Guidelines for Using Complementary and Alternative Methods

What are complementary and alternative methods?

“Complementary” and “alternative” are terms used to describe a number of products, practices, and systems that are not part of mainstream medicine. They can include things like herbs and dietary supplements, body movement, spiritual approaches, pills, extracts, and creams or ointments. Some are done by a person with formal education and training, such as art or music therapy. Others may be recommended by the person who is selling the product in a store or online, such as botanicals and exotic types of juice. The methods can involve everything from enemas, like colon therapy, to no-touch “energy work” such as reiki. Some take a lot of time or cost a lot of money, such as strict diets or travel to another country for special treatments. Others are fairly cheap and easy to use, like vitamins or homeopathy. Some can be done at home on your own, such as meditation and prayer, and others require another person to give them, like massage or acupuncture. Some almost never cause harm, while others can be dangerous and have even caused deaths.

You may hear about one or more of these treatments from friends, family, co-workers, salespeople, and others. The treatment may be something you’ve never heard of before, and it can be hard to get good, unbiased information about it. Here we will go over what you need to know before you decide to try one of these unconventional treatments. We will give you some ideas about how to look at these methods and what questions you might want to ask as you think about what might be best for you. It may also help you find out more about the treatments that interest you.

The American Cancer Society considers complementary and alternative medicine to be different from each other:

Alternative medicine is used instead of standard or mainstream medical treatment, often with serious outcomes for the patient.

Complementary medicine is used along with mainstream medical care. If carefully chosen and properly used, some of these can improve your quality of life without causing problems with your regular cancer treatment.

People with cancer might think about using alternative and complementary methods for a number of reasons:

• To relieve the side effects of mainstream cancer treatment without having to take more medicine
• To find a less unpleasant treatment approach that might have few side effects
• To take an active role in improving their own health and wellness
• Because they prefer alternative theories of health and disease, as well as alternative treatments

The decision to use alternative or complementary methods is an important one, and it is yours to make. We have put together some guidelines to help you think through the issues and make the most informed and safest decision possible.

What are the risks of not using mainstream cancer treatment?

Mainstream cancer treatments such as radiation, chemotherapy, and surgery can be unpleasant. But they have been scientifically tested and proven to work for treating cancer. Even though the side effects of mainstream cancer treatment can be serious, these treatments help you fight a life-threatening disease. Cancer patients who choose alternative medicine instead of mainstream cancer treatments may be putting themselves at serious risk. They are giving up the only proven methods of treating their disease. Delays or interruptions in standard treatment can give the cancer more time to grow. Even early stage cancers can become impossible to treat successfully if effective treatment is delayed long enough. And when cancer reaches a stage where cure is not possible, it is important to remember that mainstream care can still offer a lot in the way of cancer control and comfort.

How are complementary methods used to manage cancer?

Some people believe that mainstream medicine is the only option they have when it comes to treating symptoms and side effects, relieving pain, and improving quality of life. Actually, there are many complementary treatment methods you can use safely, right along with your medical treatment. For example, some people find that certain complementary methods – such as aromatherapy, biofeedback, massage therapy, meditation, tai chi, or yoga – are very useful to help control some of their symptoms and improve the quality of their lives. But these methods do not treat the cancer.

Some cancer treatment centers offer some of these complementary therapies on-site. When complementary treatments are offered along with mainstream care, it is called integrative therapy. That means you get can get safe complementary treatments at your cancer treatment center without having to go out and find them yourself.

How do I talk to my doctor about alternative or complementary methods?

Many cancer patients are afraid to discuss complementary or alternative methods with their doctors. It’s true that many doctors may not know about the uses, risks, and potential benefits of these unconventional treatments. This lack of knowledge can widen the gap between patient and doctor when it comes to using complementary methods along with regular cancer treatment. But this doesn’t have to stop you. You can help bridge the gap in a number of ways:

• Gather as much information as you can. Look for information from respected sources that you can trust regarding the potential benefits and risks of the treatment you are thinking about.
• When you share this information with your doctor, try to do it in a way that shows you know that your doctor wants what is best for you. Let him or her know that you are thinking about a complementary treatment and that you want to make sure it will not interfere with your regular medical treatment.
• If you are thinking of an alternative treatment, let the doctor know what you are considering. Ask the doctor about any studies on this method, and what options you might still have left if the alternative treatment does not work.
• Make a list of questions and bring it along with any other information you want to talk about. Ask your doctor to be a supportive partner as you learn more about other options and your treatment process.
• You might bring a friend or family member with you to the doctor’s office to support you. Your loved one can also help you talk with your doctor and relieve some of the stress of having to make decisions alone.
• Listen to what the doctor has to say, and try to understand his or her point of view. If the treatment you are thinking about will cause problems with your medical treatment, discuss safer choices together.
• Don’t delay or skip regular treatment without warning. If you are thinking about stopping or not taking mainstream treatment, please talk to your doctor about this. Even though you may be giving up the only proven treatment for your cancer, this is still your choice to make.
• Be sure to ask your doctor if there are mainstream methods for treating the side effects or symptoms you are having. There are many supportive medical treatments that can make you feel better.
• If you are taking dietary supplements, make a complete list of what you are taking and the amount of each. Many supplements can interact in harmful ways with other medicines, so talk with your doctor and pharmacist about your supplements and medicines. Report any changes in your supplement use to your health care team.
• If you are pregnant or breast-feeding, ask about the risks and effects of complementary or alternative methods. Never give herbal medicines to children without talking to their doctors first.
• Ask your doctor to help you identify possible fraud and fraudulent products. (See the list in the section, “How can I spot fraud and questionable treatments?”)

What questions should I ask about complementary and alternative methods that I might be thinking about using?

Here are some good questions to ask to find out about alternative or complementary treatments before you begin:

• What claims are made for the treatment? Is it supposed to help your medical treatment work better or relieve symptoms or side effects? Does it claim to cure cancer?
• What are the credentials of those supporting the treatment? Are they recognized experts in cancer and complementary medicine? If you will be seeing a complementary / alternative practitioner, find out about their training and education.
• Have scientific studies or clinical trials (tests in human volunteers) been done to find out whether this treatment works?
• Have the findings from the studies been published in trustworthy journals after being reviewed by other scientists in the same field?
• How is information about the method given? Is it promoted only in the mass media, such as books, magazines, the Internet, TV, infomercials, and radio talk shows rather than in scientific journals?
• How much does the treatment cost? Will your insurance cover it?
• Is the method widely available for use within the health care community?
• What is known about the safety of the treatment? Could it be harmful or interact badly with your other medicines or supplements?
• Does the method require that you give up regular medical treatment? If so, will doing so affect your chances for cure? Is the cancer likely to become more advanced during the delay?

How can I spot fraud and questionable treatments?

Along with the above questions, use the following checklist to help you avoid falling for fraudulent treatments. Keep in mind that if something sounds too good to be true, it usually is. This can be hard to think about if you are looking for and hoping for a miracle. If you are not sure, talk to your doctor or nurse before moving ahead.

• Does the treatment promise a cure for all cancers or other serious illnesses? Be suspicious of claims that any unconventional treatment can cure cancer. Claims that a treatment can cure all cancers, or that it can cure cancer and other hard-to-treat diseases (such as chronic fatigue, multiple sclerosis, AIDS, etc.) are certain to be fraudulent.
• Are you told not to use regular medical treatment?
• Is the treatment or drug a secret that only certain people can give?
• Is the treatment or drug offered by only one person or only one clinic? Keep in mind that once a treatment is found to be helpful, it will be used by other qualified professionals. Beware of treatments only available in one clinic, especially if it’s located in a country with less patient protection than the United States or the European Union.
• Do the promoters use terms like “scientific breakthrough,” “miracle cure,” “secret ingredient,” or “ancient remedy”?
• Are you offered personal stories of amazing results, but no actual scientific evidence?
• Do the promoters attack the medical or scientific community?
• Does the promoter promise no side effects? Many treatments promise to help you without causing any side effects, but even herbs and vitamins have side effects. If the treatment is marketed as having no side effects, it has not likely been studied in rigorous clinical trials, where side effects would be seen.

If you suspect fraud, contact the US Food and Drug Administration (FDA). The FDA is listed in the blue pages of the phone book under “US Government.” Look under the heading, “Health and Human Services.” Or visit their Web site at www.fda.gov.

Will my insurance cover alternative or complementary therapies?

Many insurance companies are starting to cover some of the more widely accepted complementary methods of treatment. Many major insurers, including Blue Cross and Medicare, cover one or more complementary methods of treatment. Acupuncture and chiropractic therapy are the ones most often covered. Contact your insurance company to find out what your plan covers.

If possible, get your doctor to write you a referral or a recommendation for the complementary therapy you want to use. Many insurance companies require that the method be shown to be reasonable and medically necessary, and it may help later on to have your doctor’s recommendation. Insurance companies usually will not cover methods that have not been proven to be helpful for the illness or symptom you have.

It’s your call

The choice to use complementary or alternative methods is yours. You can use them more safely if you:

• Learn about the risks and benefits of each therapy from reliable scientific sources.
• Talk with your doctor about your plans. Ask about risks and benefits and find out about possible interactions with mainstream treatments.
• Ask your doctor or cancer care team to refer you to someone who is reliable and trusted if you need a practitioner for your non-mainstream treatment (such as for massage therapy).
• Talk with your doctor before you use a self-prescribed remedy instead of the medicine your doctor prescribed.
• Know for sure whether you are giving up proven treatment for an unproven one. (If you decide to do this, ask your doctor beforehand what options might still work for you if the alternative treatment fails.)
• Don’t give up a proven treatment for one that has been disproven. (Disproven treatments are different from unproven treatments, which may not been studied. Disproven methods have been studied and found not to work.)
• Watch out for signs of fraud or misleading claims.
• Keep in mind that most complementary and alternative methods have not been tested for safety in women who are pregnant or breastfeeding – effects on a fetus or nursing child are mostly unknown.
• Talk with your child’s doctor before giving supplements or other remedies to your child.

To learn more about any treatment, please call us to find out what information we have to help you make your decision. Or visit our Web site at www.cancer.org.

To learn more

More information from your American Cancer Society

We have selected some related information that may also be helpful to you. These materials may be ordered from our toll-free number, 1-800-227-2345 or read online at www.cancer.org.

Complementary and Alternative Methods of Cancer Management

Dietary Supplements: How to Know What Is Safe

Placebo Effect

Learning About New Cancer Treatments

Learning About New Cancer Prevention Methods

American Cancer Society Operational Statement on Complementary and Alternative Methods of Cancer Management

Clinical Trials: What You Need to Know

Along with the above, information on many different types of complementary and alternative treatments are available at no cost to you from the American Cancer Society. You can find them on our Web site or request information from our toll-free number as noted above.

Books

The following book is available from the American Cancer Society. Call us at 1-800-227-2345 to ask about costs or to place your order.

The American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies, 2nd Edition. 2009.

National organizations and Web sites*

There is a great deal of interest in complementary and alternative therapies. The Internet makes it possible for people to share ideas and information very quickly. But too often information on the Internet is written by people promoting useless treatments. Along with the American Cancer Society, the following is a partial list of Web sites and phone numbers of reputable groups that provide reliable information on complementary and alternative therapies:

National Center for Complementary and Alternative Medicine (NCCAM)
Toll-free number: 1-888-644-6226
TTY: 1-866-464-3615
Web site: http://nccam.nih.gov

Has information on CAM-related topics and CAM-related clinical trials

Memorial Sloan Kettering Cancer Center
About Herbs and Botanicals
Web site: www.mskcc.org/mskcc/html/11570.cfm

For evidence-based information about herbs, botanicals, supplements, and more

National Cancer Institute
Toll-free number: 1-800-4-CANCER (1-800-422-6237)
TTY: 1-800-332-8615
Web site: www.cancer.gov

For complementary and alternative therapy information, visit: www.cancer.gov/cancertopics/treatment/cam

United States Department of Agriculture, Food and Nutrition Information Center
Phone: 1-301-504-5414
Web site: http://fnic.nal.usda.gov

Find out about dietary supplements, vitamins, and minerals. Choose “Dietary Supplements” from the left menu bar.

United States Food and Drug Administration
Toll-free number: 1-888-INFO-FDA (1-888-463-6332)
Web site: www.fda.gov/Food/DietarySupplements/default.htm

Learn more about herbs and dietary supplements. You can report side effects or other adverse events (harmful or bad effects) from a dietary supplement to Medwatch at 1-800-FDA-1088 (1-800-332-1088) or visit www.fda.gov/Safety/MedWatch

United States Federal Trade Commission
Toll-free number: 1-877-FTC-HELP (1-877-382-4357)
Web site: www.ftc.gov/curious

Learn about cancer ads, offers, scams, and unproven treatments. You can also log complaints that can help detect patterns of wrong-doing and lead to investigations and prosecutions. (The FTC does not resolve individual consumer complaints.)

National Council Against Health Fraud
Web site: www.ncahf.org

A private, non-profit, voluntary health agency that looks at health misinformation, fraud, and quackery as public health problems

Quackwatch
Web site: www.quackwatch.org

An international network of people who are concerned about health-related frauds, myths, fads, fallacies, and misconduct. Its main focus is on quackery-related information that is difficult or impossible to get elsewhere.

No matter who you are, we can help. Contact us anytime, day or night, for information and support. Call us at 1-800-227-2345 or visit www.cancer.org.

References

Federal Trade Commission Facts for Consumers. ‘Miracle’ health claims: add a dose of skepticism. Accessed at www.ftc.gov/bcp/edu/pubs/consumer/health/hea07.shtm on May 16, 2011.

Kurtzweil P. US Food and Drug Administration. How to Spot Fraud. Update 2/25/10. Accessed at www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm137284.htm on May 16, 2011.

National Center for Complementary and Alternative Medicine. Clinical Trials and Complementary and Alternative Medicine. Accessed at http://nccam.nih.gov/research/clinicaltrials/factsheet/ on May 16, 2011.