Considering Complementary and Alternative Medicine (CAM)

By the National Institutes of Health

Many Choices

You have many choices to make before, during, and after your cancer treatment. One choice you may be thinking about is complementary and alternative medicine. We call this CAM, for short.

Reasons People with Cancer Choose Complementary and Alternative Medicine (CAM)

People with cancer may use CAM to:

" Help cope with the side effects of cancer treatments, such as nausea, pain, and fatigue;
" Comfort themselves and ease the worries of cancer treatment and related stress;
" Feel that they are doing something more to help with their own care;
" Try to treat or reverse their cancer.

Making Choices

It's natural to want to fight your cancer in any way you can. There is a lot of information available, and new methods for treating cancer are always being tested, so it may be hard to know where to start.
This brochure may help you understand what you find and make it easier to decide whether CAM is right for you. Many people try CAM therapies during cancer care. CAM does not work for everyone, but some methods may help you manage stress, nausea, pain, or other symptoms or side effects.
The most important message of this brochure is to talk to your doctor before you try anything new. This will help ensure that nothing gets in the way of your cancer treatment.

What is Complementary and Alternative Medicine?

CAM is any medical system, practice, or product that is not thought of as standard care. Standard medical care is care that is based on scientific evidence. For cancer, it includes chemotherapy, radiation, biological therapy, and surgery.

Complementary Medicine

" Complementary medicine is used along with standard medical treatments.
" One example is using acupuncture to help with side effects of cancer treatment.

Alternative Medicine

" Alternative medicine is used in place of standard medical treatments.
" One example is using a special diet to treat cancer instead of a method that a cancer specialist (an oncologist) suggests.

Integrative Medicine

" Integrative medicine is a total approach to care that involves the patient's mind, body, and spirit. It combines standard medicine with the CAM practices that have shown the most promise.
" For example, some people learn to use relaxation as a way to reduce stress during chemotherapy.

Types of Complementary and Alternative Medicine

We are learning about CAM therapies every day, but there is still more to learn. Consumers may use the terms "natural," "holistic," "home remedy," or "Eastern medicine" to refer to CAM. However, experts use five categories to describe it. These are listed below with a few examples for each. (For a complete list of therapies, go to http://nccam.nih.gov/health.)

Mind-Body Medicines

These are based on the belief that your mind is able to affect your body. Some examples are:

Biologically Based Practices

This type of CAM uses things found in nature. This includes dietary supplements and herbal products. Some examples are:

A note about nutrition: It's common for people with cancer to have questions about different foods to eat during treatment. Yet it's important to know that there is no one food or special diet that has been proven to control cancer. Too much of any one food is not helpful, and may even be harmful. Because of nutrition needs you may have, it's best to talk with the doctor in charge of your treatment about the foods you should be eating.

Manipulative and Body-Based Practices

These are based on working with one or more parts of the body. Some examples are:

Energy Medicine

Energy medicine involves the belief that the body has energy fields that can be used for health and wellness. Therapists use pressure or move the body by placing their hands in or through these fields. Some examples are:

Whole Medical Systems

These are health systems and beliefs that have evolved over time in different cultures and parts of the world. Some examples are:

Talk with Your Doctor Before You Use CAM

Some people with cancer are afraid that their doctor won't understand or approve of the use of CAM. But doctors know that people with cancer want to take an active part in their care. They want the best for their patients and often are willing to work with them.

Talk to your doctor to make sure that all aspects of your cancer care work together. This is important because things that seem safe, such as certain foods or pills, may interfere with your cancer treatment.
What questions should I ask my doctor about CAM?

What types of CAM might:

If I decide to try a CAM therapy:

A Natural Product Does Not Mean a Safe Product

Here are some important facts about dietary supplements such as herbs and vitamins:

Herbs and some plant-based products may keep medicines from doing what they are supposed to do. These medicines can be ones your doctor prescribes for you, or even ones you buy off the shelf at the store.
For example, the herb St. John's wort, which some people with cancer use for depression, may cause certain anticancer drugs not to work as well as they should.

They may be harmful when taken by themselves, with other substances, or in large doses. For example, some studies have shown that kava, an herb that has been used to help with stress and anxiety, may cause liver damage.

Tell your doctor if you are taking any dietary supplements, no matter how safe you think they are. This is very important. Even though there are ads or claims that something has been used for years, they do not prove that it is safe or effective. It is still important to be careful.

Supplements do not have to be approved by the Federal Government before being sold to the public. Also, a prescription is not needed to buy them. Therefore, it's up to consumers to decide what is best for them.

Choose Practitioners with Care

CAM practitioners are people who have training in the therapies listed. Choosing one should be done with the same care as choosing a doctor. Here are some things to remember when choosing a practitioner:

What questions about the therapy should I ask the CAM practitioner?

Other Questions To Ask Yourself

Call your health plan or insurer to see whether they cover CAM therapies. Many are not covered.

Getting Information from Trusted Sources

Government Agencies

There is a lot of information on CAM, so it's important to go to sources you can trust. Good places to start are the government agencies listed in the back of this booklet. They offer lots of information about CAM that might be helpful to you. They may also know of universities or hospitals that have CAM resources.

Be careful of products advertised by people or companies that:

Just remember, if it sounds too good to be true, it probably is. For ways to find out more about CAM, see the resources section 1.

Health Sites on the Web

Patients and families have been able to find answers to many of their questions about CAM on the Internet. Many Web sites are good resources for CAM information. However, some may be unreliable or misleading.

Questions to ask:

For more details, see the fact sheet: How to Evaluate Health Information on the Internet: Questions and Answers

Books

A number of books have been written about different CAM therapies. Some books are better than others and contain trustworthy content, while others do not.

If you go to the library, ask the staff for suggestions. Or if you live near a college or university, there may be a medical library available. Local bookstores may also have people on staff who can help you.

It's important to know that information is always changing and that new research results are reported every day. Be aware that if a book is written by only one person, you may only be getting that one person's view.

Questions to ask:

Magazine Articles

If you want to look for articles you can trust, ask your librarian to help you look for medical journals, books, and other research that has been done by experts.

Articles in popular magazines are usually not written by experts. Rather, the authors speak with experts, gather information, and then write the article. If claims about CAM are made in magazine articles, remember:

When you read these articles, you can use the same process that the magazine writer uses:

Resources

National Cancer Institute (NCI)

Office of Cancer Complementary and Alternative Medicine (OCCAM)

Visit: cancer.gov/cam

Cancer Information Service (CIS)

National Center for Complementary and Alternative Medicine (NCCAM)

National Library of Medicine

Food and Drug Administration (FDA)

Federal Trade Commission (FTC)

National Cancer Institute-Sponsored Cancer Centers




National Institutes of Health, National Center for Complementary and Alternative Medicine.




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