Nutritional Issues in Complementary and Alternative Medicine
As defined by the ACS, “complementary” therapies are supportive methods used to complement evidence-based treatment.11 Examples include meditation to reduce stress, acupuncture for pain, and ginger for nausea. Complementary methods are not given to cure disease, rather they may help control symptoms and improve well-being.
“Alternative” refers to treatments that are promoted as cancer cures. They are unproven because they have not been scientifically tested, or were tested and found to be ineffective. If used instead of evidence-based treatment, the survivor may suffer, either because helpful treatment is not received or because the alternative treatment is harmful.
Personal testimonials are often offered as evidence of the efficacy and safety of these methods, and the treatment is often claimed to be effective in other diseases as well as cancer. Nutritional methods used within complementary and alternative medicine generally encompass vitamin and mineral supplements, herbal and botanical supplements, and dietary regimens.100-104, 110,117-138
Cancer survivors may be interested in using complementary or alternative medicine, including nutritional therapies, to enhance the effects of treatment, to protect against treatment-related side effects, or to improve quality of life during treatment and recovery. The use of such therapies has greatly increased in recent years.117 Survivors may believe that such therapies are “natural” and therefore also harmless, an assumption that may not be correct.
It is important for health care providers and survivors to discuss the use of complementary or alternative therapies so that survivors are fully informed regarding both possible benefits and risks.
In the absence of firm scientific evidence from controlled clinical trials, survivors need to make decisions about complementary and alternative therapies based on uncertain claims. Data that do not meet the usual standards of scientific proof include anecdotal reports of efficacy, uncontrolled trials, traditional use suggesting a lack of harm, and the plausibility of biological mechanisms of action.
Some herbal and botanical supplements have a long history of use in other cultures, suggesting safety when used according to traditional methods. Only a few of these traditional supplements have been studied scientifically to evaluate their effects on cancer. Little is known about the use of commonly available herbal and botanical supplements by cancer survivors.
This lack of knowledge is a strong argument for more clinical research and physician education in this area. Reliable information about the functions of supplements and their therapeutic doses is difficult to find.
For a few supplements, clinical and preclinical research provides evidence of benefit in some situations. However, for most, current information must be considered preliminary, as there have been so few controlled clinical trials. Even in the best cases, currently available research findings can only be regarded as preliminary.
Survivors should discuss their choices with their practitioners so that regimens can be tailored and monitored to reduce the possibility of adverse effects such as drug/nutrient interactions or toxicities.
The following nutritional therapies are highlighted because of their popularity among cancer survivors. Several other therapies are discussed in the longer version of this document that is available online.
For information on additional complementary and alternative therapies, refer to the American Cancer Society’s Guide to Complementary and Alternative Cancer Methods (Atlanta, GA: American Cancer Society, 2000) or call the American Cancer Society (1-800-ACS-2345).
Discussion of evidence (an interpretation)
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