Complementary and Alternative Medicine Use by Adult Cancer Patients: An Overview

Complementary and alternative medicine (CAM) continues to evoke fierce debate and divergent views within the medical community, yet complementary medicine is used by 14–65% of Australian adults diagnosed with cancer (with estimates as high as 80–91% in the US and Europe), and alternative medicine by 8–14%. Cancer patients who use CAM are typically female, younger, better educated and of higher socio-economic status. Whereas surgery, chemotherapy and radiotherapy have proven increasingly successful but still have limited curative potential, these conventional approaches are generally more invasive, aggressive and associated with greater toxicity than CAMs, which tend to take a slower, gentler approach by attempting to bolster constructive forces (e.g. the immune system) rather than battling the destructive forces of growing cancer cells. They focus on symptom control and patients are generally encouraged to be active participants in the management of their illness. This patient-centred approach, which is more easily accessible, contributes to the appeal of CAM. Many CAMs, however, have drawn steadfast opposition from cancer physicians, primarily because they remain unproven in clinical trials and pose potential safety risks and financial or psychological harm to their patients. Research indicates that 33–77% of patients do not disclose CAM use to their physicians, often because of a perceived negative response. The perception that CAMs are more “natural” and, by association, safer than conventional treatments is problematic. Indeed, they may pose direct safety risks because of their potential adverse effects or interactions with conventional oncology treatments. Alternative therapies promoted as “cures” in place of conventional treatments have the potential to cause patients harm. It is therefore imperative that those involved in the medical care of cancer patients are equipped with the skills and knowledge to help patients appropriately evaluate complementary and alternative therapies, and be aware of interactions with conventional anticancer therapies, in order to increase the likelihood that patients avoid harm and, where possible, receive benefit should they choose to use CAM.