Integrative, Complementary and Alternative Cancer Therapies

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work, emeritus

OCTOBER 17, 2018

Have they helped you?

Integrative Cancer Therapies is a term that is often used interchangeably with CAM Therapies (Complementary and Alternative Medicine). These can include everything that are not part of standard Western cancer care. Think of supplements, special teas, vitamins, acupuncture, massage, etc. We know that many, if not most, people going through or recovering from cancer treatment at least consider adding something to what their doctor is offering. The challenge becomes thinking carefully to evaluate the value of the additional therapy.

We know there is some evidence, for example, that acupuncture can be helpful to reduce nausea, increase energy and a general sense of well-being. We also know that some advertised CAM therapies are shams that can cause harm and cost a lot of money. Did you know that the business of CAM therapies makes $37 billion a year! And, you can be sure, virtually none of it is covered by insurance. If these possibilities interest you, it is important to sort out the therapies that may be truly helpful from those that are likely to waste your time and your money.

We all want to do everything to keep ourselves healthy. If you are going through cancer treatment, you also hope to beat back any cancer cells and feel as well as possible during radiation or chemotherapy. Let’s begin with the oft-repeated request to speak with your doctor about anything that you are considering. He or she may point out that there is some evidence that some CAM therapies may interfere with the efficacy of radiation or chemo. If you are considering high doses of anti-oxidant vitamins, for example, please wait until your treatment has been completed as there is some evidence that they can interfere with the efficacy of your therapy. Be prepared for your doctor to declare that she has limited knowledge of most of these integrative therapies, and that she would prefer you to hold off during active treatment.

Increasingly, proponents of CAM are using the Integrative Therapies language. This sounds more scientific, and covers a lot of territory, but you still need to be careful. Researchers at a number of academic medical centers, worldwide, have looked the possible supportive role of CAM in reducing symptoms and maximizing quality of life. If you look carefully, you'll notice that the positive studies and comments are related to life-style factors like exercise and diet. They are not about vitamins or supplements.

It's all a matter of making common sense judgments, but beware: it is easy to move towards suggested (and, probably, expensive) therapies.

A few weeks ago, I wrote about a study suggesting that people who used CAM therapies instead of Western medicine died more quickly than those who took a traditional path. Note that these were people who opted out of our standard of care treatments and used CAM instead. The study compared patients who had traditional therapy for early stage cancers to those who chose alternative therapies instead. In all cancers, except prostate cancer, survival at five years was much shorter for those who used alternative therapies. The study concluded that the value of techniques like acupuncture, massage, mindfulness and yoga is in using them along with medical treatments to help manage symptoms and side effects -- but not in using them to treat the cancer itself.

If you are considering using one or more of these therapies, how can you begin to carefully consider how to allocate your energy and your dollars? First, as stressed above, please mention to your doctor what you are thinking about doing. If there are known medical risks, you need to know about them. If there is merely no evidence that the treatment will be helpful, that is important, but a lower level of concern. Don’t just read the ads that announce or screamingly, seemingly positive reports. Remember the old cliché that Anything that seems to be too good to be true, isn’t.

Here are a couple of reliable websites that you can look at:

https://sciencebasedmedicine.org/ or  https://nccih.nih.gov/health/cancer/complementary-integrative-research

Don’t ever replace something your doctor has prescribed with an alternative therapy. Remember that CAM or integrative therapies have not been subjected to the same kind of scientific review that western medicine employs. Use your best judgment and common sense.

At BIDMC, the Cheng-Tsui Integrated Health Center offers some of the effective integrative therapies with very skilled practitioners.

What has your experience been with these treatments? Please share your thoughts at: http://www.cancercommunity.bidmc.org/