Cancer is a term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and spread to other parts of the body through the bloodstream and the lymph system, however, improvements in screening, detection, treatment, and care have increased the number of cancer survivors, and experts expect the number of survivors to continue to increase in the coming years.
Complementary and alternative medicine (CAM) is the term for medical products and practices that are not part of standard medical care, which is based on scientific evidences from research studies, but rather used, alongside mainstream cancer care.
Complementary health approaches are a group of diverse medical and health care systems, practices, and products whose origins come from outside of mainstream medicine. They include such products and practices as herbal supplements, other dietary supplements, meditation, spinal manipulation, and acupuncture. Some complementary approaches are not meant to replace, but rather, as adjuncts to mainstream cancer care. They are supportive measures that control symptoms, enhance well being, and contribute to overall patient care.
The same careful scientific evaluation that is used to assess conventional therapies should be used to evaluate complementary approaches, for some complementary approaches plans that may help patients cope with disease, are beginning to find a place in cancer treatment, not as cures, but as additions to treatment symptoms and alleviate side effects or improve a patient’s sense of well-being ( 1 ) .
Alternative therapies, on the other hand, are healing techniques and beliefs that have developed over time and include homeopathy, naturopathy, and traditional Chinese medicine, and are promoted for use instead of mainstream treatment.
Being diagnosed with cancer and undergoing treatment is a frightening, exhausting, and demanding experience. CAM appeals to many patients with cancer because these treatments often offer a chance to take control, feel better, and decrease uncomfortable symptoms, such as pain, fatigue, and nausea.
Over time, some complementary therapies are proven safe and effective. These become integrated into mainstream care, producing integrative oncology, a synthesis of the best of mainstream cancer treatment and rational, data based, and adjunctive complementary therapies. Such integration is evolving, hence, ‘the term “integrative medicine” is fast replacing that of complementary and alternative medicine, or CAM’ (2). The very term applied to the program at the Memorial Sloan-Kettering Cancer Center (Integrative Medicine Service) and similar titles applied to related programs in North America, the United Kingdom, and Europe, suggest that complementary therapies are being brought into mainstream medicine, including cancer care. Integration varies from country to country, as does the quality of therapies offered. Centers for integrative medicine are being established in many academic medical centers (3, 4).
The interest in therapies outside of mainstream oncology care is not limited geographically or among particular segments of the population. In countries in which modern medicine predominates, 40–50% of patients with cancer use CAM therapies outside the mainstream ( 5 ). Among cancer survivors in the US, up to 40% used complementary or alternative therapies during the period following their treatment.
By various accounts, from less than 10% to more than 60% of cancer patients have used CAM (6). The Datamonitor 2002 Survey in USA, indicated that 80% of cancer patients used an alternative or complementary modality (7). Some other data indicate that the likelihood of using complementary approaches varies with the type of cancer and with factors such as sex, age, and ethnicity. The results of surveys from 18 countries show that use of complementary approaches by people who had been diagnosed with cancer was more common in North America than in Australia/New Zealand or Europe and that use had increased since the 1970s and especially since 2000.
Well-designed comparative studies include a placebo treatment, (Placebo, is an inactive medication or treatment) as well as a “real” treatment, so that the two may be compared. For example, a CAM treatment that claims to improve symptoms of nausea in 50 percent of patients is of little benefit if the placebo treatment also improves symptoms in 50 percent of patients. The placebo effect is not well understood but has a strong influence on the results of any research study, whether in conventional or complementary medicine.
written by Dr Khalida Mousawy MB, ChB, Ph.D