The subject of complementary and alternative medicines (CAM) has a plethora of articles in the lay literature, read intensively by our patients, but may be only superficially covered by their medical practitioners.
Recently an article appeared in HemOnc today where David Rosenthal MD, of Harvard Medical School, discussed the relevance of CAM in oncology. He outlined the five primary domains of CAM;
1) Mind-body medicine; eg. meditation, yoga, acupuncture.
2) Biologically-based practices; eg. dietary products & herbal supplementation.
3) Manipulation & body-based practices; eg. spinal manipulation.
4) Energy medicine; eg. Qi gong, magnetic or light therapy.
5) Whole medical systems; eg. Ayurvedic & Traditional Chinese medicines.
Many of us who work in hospice and palliative medicine are familiar with at least some of these CAM agents. Our patients utilize some of the examples given, from acupuncture to St. John’s Wort, for symptomatic care. In hospice we’re aware of the shortcomings, the limitations, of these modalities.
But Dr. Rosenthal also mentioned the fact that since many of these modalities are unregulated it would be helpful for physicians (oncologists, and in general) to have more than just a rudimentary knowledge of CAM in order to help their patients retain helpful alternative therapies and steer away from agents that are useless, or worse, toxic. The article gives several helpful databases (shown below with some additional sites).
National Center of Cancer Complimentary and Alternative Medicine
Natural Medicines Comprehensive Database
(also cross-reference “complementary therapies” with ww5.komen.org)
Office of Dietary Supplements (ODS)
Article reference; “Know your patient’s use of complementary and alternative medicine in oncology” in “Ask The Expert”. HemOnc Today. 2010;11(22):50.
Robert Killeen MD