"Complementary" and "alternative" are terms used to describe a number of products, practices, and systems that are not part of mainstream (conventional, standard, or Western) medicine. They can include methods like herbs and dietary supplements, body movement, spiritual approaches, pills, extracts, and creams or ointments. Some are done by a person with extensive formal education and training (such as art therapy), while others may be recommended by the person who is selling the product in a store or on the Internet (such as herbs or other dietary supplements). They can involve everything from enemas (such as colon therapy) or needles (such as acupuncture) to no-touch "energy work" (such as reiki). Some are time-consuming or expensive (such as rigid diets or treatments in another country); others are fairly cheap and easy to use (such as 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 (such as massage). Some almost never cause harm, while others can be dangerous and have caused deaths.

You may hear about these treatments from friends, family, colleagues, 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. The purpose of this document is to help you decide what you need to know if you want to try one of these unconventional treatments. It will give you some ideas about how to look at them and what questions you might want to ask as you consider 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 medical treatment, often with serious consequences for the patient.

Complementary medicine is used along with mainstream medical care. Some complementary methods can also cause harm, but if carefully chosen and properly used, they might improve your quality of life.

People with cancer might consider 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 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. The American Cancer Society has compiled the following guidelines and information to help you think through the issues and make the most informed and safest decision possible.

What are the risks of not using conventional cancer treatment?

As difficult and unpleasant as mainstream cancer treatments such as radiation therapy, chemotherapy, and surgery can be sometimes, the truth is that they have been scientifically proven to be effective for treating cancer. Even though the side effects of mainstream cancer treatment can be serious, the treatments are helping you fight a life-threatening disease. Cancer patients who choose alternative medicine instead of mainstream cancer treatments may be putting themselves at serious and unnecessary risk. They are giving up the only proven methods of treating their disease. Delays or interruptions in conventional treatment pose a dangerous risk to cancer patients because they can give the cancer more time to grow. Even when cancer has reached a stage where cure is not possible, it is important to remember that mainstream care can offer much in the way of 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 treatments 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 reluctant to discuss complementary or alternative methods with their doctor. 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. However, this doesn't have to stop you. You can help bridge the gap in a number of ways:

• Gather as much information as possible on your own. Look for information from reputable, credible sources on the potential benefits and risks of the treatment you are thinking about.

• When you share this information with your doctor, do it in a way that recognizes your doctor wants what is best for you. Let him or her know that you are thinking about an alternative or complementary treatment and that you want to make sure it will not interfere with your regular medical treatment.

• Make a list of questions and bring it along with any information you want to talk about. Ask your doctor to be a supportive partner in your education and treatment process.

• You might bring a friend or family member with you to the doctor’s office to support you. He or she 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. If you are thinking about stopping or not taking mainstream treatment, please discuss this decision with your doctor. Remember that you may be giving up the only proven treatment for your cancer.

• 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.

• If you are taking dietary supplements, make a complete list of what you are taking and the amount. Many supplements can interact in harmful ways with other medicines, so talk with your doctor and pharmacist about your supplements. 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.

• Ask your doctor to help you identify possible fraud and fraudulent products. (See checklist below.)

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

Here are some good questions to ask about alternative or complementary treatments:

• What claims are made for the treatment? Does it claim to cure cancer?

• Is it supposed to help your medical treatment work better or to relieve symptoms or side effects?

• What are the credentials of those supporting the treatment? Are they recognized experts in cancer treatment?

• Have scientific studies or clinical trials been done to find out whether this treatment works?

• Have the findings from studies been published in trustworthy medical journals where articles are "peer-reviewed" by other scientists in the same field, and found to be careful, complete, and accurate?

• How is the method promoted? Is it promoted only in the mass media (books, magazines, TV, radio, etc.)? Is it mentioned in scientific journals?

• What are the costs of the treatment? Will your insurance cover it?

• Is the method widely available for use within the health care community, or is it controlled with limited access to its use?

• What is known about the safety of the treatment?

• Does the method require that you give up regular medical treatment? If so, will doing so affect any chances for cure? Is the cancer likely to become more advanced during the delay?

How can I spot fraud and questionable treatments?

In addition to the above questions, use the following checklist to help you avoid falling for fraudulent or questionable treatment methods. If you are still not sure whether the treatment is safe and valid, discuss it with your doctor or health care provider before trying it.

• Is the treatment based on an unproven theory?

• 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 1 person or only 1 clinic? Keep in mind that once a treatment is found to be useful, it will be adopted by other qualified professionals. Beware of treatments only available in 1 clinic, especially if it's located in a country with less regulation than the United States or the European Union.

• Does the treatment require that you travel to another country?

• Do the promoters attack the medical or scientific establishment?

• Does the promoter promise no side effects? Many treatments promise to help you without causing any side effects. Even herbs and vitamins can 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 observed

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 http://www.fda.gov.

Does 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, if any, services are covered by your plan.

If possible, you might want to get a recommendation or referral from your doctor for the complementary therapy you are thinking about. 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.

Additional Resources

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, 1800-ACS-2345 (1-800-227-2345).

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

How to Know What Is Safe: Choosing and Using Dietary Supplements

Complementary and Alternative Medicines in Cancer Management

Clinical Trials: What You Need to Know

National Organizations and Web Sites*

In addition to the American Cancer Society, other sources of patient information and support include:

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

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

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

The University of Texas MD Anderson Center
Complementary/Integrative Medicine Therapies
Web site: http://www.mdanderson.org/cimer

United States Department of Agriculture, Food and Nutrition Information Center
Web site: http://fnic.nal.usda.gov
Choose "Dietary Supplements" from the left menu bar.

United States Food and Drug Administration
Toll-free number: 1-888-463-6332 (1-888-INFO-FDA)
Web site: http://vm.cfsan.fda.gov/%7Edms/supplmnt.html
To report side effects or other adverse events from a dietary supplement, call Medwatch at 1-800-FDA-1088.

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

Quackwatch
Web site: http://www.quackwatch.org

*Inclusion on this list does not imply endorsement by the American Cancer Society.

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

References

National Center for Complementary and Alternative Medicine. About Clinical Trials and Complementary and Alternative Medicine. Available at: http://nccam.nih.gov/clinicaltrials/factsheet/index.htm#1. Accessed November 12, 2007.

Paula Kurtzweil. US Food and Drug Administration. How to Spot Fraud. November 1999. Available at: http://www.fda.gov/fdac/features/1999/699_fraud.html. Accessed November 12, 2007.

Revised: 12/18/2007