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SurvivorshipComplementary Therapies

Alternative, Complementary, or Integrative Medicine? How to Tell the Difference and Make Safe Choices

Check out the differences between alternative, complementary, and integrative medicine to help you or a loved one navigate through therapy options.
June 2017 Vol 3 No 3
Susan Yaguda, RN, MSN
Integrative Oncology Coordinator, Atrium Health, Levine Cancer Institute,
Charlotte, NC

Patients with cancer worldwide are frequently combining health interventions, such as acupuncture, massage therapy, and supplements, with conventional treatments, such as chemotherapy, radiation, and surgery. Studies suggest that as many as 90% of patients with cancer use some type of integrative medicine during their treatment, without telling their oncologist.1

Patients may not feel supported by their healthcare providers for using different therapies, and information about safety and usefulness of unconventional treatments is sometimes hard to find. However, some therapies are not safe for patients with cancer to use, and are often also very expensive.

Patients with cancer and cancer survivors need to be careful about using therapies that have not been thoroughly investigated for safety. So how can we determine what is safe, and what is quackery? First, let’s clarify the terms “alternative,” “complementary,” and “integrative” therapies.

Alternative Medicine

“Alternative medicine” refers to an intervention that takes the place of conventional medical treatment. Alternative medicine has not undergone the rigorous scientific investigation that conventional medical treatments undergo to make sure they are safe and effective.

The Internet is full of stories about patients with cancer having miraculous cures from alternative treatments. However, it is unlikely that alternative treatments can cure cancer, and some of these treatments can also be dangerous to your health.

Alternative treatments can also be expensive, and they are not covered by health insurance. Some examples of alternative medicine are:

  • Coffee enemas
  • High doses of intravenous vitamin infusions
  • Magnet therapy

Complementary Medicine

“Complementary medicine” is a term that was coined in the early 1990s to describe the coordinated use of integrative modalities along with conventional medical treatment. Complementary medicine is different from alternative medicine in that providers who use complementary medicine do not aim to replace conventional treatment with a complementary treatment. Instead, the goal of complementary therapy is to help support people who receive conventional treatments through the use of well-researched and safe interventions. Some examples of safe, effective intervention include:

  • Meditation, especially mindfulness-based meditation
  • Yoga
  • Music therapy

Integrative Medicine

“Integrative medicine” is a specialty field of medical care and a newer term that emphasizes the integration of complementary therapies and conventional treatments. Integrative medicine combines the best of both worlds, with an emphasis on safety and evidence.

Many integrative medicine doctors have undergone professional training that is focused on safe, evidence-based integrative therapies. An integrative medicine doctor will partner with your oncologist or other healthcare providers to give you the best overall care and support that combines the best of both worlds—traditional medicine and complementary therapies.

Integrative medicine providers recommend modalities and treatments that have been investigated for safety and for usefulness. For patients with cancer and cancer survivors, some integrative modalities may help with some of the side effects of cancer and cancer treatment. Some examples of integrative medicine are2:

  • Acupuncture for hot flashes and neuropathy
  • Healing touch therapy for pain and anxiety
  • Focusing on a healthy diet and certain supplements for general overall health

How Can You Tell?

How do patients know what is safe and what to avoid? Here are some tips for helping you determine which therapies are safe, and which could be harmful, or at best, a waste of your money:

  1. Always discuss using any supplements or other therapies with your doctor or healthcare team
  2. Some healthcare providers may not be familiar with certain supplements and how they interact (work together or interfere) with cancer treatment or with other prescription medications. Healthcare providers with specialized integrative training are a good source of information. Ask a physician, a nurse practitioner, or a pharmacist with integrative specialty training for guidance if you are unsure
  3. Make sure the supplements you are using are (1) safe to take with your other medicines, and (2) that they come from a laboratory that is inspected regularly for quality. Supplements, such as herbs and vitamins, are not regulated like prescription drugs. Check for the Consumer Labs (CL) or US Pharmacopeia (USP) label on the bottle or the box. These labels (CL or USP) ensure that the supplement or another product is manufactured in a lab that is regularly inspected for quality
  4. If you are considering an alternative type of treatment, ask to see the research on this therapy. Quality research comes from professional, peer-reviewed journals that are being evaluated for the accuracy of the findings (see Patient Resources)
  5. Carefully consider the cost, financially and to your health
  6. “Miracle cure” is a red flag! Steer clear of any provider who offers a miracle cure with their treatment or any commercial entity that claims to offer a miracle cure that your doctor doesn’t want you to learn about

Ask Your Doctor or Nurse

There are several integrative modalities, supplements, and interventions that may be helpful for patients with cancer and cancer survivors. Patients should talk with their healthcare providers about using any modalities and supplements before starting to use them. Although many integrative modalities are helpful, keeping safe is the most important part of your care, so always ask when in doubt.

References

  1. Yates JS, Mustian KM, Morrow GR, et al. Prevalence of complementary and alternative medicine use in cancer patients during treatment. Supportive Care in Cancer. 2005;13:806-811.
  2. Greenlee H, Balneaves LG, Carlson LE, et al. Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. Journal of the National Cancer Institute. Monographs. 2014;50:346-358.

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