Over the past decade, complementary and alternative medicine (CAM) has grown into a multi-billion-dollar industry in the United States, with the use of CAM interventions becoming increasingly popular among cancer patients.
Studies estimate that at least half of cancer patients use some type of complementary intervention,[1] though the reported range varies from less than 10% to more than 60%.[2] The number of patients who seek out alternative therapies is quite low, with experts estimating that the percentage falls in the single digits.
Although the term "CAM" combines complementary and alternative medicine, distinguishing the two is important. Complementary interventions are only intended to supplement mainstream care and are used primarily to control symptoms and bolster physical and emotional well-being throughout treatment.
"Although we can't rely on complementary therapies to shrink a tumor, if given together with chemotherapy or radiation therapy, such interventions may improve quality of life and possibly survival as well," said Gary Deng, MD, PhD, interim Chief of Integrative Medicine at Memorial Sloan Kettering Cancer Center in New York City. "It's a common misconception that cancer treatment is all about shrinking the tumor. Reducing anxiety or pain can make an enormous impact on a patient's day-to-day quality of life."
Alternative therapies, however, are meant as a substitute for mainstream care. Both supporters and skeptics of complementary treatments agree that alternative modalities are not viable substitutes for mainstream care and that using any in lieu of conventional medicine is dangerous.
"We discourage our patients from using alternative interventions instead of mainstream therapies because they will miss the opportunity for proper care," said Dr. Deng. "Even the best chemotherapy does not cure cancer. Surgery is the only cure."
David Rosenthal, MD, Medical Director of Integrative Therapies at Dana-Farber Cancer Institute and a professor in the Department of Medicine at Harvard Medical School, agrees about the harms of alternative medicine. "A major problem is there are still quacks claiming alternative cures," he said.
That is why a growing number of oncologists and policy makers want to abandon the term "CAM" in favor of "integrative oncology," which focuses solely on combining mainstream and complementary care.
These integrative services facilitate communication between oncologists and patients, providing an environment where patients can share their concerns and disclose any complementary interventions they already use or would like to try.
Disclosing this information is particularly important because some complementary modalities can interact with chemotherapy drugs. "Many patients don't realize that herbs and supplements -- one of the most common complementary interventions -- are drugs, and that some have been shown to interact with chemotherapy and can be harmful to patients," said Steven Novella, MD, a neurologist and assistant professor at Yale University School of Medicine who is executive editor of the blog Science-Based Medicine.
Still, many patients don't inform their doctors about their CAM use. One study found that only 58% of men with prostate cancer had told their physician about using CAM interventions, and even fewer asked their family physician (15%) or oncologist (7%) for guidance regarding CAM use.[3]
When it comes to treating cancer, "there are no magic bullets," Dr. Rosenthal said. Patients need proper, evidence-based guidance to get the best possible care and to avoid risky treatments.
In this column, Medscape will delve into the scientific validity of popular complementary interventions, from acupuncture to Reiki, exploring common myths about these modalities and examining what the scientific literature and experts in the field say about their safety and effectiveness.
Medscape Oncology © 2014 WebMD, LLC
Cite this: Mythbusters: Complementary and Alternative Treatments in Cancer - Medscape - Sep 02, 2014.
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