Abstract
Abstract: Complementary and alternative medicine (CAM) is becoming a significant factor in the arena of cancer care. There is an increasing body of research along with widespread popularity and use by patients with cancer. This article reviews current knowledge about the worldwide use of CAM in the treatment of cancer and patients' motives and reasoning for this use. Clinical research in CAM cancer treatments and physicians' attitudes toward this popular trend among patients with cancer are discussed as well. The physician-patient communication and its relevance to CAM use is emphasized. A step approach is suggested for primary care physicians including the discussion of CAM in the management of cancer in order to enrich the physician-patient dialogue and improve the quality of the clinical encounter.
COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) is a term encompassing various therapeutic methods and techniques, some of which are related to traditional and philosophical systems of medicine. In recent years, CAM has become more acknowledged by the medical community because of increasing public interest and use (estimated as 42% in the general US population in 1997 [Eisenberg et al., 1998]). Extrapolation of a nationally representative survey to the US population suggest that the number of total visits to alternative medicine practitioners exceeded in 1997 the total visits to all US primary care physicians (Eisenberg et al., 1998). A growing need to integrate CAM into medical education and curriculum had been indicated for both undergraduate and residency programs notably in family medicine (Frenkel & Ben-Ayre, 2001; Kligler et al., 2000; Wetzel et al., 2003).
The growing interest in CAM had raised public and academic debate worldwide. This controversy is markedly emphasized in regard to cancer treatment. CAM cancer treatment is often viewed as non-evidence-based medicine, which by causing undertreatment could hinder conventional oncological treatment and doctor-patient communication (Cassileth, 1999).
This article aims to raise and clarify several questions relating to CAM and cancer treatment. Is there any rigorous clinical research, which views efficacy and safety of CAM in the treatment of cancer? Why do patients with cancer seek CAM? What are the implications of CAM use in doctor-patient communication?
Can patients' beliefs and expectations be woven together with research evidence into a new paradigm that integrates CAM and conventional medicine?