternative Medicine Help?
USE OF COMPLEMENTARY AND ALTERNATIVE METHODS
Healthcare consumers in the United States are turning to complementary
and alternative medicine in record numbers, and this trend is predicted
to continue to grow. The use of over-the-counter herbal remedies and vitamins is also growing. As more people are living longer,
chronic illnesses, including cancer, have become more common. Sometimes conventional medicine cannot cure chronic illnesses.
As a result, many patients may turn to complementary and alternative medicine in search of cures. 1
Studies show that up to 60 percent of patients who have cancer use complementary or alternative methods. 2 Traditional medicine may seem cold and impersonal to some patients. Part of the problem is that doctors sometimes spend little
time with patients because of pressures to provide cost-effective care.3 The use of complementary or alternative methods may
make patients feel that they are taking an active part in their own treatment and care, and that they have more control over
their disease.
DEFINITIONS OF TERMS
Some of the terms used in complementary and alternative medicine need to be defined 3:
- Complementary therapy: A method added to conventional or traditional treatments. Complementary therapy may ease the side effects of standard treatments
or provide physical or mental benefits to patients with cancer; examples are meditation to relieve stress and acupuncture
to relieve pain.
- Integrative therapy: Combined use of proven treatments and complementary therapies. Integrative therapy is becoming available in cancer centers
and hospitals across the United States.
- Alternative therapy: A treatment that has not been tested scientifically and is used in place of traditional treatments.
- Unconventional therapy: All types of complementary and alternative treatments that fall outside of proven therapies.
- Proven therapies: Traditional or standard treatments that have been tested and are approved by the Food and Drug Administration (FDA).
- Questionable therapy: Unproven or untested treatments.
- Quackery: Promotion of treatments claiming to prevent, diagnose, or cure cancers that are unproven or known to be false. These methods
are often based on the use of anecdotal stories or patient testimonials about their effectiveness. Unfortunately for patients
with pancreatic cancer, there has been much of this form of treatment touted, particularly on the Internet.
Table 8-1. Some Reputable Sources of Information About Complementary and Alternative Medicine
TYPES OF COMPLEMENTARY AND ALTERNATIVE METHODS
Complementary and alternative methods can be divided into several groups 2,3:
- Medical systems (eg, homeopathic and naturopathic medicine)
- Mind-body-spirit methods (eg, support groups, meditation, aromatherapy,biofeedback, yoga, and prayer), which focus on the
connections betweenthe mind, body, and spirit, and their power to heal
- Dietary (eg, the macrobiotic diet) and special nutritional programs or herbal mixtures (eg, foods, herbs, vitamins, and dietary
supplements)
- Manipulative and body-based methods (eg, chiropractic, osteopathic manipulation, acupuncture, and massage), which are based on the idea that problems in one part of the body often affect other parts of the body
- Energy therapies (eg, biofield therapy and bioelectromagnetic-based therapy)
- Pharmacological and biological treatments, in which substances produced from chemicals or concentrated from plants and other
living things (eg, laetrile and shark cartilage) are used
RISKS AND BENEFITS
Some complementary methods may improve a patient’s well-being by relieving pain and reducing symptoms and side effects. These
methods may help patients handle stress, anxiety, and depression. Some complementary methods that have been shown to be helpful
to patients with cancer include 2:
- Acupuncture for pain or for nausea and vomiting from chemotherapy
- Massage therapy for anxiety or pain
- Mind-body-spirit therapies such as hypnosis, relaxation training,imagery, and music therapy
| ST. JOHN’S WORT AND DRUG INTERACTIONS 4 |
One herbal remedy called St. John’s Wort has been shown to interact with some drugs. The herb affects the way the body processes
or breaks down drugs; in some cases, it may speed or slow the breakdown. Drugs that can be affected include indinavir and
possibly other drugs used to control HIV infection; irinotecan and possibly other drugs used to treat cancer; cyclosporine,
which prevents the body from rejecting transplanted organs; digoxin, which strengthens heart muscle contractions; warfarin
and related blood thinning drugs; birth control pills; and antidepressants..
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However, complementary and alternative therapies have risks. Just because a product claims to be “natural” does not necessarily
mean that it is safe. 5 Most dietary supplements, vitamins, and herbs are not approved by the FDA because they have not been tested. These products
may contain contaminants, or they may interact with prescription drugs. 6 Some products can be very potent and may have unpredictable effects. 2 They also may be harmful ( Box 8-1 ). 5 In general, patients with pancreatic cancer who are considering the use of complementary therapy or alternative treatments
should discuss these methods with their healthcare team.
| Box 8-1 |
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ALERTS TO POTENTIALLY HARMFUL THERAPIES 5
- It delays conventional treatment
- It has no proven efficacy
- It is administered by an unlicensed practitioner
- It is not FDA-approved
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CONSIDERATIONS
Acknowledging the growing public interest in complementary and alternative methods, especially among patients living with
cancer, the American Cancer Society 3:
- Supports the rights of individuals with cancer to decide which treatment is best for them
- Encourages people to discuss all treatments they may be considering with their doctors and other healthcare providers
- Encourages people with cancer to consider using proven, effective methods
- Encourages people with cancer to consider enrolling in clinical trials
- Encourages healthcare professionals to ask patients about their use of these treatments
- Encourages healthcare professionals to listen and communicate with patients regarding these treatments
If you are considering using complementary or alternative therapies, the ACS has some tips for frank discussions with your
doctor and other healthcare providers ( Box 8-2 ).
| BOX 8-2 |
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TIPS FOR PATIENTS CONSIDERING COMPLEMENTARY OR ALTERNATIVE THERAPIES 3
- Educate yourself about the proven treatment and about the complementary or alternative treatment you are considering
- Let your doctor know you are thinking about using complementary or alternative treatment Write down a list of questions and
bring any literature you want to discuss to your office visit
- If you are considering stopping conventional treatment, discuss the implications with your doctor
- If you are taking dietary supplements or herbs, provide a list for your doctor and review the list with your doctor whenever
you are given a new drug or any change is made in your medications
- Continue your conversations with your doctor, and let your doctor know of any decisions you have reached
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REFERENCES ! Click reference number to return to text.
1. Eyre HJ, Lange DP, Morris LB. Informed Decisions: The Complete Book of Cancer Diagnosis, Treatment, and Recovery. 2nd ed.
American Cancer Society–Health Content Products. Atlanta, GA; 2002.
2. Cassileth BR, Deng G. Complementary and alternative therapies for cancer. The Oncologist. 2004;9:80-9.
3. American Cancer Society’s Guide to Complementary and Alternative Cancer Methods. Atlanta, GA: American Cancer Society; 2000.
4. National Center for Complementary and Alternative Medicine. http://nccam. nih.gov/health/stjohnswort. Accessed April 22,
2007.
5. Weiger WA, Smith M, Boon H, et al. Advising patients who seek complementary and alternative medical therapies for cancer.
Ann Intern Med. 202:137:889-903.
6. Cassileth BR. Evaluating complementary and alternative therapies for cancer patients. CA Cancer J Clin. 1999; 49:362-75.
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