Carolyn Vachani, RN, MSN, AOCN
Abramson Cancer Center of the University of Pennsylvania
Last Modified: September 15, 2014
What is complementary and alternative medicine ( CAM)? What is integrative therapy? You may hear these terms used by your cancer care team and wonder how CAM or Integrative Therapies can help patients with cancer? This article will help you better understand what these terms mean and how to safely explore CAM therapies.
CAM therapies may be called "natural", but it is important to remember that natural does not mean no risk or imply safety. CAM therapies are broken down into 5 categories:
If you are considering CAM or Integrative therapies, it is very important that you discuss them with your oncology providers before using these therapies. Although many of these can be helpful, others have been proven ineffective or can interact with your body or your standard cancer treatments. In recent years, oncology providers have become more aware of promising CAM therapies and are usually willing to support their patients in using CAMs that are safe. Ask your providers about which CAM therapies may be helpful in managing your specific side effects. Ask if they can suggest a practitioner for this CAM.
Many studies have shown that providers are not aware that patients are using CAMs because they do not specifically ask about them. Be sure to speak up about your use of CAMs!
Many CAM therapies are helpful in relieving side effects and supporting a patient's mental well-being. Unfortunately, for many CAM therapies, we are not certain what risks, if any, they pose and for others the risks are well known. CAM therapies that are taken by mouth or given through an IV may interfere with standard cancer treatments (either negating or intensifying its action) or cause certain blood test results to be inaccurate, so it is important to discuss those with your providers. In addition, CAM may have side effects of their own. For example, they may worsen other medical conditions a patient has, such as high blood pressure.
CAM therapies do not require FDA approval and they are not subject to the same manufacturing and purity standards as regulated pharmaceuticals. This has led to production batches containing impurities or not containing what the label states they contain. One way to safeguard against this is to buy from reputable manufacturers or those that are verified by USP (United States Pharmacopeial Convention). USP is a non-profit organization that tests vitamins and supplements for purity and assures that the products contain what the label says they contain. Verified vitamins and supplements will have a "USP verified" seal on the packaging.
There can also be safety concerns for some mind-body and body-based practices, depending on your situation. For example, deep tissue massage is typically not recommended for areas affected by lymphedema and acupuncture could increase infection risk in patients with a low white blood cell count. This underscores the importance of discussing CAM therapies with your providers.
Once you decide to use a CAM, there are some practical considerations. Where is the therapy is available – this may not be at the cancer center. What does it cost – these therapies may not be covered by insurance, but perhaps your cancer center has a program to offer a CAM at low or no cost. CAM is not always on the top of your practitioner's minds, so be sure to ask what is offered at the cancer center.
There are a number of reliable websites that you can reference to learn more about CAM in general or a specific therapy.
USP (United States Pharmacopeial Convention)