Complementary and alternative medicine, commonly referred to as CAM, is the most commonly used phrase to describe medical therapies practiced outside conventional Western medicine. CAM contains a variety of healing philosophies and medical practices that are not currently accepted or used by conventional medicine. Although Virginia Cancer Institute does not provide complementary and alternative medicine, your VCI team is here to advise you if these treatments are appropriate in combination with your standard therapy.

Complementary medicine consists of medical therapies that are most often used to supplement conventional medical treatments. Because these treatments are utilized in addition to conventional therapies, they usually focus on promoting wellness, managing symptoms or stimulating the immune system. Most CAM therapies can be used as a complement to conventional medicine. A benefit of complementary therapies is that patients can use well-researched conventional treatments against cancer, while utilizing complementary medicine to reduce stress, enhance their immune system and/or affect cancer on a different level (e.g., energetically). The vast majority of CAM practitioners and cancer patients who utilize CAM therapies use complementary medicine as a means of integrating the best of both types of medicine.

One problem with combining conventional and complementary medicine is the lack of research. Combining certain types of complementary medicine that promote wellness, like guided visualization or yoga, with conventional treatments such as chemotherapy is unlikely to create adverse reactions. However, the same may not be true for herbs or other biologically based substances that can be used as complementary medicine. For example, some herbs or supplements are contraindicated (not indicated for use) with specific chemotherapeutic agents, because they interfere with the ability of the chemotherapy to kill cancer cells. On the other hand, research has indicated that certain complementary medicine agents may reduce side effects of conventional treatment and may increase the effectiveness of chemotherapy. Complementary medicine may offer many benefits to cancer patients, but the potential for harmful reactions necessitates careful supervision of its use.

In contrast to complementary medicine, alternative medicine is used in place of conventional medicine. Alternative medicine attempts to treat disease specifically, without the use of any conventional therapies. Therapies commonly used as complementary medicine are considered alternative medicine when used in place of conventional treatment. For minor health issues, alternative medicine is generally not dangerous. However, most practitioners of conventional medicine, and many who practice complementary medicine, are uncomfortable with the exclusivity of alternative medicine and its failure to utilize treatments that are known to benefit certain diseases. In such instances, alternative therapies may delay conventional treatment and result in serious illness, complications or death. Many patients who turn to alternative medicine do so after conventional medicine has nothing more to offer or because they believe the risks of conventional treatment outweigh the risks of the alternative therapy they are investigating. In some instances, a very negative experience with conventional medicine has left a patient in search of alternative forms of medicine.

Conventional medicine is often referred to as Western or mainstream medicine and is technically known as allopathic medicine. It is the medical system practiced by MDs (medical doctors). Examples of conventional cancer treatment include surgery, chemotherapy, radiation and biologic therapies.

CAM and conventional medicine

Integrative medicine focuses on combining conventional medicine with CAM to create a comprehensive approach to healing. Integrative medicine maintains that for the whole person to heal, any number of different therapeutic approaches may need to be employed. Integrative medicine also promotes evidence-based research as a means of determining which CAM therapies are reliable, effective and safe. Because it can take many years for a CAM therapy to obtain the evidence necessary for inclusion in conventional medicine, integrative medicine facilitates these in-between years when promising therapies are undergoing research and patients are using them anyway. The goal of integrative medicine is to create a unified medicine in support of whole, healthy people.

CAM therapies and cancer

There are several common threads shared by the diverse therapies classified as CAM. CAM is generally considered holistic, looking at the physical, mental, emotional and spiritual components that make up a whole person. The purpose of most CAM is to heal the entire person, not just the disease, which is often considered only a symptom of a more fundamental imbalance. CAM therapies, such as herbs or supplements, that may be used specifically to eradicate disease are often used in combination with other CAM therapies to create a lifestyle that promotes wellness rather than one that focuses solely on recovering from ill health. Most CAM therapies have undergone very little research and have limited scientific evidence of their effectiveness. Most CAM is very individualized, with a specific therapy regimen tailored to the unique health issues of the individual. CAM also requires that patients be actively involved in their healing, promoting patient education and involvement beyond what is common in conventional medicine. This also generates a different patient-practitioner relationship than is common in mainstream medicine. In the CAM ideal, patient and practitioner engage in dialogue regarding treatment options and form a partnership dedicated to restoring and maintaining health and wellness. Patients may use CAM therapies in the following ways:

Treat cancer: Some therapies that directly treat cancer are used in addition to conventional treatments (complementary medicine), whereas others are employed instead of conventional treatments (alternative medicine).

Manage symptoms: The symptoms may be due to cancer or from side effects of treatment. In helping manage symptoms, CAM may help improve quality of life.

Promote wellness: Most CAM promotes wellness, which is more than the absence of disease. Wellness is the optimal overall health of an individual, including physical, emotional, mental and spiritual aspects. Many different activities promote wellness, from exercising to eating a healthy meal to attending a support group. Many CAM practitioners argue that promoting wellness stimulates the body to heal itself.

Types of CAM

Alternative medical systems: Alternative medical systems involve complete systems of theory and practice that have evolved independent of and often prior to the conventional medical approach. Such systems include traditional systems of medicine practiced by indigenous people worldwide for thousands of years. Some of these well-known alternative medical systems are Traditional Chinese Medicine, acupuncture and Ayurveda. Other alternative medical systems have developed more recently, such as homeopathy and naturopathy.

Biologic/orthomolecular therapies: Biologic/orthomolecular therapies are therapies that seek to correct imbalance on a molecular level. They may attempt to do so by using high concentrations of specific chemicals, similar to the use of drugs in conventional medicine, or by influencing metabolism or the immune system. These therapies usually consist of substances derived from nonplant biologic (e.g., minerals), organic (from living organisms) or pharmacologic (substances used in conventional drugs) materials. Examples include vitamins or minerals, isolated active compounds of plants or herbs, shark cartilage and vaccines.

Energy therapies: Energy therapies are divided into two categories, those that originate from within the body (biofields) and those that are generated by sources outside the body (external energy sources).

Biofield therapies are based on the theory that energy fields are generated within, and emanate from, the body and that disruption of a biofield results in disease. In some therapies, an individual performs certain postures to affect their biofields (e.g., Qi Gong, tai chi, yoga). Some therapies attempt to manipulate biofields through touching the body (as in acupressure), while others move the practitioner’s hands through the biofield without touching the patient’s body to clear energetic imbalances (e.g., reiki, therapeutic touch). Biofields may also be affected by substances such as flower remedies or crystals and stones, which may interact with the biofield to restore energetic harmony/balance. Very little research exists on biofields and conventional medicine has yet to verify their existence.

External energy sources include pulsed electrical fields, magnetic fields, radiowaves and direct or alternating current fields that may be used to treat cancer or manage symptoms, such as pain. Therapies using external energy sources are sometimes referred to as bioelectromagnetic-based therapies.

Herbal/plant therapies: Herbs are plants that do not have woody stems and usually die back at the end of each growing season. Their historical use as medicine and as culinary seasonings arises from their aromatic properties. As defined here, herbal/plant therapies include therapies using the whole plant or the parts of a plant valued for medicinal purposes. It also contains therapies that have maximized the optimal ratios of a whole product (i.e., the most effective ratio of the main constituents within an herb or plant). In contrast, isolated components of herbs or plants that are used alone are categorized under biologic/orthomolecular therapies.

Manipulative and body-based methods: This category includes methods that are based on manipulation of bone, soft tissues or organs by a practitioner or by the patient. It is based upon the theory that restoring skeletal, neuromuscular, soft tissue or organs to their correct location within the body harmonizes the entire system. Practitioners of these methods may believe that a disturbance in one part of the body creates disruptions that can manifest as disease or pain elsewhere in the body. Chiropractors, osteopaths and massage therapists are examples of practitioners employing these methods.

Mind-body interventions: Mind-body interventions are designed to utilize the mind’s ability to affect bodily symptoms and function. Many mind-body interventions have been extensively studied, including cognitive-behavioral therapy, psychotherapy and patient education. As a result of such research, these therapies have been adopted by conventional medicine and are no longer considered CAM therapies. However, there are numerous other therapies utilizing mind-body interventions that remain to be studied. Examples of such therapies include meditation, dance, music, art therapy, guided imagery and biofeedback.

Nutrition and special diets: The food we eat provides our bodies with nutrients necessary for cellular replication, repair and maintenance. Proponents of nutrition therapy or special diets maintain that certain types of food or specific combinations of food can prevent illness and facilitate recovery from disease. In addition, many non-Western cultural traditions do not distinguish between medicine and food, considering food as medicine. Special diets include macrobiotics, Gerson and vegetarianism.