Complementary And Alternative Therapies (CATs)
What are they, why are they so popular, and when should I take them?
By:
Dr
Koo Wen Hsin, Head, Dept of Medical Oncology, NCC
For thousands of years, patients have sought out practitioners of remedies that have not been proven to be effective. These alternative therapies (which differ from mainstream interventions of proven efficacy, such as surgery) have been used to treat all sorts of serious diseases, including cancers. Indeed, part of the attraction of such unproven remedies has been that practitioners often promise cure, while also telling patients to stay away from conventional treatments with known side effects such as chemotherapy or radiotherapy. In the local context, traditional Chinese medicine (TCM) is the most popular kind of alternative therapy.
Most cancer patients nowadays are keen to use supportive measures to improve their physical resistance and general health while undergoing conventional treatment. This is known as complementary therapy: aromatherapy, relaxation therapy, exercise programmes, vitamins, massage, acupuncture, and foot reflexology, are some examples of complementary therapies.
The unregulated promotion and sale of alternative and complementary medicine -- often as a substitute for medical interventions of proven value -- is a worldwide problem. A 2002 White House Report showed that more than 60% of cancer patients in USA used at least one complementary or alternative medicine. Perhaps of more concern, about 60% of these patients did not discuss it with their oncologists.
Why do people use CATs?
Conventional medicine allows us to explain the pathological process of disease and its response to treatment. However, it cannot (and hence does not attempt to) answer a central concern of the patients: “Why me?”. For many patients with a frightening illness, it is this inability of conventional doctors to give them understandable answers (including cures) to their predicament that motivates them to seek such answers elsewhere.
Unlike conventional doctors, practitioners of alternative and complementary medicine are often very persuasive when giving explanations for why one falls sick, using simple language that even people who do not have special training in medicine can understand. Such information allows patients to feel that they are participating in the decision process and carrying out measures within their own control, such as changing the foods that they eat. It should be noted, however, that such measures have in general not been proven to benefit patients in terms of objective outcomes such as cure or symptom relief.
Should I use such therapies when undergoing conventional cancer treatment ?
Since many alternative medicines are poorly characterized (in terms of chemical composition, for example), no one can predict exactly how these will interact with conventional treatments. Instead of rigorous scientific experiments, the effectiveness of such treatment tends to be supported by testimonials, usually delivered by the vendors plus a few fervent believers. Less often, such claims may be supported by laboratory studies using animal tissues or human bloods but even observations of this kind have generally not been confirmed in controlled clinical trials of human patients. On the other hand, there are some potential dangers (such as liver damage) from some alternative medicines, and these hazards may be less than predictable than those associated with conventional therapies.
The take-home message has to be this: avoid using uncharacterized therapies during conventional anti-cancer treatment. If you really feel compelled to use them, please at least inform your doctor first so that he/she can discuss the matter with you in more detail.
So – what should we do about alternative and complementary medicines CATs?
To be on the safe side, patients should always consult their (conventional) doctors before starting any (alternative) treatments. Do not be overly concerned that your doctor will be disapproving, since today’s doctors are more understanding of alternative or complementary medicine than their predecessors. If there is no likely interaction or hazard, your doctor may understand the reassurance you gain from a non-conventional therapy, while also being appreciative of your providing this information.
We need to do more scientific research and clinical trials on alternative medicines. By doing such research, we may yet be able to isolate novel substances which can be used more safely and effectively in the future to benefit cancer patients.
|
