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What is Complementary and Alternative Medicine (CAM)?
The treatment of cancer is often a complicated and multi-faceted process. Depending on the stage and extent of their cancer, patients may choose between many treatment options, such as surgery, chemotherapy and radiation. In order to choose among treatment options, it is important to understand the different types of treatment. Some patients prefer allopathic treatment, while others prefer complementary and alternative medicine. Still others prefer a blend of the two.
Allopathic medicine is the technical name for medicine practiced by MDs (medical doctors). The term allopathy is derived from two Greek words: allo meaning opposite and pathos meaning suffering. The basis of this medical system is to focus on disease and employ methods that oppose it. Within this framework, removing disease returns the body to health. Scientific studies are conducted to determine which treatments are most effective at eradicating particular diseases, or at least limiting their effects. Allopathic medicine is often referred to as conventional, mainstream or Western medicine. Examples of allopathic cancer treatment include surgery, chemotherapy and radiation.
CAM is the acronym for complementary and alternative medicine, the most commonly used phrase to describe medical therapies practiced outside conventional Western medicine. CAM contains a variety of healing philosophies and medical practices that are not currently accepted or used by conventional medicine.
Complementary medicine consists of medical therapies that are most often used to supplement conventional medical treatments. Because these treatments are utilized in addition to allopathic therapies, they most often focus on promoting wellness or managing symptoms. Most CAM therapies can be used as a complement to conventional medicine. A benefit of complementary therapies is that patients can use well-researched conventional treatments against cancer, while utilizing complementary medicine to reduce stress, enhance their immune system and/or effect cancer on a different level (e.g., energetically). The vast majority of CAM practitioners and cancer patients who utilize CAM therapies use complementary medicine as a means of integrating the best of what both types of medicine have to offer.
One problem with combining allopathic and complementary medicine, however, is that such combinations have been the subject of little research. While combining certain kinds of complementary medicine that promote wellness, like guided visualization or yoga, with conventional treatments such as chemotherapy are unlikely to create adverse reactions, the same is not true for certain herbs or other biologically-based substances that can be used as complementary medicine. Some herbs or supplements are contraindicated (not indicated for use) with specific chemotherapeutic agents, because they interfere with the ability of the chemotherapy to kill cancer cells. On the other hand, research has found that certain complementary medicine agents may reduce side effects of conventional treatment and may actually increase the effectiveness of chemotherapy. Complementary medicine can offer many benefits to cancer patients, but the potential for adverse reactions necessitates careful supervision of its use.
In contrast to complementary medicine, alternative medicine is used in place of conventional medicine. Alternative medicine attempts to treat disease specifically, without the use of any allopathic therapies. Therapies commonly used as complementary medicine are considered alternative medicine when used in place of conventional treatment. For minor health issues, alternative medicine is generally not dangerous. However, most practitioners of conventional medicine, and many who practice complementary medicine, are uncomfortable with the exclusivity of alternative medicine and its failure to utilize treatments that are known to benefit certain diseases when the illness is serious. In such instances, alternative therapies may delay conventional treatment and result in a more serious illness, complications or death. Many patients who do turn to alternative medicine do so only after conventional medicine has nothing more to offer or because they believe the risks of a mainstream treatment outweigh the risks of the alternative therapy they are investigating. In some instances, a very negative experience with conventional medicine has left a patient in search of alternative forms of medicine.
There are several common threads shared by the diverse therapies classified as CAM. CAM is generally considered holistic, looking at the physical, mental, emotional and spiritual components that make up a whole person. The purpose of most CAM is to heal the entire person, not just the disease, which is often considered only a symptom of a more fundamental imbalance. While some types of CAM therapies, such as herbs or supplements, may be used specifically to eradicate disease, such therapies are often used in combination with other CAM therapies to create a lifestyle that promotes wellness rather than one that focuses solely on recovering from ill health. Most CAM therapies have undergone very little research and have limited scientific evidence of their effectiveness. Most CAM is very individualized, with a specific therapy regimen tailored to the unique health issues of the individual. CAM also requires that patients be actively involved in their healing, promoting patient education and involvement beyond what is common in conventional medicine. This also generates a different patient-practitioner relationship than is common in mainstream medicine. In the CAM ideal, patient and practitioner engage in dialogue regarding treatment options and form a partnership dedicated to restoring and maintaining health and wellness.
It is important to remember that any new innovation in medicine will originally be classified as CAM. Chemotherapy and radiation were once considered unconventional and questioned by the mainstream medical community. Ideally, as research on a particular CAM therapy demonstrates safety and efficacy, it will become a part of conventional medicine. For this reason, therapies defined as CAM are consistently evolving, with successful therapies eventually becoming integrated into conventional medicine. This ideal is limited, however, by a number of factors: the amount of funds available for research; philosophical and political issues that affect which therapies receive funding; our current scientific understanding of how the body works; the methodologies available to investigate novel therapeutic approaches that may or may not be appropriate for CAM therapies; regulatory issues; and economic and business issues regarding patents, or the lack thereof, for natural substances. In addition, the amount of research necessary for this shift to occur is enormous, usually requiring years of sustained inquiry.
Integrative Medicine focuses on combining conventional medicine with CAM to create a comprehensive approach to healing. Integrative medicine maintains that for the whole person to heal, any number of different therapeutic approaches may need to be employed. Integrative medicine also promotes evidence-based research as a means of determining which CAM therapies are reliable, effective and safe. Because it can take many years for a CAM therapy to obtain the evidence necessary for inclusion in conventional medicine, integrative medicine facilitates these in-between years when promising therapies are undergoing research and patients are using them anyway. The goal of integrative medicine is to create a unified medicine in support whole, healthy people.
Cancer patients may use CAM therapies in several ways:
Promote Wellness: Most CAM promotes wellness, which is more than the absence of disease. Wellness is the optimal overall health of an individual, including physical, emotional, mental and spiritual aspects. Many different activities promote wellness, from exercising to eating a healthy meal to attending a support group. Many CAM practitioners argue that promoting wellness stimulates the body to heal itself.
Manage Symptoms: CAM is often used to manage symptoms. The symptoms may be due to the cancer itself or from side effects of treatment. In helping manage symptoms, CAM may help improve quality of life.
Directly Treat Cancer: CAM may also be used to directly treat cancer. Some therapies that directly treat cancer are used in addition to conventional treatments (complementary medicine), whereas others are employed instead of conventional treatments (alternative medicine).
Information presented in The Daily Tip is offered as a guide to augment a patient’s research of cancer and treatment and does not replace the advice of a doctor. For more information on a specific cancer, go to www.CancerConsultants.com, www.cancer.gov, and consult your physician.
General Disclaimer: The purpose of the Patient Resource Center is to help educate patients and their families about the management of cancer in order to facilitate shared decision-making with their treating healthcare provider. This program meets Oncology Nursing Society guidelines for quality educational content. Information on the Patient Resource Center does not constitute medical advice. Healthcare providers should exercise their own independent medical judgment. Lilly Oncology is a sponsor of the Patient Resource Center.
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